[12.71765422821045, 13.852482795715332, "Sponsored by the Robert Wood Johnson FoundationCOVID-19 and the \nExperiences of Populations at Greater Risk\nDescription and Top-Line Summary Data\u2014Wave 4, \nFall 2021\nKATHERINE GRACE CARMAN, ANITA CHANDRA, DELIA BUGLIARI, \nCHRISTOPHER NELSON, CAROLYN M"] [12.706977844238281, 13.808908462524414, "5 and 2018 (Carman et al., 2016; Carman et al., 2019) to capture how people in the United States think about, value, and prioriti ze issues of health, well-being, and \nhealth equity. Now, in the context of COVID-19, RAND and RWJF have partnered again"] [12.890009880065918, 14.160269737243652, ".......... xiv\t\nAcknowledgments ........................................................................................................................ xvi\tAbbreviations ..............................................................................."] [12.913288116455078, 14.391737937927246, ".................................................................................................... 16 \t\nQ4. [w4_wellbeing1 -w4_wellbeing6] Below are a number of things people might say they feel. \nHow much of the time in the past week, did you . . "] [12.883631706237793, 14.44150447845459, "plant \nclosure, major incident of community violence? .......................................................................... 24 \t\nCOVID Impacts: COVID Experience .................................................................................."] [12.888101577758789, 14.449074745178223, " each of the programs listed below, please indicate if you or \nanyone in your household received the assistance before coronavirus (COVID -19) started; \nstarted receiving assistance since coronavirus (COVID -19) started; applied or asked for but has "] [12.911686897277832, 14.384003639221191, "here are many activities that a person could do to influence government \ndecisions about health issues. During the past year have you voted for or against a candidate for public office because of his/her position on a health problem or issue? ......"] [12.895139694213867, 14.40881633758545, "........................................ 44 \t\nQ29c. [w4_schools] Schools in my community should be able to .................................................... 45 \t\nViews, Mindset, and Expectations: Understanding What Drives Health ..............."] [12.888392448425293, 14.429061889648438, "................................................ 51 \t\nQ35c. [w4_poschghappen] Do you think this positive change, [fill response from w4_postivechg] in \nsociety, is happening? .........................................................................."] [12.881019592285156, 14.415270805358887, "r countries (e.g., \nsending vaccines, sending money), it will put our country at greater risk. .................................. 60 \t\nQ45. [w4_afterPandemic] This is our last question: What are you looking forward to after the \npandemic? [Open Ende"] [12.922675132751465, 14.38222599029541, "llent, very good, good, fair, or \npoor? ............................................................................................................................................. 66 \t ix Q4. [w4_wellbeing1 -w4_wellbeing6] Below are a number of thi"] [12.886085510253906, 14.464570045471191, "....................................................................................................... 73 \t\nCOVID Impacts: Concerns About Equity i n COVID- 19 Response ....................................................... 74 \t\nQ18. [w4_access_aa] "] [12.888221740722656, 14.435029983520508, "nd now [Fall 2021] ), \nhave people in your community changed the way they support each other because of the pandemic, either helping each other more or less, or haven\u2019t you seen a change? ...................... 78\n\t\nQ25c. [w4_changelast] *(if w4_com"] [12.885385513305664, 14.404765129089355, "ect people\u2019s health and \nwell-being. Please rate each on a scale from 1 to 5 where 1 means it has no effect on health and \n5 means it has a very strong effect. ........................................................................................."] [12.888586044311523, 14.427224159240723, "................................ 91 \t\nQ36. [w1_riskhealth] I am willing to risk my own health in order to return to normal life. .............. 92 \t\nQ37. [w4_protest] I think it is worth protesting for things I believe in, even if it may pose a risk"] [12.737109184265137, 13.87746524810791, "............................................................... 97 \t\nRespondents by Education Level ........................................................................................................ 98 \t\nRespondents by Marital Status ........"] [12.857824325561523, 14.002922058105469, "19 survey focused specifically on experiences related to the \npandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents\u2019 views and priorities regarding health act"] [12.851293563842773, 14.001009941101074, "s that were likely eligible to receive the federal COVID-19 stimulus checks. In both panels, we oversampled low- and middle-income households. These oversamples will allow for research that compares subgroups based on income or race and ethnicity.\n1 "] [12.719261169433594, 13.841170310974121, "triple pandemic\u201d is particularly affecting populations that have historically been underserved, including people of color and low- and \nmiddle-income households. This report describes the fourth and final survey conducted as part of the COVID-19 and "] [12.72197437286377, 13.858062744140625, ". This report draws heavily on the reports written to describe two previous surveys conducted with similar methods (Carman et al., 2016; Carman et al., 2019) and the reports describing the first, second, and third waves of this survey series (Carman "] [12.719427108764648, 13.855298042297363, "act.org/ \nStanford Mind & Body Lab Mindset Measures for \nCOVID -19 study Stanford University, Mind & Body Lab \nGallup Panel survey , April 10 \u201312, 2020 Lydia Saad, \u201cIn U.S., More Fear COVID -19 Illness Than \nFinancial Harm,\u201d Gallup , April 16, 2"] [12.740194320678711, 13.882402420043945, "ex Axios -Ipsos \n Ipsos, \u201c Coronavirus Misinformation and Reckless Behavior \nLinked,\u201d October 20, 2020. As of October 20, 2020: \nhttps://www.ipsos.com/en -us/news- polls/axios -ipsos-\ncoronavirus -index \nUnderstanding America Study : Understandi"] [12.773987770080566, 13.984404563903809, "revious waves. Changes can be categorized in the following areas: \n\u2022 questions that had been asked in the first wave but not in waves 2 and 3, but were \nintended to be reintroduced in wave 4 \n\u2022 questions that were dropped for lack of relevance \n\u2022 ne"] [12.8053560256958, 13.981203079223633, "s on activities (w4_activities) was revised to relate to the current time period. Because many restrictions, such as lockdowns and school closures, had been lifted by wave 4, questions about freedom to move about (w3_liberty) and the trade-off betwee"] [12.839866638183594, 13.982654571533203, "us survey that we ran in the ALP in 2015 and 2018 (Carman et al., 2016; Carman et al., 2019) but also any other surveys previously run in the ALP. However, to boost sample size, we also conducted the survey in the KnowledgePanel. \nIn both panels, we "] [12.84411907196045, 13.988965034484863, "s update demographic data from the ALP quarterly. Additional information about the panel is available from the ALP (RAND Corporation, undated). \nOur sample was limited to panel members who had participated in our 2018 survey. From \nthis group, we sel"] [12.848431587219238, 13.984794616699219, "ited the 4,066 panel members who had participated in wave 1 to participate in the wave 4 survey, and 2,636 (64.8 percent) completed the survey.\n8 Prior to fielding wave 1, a pre-test was \nconducted with the KnowledgePanel, which we used to identify a"] [12.855424880981445, 13.995443344116211, "nd found no meaningful differences. Third, in 2015, we investigated differences by device (i.e., participation via desktops and laptops versus smartphones). In our past work, we did not identify any systematic biases across the two surveys by device "] [12.85212516784668, 13.99345588684082, "owle dgePanel , the time of sampling and the time of the survey were the same. 12 Table 1.4. Comparison of the Survey Sample and the Current Population Survey \nCharacteristic Combined ALP and KnowledgePanel \n2019 CPS (%) Unweighted (%) Weighted"] [12.861659049987793, 14.028709411621094, " demographic characteristics between our sample and the CPS, but we did not adjust the data for the differential probabilities of selection that (in addition to calibration) cause design effects. A design effect is an indicator of the impact of sampl"] [12.889270782470703, 14.178443908691406, "l point. All results are presented as the percentage of \nrespondents selecting each answer. 15 Health and Demographics: General Well -Being and Health \nQ1. [w4_lifesat] Assume the ladder is a way of picturing your life. The top of the ladder \nrep"] [12.903833389282227, 14.398171424865723, "e Missing \nWave 1 15.9 49.7 31.1 3.3 0.1 \nWave 2 17.3 49.5 29.9 3.3 0.1 \nWave 3 17.4 50.5 28.9 3.1 0.1 \nWave 4 17.6 48.6 30.4 3.2 0.1 \n \nE. Feel lonely \nSample None or almost \nnone of the time Some of the \ntime Most of the time All of the ti"] [12.894742012023926, 14.434052467346191, "ng \nWave 1 70.5 27.7 1.7 \nWave 2 75.1 24.0 0.9 \nWave 3 73.6 25.9 0.5 \nWave 4 79.6 19.7 0.7 \nSOURCE: Developed by RWJF and RAND. \nQ8b. [w4_workathome] (if YES to Q8a). In the last 7 days, does your job require you to \nwork outside of your home? \n"] [12.889318466186523, 14.441559791564941, "rocery store or drug store employee 2.3 2.2 2.3 1.9 \nOther retail employee 3.9 4.0 4.3 4.5 \nDelivery driver 2.2 2.6 2.7 2.3 \nPublic transportation employee 0.7 0.8 0.9 0.8 \nRestaurant or bar employee 1.7 1.7 1.8 1.8 \nPolice, Fire, or other first"] [12.889886856079102, 14.432987213134766, "13. [w4_covidtest] Have you been tested for coronavirus (COVID-19) (through a nasal \nswab or blood test)? \nSelect only one answer. \nSample Yes No Missing \nWave 1 11.5 88.3 0.2 \nWave 2 25.3 74.4 0.3 \nWave 3 44.4 55.3 0.2 \nWave 4 55.8 43.9 0.3 \nS"] [12.885603904724121, 14.436589241027832, "household \nSample Yes No Missing \nWave 2 13.1 86.1 0.8 \nWave 3 12.5 87.1 0.5 \nWave 4 6.6 92.8 0.6 \n \nw4_exp8. Difficulty caring for a chronic condition (yours or others) \nSample Yes No Missing \nWave 2 10.6 89.1 0.3 \nWave 3 11.2 88.4 0.4 \nW"] [12.886263847351074, 14.451725006103516, "ssworry2 My community has a high level of vaccinations 23.0 \nw4_lessworry3 I am vaccinated 75.5 \nw4_lessworry4 My loved ones are vaccinated 60.9 \nw4_lessworry5 Other 12.1 \n Refused 0.3 \nSOURCE: Developed by RWJF and RAND. \n \n \n \n15 Sample "] [12.877974510192871, 14.480548858642578, "ary Assistance for Needy Families (TANF) \n Yes, my household \nwas already \nreceiving assistance \nfrom this program \nbefore the \ncoronavirus (COVID-\n19) started Yes, my household \nstarted receiving \nassistance from \nthis program since \ncoronavirus \n"] [12.885228157043457, 14.460941314697266, "\nstarted receiving \nassistance from \nthis program since \ncoronavirus \n(COVID -19) started My household \napplied or asked for \nbut has not received \nassistance from this \nprogram since \ncoronavirus (COVID-\n19) started No, my household \nhas not receive"] [12.88104248046875, 14.455464363098145, " 4 23.3 28.1 33.7 7.2 7.4 0.4 \nSOURCE: Developed by RWJF and RAND. \nQ23. [w4_pocimpact2] People of color (e.g., African Americans, Latinos) are facing \nmore of the financial impact of coronavirus (COVID-19) than whites. \nSample Strongly agree Some"] [12.882684707641602, 14.451597213745117, " 46.7 52.7 0.5 \nWave 4 39.6 59.8 0.6 \nSOURCE: Modified from National Survey of Health Attitudes. \nQ25b. [w4_community change] Over the past year ( between Spring 2020 and now \n(Fall 2021)), have people in your community changed the way they support"] [12.88248062133789, 14.44516658782959, "ther factors. \nSelect only one answer. \nSample None A little A fair amoun t A great deal Missing \nWave 1 14.3 26.6 37.5 21.1 0.5 \nWave 2 14.6 29.9 36.5 18.4 0.7 \nWave 3 15.0 31.4 37.9 14.9 0.8 \nWave 4 22.5 32.4 33.2 10.9 1.0 \nSOURCE : Develop"] [12.879575729370117, 14.437789916992188, " employees and customers to wear a mask \nSample Yes No Missing \nWave 1 X X X \nWave 2 X X X \nWave 3 X X X \nWave 4 79.7 19.8 0.5 \nSOURCE: Developed by RWJF and RAND. \n\t\n\t \t 45 Q29c. [w4_schools] Schools in my community should be able to \nNote "] [12.884316444396973, 14.439403533935547, "ee Somewh at \nagree Neither agree \nnor disagree Somewhat \ndisagree Strongly \ndisagree Missing \nWave 1 46.0 21.4 15.2 8.1 8.9 0.4 \nWave 2 43.5 22.3 16.1 8.8 8.7 0.6 \nWave 3 39.7 25.5 16.5 8.8 9.1 0.5 \nWave 4 44.8 21.9 15.8 7.4 9.4 0.8 \nSOURCE"] [12.87948989868164, 14.448385238647461, " X X X X X \nWave 2 X X X X X X \nWave 3 16.0 17.0 19.5 19.7 27.4 0.4 \nWave 4 15.0 16.0 23.2 19.3 25.6 0.8 \nSOURCE : Developed by RWJF and RAND. \nQ35. [w4_positivech] The coronavirus outbreak can be an opportunity for our society to \nmake positive"] [12.881402969360352, 14.447698593139648, " X X \nWave 3 X X X \nWave 4 37.8 60.3 1.9 \n\t\nB. Romantic relationships (e.g., got married, found a partner, planned divorce) \nSample Yes, I have made a \npositive change No, I did not make a \npositive change Missing \nWave 1 X X X \nWave 2 X X X"] [12.872859954833984, 14.461570739746094, " one answer. \nNote: This is a new question added in wave 3. \nSample Strongly agree Somewhat \nagree Neither agree \nnor disagree Somewhat \ndisagree Strongly \ndisagree Missing \nWave 1 X X X X X X \nWave 2 X X X X X X \nWave 3 16.9 20.2 24.4 16.4 "] [12.875693321228027, 14.44233512878418, "t to a location providing vaccines 2.0 1.4 \nI want to wait for more evidence 19.9 37.9 \nI am afraid of needles 2.9 4.4 \nI was told not to by my doctor 1.6 5.4 \nI was told not to by a friend or family member 1.0 3.7 \nI am concerned about possible"] [12.876738548278809, 14.450878143310547, "ty Missing \nWave 2 46.2 42.0 10.4 1.4 \nSource: Modified from SHADAC COVID -19 Survey \nQ43. [w4_humanitarian] The US should send extra vaccines to other countries. \nSelect only one answer. Note: This question was added in wave 4. \nSample Strongly"] [12.84155559539795, 13.99721622467041, "ondents by Gender \nSample Male Female \nWave 1 42.0 58.0 \nWave 2 42.6 57.4 \nWave 3 42.7 57.3 \nWave 4 43.1 56.9 \n 62 Respondents by U.S. Region \nSample Northeast Midwest South West Unknown \nWave 1 15.8 19.3 38.7 26.2 0.0 \nWave 2 15.7 1"] [12.865964889526367, 14.130440711975098, " responses with the 952 responses from populations at greater risk in the ALP allowed us to produce results representative of the general population, with a total sample size of 1,753. This appendix provides responses for the combined general populat"] [12.893401145935059, 14.397928237915039, "t say \nthey feel. How much of the time in the past week, did you . . . \nA. Feel happy \nSample None or almost \nnone of the time Some of the \ntime Most of the time All of the time Missing \nGeneral Population \nWave 1 3.4 30.6 56.7 9.2 .a \nGener"] [12.90938949584961, 14.41836166381836, " 1 \nBeing exposed to coronavirus (COVID -19) through your \nwork or workplace 7.9 \nFeeling isolated or lonely 27.1 \nDeath or loss of a loved one 4.1 \nNot enough food for all members of the household 2.5 \nUnstable housing or unable to pay rent 3.4 "] [12.883247375488281, 14.468212127685547, "acts: Feelings of Safety \nQ16. [w4_worry] How worried are you that you or a loved one will get coronavirus \n(COVID-19)? \nSelect only one answer. \nSample Not worried at all Not too \nworried Somewhat \nworried Very worried Missing \nGeneral Popula"] [12.880759239196777, 14.454915046691895, "ifference? \nSample Easier Not much of a \ndifference Harder Missing \nGeneral Population \nWave 1 6.3 49.9 43.5 0.2 \nGeneral Population \nWave 4 7.7 49.9 42.4 .a \nSOURCE: National Survey of Health Attitudes. \na The period indicates true 0 (rat"] [12.878609657287598, 14.459521293640137, "., African Americans, Latinos) have \npoorer health outcomes (e.g., higher rates of diabetes, more deaths from coronavirus (COVID-19)) than whites is systemic racism. \nSample Strongly agree Somewhat \nagree Neither agree \nnor disagree Somewhat \ndis"] [12.872983932495117, 14.421256065368652, "eral \nPopulation Wave 4 30.6 11.0 58.3 0.1 \nSOURCE: Developed by RWJF and RAND. \n \n 79 Q25c. [w4_changelast] *(if w4_communitychange=1 or 2) Do you think this change in \nthe community (either more or less support for each other) will continue aft"] [12.880436897277832, 14.452335357666016, " 31.8 8.2 .a \nSOURCE: Developed by RWJF and RAND. \na The period indicates true 0 (rather than a number that has been rounded down to 0). 82 Views, Mindset, and Expectations: Views of Private -Sector Roles \nQ29. [w1_business] For the following ques"] [12.868157386779785, 14.454059600830078, "mployees (staff such as custodians, not teachers) to be vaccinated \nSample Yes No Missing \nGeneral Population \nWave 1 X X X \nGeneral Population \nWave 4 59.2 40.8 .a \n\t\nC. Require students [age 12 or older] to be vaccinated \nSample Yes No Miss"] [12.882010459899902, 14.460968971252441, "0 (rather than a number that has been rounded down to 0). \n \n 88 Views, Mindset, and Expectations: Trade -Offs and Perspectives \nQ32. [w3_liberty] People\u2019s right to move about freely is so important that it\u2019s worth \nrisking a substantial increase"] [12.880563735961914, 14.446137428283691, "Wave 4 19.1 17.4 22.0 20.3 21.1 0.1 \nSOURCE : Developed by RWJF and RAND. \nQ35. [w4_positivech] The coronavirus outbreak can be an opportunity for our society to \nmake positive changes. \nSelect only one answer. \nSample Strongly agree Somewhat \n"] [12.873465538024902, 14.428730964660645, " \nGeneral Population \nWave 1 X X X \nGeneral Population \nWave 4 38.7 61.1 0.2 \n \nE. Personal health (e.g., exercised more, ate better, took care of myself better) \nSample Yes, I have made a positive \nchange No, I did not make a \npositive change"] [12.873469352722168, 14.452407836914062, "only answer. \nSample Strongly agree Somewhat \nagree Neither agree \nnor disagree Somewhat \ndisagree Strongly \ndisagree Missing \nGeneral Population \nWave 1 21.4 13.9 21.7 15.8 27.2 0.0 \nGeneral Population \nWave 4 19.9 16.5 23.7 14.3 25.5 .a "] [12.841304779052734, 14.504389762878418, "en rounded down to 0). \nQ43. [w4_humanitarian] The US should send extra vaccines to other countries. \nSelect only one answer. Note: This question was added in wave 4. \nSample Strongly agree Somewhat \nagree Neither agree \nnor disagree Somewhat \ndi"] [12.828832626342773, 14.091595649719238, "h a \npartner Separated Divorced Widowed Never \nmarried \nGeneral Population \nWave 1 59.9 2.2 16.5 6.8 14.7 \nGeneral Population \nWave 4 61.0 2.2 16.0 6.6 14.1 \nRespondents by Number of Household Members \nSample 1 2 3 4 5 6 7 8 9 or \nmore \nGene"] [12.707605361938477, 13.833375930786133, "arch 3, 2021: http://www.rand.org/t/RRA764-3 \nChandra, Anita, Joie D. Acosta, Katherine Grace Carman, Tamara Dubowitz, Laura Leviton, \nLaurie T. Martin, Carolyn Miller, Christopher Nelson, Tracy Orleans, Margaret Tait, Matthew D. Trujillo, Vivian L."] [12.719232559204102, 13.855297088623047, "ttps://www.rand.org/research/data/alp.html \nRobert Wood Johnson Foundation, Culture of Health, home page, undated. As of February 13, \n2019: http://www.cultureofhealth.org/ \nRWJF\u2014See Robert Wood Johnson Foundation. \nSaad, Lydia, \u201cIn U.S., More Fear "] [13.652060508728027, 20.040014266967773, "Prepared for the California Commission on Health and Safety and Workers\u2019 \nCompensationCOVID-19 in the California \nWorkers\u2019 Compensation System\nA Study of COVID-19 Claims and Presumptions \nUnder Senate Bill 1159\nDENISE D. QUIGLEY, MICHAEL DWORSKY, NAB"] [13.647595405578613, 20.039276123046875, "its, medical benefits, and death benefits, including differences in the effects across differing occupational groups; and (3) assess the overall and cost impacts of the frontline worker and outbreak presumptions created by Senate Bill (SB) 1159 on Ca"] [13.643458366394043, 20.044322967529297, "eley; and Sandra Berry, sociologist and survey methodologist at RAND, for their outstanding \nefforts as quality-assurance reviewers. We also wish to thank Roald Euller and John Daly in the RAND information and technology division\u2019s computing environm"] [13.679905891418457, 20.066688537597656, ".88 covers workers not covered by the frontline presumption \nwho tested positive for COVID-19 while working outside the home during an outbreak period at their jobsites. We refer to this presumption as the outbreak presumption (Cal. \nLab. Code 3212.8"] [13.616475105285645, 20.02111053466797, "r, on net, a beneficial) policy response. At the time of writing, the pandemic has lasted just under two years, and many of the long-term impacts of COVID-19 (on workers and on the WC system) are not yet observable in the available data. Instead, we "] [13.57082748413086, 19.97408676147461, "f claims in June and July of 2020 and peaked at 55 percent of claims in December 2020. Workers filed a total of 82,000 claims for December 2020 injury dates. In comparison, in the decade before the pandemic (2010 to 2019), there had never been more t"] [13.471510887145996, 19.914880752563477, " \noccupational groups as follows: 32 percent of statewide COVID-19 claims were by health care workers covered by the frontline presumption, 6 percent of statewide COVID-19 claims were filed by peace officers covered by the frontline presumption, and "] [13.468531608581543, 19.893360137939453, "ustry. The COVID-19 claim rate at skilled nursing facilities (SNFs) was much higher: 394 COVID-19 claims per 10,000 workers. In both types of facility, COVID-19 claim rates were higher for health care support occupations than for health care practiti"] [13.569363594055176, 19.97609519958496, " any benefits . Estimates use sampling weights to correct for casewise deletion of incomplete \nrecords, for exclusion of data from unreliable claim s administrators, and for exclusion of claims that could not be \nassigned occupation codes. See Chapte"] [13.671542167663574, 20.05538558959961, "nt rate observed among firefighters. \nDenial rates in other industries potentially covered by the outbreak presumption were much \nhigher, ranging from 33 percent in the agriculture sector to 78 percent in the transportation and warehousing sector. \n"] [13.69194507598877, 20.071937561035156, "yee needs were not necessarily for medical care (access to medical care was not dependent on WC) but to pay for nonminor, high-cost medical care through WC benefits, \nespecially given that most workers\u2019 co-pays, deductibles, and out-of-pocket costs w"] [13.686538696289062, 20.066402435302734, "owever, was used to cover medical care for COVID-19 when the medical care needs were nonminor (that is, were high-cost, required hospitalization, or involved prolonged symptoms). Employees used WC to cover outpatient care including medications, thera"] [13.678183555603027, 20.061532974243164, "t were high-cost. \nOf the WC benefits available (indemnity, disability, medical care, death benefits), medical \ncare coverage for COVID-19 through WC was reported to be the most important WC benefit for workers. Within the context of fully insured pr"] [13.67087173461914, 20.05829620361328, "r a workplace injury occurred (in this case, a workplace exposure and contraction of COVID-19) and therefore did not impact prevention or safety directly. Furthermore, public health officials did agree that the SB 1159 presumptions for COVID-19 did a"] [13.66418743133545, 20.053924560546875, "ine industries than nonfrontline industries. More comprehensive data would be needed to test for timeline compliance across claims, but it appears that SB 1159 had an impact on claim processing timelines. Also, during interviews, claims administrator"] [13.604084968566895, 19.99837875366211, "at the frontline worker and outbreak presumptions, as written, did cover workers at the highest risk for being exposed to and contracting COVID-19. \nCost Impacts of SB 1159\u2019s Presumptions for COVID-19 \nWe investigated costs associated with COVID-19 c"] [13.64745044708252, 20.037250518798828, " It remains uncertain whether costs that were not billed to WC will have to be reimbursed by WC payers at some point in the future. \nPolicy Implications and Discussion \nSB 1159 brought several changes to WC policy for COVID-19 claims, most notably b"] [13.643266677856445, 20.03660774230957, "re typically filed at once. Whether these pressures had a meaningful impact on system expenses or the efficiency of the WC benefit delivery system is unclear from the quantitative data that were available for this study. We also cannot say how many m"] [13.682382583618164, 20.064414978027344, "ms were denied much faster than non\u2013COVID-19 claims, with faster processing \nin frontline industries than nonfrontline industries. \nHowever, we did not hear that shortened timelines and quicker initial claims decisions \nmeaningfully assisted workers"] [13.646467208862305, 20.032541275024414, "he broader state and federal policy context. \nGiven that so much remains unknown about the unequal risk of exposure to COVID-19 that \noccurred at workplaces across California, we highlight here a number of research needs that \n xxii emerged in the c"] [13.58122730255127, 19.989748001098633, "rganization of This Report ..................................................................................................................... 7 \n2. Background and Overview of the Study ............................................................"] [13.630727767944336, 20.028839111328125, "................................... 130 \nImpact of Other Policies on Safety for Workers .................................................................................. 132 \nSummary ................................................................."] [13.584019660949707, 19.98360824584961, "esumption Section and Group of Workers ........................................................................ 50 \nFigure 3.3. Initial Denial Rates on COVID-19 and Non\u2013COVID-19 Claims, by Date \nof Injury ............................................"] [13.521821022033691, 19.92662239074707, "ty Settlement Receipt for COVID-19 and Non\u2013COVID-19 \nClaims, by Presumption Section ........................................................................................... 59 \nTable 3.7. COVID-19 and Non\u2013COVID-19 Claims Without Medical Bills Sub"] [13.584451675415039, 19.979406356811523, ".......................... 155 \nTable 8.2. Temporary Disability Duration of COVID and Non-COVID Claims with \nPaid TD Benefits, by Presumption Section ......................................................................... 156 \nTable 8.3. Total Pai"] [13.68939208984375, 20.049285888671875, "in Three Months of Earliest Service Date, Including Claims with No Medical Bills, by COVID-19 Status and Presumption Section ................ 214 \n \n 1 1. Introduction \nThe novel coronavirus SARS-CoV-2 (which causes the disease known as coronaviru"] [13.68298053741455, 20.065990447998047, "d to risk infection and death by continuing to work outside the home. In recognition of the deadly workplace risks that millions of workers suddenly found themselves facing as the pandemic started, California policymakers moved quickly to facilitate "] [13.616989135742188, 20.025157928466797, "ociated with these claims in terms of denial rates, receipt of different types of benefits, and costs of benefits paid to date. As requested by CHSWC, these analyses emphasize differences in COVID-19 claims and their outcomes among workers likely to "] [13.647550582885742, 20.0375919342041, "ated with tracking outbreaks, as well as the expedited timelines for claims administrators to approve or deny COVID-19 claims (i.e., 30- and 45-day timelines for initial acceptance of the claim to conduct investigation of the claim, rather than the s"] [13.65723991394043, 20.045856475830078, "ed. \n\u2022 Substantial protection against interruption of income \n- A high proportion of a disabled worker\u2019s lost earnings should be replaced by \nworkmen\u2019s compensation benefits. \n\u2022 Provision of sufficient medical care and rehabilitation services \n- The "] [13.591774940490723, 20.012588500976562, " or quantitative methods. \n \n \n 6 Table 1.1. Chapter Topics Linked to Research Quest ions, Including Whether Question Is \nAnswered by Qualitative or Quantitative Methods \nResearch Question Qualitative Quantitative \nChapter 3: COVID -19 Claims"] [13.616096496582031, 20.009307861328125, "ive data sources. \nChapter 3 lists baseline facts about the volume, composition, and outcomes of COVID-19 \nclaims from March 2020 to April 2021. Chapter 3 presents an overview of the COVID-19 claim volumes, severity of those claims, and outcomes in t"] [13.631884574890137, 20.02533721923828, " COVID-19 claims in relation to non\u2013COVID-19 claims and discuss claims administrators\u2019 experiences with delays, denials, and claim acceptance and the type of documentation needed and requested. We also describe claims administrators\u2019 perspectives on "] [11.82153606414795, 18.383487701416016, "D benefits are assigned according to a PD rating\u2014a number between 0 and 100 percent\u2014\nassigned by an evaluating physician or medical examiner. The PD rating process involves \nadjustments for various factors, including for disability attributable to pr"] [13.672314643859863, 20.050241470336914, "ectious disease claims were rare in California\u2019s WC system, accounting for less than 0.5 percent of claims reported to the WCIS (California Department of Industrial Relations, 2020).\n2 \nWithout the executive and legislative actions that were taken in"] [13.697656631469727, 20.07065200805664, " Labor \nCode sections 3212 through 3213.2 had established presumptions for at least 11 distinct health conditions in specific groups of public safety workers. \nExecutive Order N-62-20 \nA rebuttable presumption for COVID-19 covering all essential work"] [13.673027038574219, 20.05794334411621, "ging from $0.6 billion to $2.0 billion), both because the governor\u2019s order was \ntemporary (so the projected costs were not annualized) and because the presumption was disputable. \nOn the other side of the debate, the legislative record and popular di"] [13.660812377929688, 20.048524856567383, " distinct presumptions. These presumptions were made retroactive to July 6, 2020, and will remain in effect until December 31, 2022. Table 2.1 compares selected provisions of these presumptions. We discuss the major differences below, following the l"] [13.686386108398438, 20.062801361083984, " within 14 \ndays of exposure Test positive (PCR \ntest only) during \noutbreak period \nwithin 14 days of \nexposure Diagnosed, and \nworker knows or \nshould have known \nthat illness is work -\nrelated \nDate of injury \ndefinition Last day worked at \njob"] [13.694099426269531, 20.066558837890625, " Section 3212.87, 2020, is sharply distinguished by the inclusion of a provision that limits the applicability of the presumption to workers who test positive during an outbreak period at their employer. Labor Code Section 3212.88, 2020, defines an o"] [13.678351402282715, 20.059419631958008, "c safety workers, \nsuch as lifeguards, who are assumed to face elevated risks from their employment. And while several infectious diseases (tuberculosis, pneumonia, Lyme disease, Methicillin-resistant staphylococcus aureus, and blood-borne infections"] [13.683049201965332, 20.066116333007812, " COVID-19 prevention covering \nworkplaces outside of employees\u2019 homes that were not already covered by the ATD standard. Several elements of the COVID-19 ETS posed major implications for COVID-19 WC claim volumes, particularly new requirements that a"] [13.653409004211426, 20.09976577758789, " The AB 685 notification requirements took effect on January 1, 2021. \nIn evaluating the overall impact of SB 1159 on the WC system, it is also important to \nconsider interactions between WC benefits and other public and private benefits that can he"] [13.678317070007324, 20.06307601928711, "the FFCRA regardless of employer size. \nThese pandemic-specific sick leave benefits are potentially important for the evaluation of \nSB 1159 because payment of TD benefits under SB 1159 does not begin until these pandemic-specific sick leave benefits"] [13.667893409729004, 20.051280975341797, "t (EDD, 2020b). SDI will pay the benefits until the WC claim is resolved, after which EDD may seek to recover the benefits from the WC payer through a lien (EDD, 2020b).\n7 \n \n \n7 We note that the establishment of a legal presumption that COVID -19 "] [13.64654541015625, 20.033084869384766, "y Medical care with \npotentially high \npatient cost-sharing ~100% of Californians \nover age 65 Federal \ngovernment \nSOURCE: 2019 American Community Survey Tables HIC- 5 ACS and HIC- 6 ACS in U.S. Census Bureau, 2021 a. \nEstimates reflect health in"] [13.640395164489746, 20.027801513671875, "e) their employer\u2019s plan is self-funded or fully insured. \nFinally, for workers covered by self-funded employer-sponsored insurance, differences in \nprovider payments between private health insurance and WC could have a major impact on \noverall emplo"] [13.565974235534668, 20.02250862121582, "mplish this effort, we employed a mixed-methods approach, using quantitative and \nqualitative methods to evaluate the impacts of COVID-19 claims and the SB 1159 presumptions \non the WC system. We delineated specific research questions within the fram"] [13.592914581298828, 20.005685806274414, " with COVID-19 and the WC system and for the same purpose for our TAG and study team. We convened a TAG and held a meeting at the \nbeginning of the project to discuss our research design and research questions, and at the end of the project to discus"] [13.580322265625, 20.012859344482422, " (Boyle, 2020; Luna, 2020). In industries in which there was a shortage of employees already and no telework option, such as meatpacking and warehouse work, employers reported struggling with worker absenteeism and strikes (Almeida and Hirtzer, 2020;"] [13.423331260681152, 20.04513931274414, " of these sampling pools was developed separately. Recruitment was simultaneous across the samples. We sent initial invitations, including the information sheet, via email, followed up by phone, and attempted to contact respondents five times. \nFor "] [13.406717300415039, 20.042373657226562, "om the \nCDPH website. We reviewed CDPH data on the hardest-hit counties across California, including the top four counties in rural Northern California, urban Northern California, rural Southern California, and urban Southern California. We aimed to "] [13.48103141784668, 20.02549934387207, "d attempted to screen and contact 85 (with \n13 ineligible and 21 never contacted). We completed 32 interviews (32/85): four public health \nofficials, eight claims administrators, 11 employers, and nine workers (six with COVID-19 claims and three who "] [13.400752067565918, 20.038068771362305, "3 NA 2 1 \nTotal unique interviews 32 7 10 15 \nNOTES: NA = not applicable. \n* Five of the eight claims administrators represent public safety and health care employers (n = 4 are public safety, n = \n1 is a health care employer), while the remaining"] [13.47172737121582, 20.025846481323242, "starting the interview, including consent for recording; all interviews \n 31 were audio-recorded. All interviews were transcribed verbatim and field notes documented, after \nwhich the interviewer reviewed and finalized the interview transcripts. Int"] [13.160346031188965, 20.05950164794922, "2 1 \nManufacturing/d istribution 2 1 \nGrocery 0 1 \nAgriculture 0 1 \nConstruction 0 2 \nType o f claims administration \nTPA \u2014 11 \nSelf-insured \u2014 5 \nHybrid (TPA and self -\ninsured ) \u2014 3 \nOutbreak at work 5 NA \nFiled a COVID- 19 WC claim 6 NA \nFu"] [12.964957237243652, 20.090280532836914, ", identify discrepancies, refine concepts, make codebook changes, define codes, and dialogue about concepts and themes. \nTeam members worked together in identifying themes and subthemes and in reviewing the \nsets of interviews by type of respondent "] [13.369812965393066, 20.037620544433594, " the report. \nThe TAG input and feedback at both meetings was documented by a notetaker and used to aid \nin understanding the issues across the quantitative and qualitative team members. Based on our first TAG meeting, we incorporated a specific set "] [13.281518936157227, 19.93410301208496, ", claims administrators, union representatives, and employee associations, yielded three additional injured-worker interviews. Overall, we completed nine total injured-worker interviews across public safety, health care, and manufacturing workers; si"] [11.831048965454102, 19.10270118713379, "ls in this report. We could also observe denials after indemnity benefits had been paid, because these must be reported on an SROI. However, a sizable majority of full \ndenials was reported on FROI. Looking at data on all (non\u2013COVID-19) claims with 2"] [13.164804458618164, 19.8266544342041, " to use information about both the worker\u2019s industry and their occupation. Industry codes are reported on the FROI, mostly as North American Industry Classification System (NAICS) codes, but in some cases as Standard Industrial Classification (SIC) c"] [13.249212265014648, 19.87788963317871, "umption \n(Labor Code section) Worker Group Occupations Included \n(SOC codes) Industry (NAICS) or \nClass Codes \nFrontline (3212.87(a)11) In-home supportive \nservices \u2022 Any Occupation \u2022 Services for the Elderly \nand Persons with Disabilities ("] [11.812759399414062, 19.058788299560547, "tors = those reporting paid indemnity benefits on at least 10 percent of claims prior to the pandemic (2016 \u2013\n2019). \nMissing Data and Weighting \nWCIS data, like other multipayer administrative data, vary in quality across payers and over \ntime, "] [13.083367347717285, 19.548625946044922, "ata in column (2) but only 2,000 \nof those claims are from reliable claims administrators and have a usable occupation code \nassigned, the weight assigned to claims in that cell for analyses using the sample in \ncolumn (4) would be 1.5. \nWe construct"] [13.422039985656738, 19.840620040893555, "port unweighted counts of all claims with industry and occupation codes so that all observable claims in each category are counted. As a sensitivity analysis, we also examined unweighted counts of all claims in column (1) with occupation and industry"] [13.617850303649902, 20.014436721801758, " over time, including overall denial rates \n(RQ3), benefit receipt, and medical severity. This information answers RQs 1 through 3: \n\u2022 RQ1: What is the volume of COVID-19 claims? \n\u2022 RQ2: How does COVID-19 claim volume vary across the different presum"] [13.558762550354004, 19.960317611694336, "e 3.1 are averaged over relatively long spans of time and thus \nmask important patterns in the monthly volume of COVID-19 claims. Figure 3.1 presents the monthly volume of COVID-19 and non\u2013COVID-19 claims filed from January 2019 through June 2021. \nT"] [13.575091361999512, 19.97322654724121, "d \nDate of Injury \n Frontline Presumption \nWorkers Other Occupations \nPeriod COVID Non-COVID Total COVID Non-COVID Total \nPrepandemic (2019) 0 110,161 110,161 0 601,932 601,932 \nPandemic, before temporary presumption \n(1/1/2020 \u20133/18/2020"] [13.581911087036133, 19.98564910888672, "60 \nTemporary presumption (3/19/2020 \u20137/5/2020) 10,356 15,955 26,495 1,499 7,655 9,151 473 3,223 3,689 \nSB 1159 presumptions in effect (7/6/2020 \u20136/30/2021) 35,430 61,553 100,773 6,654 24,220 31,093 4,459 11,108 15,908 \nTotal (1/1/2020 \u20136/30/2021) "] [13.590313911437988, 19.993362426757812, " the recession were far less pronounced among frontline workers than among workers in other occupations. \nOutcomes of COVID- 19 Claims \nIn this section, we present statistics describing claim denial rates (focusing on initial claim \ndenial rates) and"] [13.559148788452148, 19.96733283996582, "ntrated among health care workers but accounted for less \nthan 1 percent of claims among firefighters and peace officers; they were also rare for outbreak occupations. Payment of PD and death benefits remained too rare in COVID-19 cases to see many p"] [13.593074798583984, 19.99911880493164, "er OccupationsFrontline\nPresumption\nTotalHealth Care\nWorkersFrontline, All\nOccupationsFrontline\nOccupation\nGroups\nAxis Title\nPre-Pandemic (2019) Pandemic, Before Temporary Presumption (1/1/2020-3/18/2020)\nTemporary Presumption (3/19/2020-7/5/2020) SB"] [13.584578514099121, 19.991371154785156, "A high denial rate might mean that claims covered by the presumption were being denied, but it could just as easily mean that claims were being filed that were not covered by the presumption, either because the claim was filed on a precautionary basi"] [13.614566802978516, 20.014101028442383, "nia Workers\u2019 Compensation Institute (CWCI) shared results from a forthcoming (at the time of writing) analysis on the reasons for COVID-19 claim denials from the fourth quarter of 2020 (October\u2013December 2020), a period that covers the peak of the win"] [13.577530860900879, 19.985923767089844, "our in five) denied COVID-19 claims were filed by nonfrontline workers, about 17 percent (one in six) were filed by health care workers, and about 4 percent (about one in 25) were filed by public safety workers covered by the frontline worker presump"] [13.58347225189209, 19.98067855834961, "y to these estimates, including that outbreak tracking may have led to more marginal TD claims being filed in some cases. \nTable 3.4. Temporary Disability Benefit Receipt for COVID -19 and Non\u2013 COVID -19 Claims, \nby Presumption Section \n Frontlin"] [13.582103729248047, 19.979333877563477, ", or of \naccepted claims. We note that, throug hout this analysis, the denominator for estimated rates or averages contains all \nclaims filed, including denied claims. However, to facilitate comparison with other analyses, we can divide the rates \nof"] [13.43080997467041, 19.845670700073242, " sampling weights to correct for casewise deletion of incomplete records, for exclusion of data \nfrom unreliable claim s administrators, and for exclusion of claims that could not be assigned occupation codes. \nAdjusted totals use weights to adju st"] [13.603280067443848, 20.007225036621094, "of the worker. \nSummary \nCOVID-19 claims were, on average, about 15 percent of all claims filed in the WC system \nfrom January 2020 to June 2021. Total claim volumes over this period remained 10 percent lower than before the pandemic, a fact that is "] [13.618095397949219, 20.013118743896484, "denied in both the public and private sectors may not have been covered by the SB 1159 presumptions due to lack of a positive PCR test. This paints a picture in which a sizable proportion of COVID-19 claims filed were cases in which the worker may no"] [13.589325904846191, 19.9945125579834, " Industries \nand Workers \nChapter 3 characterized how COVID-19 claim volumes varied over time and across workers \ncovered by the different presumptions established or codified by SB 1159. CHSWC and the \nlegislature also requested that this study anal"] [13.462726593017578, 19.887929916381836, " Did workers in occupations that experienced high excess mortality in the pandemic also file high volumes of death claims? \nAs we discuss below, substantial caution must be exercised in interpreting the occupation-\nspecific estimates in this chapter."] [13.447701454162598, 19.875783920288086, "nclude all \nclaims for which industry and occupation could be ascertained that had both a cause and nature \nof injury reported. These claim counts include claims that are excluded in other analyses because of missing data, or because they were report"] [13.426916122436523, 19.87201499938965, "ment Statistics (OES) program, was used to provide context on the \n 66 approximate number of workers employed in each occupation and each industry at the start of \nthe pandemic. The OEWS surveys nonagricultural employers about the number of workers "] [13.446674346923828, 19.875776290893555, "the end of this chapter, we report the volume of death claims filed by workers in these occupations to characterize whether workers in high-mortality occupations were also likely to file death claims. In a separate table, we report the 20 detailed oc"] [13.415128707885742, 19.851543426513672, "d by occupations with high excess mortality; e.g., we included the apparel manufacturing industry (NAICS 315) because it is a major employer of sewing machine operators. Additional specific industries (e.g., retail pharmacies) were included because o"] [13.468917846679688, 19.900814056396484, " 1 and September 28, 2021. Between January 1 and August 11, 2021 (the latest COVID claim injury \ndate in our WCIS data), there were 33,024 COVID -19 claims reported to the WCIS. In industry sectors other than \npublic administration (which contains wo"] [13.3806791305542, 19.866220474243164, "uding those not identified as working in health care facilities, about 10 percent (2,000 claims unweighted) have industry codes indicating government employment but are not flagged as workers in health care facilities. Ninety-seven percent of these w"] [13.443708419799805, 19.87062644958496, "f May 2020, we see that the highest rate of claims per 10,000 workers is in state and local government (269 claims per 10,000 workers), and that this rate was more than twice the rate in health care and social assistance (130 claims per 10,000 worker"] [13.464048385620117, 19.88985824584961, " No Medical = \nproportion of claims with no medical bills submitted to the WC payer as of July 2021. State and Local Government is defined as the union of OEWS industries \n9992 (State Government) and 9993 (Local Government); OEWS employment in thes"] [13.388867378234863, 19.870288848876953, "ide employment in this sector was only 18,000 \nworkers, so the volume of claims is relatively low, and we do not report on patterns by occupation in this industry. \n 74 Frontline Presumption Industries and Occupations \nPublic Sector \nTable 4.2 rep"] [12.978160858154297, 19.821062088012695, "refighting supervisors. While this is a pattern we would expect to see if lower -rank officers \nwere incorrectly classified as supervisors, examination of the verbatim occupation descriptions in the WCIS did not \nsuggest that such misclassification "] [13.468132972717285, 19.891504287719727, "hin industry as reported by BLS OEWS program. TD Receipt = proportion of \nclaims with any paid temporary disability benefits, including temporary total disability, total permanent disability, or 4850 pay. No Medical = proportion of claims \nwith no "] [13.446072578430176, 19.8737735748291, " had high COVID-19 claim rates that were nonetheless lower than rates for workers in protective service occupations.) COVID-19 claim rates for social workers, office clerks, and business and financial operations occupations were similar to those obse"] [13.459127426147461, 19.883296966552734, "uding temporary total disability, total permanent disability, or 48 50 pay. No Medical = proportion of claims \nwith no medical bills submitted to the WC payer as of July 2021. DD = developmental disability. MHSA = mental health and subs tance abuse. "] [13.545039176940918, 19.94723892211914, "sion or generosity (in terms of days covered) of special pandemic sick leave, since large employers (which would include many if not all hospitals) were exempt from the federal pandemic sick leave mandates. \nWe also note that, although COVID-19 claim"] [13.43879508972168, 19.872060775756836, "ms with date of injury from July 6, 2020 , to June 30, 2021. Rows labeled with industry report data \nfor all workers in the industry regardless of occupation. Rows labeled with occupation report data for workers in the occupat ion who work in the ind"] [13.447540283203125, 19.876359939575195, "rid SOC) Within Industry California \nEmployment Number of \nClaims Claims per \n10,000 Workers Initial Denial \nRate TD Receipt No Medical \nCOVID Non-\nCOVID COVID Non-\nCOVID COVID \n(%) Non-\nCOVID \n(%) COVID \n(%) Non-\nCOVID \n(%) COVID \n(%"] [13.44864273071289, 19.87822914123535, " at SNFs. Claim rates were highest for nursing assistants (639 per 10,000 workers). In Ambulatory Health Care (NAICS 621), the COVID-19 claim rate (132 per 10,000 workers) was lower than in health care facilities or home health. In contrast to the ex"] [13.443699836730957, 19.870668411254883, ",271,830 7,946 56,465 63 444 49 10 15 24 89 23 \nTransportation and Material \nMoving Occupations (53 -0000) 93,760 1,309 9,804 140 1,046 51 10 11 26 86 21 \nProduction Occupations (51-\n0000) 530,320 3,050 24,248 58 457 45 10 19 24 86 22 \nFabricated "] [13.427464485168457, 19.85801124572754, "ions. \nLooking at some specific manufacturing industries with high volumes of CDPH-reported \noutbreak cases in 2021 (Fabricated Metal Products, Plastics and Rubber Products, and Computer and Electronic Products), we see variation in COVID-19 claim ra"] [13.439499855041504, 19.8695011138916, "several occupations identified by Chen et al., 2021, as having high excess mortality during the pandemic, including butchers and other meat, poultry, and fish processing workers (SOC code 51-3020) and bakers (SOC code 51-3011). Several industries rep"] [13.411460876464844, 19.846529006958008, "51-3020) 9,570 54 274 56 286 86 8 0 16 100 26 \nBakers (51 -3011) 7,450 65 337 87 452 42 8 10 39 80 21 \nFruit/Vegetable Preserving, Spec \nFood Manuf. (311400) 24,410 138 1,819 57 745 30 9 20 30 92 17 \nSeafood Product Preparation and \nPackaging (311"] [13.418767929077148, 19.84957504272461, "D-19 claims per 10,000 workers. These claims were concentrated among laborers and freight, stock, and material movers, hand (SOC 53-7062),\n19 who had a COVID-19 claim rate of 196 per 10,000 workers\u2014comparable with \nthe rate observed in the hospital i"] [13.433239936828613, 19.861526489257812, "2 169 51 7 35 32 86 18 \nTruck Transportation (484000) 133,360 538 7,256 40 544 10 9 51 42 95 37 \nTransportation and Material \nMoving Occupations (53 -0000) 100,720 222 6,515 22 647 24 8 20 48 92 38 \nLaborers and Freight, Stock, and \nMaterial Movers"] [13.406929969787598, 19.833330154418945, " a higher denial rate. With that caveat, the high claim rates and high claim denial rates in the couriers and messengers industry stand out from other industries. \nRetail \nTable 4.9 reports COVID-19 claim volumes and outcomes in the retail sector. We"] [13.440025329589844, 19.867860794067383, "jury from July 6, 2020 , to June 30, 2021. Rows labeled with industry report data \nfor all workers in the industry regardless of occupation. Rows labeled with occupation report data for workers in the occupat ion who work in the industry listed \nabov"] [13.463973999023438, 19.888824462890625, "eave for food workers may have contributed to low rates of TD receipt. However, many other factors could also be at work here. Finally, we note that accommodations and food services is the only sector examined in which most COVID-19 claims had medica"] [13.455934524536133, 19.880128860473633, "ts, including temporary total disability, total permanent disability, or 4850 pay. No Medical = proportion of claims \nwith no medical bills submitted to the WC payer as of July 2021. \n 100 Death Claims and High-Mortality Occupations \nTable 4.11 rep"] [13.440085411071777, 19.864927291870117, "ths and 143 excess deaths identified through August 2020, had zero COVID-19 death claims to date. Given that the time frame over which deaths were measured ended a year before the data were collected, the total cumulative number of deaths to date in "] [13.440673828125, 19.867935180664062, "ks \n(35-1011) 15,590 258 1,700 165.5 1,090.4 0 58 143 1.32 \n23 Driver/Sales Workers and \nTruck Drivers (53- 303) 294,840 2,451 35,554 83.1 1,205.9 35 267 474 1.3 \n24 Social Workers (21 -102) 84,730 674 2,356 79.5 278.1 3 20 54 1.29 \n25 Janitors and"] [13.441043853759766, 19.86475944519043, "e ratio of death claims to COVID-19 deaths should be in any normative sense. In addition, variation in work arrangements (i.e., direct-hire versus independent contractor) and the prevalence of labor informality (i.e., underground work) across occupat"] [13.522061347961426, 19.95759391784668, "d \nDetectives (33 -1012) 4,430 9 5 \n \n 105 Summary \nThis chapter provided a detailed description of COVID-19 claim volumes, claim rates per \n10,000 workers, denial rates, TD receipt rates, and rate of claims without medical benefits by \nindustry "] [13.57911491394043, 19.989248275756836, "aims with a positive PCR test without verifying that the claim was filed during an outbreak period), even though they were acknowledged not to have been covered by the letter of the law. We cannot pinpoint the source of the apparent leniency applied "] [13.585528373718262, 19.988733291625977, "essfully rebutted by evidence of nonoccupational exposure. All we can say is that, for some groups of workers, the outbreak presumption did not result in ready access to WC benefits. Whether these claim denials led to hardship for these workers is no"] [13.666583061218262, 20.043458938598633, "inst interruption of income and assist in the receipt of COVID-19 medical care. These views and experiences are not ones that we can observe in the WCIS claims data and were obtained to better understand the experiences of workers, employers, and oth"] [13.672769546508789, 20.061105728149414, " and then exercising that right. We heard that providing this knowledge about filing a WC claim for COVID-19 according to the SB 1159 frontline worker presumption or the outbreak presumption rested primarily on the employer. We also heard that unions"] [13.679699897766113, 20.074148178100586, "d talked about how they partnered with unions \nor labor groups to assist them with messaging about COVID-19 and claims from their workers. \nA health care hospital employer explained, \nWe had daily meetings with [REDACTED NAME OF UNION] that is our u"] [13.673651695251465, 20.06068992614746, "ere was a positive case to \nembedding their messaging about COVID -19 claims into their workplace contact \ntracing process. \nAnother statewide insurance carrier claims administrator told us, \nWe did a lot of work on messaging for COVID -19 claims an"] [13.669574737548828, 20.058589935302734, "aim. This was coupled with the fear of possibly losing pay and their job. The statewide agricultural employer stated , \nI think from just conversations that we had amongst employees and that I had \nfrom leaders in the field, particularly early on, th"] [13.683728218078613, 20.075090408325195, "o October 2020), employers and claims administrators \nindicated that employees filed COVID-19 claims for exposure only, out of fear of income loss \nand the desire to have a claim on file, i.e., a precautionary filing. Employers and claims \nadministra"] [13.70148754119873, 20.07868003845215, "safety employer provided these same insights into claim filing behavior: \nClaims [for our public safety workers] have been made almost exclusively to get \nthe claim in their record. They do not want money or require us to gain anything \nsuch as medi"] [13.70340347290039, 20.0783748626709, "mployers about workers\u2019 access to non-WC paid leave for COVID-19 when we asked about workers\u2019 claim filing behavior surrounding COVID-19. They stated that the main reason that workers filed a COVID-19 claim was for time off to quarantine that was ove"] [13.698699951171875, 20.07761001586914, "elated \nactions across the United States and in California. Early in the pandemic, the majority (88 \npercent) of workers covered by fully insured private health insurers were not required to pay co-pays and deductibles related to COVID-19 care in add"] [13.676657676696777, 20.05982780456543, "ng high-cost owing to hospitalizations that were lengthy and expensive; they also indicated that some claims also included further care required after hospitalization or follow-up care for an underlying condition that COVID-19 exacerbated. A statewid"] [13.675336837768555, 20.05967903137207, "ons. We also heard that many claims were for \nlong COVID-19 cases , with lingering symptoms and issues, and those that ended in a fatality \n(i.e., a death claim). A claims administrator for a large Northern California county recounted, \nPrimarily the"] [13.675129890441895, 20.056987762451172, "hauler cases, we are not sure if they have reached maximum medical \nimprovement , WC MMI. It is \ncomplicated for those on a vent, and had post COVID . . . issues or had Box 5.1. Symptoms and Long -Term Effects of \nCOVID -19 \nLong -term symptoms foll"] [13.71225643157959, 20.09157943725586, "tly \ndecreased health -related quality of life (Groff et al., 2021; Michelen et \nal., 2021; WHO , 2021). While vaccination is thought to lower the risk of \nlong COVID -19, its full impact is not yet known. \nIn summary, the available evidence points "] [13.692767143249512, 20.07119369506836, "positive case for COVID-19 that is work-related, which is determined after testing. \nTesting for COVID-19 was provided through other means, such as by health care facilities \nthemselves or by cities or counties that had testing sites. Testing was pr"] [13.692411422729492, 20.071334838867188, "ave \nIndemnity benefits are compensation that is paid to a WC claimant for lost time that has been \nbrought about by a work-related injury or illness. These benefits replace wages during the time \nthat an employee is not able to work because of that"] [13.704399108886719, 20.079633712768555, " think they need to work sick. For those situations, WC would \nbe a perfect solution . \nMoreover, this federal or state-provided paid leave sufficed in many cases for time off for the \nmedical needs from COVID-19 if it was not severe, as we describe"] [13.697403907775879, 20.073001861572266, " rules were not \nvisible to the employee, but the employer was responsible for putting those policies in place and updating leave already taken while dealing with other issues, such as employee safety: \nIt has been like standing in quicksand for the"] [13.694984436035156, 20.070974349975586, "h \nCOVID-19 gained access to medical care; however, WC benefits were used to pay for medical care and to claim death benefits. For medical care coverage through WC in particular, claims administrators and employers both agreed that workers did not ne"] [13.687665939331055, 20.068267822265625, "he QME [qualified medical evaluator] has been \nthe only interaction with WC. \nOne injured worker whose claim for COVID-19 was initially denied had significant issues \nwith the disease, ultimately leading to a cardiac incident. The roadblocks and is"] [13.695834159851074, 20.076406478881836, "of information increased about the requirements of needing a positive COVID-19 test for filing a COVID-19 related claim. During the winter surge in 2020, claims administrators and employers indicated that it was time-consuming to keep abreast of COVI"] [13.678561210632324, 20.05382537841797, "l-time pay, which is not the case with WC for time \noff. Thus, absent these federal and state leave innovations, the impact on WC probably would have been much greater and access problems for workers needing disability much more complicated. \nMedica"] [13.67049789428711, 20.056047439575195, "ssues because group health insurance covered workers at \nany health care facility but did need WC to pay for nonminor medical care. Some employers and \nclaims administrators did note that WC benefits were important to pay for costly care, such as ho"] [13.686013221740723, 20.06987953186035, "was how it interplayed with if \nthere was an outbreak, then it c ould be followed up on accordingly and consider \n[the COVID -19 outbreak] presumptive. So work comp helped with identifying \noutbreaks. \nOne aspect of the outbreak presumption was tha"] [13.721311569213867, 20.0937442779541, "fect workplace safety. In a few situations, public health officials noted that individuals were more likely to come forward with symptoms or positive cases because they knew WC would cover them, but since paid leave was mostly paid through federal or"] [13.677681922912598, 20.063560485839844, " to work, because they cannot \nafford to not have that income. We see this with cold and flu season. You get people exposed with the coughs and sneezes. COVID is the same. \nAlignment Between WC and Public Health Knowledge \nIn general, public heal"] [13.685928344726562, 20.068161010742188, "ioned both thresholds and context: \nI am not sure of the efficacy of the outbreak and of the percentage definitions. I \nam not sure how they came up with the 4 percent threshold. What does it \nrepresent? Where did it come from? It seems a little ra"] [13.676894187927246, 20.064056396484375, "ak presumption does align with epidemiological knowledge about COVID transmission. \nImpact of Other Policies on Safety for Workers \nAssembly Bill 685 \nWhen asked about the impact of AB 685 on WC and worker safety, claims administrators \nreported h"] [13.703916549682617, 20.079185485839844, "ostly the same. The notification went out on the s ame \nday as the exposure . \nFor employers that did have to take part in reporting, there was confusion around the policy. \nEmployees were sometimes confused by what the notifications meant for them "] [13.690240859985352, 20.071874618530273, "rnia County employer: \nIt was difficult and confusing for people to understand when it first came out. We \ndidn\u2019t have time to set up the changes and do the training before we were being \nheld accountable. We are a huge organization that needs a lot"] [13.687870025634766, 20.070465087890625, "ing was different. \nWe broke the rules up by department; the legal department took the temporary emergency standard, and I worked on 1159 to prevent confusion between the two. \nSummary \nAcross the interviews, we heard mixed perspectives from public "] [13.655455589294434, 20.04677963256836, " Claims \nThis chapter describes the views and experiences of claims administrators and employers on \nthe administration of COVID-19 claims. We review the efficiency of the delivery of WC benefits \nin terms of how the system handled COVID-19 claims; "] [13.669766426086426, 20.06032371520996, "e to estimated that the reduction in \nnon\u2013COVID-19 claims offset most of the increase in COVID-19 claims; the remaining claims administrators managed larger claim loads during most of the pandemic. A claims administrator for an employer in large urba"] [13.678930282592773, 20.064502716064453, "eed for changed processes and workflows to accommodate the type of evidence needed for a COVID-19 claim (such as a positive test, an employee interview, workplace information) with an efficient mechanism for gathering information from injured \n 139 "] [13.6810302734375, 20.06463623046875, "al claims administrators reported that they accepted \nmore COVID-19 claims, given that disproving that the COVID-19 exposure was work-related was difficult. In response to the shortened timelines, these claims administrators relaxed the level \nof pro"] [13.621005058288574, 20.019245147705078, "ce on Timing of Claim Denials from WCIS \nTo provide additional evidence on the extent to which claim administrators were able to \nimplement the shortened timelines required under SB 1159, we used the WCIS to examine the \ntiming of initial claim deni"] [13.657352447509766, 20.013874053955078, "ther \nOccupations \n COVID -19 \nInfection Non-\nCOVID COVID -19 \nInfection Non-\nCOVID COVID -\n19 \nInfection Non-\nCOVID COVID -\n19 \nInfection Non-\nCOVID COVID -19 \nInfection Non- \nCOVID \nFrontline and outbreak presumptions in effect (7/6/2020 \u20136/3"] [13.682913780212402, 20.064714431762695, "iled by frontline workers. Sixty-seven percent of COVID-19 claim denials for frontline workers were reported to the WCIS within 40 days of the date when the claim was reported. Among frontline workers, the proportion of denials reported within this t"] [13.693314552307129, 20.07270050048828, "have occurred . \nEmployers outside of the health care context were less confident in determining the work-\nrelatedness of a claim. Beyond obvious cases, such as an outbreak in the office, employers \noutside of the health care context said it was dif"] [13.70969009399414, 20.085691452026367, "ck in their family, as illustrated by these two injured manufacturing workers: \nWell I know I was exposed at work. Two others got sick that I know of, but I was \nthe one that got the sickest. In my office I later heard others got sick as well. \nVario"] [13.687236785888672, 20.071340560913086, "ansmission post vaccination. Now with vaccination, the \nsymptoms are less and look like colds or allergies, so the employees are coming \nto work. In one case, someone had been vaccinated and came in to work on \nThursday but tested positive on the we"] [13.70959186553955, 20.092864990234375, "use case law \nto determine that for exposure at work as an outbreak. When we got clarity on the \noutbreak definitions, we could apply that definition to the claims. \nTracking systems were built quickly and had to track multiple aspects of positive "] [13.694215774536133, 20.074951171875, "mber of employees, \nface the same risk without any knowledg e on the workplace environment. Is it 25 \n 148 in a small space like a retail store, or are these same 25 workers in a giant \nwarehouse? That is a whole different situation. How much ventil"] [13.705276489257812, 20.087146759033203, "racing workflow that w e had went really well. We had to \ndevelop the templates, train the HR staff, and we had it set up in April 2020 as a \nseparate reporting mechanism. The legislation came out after that so we were already there when the law came"] [13.703983306884766, 20.081134796142578, "ituation where that got challenged. We had an employee who got sick \nand there would be a carpool of people who rode together. If carpooling toge ther \nto and from work, that is not a workers\u2019 comp issue. If they were going from one \nfield to anothe"] [13.716755867004395, 20.09376335144043, "h employer cited variation in response to guidance revisions: \nWe required whatever the CDC had in place at the time. It changed at least four \ntimes that I can remember. We would ask the same questions with the \nemployees. . . . So initially this w"] [13.70952320098877, 20.086645126342773, "e to pay for people to \nbe at home. Hospitals with a larger bankroll can pay for employees to be out \nlonger. For hospitals without that financial backing, they had to bring people in after those 14 days in any capacity . They could because they nee"] [13.644410133361816, 20.038450241088867, "ifferent requirements of the two SB 1159 presumptions. Reporting requirements and outbreak tracking were an administrative burden, requiring the development of retrofitting for data systems. Some employers, particularly in home health and manufacturi"] [13.579672813415527, 19.976055145263672, "nial ($4,480 of paid and settled indemnity benefits by August 2021).\n21 Quigley et al., 2021, \nwhich focused on claims filed by public safety workers, also found that claims initially denied \noften resulted in substantial paid benefits. However, we d"] [13.574400901794434, 19.9727725982666, "ection Non-\nCOVID Total \nPrepandemic (2019) $3,619 $3,619 $2,595 $2,595 \nPandemic, before \ntemporary presumption (1/1/2020 \u20133/18/2020) $1,717 $3,002 $2,968 $848 $2,208 $2,203 \nTemporary presumption \n(3/19/2020 \u20137/5/2020) $2,067 $2,853 $2,600 "] [13.533197402954102, 19.917699813842773, "ration \nAdjusted mean TD duration \n(January 2020\u2013 June 2021 \ninjury dates) 25.3 53.3 22.1 61.9 \n \nMedian TD duration \nPre-pandemic (2019) N.A. 28 N.A. 42 \nPandemic, before temporary \npresumption (1/1/2020 \u2013\n3/18/2020) 24 20 23 41 \nTemp"] [13.58618450164795, 19.98275375366211, "claims with initial denials and claims with zero paid benefits. \n \nTable 8.3 reports the total amount of paid and settled indemnity benefits to date for COVID-\n19 and non\u2013COVID-19 claims. As suggested by the rates of benefit receipt reported in Chap"] [13.586267471313477, 19.98414421081543, "m July 6, 2020, \nthrough June 30, 2021, 77 percent of COVID-19 claims from frontline presumption workers and \n85 percent of COVID-19 claims from other workers had no medical bills submitted to WC as of July 2021. For other WC claims submitted during "] [13.591699600219727, 19.985057830810547, "r medical care through July 2021 by group of workers, COVID-19 claim status, and date of injury. When we restrict attention to claims with medical bills submitted to WC, COVID-19 claims (across all occupations) submitted in March 2020 or later have h"] [13.601518630981445, 19.994979858398438, "ere COVID, but other interview findings and other measures of claim severity suggest that many more low-severity claims may have been filed for various reasons. We also heard from interview subjects that, in some cases, workers with severe disease wh"] [13.58874225616455, 19.98345947265625, "ry \npresumption \n(3/19/2020 \u2013\n7/5/2020) 6.39 0.74 7.90 0.93 7.01 0.89 \nSB 1159 \npresumptions in \neffect (7/6/2020 \u2013\n6/30/2021) 3.90 0.56 4.22 0.82 4.04 0.77 \nTotal (1/1/2020 \u2013\n6/30/2021) 4.51 0.59 5.00 0.83 4.73 0.79 \nAdjusted total 4.51 0.47 5.0"] [13.586385726928711, 19.981889724731445, "he entire pandemic period (January 2020\u2013June 2021), spending on COVID claims involving inpatient hospitalization ($51,780) was several thousand dollars lower than on non-COVID claims involving inpatient hospitalization ($54,621). \nTo sum up, even whe"] [13.590193748474121, 19.9816951751709, "sted total 46,206 50,820 57,570 56,038 51,780 54,621 \nNOTES: Medical spending was winsorized at $ 634,862, which was the 99th percentile of total medical spending \namong claims with 2019 or later injury dates that had one or more inpatient hos"] [13.626290321350098, 19.957448959350586, "ms with one or more medical bills submitted to WC versus 0.63 percent of non\u2013COVID-19 claims), and more than three times more likely than non\u2013COVID-19 claims to involve ICU care billed to WC (0.34 percent of COVID-19 claims with one or more medical b"] [13.649580001831055, 20.042797088623047, "to date), with estimates reported for the system as a whole, for the different presumptions established for frontline workers and those in other industries under SB 1159, and for specific industries and occupations across the California economy. We a"] [13.620299339294434, 20.017250061035156, "ercent of the claim volume in the system. In most months of the pandemic, COVID-19 cases were around 10 percent or less of the total volume of WC claims. However, because claim volumes by month generally followed surges in statewide COVID-19 case vol"] [13.625648498535156, 20.01763916015625, "nvolved \nin claims administration for many public-sector entities suggested strongly that denied claims often lacked a positive PCR test result for the worker. These high denial rates should be kept in mind when interpreting differences in benefit re"] [13.65158462524414, 20.033483505249023, "ate health insurers and HRSA early in the pandemic (and phased out in summer 2021) to pay co-pays and deductibles related to COVID-19 care in addition to waiving out-of-pocket costs for hospitalization with COVID-19 for those workers who were fully i"] [13.651873588562012, 20.046030044555664, "e or covered by presumptions. Other limitations are discussed at length in Chapter 4. Rather, this analysis should highlight the need for future study that evaluates what sources of financial compensation (including, but not limited to, WC) have \nbee"] [13.64745044708252, 20.03937339782715, "y coverage of COVID-19 for some of the most exposed public \nsafety and health care workers. \nAmong most workers who were not covered by the frontline presumption, denial rates were \ngenerally higher than those observed among health care and, especia"] [13.639081954956055, 20.02630043029785, "feature of protecting workers\u2019 income with TD benefits and death benefits, as well as covering medical care costs for both frontline workers and nonfrontline workers exposed during an outbreak at work. \nThe appropriateness of the frontline presumpti"] [13.688759803771973, 20.070077896118164, "sumptions by public health knowledge was not as clear for the outbreak definition thresholds and the different workplace definitions and scenarios across industries and workplace composition. \nProvision of Medical Care \nWC was not viewed by these st"] [13.662528991699219, 20.049184799194336, "fits, if and when these are paid out, are likely to be very important for protecting workers and their surviving dependents against income loss caused by more-severe COVID-19. So, it seems likely that COVID-19 claims promote the objective of protecti"] [13.672250747680664, 20.05718421936035, "rsed resulted from the shortened timelines, this would suggest that the shortened timelines added administrative burden that does not support an efficient delivery system of WC benefits. \nGiven the global and national nature of the pandemic, which wa"] [13.66302490234375, 20.046016693115234, "e employers and nonemployee workers (e.g., grocery stores where workers might include store employees, security guard contractors, and various vendors and delivery workers employed by transportation firms or self-employed as independent contractors)."] [13.655418395996094, 20.036840438842773, "xposures: Such research efforts should be prioritized both for understanding the unequal impacts of the current pandemic and for developing prevention strategies relevant to the ongoing fight against COVID-19 or possible future pandemics. \nOur qualit"] [13.656329154968262, 20.048070907592773, " several issues around the implementation of SB 1159 by claims \nadministrators that most likely vary by claims administrator characteristics (such as TPA versus SA, size of employer, etc.). A study is needed to answer, \u201cWhat claim processing practice"] [13.607268333435059, 20.012802124023438, "ow did COVID-19 claims \noutcomes (i.e., accepted, denied, reversals, conditional denials, and litigated or set tled \noutcomes) change over the course of a given claim? And how did COVID-19 claim outcomes \n 179 and processes vary during the different"] [13.592011451721191, 19.97666358947754, "ess, we reference-mined articles to identify additional relevant literature and asked experts about articles and reports. Details of our search and review are described elsewhere (Quigley et al., 2022). \nAs shown in Figure A.1, our PRISMA flow diagra"] [13.574560165405273, 19.974637985229492, "dies and one was a gray literature study). Three of these studies were on workplace health and safety, hospitalizations and medical care, and staffing, and one was about the development and field test of a return-to-work symptom screening tool implem"] [13.6575927734375, 20.035598754882812, "spitalizations \nand Medical \nCare \n \n(n = 2) Other: \nStaffing, \nHealth \nInsurance \n \n(n = 2) \nPeer-reviewed: \nStudies \n(n = 3) Lichtman et \nal., 2021 Pasco et al., \n2020 \nHarrington et \nal., 2020 Lichtman et \nal., 2021 Pasco et al., \n2020 \n"] [13.628933906555176, 20.005687713623047, "the past five years, gig workers have brought legal cases around the w orld, \nseeking to obtain the same benefits and legal protections as traditional employees. The results, however, have been far from uniform. Numerous courts, such as those in Ital"] [13.71627426147461, 20.087278366088867, " claimed they had not been able to work from home\u2014 for an y amount of time\u2014 since the Governor\u2019s stay -at-home \norder on March 19. \nNearly half (46%) were unable to affirm that their workplaces had safe practices for preventing COVID -19 spread. Onl"] [13.718107223510742, 20.09065818786621, " is based on 40% based on CDC data from the 2018 National Health Interview Survey (NHIS). The sample includes individuals who reported being employed (18 years and older). Access to paid sick leave rates are calculated for employed individuals who re"] [13.713299751281738, 20.087560653686523, " at a \ndrive- through testing \ncenter for COVID -19 \nin Broward County, Florida , were \nscreened for COVID -19 infection \n44% male, \nmedian age 42 \nyears ( interquartile \nrange 33\u201352 years) A total of 2,902 first responders (85.9%) were asymptoma"] [13.748345375061035, 20.118812561035156, "erations. Prior research has shown that paid sick \nleave coverage induces contagious employees to take sick leave, thereby reducing influenza activity during normal times. However, \nas of the conduct of this article, it has been unclear whether this"] [13.71407413482666, 20.073455810546875, "ing review; Employers misclassify employees as independent contractors to save on paying f or employee benefits, \nemployment taxes, and workers\u2019 compensation and unemployment \ninsurance premiums which, as previously noted, can add up to \n30% on top o"] [13.739809036254883, 20.109760284423828, "ab. The mean and median number of days from first positive to first negative were 17.1 (SD, 6.7) and 17 (IQR, 9), with a minimum of 2 days and a maximum observed of 38 days. Of the 425 HCWs with positive \nSARS- CoV-2 test results, 263 (61.9%) had a s"] [13.73292350769043, 20.109033584594727, "plant workers \nin the United States \nand Canada The world\u2019s top meat producer sent thousands of vulnerable U.S. \nworkers home on paid leave. Another company facing higher \nabsenteeism at its plants. Labor union warns extra hours taking a \nphysical "] [13.72463607788086, 20.091018676757812, " U.S. businesses have been on a silencing spree . Hundreds of U.S. \nemployers across a wide range of industries have told workers not \nto share information about COVID -19 cases or even raise concerns \nabout the virus, or have retaliated against work"] [13.736608505249023, 20.10687828063965, "g firm based in Evanston, Ill. \u201cBut the novel coronavirus is extremely contagious, and we do not have the diagnostics to tell us who has the virus and who doesn\u2019t.\u201d A business may need to change its traditional sick leave policies in \nlight of the co"] [13.715743064880371, 20.08890724182129, "parate and apart \nfrom their own employees,\u201d says [NAME]. \u201cVisiting clients and vendors are being asked where they have traveled in the last few weeks, and whether they are exhibiting any flu -like \nsymptoms.\u201d \n\u2022 Coordinating with vendors. Th e CDC "] [13.701196670532227, 20.07603645324707, "h COVID -19 develop \none or more long -term symptoms. \u201cWe don\u2019t know quite yet from \nthe literature if this virus is lying dormant in the tissue for a little while and then suddenly something activates it. There\u2019s more that \nwe don\u2019t know than what "] [13.59583854675293, 19.981571197509766, "or COVID- 19 and non -COVID -19 medical claims, as \nwas the nu mber of medical visits per claim. There was no delay for \nevaluation and management services, emergency room services, \nphysical therapy, or surgery. That was true whether the claims orig"] [13.724996566772461, 20.09295654296875, "9 \npandemic Literature on \nmanaging population health as employees return to work during the \nCOVID -19 \npandemic \nGuidance for \nself-insured \nemployers \n Employers are obliged to follow Occupational Safety and Health \nAdministration (OSHA) standa"] [13.753119468688965, 20.121889114379883, "ntified as being symptomatic with an indication for S ARS- CoV-2 testing and were \ndirected to the hotline to have this ordered. Of these, 82% reported not currently staying home from work due to illness or quarantine when first \nreporting symptoms. "] [13.7344388961792, 20.10295867919922, "ity, longe r incubation period, asymptomatic transmission, \nprolonged viral shedding), data from studies of influenza can shed light on \nthe potential role of the workplace in SARS -CoV-2 transmission. \nEvaluations of influenza epidemics have demonst"] [13.726824760437012, 20.076040267944336, "coping w ith the coronavirus. \nThe cheap -chic retailer said it\u2019s raising hourly pay by $2 until at least May 2 \nand offering paid sick leave of up to 30 days for staffers who are 65 or older, pregnant or have underlying medical conditions. It\u2019s als"] [13.72240924835205, 20.09236717224121, "ossing the legal line by being \ntoo aggressive,\u201d he says. \nCamillo, \n2020 Employer \nbenefits for workers News article, \nMarch 2020 Paid leave for \nworkers \n Warehouse Close to 100 Amazon.com Inc. warehouse workers in Staten Island, New \nYork, ar"] [13.712273597717285, 20.087018966674805, "\nproof of a causal connection that a covered injury or disease was \ncontracted in the workplace is essential for a stable no -fault workers \u2019 \ncompensation system for employers and employees alike.\u201d Sampson added it is important to remember that unde"] [13.729748725891113, 20.104238510131836, "zon \u2019s wareho uses, or the independent contractors who deliver \npackages. \nHanna, 2020 Employer \n \nPresumption News article, April \n2020 Inclusion of \nworkers in \nCOVID -19 \npresumption Essential \nworkers New rules introduced last week \u2014which a"] [13.716166496276855, 20.085926055908203, "als. \nMoynihan, \n2020 Employer \n \nPresumption \n News article, \nMarch 2020 COVID -19 \npresumption \nand WC \ninformation Insurer However, by Wednesday evening the California governor\u2019s web site \nhad not immediately specified exactly what personne"] [13.731602668762207, 20.1030330657959, "ly straightforward. \nAbsent a contract or collecti ve bargaining agreement providing otherwise, \nhourly workers need be paid only for actual hours worked. To meet the \u201csalary basis\u201d test under the FLSA and many state laws, an exempt employee must rec"] [13.72586727142334, 20.09662628173828, "til April and allow workers to use their existing paid \ntime off to miss work if they feel unwell. Target similarly sai d it waived its \nabsenteeism policy, and that it would offer its current benefits including paid family leave and backup day care "] [12.836136817932129, 19.782148361206055, "cupation \nlevel for calculating rates in Chapter 4. The OEWS in 2019 and 2020 used a unique occupation \ncoding structure that BLS describes as a \u201chybrid\u201d of 2010 and 2018 SOC codes. A crosswalk from 2010 SOC codes (which are assigned by NIOCCS) and t"] [12.858509063720703, 19.763511657714844, " or direct supervision of construction or erection work) or \nmissing (public-sector claims, which are overwhelmingly self-insured, often have no \nclass code reported). \n2. The occupation description included the text \u201cFIRE\u201d (all occupation descriptio"] [13.061182975769043, 19.491065979003906, "ders. \n \n 210 Table C.1. Sample Construction and Comparison of Weighted and Unweighted Case Characteristics \n \n Unweighted \nCount of \nRecords Unweighted \nCount of \nRecords Unweighted \nAverage or \nProportion Unweighted \nAverage or \nProportion "] [13.276214599609375, 19.696596145629883, " 2016 \u20132021 0 0 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% \nOccupation group (defined on \npresumption tab) \nPublic safety 133,405 120,372 4.1% 3.4% 4.3% 5.67 6.1% 5.64% 6.0% \nHealth care 243,668 198,117 6.7% 6.3% 7.3% 10.45 10."] [13.382620811462402, 19.80185890197754, "eweight the non-\nCOVID claims to match the joint distribution of date of injury and occupation group observed among COVID claims. This provides an adjustment both for claim maturity differences and for differences in occupation mix between COVID and "] [13.596219062805176, 19.9703311920166, "o adjust for differences between COVID -19 and non \u2013COVID -19 \nclaims in date of injury and occupational group. See Chapter 3 and Appendix B for deta ils. Estimates in table include \nclaims with initial denials; claims with zero medical bills submitt"] [13.641910552978516, 19.99474334716797, " COVID-19: Imminent Hazard to Employees: Exposure: Notification: Serious \nViolations, September 17, 2020. As of November 15, 2021: \nhttps://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB685 \nBailey, M., and C. Jewett, \u201cFami"] [13.698991775512695, 20.004850387573242, "ptember 17, 2020. \nCalifornia Labor Code, Section 3212.88, Employees who test positive during an outbreak at \nplace of employment, September 17, 2020. \nCalifornia Workers\u2019 Compensation Institute, \u201cPhysicians,\u201d webpage, 2021. As of November 9, \n2021: "] [11.193583488464355, 18.190567016601562, ", \u201cDoctor\u2019s First Report of Occupational \nInjury or Illness,\u201d online form, 2020. As of December 6, 2021: \nhttp://www.dir.ca.gov/dwc/forms/5021.pdf \nDepartment of Industrial Relations, State of California, \u201cWorkers\u2019 Compensation Claim Form \n(DWC 1) & "] [13.681620597839355, 20.041255950927734, "\u201d Population Health Management, Vol. 24, No. S1, February 2021, pp. S3\u2013S15. As of January 10, 2022: https://www.ncbi.nlm.nih.gov/pubmed/33347795 \nGhilarducci, T., and A. Farmand, \u201cOlder Workers on the COVID-19-Frontlines Without Paid \nSick Leave,\u201d Jo"] [13.707437515258789, 20.06827735900879, ".bloombergquint.com/markets/trump-likely-to-reveal-sick -leave-tax-extension-\nplan-for-virus \nJewett, C., R. Lewis, and M. Bailey, \u201cMore Than 2,900 Health Care Workers Died This Year\u2014\nand the Government Barely Kept Track,\u201d San Francisco, Calif.: Kais"] [13.7853364944458, 20.130815505981445, "Booster Doses of COVID-19 Vaccines\u2014United States, 2021,\u201d MMWR: Morbidity and Mortality Weekly Report, Vol. 70, No. 44, November 5, 2021, pp. 1545\u20131552. As of January 10, 2022: https://www.ncbi.nlm.nih.gov/pubmed/34735422 \nMcDermott, D., and C. Cox, \u201c"] [13.703449249267578, 20.065046310424805, "ues New Executive Order Further \nEnhancing State and Local Government\u2019s Ability to Respond to COVID-19 Pandemic,\u201d \npress release, March 12, 2020. As of January 13, 2022: https://www.gov.ca.gov/2020/03/12/governor-newsom-issues-new-executive-order-fur"] [13.668766975402832, 20.020645141601562, "for Firefighters and Peace Officers Under Senate Bill 542, Santa Monica, Calif.: RAND Corporation, RR-A1391-1, 2021. As of January 10, 2022: https://www.rand.org/pubs/research_reports/RRA1391-1.html \nQuigley, D. D., N. Qureshi, G. Gahlon, and C. Gide"] [13.630488395690918, 19.982545852661133, "ih.gov/pubmed/32843110 \nSimpson, A. G., \u201cNo Delays Found in Medical Care for Workers\u2019 Compensation Claimants \nDuring COVID,\u201d Insurance Journal, Vol. 99, No. 9, April 26, 2021, pp. 23\u201324. As of November 10, 2021: https://www.insurancejournal.com/news"] [13.622121810913086, 19.973464965820312, "mber 13, 2021: https://www.bls.gov/oes/current/oes292040.htm#ind \nU.S. Census Bureau, \u201cHealth Insurance Historical Tables\u2014HHI Series,\u201d webpage, October 8 \n2021a. As of January 14, 2022: https://www.census.gov/data/tables/time-series/demo/health-insur"] [15.98330307006836, 10.455110549926758, "Sponsored by Pima CountyPima County Housing First \nInitiative\nFinal Evaluation Report Fall 2021\nRYAN K. MCBAIN, ADAM SCHERLING, BRIAN BRISCOMBE, \nSARAH B. HUNTER\nCORPORATIONFor more information on this publication, visit www.rand.org/t/RRA236-1 .\nAb"] [16.009241104125977, 10.466108322143555, "nclud ing health care, law enforcemen t, and legal services. We also \ndescribe program progress to da te, including patterns of referr al, eligibility, receipt of housing \nvoucher, housing obtainment, and pr ogram exits among the enroll ed population"] [15.994935989379883, 10.433061599731445, "ff\u2019s Department, \nand especially, Lindsay Eulberg , Ana Haley, and Ellyn Langer fr om Old Pueblo Community \nServices. Maya Buenaventura assisted with the literature review presented in th is report and \nTiffany Hruby assisted in report preparation. "] [16.008066177368164, 10.469898223876953, "ehavioral health needs. Our \nkey findings are described below. \nvi Participant Characteristics \n\uf0b7 Three hundred and fourteen participants were enro lled during th e pilot phase of the \nPCHF Initiative, of which 185 have obtained housing. Participan"] [16.015886306762695, 10.460092544555664, "on to Pima County \n(for criminal justice\u2013related cos ts) and the state (for health care costs bille d to Medicaid). \n\uf0b7 Accounting for programmatic costs, criminal justice\u2013related cos ts, and health care service \ncosts, we find that these indivi dual"] [16.002695083618164, 10.45860767364502, "-month basi s\u2014are likely to decrease when \nviewed over a two- to three-year tim eframe, as capital costs as sociated with the program \nare smoothed over this longer duration. \n4. Consider a larger-scale evaluation that includes a comparison group . A"] [16.14131736755371, 10.325028419494629, ".................................................................. 7 \nServices and Resources Consumed .......................................................................................................... 8 \nCost Estimation ....................."] [16.0086669921875, 10.454845428466797, "..................................................................................... ....................... 32 \nRecommendations ............................................... ............................................................... ......."] [15.99874210357666, 10.493021011352539, "acteristics ............ ......................................................... 14 \nTable 3.2. Living Situation Prior to Program Entry ............ .......................................................... 15 \nTable 3.3. Types of Health Conditi"] [15.90188980102539, 10.41772747039795, " housing (PSH) has emerged as a potential f ramework for meeting the \nneeds of individuals with multip le chronic health conditions wh o are experiencing homelessness in \ncommunities throughout the United States. PSH consists of a lon g-term housing "] [15.832275390625, 10.36957836151123, "2 significant barriers in securing stable housing and necessary treatment, driving higher rates of \nrecidivism, homelessness, a nd poor health outcomes among these individuals (Baillargeon, Hoge, \nand Penn, 2010; King, Tripodi, and Veeh, 2018; Messin"] [15.992863655090332, 10.44068431854248, "., 2021; Martinez and Burt, 2006; Shern et al., 1997; Some rs et al., 2013). Ho wever, reductions \nin jail service utilization have not been found in all instance s (Raven, Niedzwiecki, and Kushel, \n2020). Based on these fi\nndings, t he use of suppor"] [16.021425247192383, 10.458922386169434, "e in that report. Fig ure 1.1 provides an overview of \nthe PCHF Initiative\u2019s progress to date. We also note that, in t his pilot phase, the evaluation does \nnot contain a comparison group, which limits the ability of thi s report to specifically attr"] [16.009098052978516, 10.456698417663574, "alth status, income and bene fit status, household type, prior homelessness experience, and \nprior history with the criminal justice system are all importan t considerations that may shape \nprogram success. Therefore, we took a broad look at the par"] [16.019424438476562, 10.475800514221191, "of program \nmilestone dates for each enroll ee and transmitted these dates t o the research team via an encrypted \nserver containing de-identified client information. Files were updated and resubmitted several times between April and August 2021 for "] [16.041610717773438, 10.459768295288086, "equirement for program inclusion). Thus, we examined ser vices and resources consumed \nalong these three axes: criminal justice system engagement, health care services , and housing/ \nprogrammatic services. While part icipants were liable to genera t"] [16.040685653686523, 10.503297805786133, "outpatient health care service utilization or behavioral healt h services, both of \nwhich we would expect were utilized significantly over the cour se of the program. \nHousing Services \nOPCS shared key service date information, including program enr "] [16.112424850463867, 10.481971740722656, "e typ es (felonies, misdemeanors, or \nprobation) across diffe rent fiscal years. T hese values were the n applied across participants \nwho utilized public defense services, base d on case type and fi scal year in which the case \nwas processed. \nSecon"] [16.088104248046875, 10.485919952392578, "tilization from a pre-enrollment period, consisting of the 12 months prior to program enrollment, to a post-enrollment period, consisting of the 12 months follow ing program enrollment. The study \npopulation considered in these statistical analyses w"] [15.98769760131836, 10.5365629196167, " the data and were therefore unlikely t o be associated \nwith changes in service utilization over time. The tests did no t seek to determine whether any \nchange in utilization was caused by program enrollment. Such causal attributions are not \nposs"] [16.017929077148438, 10.285054206848145, "had a score of 8 or higher \n(range: 0\u201318). \nPrior Housing and Homelessness History \nAdministrative and self-reported d emographic information from p articipants indicated that \nprogram participants had extensi ve prior experience with homele ssness: "] [16.00786590576172, 10.588029861450195, "Security Disability Income or Social Security Income, and the remaining \n25 percent had some other source of income. Am ong those participants who received an income, \nincome amounts varied from $50 a month to $3 ,920 a month, with a median of roug"] [16.014047622680664, 10.61047077178955, "icipant Health Conditions 12 Months Prior to Pro gram Intake \nHealth Conditions Percentage (%) of clients\nParticipants with Health Services in One Service Category \nPhysical condition only 33 \nSubstance use condition only 2 \nMental health conditio"] [16.263036727905273, 10.447423934936523, "res. Emergency room visit s were more much more \ncommon than inpatient stays. Tes ting services accounted for les s than 2 percent of the estimated \ntotal health care expendi tures during this period. \nCriminal Justice Service Utilization and Costs \n"] [16.072519302368164, 10.456499099731445, "218 719 $136,054 $433 $123 $5,717 \nDeflection 18 20 $2,133 $7 $104 $214 \nActive Outreach 1 1 $127 $0 $127 $127 \nJail Booking 211 464 $104,979 $334 $222 $2,267 \nField Release 91 234 $28,815 $92 $121 $3,450 \n Cumulative total 306 See belo w $4,163,408"] [16.03915786743164, 10.486501693725586, "st participants five to seven weeks to obtain a housing voucher. After \nreceiving a housing voucher, par ticipants were typically placed in housing in less than two months. \nOverall, the median time from referral to housing was between f ive and six"] [15.976884841918945, 10.569374084472656, "s. \nb Monthly cost based on client-m onths contributed by each client , inclusive of multiple entry and exit dates from \nthe program for individual clients, if applicable. \nlooked similar over time in terms of resource utilization. The third and fou"] [16.056419372558594, 10.43437385559082, "Based on total person-months contributed. \nFigure 4.3. Program Services: Per Client, per Month over the An alytic Period \n \nHousing Status and Service Use \nOf the 185 individuals who have been enrolled and placed into h ousing since program \ninceptio"] [16.082870483398438, 10.508284568786621, "the pre-enrollment period. \nAn exception to this pattern was the Adult Probation Department , where there was a small \nincrease in participants using t hese services in the post-enrol lment period. The largest reductions \nobserved were for Pima Coun"] [16.179424285888672, 10.441977500915527, "f Service Even ts in the Pre- and Post-Progra m Enrollment Periods \nEntity Number of Events \nCriminal Justice Pre-Enrollment Post-Enrollment Difference p-value \nPima County Adult Probation Dept. 134 140 6 (4%) 0.32 \nPima County Pretrial Service"] [16.003896713256836, 10.543054580688477, "es \nas well. In summary, there was a 47-percent reduction in overall service costs from the post- to \nthe pre-periods among this cohort of 186 participants. \nTotal Costs Pre-Enrollment and Post-Enrollment \nTotal costs represent the combin ed, cumula"] [16.0435791015625, 10.446534156799316, "s July 1, 2020, 73 were still housed \n12 months after moving in, yiel ding a 12-month housing retentio n rate of 82 percent. \n\uf0b7 Among those who had been enrolled in the PCHF Initiative for 12 or more months \n(n = 186), we found significant reducti"] [15.839486122131348, 10.286650657653809, "l. \nFUSE focuses on individuals who are frequent users of jails, ho meless shelters, hospitals, and \nother crisis public services. C urrently, 18 jurisdictions are i mplementing FUSE programs that \nfocus on justice-involved individuals (Holliday et "] [15.974386215209961, 10.389415740966797, " and legally suitabl e for diversion int o supportive hous ing in the \ncommunity (Holliday et al., 2020). A 78-percent housing stabili ty rate at one year was found \namong 349 enrollees. To date, 44 perce nt of evaluated participants have not had a q"] [15.998620986938477, 10.46169662475586, "tudy\u2014emergency and inpatient services\u2014are \nmuch more limited, and therefore s everal sets of health care co sts (e.g., outpatient care) are likely \nto have been omitted. Ultimately, a program such as the PCHF In itiative that tends to enroll \nyounge"] [15.973721504211426, 10.475838661193848, "r. Timeliness may, ultimately, result in \nincreased client retention. Likewise, establishing administrati ve processes to more closely \nmonitor reasons for program ex it across program milestones may shed additional light on ways \nto improve the prog"] [15.95422077178955, 10.444493293762207, "s to care ear lier or addre ssing behavioral \nhealth needs before escalating to emergent or inpatient health care. \n5. Take Stock of Current Program Successes \nOverall, this pilot ev aluation indicates sev eral early successe s in the PCHF Initiativ"] [16.03013801574707, 10.424478530883789, "e d in terms of generalizability to other populations that may be \nappropriate for receiving PSH in Pima County. We did not receiv e data on individuals referred \nbut not enrolled in the program, s o we were unable to examine any differences that ma"] [6.631381511688232, 15.857137680053711, "iable Value N Percentage (%) \nAge 18\u201325 16 14 \n 26\u201335 43 39 \n 36\u201345 36 32 \n 4 6\u201355 14 13 \n 56\u201365 2 2 \nRace American Indian/Alaska Native 6 5 \n Asian 1 1 \n Black or African American 10 9 \n Native Hawaiian/Pacific Islander 2 2 \n White 83 75 \n Client do"] [16.096988677978516, 10.47389030456543, "od before enrollment with that of the 12-month period after \nhousing receipt. \n \n42 Table A.5. Number of Participant s Using Services Pre-Enrollment and Post-Housing Periods \n(n = 189) \nEntity Participants Utilizing Servicesa \nCriminal Justic"] [15.982847213745117, 10.595422744750977, "0.19 \nOverall $4,501 $2,332 \u2013$2,169 (\u201348%) <0.01 \nNOTE: P-values are from a paired t-test for the mean total service costs per participant, i ncluding participants who \nreceived no services. P-values hav e been adjusted for multiple comparisons usin"] [15.680719375610352, 10.315531730651855, "lse Dis covery Rate: A Practical and \nPowerful Approach to Multiple Testing,\u201d Journal of the Royal Sta tistical Society Series B , \nVol. 57, 1995, pp. 289\u2013300. \n46 Bernstein, Rebecca S., Linda N. Meu rer, Ellen J. Plumb, and Jef frey L. Jackson, \u201cDi"] [15.78388786315918, 10.243279457092285, " of Homecoming: Inc arceration and the Housing \nSecurity of Urban Men,\u201d Social Science Research , Vol. 40, No. 4, 2011, pp. 1196\u20131213. \n47 Gillespie, Sarah, Devlin Hanson, Mary Cunningham, Michael Perga mit, Shiva Kooragayala, \nKathryn Nearing, Trac"] [15.771899223327637, 10.198848724365234, "Partic ipants\u2019 Housing Stability and New Felony \nConvictions , Santa Monica, Calif.: RAND Corporation, RR-3232-BRC, 2019. As of \nSeptember 29, 2021: \nhttps://www.rand.org/pubs/research_reports/RR3232.html \nJacobs, Leah A., and Aaron Gottlie b, \u201cThe "] [15.760095596313477, 10.285942077636719, "Program for High \nRisk Offenders,\u201d Criminal Justice and Behavior , Vol. 41, No. 4, 2014, pp. 471\u2013491. \nMartinez, Tia E., and Martha R. B urt, \u201cImpact of Permanent Supp ortive Housing on the Use of \nAcute Care Health Services by Homeless Adults,\u201d Psyc"] [15.711400032043457, 10.247077941894531, "hemes/s tehTheme/docs/ \nCoordinatedEntry/VI-SPDAT-v2.0-Single-US-Print%20rev.pdf \nOsher, Fred C., and Henry J. St eadman, \u201cAdapting Evidence-Based Practices for Persons with \nMental Illness Involved with the Criminal Justice System,\u201d Psychiatric Ser"] [15.754419326782227, 10.266410827636719, "arlotte-Mecklenbur g Research & Evaluation Project: Final Report, Charlotte, N.C.: \nMecklenburg County, UNC Charlotte College of Health & Human Ser vices, School of Social \nWork, and the UNC Charlotte Urb an Institute, 2020. As of February 16, 2021:"] [14.398205757141113, 12.82292652130127, "LU DONG, JENNIFER BOUEY, DOUGLAS YEUNG, PEGGY G. CHEN, PRIYA GANDHI\nAddressing Anti-Asian \nRacism in the Era of COVID-19\nNext Steps for a Research Agenda\nThe Asian American1 community is a diverse and fast-growing racial group in the United \nStates. "] [14.398795127868652, 12.823492050170898, "r hate incidents than the national average in both 2020 and 2021,\n7 with about one \nin four AAPIs affected overall.8 Anti-Asian hate \ncrimes and incidents (including avoidance, verbal \nharassment, civil rights violations, and physical assault) incre"] [14.39997673034668, 12.825358390808105, "f anti-Asian racist incidents \nhighlights an urgent need for strategies to reverse the historical neglect toward the AAPI community by research and policy leaders and to build resilience and support resources for the AAPI community. 3\ncommunities\u2019 re"] [14.409401893615723, 12.826956748962402, " [Facebook, Twitter, Instagram]). We then randomly selected California-based organizations stratified by specific subgroups (e.g., young people, older people, women, LGBTQ people, AAPI in general, Chinese, South Asian, other East and Southeast Asian "] [14.4009428024292, 12.826247215270996, " advocacy groups (Table 1). The organizations serve diverse AAPI communities\u2014from ethnic communities (e.g., Chinese, Korean, South Asian) to specific populations (e.g., youth, women, sexual and gender minority individuals). We now present our key fin"] [14.401335716247559, 12.826006889343262, "ization Demographic data and policy research AAPIs\nCBO in Northern California Civil rights AAPIs, particularly immigrants\nCBO in Northern California Health, legal services, public policy, and wellness Indians and Indian Americans\nCBO in Northern Cali"] [14.399685859680176, 12.824419021606445, " of the times who\u2019s being lifted up is often East Asians. And there is a hierarchy between different Asian ethnic groups, and there has not been enough attention to AAPI groups who are being criminalized and refugee AAPI folks . . . [it] really tries"] [14.40093994140625, 12.825653076171875, "terns that it\u2019s difficult to argue otherwise that all of these things are informed by broader global tensions that exist.\nCommunity Impact\nAnti-Asian Incidents Negatively Affect \nAAPI Communities\nInterviewees described how anti-Asian hate incidents \n"] [14.398419380187988, 12.826287269592285, "increased recognition among the AAPI \ncommunity of discriminatory and racist experiences that people belonging to specific Asian subgroups (e.g., South Asians) have long faced (e.g., prejudice after the attacks on September 11, 2001), as well as the "] [14.400850296020508, 12.826208114624023, " NHPIs are vastly different from AAPI communities at large. A leader of a national organization serving NHPI populations said that disparities relating to the impact of the COVID-19 pandemic affected the Pacific Islander communities more than hate in"] [14.400468826293945, 12.82523250579834, "sian hate in the United States. A leader of a national coalition of AAPI organizations explained,\nWe welcome debates on China and broader \nglobal geopolitical issues. But when describing China in a way that can be used to actually encourage anti-Asia"] [14.399553298950195, 12.823097229003906, "\nneed more resources to provide direct support and services to victims of hate incidents, including translations and services related to mental health, immigration, and legal issues.11\nI\u2019m trying to create a different strategy for \nour funding so tha"] [14.400532722473145, 12.825301170349121, "er communities of color because of their experiences with police brutality. \nBeyond addressing specific hate incidents, \nmost interviewees pointed to the neglected issue of systemic racism, emphasizing the importance of addressing persistent and long"] [14.40328311920166, 12.821187019348145, "\u2019re seeing, and the disproportional impact is a function of the fact that we\u2019ve ignored health disparities in our communities for so long. The government has not invested in that data collection that\u2019s necessary. And certainly, those disparities have"] [14.400839805603027, 12.82283878326416, " anti-Asian hate incidents. In addition, interviewees cited unanswered questions about the rate at which Asian students were choosing not to return to school during the COVID-19 pandemic, whether and how Asian students were being protected from bull"] [14.40068531036377, 12.82398509979248, "ork.\nAssess How the K\u201312 Education \nSystem Covers the Asian American Experience\nInterviewees also discussed much-needed research \nand data on how much AAPI history and culture are currently covered in the U.S. education system, which would be a start"] [14.40062427520752, 12.823450088500977, "torically entrenched and persistent anti-Asian racism at individual and systemic levels in the United States. Many of the recommendations are not new to those who are familiar with AAPI issues and research: For decades, scholars and advocates repeate"] [14.401001930236816, 12.824719429016113, " identified three domains for focusing policy action. Because of the exploratory nature and limited scope of this project, these observations and suggested next steps for a research agenda may not represent all viewpoints and aspects of Asian America"] [14.400221824645996, 12.825702667236328, "gh collecting more and better disaggregated data. Importantly, disaggregated data should be collected using culturally and linguistically appropriate instruments to ensure that all subgroups of the community are well represented. As noted, this recom"] [14.399500846862793, 12.822528839111328, "her racial and ethnic groups, and such institutions as the government and law enforcement. For the Asian American community, building relationships requires sensitivity about the challenges facing other racial and ethnic minorities, building a broade"] [14.400147438049316, 12.825186729431152, "groups to form alliances as a community. \nBuilding alliances across AAPI community \norganizations will require financial resources (e.g., local government community grants, foundation grants), technical support, and staff training. Recent anti-Asian "] [14.400374412536621, 12.824667930603027, "ommend for stopping or mitigating the negative \nimpact of anti-Asian racism?\nData sources and information gaps \u2022 Wh\nat are the data sources you have used in the past or currently use in your \nroutine projects? How can we advocate for more data for AA"] [14.400273323059082, 12.822646141052246, " Reported,\u201d Data Bits blog (AAPI Data website), March 30, 2021.\n9 Center for the Study of Hate and Extremism, California State \nUniversity, San Bernardino, Anti-Asian Hate Crime Reported to Police in America\u2019s Largest Cities: 2019 & 2020 , fact sheet"] [14.395378112792969, 12.827414512634277, "May 20, 2021.\n22 Stanley Sue, Derald W. Sue, and David W. Sue, \u201cAsian \nAmericans as a Minority Group,\u201d American Psychologist , \nVol. 30, No. 9, 1975.\n23 Tiffany Yip, Charissa S. L. Cheah, Lisa Kiang, and \nGordon C. Nagayama Hall, \u201cRendered Invisibl"] [14.38757038116455, 12.836511611938477, "n, Xiaoli Zong, \nHyun Su Cho, and Xiaofang Xue, \u201cCOVID-19 Racism and Mental Health in Chinese American Families,\u201d Pediatrics , \nVol. 146, No. 5, November 2020, e2020021816.\nChen, Justin A., Emily Zhang, and Cindy H. Liu, \u201cPotential \nImpact of COVID-"] [14.394984245300293, 12.828344345092773, " Gaps Among Asian Americans and Pacific Islanders: What Disaggregated Data Reveals in Washington State , Los Angeles, \nCalif.: iCount: A Data Quality Movement for Asian Americans and Pacific Islanders, March 2015. As of October 5, 2021: https://files"] [14.382363319396973, 12.835101127624512, "sian-Americans and Pacific Islanders in COVID-19: Emerging Disparities Amid Discrimination,\u201d Journal of General Internal Medicine , Vol. 35, No. 12, December \n2020, pp. 3685\u20133688.\nYellow Horse, Aggie J., Russell Jeung, Richard Lim, Boaz Tang, \nMega"] [12.687776565551758, 13.70860481262207, "roving health and racial equity. Gandhi holds an M.S. in health care policy and management.RR-A1594-1The RAND Corporation is a research \norganization that develops solutions to public policy challenges to help make communities throughout the world sa"] [12.649231910705566, 13.567455291748047, " con-ducted in the Social and Behavioral Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as risk factors and prevention programs, social safety net programs and other social supports, poverty, aging, disa"] [8.627418518066406, 4.008094310760498, "The Magnitude \nand Sources \nof Disagreement\nAmong Gun Policy \nExperts\nRosanna Smart, Andrew R. Morral, Terry L. Schell\nCORPORATION\nA PART OF THE RANDGun Policy\ninAMERICA\nINITIATIVESECOND EDITIONFor more information on this publication, visit www.ra"] [8.58456802368164, 3.7263236045837402, "policymakers and the general public can access unbiased information that facilitates develop -\nment of fair and effective firearm policies. \nIn 2018, RAND published a report (Morral, Schell, and Tankard, 2018) that describes \nresults from a 2016 surv"] [8.60916519165039, 4.038336753845215, "o be the likely effects of different gun policies. \nThis work should be of interest to policymakers and other stakeholders considering deci-\nsions related to firearm policy. Furthermore, this report may be of interest to the research community and to"] [8.684576988220215, 4.045050144195557, ", there may be relatively robust evidence that the law has a beneficial effect on a particular outcome (e.g., it reduces firearm homicides), but there remains little scientific evidence on the law\u2019s potential trade-offs or unintended consequences.\n1 "] [8.573384284973145, 3.6633460521698, "reement on those effects\n4. ev\naluate the extent to which differences in the policies favored by classes of experts \nresult from disagreements about the policies\u2019 true effects or disagreements in experts\u2019 \npolicy objectives or values\n5. up\ndate the o"] [8.534002304077148, 3.6396632194519043, "n sale of \u201cassault weapons\u201d and high capacity magazines\n3. a st\nand your ground law\n4. ex\npanded mental health prohibitions\n5. req\nuired reporting of lost or stolen firearms\n6. re\nquiring a license to purchase a firearm or ammunition\n7. req\nuired rep"] [8.557233810424805, 3.6150472164154053, " more-restrictive regulatory approaches to gun \nownership and use. Because this was not a representative survey, the difference in the sizes of these groups provides no information about the relative numbers of experts in the commu -\nnity whose views"] [8.551238059997559, 3.6216111183166504, " two groups also disagreed about which policies would reduce this outcome the most, as well as how large of an effect any policy would have. Across the 19 policies that we asked about, the median permissive group member expected the larg -\nest effect"] [8.558873176574707, 3.621147394180298, "2003b, 2009a, 2009b; Donohue, Aneja, and Weber, 2019; Lott, 2003, 2010; Lott and Mustard, 1997; Moody and Marvell, 2008, 2009, 2019, 2020). Still, the magnitudes of the discrepancies in beliefs about the relationship of gun own -\nership and homicide "] [8.56888484954834, 3.610628366470337, "r effects on the right to bear arms and individuals\u2019 privacy. The median restrictive group member believed Summaryxithat these policies had no effect on either of the qualitative outcomes, while the median per -\nmissive group member perceived the two"] [8.567025184631348, 3.6527230739593506, "e policies and those who favor more-restrictive policies appear to have a broadly similar set of policy priorities or objectives that lead them to agree on what policymakers should attempt to achieve through improved gun policy (pri -\nmarily, reducin"] [8.550878524780273, 3.629988670349121, "hen considering a policy that led to 100 fewer firearm homicides, the median permissive group member expected a resulting increase of 25 nonfirearm homicides, whereas the median restrictive group member expected an increase of two nonfirearm homicide"] [8.591567039489746, 3.7191035747528076, "hich there is no common ground, it might be useful in gun policy negotiations to focus more clearly on the goals that the two sides share. \n3.\n If t\nhe majority of policy disagreements are associated with factual questions about \npolicies\u2019 true effec"] [8.57398509979248, 3.7122952938079834, "...................................... v\nFigures and Tables ..................................................................................... xvii\nCHAPTER ONE\nIntroduction ........................................................................"] [8.573051452636719, 3.6482162475585938, "Experts, Second EditionxviCHAPTER SEVEN\nDiscussion and Conclusions ........................................................................... 57\nExpert Groups\u2019 Assessments of Policies and Their Effects Showed Some Areas of \nAgreement ............"] [8.573225975036621, 3.596046209335327, " ............................................ 30\n 4.\n4. Re\nspondent Relationship to Gun Policy, by Expert Class ............................. 30\n 4.\n5. Po\nlicies Rated as Most Beneficial and Most Harmful for Each Outcome, \nby Expert Class ......."] [8.621977806091309, 4.084858417510986, "(Lott, 2015) and to reduce such risks (Giffords Law Center to Prevent Gun Violence, undated).\n1 \nIt may be true that a law could increase one type of gun violence and decrease another \nor that the effects of a law implemented in one state might be di"] [8.58691692352295, 3.7013959884643555, "n policy debates and decisions. But these opinions are not a substitute for scientific evidence (Sch\u00fcnemann, Zhang, and Oxman, 2019); although advocates\u2019 and ana -\nlysts\u2019 opinions might be shaped by existing science, they are subject to potential bia"] [8.572853088378906, 3.6622040271759033, "the Gun Policy Outcome Explorer: An \nExpert Opinion Comparison Tool, but we revised the name to better reflect that it is based on experts\u2019 esti -\nmates of gun policies\u2019 effects.Introduction3scientific study to clarify what is true and help build con"] [8.55974006652832, 3.6853840351104736, " crime. Kleck, Gertz, and Bratton (2009) asked about the effects of handgun bans on two outcomes, homicides and robberies. It is possible, how -\never, that, when judging whether to support gun policies, respondents consider other out -\ncomes as well."] [8.57992172241211, 3.6719255447387695, "mes likely was compa -\nrable to that of the general public and, like the general public\u2019s knowledge, was likely shaped by the views of the experts and advocates whom they or their peer groups regarded as cred -\nible interpreters of the science of gun"] [8.57522201538086, 3.656606435775757, "ample \nof experts by instead looking for subgroups of experts whose views are especially coherent or authoritative on the effectiveness of gun policy. Lott and Mauser (2016), for instance, com -\npared views of gun policy experts who were trained as e"] [8.574234962463379, 3.686018943786621, "ke no effort to establish a consensus or an average estimate of experts\u2019 views \non policy effectiveness. Instead, in our sampling procedure, we sought competing and alternative views on gun policy so that we could instead characterize major dif -\nfer"] [8.580667495727539, 3.71563982963562, "details the data sources, calculations, and additional assumptions for \nthe online tool.9CHAPTER TWO\nSample of Policy Experts\nAs explained in Chapter One, we use gun policy experts to refer to a diverse group of people \nwith a professional interest "] [8.612152099609375, 3.937157392501831, "ucted a systematic search of the Social Science Citation Index (available through the Thomson Reuters Web of Science data -\nbase), which indexes articles in most behavioral science, economics, and law review journals. Specifically, we searched for re"] [8.585453033447266, 3.7546796798706055, " Smith\nJoseph L. Annest Eric W. Fleegler Andrew McClurg Susan B. Sorenson\nPaul S. Appelbaum Shannon Frattaroli Bentson H. McFarland Richard Spano\nIan Ayres Sandro Galea Edmund F. McGarrell Kenneth Tardiff\nDebra Azrael Marc Gertz Emma E. McGinty Amy T"] [8.599353790283203, 3.874288320541382, "ings Institution, Ethics and Public Policy Center, Heritage Foundation) and then searched the websites of these organizations for articles written about state or federal gun policy. From this search, we identified 20 individuals who had authored rele"] [8.593149185180664, 3.802783727645874, "k Force for Global Health\na In the 2016 survey, organizations could nominate experts or request passwords for the survey so that they could invite \nexperts to participate anonymously. \nb We and other members of the RAND Gun Policy in America project "] [8.589038848876953, 3.953010082244873, " as a state law. We also solicited information from experts on five new policies not considered in the 2016 survey. We selected these five new policies using similar procedures to those for our original survey. Briefly, we drew from more than 100 gun"] [7.79625940322876, 4.456424713134766, "dly force.\n4 Expanded mental \nhealth prohibitionsWhen a judge has committed someone to an inpatient mental institution or has found them to be unable to manage their own affairs, federal law prohibits that person from having firearms. This law expand"] [7.834534645080566, 4.287098407745361, "rearm to carry a concealed weapon in public without a permit. For the questions below, assume that before adopting permitless carry , the state required concealed carry permits that were issued to those \nwith good moral character and sufficient reaso"] [8.518638610839844, 3.751345634460449, "ited possessors seeking\u00a0firearmsThis state law criminalizes attempted purchase of firearms by individuals prohibited by law from possessing a firearm. It also funds personnel who are tasked exclusively with investigating and prosecuting prohibited po"] [8.580810546875, 3.6512324810028076, " estimate the effects of a randomly selected subset of policies and outcomes. The order in \nwhich policies were presented to respondents was randomized. \nThe individuals in our sampling frame who had responded to the 2016 survey were each \nasked to r"] [8.556059837341309, 3.6454973220825195, "ifying these conditions was important for ensur -\ning that respondents\u2019 expectations about the effects of a given policy were grounded in a simi -\nlar context, the instructions asked respondents not to consider potential interactive effects of polici"] [7.925425052642822, 4.05502462387085, "tate that had 1,000 suicides without this policy would \nhave 930 suicides with this policy. In other words, the policy would reduce suicides by 7%.If a state implemented universal background checks, how much would firearm suicides change? This \nquest"] [8.53053092956543, 3.678842782974243, "tion of the survey, asked about the likely \neffects of legal gun ownership on homicide risk for three different groups: the legal gun owner, the spouse or partner living in the household of the legal gun owner, and a child living in the household of "] [8.585803985595703, 3.607722759246826, "ion, by adding complexity to the basic two-cluster solution. Both three- and four-cluster solutions had a lower Bayesian information cri -\nterion; however, it was also possible to get the same improvement within a two-factor solution by allowing corr"] [8.588289260864258, 3.5855305194854736, "he respondent on that outcome across policies (e.g., the extent to which the respondent \nbelieved that policies restricting firearms change the rates of firearm homicide). Imputations were based on predictive mean matching from this model; that is, a"] [8.573870658874512, 3.5859687328338623, "ple were from \nthe 2016 survey sample frame; 51 (29 percent) were newly identified participants who com -\npleted at least half of the effect estimates that they were presented with. In our analysis, we include data from only the 2016 survey for 37 pa"] [8.569719314575195, 3.5935604572296143, "ts / \nContacted)\n2016 survey \nrespondent 86b83 58 95b69.9%\n(58 / 83)\n2016 sample frame nonrespondent125 114 27 27 23.7%\n(27 / 114)\nNewly added to the 2020 sample114 102 51 51 50.0%\n(51 / 102)\nTotal 325 299 136 173 45.5%\n(136 / 299)\na We counted as su"] [8.56767749786377, 3.5862507820129395, "re ordered from those with the most similarity in favorability ratings between groups to those with the least similarity, as described in the text. Several results presented in this report follow this order (e.g., Figure 4.1).\na This column displays "] [8.529075622558594, 3.551764488220215, "wo classes also were sharply distinguished by the questions about how simi -\nlar their own views were to those of familiar policy advocacy and membership organizations. For instance, as shown in Table 4.3, the median rating of similarity with the pol"] [8.567166328430176, 3.594975709915161, "an), and 75th percentile (third quartile) for each \nresponse. The scale for similarity ranged from 1 = very different to 6 = very similar; N = not sure. \nTABLE 4.4\nRespondent Relationship to Gun Policy, by Expert Class\nWhich of the following best des"] [8.56577205657959, 3.616410255432129, "ent). For another 96 effect estimates (51 percent), median esti -\nmates for one group suggested that the policy would have no effect on the outcome, while the other group believed that it would have a positive or negative effect. \nIt was fairly rare "] [8.548341751098633, 3.6269419193267822, "weapons\n80 90 100 110 120 80 90 100 110 120 80 90 100 110 1204. Mass shootings 5. Property crime 6. Hunting and sport shooting1. Firearm suicides 2. Firearm homicides 3. Accidental firearm deathsSurvey Findings\n33NOTE: The circles indicate the group"] [8.548094749450684, 3.6220593452453613, " to have large effects on gun violence outcomes; for seven of the 19 poli -\ncies, the median permissive group member expected no change in firearm suicides, firearm homicides, accidental firearm deaths, and mass shootings. \nIn contrast, relative to t"] [8.5646333694458, 3.618795871734619, "ting indicating a \u201cmoderate\u201d to \u201cmajor\u201d protective effect for at least one of these two outcomes.\n2\nInterestingly, the policies for which the two classes of experts had the most similar favor -\nability ratings also tended to have higher-than-average "] [8.54626750946045, 3.6230809688568115, "cording of firearm sales, firearm and ammunition taxes, minimum age requirements, requiring a ten-day waiting period to purchase a firearm, and gun purchase limits. These same policies received median ratings of 1 to 2 for effects on individuals\u2019 pri"] [8.53053092956543, 3.6501529216766357, "mber expected no effect on mass shootings and a moderate increase in accidental firearm deaths (a 5-percent increase). Potential explanations for differences in expert class preferences are explored further in Chapter Five.\nIn Table 4.5, we present e"] [8.519250869750977, 3.6753761768341064, "% decrease)None Requiring a license to purchase a firearm or ammunition (5% increase)None\n6Participation in hunting and sport shootingNone None Requiring a license to purchase a firearm or ammunition, firearm and ammunition taxes, minimum age require"] [8.503607749938965, 3.729853630065918, "ies, all of which received positive or neutral median favorability ratings, may be particularly promising strategies to consider in gun policy discussions.\nBeliefs About Firearm Law Effects on Nonfirearm Deaths\nA striking result from our 2016 survey "] [8.521961212158203, 3.713567018508911, "ut firearm suicides.The Magnitude and Sources of Disagreement Among Gun Policy Experts, Second Edition40Across both expert classes, the median group member expected at least some of the effects \nof a policy on firearm homicides to be offset by an opp"] [8.375922203063965, 3.799527883529663, "s of violence, or by freeing up police enforcement resources. \nIf 100 firearm homicides were prevented, how would this change the number of non-firearm homicides? \nDecrease more\nthan 100Increase more\nthan 100 +75 +50 +25 0 \u201325 \u201350 \u201375 \u2013100 +100\nNo ef"] [8.563652992248535, 3.6261801719665527, "e RestrictivePermissive RestrictiveThe Magnitude and Sources of Disagreement Among Gun Policy Experts, Second Edition42or partner (15-percent reduced risk) and child (15-percent reduced risk). In contrast, the \nrestrictive g"] [8.587224960327148, 3.580495595932007, "cies that achieve one set of objectives while the other class seeks to achieve a different set. A weakness of this analysis was that we had few survey respondents favoring permissive policies on which to estimate these relationships ( n = 16). Theref"] [8.585375785827637, 3.560251235961914, "fects differently. For example, is the relationship between the favorability rating for a policy and the estimate of the policy\u2019s effect on firearm homicide the same for experts in the permissive class as for experts in the restrictive class? Do expe"] [8.592498779296875, 3.553938388824463, "cale. The addition of the ten interaction terms improved exact matches by too little to discern with two decimal digits, although it slightly improved the proportion of cases with predicted ratings within one scale point of the actual value. \nTABLE 5"] [8.584246635437012, 3.5716192722320557, "icted and Actual Favorability \nRatings for All Policies\nType of Match and ModelAll Favorability \nRatings \n(n = 2,339)Permissive Class \nRatings \n(n = 324) Restrictive Class \nRatings \n(n = 2,015)\nExact match\nMain effects only 0.60 0.55 0.61\nMain eff"] [8.575980186462402, 3.5704009532928467, "(0.59\u20130.75)\n5 Property crime 0.88 (0.79\u20130.98) 0.87 (0.78\u20130.96)\n6 Participation in hunting and \nsport shooting1.34 (1.21\u20131.48) 1.40 (1.28\u20131.54)\n7 Legal acts of defensive \ngun\u00a0use0.87 (0.77\u20130.98) 0.92 (0.83\u20131.03)\n8 Sales of new firearms 0.82 (0.74\u20130.91"] [8.575392723083496, 3.6615490913391113, "\u2019s effect on firearm suicides was second-most influential in predicting favorability \nratings, and the standardized effect size was roughly half as great as that for firearm homi -\ncides. Across all experts, policies associated with a one-standard-de"] [8.560901641845703, 3.6650617122650146, "gh a policy\u2019s expected effects on other outcomes, such as reducing firearm homicides, mass shootings, or property crime. Because our models control for expected effects of each policy on these other outcomes, the nonsignificant estimate for the effec"] [8.580230712890625, 3.677539110183716, " be expected whether or not any other policies were simultaneously introduced. Thus, the combined effect of multiple policies on firearm homicides (or other outcomes) is simply the multiplicative product of the effects on firearm homicide that the ex"] [8.591476440429688, 3.685945987701416, "single law is selected but does not provide estimates of the combined effects of multiple laws. \nIn Table 6.1, we provide two examples of policy combinations. First, we identified two of \nthe policies for which the two groups differed least in their "] [8.586569786071777, 3.7301251888275146, " net effects of any combination of laws on national outcomes. Additional details on the data sources used, assumptions made to gen -\nerate state-level base rates on each outcome, and information on state laws as of January 1, 2021, are provided in Ap"] [8.559123039245605, 3.622422218322754, "ne map displays the results expected based on effect estimates by the permissive class, and the other map shows results expected based on estimates by the restric-tive class. Users can choose any of the ten outcomes to be displayed on the maps and ca"] [8.551321029663086, 3.6226518154144287, " and surrender of firearms by prohibited possessors. We labeled this group the restrictive class because experts in this \ngroup tend to favor more-restrictive policies on gun access and use. \nIn total, we received 26 usable responses from experts wh"] [8.55540943145752, 3.6177284717559814, "s survey are representative of the opinions and estimates of the general population. We were able to divide our respondents into two highly distinct groups with clearly divergent opinions, but the general public may have a very different dis -\ntribut"] [8.453021049499512, 3.7313716411590576, "deaths, participation in hunting and sport shooting, legal acts of defensive gun use, and the right to bear arms.\nIn the 2020 survey, state prosecution of prohibited possessors seeking firearms was \ndescribed as follows:\nThis state law criminalizes a"] [8.492413520812988, 3.6608173847198486, "icies. This group tended to support the view that firearm deaths \nwould be decreased by implementing the policies nationally, although there was less agree -\nment about whether property crime would increase or decrease. This group also estimated that"] [8.550878524780273, 3.6784636974334717, "e concessions that those in the restrictive class might consider to improve the attractiveness of a bargain among stakeholders while still achieving many of the desired social benefits. For instance, according to our Gun Policy Expert-Opinion Tool, i"] [8.49256706237793, 3.7108001708984375, "itude and Sources of Disagreement Among Gun Policy Experts, Second Edition62the effects of policies on a wide variety of outcomes is weak and that, in many cases, no rigor -\nous studies are yet available (Smart, Morral, et al., 2020). Across the 144 "] [8.573689460754395, 3.636634349822998, "homi -\ncides by a factor of 0.95 (IQR: 0.90\u20131.05). \nAside from these two of the 19 policies evaluated in the survey, the research review iden -\ntified no other policies for which the weight of available evidence was strongly supportive of a particula"] [8.581338882446289, 3.5765414237976074, "ifferences in policy favorability ratings, then, in a model predicting favorability ratings, estimates of the empirical effects of policies might explain favorability ratings in comparable ways for both groups of experts. On the other hand, if groups"] [8.566347122192383, 3.6322665214538574, "r, across the policies we considered, differences in experts\u2019 estimates about the \npolicies\u2019 true effects usually concerned the magnitude of likely effects, not their direction. However, even when experts disagreed on the direction of effects, our re"] [8.56348705291748, 3.6182665824890137, "g a permissive or restrictive approach\u2014are often important expressions of their identification with various social groups on which they depend psychologically and economically (Kahan, 2017). There is compelling evidence that the public, experts, and "] [8.431241035461426, 3.8614394664764404, "ition66permissive gun policies generally believed that a substantial percentage of a gun policy\u2019s pos -\nsible benefits of reducing firearm suicide or firearm homicide are offset by increases in non -\nfirearm homicide and suicide. They also believed t"] [8.49455738067627, 3.762730836868286, "rt et al., 2020) and homicide (Braga et al., \n2021; Cook, 2018; Zimring, 2004), this does not entirely address whether policies that produce population-level reductions in firearm suicides or homicides result in minimal offsetting effects on nonfirea"] [8.621493339538574, 3.8953301906585693, "ific study of gun policies offers a promising available path for building consensus on gun policy. In 2020, for the first time in nearly 25 years, Congress appropriated funds for this kind of research, which we believe should be continued and broaden"] [8.57005786895752, 3.6577887535095215, "s survey is part of a research project estimating the likely effects of a wide range of gun \npolicies, including both the benefits and harms of each. The results of this survey will provide \nvaluable information on policies most likely to protect ind"] [7.972197532653809, 4.026124000549316, "ided.]\n[The policy should be bold in a text box and remain at the top of the page for the follow-up \nquestions.] RAND Survey of Firearms Experts711. Q1PX I f a state implemented universal background checks , how much would firearm \nsuicides change?"] [7.917515754699707, 4.0466508865356445, "nge? \nWith the law, the property crime rate would be ____% of what it was without the law\nLess than\n80%More than\n120% 115% 110% 105% 100% 95% 90% 85% 80% 120%\nNo\nchangeRate DECREASES \nby 20%Rate INCREASES \nby 20%\n\uf0a1 No opinion [PROGRAMMER: radio but"] [7.949769496917725, 4.261393070220947, " sometimes obtain them through pri -\nvate sales that do not require background checks. Universal background checks require back -\nground checks prior to all transfers of firearms, including private sales over the internet, at \ngun shows, and between "] [7.771420478820801, 4.488315105438232, " when a child accesses a usable weapon \nthat was stored in a location where the owner should have known a child could access it. \nPolicy 9. Surrender of firearms by prohibited possessors . \nWhen a judge\u2019s rulings place an individual in a class that "] [7.693287372589111, 4.305679798126221, "ent evidence they are not a high risk.\nPolicy 16. Firearms prohibitions for individuals subject to domestic violence restraining orders.\nThis state law prohibits gun possession by individuals subject to domestic violence restrain -\ning orders. Each "] [8.404794692993164, 3.851353168487549, "arm suicides could INCREASE non-\nfirearm suicides if some of those individuals switch to other means of suicide. Alter -\nnatively, preventing firearm suicides could DECREASE non-firearm suicides if sui -\ncides are contagious (i.e., each suicide puts "] [8.574268341064453, 3.604198455810547, "ientist \nb. QP1\n_2 Policy analyst \nc. QP1\n_3 Policy advocate \nd. QP1\n_4 Interested layperson \ne. QP1\n_5 Government official \nf. QP1\n_6 Congressional staff member \n17. Q18 \nIf you have comments or clarifications you would like us to consider, please p"] [8.549339294433594, 3.6234207153320312, ".4 4.6 0.1 2\n16 Firearm prohibitions for individuals subject to domestic violence restraining orders\u22122 \u22127 \u22121 \u22124 0 1 2 0 2.1 3.5 0.8 2\n5 Required reporting of lost or \nstolen firearms0 \u22125 0 \u22121 \u22121 0 0 0 0.9 1.5 0.3 2\n14 The elimination of gun-free zone"] [8.573326110839844, 3.5824663639068604, " show the mean of the absolute value of the between-class differences in medians across all eight quantitative outcomes (1\u20138), across death outcomes (1\u20134), and across \nother outcomes (5\u20138). Bold text indicates estimates for which there was higher-tha"] [8.571195602416992, 3.573110580444336, "to those with the least similarity, as described in Chapter Four. \na These columns show the mean of the absolute value of the between-class differences in medians across the two qualitative measures. Bold text indicates estimates for which there \nwas"] [8.569160461425781, 3.575286865234375, ".00 100.00 100.00 99.38 \u00a0147 90.00 95.00 98.00 93.41 \u00a0 \u22125.00 No\n2 6 26 100.00 100.00 100.00 100.23 \u00a0147 85.00 90.00 95.00 89.57 \u00a0 \u221210.00 No\n2 7 26 100.00 100.00 100.00 100.31 \u00a0147 85.00 90.00 95.00 90.53 \u00a0 \u221210.00 No\n2 8 26 98.00 100.00 100.00 99.08 \u00a0"] [8.570746421813965, 3.5746829509735107, ".00 105.00 110.00 105.90 \u00a0 5.00 No\n3 18 26 100.00 100.00 100.00 99.92 \u00a0147 95.00 98.00 100.00 96.55 \u00a0 \u22122.00 No\n3 19 26 100.00 100.00 100.00 99.46 \u00a0147 95.00 100.00 100.00 97.19 \u00a0 0.00 No\n4 1 26 97.00 100.00 100.00 99.12 \u00a0147 90.00 95.00 98.00 92.56 \u00a0"] [8.56905460357666, 3.5733320713043213, "edian) 75th % Mean N 25th %50th % \n(median) 75th % Mean DifferenceaOpposite \nSidesb\n5 12 26 90.00 96.50 100.00 94.96 \u00a0 147 100.00 100.00 105.00 103.33 \u00a0 3.50 No\n5 13 26 100.00 100.00 100.00 100.54 \u00a0147 98.00 100.00 100.00 97.97 \u00a0 0.00 No\n5 14 26 95.0"] [8.570064544677734, 3.5832371711730957, " 99.00 100.00 100.00 98.58 \u00a0 0.00 No\n7 8 26 89.00 95.00 100.00 93.42 \u00a0 147 100.00 100.00 100.00 99.49 \u00a0 5.00 No\n7 9 26 95.00 100.00 100.00 96.81 \u00a0147 99.00 100.00 100.00 98.31 \u00a0 0.00 NoTable B.3\u2014ContinuedDescriptive Statistics by Expert Class, Outcom"] [8.57103443145752, 3.579965353012085, " \u22121.00 No\n9 1 26 1.00 2.00 3.00 2.19 \u00a0147 3.00 4.00 4.00 3.86 \u00a0 2.00 No\n9 2 26 1.00 1.00 1.00 1.19 \u00a0147 3.00 4.00 4.00 3.65 \u00a0 3.00 No\n9 3 26 4.00 5.00 7.00 5.31 \u00a0147 4.00 4.00 6.00 4.69 \u00a0 \u22121.00 No\n9 4 26 2.00 2.00 3.00 2.73 \u00a0147 3.00 4.00 4.00 3.47 \u00a0"] [8.570489883422852, 3.5829803943634033, "3.00 4.00 2.92 \u00a0147 3.00 4.00 4.00 3.61 \u00a0 1.00 No\nOpinion 1 26 1.00 2.00 3.00 2.04 \u00a0147 5.00 5.00 5.00 4.77 \u00a0 3.00 Yes\nOpinion 2 26 1.00 1.00 1.00 1.23 \u00a0147 4.00 5.00 5.00 4.48 \u00a0 4.00 Yes\nOpinion 3 26 4.00 4.50 5.00 4.08 \u00a0 147 1.00 1.00 2.00 1.46 \u00a0 \u2212"] [8.587788581848145, 3.569948196411133, "the \noverall opinion measure).\nc These outcomes were not imputed and used responses from only the 2020 survey.Table B.3\u2014Continued101APPENDIX C\nStatistical Modeling of Experts\u2019 Favorability \nRatings\nIn this appendix, we provide details and sensitivity"] [8.593521118164062, 3.5541558265686035, "x responses to the ten policy effect questions. This had the effect of elim -\ninating six respondents (i.e., six respondents provided at least one policy effect response for more than \nhalf of the policies that they were asked about but did not provi"] [8.591390609741211, 3.6055386066436768, "ed to have a 75-percent and 73-percent effect on homicide, respectively, would likely be equally favored; that is, a policy that saves 2,500 lives per year would receive a favorability rating similar to a policy that saves 2,700 lives per year. \nTo c"] [8.561859130859375, 3.668222665786743, "e, estimates are presented only as changes in percentage because accurate data on the number or rate of defensive gun use in the United States do not exist. For the two qualitative outcomes (the right to bear arms and individuals\u2019 privacy), effect es"] [7.701592445373535, 4.2728071212768555, " included all states with extreme risk protection \norder laws that allow for ex parte orders. \n \u2013Fo\nr prohibitions associated with domestic violence restraining orders, we included \nall states with related laws that allow for ex parte orders and that"] [8.328245162963867, 4.237586975097656, "e incident occurred in connection to domestic violence or other criminal activity. Specifically, we used the number of events in which four or more people (including possibly the shooter) were shot and killed in the same general location and time, as"] [8.434431076049805, 4.114625930786133, "ction \nof all gun owners nationally, as follows: \nPopi * ORi* sales,\n\u2211i (Popi * ORi)\nwhere Popi is the state population, ORi is the state firearm ownership rate, and sales is \nthe national 2018 domestic firearm sales estimate, calculated as the sum "] [8.47397232055664, 3.889770746231079, "0 0 1 0 0 0 0 0 0 0 0 0 0 0 0\nR.I. 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0\nS.C. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0\nS.D. 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0\nTenn. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0\nTex. 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0\nUtah"] [8.40863037109375, 4.164322853088379, "73,985 150,111 121,556\nN.H. 1,356,458 135 13 5 0.067 16,935 218,342 66,010\nN.J. 8,908,520 193 218 5 0.773 125,156 422,237 95,189\nN.M. 2,095,428 281 136 5 0.174 71,657 441,906 90,985\nN.Y. 19,542,209 445 356 5 1.583 281,507 1,166,349 305,005\nN.C. 10,38"] [8.434686660766602, 4.1901535987854, "d, Martin, Julian Christensen, Casper Mondrup Dahlmann, Asbj\u00f8rn Mathiasen, and Niels Bj\u00f8rn Grund Petersen, \u201cThe Role of Evidence in Politics: Motivated Reasoning and Persuasion Among Politicians,\u201d British Journal of Political Science , Vol. 49, No. 3"] [8.391441345214844, 4.301248073577881, "al Bureau of Investigation, Crime in the United States 2018 , Uniform Crime Reporting \nProgram, 2019. As of December 12, 2020: https://ucr.fbi.gov/crime-in-the-u.s/2018/crime-in-the-u.s.-2018\nGalea, Sandro, and Roger D. Vaughan, \u201cTendrils of Hope in"] [8.384069442749023, 4.334146022796631, " Control Is Wrong, Washington, D.C.: Regnery Publishing, Inc., 2003.\n\u2014\u2014\u2014, More Guns, Less Crime: Understanding Crime and Gun-Control Laws , 3rd ed., Chicago, \nIll.: University of Chicago Press, 2010.\u2014\u2014\u2014, \u201cA Look at the Facts on Gun-Free Zones,\u201d Natio"] [8.36135196685791, 4.181972503662109, " \nSanger-Katz, Margot, and Quoctrung Bui, \u201cHow to Reduce Mass Shooting Deaths? Experts \nRank Gun Laws,\u201d New York Times , October 5, 2017. \nSanthanam, Laura, \u201cMost Americans Support These 4 Types of Gun Legislation, Poll Says,\u201d PBS NewsHour, September"] [8.395730972290039, 4.136592388153076, "Who Seek to Purchase Handguns: Risk Factors and Effectiveness of Denying Handgun Purchase,\u201d JAMA , Vol. 285, \nNo. 8, 2001, pp. 1019\u20131026.\n\u2014\u2014\u2014, Effectiveness of Denial of Handgun Purchase by Violent Misdemeanants, Final Report , \npresented to the Nati"] [0.4260755181312561, 7.195651054382324, "Developing Long-Term \nSocioeconomic \nStrategy in Israel\nInstitutions, Processes, and \nSupporting Information\nHoward J. Shatz, Steven W. Popper, Sami Friedrich, \nShmuel Abramzon, Anat Brodsky, Roni Harel, Ofir Cohen\nPrepared for the Prim"] [0.3781047463417053, 7.148054599761963, "ment \nofficials in developing means by which Israel could create a long-term socioeconomic strategy. The task force was appointed by the Prime \nMinister and Minister of Finance in spring 2010 and was led by the \nhead of the National Economic Council "] [0.4045563042163849, 7.166767120361328, " demographic behavior, education and training, labor markets, social welfare policy, immigration, inter -\nnational development, financial decisionmaking, and issues related to aging and retirement with a common aim of understanding how policy and soc"] [0.3284798562526703, 7.095478534698486, "\nInterministerial Processes ..................................................... 20\nPrior Institutions for Identifying Socioeconomic Challenges ............... 20\nThe General Cabinet .......................................................... 22\nT"] [0.3390422463417053, 7.106363773345947, "get .................................................... 63\nCase-Study Conclusions ......................................................... 64Contents ix\nCHAPTER FIVE\nPerceived Gaps in Israel ..................................................."] [0.35639405250549316, 7.124813556671143, ".... 62\nTables\n 3.1. Overview of Interviews Conducted with Israelis on Socioeconomic Strategy in Israel\n ................................... 15\n 6.1. Case-Study Conclusions and Recommendations for Gap\u00a01, Lack of Involvement by the Political Leadersh"] [0.36344969272613525, 7.131278991699219, "ess of cre-xiv Developing Long-Term Socioeconomic Strategy in Israel\nating the foundations for such a strategy. This document suggests the \ninstitutions for doing so.\nTo respond to this question, the RAND Corporation and Shaldor \nStrategy Consulti"] [0.33953404426574707, 7.107555866241455, "tioning strategy to policies and their implemen -\ntation\n\u2022 inadequate measurement and evaluation of policy interventions.\nThe interviews and our discussions with government officials also \nrevealed unease as to whether the government had a common vis"] [0.34188172221183777, 7.112318992614746, "ernments that are elected, not individual officeholders. \nThe distinction is important because of the parliamentary concept of shared responsibility, \nwhich, in turn, is the basis for government agreements. These play a large part in parliamen -\ntary"] [0.3268398344516754, 7.093636512756348, "erm problems; and detailed plans for specific socio -\neconomic programs to be promoted by the government.\n5. Create a mechanism, led by the professional-level socioeconomic strategy forum, for managing the plans for socioeconomic pro -\ngrams selected"] [0.4060574471950531, 7.17475700378418, "CD as a whole. And \nwith only two exceptions, starting in 2000, annual inflation as mea -\nsured by the GDP deflator has been lower than that of the world and \nthe OECD (World Bank, 2014).\nHowever, Israel faces a variety of economic and social challen"] [0.34596869349479675, 7.112545490264893, "r School, New York University.Introduction 3\n\u2022 Analyze the evaluation and monitoring processes in current strat -\negy formation.\n\u2022 Identify the gaps in current strategy-formation institutions, pro -\ncesses, information, and evaluation and monitori"] [0.3846448063850403, 7.158245086669922, "ate, \nwe discuss alternative arrangements, as well as pros and cons. A com -\npanion report describes key methods for taking a strategic perspective \nand conducting long-term socioeconomic strategic analysis (Popper et \nal., 2015).5CHAPTER TWO\nStrateg"] [0.3642299771308899, 7.137274265289307, "red to be the peak of the policy pyramid in \nterms of importance of its practitioners (usually the chief executive and \nhis or her staff) and its purpose (to set the overall direction of the \nnation, the government, or a governmental department). But"] [0.36564183235168457, 7.140325546264648, "ction, \nabout doing something\u201d (2011, p.\u00a0 87).3 Other definitions note that \nsecurity, see Douglas\u00a0C. Lovelace, Jr., director of the U.S. Army War College Strategic Stud -\nies Institute, in Yarger, 2006, p.\u00a0v.\n3 For example, Rumelt identifies \u201ccontai"] [0.38311782479286194, 7.156635761260986, " prior hypotheses. Strategic early warning would encompass the longer-term \ntrends or challenges that are discovered from the observe and orient steps. Without this prior analysis, they might be overlooked, so strate-gies and their accompanying polic"] [0.35783520340919495, 7.130465507507324, " focus on how strategic planning can support the strategic perspective. We also define other terms useful to the strategy process.\nStrategic planners and planning are best viewed not as a source \nof strategies but as creating analytic inputs to takin"] [0.3805634081363678, 7.153790473937988, "ion in \nthe thinking process. (Mintzberg, 1994, p.\u00a025)\nConsidering how to implement a strategy over the long term can pro -\nvide a test of whether that strategy is feasible.\nThis suggests that taking a strategic perspective also involves con -\nsideri"] [0.35374483466148376, 7.122541904449463, "d \npotential solutions; thinking about necessary actions, how they can be coordinated, and what their effects might be; and taking account of \nconstraints and uncertainty. Institutions and processes, as discussed in \nthis document, would then support"] [0.356588751077652, 7.125002384185791, "sive interviews, conducted by Shaldor, of those who currently are serving or have served the government of Israel in \nsenior positions. Other interviews included observers from outside the \ngovernment whom the project team felt would be valuable sour"] [0.41978955268859863, 7.192423343658447, "rspective in policy development in Israel. \nOur conclusions reflect areas of widespread agreement.\nSecond, as discussed in the previous chapter, there is no specific \nnormative model of strategy development and the use of a strategic perspective that"] [0.3284547030925751, 7.095005035400391, "focusing on tapping into opportunities offered by the global technology revolution.\nThe current strategy\u2019s achievements, which include economic sta -\nbility and a high growth rate, were made possible by the professional and institutional capabilities"] [0.33280855417251587, 7.100785732269287, "ionalize them at the govern -\nmental level.\nCharacteristics of the Israeli Government\nThe Israeli system of government has three characteristics that any \nreform proposals must take into account. First, compared with the \nU.S. system, there is weaker"] [0.33075952529907227, 7.0972981452941895, "n of this document, we use the term cabinet when we refer to the collectivity of the PM and the ministers\u2014\nthe elected political leaders.20 Developing Long-Term Socioeconomic Strategy in Israel\nInterministerial Processes\nThe Israeli government has"] [0.31837350130081177, 7.085803508758545, "3.1\nInstitutions Involved in Strategic Approaches and Policy Management\nNOTE: Operational authorities are government institutions that have operational\nmissions and mandates. They report to ministries and include such institutionsas the Israel Defens"] [0.32025212049484253, 7.087032318115234, "\nof 2013 had 31\u00a0ministers, of whom 15 were members of the socioeconomic cabinet.The Strategic Perspective and Israel\u2019s Socioeconomic Challenges 23\nnomic, social, and civic issues. In that capacity, the PMO DG is respon -\nsible for initiating and l"] [0.32298803329467773, 7.090268611907959, "D.-level research capacity or a statistical staff.\nThe NEC\u2019s activity has not yet been grounded in legislation, and \nit functions in a slightly different manner from the one assigned to it by \nthe original government decision, which stipulated its ro"] [0.3139801025390625, 7.080270290374756, "on the PM\u2019s agenda and requiring cross-ministerial coordination. It has recently developed a tracking system to monitor the implementa -\ntion phases of government decisions.\nThe Ministry of Finance\nBudget Department\nThe Budget Department is the body "] [0.32628127932548523, 7.093130111694336, "legated directly \nto them.\nAs a result of these shared management responsibilities, MOF \nDGs usually focus on promoting one or two major reforms during their terms in office, whereas department heads enjoy considerable auton -\nomy in their individual"] [0.32374557852745056, 7.089995861053467, "dependent position vis-\u00e0-vis the government.\nGovernment Ministry Policy Planning Departments\nMinisterial policy planning units exist in several government minis -\ntries.7 Most of these units were established in the previous five years as \npart of a p"] [0.3184598982334137, 7.084412097930908, "-\ntion of the annual budget proposal, performs its own economic evalu -\nation, and proposes annual targets ahead of the budgetary discussions.\nDespite this process, the budget does not necessarily reflect a stra -\ntegic perspective on Israel\u2019s socioe"] [0.3297037184238434, 7.09710693359375, "the need for multiyear allocations. Furthermore, the submission of minis -\ntry plans is not fully integrated into the budgeting process.\nExcept for the budgeting process and the ministerial planning \nprocess, there are currently no other formally str"] [0.2998497784137726, 7.065351963043213, "red to as the Trajtenberg Committee after \nits head, the former director of the NEC, Manuel Trajtenberg.32 Developing Long-Term Socioeconomic Strategy in Israel\nAnother example of this type of one-time deliberative process is \nthe socioeconomic ag"] [0.32432377338409424, 7.091272354125977, ", as suggested by the report of the \nCommittee for Evaluating Employment Policy in Israel (the Eckstein report) among others, numerous bodies have shared responsibility but suffered from lack of coordination (Committee for Evaluating Employ -\nment Po"] [0.32809677720069885, 7.095128059387207, "periodic reviews \nof the state of the economy, and members of its staff are frequently \ninvolved in professional discussions held by the MOF DG. Neverthe-\nless, according to several of our interviewees, at present, the depart -\nment is not an integra"] [0.335905522108078, 7.104780673980713, " are supported by the MOF\u2019s computer systems. Government offices seem to be undergoing a significant upgrading of the computer infrastructure designed to monitor and control the outputs and out -\ncomes of their own activities.\nIn recent years, the PM"] [0.34005552530288696, 7.107875823974609, "7\ntheir strategies, and integrating information into those institutions and \nprocesses.39CHAPTER FOUR\nInternational Comparisons of Socioeconomic \nStrategy Development and Implementation\nCountries around the world have faced the problem of how to inco"] [0.3311019241809845, 7.098400115966797, "er, \nmore-detailed information about the daily routines of strategy units \nand strategy development is difficult to capture in our case studies.\nInstitutions\nSome of our case-study countries have formal institutions with legal foundation, and others "] [0.3346768617630005, 7.102273941040039, "e central focus for strategic assessment. Creating and protecting \ninstitutions and processes for developing strategies and maintaining a \n1 Functions may also be vulnerable, although we have encountered fewer cases in which a \nstrategy organization "] [0.32617437839508057, 7.093457221984863, "uirements and engagement of the head of government can create and maintain demand for a strategic approach to chal -\nlenges. Creating a culture within the government that will value \nsuch an approach could be more difficult but will also provide \ndem"] [0.30061736702919006, 7.067607879638672, "ium-term strategies we reviewed.\nGuiding and monitoring progress of strategy development and \nimplementation often involve interministerial committees of higher-level civil servants who may prepare the ground for decisions in simi -\nlar committees of"] [0.3161039650440216, 7.0815629959106445, " research by subject-matter experts.\n\u2022 Stakeholders and sources outside the strategy unit and the gov -\nernment should be engaged early and often in the development of strategic approaches to challenges. Although publication may not be appropriate fo"] [0.30965545773506165, 7.0763959884643555, "untries. In Denmark, rather than having a dedicated strategy staff, the PMO has a domestic policy staff of around ten people, usually \nrecruited from the MOF but also containing a few experts in different \npolicy areas from the other ministries. They"] [0.32190531492233276, 7.089557647705078, "ction to scenario planning, tools for thinking systematically about the future, facilitation skills for running a foresight process, commu -\nnicating and presenting the results of exercises for visualizing potential 48 Developing Long-Term Socioec"] [0.3023257553577423, 7.068447113037109, "s-on approach to overseeing government policy development and imple-\nmentation. However, strategic practice is also backed by the Budget \nTransparency and Accountability Act (2000), which requires an overall strategy, a budget with a three-year fisca"] [0.31215161085128784, 7.0792059898376465, "olve the line ministries in filling in the details of strategic directions. In part, giving civil servants in line ministries \nroom for maneuver also helps foster active, personal engagement, we \nwere told. In fact, our conversations suggested that, "] [0.303286612033844, 7.0709710121154785, "such as officials from within the PMO, can have more influence on current policy but are likely to have less influence regarding difficult \nproblems that must be approached across governments or with which \nthe current government does not want to dea"] [0.3192805051803589, 7.086360931396484, "ariat; the rest of International Comparisons of Socioeconomic Strategy Development 53\nthe council discusses and comments on the report. The reports receive \nsignificant press coverage, and the forecasts provide one input into the \nnational budget."] [0.3243691623210907, 7.091253280639648, "rity interministerial programs \n(Finnish Ministry of Justice, 1999).\n2 The document serves as a form of \ncoalition agreement. The government also writes a term government \nimplementation plan for the top priorities; this is issued several months \naft"] [0.3533298969268799, 7.125161170959473, " Columbia, which (as noted earlier) produces a ten-year strategy along with a three-year fiscal framework. The ten-\nyear strategies have included goals along with broad policy directions. \nFor example, the 2006 strategy had as a goal making British C"] [0.3297346532344818, 7.096545219421387, "n on Policy Planning were divided into \nsubgroups by expertise, met in subcommittee meetings, and reported to the head of the commission. The commission head, in turn, would \nwork with senior staff members\u2014government officials\u2014to determine \nthe feasi"] [0.32870960235595703, 7.0951433181762695, "of the Ministry of Trade \nand Industry, which studies trends and their economic implications (Lee, 2011).58 Developing Long-Term Socioeconomic Strategy in Israel\nOccasionally, the institution that can provide long-term think -\ning is not formally "] [0.31598150730133057, 7.081730365753174, "rnment that took office in 2011 identified three strategic priorities. For each priority, the implementation plan identifies a coordinating ministry, responsible ministers, and cooper -\nating ministries. For example, for the strategic priority \u201creduc"] [0.3165907561779022, 7.083576202392578, "nistry of \nEconomic Affairs and the Interior produces a biennial economic report \nabout the same time as the report of the Economic Council. Our inter -\nviews indicated that the two reports are considered the most important \nand highest-quality input"] [0.37644654512405396, 7.143982887268066, "al engagement lets officials test their ideas and learn new ideas that may be helpful.\nGovernments use the publication of formal strategic documents \nas a tool to engage the public, coordinate across government, and pro -\nvide support for priorities "] [0.3413781523704529, 7.109522819519043, "Power by 2030 . This \nwas published in 2008, toward the end of President Roh\u2019s term. Our \ninterviews suggested that it made little difference to concrete policy \nactions. Likewise, the Presidential Council for Future and Vision under President Lee pr"] [0.3198193907737732, 7.0866265296936035, "rts of new institutions and processes in legislation or government decisions to start to create demand \nand a culture of strategy\n4. enhancement of line ministry strategy units\n5. connections between the new strategy unit linked to the PMO and analys"] [0.33414095640182495, 7.102470397949219, "views of the gaps.\nGap 1. Lack of Involvement by the Political Leadership\nThere is widespread recognition that, ultimately, strategy must come \nfrom the engagement of political leaders. However, the government infrastructure for infusing a strategic "] [0.35244831442832947, 7.122238636016846, "efined by urgent and critical \nissues that require an immediate response. There is little preparation \nregarding socioeconomic challenges for which better or more-coherent \npolicies could have been developed had there been more foresight, anticipatio"] [0.31580907106399536, 7.082676410675049, "eves] that, when [it stops] spending, \n[it is] \u201csaving the country.\u201d\nThe PMO has no one [who] directs policy in ministries, asks \nquestions of policy, and challenges them to see the whole forest rather than the trees.\nThe NEC wrote a nice document on"] [0.31787776947021484, 7.08436918258667, "r the development of \nstrategies, is underdeveloped. There are also no formal platforms or \nmechanisms in place for allowing effective public participation in these areas. The 2011 Trajtenberg Committee provided the first prominent \nand only signific"] [0.28688207268714905, 7.05327844619751, " not even sufficient sharing within the \nresearch division.\nGap\u00a06. Difficulties Transitioning Strategy to Policies and \nTheir Implementation\nIn recent years, a considerable number of policy programs have been \ndeveloped, but implementation has falter"] [0.3472653925418854, 7.119286060333252, "y in Israel\nassessment throughout the course of the policy\u2019s life cycle\u2014from for -\nmulation, through the pilot, to the complete implementation and \nbeyond. Among other examples, our interviewees mentioned plans in \nthe employment arena, which, they f"] [0.32339659333229065, 7.090957164764404, " we describe possible alterna -\ntives as well. Discussing alternatives is especially important because we \ndo not have full information regarding the entire spectrum of variables \nthat may affect future institutional composition and processes and, sp"] [0.3341367542743683, 7.101568698883057, "nd facilitating the creation of an unbro -\nken continuum from policy formulation to its implementation. These units should be assisted on a regular basis by inputs from external stakeholders and experts.\n\u2022 Action plans for the government term, upon i"] [0.3242427706718445, 7.0884480476379395, "al-level strategy forum led by the PM to serve as the focal point \nfor the adoption of a strategic perspective, decisionmaking regarding strategy development, and oversight of the management of the strategic process.\n2. Form a professional-level soci"] [0.3224239945411682, 7.088161945343018, "gic alternatives, and strategic early warningHold dedicated events organized by the strategy staff unit.\nHave the head of the NEC brief the PM on \nstrategic processes regularly.\nImproved coordination by the PMO Form a political-level strategy forum.\n"] [0.31769025325775146, 7.083115100860596, "f its outputs and decisions for approval by the entire cabi -\nnet, would address the international case-study finding on the need for engagement of the head of government and the gap identified regard -\ning the involvement of the political leadership"] [0.3164255619049072, 7.079836368560791, "tegy Form a socioeconomic strategy staff unit.\nEstablish a council of external \nstakeholders or technology-enhanced methods for eliciting opinions and participation.\nContinuous use of a strategic perspective in scanning socioeconomic issues and devel"] [0.2874494791030884, 7.052597522735596, "lanning (see \nrecommendation\u00a06). One risk in establishing such a professional-level \nforum is that it could become a pro forma organization that accom -\nplishes little, with substance discussed and decisions made more infor -Table\u00a06.6\nCase-Study Conc"] [0.32395443320274353, 7.088852405548096, "taff unit annual report.\nPublish the monitored progress of \nsocioeconomic goal attainment.90 Developing Long-Term Socioeconomic Strategy in Israel\nof education and relevant professional experience would be allowed to \napply for the position.3 The "] [0.3210928440093994, 7.086062431335449, "es as requiring action. This \ncombination of potential areas for strategic focus and strategic alterna -\ntives in the selected areas would serve as a menu from which specific governments, aided by the professional-level forum, would select spe-cific "] [0.31560346484184265, 7.080730438232422, "erve as its analytical component or manage its links to the political leadership and policy \nprocesses.\nA major risk to creating a strategy unit is that it could become a \nbureaucracy that stagnates over time, protecting its own institutional interes"] [0.31049346923828125, 7.075770854949951, "l to account for the realities of implementation, saddling the government \nwith unrealistic goals and programs. As a result, its creation will need considerable care.\nRecommendation\u00a05. Create a Mechanism for Managing the Plans for \nthe Socioeconomic "] [0.2850415110588074, 7.049602508544922, " by the strategy \nstaff unit of the PMO (professional coordination and guidance) and \nthe PMO\u2019s Policy Planning Department (methodological guidance).\nAn effort to build strategy capabilities in government ministries \nshould be initiated. In governmen"] [0.310705304145813, 7.074685096740723, " are two options regarding the professional team to coordinate the council\u2019s operation. The first is an external professional team. In this \nconfiguration, it would be much easier for stakeholders in the council \nto raise important issues that are po"] [0.38440459966659546, 7.1496663093566895, "ia, \nthere is a risk of including malicious participants who want to harm the process. Moderated sessions could mitigate this, although at a cost \nand at a risk to credibility if the public perceives the moderator as bar -\nring unpopular opinions.\nSo"] [0.3327609598636627, 7.0989909172058105, "he past. How -\never, further work will be needed to determine whether this task \ncan be carried out within existing resources and other constraints.\n4 Information may also be found at RAND Corporation, undated. Anticipating and Responding to Socioeco"] [0.2821318209171295, 7.048982620239258, "g are some of \nthe additional mechanisms whose adoption we recommend for this \npurpose.\n\u2022 formal arrangements\n \u2013Ground the establishment of the strategy staff unit and its roles, budget, and annual reporting duties in a government decision (a formal "] [0.3315272629261017, 7.0976176261901855, "ositive way, Israeli policymakers would benefit from applying the same strategic perspective to these new institutions and processes \nas they would to socioeconomic issues. In other words, they should \nobserve their operations, orient themselves towa"] [0.4439485967159271, 7.168609142303467, "11, 2010/2011 , Victoria, B.C., July\u00a020, 2011. As of May\u00a029, 2014: \nhttp://www.fin.gov.bc.ca/ocg/ma/10_11/BBMAA.pdf104 Developing Long-Term Socioeconomic Strategy in Israel\nBritish Columbia Public Service, \u201cExecutive Compensation: BC Public Servic"] [0.435910701751709, 7.203381061553955, " Finance.\nDrezner, Daniel\u00a0W., \u201cThe Challenging Future of Strategic Planning,\u201d Fletcher \nForum of World Affairs, Vol.\u00a033, No.\u00a01, Winter\u2013Spring 2009, pp.\u00a013\u201326.\nFinnish Ministry of Justice, The Constitution of Finland (731/1999, Amendments \nup to 1112"] [0.4126542806625366, 7.177864074707031, "\u201d Survival , Vol.\u00a052, \nNo.\u00a03, June\u2013July 2010, pp.\u00a0159\u2013178.Hennessey, Keith, \u201cWorking in the West Wing: Senior Staff,\u201d KeithHennessey.com , \nMay\u00a029, 2009. As of May\u00a029, 2014: \nhttp://keithhennessey.com/2009/05/29/senior-staff/\nHjortdal, Marie, \u201cPoliti"] [0.426746129989624, 7.190404415130615, "ister\u2019s Office, [State budget formulations in Israel: Fiscal rules, budgetary process and the arrangements law] [in Hebrew], March 2009. As of January\u00a07, 2013: http://www.pmo.gov.il/BranchesAndUnits/eco/Documents/finaldoc.pdf\nNEC\u2014 See National Econom"] [0.4557325839996338, 7.217308521270752, "Denmark, \u201cEconomic Model (ADAM),\u201d undated; referenced April\u00a024, \n2012. As of May\u00a029, 2014: http://www.dst.dk/en/TilSalg/ADAM.aspx\nStatutes of British Columbia, Budget Transparency and Accountability Act , \nChapter\u00a023, July\u00a06, 2000. As of June\u00a02, 2014"] [0.4680389165878296, 7.236507415771484, "talog/world-development-indicators\nYarger, Harry R., Strategic Theory for the 21st Century: The Little Book on Big \nStrategy , Carlisle, Pa.: U.S. Army War College, Strategic Studies Institute, Letort \nPaper\u00a0641, February 2006. As of May\u00a029, 2014: ht"] [0.42878738045692444, 7.191593170166016, "Netherlands, \u201cIs the Cabinet Obliged to\n Follow the Council\u2019s Advice?\u201d undated; referenced October 12, 2012. As of May\n:29, 2014\nhttp://www.ser.nl/en/faq%20and%20links.aspx#6\nGeneral Brochure: The Social and Economic Council of the\u201d ,\u2014\u2014\u2014\n.Netherlands"] [0.44052237272262573, 7.202755928039551, ", Strategic Plan 2006/7\u20132008/9, Victoria, February\n.2006\n Public Law 103-62, Government Performance and Results Act, August 3, 1993.\n:As of June 2, 2014\n:http://thomas.loc.gov/cgi-bin/bdquery/z?d103:s.00020\n RAND Corporation, \u201cWelcome to the American"] [0.39298251271247864, 7.227083206176758, "nomi-skal-strammes-gevaldigt-op\n Institute for Government, One Year On: The First Year of Coalition\n Government\u2014ACollection of Views, London, May 2011. As of May 29, 2014:\nhttp://www.instituteforgovernment.org.uk/sites/default/ \ufb01les/publications/One%"] [0.464500367641449, 7.225329875946045, "f\n.CESifo Group, \u201cThe Joint Economic Forecast,\u201d undated\nCommission on the Reform of Ontario\u2019s Public Services, Public Services for\n,Ontarians: A Path to Sustainability and Excellence, Queen\u2019s Printer for Ontario\n:As of May 29, 2014 .2012\nhttp://www. "] [0.4235815703868866, 7.202191352844238, "Model? Consensus\n Government in Practice,\u201d Parliamentary Affairs, Vol. 53, No. 4, October 2000,pp.\n.697\u2013709\n Angerman, William S., Coming Full Circle with Boyd\u2019s OODA Loop Ideas: An\n Analysis of Innovation Diffusion and Evolution, Wright-Patterson Ai"] [-6.232922554016113, 7.852573394775391, " ,\u201c\u05d4\u05dc\u05d0\u05d5\u05de\u05d9 \u05d4\u05d1\u05d9\u05d8\u05d5\u05d7 \u05e9\u05dc \u05d5\u05d4\u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d4\u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d4\u05d9\u05e6\u05d9\u05d1\u05d5\u05ea \u05dc\u05d1\u05d7\u05d9\u05e0\u05ea \u05de\u05d5\u05d3\u05dc2011)\u05dc\u05d0\u05d5\u05de\u05d9 \u05dc\u05d1\u05d9\u05d8\u05d5\u05d7 \u05d4\u05de\u05d5\u05e1\u05d3\n.\u05dc\u05d0\u05d5\u05de\u05d9 \u05dc\u05d1\u05d9\u05d8\u05d5\u05d7 \u05de\u05d5\u05e1\u05d3: \u05d9\u05e8\u05d5\u05e9\u05dc\u05d9\u05dd. \u05d1\u05d9\u05d5\u05e0\u05d918\n \u05e7\u05e8\u05df: \u05d9\u05e8\u05d5\u05e9\u05dc\u05d9\u05dd?\u201c \u05dc\u05d0\u05d1\u05d8\u05dc\u05d4 \u05d1\u05d4\u05db\u05e8\u05d7 \u05de\u05d5\u05d1\u05d9\u05dc\u05d4 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05d4\u05d6\u05d3\u05e7\u05e0\u05d5\u05ea \u05d4\u05d0\u05dd2007) \u05e0\u05d5\u05e2\u05d4, \u05d9\u05d7\u05d6\u05e7\u05d0\u05dc\n.\u05de\u05d9\u05dc\u05e7\u05df \u05e7\u05d5\u05e8\u05ea\n \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4: \u05d9\u05e8\u05d5\u05e9\u05dc\u05d9\u05dd\u201c, "] [-6.232002258300781, 7.85174036026001, "\u05e9\u05dc\u05d4 \u05d7\u05d5\u05d1\u05d5\u05ea \u05d0\u05ea \u05d2\u05dd \u05dc\u05e4\u05e8\u05d8 \u05e0\u05d9\u05ea\u05df\n \u05d4\u05de\u05d3\u05d9\u05e0\u05d4 \u05d1\u05ea\u05e7\u05e6\u05d9\u05d1 \u05d5\u05d1\u05e9\u05d9\u05dc\u05d5\u05d1\u05d4 \u05e0\u05d3\u05d4\u2018\u05d4\u05d0\u05d2 \u05d1\u05d9\u05d9\u05e9\u05d5\u05dd \u05d4\u05d4\u05ea\u05e7\u05d3\u05de\u05d5\u05ea \u05de\u05e6\u05d1\n.\u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d5\u05d1\u05e4\u05e2\u05d5\u05dc\u05d5\u05ea\n\u2022 \u05e4\u05d5\u05e8\u05de\u05dc\u05d9\u05d9\u05dd \u05d1\u05dc\u05ea\u05d9 \u05e6\u05e2\u05d3\u05d9\u05dd\n \u2013 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d5\u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e9\u05dc \u05e9\u05d5\u05d8\u05e4\u05ea \u05ea\u05e7\u05e9\u05d5\u05e8\u05ea\u05d9\u05ea \u05d7\u05e9\u05d9\u05e4\u05d4\n \u05d5\u05e4\u05e2\u05d9\u05dc\u05d5\u05ea\u05dd \u05e7\u05d9\u05d5\u05de\u05dd \u05e2\u05dc \u05e9\u05de\u05d9\u05d3\u05e2 \u05dc\u05d4\u05d1\u05d8\u05d9\u05d7 \u05db\u05d3\u05d9 \u05d4\u05ea\u05e7\u05e9\u05d5\u05e8\u05ea \u05d1\u05d0\u05de\u05e6\u05e2\u05d9\n.\u05e1\u05d3\u05d9\u05e8 \u05d1\u05d0\u05d5\u05e4\u05df"] [-6.232752799987793, 7.852236747741699, "\u05d5\u05e1\u05d3\u05d5\u05ea \u05dc\u05e8\u05d0\u05d5\u05ea \u05e0\u05d5\u05d8\u05d9\u05dd \u05d4\u05d9\u05d8\u05d1 \u05d5\u05de\u05d1\u05d5\u05e1\u05e1\u05d9\u05dd \u05e7\u05d9\u05d9\u05de\u05d9\u05dd \u05d5\u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05d4\u05d5\u05d0\u05d9\u05dc, \u05d9\u05d5\u05ea\u05e8 \u05e2\u05d5\u05d3\n.\u05d0\u05d9\u05d5\u05dd \u05d0\u05d5 \u05e9\u05d9\u05d1\u05d5\u05e9 \u05d7\u05d3\u05e9\u05d9\u05dd \u05d5\u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd\n \u05d4\u05e1\u05d3\u05e8\u05d9\u05dd \u05e9\u05dc \u05d1\u05de\u05ea\u05db\u05d5\u05e0\u05ea \u05ea\u05de\u05e8\u05d9\u05e6\u05d9\u05dd \u05dc\u05d9\u05e6\u05d5\u05e8 \u05d9\u05e9, \u05d6\u05d4 \u05d1\u05de\u05e6\u05d1 \u05d1\u05d4\u05ea\u05d7\u05e9\u05d1\n \u05d4\u05d0\u05de\u05e6\u05e2\u05d9\u05dd \u05d1\u05d9\u05df. \u05d5\u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd \u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05d0\u05d5\u05ea\u05dd \u05d0\u05ea \u05d5\u05d9\u05d7\u05d6\u05e7\u05d5 \u05d9\u05d1\u05d8\u05d9\u05d7\u05d5 \u05d0\u05e9\u05e8, \u05e4\u05d5\u05e8\u05de\u05dc\u05d9\u05d9\u05dd\n; \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d1\u05de\u05e9\u05e8\u05d3\u05d9 \u05dc\u05d0\u05e1"] [-6.233578205108643, 7.85307502746582, "\u05d5\u05d3\u05e2\u05d5\u05ea \u05d0\u05ea \u05d5\u05dc\u05d4\u05d2\u05d1\u05d9\u05e8 \u05e9\u05d5\u05e0\u05d9\u05dd\n \u05e2\u05e9\u05d5\u05d9\u05d5\u05ea \u05d1\u05ea\u05d4\u05dc\u05d9\u05da \u05d5\u05dc\u05d4\u05e9\u05ea\u05ea\u05e3 \u05d3\u05e2\u05ea\u05d5 \u05d0\u05ea \u05dc\u05d4\u05d1\u05d9\u05e2 \u05dc\u05e6\u05d9\u05d1\u05d5\u05e8 \u05d4\u05de\u05d0\u05e4\u05e9\u05e8\u05d5\u05ea \u05db\u05d0\u05dc\u05d4\n \u05d1\u05d5 \u05e9\u05d9\u05e9 \u05d3\u05d1\u05e8, \u05d1\u05d4\u05df \u05d5\u05dc\u05ea\u05de\u05d5\u05da \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d9\u05d5\u05d6\u05de\u05d5\u05ea \u05e9\u05dc \u05d4\u05dc\u05d2\u05d9\u05d8\u05d9\u05de\u05d9\u05d5\u05ea \u05d0\u05ea \u05dc\u05d7\u05d6\u05e7\n.\u05d6\u05de\u05df \u05dc\u05d0\u05d5\u05e8\u05da \u05db\u05d0\u05dc\u05d4 \u05d9\u05d5\u05d6\u05de\u05d5\u05ea \u05e9\u05dc \u05dc\u05e7\u05d9\u05d9\u05de\u05d5\u05ea \u05e2\u05dc\u05d9\u05d5\u05e0\u05d4 \u05d7\u05e9\u05d9\u05d1\u05d5\u05ea\n \u05e0\u05d1\u05d7\u05e8\u05d9 \u05db\u05de\u05d4 \u05e0\u05e2\u05d6\u05e8\u05d5, \u05d4\u05d0\u05d7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d1\u05e9\u05e0\u05d9\u05dd. \u05ea\u05e7\u05d3\u05d9\u05dd"] [-6.233322620391846, 7.852914810180664, "\u05d3\u05db\u05e0\u05d9\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e2\u05dc \u05e9\u05de\u05d9\u05e8\u05d4\n\u05de\u05e8\u05db\u05d6\u05d9\u05d9\u05dd \u05de\u05d3\u05d3\u05d9\u05dd \u05e9\u05dc \u05d5\u05e0\u05d9\u05ea\u05d5\u05d7 \u05de\u05d7\u05e7\u05e8 \u05d1\u05e1\u05d9\u05e1 \u05e2\u05dc, \u05d4\u05de\u05e9\u05e8\u05d3 \u05e9\u05dc\n \u2022 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d9\u05dd \u05d4\u05d9\u05e2\u05d3\u05d9\u05dd \u05d1\u05e0\u05d9\u05e1\u05d5\u05d7 \u05dc\u05ea\u05de\u05d5\u05da \u05db\u05d3\u05d9 \u05d4\u05e6\u05d5\u05d5\u05ea \u05e2\u05d1\u05d5\u05d3\u05ea \u05d4\u05d5\u05d1\u05dc\u05ea\n \u05db\u05d4\u05d5\u05e0\u05ea \u05dc\u05de\u05e9\u05da \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05ea \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05e9\u05dc \u05d5\u05e0\u05d9\u05d4\u05d5\u05dc \u05d5\u05d1\u05e0\u05d9\u05e1\u05d5\u05d7 \u05d4\u05de\u05e9\u05e8\u05d3 \u05e9\u05dc\n \u05dc\u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05d1\u05d9\u05d7\u05e1 \u05ea\u05e9\u05d5\u05de\u05d4 \u05ea\u05d4\u05d5\u05d5\u05d4 \u05d4\u05de\u05e9\u05e8\u05d3\u05d9"] [-6.23419189453125, 7.853331565856934, "\u05ea \u05de\u05d9\u05d3\u05e2 \u05d4\u05d7\u05dc\u05e4\u05ea, \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05ea \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05d1\u05e7\u05d1\u05d9\u05e2\u05ea\n. \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05d5\u05ea \u05d4\u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05d1\u05e7\u05e8\u05d1 \u05d4\u05de\u05de\u05e9\u05dc\u05ea\u05d9 \u05d4\u05e2\u05d3\u05d9\u05e4\u05d5\u05d9\u05d5\u05ea \u05e1\u05d3\u05e8 \u05d5\u05ea\u05e7\u05e9\u05d5\u05e8 \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05dd\n \u05ea\u05d9\u05d0\u05d5\u05dd ) \u05de\u201c\u05e8\u05d4 \u05d1\u05de\u05e9\u05e8\u05d3 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05d1\u05d9\u05d3\u05d9 \u05d9\u05d5\u05e4\u05e7\u05d3 \u05d4\u05e4\u05d5\u05e8\u05d5\u05dd \u05ea\u05d9\u05d0\u05d5\u05dd\n \u05d4\u05e0\u05d7\u05d9\u05d5\u05ea ) \u05de\u201c\u05e8\u05d4 \u05d1\u05de\u05e9\u05e8\u05d3 \u05d5\u05d7\u05d1\u05e8\u05d4 \u05dc\u05de\u05de\u05e9\u05dc \u05d5\u05d4\u05d0\u05d2\u05e3( \u05d4\u05de\u05e7\u05e6\u05d5\u05e2\u05d9 \u05d1\u05ea\u05d7\u05d5\u05dd \u05d5\u05d4\u05e0\u05d7\u05d9\u05d4\n(.\u05de\u05ea\u05d5\u05d3\u05d5\u05dc"] [-6.232917308807373, 7.852624416351318, "\u05db\u05d6\u05d9 \u05e1\u05d9\u05db\u05d5\u05df\n \u05e2\u05dc \u05d1\u05d4\u05d2\u05e0\u05d4 \u05ea\u05e2\u05e1\u05d5\u05e7, \u05d4\u05d6\u05de\u05df \u05d1\u05de\u05d4\u05dc\u05da \u05e9\u05d9\u05ea\u05e7\u05e9\u05d7 \u05d1\u05d9\u05d5\u05e8\u05d5\u05e7\u05e8\u05d8\u05d9 \u05dc\u05de\u05e0\u05d2\u05e0\u05d5\u05df \u05dc\u05d4\u05e4\u05d5\u05da\n. \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05dc\u05e7\u05d5\u05d1\u05e2\u05d9 \u05e8\u05dc\u05d5\u05d5\u05e0\u05d8\u05d9\u05ea \u05d1\u05dc\u05ea\u05d9 \u05d5\u05ea\u05d4\u05e4\u05d5\u05da \u05e9\u05dc\u05d4 \u05d4\u05de\u05d5\u05e1\u05d3\u05d9\u05d9\u05dd \u05d4\u05d0\u05d9\u05e0\u05d8\u05e8\u05e1\u05d9\u05dd\n, \u05de\u201c\u05e8\u05d4 \u05de\u05e9\u05e8\u05d3 \u05dc\u201c\u05d5\u05dc\u05de\u05e0\u05db \u05dc\u05db\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4 \u05dc\u05e8\u05d0\u05e9 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05d4\u05db\u05e4\u05e4\u05ea\n \u05dc\u05e9\u05d9\u05e8\u05d5\u05ea \u05de\u05d7\u05d5\u05e5 \u05d0\u05d5 \u05d0\u05d7\u05e8\u05d9\u05dd \u05de\u05de\u05e9\u05e8\u05d3\u05d9\u05dd \u05d6\u05de\u05e0\u05d9 \u05d4\u05e9"] [-6.234719753265381, 7.8535871505737305, "\u05e8\u05d3 \u05db\u05dc \u05e9\u05dc \u05d4\u05d0\u05d7\u05e8\u05d9\u05d5\u05ea \u05d1\u05ea\u05d7\u05d5\u05de\u05d9\n \u05dc\u05d1\u05d9\u05df \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05dd \u05e4\u05e2\u05d9\u05dc\u05d5\u05ea \u05d1\u05d9\u05df \u05d4\u05ea\u05d9\u05d0\u05d5\u05dd \u05d5\u05e9\u05d9\u05e4\u05d5\u05e8 \u05de\u05e9\u05e8\u05d3\u05d9\u05d5\u05ea- \u05d1\u05d9\u05df \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea\n.\u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d9\u05e2\u05d3\u05d9\n \u2022 \u05e9\u05dc \u05d7\u05d9\u05e6\u05d5\u05e0\u05d9\u05ea \u05de\u05d5\u05e2\u05e6\u05d4 \u05e2\u05dd \u05d5\u05ea\u05d9\u05d0\u05d5\u05dd \u05e4\u05e2\u05d5\u05dc\u05d4 \u05dc\u05e9\u05d9\u05ea\u05d5\u05e3 \u05de\u05e0\u05d2\u05e0\u05d5\u05df \u05d2\u05d9\u05d1\u05d5\u05e9 \u05d1\u05d7\u05d9\u05e0\u05ea\n7 \u05d4\u05de\u05dc\u05e6\u05d4 \u05e8\u05d0\u05d5 )\u05d5\u05de\u05d5\u05de\u05d7\u05d9\u05dd \u05e2\u05e0\u05d9\u05d9\u05df \u05d1\u05e2\u05dc\u05d9\u05d9\u05e9\u05e8\u05d0\u05dc \u05d1\u05de\u05d3\u05d9\u05e0\u05ea \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05ea- \u05e1\u05d5\u05e6\u05d9"] [-6.2327656745910645, 7.852083683013916, "\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4 \u05e8\u05d0\u05e9 \u05d1\u05e2\u05d1\u05d5\u05d3\u05ea \u05d4\u05ea\u05d5\u05de\u05da, \u05d4\u05e7\u05d9\u05d9\u05dd \u05d4\u05e6\u05d5\u05d5\u05ea \u05de\u05dc\u05d1\u05d3\n. \u05dc\u05d5 \u05e9\u05ea\u05d3\u05d5\u05d5\u05d7 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05d4 \u05dc\u05d4\u05e7\u05d9\u05dd \u05d9\u05e9, \u05de\"\u05dc\u05e8\u05d4 \u05d4\u05db\u05dc\u05db\u05dc\u05d9 \u05db\u05d9\u05d5\u05e2\u05e5 \u05d1\u05ea\u05e4\u05e7\u05d9\u05d3\u05d5\n \u05d1\u05d4\u05ea\u05d9\u05d9\u05e2\u05e6\u05d5\u05ea, \u05dc\u05db\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4 \u05e8\u05d0\u05e9 \u05d9\u05d3\u05d9 \u05e2\u05dc \u05d9\u05ea\u05de\u05e0\u05d4 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05e8\u05d0\u05e9\n \u05de\u05d5\u05e2\u05de\u05d3\u05d9\u05dd \u05e8\u05e7 \u05db\u05d9 \u05ea\u05d1\u05d8\u05d9\u05d7 \u05d4\u05de\u05d3\u05d9\u05e0\u05d4 \u05e9\u05d9\u05e8\u05d5\u05ea \u05e0\u05e6\u05d9\u05d1\u05d5\u05ea \u05d5\u05d0\u05d9\u05dc"] [-6.2322516441345215, 7.85175085067749, " \u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05e9\u05d9\u05e4\u05d5\u05e8 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05d5\u05d7\u05d9\u05d6\u05d5\u05e7 \u05dc\u05d9\u05dd\u201c\u05e1\u05de\u05e0\u05db \u05e4\u05d5\u05e8\u05d5\u05dd \u05d4\u05e7\u05de\u05ea\n\u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05d5\u05ea\n\u05dc\u05e7\u05d3\u05e0\u05e6\u05d9\u05d4 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d2\u05d9\u05d1\u05d5\u05e9\u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05d4\u05e7\u05de\u05ea\n, \u05d5\u05db\u05dc\u05db\u05dc\u05d4 \u05d7\u05d1\u05e8\u05d4 \u05d1\u05e0\u05d5\u05e9\u05d0\u05d9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e0\u05d3\u05d4\u2018\u05d0\u05d2 \u05d2\u05d9\u05d1\u05d5\u05e9\n\u05e8\u05dc\u05d5\u05d5\u05e0\u05d8\u05d9\u05d5\u05ea \u05ea\u05e4\u05d5\u05e7\u05d5\u05ea \u05db\u05d5\u05dc\u05dc\n\u05de\u201c\u05e8\u05d4 \u05de\u05e9\u05e8\u05d3 \u05de\u05e6\u05d3 \u05d4\u05ea\u05d9\u05d0\u05d5\u05dd \u05e9\u05d9\u05e4\u05d5\u05e8 \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d0\u05e1"] [-6.233426570892334, 7.853139400482178, "\u05d8\u05e3 \u05d1\u05e0\u05d9\u05d4\u05d5\u05dc \u05e9\u05e2\u05d5\u05e1\u05e7 \u05d1\u05db\u05d9\u05e8 \u05e0\u05d9\u05d4\u05d5\u05dc\u05d9 \u05dc\u05d3\u05e8\u05d2 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05ea\u2018 \u05e8 \u05e9\u05de\u05d9\u05e0\u05d5\u05d9 \u05de\u05d5\u05de\u05dc\u05e5 \u05d4\u05d9\u05d4, \u05dc\u05db\u05da \u05d1\u05d4\u05ea\u05d0\u05dd. \u05e8\u05dc\u05d1\u05e0\u05d8\u05d9\u05d5\u05ea \u05e2\u05dc \u05e9\u05de\u05d9\u05e8\u05d4\n. \u05de\u201c\u05e8\u05d4 \u05de\u05e9\u05e8\u05d3 \u05dc\u201c\u05de\u05e0\u05db \u05e2\u05dd \u05d1\u05e9\u05d9\u05ea\u05d5\u05e3 \u05dc\u05db\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4\u2018 \u05e8 \u05d9\u05d3\u05d9 \u05e2\u05dc \u05d9\u05d9\u05e2\u05e9\u05d4\n \u05d3\u05d5\u05e8\u05e9\u05d5\u05ea \u05d8\u05d5\u05d5\u05d7 \u05d5\u05d0\u05e8\u05d5\u05db\u05ea \u05e8\u05d7\u05d1\u05d4 \u05d5\u05d4\u05e1\u05ea\u05db\u05dc\u05d5\u05ea \u05e8\u05dc\u05d1\u05e0\u05d8\u05d9\u05d5\u05ea \u05e2\u05dc \u05e9\u05de\u05d9\u05e8\u05d4, \u05e9\u05e0"] [-6.233121395111084, 7.852721214294434, "\u05d5\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d5\u05ea \u05d1\u05d9\u05df \u05e7\u05d9\u05e9\u05d5\u05e8\n\u05d5\u05d4\u05ea\u05e7\u05e6\u05d9\u05d1 \u05d4\u05de\u05e0\u05d5\u05e1\u05d7\u05ea \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05dc \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05dc\u05e0\u05d9\u05d4\u05d5\u05dc \u05de\u05e7\u05e6\u05d5\u05e2\u05d9 \u05e4\u05d5\u05e8\u05d5\u05dd \u05d4\u05e7\u05de\u05ea\n\u05db\u05dc\u05db\u05dc\u05d9\u05ea\n\u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05d4\u05e7\u05de\u05ea\u05d9\u05e9\u05e8\u05d0\u05dc \u05d1\u05de\u05d3\u05d9\u05e0\u05ea \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05ea- \u05e1\u05d5\u05e6\u05d9\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e4\u05d9\u05ea\u05d5\u05d784\n \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9 \u05d4\u05d9\u05d5\u05dd \u05e1\u05d3\u05e8 \u05d0\u05ea \u05d5\u05dc\u05d0\u05e9\u05e8 \u05d5\u05dc\u05d4\u05e0\u05d7\u05d5\u05ea \u05d8\u05d5"] [-6.2334394454956055, 7.853139877319336, " \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\n \u05d4\u05d9\u05d7\u05d9\u05d3\u05d4 \u05d9\u05d3\u05d9 \u05e2\u05dc \u05e9\u05d9\u05d0\u05d5\u05e8\u05d2\u05e0\u05d5 \u05d9\u05d9\u05e2\u05d5\u05d3\u05d9\u05d9\u05dd \u05d0\u05d9\u05e8\u05d5\u05e2\u05d9\u05dd \u05e7\u05d9\u05d5\u05dd\n\u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n\u05dc\u05e7\u05d3\u05e0\u05e6\u05d9\u05d4 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d2\u05d9\u05d1\u05d5\u05e9 \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d4\u05e4\u05d5\u05dc\u05d9\u05d8\u05d9\u05ea \u05d1\u05e8\u05de\u05d4 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e4\u05d5\u05e8\u05d5\u05dd \u05d0\u05ea \u05dc\u05e2\u05e8\u05d1\n \u05e0\u05dc\u05d5\u05d5\u05d9\u05dd \u05d5\u05ea\u05d5\u05e6\u05e8\u05d9\u05dd \u05db\u05dc\u05db\u05dc\u05d9\u05ea- \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e0\u05d3\u05d4\u2018\u05d4\u05d0\u05d2\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e9\u05dc \u05de\u05ea\u05de\u05e9\u05da \u05d9\u05d9\u05e9\u05d5\u05dd\n \u05d5\u05d2\u05d9\u05d1\u05d5\u05e9 \u05db\u05dc"] [-6.234515190124512, 7.853498935699463, " .\u05e2\u05de\u05dd \u05d5\u05d4\u05ea\u05de\u05d5\u05d3\u05d3\u05d5\u05ea \u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05d9\u05dd- \u05e1\u05d5\u05e6\u05d9\u05d5 \u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05e9\u05dc \u05d7\u05d9\u05d6\u05d5\u05d9\n \u2022 \u05d5\u05d1\u05de\u05d4\u05dc\u05da \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d4\u05e7\u05de\u05ea \u05e2\u05dd \u05e9\u05d9\u05d2\u05d5\u05d1\u05e9\u05d5, \u05dc\u05e7\u05d3\u05e0\u05e6\u05d9\u05d4 \u05e4\u05e2\u05d5\u05dc\u05d4 \u05ea\u05db\u05e0\u05d9\u05d5\u05ea\n \u05dc\u05d1\u05d9\u05df \u05d4\u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05d5\u05ea \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05d1\u05d9\u05df \u05de\u05e7\u05e9\u05e8 \u05d2\u05d5\u05e8\u05dd \u05dc\u05d4\u05d5\u05d5\u05ea \u05e6\u05e8\u05d9\u05db\u05d5\u05ea \u05db\u05d4\u05d5\u05e0\u05ea\u05d4\n \u05d7\u05d1\u05e8\u05ea\u05d9\u05d9\u05dd \u05dc\u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05d1\u05d9\u05d7\u05e1 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05d2\u05d9\u05d1\u05d5\u05e9 \u05ea\u05d4\u05dc\u05d9\u05db\u05d9\n.\u05db\u05dc\u05db\u05dc\u05d9\u05d9\u05dd\n \u2022 \u05e9\u05dc"] [-6.237180709838867, 7.854959011077881, "\u05d3\u05d9\u05dd\n \u2022 \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9 \u05d1\u05ea\u05d7\u05d5\u05dd \u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05db\u05dc\u05e4\u05d9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e9\u05dc \u05d0\u05d9\u05de\u05d5\u05e5\n \u05e9\u05dc \u05d5\u05d4\u05e0\u05d9\u05d4\u05d5\u05dc \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05d5\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05e9\u05dc \u05d4\u05d2\u05d9\u05d1\u05d5\u05e9, \u05db\u05dc\u05db\u05dc\u05d9\n \u05db\u05d7\u05dc\u05e7 \u05dc\u05d4\u05ea\u05d1\u05e6\u05e2 \u05e6\u05e8\u05d9\u05db\u05d9\u05dd \u05d0\u05dc\u05d4 \u05db\u05dc \u2013 \u05de\u05d4\u05dd \u05d4\u05e0\u05d5\u05d1\u05e2\u05d9\u05dd \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea\n \u05d4\u05e4\u05d5\u05dc\u05d9\u05d8\u05d9\u05d9\u05dd \u05d4\u05de\u05e0\u05d4\u05d9\u05d2\u05d9\u05dd, \u05d3\u05d4\u05d9\u05d9\u05e0\u05d5 ) \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05dc\u05d9\u05d0\u05ea \u05de\u05e4\u05e2\u05d9\u05dc\u05d5\u05ea \u05e0\u05e4\u05e8\u05d3 \u05d1"] [-6.234225273132324, 7.853715419769287, " \u05d0\u05e4\u05e7\u05d8\u05d9\u05d1\u05d9 \u05d0\u05d9\u05e0\u05d5 \u05d4\u05d6\u05d4 \u05d4\u05db\u05dc\u05d9 \u05de\u05d3\u05d5\u05e2 \u05d1\u05d3\u05e7 \u05dc\u05d0 \u05d0\u05d9\u05e9 \u05d0\u05da, \u05d1\u05ea\u05e2\u05e9\u05d9\u05d9\u05d4\n[\u05de\u05d9\u05e2\u05d5\u05d8\u05d9\u05dd \u05e9\u05dc] \u05d4\u05e0\u05d2\u05d9\u05e9\u05d5\u05ea \u05d0\u05ea \u05dc\u05e9\u05e4\u05e8 \u05e0\u05d9\u05e1\u05d4 \u05dc\u05d0 \u05d5\u05d0\u05d9\u05e9 \u05de\u05d9\u05e2\u05d5\u05d8\u05d9\u05dd \u05d0\u05d5\u05db\u05dc\u05d5\u05e1\u05d9\u05d5\u05ea\n.\u05d9\u05d9\u05e9\u05d5\u05de\u05d5 \u05d0\u05ea \u05dc\u05d0\u05e4\u05e9\u05e8 \u05db\u05d3\u05d9 \u05d0\u05dc\u05d9\u05d5\n \u05e1\u05d9\u05db\u05d5\u05dd\n \u05e8\u05d1\u05d9\u05dd \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05e7\u05d9\u05d9\u05de\u05d9\u05dd3 \u05d1\u05e4\u05e8\u05e7 \u05e9\u05e0\u05d3\u05d5\u05df \u05db\u05e4\u05d9, \u05db\u05d9 \u05e2\u05d5\u05dc\u05d4 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05e4\u05e2\u05e8\u05d9\u05dd \u05de\u05e0\u05d9\u05ea\u05d5\u05d7\n \u05de\u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05d5\u05ea "] [-6.234589576721191, 7.8540167808532715, "\u05d9\u05dd \u05d4\u05d7\u05e8\u05d3\u05d9\u05dd \u05d1\u05e0\u05d5\u05e9\u05d0 \u05dc\u05d8\u05e4\u05dc \u05d9\u05e9 \u05db\u05d9 \u05e0\u05db\u05d5\u05e0\u05d4 \u05d6\u05d9\u05d4\u05d5 \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e7\u05d5\u05d1\u05e2\u05d9\n.\u05d9\u05d9\u05e9\u05d5\u05dd \u05d0\u05d9\u05df \u05d0\u05d1\u05dc \u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05d9\u05e9 \u05dc\u05db\u05df\n \u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05dc\u05d1\u05d9\u05df \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05d1\u05d9\u05df \u05d4\u05e8\u05d5\u05e4\u05e3 \u05d4\u05d7\u05d9\u05d1\u05d5\u05e8 \u05d0\u05ea \u05db\u05dc\u05dc\u05d5 \u05e9\u05d4\u05d5\u05d6\u05db\u05e8\u05d5 \u05d4\u05e1\u05d9\u05d1\u05d5\u05ea\n \u05dc\u05e9\u05dc\u05d1\u05d9 \u05d1\u05de\u05e2\u05d1\u05e8 \u05de\u05d7\u05dc\u05d5\u05e7\u05d5\u05ea \u05dc\u05e4\u05ea\u05e8\u05d5\u05df \u05e4\u05d5\u05e8\u05de\u05dc\u05d9\u05d9\u05dd \u05de\u05e0\u05d2\u05e0\u05d5\u05e0\u05d9\u05dd \u05d4\u05d9\u05e2\u05d3\u05e8, \u05d4\u05ea\u05e7\u05e6\u05d5\u05d1\n \u05e9\u05dc \u05d4\u05d9\u05d9\u05e9\u05d5\u05dd \u05dc\u05e6\u05d5\u05e8\u05da \u05de\u05e9\u05e8\u05d3\u05d9- \u05d1"] [-6.234437942504883, 7.854172229766846, "\u05e7\u05e8\u05d0\u05ea, \u05dc\u05d3\u05d5\u05d2\u05de\u05d4\n2.\u05d4\u05d0\u05d5\u05e6\u05e8 \u05d1\u05de\u05e9\u05e8\u05d3 \u05e9\u05d5\u05dc\u05d1\u05d4 \u05d5\u05e2\u05d3\u05d4 \u05d0\u05d5\u05ea\u05d4, \u05d0\u05d9\u05e9\u05d9\u05d9\u05dd \u05e7\u05e9\u05e8\u05d9\u05dd \u05d1\u05d0\u05de\u05e6\u05e2\u05d5\u05ea, \u05d9\u05d5\u05ea\u05e8 \u05de\u05d0\u05d5\u05d7\u05e8\u05d9\u05dd\n \u05e1\u05d5\u05d1\u05d1\u05d9\u05dd \u05d4\u05d3\u05d9\u05d5\u05e0\u05d9\u05dd. \u05d4\u05de\u05e7\u05d5\u05de\u05d9\u05d5\u05ea \u05d4\u05e8\u05e9\u05d5\u05d9\u05d5\u05ea \u05e2\u05dd \u05d5\u05de\u05ea\u05df \u05de\u05e9\u05d0 \u05e9\u05d5\u05dd \u05de\u05ea\u05e7\u05d9\u05d9\u05dd \u05dc\u05d0\n \u05de\u05d5\u05e2\u05d1\u05e8\u05ea[\u05d4\u05d0\u05d7\u05e8\u05d9\u05d5\u05ea] \u05d5\u05e9\u05d0\u05e8 \u05d4\u05ea\u05e7\u05e6\u05d9\u05d1 \u05d0\u05ea \u05dc\u05d0\u05d6\u05df \u05db\u05d9\u05e6\u05d3 \u05d4\u05e9\u05d0\u05dc\u05d4 \u05e1\u05d1\u05d9\u05d1 \u05e8\u05e7\n \u05d4\u05de\u05e7\u05d5\u05de\u05d9\u05d5\u05ea \u05d4\u05e8\u05e9\u05d5\u05d9\u05d5\u05ea \u05e9\u05dc \u05d9\u05db\u05d5\u05dc\u05ea\u05df \u05e9\u05dc \u05e0\u05d9\u05e6\u05d5\u05dc \u05d0"] [-6.233431816101074, 7.852873802185059, "\u05d1\u05e0\u05d5\u05d2\u05e2 \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05dc\u05d2\u05d1\u05d9 \u05d1\u05e1\u05d9\u05e1\u05d9\u05ea \u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05ea \u05e2\u05de\u05d3\u05d4 \u05db\u05d9\u05d5\u05dd \u05d0\u05d9\u05df\n.\u05e9\u05db\u05d6\u05d0\u05ea \u05e2\u05de\u05d3\u05d4 \u05dc\u05d2\u05d1\u05e9 \u05de\u05d0\u05d5\u05d3 \u05d5\u05e0\u05d7\u05d5\u05e5 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05e2\u05d9\u05e8\u05d5\u05e0\u05d9\u05d9\u05dd\n\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05de\u05e9\u05e8\u05d3\u05d9- \u05d1\u05d9\u05df \u05ea\u05d9\u05d0\u05d5\u05dd \u05d4\u05d9\u05e2\u05d3\u05e83 \u05e4\u05e2\u05e8\n \u05ea\u05d9\u05d0\u05d5\u05dd \u05de\u05d0\u05d5\u05d3 \u05de\u05e2\u05d8 \u05d5\u05d9\u05e9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e7\u05d9\u05d9\u05de\u05ea \u05e9\u05dc\u05d0 \u05de\u05d0\u05d7\u05e8\n \u05e4\u05e2\u05d9\u05dc\u05d5\u05d9\u05d5\u05ea \u05d1\u05d9\u05df \u05d4\u05e7\u05d9\u05d9\u05de\u05d9\u05dd \u05d4\u05e7\u05e9\u05e8\u05d9\u05dd, \u05d5\u05d4"] [-6.232568740844727, 7.852321147918701, "\u05d9\u05dd \u05d4\u05d3\u05d1\u05e8\u05d9\u05dd \u05d0\u05ea \u05e6\u05d9\u05d9\u05e0\u05d5 \u05e9\u05e8\u05d0\u05d9\u05d9\u05e0\u05d5 \u05d4\u05de\u05d5\u05de\u05d7\u05d9\u05dd\n \u05d4\u05d4\u05d7\u05dc\u05d8\u05d5\u05ea \u05e7\u05d1\u05dc\u05ea] .\u05e0\u05d1\u05d7\u05e8\u05ea \u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05d7\u05d9\u05d9\u05d1\u05d5\u05ea . . . \u05d2\u05d3\u05d5\u05dc\u05d5\u05ea \u05d4\u05d7\u05dc\u05d8\u05d5\u05ea\n[\u05d5\u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9] \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e9\u05dc \u05d4\u05ea\u05e4\u05e7\u05d9\u05d3 \u05d6\u05d4[\u05d4\u05dc\u05dc\u05d5\n \u05db\u05dc. \u05d4\u05e9\u05d0\u05e8 \u05d5\u05db\u05dc \u05e0\u05db\u05d9\u05dd, \u05e9\u05d1\u05d9\u05ea\u05d5\u05ea \u2013 \u05de\u201c\u05e8\u05d4 \u05d0\u05dc \u05de\u05d2\u05d9\u05e2\u05d4 \u05d1\u05e2\u05d9\u05d4 \u05db\u05dc \u05db\u05de\u05e2\u05d8\n.\u05d0\u05dc\u05d9\u05d5 \u05de\u05d5\u05e4\u05e0\u05d5\u05ea \u05d4\u05e2\u05d9\u05e0\u05d9\u05d9\u05dd\n \u05d5\u05e2\u05d3\u05ea \u05d9\u05e9\u05d9\u05d1\u05d5\u05ea \u05d5\u05e2\u05dc \u05d4\u05de"] [-6.233157157897949, 7.852522850036621, "\u05e6\u05d9\u05e8\u05ea \u05dc\u05d4\u05ea\u05d7\u05d9\u05dc \u05db\u05d3\u05d9 \u05de\u05de\u05e9\u05dc\u05d4 \u05d1\u05d4\u05d7\u05dc\u05d8\u05d5\u05ea\n\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e6\u05e8\u05d9\u05db\u05ea \u05e9\u05dc\n4 .\u05d4\u05e9\u05d5\u05e0\u05d9\u05dd \u05d1\u05de\u05e9\u05e8\u05d3\u05d9\u05dd \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05d7\u05d9\u05d6\u05d5\u05e7\n5 . \u05d5\u05ea\u05e9\u05d5\u05de\u05d5\u05ea \u05e0\u05d9\u05ea\u05d5\u05d7 \u05dc\u05ea\u05d5\u05e6\u05e8\u05d9 \u05d4\u05d7\u05d3\u05e9\u05d4 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05ea \u05e9\u05dc \u05e7\u05d9\u05e9\u05d5\u05e8\n\u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05d9\u05dd \u05d7\u05d5\u05e5 \u05de\u05d2\u05d5\u05e8\u05de\u05d9\u05dd\n6 . \u05e9\u05dc \u05d4\u05e7\u05d3\u05e0\u05e6\u05d9\u05d4 \u05ea\u05e7\u05d5\u05e4\u05ea \u05e2\u05dd \u05e9\u05ea\u05e7\u05d5\u05e9\u05e8 \u05dc\u05de\u05de\u05e9\u05dc\u05d4 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d2\u05d9\u05d1\u05d5\u05e9\n\u05d7\u05d3\u05e9\u05d5\u05ea \u05de"] [-6.2218756675720215, 7.841681003570557, " \u05de\u05e0\u05e1\u05d7\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4, \u05dc\u05e2\u05d9\u05dc \u05e6\u05d5\u05d9\u05df \u05e9\u05db\u05d1\u05e8 \u05db\u05e4\u05d9, \u05d1\u05e4\u05d9\u05e0\u05dc\u05e0\u05d3\n \u05d1\u05db\u05dc \u05d0\u05d7\u05ea \u05e4\u05e2\u05dd \u05de\u05e4\u05d9\u05e7\u05d4 \u05d4\u05d9\u05d0 \u05d1\u05e0\u05d5\u05e1\u05e3. \u05d4\u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05ea \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05dc\u05d9\u05d9\u05e9\u05d5\u05dd \u05d5\u05ea\u05d5\u05db\u05e0\u05d9\u05ea\n \u05d0\u05dd, \u05d4\u05d1\u05d0\u05d5\u05ea \u05d4\u05e9\u05e0\u05d9\u05dd \u05e2\u05e9\u05e8\u05d9\u05dd \u05e2\u05d3 \u05d1\u05e2\u05e9\u05e8 \u05d4\u05e2\u05d5\u05e1\u05e7 \u05ea\u05d7\u05d6\u05d9\u05ea \u05d3\u05d5\u05d7 \u05d1\u05d7\u05d9\u05e8\u05d5\u05ea \u05ea\u05e7\u05d5\u05e4\u05ea\n2011-\u05d1 \u05d4\u05d7\u05dc\u05d4 \u05e9\u05db\u05d4\u05d5\u05e0\u05ea\u05d4, \u05d4\u05d0\u05d7\u05e8\u05d5\u05e0\u05d4 \u05d4\u05de\u05de\u05e9\u05dc\u05d4. \u05db\u05d4\u05d5\u05e0\u05ea\u05d4 \u05d1\u05ea\u05d7\u05d9\u05dc\u05ea \u05dc\u05d0 \u05db\u05d9\n \u05dc\u05d4\u05db\u05d9\u05df"] [-6.23121452331543, 7.851390361785889, "2 \u05d0\u05d9\u05d5\u05e8 )\u05d1\u05ea\u05e2\u05d3\u05d5\u05e3 \u05d5\u05dc\u05ea\u05de\u05d9\u05db\u05d4 \u05de\u05de\u05e9\u05dc\u05ea\u05d9 \u05e4\u05e0\u05d9\u05dd \u05dc\u05ea\u05d9\u05d0\u05d5\u05dd, \u05d4\u05e6\u05d9\u05d1\u05d5\u05e8 \u05dc\u05d2\u05d9\u05d5\u05e1 \u05db\u05db\u05dc\u05d9\n. \u05e9\u05e0\u05d9\u05dd \u05dc\u05e2\u05e9\u05e8 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05de\u05e0\u05e1\u05d7\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4, \u05d4\u05d1\u05e8\u05d9\u05d8\u05d9\u05ea \u05d1\u05e7\u05d5\u05dc\u05d5\u05de\u05d1\u05d9\u05d4\n \u05d0\u05d7\u05d3 \u05d5\u05db\u05dc \u05e9\u05e0\u05ea\u05d9\u05ea- \u05ea\u05dc\u05ea \u05e4\u05d9\u05e1\u05e7\u05dc\u05d9\u05ea \u05d5\u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05ea\u05e7\u05e6\u05d9\u05d1 \u05de\u05db\u05d9\u05df \u05d4\u05d0\u05d5\u05e6\u05e8 \u05de\u05e9\u05e8\u05d3\n \u05d4\u05dc\u05dc\u05d5 \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea. \u05e9\u05e0\u05ea\u05d9\u05ea- \u05ea\u05dc\u05ea \u05e2\u05d1\u05d5\u05d3\u05d4 \u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05e9\u05e0\u05d4 \u05de\u05d3\u05d9 \u05de\u05db\u05d9\u05df "] [-6.2333903312683105, 7.853377342224121, "\u05d5 \u05d4\u05de\u05ea\u05d0\u05dd \u05db\u05de\u05e9\u05e8\u05d3 \u05dc\u05e9\u05de\u05e9 \u05de\u05d5\u05e0\u05d4 \u05d5\u05d1\u05e8\u05d9\u05d0\u05d5\u05ea \u05d7\u05d1\u05e8\u05d4 \u05dc\u05e2\u05e0\u05d9\u05d9\u05e0\u05d9\n. \u05d4\u05d0\u05d7\u05e8\u05d0\u05d9\u05dd \u05db\u05e9\u05e8\u05d9\u05dd \u05d4\u05d5\u05d2\u05d3\u05e8\u05d5 \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9\u05d9\u05dd \u05d5\u05d4\u05e9\u05d9\u05e8\u05d5\u05ea\u05d9\u05dd \u05d4\u05d1\u05e8\u05d9\u05d0\u05d5\u05ea \u05d5\u05e9\u05e8 \u05de\u05e9\u05e8\u05d3\n \u05e2\u05d3\u05d9\u05e4\u05d5\u05ea \u05dc\u05de\u05d9\u05de\u05d5\u05e9 \u05e9\u05d5\u05e0\u05d5\u05ea \u05dc\u05e4\u05e2\u05d5\u05dc\u05d5\u05ea \u05d0\u05d7\u05e8\u05d9\u05d5\u05ea \u05d4\u05d5\u05d8\u05dc\u05d4 \u05d4\u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05d1\u05de\u05e1\u05d2\u05e8\u05ea\n \u05e7\u05e9\u05e8 \u05d0\u05e0\u05e9\u05d9 \u05e8\u05e9\u05ea \u05d4\u05d5\u05e7\u05de\u05d4, \u05d1\u05e0\u05d5\u05e1\u05e3. \u05e0\u05d5\u05e1\u05e4\u05d9\u05dd \u05e9\u05e8\u05d9\u05dd \u05e2\u05dc \u05d2\u05dd \u05d6\u05d0\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea\n \u05d4\u05e8\u05e9\u05ea; "] [-6.231629371643066, 7.851107597351074, "\u05dc \u05d4\u05d1\u05d9\u05e0\u05d9\u05d9\u05dd \u05dc\u05d8\u05d5\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05dc\u05d2\u05d9\u05d1\u05d5\u05e9 \u05db\u05d0\u05de\u05e6\u05e2\u05d9, \u05d1\u05db\u05d9\u05e8\u05d9\u05dd\n \u05e4\u05d5\u05e8\u05de\u05dc\u05d9 \u05ea\u05d9\u05d0\u05d5\u05dd \u05e9\u05dc \u05d3\u05d5\u05d2\u05de\u05d0\u05d5\u05ea \u05d1\u05de\u05e1\u05e4\u05e8 \u05e0\u05ea\u05e7\u05dc\u05e0\u05d5. \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05e9\u05dc \u05d5\u05d4\u05d9\u05d9\u05e9\u05d5\u05dd\n \u05e9\u05dc \u05d3\u05d5\u05d2\u05de\u05d0\u05d5\u05ea \u05e4\u05d7\u05d5\u05ea \u05d4\u05e8\u05d1\u05d4 \u05de\u05e6\u05d0\u05e0\u05d5 \u05d0\u05da \u05d4\u05d1\u05d9\u05e0\u05d9\u05d9\u05dd \u05dc\u05d8\u05d5\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05e9\u05dc\n \u05d4\u05de\u05d5\u05e4\u05e7\u05d3\u05d5\u05ea \u05d4\u05e9\u05d5\u05e0\u05d5\u05ea \u05d4\u05d5\u05d5\u05e2\u05d3\u05d5\u05ea. \u05d4\u05d0\u05e8\u05d5\u05da \u05dc\u05d8\u05d5\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05e9\u05dc \u05e4"] [-6.238925457000732, 7.858578205108643, "\u05d9\u05ea\u05d5\u05d756\n\u05d4\u05d0\u05e8\u05d5\u05da \u05dc\u05d8\u05d5\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05de\u05e1\u05de\u05db\u05d9 \u05dc\u05de\u05e6\u05d5\u05d0 \u05d9\u05d5\u05ea\u05e8 \u05e0\u05d3\u05d9\u05e8, \u05d4\u05d1\u05d9\u05e0\u05d9\u05d9\u05dd \u05dc\u05d8\u05d5\u05d5\u05d7 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d1\u05d4\u05e9\u05d5\u05d5\u05d0\u05d4\n \u05d4\u05de\u05ea\u05d9\u05d9\u05d7\u05e1\u05d9\u05dd( \u05d4\u05d9\u05d8\u05d1 \u05d5\u05de\u05e0\u05d5\u05e1\u05d7\u05d5\u05ea \u05de\u05d5\u05d2\u05d3\u05e8\u05d5\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d0\u05e4\u05d9\u05dc\u05d5 \u05d0\u05d5 )\u05d1\u05e1\u05d9\u05e1 \u05e8\u05d7\u05d1\u05ea\n \u05de\u05e1\u05de\u05db\u05d9\u05dd, \u05d4\u05de\u05e7\u05e8\u05d9\u05dd \u05d1\u05e8\u05d5\u05d1. \u05d3\u05d5\u05d2\u05de\u05d0\u05d5\u05ea \u05de\u05e1\u05e4\u05e8 \u05d9\u05e9 \u05d0\u05da, \u05d9\u05d5\u05ea\u05e8 \u05d0\u05e8\u05d5\u05db\u05d9\u05dd \u05d6\u05de\u05df \u05dc\u05e4\u05e8\u05e7\u05d9\n, \u05d7\u05d9\u05e6\u05d5\u05e0\u05d9\u05d9\u05dd "] [-6.231891632080078, 7.85174560546875, "006 ,\u05d4\u05d1\u05e8\u05d9\u05d8\u05d9\u05ea \u05e7\u05d5\u05dc\u05d5\u05de\u05d1\u05d9\u05d4 \u05de\u05d7\u05d5\u05d6)\n \u05dc\u05d8\u05d5\u05d5\u05d7 \u05e4\u05d9\u05e1\u05e7\u05dc\u05d9\u05d5\u05ea \u05de\u05e1\u05d2\u05e8\u05d5\u05ea \u05de\u05e1\u05e4\u05e8 \u05e0\u05d9\u05e1\u05d7\u05d5 \u05d1\u05d3\u05e0\u05de\u05e8\u05e7 \u05e9\u05db\u05d9\u05d4\u05e0\u05d5 \u05de\u05de\u05e9\u05dc\u05d5\u05ea\n \u05de\u05e9\u05e4\u05d8\u05d9\u05ea \u05d7\u05d5\u05d1\u05d4 \u05e2\u05dc\u05d9\u05d4\u05df \u05e9\u05d7\u05dc\u05d4 \u05de\u05d1\u05dc\u05d9, \u05e2\u05e9\u05d5\u05e8 \u05e2\u05d3 \u05e9\u05dc \u05ea\u05e7\u05d5\u05e4\u05d4 \u05d4\u05de\u05db\u05e1\u05d5\u05ea \u05d4\u05d1\u05d9\u05e0\u05d5\u05e0\u05d9\n \u05de\u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d1\u05d7\u05dc\u05e7 \u05ea\u05de\u05d9\u05db\u05d4 \u05dc\u05d2\u05d9\u05d5\u05e1 \u05d0\u05de\u05e6\u05e2\u05d9\u05dd \u05db\u05dc\u05dc \u05d6\u05d4 \u05ea\u05d4\u05dc\u05d9\u05da. \u05d6\u05d0\u05ea \u05dc\u05e2\u05e9\u05d5\u05ea\n \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d1\u05db\u05dc \u05db\u05de\u05d5. \u05d4\u05d1\u05d0\u05d5\u05ea "] [-6.23981237411499, 7.860249042510986, "\u05e1\u05db\u05dd. \u05d4\u05e2\u05d1\u05d5\u05d3\u05d4 \u05d5\u05e9\u05d5\u05e7\n \u05d1\u05e0\u05e4\u05e8\u05d3 \u05d4\u05de\u05d5\u05d2\u05e9\u05d5\u05ea, \u05d4\u05de\u05e9\u05e8\u05d3\u05d9\u05dd \u05dc\u05ea\u05e7\u05e6\u05d9\u05d1\u05d9 \u05d4\u05d7\u05d5\u05e7 \u05d4\u05e6\u05e2\u05d5\u05ea \u05d0\u05ea \u05de\u05e0\u05d7\u05d5\u05ea \u05d5\u05d0\u05dc\u05d4\n.\u05d4\u05e4\u05e8\u05dc\u05de\u05e0\u05d8 \u05e9\u05dc \u05dc\u05d0\u05d9\u05e9\u05d5\u05e8\u05d5\n \u05e4\u05d5\u05dc\u05d9\u05d8\u05d9\u05ea \u05ea\u05d5\u05db\u05e0\u05d9\u05ea \u05e2\u05dc \u05d5\u05d9\u05d9\u05ea\u05e0\u05d5 \u05d9\u05d9\u05e9\u05d0\u05d5 \u05d1\u05e4\u05e8\u05dc\u05de\u05e0\u05d8 \u05d4\u05de\u05d9\u05d5\u05e6\u05d2\u05d5\u05ea \u05d4\u05e7\u05d1\u05d5\u05e6\u05d5\u05ea, \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05d1\u05d7\u05d9\u05e8\u05ea \u05dc\u05e4\u05e0\u05d9 \u201d\u05e0\u05d0\u05de\u05e8 \u05dc\u05d7\u05d5\u05e7\u05d461 \u05d1\u05e1\u05e2\u05d9\u05e32\n .\u05d4\u05e6\u05d4\u05e8\u05d4 \u05e9\u05dc \u05d1\u05de\u05ea\u05db\u05d5\u05e0\u05ea, \u05d4\u05e4\u05e8\u05dc\u05de\u05e0\u05d8 \u05dc\u05e4\u05e0\u05d9"] [-6.236032009124756, 7.8557257652282715, "\u05d4\u05e7\u05e9\u05d5\u05e8\u05d9\u05dd\n \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d5\u05e2\u05d3\u05d42009 \u05d1\u05de\u05d0\u05d9 \u05de\u201c\u05e8\u05d4 \u05db\u05d9\u05e0\u05e1, \u05d4\u05e2\u05d5\u05dc\u05de\u05d9 \u05d4\u05e4\u05d9\u05e0\u05e0\u05e1\u05d9\n, \u05e0\u05d5\u05e1\u05e4\u05d9\u05dd \u05e9\u05e8\u05d9\u05dd \u05d0\u05e8\u05d1\u05e2\u05d4 \u05d5\u05d1\u05d4\u05e9\u05ea\u05ea\u05e4\u05d5\u05ea \u05d4\u05d0\u05d5\u05e6\u05e8 \u05e9\u05e8 \u05d1\u05e8\u05d0\u05e9\u05d5\u05ea, \u05d7\u05d1\u05e8\u05d9\u05dd25 \u05d5\u05d1\u05d4\n \u05d4\u05e1\u05e4\u05e8 \u05d1\u05d9\u05ea \u05d5\u05d3\u05d9\u05e7\u05df \u05d5\u05e2\u05d5\u05d1\u05d3\u05d9\u05dd \u05e2\u05e1\u05e7\u05d9\u05dd \u05e0\u05e6\u05d9\u05d2\u05d9, \u05d1\u05db\u05d9\u05e8\u05d9\u05dd \u05e9\u05e8\u05d9\u05dd \u05e9\u05e0\u05d9, \u05e9\u05e8 \u05de\u05e7\u05d5\u05dd \u05de\u05de\u05dc\u05d0\nSingaporean Economic) \u05e1\u05d9\u05e0\u05d2\u05e4\u05d5\u05e8 \u05e9\u05dc \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea"] [-6.235498428344727, 7.8549652099609375, "\u05e9\u05e8 \u05d4\u05de\u05de\u05e9\u05dc\u05d5\u05ea \u05db\u05dc \u05e9\u05dc \u05d8\u05d9\u05e4\u05d5\u05dc \u05d4\u05de\u05d7\u05d9\u05d9\u05d1\u05d5\u05ea \u05de\u05d5\u05e8\u05db\u05d1\u05d5\u05ea \u05d1\u05e2\u05d9\u05d5\u05ea\n.\u05e2\u05de\u05df \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3 \u05de\u05e2\u05d5\u05e0\u05d9\u05d9\u05e0\u05ea \u05d0\u05d9\u05e0\u05d4 \u05d4\u05e0\u05d5\u05db\u05d7\u05d9\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4\n \u05d0\u05d7\u05ea \u05d4\u05d9\u05d02006-\u05d52005 \u05d1\u05e9\u05e0\u05d9\u05dd \u05e9\u05e4\u05e2\u05dc\u05d4 \u05d4\u05d3\u05e0\u05d9\u05ea \u05d4\u05d2\u05dc\u05d5\u05d1\u05dc\u05d9\u05d6\u05e6\u05d9\u05d4 \u05d5\u05e2\u05d3\u05ea\n, \u05d1\u05d5\u05d5\u05e2\u05d3\u05d4. \u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d1\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05d8\u05d9\u05e4\u05dc\u05d4 \u05d4\u05d5\u05e7-\u05d0\u05d3 \u05dc\u05d5\u05d5\u05e2\u05d3\u05d4 \u05d4\u05d3\u05d5\u05d2\u05de\u05d0\u05d5\u05ea\n \u05e8\u05d0\u05e9, \u05d0\u05e7\u05d3\u05de\u05d9\u05d4 \u05d0\u05e0\u05e9\u05d9, \u05e9\u05e8\u05d9\u05dd \u05d7"] [-6.232558250427246, 7.8520965576171875, "\u05d9\u05e0\u05dc\u05d0\u05d5\u05de\u05d9\u05d5\u05ea \u05d4\u05e9\u05d5\u05d5\u05d0\u05d5\u05ea\n \u05d5\u05d3\u05e8\u05d9\u05e9\u05d5\u05ea \u05de\u05e0\u05d4\u05d9\u05d2\u05d5\u05ea\u05d9 \u05d7\u05d6\u05d5\u05df \u05e9\u05d1\u05d5 \u05dc\u05d0\u05d5\u05e4\u05df \u05d3\u05d5\u05d2\u05de\u05d4 \u05d4\u05d9\u05d0 \u05d4\u05d1\u05e8\u05d9\u05d8\u05d9\u05ea \u05e7\u05d5\u05dc\u05d5\u05de\u05d1\u05d9\u05d4\n \u05e9\u05e7\u05d9\u05d9\u05de\u05e0\u05d5 \u05de\u05d4\u05e8\u05d0\u05d9\u05d5\u05e0\u05d5\u05ea. \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05d7\u05e9\u05d9\u05d1\u05d4 \u05dc\u05d8\u05e4\u05d7 \u05db\u05d3\u05d9 \u05d9\u05d7\u05d3 \u05d7\u05d1\u05e8\u05d5 \u05de\u05e9\u05e4\u05d8\u05d9\u05d5\u05ea\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05dc\u05e8\u05d0\u05e9\u05d5\u05e0\u05d4 \u05d2\u05d5\u05d1\u05e9\u05d4 \u05db\u05d4\u05d5\u05e0\u05ea\u05d5 \u05e9\u05d1\u05de\u05e1\u05d2\u05e8\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e9\u05e8\u05d0\u05e9 \u05e2\u05d5\u05dc\u05d4\n \u05d4\u05d3\u05d5\u05e7 \u05d1\u05d0\u05d5\u05e4\u05df \u05d5\u05e4\u05d9\u05e7\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05d7\u05e9\u05d9\u05d1\u05d4 "] [-6.2326226234436035, 7.852011203765869, "\u05dc\u05e0\u05d5 \u05de\u05e8\u05d0\u05d9\u05d5\u05ea \u05e9\u05dc\u05e0\u05d5 \u05d4\u05d4\u05ea\u05e8\u05e9\u05de\u05d5\u05d9\u05d5\u05ea \u05d0\u05ea\n.\u05d1\u05d9\u05e7\u05d5\u05e9 \u05e9\u05dc \u05d1\u05d9\u05d5\u05ea\u05e8 \u05d4\u05d7\u05d6\u05e7\u05d9\u05dd \u05d4\u05de\u05d3\u05e8\u05d1\u05e0\u05d9\u05dd \u05d4\u05d2\u05d5\u05e8\u05de\u05d9\u05dd \u05dc\u05e9\u05e0\u05d9 \u05d1\u05d0\u05e9\u05e8, \u05e9\u05d1\u05d3\u05e7\u05e0\u05d5\n \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05de\u05e6\u05d3 \u05de\u05d7\u05d5\u05d9\u05d1\u05d5\u05ea \u05db\u05d5\u05dc\u05dc\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05de\u05e6\u05d3 \u05de\u05e2\u05d5\u05e8\u05d1\u05d5\u05ea\n \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e9\u05dc \u05d1\u05e4\u05d9\u05ea\u05d5\u05d7 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05d7\u05e9\u05d9\u05d1\u05d4 \u05dc\u05db\u05dc\u05d5\u05dc \u05d4\u05de\u05d3\u05d9\u05e0\u05d4 \u05e9\u05d9\u05e8\u05d5\u05ea \u05e8\u05d0\u05e9 \u05d0\u05d5\n \u05d4\u05de\u05d7\u05d9\u05d9\u05d1\u05d9\u05dd \u05d7\u05d5\u05e7\u05d9\u05dd \u05e8\u05e7 \u05dc\u05d0 \u05db\u05d5\u05dc\u05dc\u05d5"] [-6.238543510437012, 7.856273174285889, "\u05d4\u05e9\u05d5\u05e0\u05d9\u05dd \u05d4\u05e1\u05e2\u05d9\u05e4\u05d9\u05dd. \u05d5\u05dc\u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd \u05dc\u05ea\u05d5\u05db\u05df \u05d5\u05e0\u05e2\u05d1\u05d5\u05e8 \u05d1\u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e0\u05ea\u05d7\u05d9\u05dc. \u05db\u05dc\u05db\u05dc\u05d9\u05ea\n.\u05d6\u05d4\u05d4 \u05d1\u05e1\u05d3\u05e8 \u05d5\u05e2\u05e8\u05d5\u05db\u05d9\u05dd \u05dc\u05e2\u05d9\u05dc \u05d4\u05de\u05d5\u05d1\u05d0\u05ea \u05d4\u05ea\u05d5\u05d1\u05e0\u05d5\u05ea \u05dc\u05e8\u05e9\u05d9\u05de\u05ea \u05de\u05e7\u05d1\u05d9\u05dc\u05d9\u05dd\n \u05d1\u05d9\u05db\u05d5\u05dc\u05d5\u05ea \u05d5\u05de\u05d0\u05d5\u05d9\u05e9\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05e9\u05dc \u05dc\u05d1\u05d5 \u05d1\u05ea\u05e9\u05d5\u05de\u05ea \u05d4\u05d6\u05d5\u05db\u05d4 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05d4\n\u05de\u05e7\u05e6\u05d5\u05e2\u05d9\u05d5\u05ea\n \u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05dc\u05d1\u05d7\u05d5\u05df \u05e9\u05ea\u05e4\u05e7\u05d9\u05d3\u05dd \u05d9\u05d9\u05e2\u05d5\u05d3\u05d9\u05d9\u05dd \u05e6\u05d5\u05d5\u05ea\u05d9\u05dd \u05d9\u05e9"] [-6.234063625335693, 7.853303909301758, "\u05d5\u05d9\n.\u05dc\u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05d7\u05d5\u05e5 \u05e2\u05e0\u05d9\u05d9\u05df \u05d1\u05e2\u05dc\u05d9 \u05d0\u05d5 \u05de\u05d5\u05de\u05d7\u05d9\u05dd \u05d9\u05d3\u05d9 \u05e2\u05dc \u05e9\u05d9\u05d5\u05d2\u05e9\u05d5 \u05e2\u05d6\u05e8\n \u2022 \u05dc\u05d4\u05d9\u05d5\u05ea \u05d0\u05de\u05d5\u05e8\u05d4 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05dc\u05d9\u05d7\u05d9\u05d3\u05d4. \u05d1\u05d9\u05d9\u05e9\u05d5\u05dd \u05d9\u05e1\u05d9\u05d9\u05e2\u05d5 \u05dc\u05ea\u05e7\u05e6\u05d9\u05d1 \u05e7\u05e9\u05e8\u05d9\u05dd\n \u05dc\u05db\u05d4\u05d5\u05e0\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05dc \u05d4\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d1\u05e2\u05ea \u05ea\u05e7\u05e6\u05d9\u05d1\u05d9\u05d9\u05dd \u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd \u05e2\u05dc \u05d4\u05e9\u05e4\u05e2\u05d4\n \u05d1\u05d9\u05d9\u05d7\u05d5\u05d3, \u05d6\u05d5 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05ea\u05e9\u05d5\u05de\u05d5\u05ea \u05dc\u05e1\u05e4\u05e7 \u05d4\u05ea\u05e7\u05e6\u05d9\u05d1 \u05d0\u05e0\u05e9\u05d9 \u05d5\u05e2\u05dc \u05d4\u05de\u05de\u05e9\u05dc\u05d4\n "] [-6.233606815338135, 7.853204727172852, "\u05e8. \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4\n \u05dc\u05e2\u05d5\u05e1\u05e7\u05d9\u05dd \u05de\u05d9\u05d5\u05d7\u05d3\u05ea \u05d4\u05db\u05e9\u05e8\u05d4, \u05de\u05e9\u05e8\u05d3\u05d9\u05d5\u05ea \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05e9\u05dc\n \u05e9\u05d1\u05de\u05e1\u05d2\u05e8\u05ea\u05d5 \u05de\u05e0\u05d2\u05e0\u05d5\u05df \u05d5\u05d9\u05e6\u05d9\u05e8\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05e9\u05e8\u05d3\u05d9 \u05d1\u05ea\u05d5\u05da \u05d1\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05d5\u05dc\u05ea\u05e7\u05e6\u05d9\u05d1 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05ea\u05e9\u05d5\u05de\u05d5\u05ea \u05d1\u05de\u05e9\u05e8\u05d3 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d0\u05e0\u05e9\u05d9 \u05ea\u05d5\u05e8\u05de\u05d9\u05dd\n.\u05d4\u05de\u05e9\u05e8\u05d3 \u05e9\u05dc\n \u2022 \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05dc \u05d5\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea "] [-6.2337141036987305, 7.853189945220947, " \u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05dc \u05d5\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e9\u05dc \u05e0\u05e7\u05d9\u05d8\u05d4\n \u05d9\u05d7\u05d9\u05d3\u05d4 \u05e9\u05dc \u05ea\u05d2\u05d1\u05d5\u05e8\u05d4 \u05d0\u05d5 \u05de\u05d4\u05e7\u05de\u05ea\u05d4 \u05ea\u05d5\u05e2\u05dc\u05ea \u05d9\u05e4\u05d9\u05e7\u05d5 \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05db\u05dc\u05db\u05dc\u05d9\u05ea\n \u05d5\u05ea\u05d0\u05d5\u05d9\u05e9 \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05e9\u05dc \u05dc\u05d1\u05d5 \u05d1\u05ea\u05e9\u05d5\u05de\u05ea \u05e9\u05ea\u05d6\u05db\u05d4 \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05d9\u05d5\u05ea\u05e8 \u05d7\u05e9\u05d5\u05d1\u05d9\u05dd \u05d5\u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e9\u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd \u05de\u05db\u05d9\u05d5\u05d5\u05df. \u05d7\u05d6\u05e7\u05d5\u05ea \u05de\u05e7\u05e6\u05d5\u05e2\u05d9\u05d5\u05ea \u05d1\u05d9\u05db\u05d5\u05dc\u05d5\u05ea\n \u05e2\u05e9\u05d5\u05d9\u05d4 "] [-6.234196186065674, 7.853911399841309, "\u05d9\u05d3\u05d9 \u05e2\u05dc \u05e9\u05e4\u05d5\u05e8\u05e7\u05d4, \u05d1\u05e8\u05d9\u05d8\u05e0\u05d9\u05d4 \u05de\u05de\u05e9\u05dc\u05ea \u05e8\u05d0\u05e9 \u05e9\u05dc \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\nInstitute for Government, 2011; UK Prime Minister\u2019s Strategy Unit,) 2002-\u05d1 \u05d1\u05dc\u05d9\u05d9\u05e8 \u05d8\u05d5\u05e0\u05d9 \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e8\u05d0\u05e9 \u05d9\u05d3\u05d9 \u05e2\u05dc\n \u05d5\u05d4\u05ea\u05e4\u05ea\u05d7\u05d4 \u05e7\u05d9\u05d9\u05de\u05d9\u05dd \u05d0\u05e8\u05d2\u05d5\u05e0\u05d9\u05dd \u05e9\u05e0\u05d9 \u05d1\u05d9\u05df \u05de\u05e9\u05d9\u05dc\u05d5\u05d1 \u05e0\u05d5\u05e6\u05e8\u05d4 \u05d4\u05d9\u05d0 \u05d0\u05dc\u05d0, \u05d7\u05d3\u05e9\u05d4 \u05d9\u05d7\u05d9\u05d3\u05d4 \u05d4\u05d9\u05d9\u05ea\u05d4 \u05dc\u05d0 \u05de\u05dc\u05db\u05ea\u05d7\u05d9\u05dc\u05d4 \u05d4\u05d9\u05d7"] [-6.238113880157471, 7.85626745223999, "\u05d7\u05d5\u05ea \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05d5\u05ea \u05e1\u05d5\u05d2\u05d9\u05d5\u05ea \u05d1\u05d5\u05d7\u05e0\u05d5\u05ea \u05d4\u05df \u05e9\u05d1\u05d5 \u05d1\u05d0\u05d5\u05e4\u05df \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea\n \u05dc\u05de\u05de\u05e9\u05dc\u05d4 \u05d4\u05df \u05e9\u05d9\u05d5\u05e2\u05d9\u05dc \u05d1\u05d0\u05d5\u05e4\u05df, \u05d0\u05dc\u05d4 \u05d1\u05e0\u05d5\u05e9\u05d0\u05d9\u05dd \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d5\u05de\u05d9\u05d9\u05e9\u05de\u05d5\u05ea\n \u05e9\u05dc \u05d4\u05d9\u05d9\u05d7\u05d5\u05d3\u05d9\u05d9\u05dd \u05d4\u05de\u05d0\u05e4\u05d9\u05d9\u05e0\u05d9\u05dd \u05d0\u05e3 \u05e2\u05dc. \u05d1\u05e2\u05e7\u05d1\u05d5\u05ea\u05d9\u05d4 \u05e9\u05d9\u05d1\u05d5\u05d0\u05d5 \u05dc\u05d0\u05dc\u05d4 \u05d5\u05d4\u05df \u05d4\u05de\u05db\u05d4\u05e0\u05ea\n \u05d0\u05d7\u05e8\u05d5\u05ea \u05de\u05d3\u05d9\u05e0\u05d5\u05ea \u05e9\u05dc \u05d5\u05de\u05d4\u05db\u05d9\u05e9\u05dc\u05d5\u05e0\u05d5\u05ea \u05de\u05d4\u05d4\u05e6\u05dc\u05d7\u05d5\u05ea \u05dc\u05dc\u05de\u05d5\u05d3 "] [-6.233823299407959, 7.853091239929199, " \u05d4\u05ea\u05db\u05e0\u05d5\u05df \u05d5\u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05d4\u05e9\u05e0\u05ea\u05d9 \u05d4\u05ea\u05e7\u05e6\u05d9\u05d1 \u05d4\u05db\u05e0\u05ea \u05d4\u05dd \u05d4\u05de\u05e8\u05db\u05d6\u05d9\u05d9\u05dd\n, \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e9\u05dc \u05e4\u05d9\u05ea\u05d5\u05d7 \u05de\u05d5\u05e0\u05e2\u05ea \u05e9\u05d4\u05e9\u05e4\u05e2\u05ea\u05dd \u05d5\u05d9\u05d9\u05ea\u05db\u05df \u05d1\u05d5\u05e0\u05d9\u05dd \u05d2\u05d5\u05de\u05dc\u05d9\u05df \u05e7\u05e9\u05e8\u05d9\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05dc\u05e0\u05e7\u05d5\u05d8 \u05d4\u05d9\u05db\u05d5\u05dc\u05ea \u05d1\u05d4\u05d9\u05e0\u05ea\u05df \u05dc\u05d4\u05ea\u05d0\u05e4\u05e9\u05e8 \u05e2\u05e9\u05d5\u05d9\u05d4 \u05e9\u05d4\u05d9\u05d9\u05ea\u05d4\n \u05d5\u05d0\u05d5\u05dc\u05dd \u05d5\u05e0\u05d9\u05ea\u05d5\u05d7\u05d9\u05dd \u05e0\u05ea\u05d5\u05e0\u05d9\u05dd \u05e9\u05dc \u05e9\u05e4\u05e2 \u05d1\u05e0\u05de\u05e6\u05d0 \u05d9\u05e9. \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9"] [-6.245527744293213, 7.866263389587402, "\u05d1\u05d5\u05ea \u05dc\u05e2\u05ea\u05d9\u05dd\n \u05d0\u05d9\u05e0\u05d5 \u05d4\u05d0\u05d2\u05e3 \u05db\u05e8\u05d2\u05e2, \u05e9\u05dc\u05e0\u05d5 \u05de\u05d4\u05de\u05e8\u05d5\u05d0\u05d9\u05d9\u05e0\u05d9\u05dd \u05db\u05de\u05d4 \u05e9\u05dc \u05d3\u05d1\u05e8\u05d9\u05d4\u05dd \u05e4\u05d9 \u05e2\u05dc, \u05d6\u05d0\u05ea \u05d5\u05d1\u05db\u05dc\n \u05dc\u05e2\u05ea\u05d9\u05dd \u05d5\u05e8\u05e7 \u05d4\u05d0\u05d5\u05e6\u05e8 \u05d1\u05de\u05e9\u05e8\u05d3 \u05d4\u05d4\u05d7\u05dc\u05d8\u05d5\u05ea \u05e7\u05d1\u05dc\u05ea \u05de\u05ea\u05d4\u05dc\u05d9\u05da \u05e0\u05e4\u05e8\u05d3 \u05d1\u05dc\u05ea\u05d9 \u05d7\u05dc\u05e7\n \u05d1\u05de\u05e7\u05d1\u05d9\u05dc \u05db\u05d9 \u05dc\u05e6\u05d9\u05d9\u05df \u05d9\u05e9. \u05ea\u05e7\u05e6\u05d9\u05d1\u05d9\u05dd \u05d1\u05d0\u05d2\u05e3 \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05d1\u05e0\u05d9\u05e1\u05d5\u05d7 \u05de\u05e9\u05ea\u05ea\u05e3 \u05d4\u05d5\u05d0 \u05e0\u05d3\u05d9\u05e8\u05d5\u05ea\n, \u05d4\u05de\u05d5\u05e4\u05e7\u05d3\u05ea, \u05d4\u05d4\u05db\u05e0\u05e1\u05d4 \u05de\u05e1 \u05e8\u05e9\u05d5\u05ea \u05d0\u05ea \u05d4\u05d0\u05d5\u05e6\u05e8"] [-6.232448577880859, 7.851969242095947, "\u05d4 \u05d4\u05d4\u05e2\u05e8\u05db\u05d4 \u05d1\u05d9\u05db\u05d5\u05dc\u05d5\u05ea \u05d3\u05e0\u05d9\u05dd \u05d0\u05e0\u05d5 \u05de\u05db\u05df \u05dc\u05d0\u05d7\u05e8\u05d9\u05e9\u05e8\u05d0\u05dc \u05d1\u05de\u05d3\u05d9\u05e0\u05ea \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05ea- \u05e1\u05d5\u05e6\u05d9\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e4\u05d9\u05ea\u05d5\u05d732\n \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9\u05ea \u05e0\u05d3\u05d4\u2018\u05d4\u05d0\u05d2 \u05d4\u05d9\u05d0 \u05e9\u05db\u05d6\u05d4 \u05e4\u05e2\u05de\u05d9-\u05d7\u05d3 \u05d1\u05d7\u05d9\u05e0\u05d4 \u05dc\u05ea\u05d4\u05dc\u05d9\u05da \u05e0\u05d5\u05e1\u05e4\u05ea \u05d3\u05d5\u05d2\u05de\u05d4\n \u05e2\u05dc \u05e0\u05d5\u05e1\u05d7 \u05d6\u05d4 \u05e2\u05de\u05d3\u05d4 \u05e0\u05d9\u05d9\u05e82007 ,\u05de\u201c\u05e8\u05d4 \u05de\u05e9\u05e8\u05d32010-2008 \u05dc\u05e9\u05e0\u05d9\u05dd \u05db\u05dc\u05db\u05dc\u05d9\u05ea\n \u05d0\u05d5\u05e9\u05e8 \u05d4\u05d5\u05d0. \u05e9\u05dc\u05d4 \u05d4\u05e8\u05d0\u05e9\u05d5\u05e0\u05d4 \u05d4\u05e4\u05e2\u05d5"] [-6.234137535095215, 7.8538360595703125, "\u05e7\u05dc\n \u05d4\u05d1\u05e2\u05d9\u05d5\u05ea \u05db\u05d9 \u05d7\u05e9\u05e9 \u05de\u05e2\u05dc\u05d4 \u05d9\u05d9\u05e9\u05d5\u05de\u05df \u05dc\u05e6\u05d5\u05e8\u05da \u05d4\u05de\u05ea\u05d0\u05d9\u05de\u05d9\u05dd \u05dc\u05d2\u05d5\u05e4\u05d9\u05dd \u05db\u05d0\u05dc\u05d4 \u05d5\u05e2\u05d3\u05d5\u05ea \u05e9\u05dc\n \u05e1\u05d5\u05d2\u05d9\u05d5\u05ea \u05db\u05d9 \u05d0\u05d5, \u05de\u05e9\u05e8\u05d3\u05d9\u05dd \u05de\u05e1\u05e4\u05e8 \u05e9\u05dc \u05e4\u05e2\u05d9\u05dc\u05d5\u05ea\u05dd \u05e2\u05dc \u05d4\u05de\u05db\u05d1\u05d9\u05d3\u05d5\u05ea \u05d4\u05de\u05e2\u05e8\u05db\u05ea\u05d9\u05d5\u05ea\n \u05d2\u05d9\u05d1\u05d5\u05e9 \u05dc\u05d0\u05d7\u05e8 \u05d4\u05d5\u05dc\u05dd \u05dc\u05d8\u05d9\u05e4\u05d5\u05dc \u05d9\u05d6\u05db\u05d5 \u05dc\u05d0, \u05e9\u05d5\u05d8\u05e4\u05d9\u05dd \u05d5\u05d1\u05e7\u05e8\u05d4 \u05e0\u05d9\u05d4\u05d5\u05dc \u05d4\u05de\u05d7\u05d9\u05d9\u05d1\u05d5\u05ea\n.\u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d7\u05d1\u05e8\u05ea\u05d9\u05d5\u05ea \u05d1\u05e1\u05d5\u05d2\u05d9\u05d5\u05ea \u05d8\u05d9\u05e4\u05d5"] [-6.235428333282471, 7.854618072509766, "\u05d5\u05ea \u05e7\u05d8\u05d2\u05d5\u05e8\u05d9\u05d5\u05ea \u05d1\u05d9\u05df \u05d4\u05e7\u05e6\u05d0\u05d5\u05ea\n \u05d4\u05e2\u05d3\u05d9\u05e4\u05d5\u05d9\u05d5\u05ea \u05dc\u05e1\u05d3\u05e8 \u05d1\u05d4\u05ea\u05d0\u05dd( \u05d9\u05e9\u05e0\u05d5\u05ea \u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05e9\u05dc \u05d1\u05d9\u05d8\u05d5\u05dc \u05d0\u05d5 )\u05d7\u05d3\u05e9\u05d5\u05ea \u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea\n \u05e7\u05d9\u05e6\u05d5\u05e6\u05d9\u05dd \u05db\u05dc\u05dc \u05d1\u05d3\u05e8\u05da \u05db\u05d5\u05dc\u05dc \u05d6\u05d4 \u05d7\u05dc\u05e7. \u05ea\u05e7\u05e6\u05d9\u05d1\u05d9\u05dd \u05d0\u05d2\u05e3 \u05d9\u05d3\u05d9 \u05e2\u05dc \u05e8\u05d1\u05d4 \u05d1\u05de\u05d9\u05d3\u05d4 \u05e9\u05e0\u05e7\u05d1\u05e2\n \u05ea\u05d4\u05dc\u05d9\u05da \u05d0\u05ea \u05d9\u05e9\u05e8\u05d0\u05dc \u05de\u05de\u05e9\u05dc\u05ea \u05d4\u05d7\u05dc\u05d9\u05e4\u05d4, \u05d5\u05d4\u05dc\u05d0\u05d42009 \u05de\u05e9\u05e0\u05ea. \u05de\u05e9\u05de\u05e2\u05d5\u05ea\u05d9\u05d9\u05dd\n \u05d4\u05e7\u05e6\u05d0\u05d5\u05ea \u05e2\u05dc \u05d3\u05d9\u05d5\u05d5\u05d7 \u05d2\u05dd \u05db\u05d5\u05dc"] [-6.237427711486816, 7.855583667755127, " \u05d7\u05d1\u05e8\u05ea\u05d9\u05d9\u05dd \u05dc\u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05d4\u05ea\u05d9\u05d9\u05d7\u05e1\u05d5\u05ea \u05e9\u05dc \u05dc\u05d2\u05d9\u05e9\u05d4\n, \u05d1\u05e0\u05d5\u05e1\u05e3. \u05e2\u05de\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3 \u05db\u05d3\u05d9 \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05e9\u05dc \u05d5\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea\n \u05dc\u05d2\u05d9\u05d1\u05d5\u05e9 \u05de\u05d9\u05d5\u05d7\u05d3\u05d9\u05dd \u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd \u05d4\u05d9\u05d5\u05dd \u05d0\u05e3 \u05d1\u05d4 \u05d5\u05de\u05ea\u05e7\u05d9\u05d9\u05de\u05d9\u05dd \u05d1\u05e2\u05d1\u05e8 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05ea\u05e7\u05d9\u05d9\u05de\u05d5\n, \u05d5\u05e6\u05d9\u05d1\u05d5\u05e8\u05d9\u05d5\u05ea \u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05d5\u05ea \u05d5\u05e2\u05d3\u05d5\u05ea \u05dc\u05de\u05e0\u05d5\u05ea \u05e0\u05d9\u05ea\u05df \u05d0\u05dc\u05d4 \u05d1\u05d9\u05df. \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e9\u05dc\n."] [-6.233804225921631, 7.852919101715088, " \u05d0\u05ea \u05d1\u05d5\u05e8\u05d9\u05d9\u05df \u05e2\u05dc \u05d4\u05de\u05db\u05d9\u05e8\u05d9\u05dd \u05d5\u05de\u05d5\u05de\u05d7\u05d9\u05dd \u05de\u05e7\u05e6\u05d5\u05e2 \u05d0\u05e0\u05e9\u05d9 \u05dc\u05e8\u05d5\u05d1 \u05d4\u05dd \u05ea\u05e7\u05e6\u05d9\u05d1\u05d9\u05dd\n-\u05d4\u05de\u05d0\u05e7\u05e8\u05d5 \u05de\u05d4\u05d4\u05d9\u05e9\u05d2 \u05d2\u05d3\u05d5\u05dc \u05d7\u05dc\u05e7 \u05dc\u05d6\u05db\u05d5\u05ea\u05dd \u05dc\u05d6\u05e7\u05d5\u05e3 \u05d9\u05e9. \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e7\u05d1\u05d9\u05e2\u05ea\n, \u05d6\u05d0\u05ea \u05e2\u05dd. \u05d4\u05d0\u05d7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d4\u05e9\u05e0\u05d9\u05dd \u05e9\u05dc \u05d4\u05d7\u05e9\u05d5\u05d1\u05d5\u05ea \u05d4\u05db\u05dc\u05db\u05dc\u05d9\u05d5\u05ea \u05d5\u05d4\u05e8\u05e4\u05d5\u05e8\u05de\u05d5\u05ea \u05db\u05dc\u05db\u05dc\u05d9\n \u05e0\u05d9\u05db\u05e8\u05ea \u05d1\u05de\u05d9\u05d3\u05d4 \u05dc\u05d4\u05e4\u05e8\u05d9\u05e2 \u05d5\u05e0\u05d5\u05d8\u05d5\u05ea \u05de\u05d5\u05d2\u05d6\u05de\u05d5\u05ea \u05d4\u05d0\u05d2\u05e3 \u05e1\u05de\u05db\u05d5\u05d9\u05d5\u05ea "] [-6.235058307647705, 7.853800296783447, "\u05de\u05de\u05e9\u05dc\u05ea\u05d9\u05ea \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05d1\u05e4\u05d9\u05ea\u05d5\u05d7 \u05de\u201c\u05dc\u05e8\u05d4 \u05d4\u05de\u05e1\u05d9\u05d9\u05e2 \u05db\u05de\u05d8\u05d4\n \u05ea\u05e4\u05e7\u05d9\u05d3\u05d9, \u05dc\u05db\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4 \u05e7\u05de\u05d4 \u05e9\u05d1\u05e2\u05e7\u05d1\u05d5\u05ea\u05d9\u05d4 \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d4\u05d7\u05dc\u05d8\u05ea\n \u05de\u05e7\u05e6\u05d5\u05e2\u05d9\u05ea, \u05e9\u05d9\u05d8\u05ea\u05d9\u05ea \u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d7\u05e9\u05d9\u05d1\u05d4 \u05e9\u05dc \u05e7\u05d9\u05d3\u05d5\u05dd, \u05d4\u05e9\u05d0\u05e8 \u05d1\u05d9\u05df, \u05d4\u05dd \u05d4\u05de\u05d5\u05e2\u05e6\u05d4\n \u05e2\u05dc \u05de\u05ea\u05de\u05e0\u05d4 \u05d4\u05d5\u05d0. \u05de\u201c\u05dc\u05e8\u05d4 \u05db\u05dc\u05db\u05dc\u05d9 \u05db\u05d9\u05d5\u05e2\u05e5 \u05de\u05db\u05d4\u05df \u05d4\u05de\u05d5\u05e2\u05e6\u05d4 \u05e8\u05d0\u05e9. \u05d8\u05d5\u05d5\u05d7 \u05d5\u05d0\u05e8\u05d5\u05db\u05ea\n \u05d1\u05de\u05e1\u05d2\u05e8\u05ea \u05e4"] [-6.23514461517334, 7.854167938232422, "\u05e2\u05d5\u05e1\u05e7\u05d9\u05dd\n \u05de\u05e9\u05e8\u05d3 \u05dc\u201c\u05de\u05e0\u05db. \u05e8\u05e7\u05e1\u05d9\u2018\u05d5\u05d4\u05e6 \u05d4\u05d3\u05e8\u05d5\u05d6\u05d9, \u05d4\u05e2\u05e8\u05d1\u05d9 \u05d4\u05de\u05d2\u05d6\u05e8 \u05e9\u05dc \u05db\u05dc\u05db\u05dc\u05d9 \u05dc\u05e4\u05d9\u05ea\u05d5\u05d7 \u05d4\u05e8\u05e9\u05d5\u05ea\n \u05d1\u05e8\u05d0\u05e9 \u05d2\u05dd \u05d4\u05d0\u05d7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d5\u05d1\u05e9\u05e0\u05d9\u05dd \u05e9\u05d5\u05e0\u05d5\u05ea \u05d4\u05d5\u05e7-\u05d0\u05d3 \u05d5\u05e2\u05d3\u05d5\u05ea \u05d1\u05e8\u05d0\u05e9 \u05d9\u05d5\u05e9\u05d1 \u05d2\u05dd \u05de\u201c\u05e8\u05d4\n \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05e9\u05e8\u05d3\u05d9 \u05db\u05dc \u05dc\u05d9\u201c\u05de\u05e0\u05db \u05d1\u05d5 \u05e9\u05d7\u05d1\u05e8\u05d9\u05dd, \u05de\u05de\u05e9\u05dc\u05d4 \u05de\u05e9\u05e8\u05d3\u05d9 \u05dc\u05d9\u201c\u05de\u05e0\u05db \u05e4\u05d5\u05e8\u05d5\u05dd\n.\u05e1\u05d3\u05d9\u05e8\u05d5\u05ea \u05e4\u05d2\u05d9\u05e9\u05d5\u05ea \u05de\u05e7\u05d9\u05d9\u05dd \u05d5\u05d4\u05d5\u05d0\n \u05d1\u05de\u05d4\u05dc\u05da \u05de\u201c\u05e8"] [-6.238579273223877, 7.8557868003845215, "\u05d2\u05e8\u05d9\u05dd \u05dc\u05d6\u05d9\u05d4\u05d5\u05d9 \u05e2\u05d1\u05e8 \u05de\u05d5\u05e1\u05d3\u05d5\u05ea\n \u05d1\u05e4\u05d9\u05ea\u05d5\u05d7 \u05de\u05e2\u05d5\u05e8\u05d1\u05d9\u05dd \u05e9\u05d4\u05d9\u05d5 \u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e9\u05dc \u05de\u05d2\u05d5\u05d5\u05df \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05ea\u05e7\u05d9\u05d9\u05de\u05d52011 \u05d1\u05e9\u05e0\u05ea\n \u05d5\u05e9\u05dc \u05db\u05dc\u05db\u05dc\u05d9\u05d9\u05dd \u05d7\u05d1\u05e8\u05ea\u05d9\u05d9\u05dd \u05dc\u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05d1\u05d9\u05d7\u05e1 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d2\u05d9\u05e9\u05d5\u05ea \u05e9\u05dc \u05d5\u05d1\u05e0\u05d9\u05d4\u05d5\u05dc\n \u05e7\u05e9\u05e8\u05d9 \u05d0\u05ea \u05de\u05e8\u05d0\u05d43.1 \u05d0\u05d9\u05d5\u05e8. \u05e2\u05de\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3 \u05db\u05d3\u05d9 \u05e9\u05d0\u05d5\u05de\u05e6\u05d5 \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea\n \u05d4\u05de\u05e8\u05db\u05d6\u05d9\u05d9\u05dd \u05d4\u05de\u05d5\u05e1\u05d3\u05d5\u05ea. \u05d4\u05de\u05de\u05e9\u05dc"] [-6.231888294219971, 7.851432800292969, "\u05e9\u05e8\u05d0\u05d5\u05d9 \u05d4\u05e0\u05e7\u05d5\u05d3\u05d5\u05ea \u05d0\u05d7\u05ea. \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05de\u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4\n \u05de\u05d5\u05d8\u05dc \u05d6\u05d0\u05ea \u05d5\u05d1\u05db\u05dc \u05ea\u05e8\u05d9\u05e1\u05e8 \u05e2\u05dc \u05e2\u05d5\u05dc\u05d4 \u05d0\u05d9\u05e0\u05d5 \u05d4\u05e2\u05d5\u05d1\u05d3\u05d9\u05dd \u05de\u05e1\u05e4\u05e8, \u05d4\u05dc\u05dc\u05d5 \u05d4\u05de\u05d5\u05e1\u05d3\u05d5\u05ea\n \u05db\u05de\u05d5 \u05de\u05d2\u05d5\u05d5\u05e0\u05ea \u05d1\u05d7\u05d1\u05e8\u05d4 \u05d4\u05de\u05ea\u05e2\u05d5\u05e8\u05e8\u05d5\u05ea \u05d4\u05e1\u05d5\u05d2\u05d9\u05d5\u05ea \u05d0\u05d9\u05e0\u05e1\u05e4\u05d5\u05e8 \u05e2\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3 \u05e2\u05dc\u05d9\u05d4\u05dd\n \u05db\u05de\u05d4 \u05e2\u05dd \u05d1\u05de\u05dc\u05d7\u05de\u05d4 \u05e0\u05ea\u05d5\u05e0\u05d4 \u05e2\u05d3\u05d9\u05d9\u05df \u05d4\u05d9\u05d0 \u05e8\u05e9\u05de\u05d9 \u05d1\u05d0\u05d5\u05e4\u05df \u05d0\u05e9\u05e8, \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05d7\u05d1\u05e8\u05d4\n.\u05de\u05e9\u05db\u05e0\u05d5\u05ea\u05d9\u05d419 "] [-6.234132289886475, 7.8533759117126465, " \u05d1\u05d4\u05e9\u05d5\u05d5\u05d0\u05d4, \u05e8\u05d0\u05e9\u05d9\u05ea. \u05d1\u05d7\u05e9\u05d1\u05d5\u05df \u05dc\u05d4\u05d1\u05d9\u05d0 \u05d7\u05d9\u05d9\u05d1\u05ea \u05dc\u05e8\u05e4\u05d5\u05e8\u05de\u05d4\n \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc ) \u05d4\u05de\u05d1\u05e6\u05e2\u05ea \u05d4\u05e8\u05e9\u05d5\u05ea \u05d1\u05d9\u05df \u05d1\u05e8\u05d5\u05e8\u05d4 \u05e4\u05d7\u05d5\u05ea \u05d4\u05e4\u05e8\u05d3\u05d4 \u05d9\u05e9 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc, \u05d1\u201c\u05d1\u05d0\u05e8\u05d4\n \u05de\u05e2\u05e8\u05da \u05dc\u05db\u05df(, \u05d4\u05db\u05e0\u05e1\u05ea \u2013 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc ) \u05d4\u05de\u05d7\u05d5\u05e7\u05e7\u05ea \u05d4\u05e8\u05e9\u05d5\u05ea \u05dc\u05d1\u05d9\u05df( \u05d4\u05de\u05de\u05e9\u05dc\u05d4\u2013 \n \u05d7\u05d6\u05e7\u05d4 \u05d4\u05de\u05d1\u05e6\u05e2\u05ea \u05d4\u05e8\u05e9\u05d5\u05ea. \u05d9\u05d7\u05e1\u05d9\u05ea \u05d7\u05dc\u05e9 \u05d4\u05e8\u05e9\u05d5\u05d9\u05d5\u05ea \u05e9\u05ea\u05d9 \u05d1\u05d9\u05df \u05d5\u05d4\u05d0\u05d9\u05d6\u05d5\u05e0\u05d9\u05dd \u05d4\u05d1\u05dc\u05de\u05d9\u05dd\n \u05dc"] [-6.233021259307861, 7.852468013763428, " \u05d4\u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d1\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05e9\u05e0\u05e7\u05d1\u05e2\u05d5 \u05d1\u05d9\u05e2\u05d3\u05d9\u05dd \u05dc\u05e2\u05de\u05d5\u05d3 \u05db\u05d3\u05d9 \u05e0\u05d7\u05d5\u05e6\u05d9\u05dd \u05d4\u05dd \u05db\u05d9 \u05e1\u05d1\u05d5\u05e8\u05d4 \u05e9\u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d4\u05d7\u05e7\u05d9\u05e7\u05d4 \u05d5\u05ea\u05d9\u05e7\u05d5\u05e0\u05d9 \u05d4\u05d7\u05d5\u05e7\u05d9\u05dd \u05db\u05dc\n \u05dc\u05d3\u05d1\u05d5\u05e7 \u05d1\u05d9\u05db\u05d5\u05dc\u05ea \u05e4\u05d5\u05d2\u05e2\u05d9\u05dd \u05e9\u05d4\u05dd \u05ea\u05d7\u05dc\u05d9\u05d8 \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d0\u05dd, \u05d1\u05db\u05e0\u05e1\u05ea \u05e2\u05d1\u05e8\u05d5 \u05e9\u05db\u05d1\u05e8 \u05d7\u05d5\u05e7\u05d9\u05dd \u05dc\u05d0\u05d9\u05d9\u05df \u05db\u05d3\u05d9 \u05d1\u05d4\u05dd \u05e9\u05d9\u05e9 \u05ea\u05d9\u05e7\u05d5\u05e0\u05d9\u05dd \u05d2\u05dd \u05dc\u05db\u05dc\u05d5\u05dc \u05e2\u05e9\u05d5\u05d9\n.\u05d4\u05db\u05dc\u05db\u05dc\u05d9\u05ea \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05d1\u05d9\u05e2\u05d3\u05d9\u05d9\u05e9\u05e8\u05d0\u05dc "] [-6.234253883361816, 7.853450775146484, "\u05d5\u05ea \u05e8\u05d0\u05e9\u05d9\n \u05d0\u05d5 \u05d1\u05d4\u05d5\u05d5\u05d4 \u05e8\u05e9\u05d5\u05d9\u05d5\u05ea\n\u05d0\u05d7\u05e8\u05d9\u05dd\u05dc\u05e9\u05e2\u05d1\u05e8 \u05db\u05d1\u05db\u05d9\u05e8\u05d9\u05dd \u201c\u05e1\u05d4\n\u05de\u201c\u05e8\u05d4 \u05de\u05e9\u05e8\u05d36 7 13\n\u05d4\u05d0\u05d5\u05e6\u05e8 \u05de\u05e9\u05e8\u05d32 10 2 14\n\u05d0\u05d7\u05e8\u05d9\u05dd \u05de\u05e9\u05e8\u05d3\u05d9\u05dd4 7 11\n\u05d0\u05d7\u05e8\u05d9\u05dd\u05d0 \u05de\u05de\u05e9\u05dc \u05d2\u05d5\u05e4\u05d93b4 1 8\n\u05d4\u05de\u05e7\u05d5\u05de\u05d9 \u05d4\u05de\u05de\u05e9\u05dc3 3\n \u05ea\u05e2\u05e9\u05d9\u05d9\u05e0\u05d9\u05dd \u05d0\u05d9\u05d2\u05d5\u05d3\u05d9\n\u05e2\u05d5\u05d1\u05d3\u05d9\u05dd \u05d5\u05d0\u05d9\u05d2\u05d5\u05d3\u05d93 3\n\u05d4\u05e4\u05e8\u05d8\u05d9 \u05d4\u05de\u05d2\u05d6\u05e84 4\n\u05db\u201c\u05e1\u05d415 28 13 56\n . :\u05d4\u05e2\u05e8\u05d4\n \u05d7\u05d1\u05e8\u05d5\u05ea, \u05d2\u05d1\u05d5\u05d4\u05d4 \u05dc\u05d4\u05e9\u05db"] [-6.236699104309082, 7.854974746704102, "\u05d4\u05e6\u05e2\u05d3\n, \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05e2\u05ea \u05d1\u05d0\u05d5\u05ea\u05d4 \u05e9\u05e9\u05dc\u05d8\u05d4 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d0\u05ea \u05dc\u05d4\u05d1\u05d9\u05df \u05d4\u05d9\u05d4 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc\n \u05d4\u05d9\u05d0 \u05db\u05d9\u05e6\u05d3, \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e4\u05d9\u05ea\u05d7\u05d4 \u05d9\u05e9\u05e8\u05d0\u05dc \u05de\u05de\u05e9\u05dc\u05ea \u05db\u05d9\u05e6\u05d3 \u05dc\u05d1\u05d7\u05d5\u05df\n \u05d1\u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05e9\u05d4\u05ea\u05e7\u05d9\u05d9\u05de\u05d5 \u05d4\u05e4\u05e2\u05e8\u05d9\u05dd \u05d0\u05ea \u05d5\u05dc\u05d6\u05d4\u05d5\u05ea \u05e9\u05dc\u05d4 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d0\u05ea \u05d9\u05d9\u05e9\u05de\u05d4\n \u05e9\u05d4\u05d9\u05d4 \u05db\u05e4\u05d9 \u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05d4\u05de\u05e6\u05d1 \u05d0\u05ea \u05de\u05ea\u05d0\u05e8 \u05d6\u05d4 \u05e4\u05e8\u05e7. \u05d9\u05e9\u05e8\u05d0\u05dc \u05e9\u05dc \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2"] [-6.2348952293396, 7.853895664215088, "\u05e9\u05e0\u05e7\u05d9\u05d8\u05ea \u05de\u05db\u05da \u05e2\u05d5\u05dc\u05d4\n \u05d2\u05d5\u05e8\u05de\u05d9 \u05e9\u05dc \u05d4\u05d1\u05d7\u05d9\u05e0\u05d4 \u05d2\u05dd. \u05e9\u05d5\u05e0\u05d9\u05dd \u05e4\u05e2\u05d5\u05dc\u05d4 \u05e0\u05ea\u05d9\u05d1\u05d9 \u05e9\u05dc \u05d5\u05d1\u05de\u05e2\u05e9\u05d9\u05d5\u05ea \u05d1\u05d4\u05d9\u05ea\u05db\u05e0\u05d5\u05ea\n \u05e6\u05d5\u05d5\u05ea \u05d1\u05d9\u05df \u05de\u05dc\u05d0\u05d4 \u05d4\u05e4\u05e8\u05d3\u05d4 \u05dc\u05d9\u05e6\u05d5\u05e8 \u05e0\u05d9\u05ea\u05df \u05e9\u05dc\u05d0 \u05de\u05dc\u05de\u05d3\u05ea \u05d1\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05d9\u05e9\u05d5\u05dd\n \u05dc\u05d4\u05dd \u05dc\u05d0\u05e4\u05e9\u05e8 \u05db\u05d3\u05d9. \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e9\u05dc \u05d4\u05e4\u05e2\u05d5\u05dc\u05d4 \u05de\u05e2\u05e8\u05db\u05d9 \u05d9\u05ea\u05e8 \u05dc\u05d1\u05d9\u05df \u05db\u05dc\u05e9\u05d4\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\n \u05e4\u05d5\u05e2\u05dc\u05ea \u05db\u05d9\u05e6\u05d3 \u05dc\u05d4\u05d1\u05d9\u05df \u05e2\u05dc\u05d9\u05d4\u05dd, \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 "] [-6.234714508056641, 7.853609561920166, "\u05d9\u05d4 \u05d4\u05ea\u05d5\u05e6\u05d0\u05d4336 \u2018\u05e2\u05deMintzberg 1994)\n.\u05d0\u05d5\u05e4\u05e8\u05d8\u05d9\u05d1\u05d9\u05d9\u05dd \u05de\u05d4\u05dc\u05db\u05d9\u05dd \u05dc\u05db\u05dc\u05dc \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d0\u05ea \u05d4\u05de\u05ea\u05e8\u05d2\u05de\u05ea, \u05d9\u05d5\u05ea\u05e8 \u05d0\u05e8\u05d5\u05da \u05d8\u05d5\u05d5\u05d7\n, \u05d1\u05d4\u05db\u05e8\u05d7, \u05de\u05d7\u05d9\u05d9\u05d1\u05ea \u05d0\u05d9\u05e0\u05d4 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05de\u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05dc\u05d1\u05e2\u05d9\u05d5\u05ea \u05d4\u05ea\u05d9\u05d9\u05d7\u05e1\u05d5\u05ea\n \u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05e4\u05d9\u05ea\u05d5\u05d7 \u05e9\u05dc \u05d1\u05de\u05d5\u05d1\u05df, \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05d9\u05e6\u05d9\u05e8\u05ea \u05d0\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9 \u05ea\u05db\u05e0\u05d5\u05df\n \u05de\u05d0\u05e8\u05d1\u05e2 \u05e9\u05e2\u05d5\u05dc\u05d4 \u05db"] [-6.234490871429443, 7.853573322296143, " .\u05d8\u05d5\u05d1\u05d4\n \u05ea\u05d5\u05d1\u05e0\u05d5\u05ea \u05e1\u05de\u05da \u05e2\u05dc, \u05d9\u05ea\u05e8\u05d7\u05e9\u05d5 \u05d0\u05d5 \u05d9\u05e4\u05e2\u05dc\u05d5 \u05d3\u05d1\u05e8\u05d9\u05dd \u05e9\u05d1\u05d5 \u05dc\u05d0\u05d5\u05e4\u05df \u05d1\u05d9\u05d7\u05e1 \u05de\u05d5\u05e9\u05db\u05dc \u05e0\u05d9\u05d7\u05d5\u05e9\n \u05d1\u05d3\u05d9\u05e7\u05ea \u05e9\u05dc\u05d0\u05d7\u05e8 \u05e0\u05d9\u05d7\u05d5\u05e9, \u05e6\u05d1\u05d5\u05e8 \u05d5\u05d9\u05d3\u05e2 \u05d9\u05d3\u05d5\u05e2\u05d9\u05dd \u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05e9\u05dc \u05de\u05d1\u05d7\u05df \u05e4\u05d9 \u05e2\u05dc \u05d2\u05dd \u05d0\u05da\n \u05e7\u05e9\u05d5\u05e8\u05d4 \u05d6\u05d4 \u05e8\u05e2\u05d9\u05d5\u05df \u05dc\u05d4\u05d1\u05d9\u05df \u05e0\u05d5\u05e1\u05e4\u05ea \u05d3\u05e8\u05da. \u05d0\u05d5\u05ea\u05d5 \u05d5\u05dc\u05e2\u05d3\u05df \u05dc\u05e9\u05db\u05dc\u05dc \u05e0\u05d9\u05ea\u05df \u05d4\u05d4\u05e9\u05e2\u05e8\u05d4\n \u05d5\u05df\u2018\u05d2 \u05e7\u05d5\u05dc\u05d5\u05e0\u05dc \u05d9\u05d3\u05d9 \u05e2\u05dc \u05e9\u05e4\u05d5\u05ea\u05d7 \u05d4\u05d7\u05dc\u05d8\u05d5\u05ea \u05e7"] [-6.234708309173584, 7.853581428527832, " \u05e9\u05dc \u05d0\u05d5\u05e1\u05e3\n77 \u2018\u05e2\u05de )\u05d4\u05de\u05e0\u05d7\u05d4 \u05d4\u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05d0\u05ea \u05dc\u05de\u05de\u05e9 \u05d1\u05de\u05d8\u05e8\u05d4 \u05d9\u05d7\u05d3\n \u05d5\u05d0\u05e3\u2018( \u05d2\u05d3\u05d5\u05dc\u05d5\u05ea \u05de\u05d8\u05e8\u05d5\u05ea )\u2019 \u05d9\u05e2\u05d3 \u05e9\u05dc \u05de\u05e1\u05d5\u05d9\u05dd \u05d0\u05dc\u05de\u05e0\u05d8 \u05de\u05db\u05d9\u05dc\u05d5\u05ea \u05d0\u05dc\u05d4 \u05d4\u05d2\u05d3\u05e8\u05d5\u05ea\n \u05e9\u05db\u05dc \u05de\u05e6\u05d9\u05d9\u05e0\u05d5\u05ea \u05d0\u05e3 \u05d4\u05d4\u05d2\u05d3\u05e8\u05d5\u05ea \u05e9\u05ea\u05d9. \u05e9\u05d6\u05d5\u05d4\u05d4 \u05d4\u05d0\u05ea\u05d2\u05e8 \u05e2\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3\u05d5\u05ea \u05d2\u05d9\u05e9\u05d4\n \u05dc\u05d4\u05e9\u05d9\u05d2 \u05e9\u05ea\u05db\u05dc\u05d9\u05ea\u05df \u05de\u05ea\u05d5\u05d0\u05de\u05d5\u05ea \u05e4\u05e2\u05d5\u05dc\u05d5\u05ea \u05e9\u05dc \u05d0\u05d5\u05e1\u05e3 \u05de\u05ea\u05d0\u05e8\u05ea \u05e0\u05ea\u05d5\u05e0\u05d4 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05de\u05d1"] [-6.234883785247803, 7.853872776031494, "\u05dc\u05de\u05e2\u05e9\u05d41\n \u05d5\u05ea\u05db\u05e0\u05d5\u05df \u05ea\u05db\u05e0\u05d5\u05df, \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05de\u05d5\u05e0\u05d7\u05d9\u05dd \u05d0\u05ea \u05dc\u05de\u05d6\u05d2 \u05e0\u05d4\u05d5\u05d2 \u05e8\u05d1\u05d9\u05dd \u05d1\u05de\u05e7\u05e8\u05d9\u05dd. \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05dc\u05de\u05d9\u05dc\u05d4 \u05de\u05d9\u05d9\u05d7\u05e1\u05d9\u05dd\n \u05d4\u05d7\u05e4\u05d9\u05e4\u05d4 \u05dc\u05e0\u05e7\u05d5\u05d3\u05d5\u05ea \u05d1\u05d0\u05e9\u05e8 \u05d1\u05d4\u05d9\u05e8\u05d5\u05ea \u05d4\u05d9\u05e2\u05d3\u05e8 \u05d4\u05de\u05d5\u05dc\u05d9\u05d3 \u05d3\u05d1\u05e8, \u05d4\u05d2\u05d3\u05e8\u05d4 \u05dc\u05dc\u05d0 \u05dc\u05d4\u05d5\u05ea\u05d9\u05e8\u05dd \u05e4\u05e9\u05d5\u05d8 \u05d0\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\n.\u05d6\u05d4 \u05e2\u05dc \u05d6\u05d4 \u05de\u05e9\u05e4\u05d9\u05e2\u05d9\u05dd \u05d4\u05dd \u05d5\u05db\u05d9\u05e6\u05d3 \u05dc\u05ea\u05db\u05e0\u05d5\u05df \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d1\u05d9\u05df \u05d5\u05d4\u05d4\u05e9\u05e7\u05d45.2 \u05e4\u05e8\u05e7\n\u05d4\u05d0"] [-6.237884044647217, 7.8553056716918945, " \u05d0\u05ea \u05d4\u05e8\u05d7\u05d1\u05e0\u05d5, \u05d4\u05de\u05de\u05de\u05e0\u05d9\u05dd\n \u2022 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05dc\u05d9\u05d9\u05e9\u05d5\u05dd \u05e4\u05d5\u05e2\u05dc\u05d5\u05ea \u05de\u05de\u05e9\u05dc\u05d5\u05ea \u05e9\u05d1\u05d5 \u05d4\u05d0\u05d5\u05e4\u05df \u05d5\u05ea\u05d9\u05e2\u05d5\u05d3 \u05d1\u05d9\u05e8\u05d5\u05e8 \n.\u05e9\u05dc\u05d4\u05df\n \u2022 \u05d4\u05d2\u05d9\u05d1\u05d5\u05e9 \u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05d0\u05ea \u05d4\u05de\u05dc\u05d5\u05d5\u05ea \u05d4\u05e1\u05e4\u05e6\u05d9\u05e4\u05d9\u05d5\u05ea \u05d4\u05ea\u05e4\u05d5\u05e7\u05d5\u05ea \u05dc\u05d2\u05d1\u05d9 \u05d4\u05e0\u05d7\u05d9\u05d5\u05ea \u05d2\u05d9\u05d1\u05d5\u05e9 \n.\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea\n \u05d4\u05d2\u05e2\u05e0\u05d5, \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05dc\u05d4\u05ea\u05de\u05e7\u05d3 \u05d0\u05de\u05d5\u05e8\u05d9\u05dd \u05d4\u05d9\u05d9\u05e0\u05d5 \u05d1\u05de\u05e7\u05d5\u05e8 \u05db\u05d9 \u05d0\u05e3\n \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05dc\u05d2\u05d9"] [-6.232475280761719, 7.8519511222839355, "\u05d5\u05d1\u05e8 \u05e4\u05d5\u05e8\u05e1\u05dd\n2011 \u05e7\u05d9\u05e5 \u05e9\u05dc1 .1 \u05e4\u05e8\u05e7\n\u05d4\u05e7\u05d3\u05de\u05d4\n \u05d1\u05d9\u05e6\u05d5\u05e2\u05d9\u05dd \u05de\u05e4\u05d2\u05d9\u05e0\u05d4 \u05d9\u05e9\u05e8\u05d0\u05dc, \u05d5\u05d0\u05d9\u05dc\u05da \u05d4\u05e7\u05d5\u05d3\u05de\u05ea \u05d4\u05de\u05d0\u05d4 \u05e9\u05dc \u05d4\u05e9\u05de\u05d5\u05e0\u05d9\u05dd \u05e9\u05e0\u05d5\u05ea \u05de\u05d0\u05de\u05e6\u05e2\n \u05e2\u05de\u05d32010 \u05e2\u05d31985 \u05d1\u05e9\u05e0\u05d9\u05dd \u05d2\u201c\u05d1\u05ea\u05de \u05d4\u05d2\u05d9\u05d3\u05d5\u05dc. \u05d4\u05db\u05dc\u05db\u05dc\u05d9 \u05d1\u05ea\u05d7\u05d5\u05dd \u05de\u05e8\u05e9\u05d9\u05de\u05d9\u05dd\n \u05d1\u05e2\u05d5\u05dc\u05dd \u05e9\u05e0\u05e8\u05e9\u05de\u05d5 \u05d4\u05d0\u05d7\u05d5\u05d6\u05d9\u05dd2.9-\u05dc \u05de\u05e2\u05dc \u05d4\u05e8\u05d1\u05d4, \u05d0\u05d7\u05d5\u05d6\u05d9\u05dd4.4 \u05e2\u05dc \u05d1\u05de\u05de\u05d5\u05e6\u05e2\n \u05d2\u201c\u05d1\u05ea\u05de \u05d4\u05d2\u05d9\u05d3\u05d5\u05dcOECD-\u05d4 \u05d1"] [-6.232385635375977, 7.85182523727417, "\u05e1\u05de\u05e0\u05db \u05e4\u05d5\u05e8\u05d5\u05dd \u05d4\u05e7\u05de\u05ea\n \u05d9\u05db\u05d5\u05dc\u05d5\u05ea \u05d5\u05e4\u05d9\u05ea\u05d5\u05d7; \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d1\u05de\u05e9\u05e8\u05d3\u05d9 \u05d5\u05ea\u05db\u05e0\u05d5\u05df \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea, \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n \u05ea\u05e8\u05d2\u05d5\u05dd \u05db\u05d5\u05dc\u05dc, \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05d1\u05de\u05e9\u05e8\u05d3\u05d9 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05dc\u05e0\u05e7\u05d9\u05d8\u05ea\n.\u05d0\u05dc\u05d4 \u05e9\u05dc \u05d5\u05d9\u05d9\u05e9\u05d5\u05de\u05dd \u05d5\u05ea\u05d5\u05db\u05e0\u05d9\u05d5\u05ea \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea \u05dc\u05e2\u05e7\u05e8\u05d5\u05e0\u05d5\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05e9\u05dc\n7 . \u05db\u05d3\u05d9, \u05d7\u05d9\u05e6\u05d5\u05e0\u05d9\u05d9\u05dd \u05d5\u05de\u05d5\u05de\u05d7\u05d9\u05dd \u05e2\u05e0\u05d9\u05d9\u05df \u05de\u05d1\u05e2\u05dc\u05d9 \u05d4\u05de\u05d5\u05e8\u05db\u05d1\u05ea \u05de"] [-6.234055042266846, 7.853657245635986, "\u05de\u05e9\u05d9\u05de\u05d5\u05ea \u05d0\u05d7\u05ea\n. \u05d4\u05e0\u05d1\u05d7\u05e8\u05ea \u05d4\u05de\u05de\u05e9\u05dc\u05d4 \u05e9\u05dc \u05d1\u05db\u05d4\u05d5\u05e0\u05ea\u05d4 \u05d4\u05e7\u05e9\u05d5\u05e8\u05d4 \u05e1\u05e4\u05e6\u05d9\u05e4\u05d9\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n1.\u05d4\u05e9\u05d2\u05d4 \u05d5\u05d1\u05e0\u05d9 \u05e1\u05e4\u05e6\u05d9\u05e4\u05d9\u05d9\u05dd \u05d9\u05e2\u05d3\u05d9\u05dd \u05d1\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05dc\u05e9\u05dc\u05d1 \u05e0\u05d9\u05ea\u05df\n \u2022 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05e9\u05dc \u05ea\u05de\u05d9\u05d3\u05d9\u05ea \u05e0\u05e7\u05d9\u05d8\u05d4 \u05e2\u05dc \u05d2\u05dd \u05dc\u05d4\u05e7\u05e4\u05d9\u05d3 \u05d9\u05e9\n, \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e9\u05dc \u05d5\u05d2\u05d9\u05d1\u05d5\u05e9 \u05db\u05dc\u05db\u05dc\u05d9\u05d9\u05dd \u05d7\u05d1\u05e8\u05ea\u05d9\u05d9\u05dd \u05d0\u05ea\u05d2\u05e8\u05d9\u05dd \u05db\u05dc\u05e4\u05d9\n \u05d1\u05d9\u05d9"] [-6.235821723937988, 7.854241371154785, "\u05e8\u05d0\u05dc \u05db\u05dc\u05db\u05dc\u05d9\u05ea\n\u2022 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05d4\u05ea\u05d5\u05de\u05da \u05d4\u05de\u05d9\u05d3\u05e2 \u05ea\u05d9\u05d0\u05d5\u05e8\n \u2022 \u05e9\u05dc \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05db\u05d9\u05d5\u05dd \u05d4\u05de\u05d9\u05d5\u05e9\u05de\u05d9\u05dd \u05d5\u05d4\u05d1\u05e7\u05e8\u05d4 \u05d4\u05d4\u05e2\u05e8\u05db\u05d4 \u05ea\u05d4\u05dc\u05d9\u05db\u05d9 \u05e0\u05d9\u05ea\u05d5\u05d7\n\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea\n \u2022 \u05d4\u05de\u05e9\u05de\u05e9\u05d9\u05dd \u05d5\u05d1\u05e7\u05e8\u05d4 \u05d4\u05e2\u05e8\u05db\u05d4, \u05de\u05d9\u05d3\u05e2, \u05ea\u05d4\u05dc\u05d9\u05db\u05d9\u05dd, \u05d1\u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e4\u05e2\u05e8\u05d9\u05dd \u05d6\u05d9\u05d4\u05d5\u05d9\n\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d5\u05ea \u05d1\u05d2\u05d9\u05d1\u05d5\u05e9 \u05db\u05d9\u05d5\u05dd\n\u2022 \u05d4\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d2\u05d9\u05d1\u05d5\u05e9 \u05d1\u05ea\u05d7\u05d5\u05dd \u05d1\u05d9\u05e0\u05dc\u05d0\u05d5\u05de\u05d9\u05d9\u05dd \u05de\u05d1"] [-6.2325286865234375, 7.851766586303711, " \u05d1\u05e0\u05d5\u05e1\u05e3. \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05da \u05d1\u05de\u05d1\u05d8 \u05d9\u05e9\u05e8\u05d0\u05dc\n \u05dc\u05d2\u05d1\u05d9 \u05dc\u05e9\u05d0\u05dc\u05d4 \u05d4\u05ea\u05e9\u05d5\u05d1\u05d5\u05ea \u05d0\u05ea \u05de\u05e6\u05d9\u05d2 \u05d6\u05d4 \u05de\u05e1\u05de\u05da. \u05db\u05d6\u05d0\u05ea \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05d4\u05d9\u05e1\u05d5\u05d3\u05d5\u05ea\n.\u05d6\u05d0\u05ea \u05dc\u05e2\u05e9\u05d5\u05ea \u05e9\u05d9\u05d0\u05e4\u05e9\u05e8\u05d5 \u05d4\u05de\u05d5\u05e1\u05d3\u05d5\u05ea \u05e9\u05dc \u05d3\u05de\u05d5\u05ea\u05dd\u05d9\u05e9\u05e8\u05d0\u05dc \u05d1\u05de\u05d3\u05d9\u05e0\u05ea \u05d8\u05d5\u05d5\u05d7 \u05d0\u05e8\u05d5\u05db\u05ea \u05d0\u05e7\u05d5\u05e0\u05d5\u05de\u05d9\u05ea- \u05e1\u05d5\u05e6\u05d9\u05d5 \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4 \u05e4\u05d9\u05ea\u05d5\u05d7xii\n\u05de\u05e1\u05e4\u05e7\u05ea \u05dc\u05d0 \u05e8\u05de\u05d47 \u05e4\u05e2\u05e8 \u05dc\u05d2\u05d1\u05d9 \u05d5\u05d4\u05de\u05dc\u05e6\u05d5\u05ea \u05d4\u05de\u05d1\u05d7\u05df \u05de\u05de\u05e7\u05e8\u05d9 \u05de\u05e1\u05e7\u05e0\u05d5\u05ea6"] [-6.23400354385376, 7.853097915649414, "\u05d9\u05d5\u05ea \u05d4\u05d9\u05d7\u05d9\u05d3\u05d5\u05ea \u05d5\u05d7\u05d9\u05d6\u05d5\u05e7 \u05dc\u05d9\u05dd\u201c\u05e1\u05de\u05e0\u05db \u05e4\u05d5\u05e8\u05d5\u05dd \u05d4\u05e7\u05de\u05ea6 \u05d4\u05de\u05dc\u05e6\u05d4\n94 ............................................\u05d5\u05ea\u05db\u05e0\u05d5\u05df \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea, \u05dc\u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05d4\n95 ........\u05d7\u05d9\u05e6\u05d5\u05e0\u05d9\u05d9\u05dd \u05d5\u05de\u05d5\u05de\u05d7\u05d9\u05dd \u05e2\u05e0\u05d9\u05d9\u05df \u05de\u05d1\u05e2\u05dc\u05d9 \u05d4\u05de\u05d5\u05e8\u05db\u05d1\u05ea \u05de\u05d5\u05e2\u05e6\u05d4 \u05d4\u05e7\u05de\u05ea7 \u05d4\u05de\u05dc\u05e6\u05d4\n98 .................................\u05d5\u05de\u05d7\u05e7\u05e8 \u05d4\u05e2\u05e8\u05db\u05d4, \u05d1\u05d1\u05e7"] [-6.23071813583374, 7.851566791534424, "..................\u05de\u05e1\u05e7\u05e0\u05d5\u05ea \u2013 \u05d4\u05de\u05d1\u05d7\u05df \u05de\u05e7\u05e8\u05d9vii\u05e2\u05e0\u05d9\u05d9\u05e0\u05d9\u05dd \u05ea\u05d5\u05db\u05df\niii ..........................................................................\u05d4\u05e7\u05d3\u05de\u05d4\nxi ...............................................................\u05d5\u05d8\u05d1\u05dc\u05d0\u05d5\u05ea \u05d0\u05d9\u05d5\u05e8\u05d9\u05dd\nxiii ......................."] [-6.240328788757324, 7.856671333312988, "\u05d7\u05d1\u05e8, \u05d6\u05d4 \u05d0\u05ea\u05d2\u05e8 \u05e2\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3\n.\u05d1\u05d9\u05e9\u05e8\u05d0\u05dc \u05de\u05d5\u05d1\u05d9\u05dc\u05d4 \u05d9\u05d9\u05e2\u05d5\u05e5 \u05d7\u05d1\u05e8\u05ea\n, \u05db\u05d9\u05d5\u05dd \u05d0\u05e1\u05d8\u05e8\u05d8\u05d2\u05d9\u05ea \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05de\u05d9\u05d9\u05e9\u05de\u05ea \u05d9\u05e9\u05e8\u05d0\u05dc \u05de\u05de\u05e9\u05dc\u05ea \u05db\u05d9\u05e6\u05d3 \u05d1\u05d3\u05e7\u05e0\u05d5\n \u05d1\u05d9\u05e6\u05d9\u05e8\u05ea \u05e9\u05db\u05d6\u05d5 \u05e4\u05e8\u05e1\u05e4\u05e7\u05d8\u05d9\u05d1\u05d4 \u05d5\u05dc\u05e0\u05d4\u05dc \u05dc\u05e4\u05ea\u05d7 \u05d1\u05d1\u05d5\u05d0\u05df \u05d0\u05d7\u05e8\u05d5\u05ea \u05de\u05d3\u05d9\u05e0\u05d5\u05ea \u05e0\u05d5\u05d4\u05d2\u05d5\u05ea \u05db\u05d9\u05e6\u05d3\n \u05d1\u05d7\u05e0\u05d5 \u05d5\u05db\u05df \u05db\u05dc\u05db\u05dc\u05d9 \u05d4\u05d7\u05d1\u05e8\u05ea\u05d9 \u05d1\u05de\u05d9\u05e9\u05d5\u05e8 \u05d0\u05ea\u05d2\u05e8\u05d9\u05d4\u05df \u05e2\u05dd \u05dc\u05d4\u05ea\u05de\u05d5\u05d3\u05d3\u05d5\u05ea \u05de\u05d3\u05d9\u05e0\u05d9\u05d5\u05ea "] [-6.234662055969238, 7.853701591491699, "\n \u05d1\u05d9\u05df. \u05d1\u05e8\u05d0\u05e9\u05d5 \u05dc\u05e2\u05de\u05d5\u05d3 \u05d4\u05ea\u05de\u05e0\u05d5 \u05d4\u05d0\u05d5\u05e6\u05e8 \u05de\u05e9\u05e8\u05d3 \u05dc\u201c\u05d5\u05de\u05e0\u05db \u05dc\u05db\u05dc\u05db\u05dc\u05d4 \u05d4\u05dc\u05d0\u05d5\u05de\u05d9\u05ea \u05d4\u05de\u05d5\u05e2\u05e6\u05d4\n \u05d1\u05d9\u05db\u05d5\u05dc\u05ea \u05dc\u05ea\u05de\u05d5\u05da \u05e2\u05e9\u05d5\u05d9 \u05de\u05d5\u05e1\u05d3\u05d9 \u05de\u05d1\u05e0\u05d4 \u05d0\u05d9\u05d6\u05d4 \u05dc\u05d1\u05d3\u05d5\u05e7 \u05e8\u05d0\u05e0\u05d3 \u05ea\u05d0\u05d2\u05d9\u05d3 \u05d4\u05ea\u05d1\u05e7\u05e9, \u05d4\u05e9\u05d0\u05e8\n \u05d4\u05e0\u05d9\u05e1\u05d9\u05d5\u05df \u05e9\u05dc \u05d1\u05d7\u05e9\u05d1\u05d5\u05df \u05d4\u05d1\u05d0\u05d4 \u05ea\u05d5\u05da, \u05d9\u05e9\u05e8\u05d0\u05dc \u05e9\u05dc \u05d4\u05e6\u05e8\u05db\u05d9\u05dd \u05e0\u05d5\u05db\u05d7, \u05d4\u05de\u05d9\u05d8\u05d1\u05d9 \u05d1\u05d0\u05d5\u05e4\u05df \u05d6\u05d5\n \u05e9\u05dc \u05d4\u05d0\u05de\u05d9\u05ea\u05d9 \u05d4\u05e2\u05e8\u05da \u05db\u05d9 \u05dc\u05de\u05e1\u05e7\u05e0\u05d4 \u05d4\u05d2\u05e2\u05e0\u05d5"] [-0.3918246924877167, 14.388559341430664, "CORPORATION\nAnalysis to Support \nLouisiana\u2019s Flood Risk and Resilience Program and Application to the National Disaster Resilience Competition\nDavid G. Groves, Kenneth Kuhn, Jordan R. Fischbach, David R. Johnson, \nJames Syme\nPrepared for the State of"] [-0.4273238182067871, 13.728991508483887, "rior RAND studies help ing the State of Louisiana \nmitigate flood risk including Fischbach et al. (2012) and Groves et al. (2014). \nOn January 21, 2016, HUD announced that it is awarding the state of Louisiana $92.3 million \nand the city of New Orl"] [-0.33259204030036926, 14.524956703186035, "................................. ix\t\r \u00a0\n1. Introduction ................................................................................................................................. 1\t\r \u00a0\n2. Methods..............................................."] [-0.3102787435054779, 14.549172401428223, "...................................................................................... 28\t\r \u00a0\n v Figures and Tables \nFigures \nFigure 1.1: Target Areas Considered for Nonstructural Investments ............................................. 2\t\r \u00a0\nFi"] [-0.3142241835594177, 14.546655654907227, "A.1: Costs and Structures Mitigated by Block Group, Low -Budget Levels ...................... 24\t\r \u00a0\nTable A.2: Costs and Structures Mitigated by Block Group, Medium-Budget Levels ................ 25\t\r \u00a0\nTable A.3: Costs and Structures Mitigated by B"] [-0.3094788193702698, 14.549530982971191, "h, and $100 million in Plaquemines Parish. Structures would be elevated to a height of two feet above the local Base Flood Elevation and all areas would be eligible for project work (no filter applied) in this example project. Project work would \nbe "] [-0.3765988051891327, 14.443999290466309, "tal Louisiana Risk Assessment model, are increasingly available and can be used to evaluate risks over a wide range of flood events. Planning organizations can then augment risk data with other metrics, such as income or repetitive loss data to ident"] [-0.3449646830558777, 14.498464584350586, "eveloped and evaluated \u201cnonstructural projects\u201d for 56 regions. \nEach of these projects specified for each region the extent to which residential structures would need to be elevated, the extent of flood -proofing residential and commercial structure"] [-0.3467003405094147, 14.521692276000977, "ges. A version of the CLARA \nmodel that has been updated to support Louisiana\u2019s 2017 Coastal Master Plan analysis was used in this study (Fischbach et al., 2015). \nFigure 2.1 provides a high-level overview of the CLARA model. CLARA takes storm surge"] [-0.32364094257354736, 14.534072875976562, " locations along the coast (called \u201cgrid points\u201d in CLARA). It can also aggregate the results to more commonly used geographic areas, such as U.S. Census block groups (Figure 2.2). \nFigure 2.2:Census Block Groups for Each Target Area\n \n 5 Formulation"] [2.7647581100463867, 16.60636329650879, "he State.\n4 The cost of elevating a structure three to seven \nfeet is $82.50 per square foot. The cost of elevating a structure seven to ten feet is $86.25 per \nsquare foot. The cost of elevating a structure ten to 14 feet is $103.75 per square foot."] [-0.3174813389778137, 14.54776382446289, "om HUD and FEMA, respectively. Figure 2.4 shows the geographic patterns of current 100-year flood depths (upper) and percentage of LMI properties (lower). Areas with relatively high flood depths are shaded red and areas with relatively low flood dept"] [-0.30561119318008423, 14.534967422485352, "et of flo oding depth\u2014they must \nbe projected onto a common scale in order to combine them. The following equation is used to \nscale each component of the metric:6 \n Scaled value of a component = \nScore at a grid point \u2013 Mean score across all grid p"] [-0.3620358109474182, 14.464093208312988, "d damage. One approach uses current-\ncondition flood depths and a constant dollar estimate of damage reduction to estimate benefits. This is consistent with standard benefit-cost practice, using only a current snapshot of risk. However, the 2012 Coas"] [-0.3180118799209595, 14.53790283203125, "y \nproviding a convenient and user-friendly way to review interim results. The figures shown in this report are static reproductions of some of the visualizations. Second, the tool provides others \nwith easy access to these results: A web link produc"] [-0.3009816110134125, 14.566277503967285, "en Meadow structural flood protection system , which \nleads to low risk for much of the populated area in this parish under current flood depths , and (2) \nhigh projected flood depths in other areas that rule out elevating structure s. Note that this"] [-0.3085601031780243, 14.553862571716309, "gated by U.S. Census block group for the \nhigh-budget proposed project. The shading represents the number of structures from 0 (white) to \n400 (dark green). The majority of the elevations are concentrated in two Census block groups in \nPlaquemines Pa"] [-0.30955028533935547, 14.551608085632324, "nts of structures to be elevated when the project \ndefinition strategy focuses on the LMI metric alone, instead of the combined criterion that factors in LMI, cost-effectiveness, and flood depth. In Terrebonne Parish, defining the project based on LM"] [-0.28597941994667053, 14.558582305908203, "ff speaks to the value in the composite criterion \nused for the proposed project that focus es on LMI, current flood depths, and cost-effectiveness. \nIn Terrebonne Parish, all project variants perform well. Terrebonne Parish is exposed to \nsmall and"] [-0.3181983232498169, 14.53514575958252, "me data inputs are treated as static although conditions will c ertainly change in the future. \nExamples include the use of historical data on RL properties and LMI populations. \nNevertheless , this analysis provides a step forward and enables the "] [-0.3065381348133087, 14.553886413574219, "001 Plaquemines $6,400,000 46 \n220750507002 Plaquemines $3,000,000 21 \n220750507003 Plaquemines $1,000,000 8 \n220750508001 Plaquemines $100,000 1 \n220750508002 Plaquemines $3,000,000 22 \nSum Plaquemines $100,000,000 667 \n221090011002"] [-0.3894215524196625, 14.42184066772461, " 305 \n221090012021 Terrebonne $61,600,000 394 \n221090012022 Terrebonne $80,000,000 506 \n221090012023 Terrebonne $41,000,000 265 \n221090013001 Terrebonne $61,500,000 417 \n221090013002 Terrebonne $17,500,000 120 \n221090013003 Terrebonne"] [-0.6759456992149353, 13.37089729309082, "ch Foundation, 2013, pp. 109 \u2013126. \nNational Research Council, Informing Decisions in a Changing Climate, Panel on Strategies and \nMethods for Climate-Related Decision Support, Committee on the Human Dimensions of \nClimate Change, Division of Behav"] [13.853168487548828, 4.032699108123779, "Sponsored by the National Institute of Justice The Role of Technology \nin Improving K\u201312 School Safety\nHeather L. Schwartz, Rajeev Ramchand, Dionne Barnes-Proby, Sean Grant, \nBrian A. Jackson, Kristin J. Leuschner, Mauri Matsuda, Jessica SaundersP"] [11.020379066467285, 0.5943922400474548, ", the report presents the results of two rapid reviews of literature on school \nsafety and school safety technologies, the highest-priority technology needs that school practi -\ntioners identified in two day-long workshops and a pre-workshop question"] [11.010688781738281, 0.5869298577308655, "............. xix\nCHAPTER ONE\nIntroduction ..................................................................................................... 1\nPurpose of This Research ............................................................................"] [11.015534400939941, 0.5901523232460022, "al Media Monitoring, Visitor Entry, and Surveillance at the Glendale School District, \nGlendale, California ..................................................................................... 42\nAnonymous Bystander Tip Line in Colorado ........."] [11.035650253295898, 0.5999912023544312, "B.1. School Safety Technology Flow Diagram ..................................................... 101\n B.2. Number of Original Panel Needs Combined to Produce Final Combined Needs ...... 106\nTables\n S.1. Twelve Categories of School Safety Technologie"] [10.8672456741333, 0.4723855257034302, "of all forms of school violence. Because of their severity, these occurrences \nreceive most of the attention from the media and policymakers. It is the more commonplace types of violence, such as physical bullying, assault, threats, and weapon-carryi"] [10.829858779907227, 0.44198155403137207, "fatalities among staff, students, or other individuals on school grounds in the \nUnited States\u2014less than 1 percent of youth homicides that occurred nationally during this \nperiod (Robers et al., 2014). The majority of schools do not experience violen"] [10.823925018310547, 0.43659859895706177, "rcent) than white students (5.8 percent), with black males reporting the highest levels of victimization (10.1 percent), \nfollowed by Hispanic males (9.5 percent), Hispanic females (7.5 percent), black females (6.8 \npercent), white males (6.2 percent"] [11.002946853637695, 0.5796232223510742, "logy are not. For most technologies, there is limited information about their prevalence. For all tech -\nnologies, evidence on effectiveness is severely limited or nonexistent. Many technologies are relatively new and are still being developed (e.g.,"] [11.019977569580078, 0.5915058255195618, "tectors and X-ray machinesHand-held and walkthrough metal detectors, X-ray machines to scan book bags. often at entrance to school or as students exit school busesPrevents weapons from being brought into schoolApproximately 5 out of 100 public sch"] [11.016552925109863, 0.5899642705917358, "eved that metal detectors and X-ray machines increased students\u2019 \nnegative attitudes toward school and made schools seem too fortified and unwelcoming. The cost to adopt a given technology and how its adoption may drain resources for other aspects of"] [11.02781867980957, 0.5983095169067383, "ation on school safety. Panelists saw this \nimproved access to information and guides as key to preventing, reducing, and responding to \nthe entire spectrum of school violence. Several other themes emerge from their ratings: \n\u2022 Direct two-way communi"] [11.00561809539795, 0.5822339653968811, "fety initiatives brings only false security rather than effective solutions. Consequently, \nrigorous research designs such as randomized controlled trials are needed to instill trust \nin evaluation results about school safety technologies. \n\u2022 Measure"] [11.001490592956543, 0.5792399048805237, "efore buying technologies, \nschools should make sure that the technology can be integrated with their current systems and upgraded in the future. This is particularly important for technologies that generate \ndata (e.g., tip lines, social media monit"] [10.832743644714355, 0.4436655640602112, "e report itself at the conclu -\nsion of the project. We would also like to acknowledge the publishing contributions of \nPatricia Bedrosian for editing the report and Mary Wrazen for creating and helping design \nthe figures .xixAbbreviations\nCCSD Clar"] [10.893799781799316, 0.4919901192188263, "lence can also have damaging effects on children\u2019s short- and long-term outcomes (Ttofi, Farrington, and \nL\u00f6sel , 2012). Beyond the immediate effects of such incidents, threats to students\u2019 safety and \nwell-being may undermine their ability to learn "] [10.858628273010254, 0.4606989324092865, "owing tasks for this study:\n\u2022 developed a typology of school safety technologies based on the literature\n\u2022 summarized the available evidence about technology and the main forms of school \nviolence\n\u2022 interviewed experts about their perceptions of the"] [10.824975967407227, 0.4367360770702362, "rs to the absolute and relative size of \nthe school in terms of enrollment (total students, student to teacher ratio), source of funding (public versus private), and grade level (middle, high). School demographic composition refers to \nthe represent"] [10.82056999206543, 0.44250354170799255, "ks, or threats of physical attack. The incidence of any type of violence was 25 events per 1,000 students annually. These rates are likely to \nunderestimate the true prevalence and incidence of violence.\nEight percent of students reported being in a "] [10.829573631286621, 0.44339683651924133, "t inherently implies that both law enforcement personnel and citizens have the \npotential to affect the outcome of the event based upon their responses (FBI, 2013, p. 4).Introduction 5\non school grounds (7 percent); the percentage of teachers who"] [10.824002265930176, 0.4377925992012024, "they had the greatest interaction with other, \nparticularly older, students. \n7. Rates of violence differ significantly among students. Just as there is variation by \nschool characteristics, there is variability in who is victimized and who perpetrat"] [10.82164192199707, 0.4343729019165039, " correlated with perpetration and victimization (Horner, Rew, \nand Brown, 2012). Other factors that are less consistently related include academic \ninvolvement and achievement and family and peer factors. Often, these factors attenu -\nate some of the"] [11.000102043151855, 0.577580988407135, "ved two reviewers), and the review did not involve querying listservs, making contacts \nwith authors, and going through reference lists of full-text reports to identify more potentially \neligible reports. Because of the short time frame of this revie"] [10.998773574829102, 0.5764819383621216, "school safety technologies currently \nemployed in the United States. All types of reports (e.g., newspaper articles, magazine entries, reports of government legislation, nonpeer-reviewed reports, scientific journal articles) were \neligible. \nTechnolo"] [11.037909507751465, 0.6131488084793091, "s (e.g., walkie-talkies, phones, emergency communication systems, radios)Allows students/staff to notify school office and law enforcement about incidents, unauthorized individuals, and dangers/risksSchool communication network that links classrooms,"] [11.022544860839844, 0.5955410003662109, ", although potentially prevalent with smart phones\n10. Maps of school terrain and bus routes Geographic Information System (GIS)Helps emergency responders prepare for crisisSoftware used to plot school terrain and transit routes used for school purpo"] [11.041443824768066, 0.6176972985267639, "choolyard supervisors, and bus drivers with the front office or security staff, as well as with local law enforcement and fire departmentsIntercoms and two-way, hand-held radios are thought to be used extensively\n5. School-site alarm and protection "] [11.022045135498047, 0.597289502620697, "nd barricades are standard, low-tech protection technolo -\ngies. However, electromagnetic locking systems, considered for use by some urban schools, can \nhave prohibitive expenses for many school districts (Gray, 2014). \nEvidence on outcomes. No rig"] [11.014244079589844, 0.5919108390808105, "hool safety. However, there is little \nconcern about identification technology causing harm or being unacceptable to students, staff, \nand communities. School leaders need to consider the physical layout of their schools and the risk of intrusion whe"] [11.030848503112793, 0.6045600175857544, "on materials used include intercoms, walkie-talkies, \nemergency communication systems, radios, and phones (McLester, 2011). These devices are \nused to establish school communication networks that link classrooms, schoolyard supervisors, and bus drive"] [11.003708839416504, 0.5797759890556335, " when activated. \nPrevalence of use. This review did not identify any estimates of the prevalence of school-\nsite alarm system technologies. However, local alarms use similar technology to fire alarms, which are extremely common in U.S. schools\u2014the"] [11.026097297668457, 0.6006748676300049, " a month, whereas mass email messaging is likely to have minimal costs if existing school facilities are the email recipients.\nTechnology #7: Metal Detectors and X-Ray Machines\nWhat it is. Metal detectors and X-ray machines are used by school securit"] [11.039069175720215, 0.6112983822822571, "low users to make \nanonymous posts. Signs, posters, and messages are typically delivered to students, families, and community members to inform them about the existence and purpose of these technologies. \nPhone hotlines or voicemail systems, anonymou"] [11.02422046661377, 0.6009966731071472, "students who have smart phones with built-in track -\ning systems may save on costs. Bus-tracking may lead to more efficient and safer routes, which proponents have argued save schools costs on fuel and insurance.\nTechnology #10: GIS-Informed Maps of "] [11.00941276550293, 0.5862462520599365, " pre-dictors of violence); the information is used to detect and predict possible future violent behav -\nior (Chandler, Levitt, and List, 2011). \nPrevalence of use. Use of this type of technology is not very common, as the software \nand skills requi"] [11.008312225341797, 0.585313618183136, "uipment), for most there is limited information about their prevalence. For all technologies, evidence on outcomes is limited or nonexistent. Many technologies are relatively new and are still being \ndeveloped (e.g., tracking systems, violence predic"] [11.025999069213867, 0.5966912508010864, "es listed in Table 2.1. A total of 18 participants (82 percent) completed the urban \npre-panel online questionnaire, and 16 (80 percent) completed the suburban/rural pre-panel online questionnaire.\nOn the questionnaire, participants were asked to rat"] [11.028133392333984, 0.6014218926429749, "searchers, with \nan additional researcher present to take notes. The panels were highly structured (details are presented in Appendix B).\nStakeholder Interviews\nOver the course of four months (January 2015 to May 2015), we invited 53 representatives "] [11.022234916687012, 0.5942222476005554, "e greater manpower and infrastructure that panelists said was needed for effective video monitoring, which a larger school district could provide. Sub -\nurban/rural panelists, meanwhile, rated social media monitoring as very appropriate for both type"] [11.027897834777832, 0.5986102223396301, "riate nor Inappropriate Technologies\nGPS tracking of students or buses 3.43 Metal detectors and X-ray machines 3.44\nViolence prediction technology 3.21Perceived Appropriateness and Barriers to Adoption of School Safety Technology 23\nof classroom d"] [11.02109146118164, 0.5908750295639038, "as very appropriate \nfor addressing both severe (mean = 4.7) and frequent (mean = 4.7) forms of violence, whereas \nsuburban/rural panelists rated it as only somewhat appropriate for both forms (severe mean \n= 4.3; frequent mean = 4.2). Discussions i"] [11.031781196594238, 0.6025597453117371, "o be able to directly contact emergency responders rather than have to report to central office staff who, in turn, contact emergency responders. Those who disagreed \nstressed the possibility of teachers making false emergency calls to 911, potential"] [11.017683982849121, 0.5905650854110718, " have cell \nphones and . . . pictures, photos, video gets out into the public immediately.\u201d Another men -\ntioned the need for accurate contact information for parents, because \u201cthere are some districts \nwhere many parents don\u2019t have access to compute"] [11.03120231628418, 0.6013935208320618, "hat use Internet-based tips, one panelist talked about the \nneed to be able to \u201crapidly track IP addresses to identify the source of tips.\u201d A frequently men -\ntioned theme was that tip lines need to be multimodal in the sense that they have the capac"] [11.02924919128418, 0.6001991629600525, "erceived Appropriateness and Barriers to Adoption of School Safety Technology 27\nmore frequent forms of violence (urban mean = 3.4; suburban/rural mean = 3.4). Although \ninfrequently mentioned, panelists described GIS-informed maps of school terra"] [11.023053169250488, 0.5946794152259827, "t told us: \u201c[I]t is hard \nto track cyberbullying, because much happens outside the school so tools around this would \nbe useful.\u201d \nPanelists also expressed doubt about effective monitoring because of the sheer number \nof social media platforms and th"] [11.037871360778809, 0.6071143746376038, "d when mentioned during the expert panel, panelists \nraised significant concerns about privacy, lack of legal clarity regarding the technology\u2019s juris -\ndiction (e.g., whether or not the video footage is protected by the Family Educational Rights \nan"] [11.037712097167969, 0.6073030233383179, "d fear. She summarized: \u201cI cringe when it comes down to tech versions of security.\u201d Similarly, a \nresearcher we interviewed talked about the mixed message safety technology can send: \u201cWe \nwant you to be a part of the community but we don\u2019t trust you."] [11.028660774230957, 0.5997725129127502, "hnologies can promote \nthe opposite. During the expert panel, one panelist remarked: \u201cThere is a strong psychological \neffect in making people [students, parents, teachers] feel safe.\u201d Metal detectors, for example, are a visible way that some school "] [11.024364471435547, 0.6001974940299988, " half of \nthe stakeholders we interviewed cited cost issues and specifically how investing in technology reduced other resources that they felt were more important. A researcher we interviewed stated \nthe following, which is representative of what se"] [11.029460906982422, 0.6013098955154419, "nication technology and school-site alarms, concerns \nabout the cost of adopting emergency alert systems were raised by 39 percent of suburban/ \nrural panelists, and 33 percent were concerned about the risk of false identification of \nthe perpetrator"] [11.012155532836914, 0.5873711705207825, "essment looking at costs and staff capacity in order to implement [tech] efficiently. \nCan they afford staff and the upkeep of these techs? That has to be done in a very thoughtful manner at the district level.\u201d \nConclusions\nOne of our key findings f"] [11.009312629699707, 0.5846599340438843, "opriate for schools and barriers to adopt, in the next chapter we present six case studies that describe how school districts themselves have adopted technol -\nogy in an effort to keep their students safe. 35CHAPTER FOUR\nUsing Innovative Technology t"] [11.030755996704102, 0.6035373210906982, "e selected seven potential locations, which we selected for geographic diversity and for \nuse of a diverse set of technologies from the types that the expert panel had described as very 36 The Role of Technology in Improving K\u201312 School Safety\napp"] [11.043086051940918, 0.6190677881240845, "the technology in the wake of the Sandy Hook Ele-\nmentary School shooting in December 2012. In addition, the NPD rated Skyview as \u201cthe most unsafe school\u201d in Nampa because of the multiple points of entry into the school. Another con -\ncern at the sch"] [11.05656909942627, 0.631104052066803, "e badges, the program has been viewed as a success. According to those we inter -\nviewed for this case study, administrators, teachers, parents, and students generally like the system, and some have said that they would not want to be at a school tha"] [11.052441596984863, 0.6288623213768005, "respond to or investigate offenses occurring on district property. \nAlert/Alarm System\nThree schools in the CCSD\u2014Desert Oasis High School, Jack Lund Schofield Middle School, and Stuckey Elementary School\u2014have implemented a security alarm system known"] [11.06482219696045, 0.6502599716186523, "ow how to use it. Despite these limitations, practitioners recom -\nmended this system given its potential to assist in emergency situations.\nVideo Surveillance\nThe CCSDPD Security Systems division includes a network of over 12,400 cameras installed \n"] [11.05468463897705, 0.6314069628715515, "screens in the event of an emergency. Initial costs were quite high and were covered through a $100,000 grant from the Corporation for Public Broadcasting, which covered the cost of set -\nting up the secure data servers and providing receivers/conver"] [11.03921890258789, 0.6123888492584229, " technologies.\nIn the 2001\u20132 school year, the district experienced a series of unsubstantiated bomb \nthreats, many of which were written on walls on school property. Initially, the standard emer -\ngency response procedures were to evacuate the buildi"] [11.05123519897461, 0.6265740990638733, "e monitoring doors can notify all relevant per -\nsonnel within the school of a door that is open and should not be, and the nearest person can \ninvestigate. The walkie-talkies have an \u201call school\u201d setting by which anyone carrying them can \nbroadcast "] [11.049490928649902, 0.6251728534698486, "r the existing panic buttons located in multiple locations in each school building; those alerts might \ntake 30 to 90 seconds before reaching the Londonderry police dispatch. Representatives from \nCOPsync911 informed us that the cost differs by schoo"] [11.039973258972168, 0.6146547794342041, "a Crescenta), with nearly \n27,000 students across 21 elementary schools, four middle schools, and six high schools. The school district was motivated to adopt school safety technologies by a range of factors, includ -\ning national, high-profile incid"] [11.049569129943848, 0.6208856701850891, "ontact at individual school sites (typically an assistant principal) to find out how the school administrator chose to deal with the particular student. If needed, \nthe school will ask Geo Listening to gather additional information. \nAlthough initia"] [11.04813003540039, 0.6190528869628906, "students about the use of Geo Listening. Transparency is particularly important because some may perceive Geo Listening as an invasion of privacy, a feeling that might be magnified if districts implement the system without informing the community. Th"] [11.04454231262207, 0.6179420351982117, " practices and to educate them (through letters, phone calls, text messages) on such \nissues as ensuring acceptable IDs so that parents are knowledgeable about how to access the \nschool. As with Geo Listening, gaining community buy-in is essential. \n"] [11.04357624053955, 0.6147679686546326, " a hotline implemented after the Columbine shootings was underused and less than effec -\ntive. Safe2Tell\u2019s core competency is giving a bystander a reporting tool, allowing people who know of concerning or dangerous situations to report them; traditio"] [11.041680335998535, 0.6091415882110596, "Information Services security policy, and the Health Insurance \nPortability and Accountability Act, and encrypted to ensure anonymity. Attachments such \nas photographs, videos, social media posts, and other pieces of evidence can be uploaded by \nrepo"] [11.038150787353516, 0.6109281778335571, "culture to a positive climate in which students care for and look out for one \nanother and that trusting relationships between staff and students have been established. By \nimplementing a consistent marketing strategy across Colorado, Safe2Tell educa"] [11.056014060974121, 0.6329659223556519, "uired to make the program work. These issues can be 48 The Role of Technology in Improving K\u201312 School Safety\novercome by the use of technology and online tools to provide toolkits for classrooms, webinars \nfor trainings, and marketing materials a"] [11.045413970947266, 0.6188442707061768, "ans \nprovide lessons that are widely applicable to the range of small to large school districts. \n1 The number of unarmed security guards per school facility depends on a number of factors. School administrators have \nsome discretion to convert one f"] [11.067927360534668, 0.6393499970436096, "estee wears. Informa -\ntion is thus easily scanned and uploaded for jail staff.\nInternet Security. Given that the Miami-Dade Schools police work with minors, secur -\ning police Internet transmissions was of paramount importance. For this reason, the"] [11.025171279907227, 0.6034493446350098, "tty theft Disorderly conduct Burglary Vehicle burglary Arson Aggravated battery Aggravated assault \n2013\u201314 \n2012\u201313 \nNumber of incidentsUsing Innovative Technology to Enhance School Safety in Practice 51\ninformation to, say, determine where to en"] [11.049440383911133, 0.623765766620636, " wanted to access live video feeds to enable them to respond to calls in a safer and more efficient manner. As a result, the police \ndepartment worked for a year and a half to create a system by which all school surveillance \ncameras across the distr"] [11.055517196655273, 0.6343345642089844, "onitoring of CompStat data, the police department noted \nthis difference and, by investigating the cause, determined that discrepancies largely resulted from how schools measure incidents (e.g., a school may include in its SESIR an incident that \nres"] [11.022236824035645, 0.5974000096321106, "gram.\nConclusions\nIn Chapters Two through Four, we presented an overview of technologies that exist for pro -\nmoting school safety, key stakeholders\u2019 perspectives of these technologies, and case studies \nabout how schools are using these technologies"] [11.031275749206543, 0.5981729626655579, "of the three sets of concerns (see Tables 3.2 and 3.3 in Chapter Three)\n\u2022 needs for those technologies that questionnaire results indicated were neither appropriate \nnor inappropriate technologies for each of the three sets of concerns (see Tables 3."] [11.123734474182129, 0.6278186440467834, "we combined the needs are shown in Table 5.1. Details are presented in Appendix B.\nNext, the research team used the original 199-item ranking data provided by the pan -\nelists to identify the highest-priority technology and related needs out of the r"] [11.036483764648438, 0.6054966449737549, "police officer body cameras with live feed capability\nCreation of model policy for body-worn cameras for \nboth SROs and outside police\nDrone surveillance of school grounds or at school eventsAutomated drone surveillance of school grounds\nDrones for "] [11.043632507324219, 0.6034204959869385, "icates both the high salience \nof and degree of consensus about the importance of a given technology need across a range \nof school types because it means that all four panels of experts independently identified the given technology need through thei"] [11.035844802856445, 0.5993791222572327, ") 1\nEarly warning student tracking systems 1\nMultimodal tip line that centralizes and compiles tips from various sources and in various forms (video, text, images)1\nPlatform for sharing school safety best practices (regional and national) 1\nQuick and"] [11.039277076721191, 0.6034746766090393, "ack of training as a common barrier to the faithful implementation of school safety plans. Given the high rates of turnover \nin some categories of school-based staff\u2014especially among school support staff, such as teach -\ners\u2019 aides\u2014the online deliver"] [11.037006378173828, 0.600275993347168, "Related Needs to Improve School Safety 61\nthe mapping of school grounds to allow emergency responders to quickly isolate and access \nparts of a campus where the emergency occurs. Both tap into the theme of better connecting \nschools to emergency "] [11.042383193969727, 0.610920786857605, "imilar themes of how to obtain economies of scale in tip line monitoring and how to better \npool information to more efficiently weed out false alarms and identify problem instances or \npersons who may be on another agency\u2019s radar before a given scho"] [11.0364351272583, 0.6004291772842407, "ral \npanels ranked highly: better ways to engage, train, and inform parents in particular and other \ncommunity members more generally. Picking up on the often repeated theme that \u201cproblems start at home,\u201d panelists looked for engaging new ways to edu"] [11.036651611328125, 0.6031174659729004, "nment 1\nPlatform for sharing customized school safety best-practices (local) 1\nAbility to collect incident details on tip lines 1\nCameras in school hot spots 1\nInteractive code-of-conduct technology (software, simulations, video games, virtual realit"] [11.036922454833984, 0.6027026176452637, "esults, respectively. \nTechnology and Related Needs That Both Urban and Suburban/Rural Panels Ranked Highly\nWhen asked to consider which needs to invest in across the whole spectrum of a school\u2019s needs, experts again ranked two-way communication betw"] [11.085680961608887, 0.6410233378410339, "eeds were also rated as Tier 2 by one panel in prior ranking exercises. \nTable 5.7\nTier 2 Technology and Related Needs Identified out of All School Safety Needs \nCombined Technology or Related NeedNumber of Panels That Identified \nthe Improvement Wit"] [11.037506103515625, 0.6034954786300659, "chool \nViolenceTier When Ranked \nAcross All Identified \nNeeds\nCombined Technology or Related Need UrbanSuburban/\nRural UrbanSuburban/\nRural UrbanSuburban/\nRural\nDirect two-way communication between \nteachers and law enforcement1 1 1 1\nAll-in-one appl"] [11.032938957214355, 0.5981231331825256, "bined Technology or Related Need UrbanSuburban/\nRural UrbanSuburban/\nRural UrbanSuburban/\nRural\nVirtual counselors for students 1\nVirtual training simulations for students \nand staff about school safety1\nOnline platform for communicating with parents"] [11.039220809936523, 0.6073227524757385, "ce be able to contact 911, and (b) two-way communication abilities are critical (rather than, say, only panic buttons) so that \nemergency responders can gather information during the emergency about the location, \nevents, and condition of victims. \n\u2022"] [10.977957725524902, 0.5583351850509644, "ategories of school safety technologies, and is there evidence of their effectiveness? \n3. What do experts think are the most important improvements that can be made to \ntechnologies to address the most severe and the most frequent forms of school vi"] [11.01252269744873, 0.5854388475418091, " safety plans and policies must be customized to the individual school, but our \nstudy revealed some commonalities among safety experts about schools. The first is the impor -\ntance of the length of emergency response time to the school for the unfor"] [11.038939476013184, 0.6067613959312439, "nate Emergency Plans and Procedures from One Place, \nImprove Tip Lines, and Reduce Human Error/Improve Accountability\nWhen asked to rank the most important technology needs to prevent, reduce, and respond \nto school violence of various forms, a consi"] [11.02564811706543, 0.5972006320953369, "re for an all-in-one place where staff could go to access school policies, protocols for what to do when behaviors are observed or when events occur, legal forms, engag -\ning online training modules customized to different school staff types, and sug"] [11.015047073364258, 0.589809238910675, "in their classrooms, and the lack of manpower \nto investigate tips, alleged bullying, or other reported threats. Through our discussion with the \nexperts, it became clear that technologies are often not implemented as intended, and, there-fore, they "] [11.01582145690918, 0.5900399088859558, " -\nceptions of safety are needed to instill trust in evaluation results about school safety tech -\nnologies. \n\u2022 Given implementation challenges, researchers should include in their research design \nmeasures of proximal outcomes (adherence to protocol"] [11.017011642456055, 0.5915482640266418, "well-being of students \nand staff, and physical alterations to the facilities and campus if needed to improve safety. \n\u2022 Schools must remember that not only can technology fail in certain instances, but, more \nimportantly, experts stressed repeatedly"] [11.01081657409668, 0.5863194465637207, "ity emergency responders (e.g., police, fire, medical services). A security assessment examines a wide range of factors, including the physical features of the school grounds and \nbuilding, preparation for weather-related threats, threats from the st"] [10.870461463928223, 0.4724007844924927, "nd ethically, schools need to \nconsider whether and how particular technologies could feasibly be adopted and used to suc -\ncessfully address the specific issues related to student safety for which solutions are needed. \nUnderstanding how these techn"] [10.83437728881836, 0.44541114568710327, "ugh fatal and serious violence at schools generates the most media attention, such inci -\ndents are rare. According to the School Associated Violent Death study, between July 1, 2010, 80 The Role of Technology in Improving K\u201312 School Safety\nand J"] [10.827242851257324, 0.4393133521080017, " than 20 percent of schools experience episodes of fatal or serious violence, most \nschools experience some type of violence during the school year. According to the SSCS, in the \n2009\u201310 school year, 74 percent of public schools recorded at least on"] [10.789714813232422, 0.42262744903564453, " during the same time frame, 15 percent of students were electronically bul -\nlied through email, instant messaging, chat rooms, websites, or texting (Kann et al., 2014). The Table A.1\nCharacteristics of Active Shooting Incidents in K\u201312 Schools in t"] [10.844019889831543, 0.46470344066619873, "nomic condi -\ntions, drug markets, law enforcement practices, and school policies and environments as well as increases in programs geared toward violence prevention (Brener et al., 1999).\nThere are a few notable exceptions to the overall decline in "] [10.828951835632324, 0.44203266501426697, "ence rates across middle and high schools, indicates that although a comparable proportion \nof middle and high schools experience violence, such events occur more frequently in middle schools. \nEnrollment Size\nThe prevalence of all forms of violence"] [10.846797943115234, 0.4550606608390808, "ver 20 percent of schools located in cities experienced an event involving serious violence, followed by over 15 percent of schools in suburbs and towns and 13 percent of schools in rural \nareas. Incidence of violence, as reported to administrators, "] [10.824041366577148, 0.4366743564605713, "es to, the \ncausal effects of urbanicity on school violence, see Maume, Kim-Godwin, and Clements, 2010; Veliz and Shakib, 2012; \nand Klein and Cornell, 2010.An Overview of Violence in U.S. K\u201312 Schools Today 85\nchuk, 2007) and self-reported weapon"] [10.826884269714355, 0.4384048879146576, "The definition we apply in this report refers primarily to school-level norms and \ninteractions, encompassing a range of positive indicators (e.g., parent and community involve-ment; average levels of students\u2019 self-reported attachment to their schoo"] [10.819151878356934, 0.4343266785144806, "atings of students\u2019 college-going expectations (Maume, Kim-Godwin,and Clements, 2010) and athletic and math participation (Veliz and Shakib, 2012) are associated \nwith lower rates of school violence.\nFamilial and Community Factors\nAlthough parental i"] [10.794865608215332, 0.42171576619148254, "eir own reports, \nmales are also more likely than females to carry weapons to school (8 versus 3 percent) and to \nfight at school (10.7 versus 6 percent; Kann et al., 2014). \nAge\nStudents ages 12\u201314 experience greater rates of violent victimization t"] [10.808374404907227, 0.42427489161491394, " school property were greater among youth who had experienced any or exclusively same-sex contact. Similarly, a median of \n16 percent of gay and lesbian youth, 13 percent of bisexual youth, and 10 percent of youth who were unsure of their sexual ide"] [10.820324897766113, 0.4335326552391052, "ed or injured at school (Zhang and Johnson, 2005). \nMental Health\nMental health symptoms are also positively associated with perpetration of violence at school. Students reporting high levels of stress (Horner, Rew, and Brown, 2012), symptoms of \ndep"] [10.809112548828125, 0.424943745136261, ".90 The Role of Technology in Improving K\u201312 School Safety\n2002). Impulsivity and low self-control were associated with being victimized at schools in two \nstudies (Augustine et al., 2002; Tillyer, Fisher, and Wilcox, 2011), but another study foun"] [10.776545524597168, 0.39893773198127747, "rying. Other studies have found that weapon victimization (Muula, Rudatsikira, and Siziya, 2008; Watkins, 2008), property victimization (Muula, Rudatsikira, \nand Siziya, 2008), violent victimization (Kodjo, Auinger, and Ryan, 2003; Muula, Rudatsikira"] [10.807693481445312, 0.42358386516571045, " (Burrow and Apel, 2008) or residing in a two-parent household both appear to \nbe unrelated to victimization (Burrow and Apel, 2008; Peguero and Jiang, 2014; Vogel and Barton, 2013; Watkins, 2008). \nQualitative aspects of family functioning seem to b"] [10.773599624633789, 0.4050658643245697, " the direct report of their peers themselves, these results should \nbe interpreted somewhat cautiously. \nPeer attachment has been found to reduce the likelihood of victimization (Tillyer, Fisher, \nand Wilcox, 2011). In one study, however, positive pe"] [10.839366912841797, 0.44893214106559753, "ith behavioral issues. On the other hand, \nteachers assigned to smaller numbers of students were at lower risk (Gerberich et al., 2014). \nConclusion\nTo summarize, violence in U.S. schools is not uncommon; however, as one of our interviewees \ncommente"] [10.864752769470215, 0.4669465720653534, "these constraints, we made every attempt to scan and identify literature on studies of school-level violence and individual-level perpetration of \nor victimization by violence at schools.\nSearch Strategy\nWe developed a systematic search strategy for "] [10.836051940917969, 0.4447791576385498, " school-level violence or individual- level perpetration or victimization of violent behaviors occurring in school settings (question 2). \nOnce these studies were categorized, we further extracted from them data along several dimen -\nsions and catal"] [10.827842712402344, 0.4390775263309479, ".S. Centers for Disease ControlRepresentative samples of 9th\u201312th-grade students at national, state, and large urban levels5\nNational Longitudinal Study of Adolescent to Adult HealthStudent-reported weapon-carryingUniversity of North CarolinaNation"] [10.904914855957031, 0.49946147203445435, "ey sources identi -\nfied by the project team and client representatives were also examined. No other information sources were searched. \nSelection Criteria\nTo be eligible for this rapid review, retrieved citations must have discussed school safety te"] [10.875418663024902, 0.474824994802475, "g fights on school playgrounds at nights or on weekends).\nA priori examples of ineligible forms of violence include:\n\u2022 all forms of self-harm, such as suicide, cutting, or eating disorders, even when that self-\nharm occurs at school\n\u2022 verbal abuse th"] [11.005372047424316, 0.5812878608703613, "n real-world applications\n\u2022 information about the prevalence or use of the technology\n\u2022 information about the cost associated with using the technology\n\u2022 information about the acceptability of the technology to various stakeholders (e.g., stu -\ndents"] [11.05228328704834, 0.630486249923706, "er \ngroups. See Table B.2 for a breakdown of our recruitment efforts. \nTo protect confidentiality, we do not name the individuals or their organizations, but \nthey came from county offices of education, associations of school principals, universities"] [11.036283493041992, 0.606689453125, "nt analysis. Subthemes were then highlighted to another color for easier text analysis and \nvalidation, and a new bivariate was created for each theme and a \u201c1\u201d was assigned to each quote \nto indicate that a specific theme was mentioned within a spec"] [11.025668144226074, 0.5986852645874023, "ve, somewhat ineffective, neither effective nor ineffective, somewhat effective, very effective, and don\u2019t know.104 The Role of Technology in Improving K\u201312 School Safety\nParticipants were also asked to describe the most likely harms, if any, asso"] [11.025672912597656, 0.5964550971984863, "-\ngies were appropriate for addressing the form of violence being discussed, and then they were asked to describe the most important improvements that could be made to these technologies to make them even more appropriate for addressing that form of "] [14.69509506225586, 1.7509490251541138, "here were four subpanels: two working groups representing urban schools and school districts on Day 1 and \ntwo working groups representing suburban/rural schools and school districts on Day 2. This \nresulted in 12 sets of ratings. Across Phases 1 and"] [14.721406936645508, 1.7420504093170166, "ng the panels\u2019 priorities, given that different numbers of needs were combined \nduring the simplification process (Figure B.2). \nOur approach also had to account for the different lists of needs identified by each working group (which varied in numbe"] [14.724939346313477, 1.7181559801101685, "e need received: To have a measure that was \ntruly independent of the number of original needs that were combined during our sim -\nplification process of creating combined needs, we added the normalized scores for each \ncombined need and divided that"] [11.001709938049316, 0.5787283778190613, "ocalities with media coverage about innovative use of school safety technology \nusing such keywords as \u201cschool safety,\u201d \u201cschool violence,\u201d and \u201ctechnology.\u201d These two meth -\nods yielded a total of 18 candidate locations for our case studies. From thi"] [13.769716262817383, 3.916839122772217, "cilSean Burke, President, School Safety Advocacy Council\nMo Canady, Executive Director, National Association of School Resource OfficersMo Canady, Executive Director, National Association of School Resource Officers\nJadine Chou, Chief Safety and Secu"] [11.076857566833496, 0.6284869909286499, "e2Tell\nNancy Ritter, Writer/Editor, National Institute \nof Justice, Office of Communications\nSteve Schuetz, Physical Scientist, Information \nTechnologies, National Institute of Justice, \nResearch Division\nEmily Tanner-Smith, Research Assistant \nProfe"] [11.05598258972168, 0.6170251369476318, "plete List of Panel Rankings of Combined Technology and Related Needs\nCombined Technology ImprovementIdentified InTier with Respect to \nthe Most Severe \nForms of School \nViolenceTier with Respect to \nthe Most Frequent \nForms of School \nViolenceTier "] [11.030999183654785, 0.5969907641410828, "s on school safety 3 Urban, suburban/\nrural1 1 3 3 3 3\nClearinghouse of information about funding available to purchase school safety products1 Urban 3 3 3 3 3 3\nConversion of voice tips into text for easier triage and tracking on tip lines3 Urban, s"] [11.028407096862793, 0.5948169231414795, " scanning and retrieval of electronic archived information2 Urban, suburban/\nrural3 3 3 3 3 3\nEasier-to-use ID technology 1 Urban 3 3 3 3 3 3\nEasier, faster identification of IP address of social media user 1 Urban 3 3 3 3 3 3\nEducational materials ("] [11.030033111572266, 0.5958101749420166, "and retrieval of electronic archived information2 Urban, suburban/\nrural3 3 3 3 3 3\nEasier-to-use ID technology 1 Urban 3 3 3 3 3 3\nEasier, faster identification of IP address of social media user 1 Urban 3 3 3 3 3 3\nEducational materials (e.g., TED "] [11.031670570373535, 0.597285270690918, "t school safety2 Urban, suburban/\nrural3 3 2 2 3 3\nPublic announcement (PA) system available to CCTV staff to intervene immediately1 Suburban/rural 3 3 3 3 3 3\nPeer-led tip line for less serious school safety threats 1 Suburban/rural 3 3 3 3 3 3\nPlat"] [10.97713565826416, 0.5537065863609314, "gement system 3 Urban, suburban/\nrural3 3 3 3 3 3\nTechnology to monitor and alter students\u2019 classroom assignments to minimize conflicts between students1 Urban 3 3 3 3 3 3\nTraining for educators about student profiling 1 Urban 3 3 3 3 3 3\nUse of data"] [10.812568664550781, 0.42685067653656006, " Victims 17(2): 233\u2013253.\nBachman, R., A. Randolph, and B. L. Brown, (2011). \u201cPredicting Perceptions of Fear at School and Going to and from School for African American and White Students: The Effects of School Security Measures.\u201d Youth & Society 43"] [10.835376739501953, 0.4438028931617737, "40. DeNisco, Alison, \u201cEnhancing Visitor Management After Sandy Hook\u201d (2013). District Administration \n49(5): 16.DeVoe, J. F., L. Bauer, and M. R. Hill (2011). Student Victimization in US Schools: Results from the 2009 \nSchool Crime Supplement to th"] [10.803091049194336, 0.4181695282459259, "cators.\u201d Annals of Epidemiology 24(5): 325\u2013332.References 123\nGladden, R. M., A. M. Vivolo-Kantor, M. E. Hamburger, and C. D. Lumpkin (2014). Bullying Surveillance \nAmong Youths: Uniform Definitions for Public Health and Recommended Data Elements"] [10.85493278503418, 0.46080732345581055, "and Automotive Mechanics Conference, Proceedings . Los Alamitos, Calif.: IEEE Computer \nSociety: 127\u2013132\n\u201cImproving Classroom Attendance\u201d (2014). Security Management 58(8): 75.\nIngersoll, R. M. (2001). \u201cTeacher Turnover and Teacher Shortages: An Org"] [10.832951545715332, 0.44321388006210327, "win, and C. M. Clements (2010). \u201cRacial Tensions and School Crime.\u201d Journal of Contemporary Criminal Justice 26(3): 339\u2013358.\nMcLester, S. (2011). \u201cDesigning Safe Facilities.\u201d District Administration 47(8): 71\u201378.\nMiami-Dade Police Department (undat"] [10.839040756225586, 0.4475201964378357, "eguero, A. A., and X. Jiang (2014). \u201cSocial Control Across Immigrant Generations: Adolescent Violence at \nSchool and Examining the Immigrant Paradox.\u201d Journal of Criminal Justice 42(3): 276\u2013287.\nPerumean-Chaney, S. E., and L. M. Sutton (2013). \u201cStude"] [10.833548545837402, 0.4432905912399292, "or-cobb-county-schools\nSprague, J. (2007). Creating Schoolwide Prevention and Intervention Strategies . The Hamilton Fish Institute on \nSchool and Community Violence and Northwest Regional Educational Laboratory.Stroud, S. (2009). \u201cFight Fire with Fi"] [10.81423282623291, 0.4274388551712036, "ossession.\u201d Justice \nQuarterly 18(3): 509\u2013541.\nWilcox, P., D. C. May, and S. D. Roberts (2006). \u201cStudent Weapon Possession and the \u2018Fear And Victimization Hypothesis\u2019: Unraveling the Temporal Order.\u201d Justice Quarterly 23(4): 502\u2013529.\nWilson, D. B.,"] [1.8093585968017578, 19.393831253051758, "Cost\u2013Benefit Analysis \nof Proposed California Oil and Gas Refinery Regulations\nDaniel Gonzales, Timothy R. Gulden, Aaron Strong, William HoyleLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protect"] [1.820683479309082, 19.410003662109375, "d regula -\ntion, the regulation could provide safety and health benefits to the public in nearby \ncommunities and might provide other economic benefits. We examined these poten -\ntial benefits in this study. This report explains the proposed regulati"] [1.8149008750915527, 19.400665283203125, ".... 1\nBackground ............................................................................................. 1\nObjectives ............................................................................................... 2\nCalifornia Oil and Gas Re"] [1.7993903160095215, 19.38129425048828, "es ......................................................................................... 42\nRefinery-Worker Deaths ............................................................................. 44\nIndustrial Safety Ordinance Refinery-Incident Hi"] [1.8026022911071777, 19.38408088684082, " and Tables\nFigures\n S.1. Critical Risk Reduction as a Function of Differing Estimates of \nPreregulation Expected Annual Loss from Costly Major Refinery Incidents\n ................................................................................ xvi"] [1.8020696640014648, 19.385805130004883, "y Ordinance Refineries Between 2000 and 2013 .......... 43\n 5.4. Industrial Safety Ordinance Refineries After 2013 ................................. 43\n 5.5. Non\u2013Industrial Safety Ordinance Refineries After 2013 .......................... 43\n 5.6."] [1.8066380023956299, 19.389925003051758, "in industry costs)\n\u2022 benefits to industry (costs avoided)\n\u2022 benefits to society (costs avoided and other improvements and fewer worker deaths).xii Cost\u2013Benefit Analysis of Proposed California Oil and Gas Refinery Regulations\nOnce we have estimated"] [1.800169587135315, 19.380231857299805, "er cost estimates was regard -\ning start-up costs. Most refiners estimated start-up costs for the first one to five years to be on the same order as, or lower than, ongoing costs. One refining company, however, \nexpressed concern about the costs to c"] [1.8007829189300537, 19.38319969177246, "s slightly higher cost of gasoline places on the economy. On net, we con -\nclude, the stimulatory effect of the refiners\u2019 additional spending would slightly exceed the inhibitory effect of higher gas prices.\nBenefits to Industry: Safety Improvements\n"] [1.7928588390350342, 19.377582550048828, " company reputation damage, overseas production costs for reformulated California gasoline, intermediate feedstock production and transportation costs, or gasoline transportation costs without access to detailed proprietary information that \nrefiners"] [1.7963649034500122, 19.379472732543945, "ty will be improved, and the number of workers who die will be reduced. In this study, we examined the hypothesis that the implementa -\ntion of the proposed regulation will result in fewer refinery-worker deaths. We examine worker deaths in ISO and N"] [1.8034391403198242, 19.381790161132812, "ated with the critical risk-\nreduction factor. Table\u00a0S.2 shows a small subset of possible points from the figure to illustrate how several key factors are related in these uncertainty calculations. Table\u00a0S.2 shows that, assuming our best estimate of "] [1.821157455444336, 19.39961051940918, "fety gains\u2014though various differences in the structure \nand implementation of the two regulatory regimes make precise quantitative compari -\nson difficult.\nUnder most scenarios examined in this analysis, the regulations appear to be \ncost-effective. "] [1.803899884223938, 19.388134002685547, "is true, the numbers presented here provide a conservative estimate of the benefits. This has the effect of lowering the required break-even point and making \nthe regulations easier to justify.xxiAcknowledgments\nWe recognize California governor Edmun"] [1.797598123550415, 19.381122589111328, "nia Business Coordination for Shell Oil \nProducts U.S.\n\u2022 Mary Kay Nye, manager, process safety, Shell Oil Products U.S. Martinez Refin -\nery\n\u2022 James Jeter, senior manager, environmental, health, and safety, Tesoro Refining \nand Marketing\n\u2022 Sabiha Gok"] [1.7970050573349, 19.379459381103516, "in\u00a0A. Serna, fire chief, fire department, City of Torrance\n\u2022 James Carver, fire marshal, El Segundo Fire Department\n\u2022 Colby La Place, senior hazardous material specialist, Solano County Department of Resource Management.\nFinally, we thank our peer re"] [1.7905205488204956, 19.360448837280273, "s on the road today in California use gasoline or diesel fuel.\nCalifornia motor vehicles and commercial aircraft consumed 14.5\u00a0 billion gal -\nlons of gasoline, diesel, and jet fuel in 2012. Gasoline consumption fell about 14\u00a0per -\ncent from 2006 to 2"] [1.808589220046997, 19.3935489654541, "d will be charged with enforc -\ning the new proposed PSM standard for refineries, \u00a7\u00a05189.1.\nCalEPA oversees the implementation of the CalARP program. The California \nGovernor\u2019s Office of Emergency Services is the lead agency for the program and track"] [1.7961474657058716, 19.378562927246094, "s.\nThe Phillips\u00a066 Santa Maria Refinery is considered a part of Phillips\u00a066\u2019s San \nFrancisco Refinery, which is in Northern California (it is connected to it by pipeline). The capacity figure shown in Table\u00a01.1 for Phillips\u00a066\u2019s San Francisco Refiner"] [1.7937719821929932, 19.37232208251953, "ery Tesoro Petroleum Martinez 168,000\nLos Angeles Refinery Tesoro Petroleum Carson 377,000\nValero Wilmington RefineryValero Marketing and \nSupplyWilmington 80,000\nBenicia Refinery Valero Marketing and \nSupplyBenicia 165,000\nTotal capacity 2,047,000\nS"] [1.8088935613632202, 19.392822265625, " production. The first two items are costs that are avoided under the \nproposed regulation. The last item is an economic benefit of the proposed regulation: \nincreased refinery output and sales.\nAdditional qualitative benefits to society could result"] [1.8036749362945557, 19.379308700561523, " be implemented and how much compliance might cost. We \ndiscussed the few outlying estimates with the refiners and either revised them upon \nfurther clarification of the questions or retained them as legitimately different esti -\nmates. In general, h"] [1.7982544898986816, 19.37846565246582, "agement plan (RMP) that includes a description of the worst-case refinery-incident \nscenarios based on the types and amounts of hazardous chemicals present at the facil -\nity. We reviewed California refinery RMPs and the worst-case scenarios for most"] [1.8244026899337769, 19.40867805480957, "the past several decades. The chapter also \ndescribes a California gas price model that can be used to assess the impact that MRIs \ncan have on California gas prices. Chapter Seven includes the macroeconomic impact \nanalysis for the proposed regulati"] [1.8239915370941162, 19.41452980041504, "focuses on minimizing risks to \nemployees, whereas the CalARP regulation focuses on protecting the safety and health \nof the community, as well as the environment.\nActions Already Taken on Refinery Safety\nAfter the Chevron Richmond fire, the Californ"] [1.8653380870819092, 19.463003158569336, "ntly Safer Measures\nHCA is\n[a] procedure that applies the Hierarchy of Hazard Controls for the purpose of \nselecting recommendations that eliminate or minimize a hazard, or that reduce the risk presented by a hazard. (Cal/OSHA, 2015, p.\u00a04)\nInherent s"] [1.8919018507003784, 19.500774383544922, "ng effective process safety leadership at all levels of the organization. (Cal/OSHA, 2015, p.\u00a025)\nDamage Mechanism Reviews\nThe employer shall complete a Damage Mechanism Review (DMR) within five (5)\u00a0years of the effective date of this Section for eac"] [2.0944502353668213, 19.75901222229004, "ng additional or alternative safeguards that will reduce the risk of a \nmajor incident. The team shall select and recommend the most protective safe -\nguards, unless the team can demonstrate in writing that it is not feasible to do so. Where the team"] [2.093799591064453, 19.758146286010742, "these RAGAGEP requirements:\nInspections and tests shall be performed on process equipment, using procedures \nthat meet or exceed RAGAGEP. (Cal/OSHA, 2015, p.\u00a016)\nThe frequency of inspections and tests shall be consistent with the applicable man -\nufa"] [1.875567078590393, 19.475976943969727, " first- and second-order inherent-safety measures, as well as passive, active, and \nprocedural safeguards. It should eliminate hazards to the greatest extent feasible using first-order inherent-safety measures.\nSafeguard Protection Analysis, Part of "] [1.8475884199142456, 19.431541442871094, "and Information\nEach refiner should provide all documents and information developed or collected pur -\nsuant to the PSM regulation to Cal/OSHA upon request.\nImplementation\nEach refiner should establish a corrective action program to prioritize the re"] [1.8092471361160278, 19.391971588134766, "fewer refinery-worker deaths\n \u2013changes in employment\n \u2013uninterrupted fuel supply\n \u2013uninterrupted employment in the oil sector.\nWe could not estimate some costs because of a lack of data. These include crimi -\nnal liability charges, reputation damage,"] [1.8126507997512817, 19.396163940429688, "y in the refinery industry. Despite this, we believe that it is possible to estimate the \namount of revenue lost in at least some types of refinery incidents, as we describe later \nin this report. Refiners were similarly unable to identify benefits o"] [5.583807468414307, 11.95731258392334, "s. They further attempt to elicit enough context for the answers to allow us to identify which costs are marginal costs that the regulations add (these are \nthe focus of this study) and which are total or historical safety-related costs. They fur -\nt"] [5.560412406921387, 11.975043296813965, "demand in one sector will stimulate \ndemands for inputs across other regional sectors, generating additional demand.\nIndustry and academia use IMPLAN widely. In recent studies, the oil and gas \nindustry has used IMPLAN for macroeconomic studies in Ca"] [1.8047298192977905, 19.3759822845459, " economies of the United States are usually calibrated using the IMPLAN data because the model assumes that the \nIMPLAN data are in equilibrium. One of the main advantages of using a CGE frame-\nwork as opposed to an input\u2013output framework is the abil"] [1.7903597354888916, 19.37328338623047, "or which we have data of reasonable qual -\nity). We developed an estimate of these costs by examining the 1999 Tosco incident, the 2012 Chevron Richmond incident, and the 2015 ExxonMobil Torrance incident. \nFor the Richmond case, we obtained data on "] [1.823771595954895, 19.38356590270996, " to support the assertion that Pp is lower than Pc.\nHowever, we do not find evidence that the consequences of MRIs will be reduced \nunder the proposed regulations, i.e., that Cc\u00a0\u2013\u00a0Cp\u00a0>\u00a00. The costly major incidents that \nhave occurred have varied sig"] [1.8037716150283813, 19.38624382019043, "the pro -\nposed regulations\u2019 costs, we excluded any safety-related initiatives already under way that the regulations do not directly mandate.30 Cost\u2013Benefit Analysis of Proposed California Oil and Gas Refinery Regulations\nMethods Used to Obtain A"] [1.8071225881576538, 19.390426635742188, "at the refin -\ners actually reported as a \u201cbest\u201d or average cost estimate. We take the 10th-percentile \n(second-lowest) and 90th-percentile (second-highest) estimates as the likely lower and \nupper bounds for this cost. Note that most estimates clust"] [1.805214285850525, 19.388874053955078, "t cost to comply with them. We have incorporated all answers regarding ongoing cost of com -\npliance into the estimates presented here. Differences in opinion along these lines have Figure\u00a04.1\nEstimated Annual Recurring Program Costs, in Dollars\nRAND"] [1.7962818145751953, 19.377805709838867, "sts of the \nproposed regulations, with most of the cost being the ongoing operational costs of run -\nning facilities as the new regulations would require. Under most refiners\u2019 estimates, the first one to five years could cost more than the following "] [1.795807957649231, 19.378389358520508, "nt reporting by all California refineries, \nwould be insufficient to provide statistically significant results.36 Cost\u2013Benefit Analysis of Proposed California Oil and Gas Refinery Regulations\nClassification of Refinery Incidents\nLocal government o"] [1.7920278310775757, 19.374866485595703, "mbustibles that is more than \n5,000\u00a0pounds1\nCharacteristics of Major Refi nery Incidents\nTh e defi nition of a level\u00a03 MCAR above does not provide quantitative criteria that can \nbe used to defi ne MRI , nor does it provide information to estimat"] [1.7971633672714233, 19.38022804260254, "t. Califor -\nnia regulators denied this request (Penn, 2015). ExxonMobil began to import spe-\ncially produced batches of gasoline from overseas refineries capable of producing the \nCalifornia blend of reformulated gasoline or nearly finished Californ"] [1.7881375551223755, 19.369728088378906, " shut down, and repairs were made within a matter of days. Full production \nat the refinery was possible, and production capacity was restored at the refinery in a \nfew days. But county leaders and regulators asked the refinery operator to shut down "] [1.7936716079711914, 19.376420974731445, " chemicals released and the area to which they could spread beyond the facility itself. Some of the \nhazardous chemicals stored and used at refineries include ammonia, sulfuric acid, and \nhydrogen fluoride, as well as a host of hydrocarbon molecules "] [1.7956129312515259, 19.379114151000977, "haracterized by relatively few worker deaths but long refinery-outage periods. In a few cases, a large number of nearby residents have suffered significant adverse health effects, while, in \nothers, the health of nearby residents has not been affecte"] [1.7941032648086548, 19.3773250579834, ", the ISO and Richmond ISO contained similar regulatory guid -\nance. The ISO was amended in 2006 to extend ISO requirements for facility HF \nprograms to include maintenance and safety culture assessment. The revised ISO also \nexpanded MOOC requiremen"] [1.8004153966903687, 19.3843994140625, "ineries because, prior to 1999, the ISO did not exist, and, between 1999 \nand 2000, the ISO had not yet come fully into effect.\nRefinery-Worker Deaths\nTable\u00a05.6 shows refinery incidents in California that resulted in the deaths of one or \nmore refine"] [1.7972521781921387, 19.380563735961914, "e than 200), we can approximate key statisti -\ncal measures of the binomial distribution by the normal distribution (this holds in the NISO case but not for the ISO case) (Rosner, 2015). We can employ the normal Table\u00a05.6\nCalifornia Refinery-Worker D"] [1.7960309982299805, 19.380496978759766, "he MCARs that have taken place in Contra Costa County since the \nISO was enacted. CCHMP tracks MCARs each year and reports these to the public \nin its annual performance report. CCHMP also maintains a website that has data on Contra Cost County\u2013regul"] [1.7978386878967285, 19.3818302154541, " possible refinery incidents that could have released large amounts of \nhazardous chemicals into the air and caused adverse health effects off-site (thereby \nconstituting an MRI). In addition, we used data available from CCHMP and that Randall Sawyer"] [1.7951537370681763, 19.378376007080078, " 49\nrefinery-years or samples available for the NISO case (237\u00a0refinery-years). The normal \napproximation reveals the CI to be 0.032 to 0.094.\nWe cannot use the normal approximation to determine the CI for PMRI (ISO) \nbecause of the small size of "] [1.7541102170944214, 19.3123836517334, "in the rest of the United States. A premium is paid for California gasoline because of the unique California formulation requirements for gasoline and because \nlarge-scale pipelines do not exist from the eastern United States into California. Nev -\ne"] [1.7876132726669312, 19.362682342529297, "ance in the California gasoline prices ( R2\u00a0=\u00a00.98). From this estimation, we can Figure\u00a06.1\nCalifornia Versus U.S. Gasoline Prices\nSOURCE: U.S. Energy Information Administration.\nRAND RR1421-6.1January 1,\n2010January 1,\n2005January 1,\n2000January 1,"] [1.784712791442871, 19.36717987060547, "the fire.\n1 And at the same time, the delivery \nof crude oil to the refinery was probably stopped.\nFigure\u00a06.3 shows the impact that the Chevron Richmond Refinery incident had \non California gas prices. We see that, immediately after the incident, the"] [1.7863260507583618, 19.368669509887695, "the \nelderly, and children to shelter in place and for residents to shut down air-conditioning \nunits. Children at local schools were told to shelter in place for several hours. The fire \ndepartment recommended that the same precautions be taken at c"] [1.7831138372421265, 19.363256454467773, "is small for the size of the industry. The best estimate of $58\u00a0million is only 0.04\u00a0percent of industry revenue not devoted to inputs \nand about 0.005\u00a0percent of industry revenue overall.\nIMPLAN estimates total compensation in the California refiner"] [1.7914363145828247, 19.373220443725586, ". For example, the impact of a shutdown of a 150,000-bpd plant for 12\u00a0months is twice the impact \nof shutting it down for six months in all categories of impacts. Our base impact is to \nconsider a 150,000-bpd refinery being shut down for six months. "] [1.7626734972000122, 19.3469295501709, "the regulations to reduce this probability.\nWe can use this analysis to estimate the total macroeconomic impact of the three \ncostly major incidents that have occurred in the state of California in the past two \ndecades. Here, we are interested in th"] [1.8150792121887207, 19.39840316772461, "\nPotential Benefits to Industry\nThe safety improvements that might result from the proposed regulation could reduce \nthe number of future refinery incidents. If this is the case, refiners that implement the \nmeasures called for in the proposed regula"] [1.7829124927520752, 19.36644744873047, "be subject to fines that regulators impose after such incidents. ExxonMobil was recently fined $566,000 in conjunction with the 2015 incident. The \nCSB investigation into the cause of the incident continues. So regulators might levy \nadditional fines"] [1.7814390659332275, 19.365314483642578, " \nexposure to the hazardous smoke plume from the fire. Six employees received first aid as a result of the incident, but there were no injuries (Chevron USA, 2013).\nRepair Costs\nChevron was also unwilling to provide us with the final costs to repair "] [1.7856577634811401, 19.369190216064453, "rmission to resume full production), we can develop a rough \nestimate of the lost production at the refinery. We estimate the total value of this lost \nproduction to be approximately $900\u00a0million. From this, we estimate the lost profit to the refiner"] [1.7854015827178955, 19.368310928344727, " on the California gas market. At today\u2019s prices\u2014say, $4 per gallon\u2014its output for six months is worth about $2.8\u00a0billion. As \ndescribed earlier in this report, a production loss of this magnitude qualifies this inci -\ndent as a CMRI.\nWe use the same"] [1.787837028503418, 19.369853973388672, "nia refin -\ners $220\u00a0million. This is a cost that could be avoided if the proposed regulations are \nimplemented and do, as intended, improve refinery and worker safety.\nIt should also be noted that the loss to the refiner is not the same as the impac"] [1.8033971786499023, 19.385971069335938, "ffset the costs, while lower estimates \nof expected annual loss (because, for example, of lower estimates of refinery incident frequency) must produce greater improvements in risk to be worthwhile. Figure\u00a09.2 70 Cost\u2013Benefit Analysis of Proposed C"] [1.79896879196167, 19.381868362426758, "te of break-even point.72 Cost\u2013Benefit Analysis of Proposed California Oil and Gas Refinery Regulations\nan expected annual cost of $1.2\u00a0billion, the critical risk-reduction values are 4.8\u00a0per -\ncent in the refiner-estimated case, 1.7\u00a0percent in th"] [1.80287766456604, 19.386049270629883, "as of this writing \nare that the refinery might be off-line for a full 12\u00a0months. This might lead to a sig -\nnificant increase in the estimate for expected annual losses. If so, this would drive the \ncritical risk-reduction levels downward, making th"] [1.8044912815093994, 19.388172149658203, "timates to \nconstruct the range of estimates by calculating a size-adjusted cost for each refiner and \nthen taking the 10th percentile (second-lowest) and 90th percentile (second-highest) \nestimates as the likely lower and upper bounds for the unit c"] [1.7896130084991455, 19.373188018798828, "ber of CMRIs. Therefore, a benefit to indus -\ntry of the proposed regulation is that the costs of major incidents could be avoided in the future. Below, we estimate the costs of a major incident for a California refinery that suffers the incident.\nRe"] [1.7897639274597168, 19.37385368347168, "ajor incident rate for refineries operating \nunder the proposed regulation will also likely lead to\n\u2022 improved reliability of systems\n\u2022 reduction in certain workers\u2019 compensation premiums\n\u2022 improved community relations\n\u2022 improved labor\u2013management rel"] [1.8318613767623901, 19.41385269165039, " and find that these data provide \nstatistically significant evidence to support this hypothesis.\nTable\u00a010.3 summarizes our analysis of refinery-worker death rates.80 Cost\u2013Benefit Analysis of Proposed California Oil and Gas Refinery Regulations\nSt"] [1.8527356386184692, 19.441669464111328, "esources\t\r \u00a0required .\t\r \u00a0\t\r \u00a0We\t\r \u00a0are\t\r \u00a0meeting\t\r \u00a0virtually\t\r \u00a0all\t\r \u00a0of\t\r \u00a0the\t\r \u00a0\nrequirements\t\r \u00a0already.\t\r \u00a0\n2. Marginal\t\r \u00a0additional\t\r \u00a0resources\t\r \u00a0required .\t\r \u00a0\t\r \u00a0We\t\r \u00a0are\t\r \u00a0doing\t\r \u00a0the\t\r \u00a0many\t\r \u00a0of\t\r \u00a0the\t\r \u00a0things\t\r \u00a0\nrequired,\t\r "] [1.836707592010498, 19.4260311126709, "s)\t\r \u00a0in\t\r \u00a0the\t\r \u00a0refinery? \t\r \u00a0\n\t\r \u00a0\nIf\t\r \u00a0you\t\r \u00a0have\t\r \u00a0calculated\t\r \u00a0it,\t\r \u00a0what\t\r \u00a0is\t\r \u00a0the\t\r \u00a0Nelson\t\r \u00a0Complexity\t\r \u00a0Index\t\r \u00a0of\t\r \u00a0your\t\r \u00a0refinery?\t\r \u00a0\n\t\r \u00a0\nSafety\t\r \u00a0Training \t\r \u00a0\nThe\t\r \u00a0new\t\r \u00a0regulations\t\r \u00a0require\t\r \u00a0a\t\r \u00a0well-\u00ad\u2010docume"] [1.8416969776153564, 19.432039260864258, " \u00a0new\t\r \u00a0\nrequirements?\t\r \u00a0\t\r \u00a0Please\t\r \u00a0describe\t\r \u00a0the\t\r \u00a0costs\t\r \u00a0associated\t\r \u00a0with\t\r \u00a0these\t\r \u00a0changes.\t\r \u00a0\n\t\r \u00a0Please\t\r \u00a0estimate\t\r \u00a0any\t\r \u00a0cost\t\r \u00a0savings\t\r \u00a0associated\t\r \u00a0with\t\r \u00a0the\t\r \u00a0DMR\t\r \u00a0process \t\r \u00a0and\t\r \u00a0the\t\r \u00a0actions\t\r \u00a0\nthat\t\r \u00a0fol"] [1.836099624633789, 19.426321029663086, "se\t\r \u00a0describe\t\r \u00a0the\t\r \u00a0costs\t\r \u00a0associated\t\r \u00a0with\t\r \u00a0these\t\r \u00a0changes. \t\r \u00a0\n\t\r \u00a0\nPlease\t\r \u00a0estimate\t\r \u00a0any\t\r \u00a0cost\t\r \u00a0savings\t\r \u00a0associated\t\r \u00a0with\t\r \u00a0the\t\r \u00a0RCA\t\r \u00a0process\t\r \u00a0and\t\r \u00a0the\t\r \u00a0actions\t\r \u00a0\nthat\t\r \u00a0follow\t\r \u00a0the\t\r \u00a0recommendations.\t\r \u00a0"] [1.8432527780532837, 19.432641983032227, "\t\r \u00a0\nregulations\t\r \u00a0or\t\r \u00a0just\t\r \u00a0for\t\r \u00a0a\t\r \u00a0subset?\t\r \u00a0\t\r \u00a0 \t\r \u00a0\n\t\r \u00a0\nAre\t\r \u00a0HCAs\t\r \u00a0incorporated\t\r \u00a0into\t\r \u00a0the\t\r \u00a0PHA,\t\r \u00a0Root\t\r \u00a0Cause\t\r \u00a0Analysis,\t\r \u00a0or\t\r \u00a0Mechanical\t\r \u00a0Integrity\t\r \u00a0\nprogram?\t\r \u00a0\n\t\r \u00a0\t\r \u00a0\nAbout\t\r \u00a0how\t\r \u00a0many\t\r \u00a0HCAs\t\r \u00a0do\t\r \u00a0"] [1.8343617916107178, 19.421541213989258, "eport\t\r \u00a0and\t\r \u00a0action\t\r \u00a0plan\t\r \u00a0that\t\r \u00a0is\t\r \u00a0\ncommunicate d\t\r \u00a0to\t\r \u00a0employees.\t\r \u00a0The\t\r \u00a0regulations\t\r \u00a0require\t\r \u00a0that\t\r \u00a0employees\t\r \u00a0and\t\r \u00a0\ntheir\t\r \u00a0representatives\t\r \u00a0participate\t\r \u00a0in\t\r \u00a0all\t\r \u00a0aspects\t\r \u00a0of\t\r \u00a0the\t\r \u00a0safety\t\r \u00a0culture\t\r \u00a0\n"] [1.8725658655166626, 19.463600158691406, "fety,\t\r \u00a0operational,\t\r \u00a0and\t\r \u00a0\nmaintenance \t\r \u00a0information.\t\r \u00a0\t\r \u00a0They\t\r \u00a0would\t\r \u00a0also\t\r \u00a0state\t\r \u00a0how\t\r \u00a0findings\t\r \u00a0of\t\r \u00a0all\t\r \u00a0\nprevention\t\r \u00a0elements\t\r \u00a0are\t\r \u00a0communicated\t\r \u00a0to\t\r \u00a0employees\t\r \u00a0and\t\r \u00a0how\t\r \u00a0employee\t\r \u00a0\nparticipation\t\r \u00a0is"] [1.8473231792449951, 19.438108444213867, "I\t\r \u00a0RP\t\r \u00a0570\t\r \u00a0Tier\t\r \u00a01\t\r \u00a0and\t\r \u00a02\t\r \u00a0incidents.\t\r \u00a0\n\t\r \u00a0\nIs\t\r \u00a0this\t\r \u00a0currently\t\r \u00a0being\t\r \u00a0done\t\r \u00a0at\t\r \u00a0your\t\r \u00a0facility?\t\r \u00a0 (For\t\r \u00a0example,\t\r \u00a0does\t\r \u00a0your\t\r \u00a0company\t\r \u00a0\ncurrently\t\r \u00a0use\t\r \u00a0API\t\r \u00a0754?)\t\r \u00a0\t\r \u00a0Do\t\r \u00a0you\t\r \u00a0currently\t\r \u00a0t"] [1.838480830192566, 19.427377700805664, "s.\t\r \u00a0\n\t\r \u00a0\nHow\t\r \u00a0familiar\t\r \u00a0are\t\r \u00a0you\t\r \u00a0with\t\r \u00a0the\t\r \u00a0proposed\t\r \u00a0Human\t\r \u00a0Factors\t\r \u00a0regulations?\t\r \u00a0\t\r \u00a0\nDo\t\r \u00a0you\t\r \u00a0currently\t\r \u00a0have\t\r \u00a0a\t\r \u00a0written\t\r \u00a0human\t\r \u00a0factors\t\r \u00a0program?\t\r \u00a0\n\t\r \u00a0If\t\r \u00a0you\t\r \u00a0have\t\r \u00a0such\t\r \u00a0a\t\r \u00a0program,\t\r \u00a0does"] [1.8402646780014038, 19.430253982543945, "ule\t\r \u00a0for\t\r \u00a0actions\t\r \u00a0to\t\r \u00a0be\t\r \u00a0taken.\t\r \u00a0Structured Interview Questions 91\n\t\r \u00a0\nDo\t\r \u00a0you\t\r \u00a0currently\t\r \u00a0do\t\r \u00a0L OPAs?\t\r \u00a0\t\r \u00a0If\t\r \u00a0not,\t\r \u00a0do\t\r \u00a0you\t\r \u00a0currently\t\r \u00a0do\t\r \u00a0some\t\r \u00a0other\t\r \u00a0form\t\r \u00a0of\t\r \u00a0SPA?\t\r \u00a0\n\t\r \u00a0Do\t\r \u00a0you\t\r \u00a0currently\t\r"] [1.8309646844863892, 19.41988182067871, "\r \u00a0outage\t\r \u00a0caused\t\r \u00a0by\t\r \u00a0an\t\r \u00a0external\t\r \u00a0utility\t\r \u00a0provid er\t\r \u00a0please\t\r \u00a0\ninclude\t\r \u00a0but\t\r \u00a0specify.\t\r \u00a0If\t\r \u00a0there\t\r \u00a0are\t\r \u00a0other\t\r \u00a0unplanned\t\r \u00a0downtimes\t\r \u00a0that\t\r \u00a0occur\t\r \u00a0due\t\r \u00a0to\t\r \u00a0other\t\r \u00a0external\t\r \u00a0factors\t\r \u00a0please\t\r \u00a0specify. "] [1.8013299703598022, 19.386322021484375, "u\t\r \u00a0have\t\r \u00a0given? \t\r \u00a0\n\t\r \u00a0Please\t\r \u00a0indicate \t\r \u00a0the\t\r \u00a0answer\t\r \u00a0that\t\r \u00a0describes\t\r \u00a0your\t\r \u00a0confidence\t\r \u00a0level.\t\r \u00a0 \t\r \u00a0\n1. Not\t\r \u00a0very\t\r \u00a0confident.\t\r \u00a0Structured Interview Questions 93\n2. Somewhat\t\r \u00a0confident.\t\r \u00a0Significant\t\r \u00a0uncertain"] [1.793736457824707, 19.3772029876709, "ry Regulations\nChevron USA Richmond Investigation Team, \u201cRichmond Refinery 4 Crude Unit Incident, \nAugust\u00a06, 2012,\u201d April\u00a012, 2013. As of January\u00a019, 2016: http://richmond.chevron.com/Files/richmond/Investigation_Report.pdf\nCity of Richmond, Californ"] [1.7854655981063843, 19.36907386779785, "Texas Tribune , March\u00a022, 2015. As of \nJanuary\u00a019, 2016: http://apps.texastribune.org/blood-lessons/disaster/Bibliography 97\nPenn, Ivan, \u201cExxon Mobil Scraps Plans for Temporary Fix to Damaged Torrance Refinery,\u201d Los \nAngeles Times , September\u00a023, "] [1.7933963537216187, 19.37730598449707, "rt: Chevron Richmond Refinery Fire , April 2013. As of January\u00a019, \n2016: \nhttp://www.csb.gov/assets/1/19/Chevron_Interim_Report_Final_2013-04-17.pdf\u2014\u2014\u2014, Regulatory Report: Chevron Richmond Refinery Pipe Rupture and Fire , Report\u00a02012-03-I-CA, \nMay "] [3.132449150085449, -1.2654047012329102, "Developing a \nRisk Assessment \nMethodology \nfor the National \nAeronautics \nand Space \nAdministrationCORPORATION\nDaniel M. Gerstein\nJames G. Kallimani\nLauren A. Mayer\nLeila Meshkat\nJan Osburg\nPaul Davis\nBlake Cignarella\nClifford A. GrammichThe Nationa"] [3.131117820739746, -1.269281029701233, "fer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. \nRAND\u2019s publications do not necessarily reflect the opinions of its research clients and sponsors.\nSupport RAND\nMake a tax-deduc"] [13.795483589172363, 4.544975280761719, "dministration\nnology have on policy analysis and policy choices. The program covers such topics as \nspace exploration, information and telecommunication technologies, and nano- and biotechnologies. Program research is supported by government agencies"] [3.1512508392333984, -1.2427420616149902, ".............................. 35\nPolitical Risks ........................................................................................ 38\nTechnical Risks ....................................................................................... 39"] [3.164761781692505, -1.2261626720428467, "......... 87viiFigures and Tables\nFigures\n 1. 1. S tudy Approach ........................................................................... 4\n 2\n.1.\n E\nxample Risk Matrix ..................................................................... 9\n 2\n"] [3.1628289222717285, -1.2295403480529785, "\n.5.\n S\nhuttle Cancellation/ISS Transport Cost and Schedule Evaluation \n(Alternative #1) (Notional) ............................................................ 68\n 5\n.6.\n S\nhuttle Cancellation/ISS Transport Decision Risk Assessment (Notional) ..."] [3.1533429622650146, -1.2404279708862305, " was to inform NASA\u2019s ultimate interest in evaluating specific risk postures of the agency; such evaluations are beyond the scope of this study but could be follow-on projects for RAND.x Risk Assessment Methodology for the National Aeronautics and"] [3.176617383956909, -1.2095438241958618, "cal risk assessment format, when risks are represented by the likelihood of some outcome occurring \n(e.g., 10\u00a0percent of five fatalities), absolute values are very important. Once these risk values have been normalized \nto a common ordinal scale (e.g"] [3.1676599979400635, -1.2221755981445312, "d be incorporated into analysis at various levels of fidel -\n2 For example, if the value of the cost growth component is less than 5\u00a0percent, this may be mapped to the risk \nscale value of 0 (low), while 5\u201310\u00a0percent may be mapped to a 1 (some), all "] [3.1572306156158447, -1.2355085611343384, "risk-reward strategies (e.g., high-risk, high-payoff versus low-risk, low-payoff), and uncertainties from forecasting technology development.\nAs such, this methodology provides a comprehensive approach for guiding staff \nand decisionmakers through a"] [3.1730880737304688, -1.215872049331665, "e ability to understand comparisons within or among them or the overall risk burden associated with a decision. \nThe normalization process allows for determining relative component risks, and \neven risk indicators and mitigation strategies. However, "] [3.1752092838287354, -1.2133369445800781, " interdependencies, it is certainly possible to define, understand, and assess how various relationships among the risk factors, components, indicators, and mitigations interact. Such reflection will provide insights into how best to manage and mitig"] [3.146056890487671, -1.2500200271606445, "int, only from a method -\nological perspective. For this reason, all the tables for our case study are marked as having notional data. \nMoving Forward\nThe steps developed in the methodology provide a structured way to consider a risk-\ninformed decisi"] [3.150235891342163, -1.2437974214553833, "of how various disparate factors contribute to overall risk to project- or mission-level success that is associated with NASA-level decisions. The specific mandate was to provide NASA\u2019s Office of Strategy and Plans with a risk-informed decision suppo"] [3.1442441940307617, -1.2505372762680054, "pproaches analyzed in the study, will be summarized in this report, along with extensive citations on each of these topics. \nAny organization faces a range of risks to meeting its objectives. Risks cannot be \neliminated, but they can be consciously m"] [3.1703765392303467, -1.2196130752563477, "roadmaps, and risk-reward strategies (e.g., high-risk, high-payoff versus low-risk, low-payoff), and uncertainties from forecasting technology development.\nStudy Approach\nDevelopment of the study approach ensured that the team would begin from a posi"] [3.1721649169921875, -1.2166763544082642, " risk factors, each with multiple components\u2014and within those, a set of indicators that suggest the level of risk (i.e., the likelihood that a certain consequence of concern will occur) associated with that area. We chose this method of risk assessme"] [3.1600961685180664, -1.2319283485412598, "for every risk factor, the risk factors are then graphically displayed on a radar chart, allowing graphical comparisons to be made. \nIn the case study analysis section, two decisions\u2014one past and one future\u2014were \nconsidered. This served to test and p"] [3.1822128295898438, -1.2016029357910156, " and \napplication. Thus, there is no one definition of risk. The Society for Risk Analysis (SRA) \nprovides both qualitative and quantitative definitions of risk in their glossary (SRA, 2015). Qualitatively, risk is the \u201cpossibility of an unfortunate "] [3.1809093952178955, -1.204704999923706, "s, the component would be expected to fail eight times (the expected risk).\nRisk Assessment Methods\nIn this section, we focus on examples of different methods for assessing a risk that may \nbe used to obtain the lower-level inputs needed for the meth"] [3.1824469566345215, -1.2027769088745117, " A further disadvantage with the risk matrix approach is that these matrices are typically structured with only one consequence and one probability. In reality, most risks have multiple consequences, each with an assigned probability (e.g., a car acc"] [3.183521032333374, -1.1988461017608643, "\ninterpretation of the risk characterization; and, in the case of continuous distributions, probability distributions remove the need for assigning (what may be arbitrary) prob -\nability and consequence categories. Overall, compared with a risk matri"] [3.1790382862091064, -1.1950935125350952, "milarly, the Integration Readiness \nLevel (IRL) scale provides a measure on the maturity between systems (Sauser et al., 2009). Figure 2.3 shows the TRL scale and its acquisition phases. The concept behind this readiness level is that the current sta"] [3.1960384845733643, -1.18734610080719, "a\u00a0percentage of the earned value\n \u2013c\nost performance index (CPI): CPI = EV/AC; efficiency ratio for cost variance\n\u2022\n s\nchedule:\n \u2013s\nchedule variance (SV): SV = EV \u2013 PV ; measures the conformance of actual \nprogress to the schedule\n \u2013s\nchedule varian"] [3.2093238830566406, -1.181047797203064, "triangular distribution may be developed by asking experts how long it will take for a technology to be ready for deployment. An elicitation facilitator could ask experts for the least and most amount of time it could take, followed by the most likel"] [3.1844305992126465, -1.1989442110061646, "order of concern. Here, we review these three concepts.\nAcceptable Risk\nOnce risks have been characterized, the logical next step of any individual or organi -\nzation being exposed to those risks is to determine whether they are at an acceptable leve"] [3.191026210784912, -1.1902151107788086, "er -\ntainty may choose the sure payment, while a risk-seeking individual (someone with a high tolerance for risk) may choose the coin toss. A risk-neutral individual would be indifferent to the choice. Individuals with different risk attitudes will v"] [3.1752824783325195, -1.2122381925582886, "ability Distributions\nSimilar to the risk matrix, probability distributions cannot accommodate comparisons of disparate risks unless given a common consequence metric. But, unlike the risk matrix approach, probability distributions provide more infor"] [3.209510564804077, -1.1735042333602905, "tem safety risk (e.g., helicopter crash due to material failure) and an occupational health risk to the organization\u2019s employees (e.g., injury of workers on the manufacturing line). If the organization does not prefer to monetize all risks, or if its"] [3.1838581562042236, -1.2007440328598022, "f Two Disparate Risks\nAttribute System Safety Risk Occupational Health Risk\nMaximum possible cost ($ millions) 10 2\nMost likely cost ($ millions) 5 0.01\nExpected frequency per year 0.25 10\nExpected number of fatalities per occurrence 1 0.05\nUncertain"] [3.1916112899780273, -1.196901559829712, "bute weights (Keeney, 1974). In addition to linear models, utility functions may take on nonlinear forms. An applicable nonlinear form includes that of threshold values for specific attributes to indicate their acceptability levels. For example, if t"] [3.1782679557800293, -1.2061132192611694, "-\nple, consider three weights w\n1, w2, and w3. Using an absolute pairwise judgment method, \nwe may assert that attribute 2 is twice as important as attribute 1, and attribute 3 is three times as important as attribute 1. The following set of equation"] [3.1447579860687256, -1.249820590019226, "the case studies presented in Chapter Five. Additional components or indicators may exist for each risk factor but may not be relevant for our case stud -\nies. Our methodology does allow the choice of other components and indicators where appropriate"] [3.115053415298462, -1.2806137800216675, "while others may only be able to be characterized qualitatively. To ensure missions are able to operate as planned, a number of components should be analyzed as part of supply-chain risk. These include the following items:\n\u2022\n a\nvailability of materia"] [3.1374666690826416, -1.2577539682388306, "ital projects, though different components may exist for each. 26 Risk Assessment Methodology for the National Aeronautics and Space Administration\nNASA\u2019s Office of the Inspector General released a report in 2012 detailing some \ncost and schedule "] [3.138784170150757, -1.2618275880813599, "e delays faced by the program prior to the first flight of Columbia in \n1981. Original plans called for the shuttle to begin flying in 1977, four years earlier \nthan what was achieved (Armagh Planetarium, 2013). This would have allowed the shuttle t"] [3.1056251525878906, -1.2948265075683594, "y on work. Federal funds must be used within a relatively short period of time; thus, many NASA programs and projects are well-detailed for two years\u2019 worth of budget. Within those two years, managers can assess the stability of the funding and there"] [2.821850299835205, -1.6484373807907104, "her modifications to a new aircraft. The following staff skills and experience are unique to flight research:\n\u2022\n r\nesearchers\n\u2022\n a\nirworthiness and flight safety staff (particularly for NASA-unique safety \nstandards and procedures)\n\u2022\n e\nxperimental t"] [3.1130828857421875, -1.286957859992981, "\n c\nost of talent\n\u2022\n a\ndaptable skill mix/adaptability to changing missions\n\u2022\n t\nraining programs in place.\nTechnical Expertise\nNASA needs skilled individuals who understand and have responsibility for all tech -\nnology, with support pyramids within "] [3.0535268783569336, -1.3586682081222534, "asses the strength of leadership, congressional interest, and funding dispersion. Leadership and culture is different at each center.\nThe current organization of NASA is the result of decades of development. NASA \nHQ in Washington, D.C., is supported"] [3.062199354171753, -1.3485769033432007, "g of individual locations\n\u2022\n c\nultural differences between locations.\nStrength and Interest of Leadership\nLeadership strength affects an organization. Leaders give organizations direction, set expectations, and provide an interface to the public. The"] [3.0951735973358154, -1.3091387748718262, ", Navy ships with a well deck (a large opening in the rear of certain ships that can be flooded so equipment and ships can float in and out of the host vessel) are required for safe process -\ning and transport of Orion capsules after splashdown (Figu"] [3.1117489337921143, -1.2888413667678833, " and Cruise Emissions II \n(ACCESS-II) testing? Partnerships provide NASA projects and programs with the potential for higher aggregated funding and scope, but also rely on foreign govern -\nments to provide what NASA needs. Alternatively, NASA may pa"] [3.1195566654205322, -1.279465913772583, " budget cuts. Foreign government agencies face similar risks. Private institutions, which rely on the support of shareholders or directors, have their own rules for operations. Every organization has its own strategic plan. Working with NASA may or m"] [3.1199328899383545, -1.2791268825531006, "uld internally analyze the possible \npriorities. \nAccounting for political risks should also account for changes in national strategy \nand goals. The national strategy toward space exploration, aeronautics research, and science can change, meaning ex"] [3.11726713180542, -1.2814874649047852, "er programs.\nDocumentation for Key Technology Cost and Schedule Assumptions\nDocumentation and peer reviewing of assumptions would help NASA develop more-accurate assessments.\n2 This will also allow persons responsible for the key technology to \nasses"] [3.1327600479125977, -1.2641054391860962, "her program. Hence, consideration of technology risk should consider whether a program or project assumes that a key piece of technology will be available from another program. For example, if Program A is developing a widget that Program B plans to "] [3.1772613525390625, -1.2111740112304688, " on top of lower-level assessments that allow for analyzing individual risk elements. The subordinate analyses will allow for normalizing and assessing the NASA-level risk associated with a particular decision or set of decisions. As such, the method"] [3.176487684249878, -1.2110623121261597, "tion measures must be done to ensure that all boundary conditions are eventually met. Should a component boundary condition not be met, the overall risk is determined to be unacceptable for the entire risk factor being analyzed. \n1 In the classical r"] [3.179305076599121, -1.2083402872085571, "ll vary by \nrisk factor and component. Some will lend themselves to quantitative measures, while \nothers will be analyzed qualitatively. A mix of objective and subjective measures will likely be employed to evaluate each component. A number of these "] [3.1764278411865234, -1.2120025157928467, " with each. Development of the Risk-Informed Decision Methodology 47\nFor each risk, the components are defined, the indicators identified, evaluation \nmethods presented, and mitigation possibilities identified. Figure\u00a0 4.4 presents an \nexample of "] [3.1561100482940674, -1.2375617027282715, "ce on analysis \nusing the full gambit of tools ranging from cost, schedule, and performance methods such as EVM to modeling and simulation (where available) to assess a component in detail. Input for such tools will likely rely on subject-matter expe"] [3.1797001361846924, -1.2084420919418335, "reshold values to be /f_illed out\nusing subject-matter expertsCalculation of risk\nand mitigation50 Risk Assessment Methodology for the National Aeronautics and Space Administration\nfor a component. These normalized risk values can be summed to pro"] [3.1783266067504883, -1.2081828117370605, " total mitigated value may also be calculated. In this case, a mitigation will be assigned to an indicator (e.g., M1 is assigned to R1) and will reduce its overall score. Thus, if R1 had a score of 4, M1 may result in a mitigated score of 3. In some "] [3.183964490890503, -1.2044979333877563, "0-5) Value \n(0-5) Weighted \nValue \n(Score X \nWeight) Normalized \nValue \n(Weighted\n Value/ \nTotal \nWeight) \nStability of \nsources ! !\nAlternative sources ! !\nMaterials \n! !\nServices \n! !\n ! !\nQuality \nmanagement \nTotal 52 "] [3.176077365875244, -1.2125400304794312, "if several different strategies for a particular NASA issue were consid -\nered, one could run the analysis multiple times, employing different threshold values for each strategy, to arrive at a different perception of risk. In this way, one could gra"] [3.14845609664917, -1.240376353263855, "s for one strategy and 27 for another should likely be considered as depicting equivalent risk. \nFourth, the radar chart depictions are highly dependent on the assumptions and \nthreshold values for the strategies under consideration. In conducting a "] [3.1759207248687744, -1.2125252485275269, " The team \ndeveloping the risk indicators and mitigation strategies serves as one set of experts, while senior-level NASA personnel would be used for setting threshold values. The final sets of experts to be consulted are the decisionmakers who inter"] [3.1793525218963623, -1.2092355489730835, "acceptable risk category to provide a way to characterize the risk associated with a particular assess -\nment. The term \u201cunacceptable\u201d serves as a boundary condition indicating that the risk burden must be mitigated or a different strategy devised. \n"] [3.1785593032836914, -1.2093242406845093, "tations. These objective methods must be augmented using subject-matter expertise and elicitation to arrive at the measure for each component. As additional information becomes available, the component evalua -\ntions should be updated and the overall"] [3.1714773178100586, -1.2181353569030762, "ology\nTable\u00a04.1 summarizes the steps for the risk-informed decision methodology. While the \nsteps have been presented in detail already, this step-by-step presentation provides a consolidated description of the methodology. The table is designed to e"] [3.1785669326782227, -1.2091425657272339, "zation and subsequent comparison of risk factors and their components. Expert elicitation is essential for establishing these values. These values should also be developed in isolation from those charged with \u201cscoring\u201d the risk indicators. \n4d Establ"] [3.15350079536438, -1.241502046585083, "se and even various mitigation strategies. One can make ordinal decisions between options using this methodology, but should not attempt to quantify the actual intervals between them. 60 Risk Assessment Methodology for the National Aeronautics and"] [3.138324499130249, -1.257422685623169, "n the lessons learned from ISS to improve life support, crew health, extravehicular activity capabilities, radiation shielding, and other areas. Much of the mission will validate pro -\ncesses, procedures, technology, and operations to be used on a hu"] [3.1533448696136475, -1.2404769659042358, "ctor assessments for the supply-chain and political components, and the abbreviated Case Studies 63\nassessments for the technical, human capital, cost and schedule, organizational and \nmanagerial, and external dependency components (Figure\u00a05.1). \n"] [3.1686043739318848, -1.2223838567733765, "ed cost, and \u201csome\u201d if there was 10-percent cost growth. We repeated this process for all elements in the table. Because the risk of R1 was assessed as 25-percent growth being too high, it was given a score of 4. The corresponding mitigation M1 was d"] [3.199585199356079, -1.1929460763931274, ". Expected \nschedule 6-month \ndelay 1-year \ndelay 18-month \ndelay 2-year \ndelay >2-year \ndelay 3 2 6 0.50 /uni00A0 \nR3: Commercial Transportation \nunreliable due to less heritage . Same \nreliability 0.1% less \nreliable 0.2% less \nreliable 0.3% les"] [3.177062749862671, -1.214142084121704, "r factor, we calculated a score of 3.95, approaching the threshold of \u201cextremely high\u201d risk. \nAfter evaluating all risk factors for the ISS transport decision, we plotted them on \na radar chart. Figure\u00a05.6 shows the overall scores for each risk facto"] [3.1543209552764893, -1.242470145225525, "aintaining supply \nchains Expected \nschedule 1-week \ndelay 2-week \ndelay 3-week \ndelay 4-week \ndelay >5-week \ndelay 4 5 20 1 \nBudget stability Expected \nstability 5% \nunstable 10% \nunstable 20% \nunstable 30% \nunstable > 35% \nunstable 4 4 16 0.8 \n"] [3.176873207092285, -1.2161179780960083, " in Table\u00a05.1 and \nFigure\u00a05.8. As with the ISS transport analysis, the values refl ect the unmitigated risks only. (Th e worksheets for the three options are provided online in the supplemental notional data for Appendix C.) Th e radar chart allow"] [3.164398193359375, -1.2280516624450684, "blic-private partnershipsNASA-driven N O T I O N A L D A T A O N L Y73CHAPTER SIX\nFindings and Conclusions\nIn this chapter, we summarize our accomplishments, our thoughts on the methodol -\nogy we presented, and recommendations for future work. \nA"] [3.173051357269287, -1.2157540321350098, " thinking process that will allow for clearer and more thoughtful decisions. While employing the methodology may not change decisions, gaining better understanding of key sensitivities will undoubtedly be an important outcome. \nThe use of a normaliza"] [3.177499532699585, -1.2116899490356445, " eliminate these interdependencies, it is possible to define, understand, and assess how various relationships among the risk factors, components, indicators, and mitigations interact. Such reflection will provide insights regarding how best to manag"] [3.1403727531433105, -1.2586917877197266, "iated case studies validating it, conducting a more robust analysis for a future NASA decision is important. Given the work we have begun on it, applying this model to a more expanded analysis of the pending Cislunar Habitat decision may be most appr"] [3.100817918777466, -1.3060023784637451, "er to meet the cost constraints: \n \u2013U\nse off-the-shelf hardware components and inherited designs to the maximum \nextent possible.\n \u2013 U\nse analysis and modeling as an acceptable lower-cost approach to system test \nand validation.\n \u2013L\nimit changes to t"] [3.1290886402130127, -1.2683768272399902, "panies. Agreements between NASA and these organizations are controlled by the executive and legislative branches of the U.S. government. In the last few years, the relationship between NASA and Roskomos, the Russian Space Agency, has been the subject"] [3.092440605163574, -1.3077086210250854, "ical leaders of the country\n\u2022\n R\neliance on foreign entities\n\u2022\n C\nongressional restrictions \n\u2022\n F\nederal budget process\nTechnical\n\u2022\n D\nocumentation for key technology cost and schedule assumptions\n\u2022\n P\nayoff of technology\n\u2022\n R\neadiness levels \n\u2022\n S\na"] [3.1094822883605957, -1.2909574508666992, "n make use of existing concepts. \nIndividual competency or skills can be tracked and assessed annually. Performing this task will cover many of the metrics that were listed earlier. \nAn external example of managing human capital can be seen in the U."] [3.1463184356689453, -1.2451928853988647, " U.S. Nuclear Regulatory Commission, 2005. \nAyyub, Bilal M., Elicitation of Expert Opinions for Uncertainty and Risks , Boca Raton, Fla.: CRC \nPress, 2001a. \u2014\u2014\u2014, A Practical Guide on Conducting Expert-Opinion Elicitation of Probabilities and Conseque"] [3.139218330383301, -1.2571645975112915, ".org/pubs/technical_reports/TR756.html\nDavis, Paul K., Russell D. Shaver, and Justin Beck, Portfolio-Analysis Methods for Assessing Capability \nOptions , Santa Monica, Calif.: RAND Corporation, MG-662-OSD, 2008. As of May 31, 2016: \nhttp://www.rand.o"] [3.1140103340148926, -1.2949440479278564, "st U.S. Space Station\u2019s Re-Entry,\u201d History.com, July 11, 2012. As of April 20, 2016: http://www.history.com/news/the-day-skylab-crashed-to-earth-facts-about-the-first-u-s-space-stations-re-entry\nHastie, Reid, and Robyn M. Dawes, Rational Choice in an"] [3.008007049560547, -1.4215487241744995, "1, 2015. As of April 20, \n2016: \nhttps://www.nasa.gov/directorates/heo/scan/engineering/technology/txt_accordion1.html\nMankins, John C., \u201cTechnology Readiness Assessments: A Retrospective,\u201d Acta Astronautica, \nVol. 65, No. 9, 2009, pp. 1216\u20131223. \n"] [2.9879043102264404, -1.452267050743103, " General, National Aeronautics and Space Administration, IG-12-021 (Assignment \nNo. A-11-009-00), September 27, 2012. As of April 20, 2016: https://oig.nasa.gov/audits/reports/FY12/IG-12-021.pdf\nOffice of the Secretary of Defense Manufacturing Techn"] [3.127176284790039, -1.2736945152282715, "n Heavy Rocket Debuts in 2016,\u201d International Business Times , July 21, 2015. As of April 20, 2016: \nhttp://www.ibtimes.com/elon-musk-spacex-complacency-contributed-falcon-9-crash-falcon-heavy-rocket-debuts-201780992 Risk Assessment Methodology fo"] [3.155550718307495, -1.2373135089874268, ". For this effort, a methodology was developed for normalizing and comparing supply chain, external dependency, cost and schedule, human capital, organizational and managerial, political, and technical risks. The goal ultimately was to develop a sing"] [3.9474616050720215, 18.302583694458008, "CORPORATION\nPreservation of \nAffordable Rental Housing\nEvaluation of the MacArthur Foundation\u2019s \nWindow of Opportunity Initiative\nHeather L. Schwartz, Raphael W. Bostic, Richard K. Green, Vincent J. Reina, \nLois M. Davis, Catherine H. AugustineThis"] [3.9309797286987305, 18.29439926147461, " public investment in this country\u2019s increasingly critical affordable housing stock. \nSecond, we did not foresee the Great Recession. Its significant shock to the national \neconomy made it harder for nonprofit owners to acquire properties, and dimini"] [3.9529941082000732, 18.27703857421875, " -\nthropic initiative started in 2000 and will end in 2020, allocating $187 million in grants and \nloans to preserve privately owned affordable rental housing. The purpose of the evaluation is \nto assess whether the initiative achieved its goals, as "] [3.96319580078125, 18.273218154907227, "ity, transportation and energy policy, and environmental and natural resource policy.\nQuestions or comments about this report should be sent to the project leader, Heather \nSchwartz (Heather_Schwartz@rand.org). For more information about RAND Infrast"] [3.9071171283721924, 18.267370223999023, ".......... 42\nNetworking Large Nonprofit Preservation Owners: Stewards of Affordable Housing for the \nFuture ....................................................................................................... 48\nLocal Partnerships: The Preserva"] [3.9032206535339355, 18.2427978515625, "ally Reinforcing ....... 33\n 5.1. Number of States with Preferences for Preservation .......................................... 90\n 5.2. Dollar and Share of Tax Credit Investments in Preservation ................................. 91\n 5.3. Numbe"] [3.920379400253296, 18.284643173217773, "e Rental Housing: The Window of Opportunity Initiative\n 4.4. Overview of Three Grantees\u2019 Accomplishments ............................................... 70\n 5.1. Outcomes from Window of Opportunity ................................................"] [3.9229209423065186, 18.324033737182617, " and grants to a wide range of recipients, including nonprofit developers, loan funds, networks of non -\nprofit owners of affordable rental housing, advocacy organizations, state and local government agencies, and researchers. The foundation\u2019s ultima"] [3.9327666759490967, 18.320772171020508, "cy framework to achieve preservation of 1 million affordable rental homes by 2020 Modest yes\na. Increased resources for preservation Yes\nb. New regulations and legislation for preservation Modest yes\nc. New federal incentives for preservation No\n4. G"] [3.9213030338287354, 18.318647384643555, "aterialize, nor have there been new federal laws or regulations \nto promote preservation. \n\u2022 More groups have become involved in preservation than before WOO began in 2000. \nInterviewees credited WOO with accelerating changes ongoing within the affor"] [3.9264039993286133, 18.325254440307617, "ing their assets to pro -\nduce cash flow, building databases, and buying out co-general partners to become sole owners of properties they intended to preserve. \nA third feature of WOO is that the MacArthur Foundation\u2019s two competitive solicita -\ntion"] [3.921907901763916, 18.31869125366211, "h as housing \nare vulnerable to significant macro-economic forces that affect the broader market. The Great \nRecession that started in 2007 fueled significant declines in the development and preservation \nof affordable rental housing, and it slowed "] [3.894685983657837, 18.31459617614746, "bills related to preservation, each of which died in committee. Such federal action would have likely have caused much more preservation \nactivity. xvi Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\nA fourth reason"] [3.925065755844116, 18.295373916625977, "iew by Jeffrey Lubell (Abt Associates). The two reviews helped us improve the report. Finally, we would like \nto acknowledge the publishing contributions of James Torr for editing the report and Sandy Petitjean for creating and helping design the fig"] [3.9232213497161865, 18.313064575195312, "s to put in place a policy framework\u2014i.e., laws and regu -\nlations, incentives, and funding\u2014that would enable the preservation of 1 million affordable \n1 Preservation can also include public-sector-owned housing, such as public housing, but the MacAr"] [3.9357218742370605, 18.314409255981445, "ement \nof its other philanthropic initiatives. The report\u2019s overview of preservation and the evolution \nof practices to preserve affordable rental housing is also intended for developers/owners, advo -\ncates, and policymakers who work on affordable r"] [3.9191975593566895, 18.337501525878906, "ivity post-WOO and to identify lessons learned that might inform other jurisdictions interested in replicating similar initiatives.\nLimitations \nThere are two primary limitations to this evaluation. The first and most important one is \nthat we do not"] [3.9059603214263916, 18.29806137084961, "on defined preservation as \u201cAffordable rental housing is preserved when an owner acts to keep rents affordable for low- and moderate-income house-\nholds while ensuring that the property stays in good physical and financial condition for an extended p"] [3.927504301071167, 18.285789489746094, "rks, and types of preservation activity from the 1980s to 2015. Even though Window of Opportunity focused largely (but not exclusively) on the pres -\nervation of multifamily rental housing (defined as five or more rental units per property), we inclu"] [3.882871627807617, 18.060178756713867, "f federal housing subsidies go to them. \nThe set of U.S. federal housing policies to promote rental housing has been and remains \nfar less than the large federal apparatus to support homeowners. Policies and programs that \npromote homeownership inclu"] [3.7946953773498535, 17.842010498046875, " we select a relatively low income of 50 percent of the area median income as a \nbenchmark. By this metric, Census data indicate that 68 percent of the 34 million rental units \n(which is a little over 23 million homes) occupied in 1990 were affordabl"] [3.7948663234710693, 17.84222412109375, "tion within their MSA. We repeat that same matching of income percentile to rent percentile for the 40th, 60th, and 80th \npercentiles.\n5 \n3 The 30 percent threshold is a common threshold for the appropriate share of income a household should devote t"] [3.809412717819214, 17.87180519104004, ", and more than 50 percent in none. Affordability conditions were acceptable in all but 3 out of 238 \nMSAs at the 60th percentile. Those at the 80th percentile of the income distribution could \nafford an 80th percentile rental unit in all the MSAs as"] [3.8089168071746826, 17.87555694580078, " \nwhite decreased. As a result, the five percentage point decrease in the share of the population that was white over the 1990s, combined with the differences in homeowner and renter pro -\nfile for white and nonwhite households, increased the nationa"] [3.8090145587921143, 17.882476806640625, ". The net impact of the demographic changes was a slight uptick in the share of households demanding \nownership compared with rental housing. At the same time, the U.S. population grew, and \nthe growth in the total number of renter households from 19"] [3.8386824131011963, 17.88727569580078, " 2000 that many \nof the lowest-income renters would have had to pay more than 30 percent of their income to rent a home at a corresponding percentile of rental prices. Those at the 20th percentile of the \nrental income distribution for their MSA woul"] [3.8757400512695312, 18.067411422729492, "ffordable; it can become unaffordable due to increased rent \nlevels; it can become owner-occupied housing; it can become vacant; or it can fall out of the \nstock. For the current analysis, we apply this methodology to the AHSs of 1991 and 2001 and tr"] [3.910026788711548, 18.25977897644043, "or preservation \nbecause of the expiration of rent restrictions on units produced with some sort of federal rental \nsubsidy. To understand the supply of affordable housing, we look at changes in rents, renters\u2019 \nincomes, and rent-to-income ratios ove"] [3.906217575073242, 18.257762908935547, "d LIHTC programs, administered by HUD and by the Internal Revenue Service (IRS), respectively, are relevant from a preservation \nperspective, as each provides financing for private developers and owners, and in return the \nowners agree to maintain th"] [3.9598567485809326, 18.155067443847656, "portive Housing for the Elderly loan program (HUD)Low-interest 40\u201350-year loans to nonprofit owners in exchange for affordability restrictions on rents. Income eligibility rules have changed over time, but generally for low-income elderly. As of 1990"] [3.904837131500244, 18.272722244262695, "nded, \ncodified at 42 U.S.C., Section 1485. Section 521 refers to that section of the Housing Act of 1949, as amended, \ncodified at 42 U.S.C., Section 1490A.18 Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\nized i"] [3.8801212310791016, 18.277021408081055, "bsolescence and potential demolition. \nThis simple characterization captures a large majority, but not all, types of preservation \nactivities, which are difficult to include in a single universal definition because of the wide vari -\nety in the types"] [3.880815029144287, 18.269275665283203, "tention. \nHow Does Preservation Work?\nAs noted, there are three distinct channels by which preservation can become a need: strong \nmarket conditions, subsidy opt-out or expiration, and building obsolescence. In this section, \nwe describe these channe"] [3.9017956256866455, 18.286020278930664, "idy and the affordability period both typically \nhave a set term. For example, the subsidy and affordability requirements for a Project-Based Section 8 property continue for 20 years. For an LIHTC property, the subsidy is provided over \n10 years, and"] [3.873295307159424, 18.276714324951172, "able rentals to households \nat income levels previously served by that property, 14 percent were mixed-income rentals, and only 16 percent became unaffordable rentals (Blanco et al., 2015). \nThe Dynamics of Preservation: Building Obsolescence\nBuildin"] [3.8978397846221924, 18.26849365234375, "d means (e.g., market-rate loans for rehabilitation), although the added \ncost of doing so must presumably be recaptured in the form of at least modestly increased rents that could nonetheless remain affordable. \nRegardless of whether preservation oc"] [3.929729461669922, 18.256412506103516, " down-side risk, 5 percent have an up-side risk, and so every year you should find \na way to deal with the \u201cX\u201d percent that are rolling into their risk profile. These come in \ncohorts or waves that are reasonably predictable.\nPreservation from the 19"] [3.9078590869903564, 18.255470275878906, "converting to unaffordable market-rate rents\u2014as one HUD field staff person put it, \u201cconvincing owners to stay in, or [else convincing] \nowners [to sell] projects to other entities that would keep them affordable.\u201d By the mid-1990s, \nfunding through t"] [3.9048197269439697, 18.259706497192383, "edits, and volume cap \nbonds. Compared with the 1990s, preservation \u201cgrew up\u201d and got ahead of the curve by antici -\npating upcoming expirations or opt-out periods and re-underwriting properties to infuse them \nwith capital for building system renewa"] [3.9027209281921387, 18.275779724121094, "nd this only increased to seven states as of 2000. (We revisit these data to examine 2000\u20132010 in Chapter \nSix.)Rental Housing and the Role of Preservation 25\nConclusion\nThe landscape for affordable rental housing in the years leading up to the st"] [3.940473794937134, 18.303606033325195, "n illustrates four of these strategies via case studies. \nOverview\nThe Launch of Window of Opportunity\nThe MacArthur Foundation first learned of the importance of preservation in 1999 when a \nprogram officer attended a Chicago symposium at which a pa"] [3.9417855739593506, 18.31549072265625, "is tour that it could issue PRIs to finance products \nsuch as loan funds and for \u201cwalking around [predevelopment] money\u201d for nonprofit developers/\nowners to compete for with for-profit developers who had deeper pockets that enabled them to more quick"] [3.9403319358825684, 18.320363998413086, " the largest \nsingle source of subsidy for the construction and preservation of affordable rental housing in the United States. State hous -Window of Opportunity 29\nfrom a wide variety of housing markets that could influence preservation policy re"] [3.946647882461548, 18.338848114013672, "ts.\n\u2022 2002: MacArthur issues regional preservation leaders RFQ to select ten regional non -\nprofit owners.\ning finance agencies must allocate the tax credits to developers through a competitive process specified in their state-created \nqualified allo"] [3.959181308746338, 18.324308395385742, "s of affordable rental housing from 2003 through 2013, according to the Joint Center for Housing Studies (1999). \nIn recognition of the stronger focus on policy, the second iteration of the initiative dou -\nbled the budget (from $5 million to $10 mil"] [3.9250595569610596, 18.3176326751709, "n strategies is provided in another section below.\nTo achieve the outcomes shown in the right-hand column of Figure 3.1, the WOO initia -\ntive has ultimately adopted both a bottom-up and a top-down approach by funding actors who worked at state, mult"] [3.9118592739105225, 18.311857223510742, "isits, \nidenti/f_ied: \n(1) lack of working capital as a barrier for nonpro/f_it owners; (2) need \nfor regulatory \nand legislative change to ease preservation; and (3) variety of housing types in need of preservation.\n\u007f Vetted strategy \nin 2001 with "] [3.945493459701538, 18.308439254760742, "/f_ication \n(1999\u20132001)Designing the\ninitiative \n(1999\u20132007)The strategies of window of opportunity\n(2000\u20132020)Desired\noutcomesWindow of Opportunity 33\nInvestments Made Through Window of Opportunity\nAs shown in Figure 3.1, there were ultimately se"] [3.921579599380493, 18.335079193115234, "State and\nlocal\ngovernmentsNetworks\nof\nownersRegional \npreservation \nownersFederal\ngovernment\u007f Seed loan funds and /f_inancial \nvehicles for preservation\n\u007f Increase private and public \ncapital for preservation34 Preservation of Affordable Rental H"] [3.929598093032837, 18.31586265563965, "o build \na cadre of large nonprofit owners started with the MacArthur Foundation issuing an RFQ in 2002 for regional nonprofit preservation leaders. The intention of the open-call request (as \nopposed to inviting only particular developers to apply) "] [3.944659948348999, 18.32084083557129, " (SAHF), the Housing Partnership Network, and \nNeighborWorks (to form Strength Matters). Ultimately, the MacArthur Foundation awarded \n22 grants to these three networks amounting to $4.6 million during the period from 2002 to 2014. In this manner, WO"] [3.9345998764038086, 18.32398796081543, "the New York City Acquisition Fund or to preservation owners \nfor the preservation of affordable rental housing in the Chicago area. \nReflecting the interagency structure of the The Preservation Compact (described in more \ndetail in a case study in C"] [3.9269189834594727, 18.319562911987305, "erences on preservation\n\u2022 create or expand state or city databases of subsidized rental properties\n\u2022 develop early warning systems\n\u2022 provide access for grantees to a subscription-based web mapping tool\n\u2022 conduct studies of local housing markets\n\u2022 cre"] [3.9117000102996826, 18.32799530029297, " words, was putting preservation at the center of a state and local agenda. As a \nMacArthur staff person put it, \u201cAre you making people say, \u2018What about preservation? How \ndo we need to work together in a different way on it?\u2019\u201d\nThe foundation\u2019s goals"] [3.931077241897583, 18.322612762451172, "at risk of converting from subsidized to unsubsidized rental housing.\nStrategy to Improve Funding, Regulatory, and Legislative Context for Preservation \nThis strategy is the collection of the previous six strategies, plus the 20 general operating gra"] [3.9343199729919434, 18.337875366210938, "er what those \nstrategies involved. We selected activities that we or the MacArthur Foundation believed were \nsuccessful and had the potential to be sustained post-WOO. But the chief aim of the case studies is to identify the structural features that"] [3.9753904342651367, 18.30105209350586, "tive\ntion Compact (TPC) and the state and local initiatives studied. These themes are discussed in \ndetail in each section, and summarized at the end of this chapter.\nSeeding Innovative Preservation Finance Vehicles: Housing Partnership \nEquity Trust"] [3.9924004077911377, 18.276453018188477, "l $75 million. Prudential agreed to provide $10 million in \npreferred equity, and Citibank agreed to provided $65 million in debt financing. \nHaving raised the $100 million, HPET management sought to deploy it by purchasing \nproperties that meet the "] [4.00323486328125, 18.26787567138672, "ommitment had been secured. HPET approached Prudential\u2019s social investment division about the possibility of obtaining $10 million in mezzanine debt.\n1 Pruden -\ntial was not interested in providing a loan: According to our interview with this investo"] [4.0368170738220215, 18.228681564331055, " costs \nthan the HPET deals, the development fees associated with such deals are higher. \nThe Housing Partnership Equity Trust Has Been Able to Close Deals Quickly\nInterviewees frequently noted the speed at which HPET was able to close deals. In the "] [4.002872943878174, 18.264366149902344, "reholder, and HPET must provide an equity return to its common shareholders. The key distinction between HPET and the typical REIT is that enti -\nties investing in HPET are looking to profit\u2014just not by as much as if they invested elsewhere.\nThe key "] [4.066788673400879, 18.21027946472168, "s $127,140 per unit for this property. In other words, HPET would be willing to purchase the property at a price up to $127,140 per unit. \nIn contrast, the benefits from a LIHTC deal come largely from the credits themselves, as \nwell as from financin"] [4.1220831871032715, 18.159578323364258, "ties. Thus, \nthe investor in the LIHTC requires an 8 percent rather than a 6 percent return. Now we can \ncompute the costs that a developer is willing to pay in exchange for $7,628 in rent per year:\n\u2022 $7,628/0.08 capitalization rate = (hard construct"] [3.9711754322052, 18.288776397705078, "n \nthose of alternative real estate investments.\nLessons Learned\nThis case study has highlighted the structural features of HPET that have helped it recalibrate the balance of competitive power between nonprofit and for-profit developers interested i"] [3.8934879302978516, 18.36190414428711, "n transactions, while also increasing standardiza -\ntion of practices among preservation owners, which could ultimately help owners access larger \namounts of funding and more diverse types of private capital.\nSAHF is a structure that enables informat"] [3.902491569519043, 18.355138778686523, "worked with more than one mayor, more than one HUD office, [and] generally in more than \none state.\u201d The organizational scale of the owner members gives them the resources to frame \nand address policy questions and to execute longer-range planning, w"] [3.8968665599823, 18.35613250732422, "f Affordable Rental Housing: The Window of Opportunity Initiative\ning HUD, write regulations that are conducive to good preservation work has been one of \nthe strengths of SAHF. \nA nonmember explained that SAHF has a \u201cunique ability as a union of the"] [3.884395122528076, 18.368244171142578, "ta collection about resident services and resident outcomes with an emphasis on identifying potential innovative funding sources for resident services.2012\nAcquisition of National Affordable Housing Trust: This financial intermediary and advisory fi"] [3.891206979751587, 18.35710906982422, " of transactional problems required technical knowledge \nby SAHF staff, as discussed in more detail below. Staff\u2019s ability to facilitate SAHF member conversations required understanding the history of the \u201cold [housing subsidy] programs,\u201d \nas well as"] [3.8774185180664062, 18.357501983642578, "p Network (described in the first case study in \nthis chapter) and the Data Warehouse through Strength Matters. SAHF\u2019s participation in Strength Matters gave other nonprofits a link to the property management and portfolio \ndata of some of the larges"] [3.914931297302246, 18.33953857421875, "with large \nmemberships, SAHF has not had to bridge disparate members\u2019 concerns and interests. \nSAHF members share an orientation toward the use of metrics, business analytics, and \ndata to run more effective businesses. This orientation propels an i"] [3.8536884784698486, 18.40062141418457, "\nwould have had anything like the impact we had. In the absence of adequate support, we \n6 As of February 2015, SAHF\u2019s mission statement is \u201cto lead policy innovation and advance excellence in the delivery of \naffordable rental homes that expand oppo"] [3.9243459701538086, 18.368932723999023, "own organizational practices, and sets the stage \nfor the participation of other partners, industries, and stakeholders, through such means as pay-for-success programs. Another example, according to an SAHF member, is SAHF\u2019s opera -\ntions and mainten"] [4.012196063995361, 18.287031173706055, "pri -\nvate, and nonprofit sectors established to coordinate and prioritize preservation efforts and to increase awareness of the importance of affordable rental housing preservation in Cook \nCounty. Its central features include interagency coordinati"] [4.013495445251465, 18.29648780822754, " TPC\u2019s goal was to devise solutions and implement strategies that could assist developers, owners, tenants, government agencies, and nonprofit organizations concerned with preserv -\ning affordable rental housing and to develop a policy framework for "] [4.025661468505859, 18.281509399414062, "he 2008 recession, the housing market collapsed, and neighbor -\nhoods struggled with foreclosed and abandoned housing. Although real estate values declined across Chicago about 35 to 38 percent on average during the recession, in communities with \na "] [4.049642562866211, 18.268653869628906, "and \ntheir primary accomplishments. Below we discuss in detail two of the strategies often cited as \nkey accomplishments of TPC.\nKey Accomplishments of the Preservation Compact\nOf the strategies listed in Table 4.2, there are two particular initiativ"] [4.02004861831665, 18.274423599243164, "vers Loan fund.Case Studies of Window of Opportunity 59Table 4.2\nThe Preservation Compact\u2019s Strategies, Actions, and Accomplishments\nChallenge and Resulting Strategy Actions Accomplishments\nChallenge: High operating costs.\nStrategy: Manage operati"] [4.027317523956299, 18.277488708496094, "using Studies, TPC working groups monitor subsidized properties and intervenes when contracts are expiring or when building condi -\ntions deteriorate.\n\u2022 For properties with building condition problems, or if contracts are at risk of being lost in str"] [3.9812095165252686, 18.285015106201172, "mily rentals are an underserved but significant share of the affordable housing market. Provide assistance to 1\u20134-unit property owners:\n\u2022 Analysis by DePaul University showed that 1\u20134-unit properties comprised 48 percent of Chicago\u2019s rental stock. \n\u2022"] [4.37639045715332, 18.0927791595459, "s required to invest in energy efficiency upgrades. \nThe Energy Savers Program was able to address some of these challenges through its pro -\ngram delivery method. TPC created a working group to further expand resources for multi -\nfamily retrofits a"] [3.9797825813293457, 18.21649169921875, "analysis surprisingly showed that approximately 33 percent of the rental \nhousing stock in Cook County was composed of 2\u20134-unit buildings (DePaul University, \n2012). In light of the 2008 recession, these buildings also accounted for a large portion o"] [3.9716286659240723, 18.31120491027832, "ail -\nable to rehabilitate and preserve groups of 1\u20134-unit buildings as affordable rental housing. The program is intended to help finance clusters of distressed 1\u20134-unit buildings in neighbor -\nhoods by providing a takeout term loan for groups (9-un"] [4.035351276397705, 18.273488998413086, " long-\nterm funding commitment of the MacArthur Foundation. This long-term funding allowed \nTPC to convene the diverse group of government agencies, nonprofits, building owners, tenant \nadvocates, and other housing stakeholders many times over severa"] [4.0340704917907715, 18.272769927978516, "ressing energy efficiency; the interviewee noted that the Energy Savers Program is now the largest energy conservation program of its kind in the coun -\ntry, and other jurisdictions are replicating it. The PRI also enabled the Energy Savers Program t"] [3.9392635822296143, 18.30592155456543, "vation of Affordable Rental Housing: The Window of Opportunity Initiative\n1. Seek a founding funder, such as a foundation or other entity, that is seen as a neutral \nand respected broker. It is important to bringing a diverse set of stakeholders to t"] [3.8939974308013916, 18.355619430541992, ", tax credits, real estate transaction-related surcharges and user fees, trust funds, \nguaranty products and bond insurance programs.\nThe MacArthur Foundation also gained a deeper understanding over the course of the \nWindow of Opportunity initiative"] [3.9322073459625244, 18.3200740814209, "the \ncoordinated preservation efforts of several state and city actors would both deepen their under -\nstanding of the importance of preservation and elevate its priority in the state\u2014changing the general climate and culture around preservation. The "] [3.9348013401031494, 18.294921875, "dized properties throughout their \nstates. Prior to their work, there was no single source in Ohio that stored the location of all the \nsubsidized properties in the state. Developers can now search for properties by city, and both Ohio and Oregon/Por"] [3.9275617599487305, 18.311811447143555, "llion\nVermont Accelerate preservation of and reinvestment in affordable rental housing through targeted outreach and technical assistance for private owners and nonprofits, energy efficiency, predevelopment, bridge loans, and a demonstration using Me"] [3.9350037574768066, 18.33415985107422, "ation in the Minnesota metropolitan area. Groups meet \nmonthly (in Minnesota) to quarterly (in Ohio) to biannually (in Oregon/Portland). Members of these working groups tend to be similar in each of the three states. State finance agencies, \nHUD, USD"] [3.9532148838043213, 18.321985244750977, "s. No program has come out of this work yet, but the Family \nFund and the Greater Minnesota Housing Fund have developed a joint work plan to further \ninvestigate capacity building, data, financing, policy, and other tools to support unsubsidized affo"] [3.9823856353759766, 18.280672073364258, " it has also led to funders now consistently applying capital needs assessments and coordinating on appraisals. \nOutcomes\nWe now turn to the outcomes grantees realized during their tenure in the State and Local Housing Preservation Leaders initiative"] [3.9671027660369873, 18.311532974243164, "ars to continue the preservation work at the Net -\nwork for Oregon Affordable Housing. In 2012, this Network received a $3 million HUD \nEnergy Innovation Fund grant to support the MPower program, a wholly owned subsidiary \nthat provides financing to "] [3.947391986846924, 18.319528579711914, "g even before they were awarded the MacArthur Foundation funding. Minnesota started to focus on preservation in \nthe late 1990s as some of the earliest LIHTC developments, which had been allocated relatively \nsmall tax credit awards, began to physica"] [3.969874858856201, 18.300310134887695, "ter-organizational group would not have been as successful without the funding for Network for Oregon Affordable Housing to ensure that \nthe group met on a regular basis. An Ohio interviewee noted that the operational funding \nthere also led them to "] [3.954111099243164, 18.313302993774414, "\u201d Oregon/Portland inter -Case Studies of Window of Opportunity 75\nviewees highlighted the trust that had developed among both staff and management group \nmembers. Some wondered if excluding owners from these working groups had helped to build \nthi"] [3.95455265045166, 18.312467575073242, "at although this may be the case, there are not enough non -\nprofit developers to do the \u201cmore difficult-to-develop projects,\u201d and that the projects they need \nto now address, which include \u201cold HUD programs and old tax credit properties,\u201d are more \n"] [3.943042278289795, 18.3046817779541, " \npreservation through either a set-aside in their QAP or a point system similar to the one used in Minnesota. The balance Minnesota Housing has struck between the burden \nplaced on developers to demonstrate property risk and rewarding points toward "] [3.926194429397583, 18.331783294677734, "t the benefits of investing in a research and development function of the network, with staff explicitly tasked with time to pool data across member organizations, conduct analyses, and structure pilot programs for members to test. State housing fina"] [3.9254519939422607, 18.323232650756836, "ils about the interviews and the methods for analyzing their themes are included in Appendix A.\nWe augmented our interviews with secondary data to the extent that they were available. \nTo understand whether WOO recipients preserved the desired number"] [3.9398884773254395, 18.296350479125977, "\nIncreased Organizational Size\nNonprofit real estate developers\u2019 growth in size has been fueled partly by mergers and the acquisition of property for preservation. Those with whom we spoke stressed the importance \nof these changes with phrases such a"] [3.953396797180176, 18.29482078552246, "tead of one, or internal bridge \nfunds can be drawn on for quick acquisition. Interviewees stressed that timing is everything; as one expert noted, \u201cFlexible and nimble and speedy tends to win the day.\u201d \nBetter Ability to Partner with Resident Servic"] [3.928112745285034, 18.288591384887695, "rviewees wrestled with the question of who is the ideal organization to preserve affordable rental housing. In general, experts we spoke with described a changing nonprofit developer/\nowner industry that is shedding small CDCs and moving away from a "] [3.925921678543091, 18.3035888671875, "lly painful to have to move up the income stream because you\u2019re moving away from mission for the financial benefits. And it\u2019s true; \nit does move you away from mission, and yet you just can\u2019t grow without that rebalancing. \nInterviewees expressed con"] [4.005263328552246, 18.284404754638672, "helped them shift into more financially sustainable \npractices with greater clout and policy influence. Notably, only one of the 30 owners provided 84 Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\na PRI defaulted;"] [3.9601614475250244, 18.312515258789062, "ting out there is for sophisticated groups, the kind of money that we really need.\nThe intermediate objective of the PRIs was to build better-capitalized, more-durable, \nmore-scaled nonprofit organizations that can, in turn, preserve more units. Inte"] [3.994845151901245, 18.304378509521484, " an avenue by which MacArthur hoped owners could influence policy through large nonprofit owners\u2019 practices. Interviewees felt that Mac -\nArthur\u2019s investment in both individual nonprofit developer/owner organizations and in owner networks were mutual"] [3.9390084743499756, 18.32622528076172, "e. As one interviewee noted, \u201cthere is an increasing amount of \nintent at least to standardize processes and other tools of business\u201d as a means to become more \nefficient and to access more capital. Importantly, networks can serve this information-sh"] [3.941026449203491, 18.324193954467773, "of acquisition \nand predevelopment funds for affordable housing developers. Several large nonprofit develop -\ners with whom we spoke indicated that predevelopment funding is no longer in as short supply, although permanent sources of capital are stil"] [3.980609178543091, 18.28403091430664, "tion Loan Fund; Southland Community Development Loan Fund (Chicago); Mas -\nsachusetts Preservation Loan Fund (WOO); Vermont Loan Fund (WOO); Family Housing Fund (Minneapolis; WOO); Preservation Compact Fund (WOO); and Ohio Preservation Loan Fund (WOO"] [3.907860279083252, 18.312562942504883, "be below. \n3 Section 8 overhang refers to the potential for revenue loss for a property if Section 8 rents are not recognized in locali -\nties where rent levels paid through Section 8 are substantially higher than the maximum rent levels allowed thro"] [3.891517162322998, 18.274002075195312, "ty of funding to increase the preservation of affordable rental housing \nthroughout the WOO years (Schwartz, 2015; National Housing Law Project, 2003) likely influenced the perspective of respondents. There was broad consensus that permanent sources "] [3.941377878189087, 18.32200050354004, "d from 2008 to 2010 and then peaked in 2011. There are many factors that could explain this dip between 2008 and 2010, not the least of which is that the odds of an owner \ntrying to leave a subsidy program during this time were likely less due to the"] [3.942061424255371, 18.323049545288086, "ousing Trust, many interviewees who were familiar with \nWOO credited the MacArthur Foundation for funding high-impact national advocacy orga -Figure 5.2\nDollar and Share of Tax Credit Investments in Preservation\nSOURCE: Data from the National Housing"] [3.9003283977508545, 18.343225479125977, " 2007 2008 2009 2010 2011 2012 Outcomes of Window of Opportunity 93\npreservation-related changes at the agency. Interviewees credited HUD with substantial, if \n\u201cincremental,\u201d progress under the Obama administration to make preservation easier. \nWh"] [3.929631471633911, 18.320920944213867, " persistently advocated for preservation policies that were in a bill called the Housing Preservation and Tenant Protec -\ntion Act, sponsored by Barney Frank, that had been repeatedly introduced over several years but died in the House Financial Serv"] [3.8853936195373535, 18.374488830566406, "nt for advancing preservation. Given the central role \nplayed by state and local government\u2014especially housing finance agencies\u2014in preservation, one interviewee told us that this particular strategy was the foundation\u2019s \u201cbest bet\u201d to change \nthe fiel"] [3.918945550918579, 18.321903228759766, "\ntwo questions. First, was the affordable housing preservation sector larger after WOO\u2019s 14 \nyears of existence than it was before WOO began in 2000? If yes, the second question was whether WOO contributed to this growth. As was the case for the othe"] [3.885287284851074, 18.337608337402344, " years for a profit \u201cbefore the roof caves in,\u201d without recapitalizing the property. Interviewees worry that such buyers, with their \u201cshort-sighted dumb money,\u201d are \ndoing a \u201cdisservice\u201d to the subsidized inventory, leaving a mess for future preserva"] [3.91517972946167, 18.328073501586914, "uncil of State Hous -\ning Agencies) were the second most frequently named, each with 18 mentions. \nSeveral interviewees concluded that the majority of champions are at the local level\u2014\nmany of them MacArthur WOO grantees or borrowers\u2014which is where t"] [3.8801889419555664, 18.29094696044922, "rvation, if not general appreciation of renting, to \u201cbalance\u201d housing policy. We found a diversity of views about preservation\u2019s definition and importance, suggesting that awareness of \npreservation did not result in a unified understanding of the co"] [3.8862977027893066, 18.317672729492188, "ndents saying they aspired to homeown -\nership (Hart Research Associates, 2015). While \u201cthe infatuation with ownership as the means of wealth accumulation\u201d might be over, opined one interviewee, \u201cthe love affair with home ownership is ready to burst "] [3.9257287979125977, 18.327302932739258, "among state and federal government \nemployees to WOO advocates\u2019 education of state housing finance agencies, a greater awareness of the scope of the problem due to data advances, the proliferation of examples of preservation \ndone well, a greater und"] [3.8640573024749756, 18.338193893432617, "policymakers that preservation of that stock was important, because there was not stock like that being built, and so you have to save it like an endangered species or else it will be gone. \nGrantees described a two-step process to first try to ident"] [3.8766140937805176, 18.276559829711914, "xisting subsidized rental housing stock. \nSeveral interviewees also praised HUD for putting out more information (and more fre-\nquently updated information) about subsidized rental housing through the national LIHC database (HUD PD&R, no date-a), the"] [3.8909549713134766, 18.29009246826172, "ouse-\nholds. This discussion covered the same terrain as the trade-offs of targeting housing aid, \nwhich we discuss in Outcome 1 regarding nonprofit owners\u2019 struggle to \u201cmaintain mission\u201d while running a financially sound, sustainable business. \nWher"] [3.8829619884490967, 18.28534698486328, "gree with me \non that. A lot of the people, even on the rural preservation working group call, they \nwant project-based rental assistance for forever. It doesn\u2019t always make sense.\u201d\n3. Prioritize preservation of properties in \u201copportunity-rich areas."] [3.8777709007263184, 18.285594940185547, "nging \nfrom the economic, to the moral, to the politically expedient. These reasons, along with exam -\nples, are listed in Table 5.2. Among the 15 justifications, cost-effectiveness was the most com -Outcomes of Window of Opportunity 103\nTable 5.2"] [3.8710145950317383, 18.28818130493164, "cause of physical deterioration.\u201d\n\u2022 \u201cThe risk in preservation environment is, I got housing authorities who are incompetent, I got 515 projects that have obsolete owners. I\u2019ve got 202s and other very old properties that need renovation and reinvigora"] [3.87559175491333, 18.288728713989258, "d-ism] quite as frontally.\u201d\n\u2022 \u201cPreservation of existing [housing] is an easier path than getting a re-zoning and going through a public process around affordable [housing]\u2026.\u201d \n9. Tenants, particularly seniors, can remain in place.\u2022 \u201cIt just makes so "] [3.8749940395355225, 18.29031753540039, "o, you know, it\u2019s just more efficient to get control of it rather than let it get lost and gone forever.\u201d\n14. Preservation is less risky than new construction.\u2022 \u201cWe do not have entitlement risk. We do not have construction risk. We do not have demand"] [3.8838350772857666, 18.288990020751953, "ation means ten years into it.\u201d The \nclosest interviewees came to a distilled schematic for preservation is the \u201cbifurcated challenge\u201d of, on the one hand, the upside risk of displacing low-income residents due to owners opting \nout of maintaining th"] [3.917050838470459, 18.32221031188965, "t \nan issue? Are they campaigning for Grandma? Is it poor people? I mean it\u2019s very retail, very \nbasic, political.\nThe relative invisibility of preservation and its inherent variation, which depends on local \nmarket conditions, tenant mix, ownership "] [3.9212217330932617, 18.310047149658203, "y homeless. \nNote that we do not know how many of these units would have been lost from the afford -\nable stock if not for WOO. And three interviewees questioned whether WOO substantially increased the number of units preserved. Despite the wide agre"] [3.906783103942871, 18.267601013183594, "himberg Center and the Furman Center, have better approximations of which owners \nrenewed their subsidies, with and without a repositioning, as far back as 2004 and 2002, \nrespectively, but not before then and not on a national level. \nIn light of th"] [3.920792818069458, 18.33028221130371, "Units out that year \nUnits out that year as a share of existing units\nCumulative units out as a share of units ever built\n1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Outcomes of Window of Opportunity 109\nwas sem"] [3.9132769107818604, 18.320579528808594, "ded to change housing pol -\nicies and practices to facilitate more preservation of affordable rental housing. The MacArthur \nFoundation identified five principal barriers to achieving this goal: \n\u2022 too few significant nonprofit owners who had made pr"] [3.931077718734741, 18.3415470123291, "oritized changing the nonprofit owner industry, not the much larger for-profit owner industry, \nand it prioritized the policy environment over the unit count.\nInterviewees continue to grapple with fundamental questions about preservation. These \ndile"] [3.8867058753967285, 18.28386688232422, "ver, these accomplishments did not resolve structural problems for preservation that \nwe believe inhibited WOO\u2019s ability to achieve impacts at the desired scale. The largest inhibi -\ntor of preservation was the economic downturn in the WOO years. Due"] [3.904653549194336, 18.28583335876465, " choice by the \nfoundation to focus on large nonprofit preservation-oriented owners who, by and large, were preserving subsidized rental housing, which is most often in multifamily dwellings. The ratio -\nnale for focusing on large nonprofit preservat"] [3.8948781490325928, 18.2847843170166, "hereby expanding the resources devoted to preservation.\n\u2022 Few funding vehicles and policy efforts to engage the largest owner type of affordable \nrental housing: for-profit owners of small numbers of units.\n\u2022 A lack of significant new funding sources"] [3.886261224746704, 18.281633377075195, "nsensus policy motivation for, preservation. That the initiative is not likely to reach its goal to catalyze major preservation-related policy changes speaks to the limitation of a single philanthropic initiative targeting a massively large asset suc"] [3.923089027404785, 18.336061477661133, "w subsidized rental housing for lower-income families. \nLessons for MacArthur and Other Philanthropies\nThrough our review of WOO and its outcomes, we conclude with six lessons for philanthropies \nas they consider the design of future initiatives.\nLes"] [3.993901491165161, 18.302019119262695, "ditional funds on it. The designated beneficiaries of WOO were accorded an advantage \nthat helped to attract outside dollars. 116 Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\nAlso, in selecting a relatively narro"] [3.9042160511016846, 18.35188865661621, "ard goals. A fourth challenge is the continued lack of data to mea -\nsure preservation activity and resources to quantify changes over time. The four challenges, in combination, prevented the foundation from knowing empirically along the way whether "] [3.809536933898926, 17.86134147644043, ". population. The IPUMS is a series of data compiled by the Univer -\nsity of Minnesota that allows us to follow the evolution of metropolitan area characteristics, \nkeeping boundaries constant. \nWe looked at homeownership by marital status, race/ethn"] [3.8062291145324707, 17.867984771728516, " income is matched with the unit having the second-lowest rent, and so forth, \nuntil we reach the 20th, 40th, 60th, and 80th percentiles. Consider a household with income at the 20th percentile of the income distribution. The perfect distributional m"] [3.837796926498413, 17.921419143676758, "ille\u2212Cocoa\u2212Palm Bay, FL\nColumbus, OH\nAlbuquerque, NM\nSanta Fe, NM\nSan Jose, CA\nNorfolk\u2212VA Beach\u2212Newport News, VA\nTacoma, WA\nFort Collins\u2212Loveland, CO\nSalt Lake City\u2212Ogden, UT\nDayton\u2212Spring/f_ield, OH\nColumbia, SC\nMacon\u2212Warner Robins, GA\nSpring/f_ield"] [3.805824041366577, 17.868619918823242, "oga, TN/GA\nKilleen\u2212Temple, TX\nColorado Springs, CO\nIndianapolis, IN\nHouma\u2212Thibodaux, LA\nHickory\u2212Morgantown, NC\nLancaster, PA\nHouston\u2212Brazoria, TX\nAnchorage, AKMethods for the Evaluation of Window of Opportunity 123\nFigure A.5\nRent-to-Income Ratio "] [3.795605421066284, 17.873136520385742, "015).\nNOTE: Figure shows the ratio of 60th percentile gross rent to 60th percentile income in 1990.\nRAND RR1444\u2013A.780 60 40 20 100 0\nPercentageMetropolitan Statistical Area\nBryan\u2212College Station, TX\nMiami\u2212Hialeah, FL\nBridgeport, CT\nFlint, MI\nDaytona "] [3.8381285667419434, 17.940120697021484, "L\nDanbury, CT\nAkron, OH\nKnoxville, TN\nSouth Bend\u2212Mishawaka, IN\nCharleston\u2212N. Charleston, SC\nMontgomery, AL\nGalveston\u2212Texas City, TX\nAnniston, AL\nReno, NV\nRichmond\u2212Petersburg, VA\nGreensboro\u2212Winston Salem\u2212High Point, NC\nYoungstown\u2212Warren, OH\u2212PA\nOklahom"] [3.971773147583008, 18.25276756286621, "\u2212PA\nSpring/f_ield, IL\nJoplin, MO\nLongview\u2212Marshall, TX\nWausau, WI\nBenton Harbor, MI\nAppleton\u2212Oshkosh\u2212Neenah, WI\nJohnstown, PA130 Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\nFigure A.12\nRent-to-Income Ratio for t"] [4.033234596252441, 18.29006576538086, "fit into \nthese changes\n\u2022 key remaining challenges facing the field of affordable rental housing preservation.\nAll interviews were audio-recorded, and virtually all were subsequently transcribed. At \nthe end of each interview, interviewees were asked"] [3.956296920776367, 18.32307243347168, "ere confidential. In this report, interviewee comments and opinions are not attributed to specific individuals unless permission was explicitly sought \n(as was done for the case studies).\nSelection of Case Studies\nWe worked with the MacArthur Foundat"] [3.957530975341797, 18.31932258605957, "in 2007 and continues to be an important organization for addressing preservation issues in Cook County. In addition to grants supporting the establishment and coordination of TPC \nand participation in it, the MacArthur Foundation has funded between "] [4.018458366394043, 18.282100677490234, "ity Initiative\nin Chapter Five), and they were also asked for permission to audio-record the interviews. All \nof the interviewees consented to having their interview audio-recorded. The audio-recordings \nwere transcribed for use only by the research "] [3.9753401279449463, 18.315200805664062, " asked questions about SAHF and peer networks of each interviewee. The spe-\ncific interview protocol for this case study covered the following topics: (1) perceptions of the most significant accomplishments of SAHF, (2) whether SAHF enabled members t"] [3.956416368484497, 18.303272247314453, "\nState and Local Housing Preservation Leaders Initiative Interviews \nFor this case study, we interviewed Robyn Bipes, director of programs and lending, Greater \nMinnesota Housing Fund; Anne Heitlinger, preservation manager, Minnesota Housing; \nRobert"] [3.9899849891662598, 18.24976921081543, "nergy\n\u2022 Francie Ferguson, director of the Multifamily Initiative, NeighborWorks 138 Preservation of Affordable Rental Housing: The Window of Opportunity Initiative\n\u2022 James Grow, deputy director and senior staff attorney, National Housing Law Proje"] [4.0829596519470215, 18.216182708740234, "isors\n\u2022 James Logue, chief operating officer, Great Lakes Capital \n\u2022 John Markowski, president, CIC (interviewed with Stacie Young)\n\u2022 Patrick Nash, managing director, JP Morgan Capital Corporation\n\u2022 Daniel Nissenbaum, managing director, Goldman Sachs"] [4.001410961151123, 18.273040771484375, "mpact\u2019s List of Events (2009\u20132014)\nTable C.1 \nThe Preservation Compact\u2019s List of Events (2009\u20132014)\nEvent Title Purpose\nGreen Retrofit Program \nWorkshop\nMay 2009\n(50 attendees)A workshop to market the Green Retrofit Program, a program created with fe"] [4.00434684753418, 18.248291015625, "vation of Affordable Rental Housing: The Window of Opportunity Initiative\nEvent Title Purpose\nPreserving Chicagoland\u2019s \nSmall Multifamily Housing \nStock\nMay 22, 2014(75 attendees)The forum examined the stock of 5\u201349-unit rental properties in the Chic"] [4.098034858703613, 18.130481719970703, "Housing in Cook County: \nCurrent Conditions and Forecast , Chicago.: DePaul University Real Estate Center, 2007. As of April 20, 2016: \nhttps://www.macfound.org/media/article_pdfs/REPORT_STATE_OF_RENTAL_HOUSING_1.PDF\nChetty, Raj, Nathaniel Hendren, a"] [4.019035816192627, 18.110431671142578, "icy Development and \nResearch.IPUMS\u2014 See Ruggles, Steven, Katie Genadek, Ronald Goeken, Josiah Grover, and Matthew Sobek, \nIntegrated Public Use Microdata Series: Version 6.0 [Machine-readable database], Minneapolis: University of \nMinnesota, 2015.\nJ"] [3.9757649898529053, 18.193857192993164, "w.law.umaryland.edu/marshall/crsreports/crsdocuments/RL34728_01282013.pdf\nPreservation Compact, \u201cStrategies That Work: Preserving Affordable Rental Housing,\u201d Chicago, 2014. As of \nApril 20, 2016: http://www.preservationcompact.org/wp-content/uploads/"] [4.06217098236084, 18.093847274780273, "er 8, Low-Income Housing, Subchapter I, General \nProgram of Assisted Housing, Section 1437f, Low-Income Housing Assistance, January 3, 2012. As of April 22, 2016: https://www.gpo.gov/fdsys/granule/USCODE-2011-title42/USCODE-2011-title42-chap8-subchap"] [4.592377662658691, 8.572980880737305, "CORPORATION\nDriving to Safety\nHow Many Miles of Driving Would It Take to Demonstrate \nAutonomous Vehicle Reliability?\nNidhi Kalra, Susan M. Paddock\n\u2022 Autonomous vehicles would have to be driven hundreds \nof millions of miles and sometimes hundreds of"] [4.672171115875244, 8.418741226196289, "for autonomous vehicles, as well as for human drivers, and autonomous vehicles might perform worse than human drivers in some cases (Gomes, 2014). There is also the potential for autonomous vehicles to pose new and \n1 This does not mean that 53.5 per"] [4.598962306976318, 8.570423126220703, "enables laboratory testing and verifi-cation. Curtain-style air bags, for example, are tested with a combina-tion of component tests to assess inflation time, fill capacity, and other responses in a range of temperature conditions and impact configur"] [4.590470314025879, 8.576764106750488, "rt assess the miles needed to demonstrate the reliability of this last class of fully autonomous vehicles. Therefore, we use the total fatality, injury, and crash rates of human drivers in the United States as benchmarks against which to compare auto"] [4.586059093475342, 8.585716247558594, " driven \nautonomous vehicles for a certain number of failure-free miles \nand wishes to know the reliability (or, equivalently, the failure rate) that can be claimed at a particular level of confidence. Alternatively, for a given confidence C and reli"] [4.587284564971924, 8.584519386291504, "It is also known that injuries and crashes may be \nsignificantly underreported; one study suggests by 25 percent and 60 percent, respectively (Blincoe et al., 2015). Therefore, we have also shown reference lines that could reflect a truer estimate of"] [4.5878005027771, 8.582881927490234, "ere is 100(1 \u2212\u03b1/2)th quantile of standard normal \ndistribution.10 The half-width of the CI, provides \nan estimate of the precision of the failure rate estimate, \nWe can calculate the precision relative to the failure \nrate estimate:\nwhich simp"] [4.587449073791504, 8.5799560546875, ". The 8.8-billion mile data point corresponding to this example is annotated in Figure 2.\nThese results show that it may be impossible to demon -\nstrate the reliability of high-performing autonomous vehicles (i.e., ones with failure rates comparable "] [4.58357048034668, 8.588608741760254, "ct, \u03bb\nalt. We set \n12 The subscript on z is 1\u2212 \u03b1 here because this is a one-sided hypoth-\nesis test.Figure 2. Miles Needed to Demonstrate Failure Rates to a Particular Degree of Precision\nFailure rate (failures per 100 million miles)Miles needed to b"] [4.58465051651001, 8.586323738098145, "te of autonomous vehicles. This is shown on the horizontal axis and de/f_ined as a percent improvement over the human driver failure rate. The comparison can be made to the human driver fatality rate (blue line), reported injury rate (purple line), e"] [4.595396518707275, 8.568146705627441, "take 518 years\u2014about a half a millennium.\nFigure 4 shows how many miles fully autonomous vehicles \nwould have to be driven to demonstrate with 95% confidence and 80% power that their failure rate is A % better than the \nhuman driver failure rate. The"] [4.585938930511475, 8.58626937866211, "f human driver failures. Second, injuries and crashes are significantly underreported and there is conflicting evidence about the rate of underreporting. Experiments in which injuries and crashes are accurately recorded could yield different rates. T"] [4.590676307678223, 8.57518482208252, "esting (Nelson, 2009), virtual testing and simulations (Chen and Chen, 2010; Khastgir et al., 2015; Olivares et al., 2015); mathematical modeling and analysis (Hojjati-Emami, Dhillon, and Jenab, 2012; Kianfar, Falcone, and Fredriksson, 2013); scenar"] [4.588850975036621, 8.581786155700684, "es?\n(1) without failure to demonstrate with 95% confidence that their failure rate is at most\u2026275 million miles \n(12.5 years)3.9 million miles \n(2 months)1.6 million miles \n(1 month)\n(2) to demonstrate with 95% confidence their failure rate to wit"] [4.4101176261901855, 7.954357624053955, "ashes 2010 (Revised) , Washington, D.C.: National Highway Traffic Safety \nAdministration, DOT HS 812 013, 2014, revised May 2015. As of March 3, 2016: http://www-nrd.nhtsa.dot.gov/pubs/812013.pdf\nBureau of Transportation Statistics, Motorcycle Rider "] [4.673346996307373, 8.02038288116455, "logy & Therapeutics, Vol. 97, No. 3, March 2015, pp. 234\u2013246. As of April 1, 2016: http://dx.doi.org/10.1002/cpt.59\nFagnant, Daniel J., and Kara Kockelman, \u201cPreparing a Nation \nfor Autonomous Vehicles: Opportunities, Barriers and Policy Recommendatio"] [4.589739799499512, 8.015376091003418, "ons, 1982. Mathews, Paul, Sample Size Calculations: Practical Methods for \nEngineers and Scientists , Fairport Harbor, Ohio: Mathews, Malnar, \nand Bailey, Inc., 2010. \nMisra, Krishna B., ed., Handbook of Performability Engineering , New \nYork: Spring"] [4.595421314239502, 8.058690071105957, "is a senior information scientist at the RAND Corporation, a codirector of RAND\u2019s Center for Decision Making \nunder Uncertainty, and a professor at the Pardee RAND Graduate School. Her research addresses energy, environment, \nand science and technolo"] [13.807023048400879, 4.635661602020264, "science and technology, and the concurrent effects that science and technology have on policy analysis and policy choices. The program covers such topics as space exploration, information and telecommunication technologies, and nano- and biotechnolog"] [17.481037139892578, 5.701759338378906, "Programs for Incarcerated \nParents\nPreliminary Findings from a Pilot Survey\u2014 \nAppendixes\nDIONNE BARNES-PROBY, CELIA J. GOMEZ, MONICA WILLIAMS, \nMATT STRAWN, ISABEL LEAMON\nCORPORATIONFor more information on this publication, visit www.rand.org/t/RRA1"] [17.48348617553711, 5.701000213623047, "and their children; however, little is known about exactly what programs exist, how they are implemented, and the extent to which incarcerated parents participate. In this pilot study, RAND researchers sought to explore and describe the current lands"] [17.4837703704834, 5.705441474914551, " understandable, organized, relevant, and straightforward; to evaluate respondents\u2019 ability to recall information and answer survey questions; to assess the ease of following skip patterns within the survey; and to confirm projected time estimates to"] [17.48800277709961, 5.699962615966797, "cation (e.g., courses designed to improve parenting skills); literacy development and/ or book reading programs (e.g., activities designed to connect incarcerated parents and their children through shared reading and literacy activities); written com"] [17.496633529663086, 5.6997456550598145, "f that is applicable)? (enter a number) \n1. Box that accepts integers \n\u2022 No \n [If yes, move on to \u201cProgram Name and Description\u201d section] [If no, show text below] \nSome facilities do not have parenting programs that meet our definition, but they m"] [17.49839973449707, 5.698279857635498, " (select all that apply) \n\u2022 Child development \n\u2022 Parenting techniques \n\u2022 Communication with child \n\u2022 Anger management \n\u2022 Co-parenting \n\u2022 Parenting self-esteem or self-efficacy \n\u2022 Plans to re-enter child\u2019s life upon release \n\u2022 Other (specify): \n 10. D"] [17.502220153808594, 5.697137355804443, " children: \n(e.g., children participate in monthly support groups) \n1. Free response \n 16. Does [PROGRAM NAME] include any of the following general education courses or job training specifically for parents in the program? (select all that apply) \nOn"] [17.50615119934082, 5.70249080657959, "eligibility requirements (e.g., only biological or adoptive parents are eligible for the program, or only parents with children of a certain age are eligible for the program)? (select one response) \n\u2022 Yes 9 \u2022 [If yes, appears on next screen] Please "] [17.50566864013672, 5.698627948760986, " length varies \n(e.g., Some parenting classes last for one month; some reading and literacy \nactivities last for three months) \n\u00a7 Free response \n\u2022 Don\u2019t know \n \n30. Does [PROGRAM NAME] include any supports or services for parents after they have \nlef"] [17.49640464782715, 5.699857711791992, "ls, Wi-Fi) used for [PROGRAM \nNAME]: \n\u00a7 Free response \n\u2022 Classroom space \n\u2022 Visitation space \n\u2022 Other resources (specify): \n \n[Perceptions of Program] \n37. To what extent do you agree that [PROGRAM NAME] is meeting its goals and \nobjectives? (select"] [17.49354362487793, 5.701773643493652, "tion about other parenting programs or services, supports, or resources for \nincarcerated parents that were not captured in the survey. If you do not have \nadditional information to share, select next. \n\u2022 Free response box \n "] [0.27371132373809814, 20.767133712768555, "A Green\nCosta Rican COVID-19 Recovery\nDavid G. Groves, Edmundo Molina-Perez, James Syme, and Gabriela Alvarado\n(RAND Corporation)\nFelipe De Le\u00f3n Denegri\n(Ministry of Environment and Energy, Climate Change Directorate)\nJuan Daniel Acu\u00f1a Rom\u00e1n and Agri"] [0.25238803029060364, 20.744857788085938, "s is authorized, without any special \npermission of the owner of rights, provided that the source is indicated. UNDP-Costa Rica will appreciate a copy of any text prepared \nbased on t his publication.\nTelephone: (506) 2 2961544\nhttp://www.cr. undp.or"] [0.2949781119823456, 20.786510467529297, "COVID-19 has had a significant impact on prevailing economic conditions, particularly for vulnerable indi -\nviduals and households. From 2019 to 2020, the pandemic led to a sharp increase in unemployment, from about 12 percent to more than 24 percent"] [0.3145489990711212, 20.803829193115234, " and governmental responses \nin 2020. We then use a general equilibrium model of the Costa Rican economy\u2014Plataforma de Modelaci\u00f3n Econ\u00f3mico-Ambiental Integrada (Integrated Economic-Environmental Modeling [IEEM]; Banerjee and Cicowiez, 2020a, 2020b; B"] [0.36248070001602173, 20.849029541015625, " The numbers in each chart indicate the percentage change relative to the no COVID-19 baseline case. The results for employed \nworkers are based on a calibration optimized for employment; results for value added are based on a calibration optimized f"] [0.34517112374305725, 20.83448028564453, " five-year recovery trajectory; the numbers in each chart indicate the percentage change relative to the baseline. The results for employed workers are based on a calibration optimized for employment; results for value added are based on a calibratio"] [0.2866508960723877, 20.784048080444336, "We mapped low-productivity jobs to low-wage and low- and mid-skilled jobs, which we refer to as \u201clower-skilled\u201d jobs in this figure. Green bars represent women; orange bars represent men. Results are based on a five-year recovery trajectory and calib"] [0.296400249004364, 20.78974151611328, "show that upfront decarbonization investments of the scale \nrequired to implement the NDP could accelerate employment and economic recovery from COVID-19, and these investments would lead to higher employment and value added by 2025 than would have o"] [0.30198100209236145, 20.792448043823242, "or a green transition are very often different from current employment opportunities, and workers will require training to transition to these new jobs. \n\u2022\n Co\nsta Rica should continue to develop an analytical framework for identifying, measuring, an"] [0.29601430892944336, 20.78780174255371, "nization Investments Will Vary Across Sectors and Socioeconomic Groups .............. 37\nCHAPTER FIVE\nAligning Decarbonization with Broader Sustainable Development Goals ....................................... 45\nCHAPTER SIX\nConclusion ..........."] [0.3273247480392456, 20.81694221496582, "r the National Decarbonization Plan, by Lines of Action, \nfor the First Five, Ten, and 15 Years from the Benefits and Costs of Decarbonization Study ....... 13\n 2.\n1. Va\nlue Added by Sector as a Percentage of GDP, 2019 ............................"] [0.3413080871105194, 20.831083297729492, "nd Gender, in 2025, Relative to the \nN\no COVID-19 Baseline ....................................................................................... 40\n 4.\n5. Di\nfference in Low-Wage Jobs, by Wage and Gender, in 2025, Relative to \nthe No COVID-19 Ba"] [0.32196176052093506, 20.814563751220703, "e Development Goals for Each Nationally Determined Contribution \nDecarbonization Action ...................................................................................... 661CHAPTER ONE\nIntroduction\nCOVID-19 in Costa Rica\nOn January 30, 2020, th"] [0.312032014131546, 20.80331039428711, "al Response to the Pandemic\nAt the onset of the pandemic, the Costa Rican government imposed numerous measures to reduce mobility and slow the spread of COVID-19, such as\n\u2022\n Wo\nrkplace closings: On March 9, 2020, public sector workers were asked to "] [0.31450989842414856, 20.805675506591797, "es, and it was considerably more stringent than Nicara-gua\u2019s. In each country, stringency was highest during the early period of the pandemic\u2014April to June 2020\u2014and then it gradually declined to a steady state through the deployment of vaccinations ("] [0.34171509742736816, 20.829851150512695, "wever, declined by 4.1 percent, a loss of 1.76 trillion Costa Rican colones (about $3 billion U.S. dollars [USD]), according to the International Monetary Fund (IMF, undated; see Figure 1.4). In the early months of the pandemic, a report by the Minis"] [0.42606601119041443, 20.913389205932617, "Category 2019 2020Total Job Loss \n(%)a2019 Jobs \n(%)b\nFemale Low-skilled 182,208 155,534 \u201326,673 9.3 14.6 \nMid-skilled 436,023 341,200 \u201394,823 33.1 21.7 \nHigh-skilled 220,574 193,251 \u201327,323 9.6 12.4 \nSkill not specified 3,417 2,725 \u2013692 0."] [0.34693676233291626, 20.826229095458984, "lined only modestly. The exact source of this discrepancy is not yet known but could be due in part to FIGURE 1.4\nAnnual Change in GDP, 2010\u20132020\nYearAnnual GDP change (%)\nAnnual GDP (trillion colones)\nSOURCE: Author analysis of preliminary figures f"] [0.32650572061538696, 20.81587028503418, "llions)\u201320 \u201340 \u201360 0 0 \u201310 \u201320 \u201330 \u201340 20All sectors (\u20133.8, \u20132.8)\u201317 (\u201325.9)\n\u201316 (\u201318.9)\n\u201312 (\u20135.8)\n\u201312 (\u201327.1)\n\u201312 (\u201336.6)\n\u201312 (\u201362.8)\n\u20137 (\u201317.5)\u201325 (\u201335.2)\n\u20133 (\u20137.0)\u201310 (\u2013237)\n\u201321 (\u2013498)\n\u20134 (\u2013111)\n1 (103)\n0 (\u201310)\n\u20135 (\u2013455)\n0 (10)\u201340 (\u2013692)\u201332 (\u201349."] [0.26799482107162476, 20.780349731445312, "owners, the government also temporarily reduced the origi -\nnal rate of social security taxes by 5 percent. \nCosta Rica\u2019s Performance on the United Nations Sustainable Development Goals\nThe United Nations sustainable development goals (SDGs), adopted"] [0.2991209030151367, 20.790081024169922, "ic activity, are likely to be long-lasting without mitigation. Green government investment and policies, when properly directed, can increase employment and economic development (Ianchovichina et al., 2012). These green industrial policies are sector"] [0.22219108045101166, 20.709693908691406, ", or a strong state, these policies can also lead to inefficiencies and corruption (Acemoglu and Robison, 2012, 2019). There are numerous benefits to public infrastructure investment, including increased private sector productivity, a higher rate of "] [0.2471284121274948, 20.735870361328125, " S.1.A Green Costa Rican COVID-19 Recovery: Aligning Costa Rica\u2019s Decarbonization Investments with Economic Recovery\n12economic and infrastructure sectors of Costa Rica\u2019s economy. Table 1.3 summarizes these investments, and \nTable C.1 (in Appendix C)"] [0.2519752085208893, 20.740270614624023, " as well as in transport and circular economy (Figure 1.8). \nMore recent estimates of the total investment required to both support ongoing economic development \nand decarbonization in the transport sector (South Pole Carbon Asset Management [hereaft"] [0.3070621192455292, 20.796375274658203, "e Effect of COVID-19 and \nDecarbonization Investment on Costa Rica\u2019s Economy\nCosta Rica\u2019s Economy: More Than Just Tourism \nCosta Rica\u2019s economy is ranked 13th out of 40 in Latin America and the Caribbean, with a GDP of $63.9 bil -\nlion in 2019 (World"] [0.3238006830215454, 20.812183380126953, "a). Petroleum oil and diesel accounted for about $1.4 billion of imports, followed by textiles and clothing, medications, and automobiles at around $500 million each. Most employment comes from commercial (retail trade) and ser -\nvice provision secto"] [0.32826530933380127, 20.81615447998047, "l Costa Rican market. This distinction is relevant because it deter -\nmines how much an economic sector can expand in response to higher capital investments; export-oriented \n1 IEEM was provided to the study team by BCCR, through a partnership with O"] [0.33604446053504944, 20.821186065673828, "is report.A Green Costa Rican COVID-19 Recovery: Aligning Costa Rica\u2019s Decarbonization Investments with Economic Recovery\n18would incorporate additional information about how the relative share of jobs for women and men within \na sector might change "] [0.3303242325782776, 20.81767463684082, ", we assume that these parameters are exogenously determined even though these parameters are deter-\nmined by economic conditions and policies. Such consideration falls outside the scope of this study. FIGURE 2.2\nFramework for Modeling COVID-19 Effec"] [0.3526146709918976, 20.839506149291992, "metric it was possible to match the behavior of the \nmodel to the statistical reports produced by INEC. Future work can take this approach further to consider both value added \nand the demand for intermediary inputs as metrics for calibration. This a"] [0.3360128104686737, 20.8245792388916, "use existing prepandemic economic models have been configured and calibrated to account for more-common economic conditions. Further research and model development will allow IEEM and similar models to reflect COVID-19 effects more closely. Despite t"] [0.3331277668476105, 20.821691513061523, "tion and the economic census data. Estimated changes in these economic indicators using the economic census data are calculated by comparing census data between 2019 and 2020. Estimated changes in these economic indicators using the numerical results"] [0.27866896986961365, 20.772130966186523, " collaboration of multilateral organizations, such as multilateral development banks or the Green Climate Fund. However, further research is needed to understand in more detail how these investments can be incentivized through the deployment of publi"] [0.230220764875412, 20.71678924560547, "). \nThe South Pole studies estimate total investment costs for the NDP, including those that would have been \notherwise incurred in BAU conditions; they do not specify the incremental costs associated with implement -\ning the NDP. For the transport l"] [0.2915140390396118, 20.778905868530273, "\nCircular economy 1.20a1.20a1.20a\nLivestock 0.06a0.78c1.56d\nAgriculture 0.08a0.42c0.84d\nForestry 0.12a0.92c1.84d\nTotal 4.85 6.17 8.29\na Cost derived directly from Groves et al., 2020. \nb Transport NDP net cost based on South Pole, 2019, estimates of "] [0.37106722593307495, 20.858963012695312, " -\nanced calibration case, which simulates lower employment losses. In both cases, the differences in employ -\nment between no COVID-19 and with COVID-19 conditions lessen over time inversely proportional to the \nassumed recovery time. For both calib"] [0.38215669989585876, 20.870086669921875, "y to leave the workforce to care for sick family members or to support children who are no longer going to school due to school closures.\nTo better visualize the changes in employment by skill classification and gender, we show total employed \nworker"] [0.3841716945171356, 20.87163543701172, "Between COVID-19 Conditions and the No COVID-19 Baseline, by Gender and Skill Classification\nGender Skill ClassificationDifference in 2020 \nJobs Compared \nwith 2019 Jobs\n(Absolute and \nPercentage)Difference in Jobs in 2025 Compared with the No COVID-"] [0.3738948404788971, 20.861679077148438, " as measured by value added (i.e., a decline of 4.3 percent in 2020 versus the Central Bank\u2019s estimated FIGURE 3.4\nLower-Skilled Jobs, by Gender, and Change in Lower-Skilled Jobs, by Gender, 2019\u20132020 and \n2025, With and Without COVID-19\nScenario\nNo "] [0.36920085549354553, 20.856863021850586, "s: \n\u2022 The significant declines in employment due to the COVID-19 pandemic that have been observed in \n2020 and replicated by our models will largely recover; however, there will be slightly fewer total jobs in 2025 than there would have been without "] [0.3657374382019043, 20.854267120361328, "m COVID-19.\n\u2022 De\nclines in economic activity, measured by value added, are modeled to mostly recover by 2025, regard -\nless of the recovery time frame. \n\u2022 In 2\n025, value added would be 0.5 percent lower under a five-year recovery trajectory than it "] [0.364082932472229, 20.85354232788086, "it would have been without COVID-19 and decarboniza -\n1 Higher productivity is positively correlated with higher wages in the job market, and higher wages increase the probability \nof workers saving the financial resources needed to deal with unexpec"] [0.345572292804718, 20.834566116333008, " a calibration that \nbalances model performance across employment and value added. The value labels indicate the percentage change relative to the no COVID-19, no investment baseline.Employment calibration\n0\n\u2013100\n\u2013200\u2013300Difference in number of emplo"] [0.324813574552536, 20.812164306640625, "n COVID-19 Recovery: Aligning Costa Rica\u2019s Decarbonization Investments with Economic Recovery38economy, because these investments will change its underlying structure. Figure 4.3 shows how employment \ncould differ from the conditions in 2025 that cou"] [0.3341696858406067, 20.824066162109375, "r employment than otherwise would have occurred without decarbonization spending is seen in \nall but one sector and funding scenario.\n3 The most significant effect is seen in the construction sector, which \ncould experience between 7.3 percent and 13"] [0.37936148047447205, 20.86797332763672, "s of female workers, such as commerce, home employees, and hotels and restaurants. The higher spending sce -\nnarios show continued employment gains by lower-skilled female workers and even greater gains by lower-skilled male workers.\nThis modest incr"] [0.349420428276062, 20.839515686035156, ". We mapped low productivity to low-wage and low- and mid-skilled jobs, which we refer to as \u201clower-skilled\u201d jobs in this figure. Results are based on a five-year recovery trajectory and calibration optimized for employment.Decarbonization \ninvestmen"] [0.3386475741863251, 20.828868865966797, " of these decarbonization investment scenarios as follows: \n\u2022 Decarbonization investments induce a faster COVID-19 recovery in terms of employment and value \nadded by about two years.\n\u2022 Decarbonization investments lead to improved recovery outcomes "] [0.26846858859062195, 20.76095199584961, "e investments. \n\u2022 As c\nurrently modeled, decarbonization investment only slightly reduces existing gender inequalities in \nCosta Rica\u2019s labor market because many of the jobs needed for decarbonization are from sectors with a larger share of male work"] [0.25006863474845886, 20.748029708862305, "ong link between NDP benefits and SDGs, we describe how the modeled NDP benefits would contribute to or work against progress toward the SDGs. We summarize this analysis in Table 5.1 and in our subsequent discussion.\n1 See the performance-by-indicato"] [0.22236359119415283, 20.716392517089844, "021\u20132050 due to reduced transportation pollution is valued at nearly $1.6 billion. \nIncreased freight transport efficiencySDG 9\n(industry, \ninnovation, and \ninfrastructure)Logistic Performance Index: Quality of trade and transport-related infrastruct"] [0.22991064190864563, 20.733139038085938, " connected to treated water supplies and wastewater systemsSDG 6\n(clean water \nand sanitation)Population using at least basic drinking water and sanitation services (%)The NDP would ensure that all households have access to clean water and that 80% o"] [0.24012641608715057, 20.73796272277832, "rban solid waste generated by cities (11.6.1)\na The NDP would increase trash collection and treatment by 20% and increase the share of recyclable materials recycled 11-fold. \nAgriculture Improved agricultural practices to reduce emissionsSDG 2\n(zero "] [0.25353768467903137, 20.762516021728516, "rted by the most decarbonization actions are SDG 12 (responsible consumption and production), SDG 8 (decent work and economic growth), and SDG 3 (good health and well-being). This reflects the significant investment in the circular economy and the ec"] [0.27117255330085754, 20.764856338500977, ", Afrodescendants, and other local communi -\nties. In addition, with billions of dollars of spending required to implement the NDP, Costa Rica will need to ensure that graft and other forms of corruption are limited. The potential for special interes"] [0.24591928720474243, 20.736141204833984, "chnical decarbon -\nization trajectories laid out in the NDP and provide a framework for just decarbonization centered on the most-vulnerable people, communities, and ecosystems. \nOur analysis shows that the upfront decarbonization investments based o"] [0.25453847646713257, 20.746166229248047, "i -\ntional research is needed to improve understanding for informed policymaking:\n\u2022 Co\nsts of decarbonization. Detailed estimates of the upfront costs of decarbonization have yet to be \ndeveloped for all parts of the NDP. New action-by-action estimat"] [0.2614167034626007, 20.759109497070312, "ining of vulnerable groups (lower-skilled workers, racial/ethnic minority groups, and women) when meeting the employment requirement of decarbonization.\nNext, we suggest that employment outcomes across the sectors be carefully monitored as NDP invest"] [0.290020227432251, 20.77792739868164, "rofesionales y administrativas de apoyoCommerce\na\nProfessional servicesa\nCommunication and services, public administration and othersOtrosAdministraci\u00f3n p\u00fablicaComunicaci\u00f3n y otros serviciosNo especificadoOther servicesPublic administration\na\nConstru"] [0.24667353928089142, 20.735551834106445, "ees ls_a-domest (domestic services)0.85 0.88 1.04 0.96 1.05\nHotels and restaurantsls_a-hotelrest (hotels and restaurants)0.85 0.86 0.87 1.00 1.05A Green Costa Rican COVID-19 Recovery: Aligning Costa Rica\u2019s Decarbonization Investments with Economic Re"] [0.2990444600582123, 20.788732528686523, "-IDPM and indicates the cost drivers that are multiplied by cost factors to estimate costs.\nIn general, costs are not estimated based on specific investments or programs, but instead they are based \non cost factors applied to sector-specific cost dri"] [0.2543894648551941, 20.743648529052734, " Investments to Sector Capital Stocks\nTable B.4 shows how we linked the capital investments for the different NDP lines of action (columns) \nwith private investment levels, as represented in IEEM across different economic activities (rows) in Costa \n"] [0.2175329029560089, 20.70855712890625, "ts and urban areas.\n\u2022\n By 20\n50, have highly efficient \nfreight transport with 20% reduced emissions compared with 2018 emissions.\nNOTE: LPG = liquified petroleum gas; PT = public transport.A Green Costa Rican COVID-19 Recovery: Aligning Costa Rica\u2019s"] [0.2476995289325714, 20.760574340820312, "\nally Determined Contribution (INDC) previously commissioned by the Climate Change Directorate with \nsupport from the German Agency for International Cooperation.1 That effort used document review, aug -\nmented by interviews with subject-matter exper"] [0.23609891533851624, 20.75046730041504, "s of the well-being of people and ecosystems.SDG1, SDG2, SDG3, SDG4, SDG5, SDG6, SDG7, SDG8, SDG9, SDG10, SDG11, SDG12, SDG13, SDG14, SDG15, SDG16, SDG17\n0.2By 2022, Costa Rica will have carried out an analysis of Costa Rican green and blue jobs, whi"] [0.22495593130588531, 20.739225387573242, "bution Decarbonization Actions to the United Nations Sustainable Development Goals67NDC Action Relevant SDG\n1.5By 2030, the infrastructure will have been expanded and improved to increase non-motorized \nmobility trips (including pedestrian and bicycl"] [0.23379822075366974, 20.748138427734375, "d intersectoral planning of the process of electrification of energy demand, which will incorporate the needs of the various sectors and the diversity of renewable energy sources available in the different regions of the country. SDG3, SDG7, SDG8, SD"] [0.23487989604473114, 20.74938201904297, "area of industry, trade, and services will have innovative production models from \u201ccradle to grave\u201d or with a circular economy approach in the main productive chains of agroindustry, services, construction, and creative and cultural economy, among ot"] [0.22397126257419586, 20.726802825927734, "e, livestock, sugar cane, rice, and bananas will apply production systems that are low in GHG emissions both at the farm level and at the processing stage level.SDG2, SDG6, SDG7, SDG8, SDG12, SDG13, SDG15\n7.2In 2025, the country will promote a circul"] [0.23216018080711365, 20.746461868286133, "he Payment for Ecosystem Services program, including other services and ecosystems not covered so far, including as a priority soils, peatlands, and other ecosystems with high potential for carbon sequestration, identifying and increasing the funding"] [0.23231007158756256, 20.746675491333008, "ontribution Decarbonization Actions to the United Nations Sustainable Development Goals71NDC Action Relevant SDG\n9.5The country will protect and conserve 100% of the coastal wetlands included and reported in the \nNational Inventory of Wetlands (in th"] [0.23684853315353394, 20.751041412353516, " with Economic Recovery72NDC Action Relevant SDG\n10Action for climate empowerment\n10.1 In the first two years of the implementation period of this contribution, a national strategy for \nclimate empowerment will be in operation with actions in educati"] [0.2327551245689392, 20.74700927734375, ", SDG10, SDG11, SDG12, SDG13, SDG16, SDG17\n10.5 By 2030, the capacities in mitigation and adaptation to climate change of decisionmakers at different levels of government, as well as community leaders and young people, have been strengthened in a man"] [0.21247652173042297, 20.72703742980957, " 2022, Costa Rica will have established processes and institutional arrangements that allow it to have a permanent capacity for analysis, prospecting, and independent technical publication on climate action. SDG3, SDG5, SDG6, SDG7, SDG8, SDG9, SDG12,"] [0.2301446944475174, 20.752958297729492, "ated, including \nthe platform of the National System for Monitoring Cover and Land Use and Ecosystems (SIMOCUTE) and its link with the National System of Climate Change Metrics (SINAMECC) and other national environmental reporting systems and their s"] [0.2310417890548706, 20.74671173095703, "c Plan as long-term planning instruments aimed at achieving inclusive and decarbonized economic development.SDG1, SDG2, SDG3, SDG4, SDG5, SDG6, SDG7, SDG8, SDG9, SDG10, SDG11, SDG12, SDG13, SDG14, SDG15, SDG16, SDG17\n13.2 The country undertakes to ta"] [0.23619727790355682, 20.74427032470703, "priority adaptation measures are identified for each region, as well as the institutional arrangements necessary for its implementation. SDG3, SDG5, SDG6, SDG9, SDG11, SDG13, SDG14, SDG15, SDG16, SDG17\n13.10 By 2030, adaptation criteria and guideline"] [0.29024457931518555, 20.77657699584961, "ouse UK, 2019.Aghion, Philippe, Jing Cai, Mathias Dewatripont, Luosha Du, Ann Harrison, and Patrick Legros, \u201cIndustrial \nPolicy and Competition,\u201d American Economic Journal: Macroeconomics , Vol. 7, No. 4, October 2015, pp. 1\u201332.\nAyA (Instituto Cost"] [0.30571097135543823, 20.798139572143555, "pandemia,\u201d \nLa Naci\u00f3n , January 20, 2021.\nCosta Rican Ministry of Health, \u201cNational COVID-19 Situation,\u201d webpage, undated. As of December 27, 2021: https://www.ministeriodesalud.go.cr/index.php/centro-de-prensa/noticias/741-noticias-2020/ \n1532-lin"] [0.27291786670684814, 20.751251220703125, "orld \nBank Policy Research Working Paper No. 6677, Washington, D.C.: World Bank, 2013. \nIanchovichina, Elena, Antonio Estache, Renaud Foucart, Gr\u00e9goire Garsous, and Tito Yepes, \u201cJob Creation \nThrough Infrastructure Investment in the Middle East and N"] [0.19325700402259827, 20.763731002807617, "156.\nMazzucato, Mariana, Governing Missions : Governing Missions in the European Union , Brussels: European \nCommission, June 2019.\nMazzucato, Mariana, and Gregor Semieniuk, \u201cFinancing Renewable Energy: Who Is Financing What and Why \nIt Matters,\u201d T"] [0.26406556367874146, 20.758237838745117, " del Plan Nacional de Descarbonizaci\u00f3n 2018 \u20132050 de Costa Rica : \nEstimaci\u00f3n de costos y necesidades para la consecuci\u00f3n de las 24 medidas de descarbonizaci\u00f3n dispuestas en sus \nejes 8, 9 y 10 , Zurich, September 2021.\nState of the Nati"] [0.2715842127799988, 20.764110565185547, "ic, however, led to a sharp increase in unemployment; \nthe number of unemployed workers increased by over 240,000 people between February and June 2020, and the unemployment rate peaked at over 24 percent, exacerbating prepandemic inequities.\nIn this"] [13.158966064453125, 7.463777542114258, "Sponsored by Arnold VenturesProviding Another Chance\nResetting Recidivism Risk in Criminal Background \nChecks\nSHAWN D. BUSHWAY, BRIAN G. VEGETABILE, NIDHI KALRA, LEE REMI, \nGREG BAUMANN\nCORPORATIONFor more information on this publication, visit www.r"] [13.1521635055542, 7.477811336517334, "ch the individual has lived in the community without a new conviction. Given that recidivism risk declines the longer a person lives in a community without a new conviction, risk assessments that omit this information may make people look riskier tha"] [13.157244682312012, 7.476894855499268, " and weaknesses of various kinds of criminal history record searches. We thank reviewers Greg Ridgeway, Matt Cefalu, and James Anderson for suggestions that greatly improved the work. We are enormously grateful to all the workshop speakers and attend"] [13.145627975463867, 7.480035305023193, " and others can use to assess recidivism risk, they may offer a more accurate way to distinguish candidates\u2019 risk of recidivism. Thus, they may offer many with criminal histories a way to demonstrate that they should be offered another chance. \nThis "] [13.151148796081543, 7.472130298614502, "t a conviction. \n\u2022 After a sufficient period without a new conviction, even people initially deemed to be at \nhighest risk for reoffending (such as those with a more extensive criminal background) transition to risk levels that appear similar to thos"] [13.155933380126953, 7.475482940673828, "ermine who actually get hired. Evaluating the hiring threshold also helps anchor the decision relative to current practices\u2014an important feature of any evaluation. viii Implication: Data Quality Can Limit the Development of Successful Recidivism Ri"] [13.154419898986816, 7.476906776428223, "bug but rather a feature of signaling systems that use information to systematically make inferences about an unobservable characteristic, such as recidivism risk or desistance (Bushway and Apel, 2012). ix Implication: Exploring and Stressing Model"] [13.155341148376465, 7.475393295288086, "f techniques and data sources is required before models can be integrated into tools actually used in any given context. For example, we developed our model for the employment context, and therefore designed a model that can be validated under the EE"] [13.088134765625, 7.421588897705078, "................... 25 \nConsideration 2 ....................................................................................................................................... 32 \nConsideration 3 ....................................................."] [13.133739471435547, 7.483523845672607, ".................................................................... 75 \nAbbreviations ................................................................................................................................ 77 References ...................."] [13.143251419067383, 7.490868091583252, "tional Information on Example 1\u2019s Criminal \nDemonstrating Offense Codes That Occur Through Time ................................................... 62 \nFigure A.3. Example 2 of an Individual\u2019s Sentencing History, Including \na Subset of Covariate In"] [13.153186798095703, 7.477766990661621, "pproaches can ignore valuable information that a person has signaled about their propensity, or lack thereof, to reoffend between the time of their last major interaction with the criminal justice system and when they apply for a job. The predictive "] [13.19300365447998, 7.485272407531738, "trictions than individuals who do not have records (Pager, 2003; Pager, 2007). Most employers report that they would not knowingly hire applicants with criminal records (Pager, 2007). Employers also worry about legal liability if the job candidate go"] [13.153485298156738, 7.47942590713501, "d information be used to differentiate between applicants with \nrecords in terms of their levels of recidivism risk? \nThe answer to the first question is undoubtedly no (Bushway, Nieuwbeerta, and Blokland, 2011; \nEEOC , 2012). The answer to the secon"] [13.152487754821777, 7.480573654174805, "lid ones that motivate employer decisionmaking. \nTo help readers understand the potential effect of our ideas on how background checks \nshould be conducted, we introduce a hypothetical employment scenario grounded in actual 4 reentry policy. Suppo"] [13.142391204833984, 7.475363254547119, "the use of predictive risk models in \nthis context. A statistical tool used to eliminate some subjective human biases could unintentionally perpetuate other unfair practices and biases. Even algorithms designed to avoid unfairness can result in inequ"] [13.153136253356934, 7.497137069702148, "021 (when we \ndownloaded the data). Table 1.1 shows an overview of the files used and their relevant information. \n \n \n3 See NCDPS, undated -a. This portal provides access to the data files , which can be downloaded for research \npurposes : \nThe fi"] [13.16060733795166, 7.47614860534668, "cks. This workshop featured a speech by EEOC chair Charlotte Burrows and a series of discussions about this report. Chapter 7 discusses the implications of this report and points for policymakers to consider as they move forward with new policies on "] [12.804147720336914, 3.622689723968506, "entary ranking of risk among people with different risk factors. The most formal form of this approach is a risk score known as the Burgess tool (Burgess, 1928). The approach makes no claim that the given factors are strictly predictive in any partic"] [13.1580171585083, 7.471229076385498, "riminal history information to predict risk is framed by the \nfederal regulations arising from the Civil Rights Act of 1964. Title VII of this act prohibits employment practices that have a disparate effect on minorities, unless the employer can show"] [13.157992362976074, 7.477888584136963, "trix to produce a recommendation about whether to hire someone. This recommendation can often be adjusted by an expert within the hiring company who is tasked with making the final decision. In general, this approach meets many of the objectives of a"] [13.163713455200195, 7.481386184692383, "b was performed without \nincident following the most recent conviction \n5. evidence of rehabilitation and references \n6. participation in a government bonding program. \nThe EEOC\u2019s new guidance further notes that, where a plaintiff in litigation es"] [13.160096168518066, 7.477553367614746, " studies that assess whether convictions are linked to future \nbehaviors, traits, or conduct with workplace ramifications, and thereby provide a framework for \nvalidating some employment exclusions, such studies are rare at the time of this draftin"] [13.153168678283691, 7.471161842346191, "representing the employer\u2019s own experience and the criminological literature assessment of relative risk. A cutoff point would then be set, allowing anyone who received a risk score below that cutoff to be hired and moving those with a score above th"] [5.791506767272949, 3.831019878387451, "rsonnel selection psychology (American Psychological Association, 2018). These tests could \nbe then statistically linked to outcomes using the three kinds of validity checks described in the Uniform Guidelines on Employee Selection Procedures written"] [13.163392066955566, 7.458090782165527, "iction models of the kind currently in use, and the guidelines should be updated to reflect this new approach (Maurer, 2020). \n \n7 The Uniform Guidelines identif y construct validity as a distinct validation approach. Construct validity involves \nt"] [13.139835357666016, 7.459144115447998, "2016). The second deals with transparency. Regarding the first, a broad concern around algorithmic hiring tools is that measures of job performance in discriminatory workplaces will be biased. Creating tools that predict job performance in discrimina"] [13.142322540283203, 7.483068466186523, " able to consider the relative risk of a new conviction over some period both for people who have just been convicted and for people who were convicted many years ago. \nThis principle is easy to state and explain but surprisingly difficult to impleme"] [13.12304973602295, 7.480645179748535, "methods from \nstatistics known as survival analysis or, more generally, time-to-event analyses. To help readers understand simple ideas from survival analysis, we will provide a brief primer on concepts via figures in the remainder of the report. \nA"] [13.127419471740723, 7.487039566040039, "ine event .\u201d That is, typical survival functions evaluate risk only as anchored from the \nbaseline event. This figure represents the one -year survival probability . \n 19 Now consider the goal of comparing the risk level of individuals A and B usi"] [13.129697799682617, 7.482110500335693, " baseline. The last graph demonstrates \nhow, with differing times for when their respective background check s occur, individual A is now slightly lower risk \nthan individual B. \n 21 Demonstrating the Reset Principle in the North Carolina Data Set"] [13.129363059997559, 7.486226558685303, "t, if we consider risk, two individuals may now represent equivalent \nrisk if we match them on their prior number of convictions and respective update times. This \nmeans the risk profiles of individuals with more than ten prior convictions may look s"] [13.136289596557617, 7.475608825683594, " context to the literature. The primary considerations are outlined in Figure 4.1, and many should be intuitive to those familiar with research design. \nNote that the last estimation consideration, which focuses on the external validation of the \nri"] [13.141681671142578, 7.486024856567383, "l. , 2014, posited the choice of population as p erson -based v ersus event- based \nsamples but is only part of the estimation problem. As a result, although we use Rhodes et al., 2014, as an exemplar \nfor the idea that population matters, we start "] [13.1400785446167, 7.487250328063965, "though this ideal setting is clearly impossible to obtain (for both \nimplementation reasons and obvious ethical concerns), a failure to attempt to construct a sample \nto estimate models as similar as possible to this ideal setting can lead to bias or"] [13.129772186279297, 7.494494438171387, "how risky specific individuals are for any \n 29 given opportunity.4 Additionally, it allows us to assume that we are following a specific \u201cgroup\u201d \nof independent individuals through time, as we will only observe their events. \nTo further demonstrate"] [13.138068199157715, 7.491706848144531, " in prison or jail are generally not facing background checks by employers, volunteer organizations, or landlords. Unfortunately, this reasonable consideration creates a difficult data requirement. Most formal state criminal record repositories (i.e."] [13.135290145874023, 7.487921237945557, "owest risk, but there are no longer flat spots in the estimated survival function. We caution readers not to take away a causal relationship between length of sentence and risk profile at a given point in time from this figure; the differences among "] [13.175228118896484, 7.47150182723999, "lected in data from discriminatory environments. The criminological literature is quite clear that there is less evidence for racial bias in convictions than in arrests. It is now a routine finding that white people are more likely to be convicted af"] [13.097743034362793, 7.5110697746276855, " an \nupdated one-year survival probability requires at least ten years of data. An inspection of the \nNorth Carolina data demonstrates that this choice has at least face validity. Additionally, a closer look at Figure 4.7 shows that the survival curv"] [13.127931594848633, 7.496335506439209, "demonstrate the validity of our modeling approach to creating estimates that could be used in the background check context. It is important to note that we acknowledge that there are other approaches and models that could also be created to follow th"] [13.103147506713867, 7.4818878173828125, "in the machine learning community (Bennis, Mouysset, and Serrurier, 2020; Eri\u015fo\u011flu, Eri\u015fo\u011flu, and Erol, 2011; Kuo and Peng, 2000; Nagpal et al., 2019; Raman et al., 2010). These models create estimates through a weighted average of many underlying fu"] [13.112154006958008, 7.480288505554199, "ellow, Bengio, and \nCourville, 2016, chapter 5, for a methodological introduction to machine learning basics, and Hastie, Tibshirani, and Friedman, 2009, chapter 7, for a thorough overview on model assessment and selection). \nReaders might note that "] [13.112659454345703, 7.489264011383057, "different points in time for each \ndata set to illustrate performance of the estimated risk scores through time. The \ud835\udc50-index is a \nmeasure of discriminatory ability of a risk score and provides an assessment of the number of \u201cconcordant pairs\u201d when c"] [13.112161636352539, 7.488999366760254, "re the survival probability is also 0.5. The results also present variation in predictions across wide time ranges. See Appendix D for additional calibration curves for one-year, ten-year, and 20-year survival probability estimates. 40 Figure 5. 2"] [13.13760757446289, 7.490816593170166, "ic groups of columns as presented in the rest of the table. We see that current prison information changes performance the most (about 8 percent decrease in performance), followed by information related to current number of conviction s \n(about 6 per"] [13.166252136230469, 7.470172882080078, "al background checks. \nIn the employment context, the additional factors not included in the first step of the formal \nbackground check are brought into play through an appeals process initiated by a person challenging an employment decision. It can"] [13.17184066772461, 7.470315456390381, " of background checks. Charlotte Burrows, \nchair of the EEOC, then delivered the keynote address, which is summarized in the next section of this chapter. Nina Hicks, the Detroit director of the Center for Employment Opportunities, provided insight a"] [13.163406372070312, 7.477983474731445, " the hiring process? \n\u2022 How can information generated during the time gap between a candidate\u2019s last conviction \nor release from prison and when a candidate applies for a job be used to improve \nemployers\u2019 understanding of a candidate\u2019s recidivism ri"] [13.159052848815918, 7.473174095153809, "said that, in order for risk-prediction models that adhere to \nthe reset principle to succeed, innovation is needed in the data and policy environments. These discussions highlighted concerns about data quality that were not featured heavily in this "] [13.153367042541504, 7.476875305175781, "sfy the reset principle). Current record-compilation efforts focus on finding out when the offense occurred, and there is not currently a policy motivation to look beyond that. The industry itself, she explained, does not have the experience or the d"] [13.157052993774414, 7.476038455963135, "sk (Bushway and Kalra, 2021), then risk assessment itself is not the key to solving the problem. Instead, the goal needs to be structuring negligent hiring liability so that companies can tolerate more risk in their hiring practices. \nRegarding fact"] [13.16114616394043, 7.474641799926758, "en case. The court recognized the three main factors that should be used by employers when considering a candidate with a criminal record history: type of job, type of crime, and time since last conviction. \nLopez asserted that this research was impo"] [13.207694053649902, 7.449182987213135, "l history records. \n 50 Table 6.1. Workshop Agenda \n11:00 a.m. Welcome Remarks \nLee Remi, project m anager, RAND Corporation \nShawn Bushway ( https: //www.rand.org /about /people/b/ bushway_shawn.html ), senior policy \nresearcher, RAND Corpor"] [13.167101860046387, 7.4725728034973145, "loyers and Employees \n Moderator: Esta Bigler (https: //www.littler.com /people/ rod-m-fliegel), d irector, Labor and \nEmployment Law Program, Cornell School of Industrial and Labor Relations \nPanelists: \nRod Fliegel (https: //www.littler.com /p"] [13.136754989624023, 7.470455646514893, "olunteer screening. In Chapter 4, we discussed empirical considerations for researchers interested in building a risk-prediction model. In Chapter 5, we demonstrated the viability of creating a risk-prediction model that respects the reset principle "] [13.157661437988281, 7.471296310424805, "riginally high-risk individuals can signal to employers through their behavior after a conviction that they are actually less risky than others. \nModels Can Be Used to Predict Risk of a New Conviction \nThe EEOC worried that it would be impossible to "] [13.153303146362305, 7.467907905578613, " individuals. \nThe next step is for an employer to define whether the level of risk is acceptable or low enough \nfor a particular job. Recidivism risk models do not include characteristics of the job as a parameter because recidivism risk is not job-"] [13.150222778320312, 7.4620771408081055, "e same throughout the \nentire distribution of risk, a situation that is unlikely to occur. 55 of model we developed requires a comparison with the current state. We discuss this issue in the \nnext section. \nData Quality Can Limit the Development "] [13.148557662963867, 7.480379581451416, "or the Criminal Justice Administrative Record System \n(CJARS), an effort to combine administrative criminal justice data with data from the U.S. Census Bureau . The \nresearchers who built CJARS have had to address many of the same issues that we add"] [13.150955200195312, 7.485434532165527, "nce is \u201cThe Time That Has Passed Since the Offense, Conduct and/or Completion of the Sentence\u201d (EEOC, 2012). There is no discussion about what the relevant frame of reference is or whether this information was available, but in the end, the lack of i"] [13.15237808227539, 7.44289493560791, "art, on the job. If these characteristics are static, then there will be nothing that the applicant can do except wait. However, if dynamic characteristics are included, then applicants interested in employment could take steps to reduce their percei"] [13.169629096984863, 7.462362766265869, "need for new tools is urgent given the number of people who have convictions in the United States, and we look forward to an active discussion about the fairness and equity of models and tools anchored in the reset principle. \nRisk of Recidivism Is N"] [13.140654563903809, 7.483410835266113, " frames, modeling architecture, and variable measures initially created for the criminal justice context rather than the background check context. This report\u2019s development of the reset principle makes a clear statement that there needs to be a new s"] [13.1388521194458, 7.492809295654297, "history data: \n1. How convictions \u201ccluster\u201d on particular days and how this affects analysis. \n2. How the longitudinal structure of the data necessitates complex decisions in defining \ndifferent discrete \u201cevents\u201d (conviction, release, etc.) and conti"] [13.136636734008789, 7.501410484313965, "er precision for predicting an individual\u2019s time to their next conviction. \n \n3 Although these figures demonstrate many events for each individual, we note that many individuals actually have \nonly one sentencing record in the data set (a fact tha"] [13.139236450195312, 7.494417190551758, " arises related to time spent in county jail rather than state prison: The NCDPS data sets do not contain direct information on county jail incarceration. This problem will appear in many data sets and may cause issues for accurately quantifying risk"] [13.14460277557373, 7.495485782623291, "For example, in the criminal justice system, sen tences often may be \nsuspended and a conviction will not immediately send an individual to prison (see third row of Figure A.5). How we choose to define events, transitions among states, and timing bet"] [13.131590843200684, 7.482346057891846, "re split into different levels (I through V) to capture the severity of the offense. Such alterations in scope and distinctions of offenses are expected to continue sporadically through time as laws and norms change in society. These changes can caus"] [13.12395191192627, 7.488767623901367, "as \ud835\udc46!(\ud835\udc61), and represent the \nprobability that the next event time occurs after some time as \ud835\udc61, i.e., \ud835\udc47!>\ud835\udc61, from a baseline \nevent. This is represented mathematically as \ud835\udc46!(\ud835\udc61)\u2261Pr(\ud835\udc47!>\ud835\udc61). \nIn the case of the criminal background-check context, survival f"] [13.112290382385254, 7.486868381500244, "reshold of acceptable risk \n\u211b9? This last query may be similar to what was \ndesired in El v. SEPTA, an absolute standard of risk (Douglas El v. Southwestern Pennsylvania \nTransportation Authority, 2005), and could prompt a future policy discussion ab"] [13.066884994506836, 7.524036884307861, "es that are similar to this form of the model that allow both \ncomponents to be functions of \ud835\udc65, but we do not consider them here. \nTo estimate the weights \ud835\udc64\"(\ud835\udc65|\ud835\udefe), we used neural networks (see Goodfellow, Bengio, and \nCourville, 2016, for a methodol"] [13.138347625732422, 7.494354248046875, "s were estimated on a subset of data from the NCDPS data set. \nThe data are restricted to those events occurring after 1995 until April 8, 2021 (when the data were downloaded), events for individuals who are between 18 and 70 years of age, and people"] [13.150559425354004, 7.495819568634033, " date \nCurrent event \ninformation Convictions on date Number of convictions that align on this event date \nNumber of felonies Of the number of convictions, how many were felonies? \nNumber of \nmisdemeanors Of the number of convictions, how many w"] [13.11435317993164, 7.47276496887207, "exual assault \nViolation of sexual offense conditions \nWeapons offenses \nWorthless checks \n \n 75 Appendix D . Additional Model Calibration Curves \nAs described in the main body of the report, calibration assesses how well probability \nestimate"] [14.191635131835938, 3.696457862854004, ".pdf \nBarocas, Solon, and Moritz Hardt, \u201cNIPS 2017 Tutorial on Fairness in Machine Learning,\u201d paper \npresented at NeurIPS 2017, Long Beach, Calif., December 4, 2017. As of November 30, 2021: https://fairmlbook.org/tutorial1.html \nBarocas, Solon, and "] [13.22297477722168, 7.471017837524414, "2d 1290 (8th \nCir. 1975), U.S. Court of Appeals, 8th Circuit, July 23, 1975. As of November 30, 2021: https://casetext.com/case/green-v-missouri-pacific-railroad-company \nBurgess, Ernest W., \u201cFactors Determining Success or Failure on Parole,\u201d in Andr"] [14.187116622924805, 3.6875317096710205, "7, 2013, pp. 971\u20131005. As of November 30, 2021: https://core.ac.uk/download/pdf/151523478.pdf \nCorbett-Davies, Sam, Emma Pierson, Avi Feller, and Sharad Goel, \u201cA Computer Program Used \nfor Bail and Sentencing Decisions Was Labeled Biased Against Blac"] [14.183963775634766, 3.683807373046875, "big-data-workplace-examining-\nimplications-equal-employment/dunleavy%2C%20phd \nDwork, Cynthia, Moritz Hardt, Toniann Pitassi, Omer Reingold, and Richard Zemel, \u201cFairness \nThrough Awareness,\u201d Proceedings of the 3rd Innovations in Theoretical Computer "] [14.024701118469238, 3.7246720790863037, "ications,\u201d Crime and Delinquency, Vol. 52, No. 1, January 2006, pp. 178\u2013200. As of April 19, 2021: https://doi.org/10.1177/0011128705281748 \nGriggs v. Duke Power Co., 401 U.S. 424 (1971), U.S. Supreme Court, March 8, 1971. As of \nDecember 2, 2021: ht"] [13.122323989868164, 7.4506940841674805, ", and Melvin L. Moeschberger, Survival Analysis: Techniques for Censored and \nTruncated Data, 2nd ed., New York: Springer-Verlag, 2003. As of November 30, 2021: https://www.springer.com/gp/book/9780387953991 \nKuo, Lynn, and Fengchun Peng, \u201cA Mixture-"] [14.130979537963867, 3.7306129932403564, " 2010. As of December 1, 2021: https://www.prisonpolicy.org/scans/sp/Justice-for-All -Challenging-Racial-Disparities-in-the-\nCriminal-Justice-System.pdf \nMaurer, Roy, \u201cAI-Based Hiring Concerns Academics, Regulators,\u201d Society for Human Resource \nManag"] [14.170586585998535, 3.717623710632324, "er/files/pager_ajs.pdf \nPager, Devah, Marked: Race, Crime, and Finding Work in an Era of Mass Incarceration, \nChicago: University of Chicago Press, 2007. \nPennsylvania Commission on Sentencing, Interim Report 4: Development of Risk Assessment \nScale"] [13.291739463806152, 7.503108024597168, "r Uggen, Jason Schnittker, Melissa Thompson, Sara Wakefield, \nand Michael Massoglia, \u201cThe Growth, Scope, and Spatial Distribution of People with Felony Records in the United States, 1948\u20132010,\u201d Demography, Vol. 54, No. 5, 2017, pp. 1795\u2013 88 1818. As"] [13.296045303344727, 7.49995756149292, " 42, The Public Health and Welfare; Chapter 21, Civil Rights; Subchapter VI, \nEqual Employment Opportunities; Section 2000e-2, Unlawful Employment Practices. As of December 2, 2021: https://www.law.cornell.edu/uscode/text/42/2000e-2 \nU.S. Code, Title"] [18.760906219482422, 17.19130516052246, "Sponsored by the National Institute of Standards and TechnologyThe National Institute \nof Standards and Technology\u2019s Impact on Fire Safety Standards\nBENJAMIN M. MILLER, TOM LATOURRETTE, DRAKE WARREN, DAVID METZ\nC O R P O R A T I O NFor more informati"] [18.75876235961914, 17.195831298828125, "T\u2019s research contributing to p articular fire \nsafety standards. The original ob jectives of the project were to (1) document the role of the NIST \nin the standards development pro cess, (2) estimate the value th ese standards provide to society, \na"] [18.76056671142578, 17.192520141601562, "....................................................................................................... xv \n1. Introduction ............................................................................................................................."] [18.737064361572266, 17.193647384643555, "........................................................................... ........................... 37 \n5. Wildland-Urban Interface Standards ......................... ............................................................... 38 \nCase Stu"] [18.761640548706055, 17.19341278076172, "y\u2019s Fire \nResearch Division ............................................. ...................................................................... 8 \nFigure 2.2. Standards Development Organizations\u2019 Roles Held by Researchers in the \nNational Institu"] [18.73201560974121, 17.22403335571289, ".......... 50 \nFigure 6.4. Average Year Built f or Single-Family Homes ........ ................................................... 52 \nFigure 6.5. Number of Decades Represented by the Year Housing w as Built ............................. 53 \nFigu"] [18.75247573852539, 17.200170516967773, "ne of Key Wilder ness Urban Interface Codes ... ................................................ 41 \nTable 5.3. The National Institut e of Standards and Technology\u2019s Involvement in Wilderness \nUrban Interface Standards Develo pment Organization (an"] [18.761735916137695, 17.194353103637695, "ds. This report pr esents results for the first two \nobjectives. Given that NIST\u2019s contribution is one of several in puts combining to create these \nstandards, NIST\u2019s share of the credit for their value could not be quantified. \nOur analysis focus"] [18.758563995361328, 17.19878578186035, "t and perfo rmance. One area of research \nfocused on revisiting smoke ala rm design and testing in light o f the shift to the use of largely \nsynthetic materials in upholstered furniture versus natural fur nishing materials for which early \nsmoke al"] [18.74619483947754, 17.204736709594727, "sance alarms, as well as test ing requirements, system \ninterconnection, notifi cations targeting ch ildren, and other topics. A nationally representative \nsurvey of American h ouseholds conducte d by RAND in March 2020 f ound that 36 percent of \nhou"] [18.741958618164062, 17.21213722229004, "ng the 2018 \nCamp Fire in Paradise, Californi a. Our results suggest that the survivability of houses has \ngenerally been improving over time . This result is consistent w ith steady improvements in \nstandards and the associated cha nges in building"] [18.760461807250977, 17.195674896240234, "he active researc h stages, and the biggest benefits are likely yet to be \nrealized. In both cases, we disc uss clear evidence of steady sa fety improvements over time and \nsuggest that those steady improve ments may be largely or partly attributed"] [18.75611686706543, 17.197629928588867, "ata at truly astounding speed. \nWe again find ourselves thanking NIS T staff, David Butry and Douglas Thomas, who shared \ncode and insights from their wor k, which served as an inspiration for our approach to weighting \nNFIRS responses. On the WUI si"] [18.76045036315918, 17.19514274597168, "it as the U.S. g overnment\u2019s primary agency for shaping and \ninfluencing the development of m easurement stand ards, both nati onally and internationally. \nAs evidenced in this r eport, NIST plays a un ique and critical r ole in the development of \n"] [18.754981994628906, 17.196945190429688, "day-to-day life. Standards affect food production, \ntransportation services, building design, and consumer products and services of all types. For more \nthan a century, national and international SDOs have been developing detailed specifications an"] [18.754533767700195, 17.192243576049805, "rocesses and production methods, and related managemen t systems practices.\u201d \nWhile NIST develops standard ref erence materials internally, in general its research in the \ndevelopment of standards suppor ts the development of voluntary consensus sta"] [18.756486892700195, 17.197566986083984, " competitiveness, and effici ency. In some cases VCSs are \nadopted internationally. In addition, VCSs are often incorporat ed into government regulations \nsuch as building codes or other le gal instruments, thus shiftin g a voluntary standard to a \nm"] [18.75892448425293, 17.196012496948242, "o Economic Impacts \n \nstandards development process as well. Other federal government agencies, as well as state and \nlocal government entities, often provide subject matter experti se or technical knowledge on \nstandards related to their mission or"] [18.757946014404297, 17.196813583374023, "upled together\u201d (Gross, 1991, p. 119).4 Foreshadowing its con tinued standard-based \napproach for add ressing fire safety challenges, NIST worked wit h NFPA to create a national \nstandard for couplin g hoses and fire hydrants. In 1914, a Fire Resista"] [18.77802276611328, 17.17877197265625, "ams at NIST and also established the \nNational Commission on Fire Pr evention and Control. In 1973, the commission published its \nfamous report, America Burning, which included several reco mmendations related to expanding \nfire research at NIST.6 T"] [18.762741088867188, 17.193466186523438, "4, including \u201cnew standards on firebrand penetration of vents; firebrand ignition of \nroofing, siding, window glazing, and decks; window vulnerabilit y to firebrand assault\u201d (Hamins et al., 2012). The \nsecond is replacing or improving test methods f"] [18.76616096496582, 17.19028663635254, "RAND survey of researchers in NIST Fire Research Divisi on, September 2019. \nRAND spoke with representatives from NFPA, ASTM, Underwriters Laboratories, and ICC \nabout their standards development procedures and NIST\u2019s involve ment, obtained and revie"] [18.7828426361084, 17.173765182495117, "ess, \npresent research findings at SDO events, and communicate with S DO committee members about \nstandards. Figure 2.4 shows res ponses from our survey of the nu mber of NIST Fire Division \nresearchers who have submitted for mal proposals, revisions"] [18.767438888549805, 17.18914222717285, " 1 0 1 2 1 4 1 6Less than 1 year1 to 3 years3 to 5 yearsMore than 5 years \n13 Division includes over a dozen current sta ff who have been enga ging with SDOs for more than \nfive years, and emeritus staff al so have a lengthy record of en gagement wit"] [18.762773513793945, 17.193462371826172, " unique \norganization, with other research organizations often benefitin g from that work. \n \n14 3. Smoke Alarm Standards \nAs introduced in Chapter 1, two of the case studies we used to examine the impacts of fire \nsafety standards focus on standar"] [18.759611129760742, 17.1970272064209, " to a broad er understanding of the benefit of home smoke alarms, their \nwidespread adoption, and developmen t of the first smoke alarm d evice standard. Table 3.1 \nsummarizes several important stu dies and milestones, which are discussed below. \nAn "] [18.75977325439453, 17.197086334228516, "he next few years showed remarkable benefits from the smoke al arms\u2019 installation: while the \nnumber of fires was no different f rom expected fire rates for m obile homes without smoke \nalarms, the number of deaths and injuries from these fires was f"] [18.760711669921875, 17.196842193603516, "is further bolstered the ca se for the benefits of \nsmoke alarms. \n\uf0b7 the observation that smoke alar ms on the second floor of a home had marginal performance \nfor fires on the first floor. At the time of the tests, the sta ndard on smoke alarm plac"] [18.765544891357422, 17.19154167175293, "ial smoke alarms, which revealed the need for a device standard. Although \ntechnically at UL at the time, Richard Bukowski worked with NIS T (and in residence at NIST \nfor part of the time) on smoke alarm research that led to the d evelopment of UL "] [18.766756057739258, 17.1905574798584, "e Event NIST Role Impact \n2000\u20132004; \n2008 Home Smoke Alarm Tests\n Research experiments on smoke alarm performance \nwere conducted from 2000 to \n2002; NIST published the \noriginal report in 2004, and a \nrevised version in 2008 Measurement of smoke p"] [18.787538528442383, 17.17038917541504, "nsitivities of photoelectric and \nionization detectors to smolder ing and flaming fires, respectively. Performance of commercially \navailable smoke alarms of either type was nonetheless generally sufficient to provide adequate \nescape time. \nA sec"] [18.764713287353516, 17.192407608032227, "ff and \nresearch were central to their work. The process was marked by disagreement among the UL 217 \nStandard Technical Panel members, and multiple proposals failed . NIST research, particularly \nby Cleary (2014), played a pivotal role in reaching "] [18.802658081054688, 17.15508270263672, "ot allowed withi n 3 feet of a door to a kitchen or bathroom containing a shower or tub \n\uf0b7 Smoke alarms not allowed within 3 feet of supply registers of a forced air heating or cooling system \n1999 NFPA 72 \n\uf0b7 If within 20 feet of a cooking appliance,"] [18.769378662109375, 17.188032150268555, "researcher Richard Bukowski was an active member of the UL 217/268 Standard Technical \nPanel and of NFPA 72 Technical Committees throughout his career, starting in the 1970s until \nhis retirement in the late 2000s. Thomas Cleary of NIST phased into"] [18.778167724609375, 17.181108474731445, "esearch reports have been cited in NFPA 72 since 1990. \nConclusion \nNIST research and other activit y summarized in Tables 3.1, 3.3, and 3.5 provided important \ncontributions to our understanding o f the effectiveness of smok e alarms, the developme"] [18.754911422729492, 17.201921463012695, " enforced, and effective, their \nadoption is of no consequence. \n \n14 Most building codes apply to new construction only, so they wo rk their way into the building stock through \naddition or replacemen"] [18.75909996032715, 17.198305130004883, "ectiveness Gradi ng Schedule is available at Thomure (undated). \nMore information about ISO\u2019s meas ure of states\u2019 fire protection capabilities is available at ISO (undated), \n16 See also IBHS (undated a). \n17 See also IBHS (undated a). \n27 This app"] [18.7489070892334, 17.207860946655273, "or infers that this so mewhat surprising finding results from occupants preferentially \n \n18 As long as the number of fatalities per fatal fire is the same in cases with and without smoke alarms, both "] [18.75963020324707, 17.197463989257812, "for \nexample, factors other than smoke alarms that influence the ris k of fire fatalities (e .g., construction, \n29 furnishings, occupant behaviors) differ systematically between homes with and without smoke \nalarms, then the actual effect of smoke "] [18.75853157043457, 17.1971492767334, "\u2014was first published in 1945 by \nthe Southern Building Code Congress International and used main ly in the southern states. The Building Officials \nConference of America, later know n as the Building Officials an d Code Administrators International, "] [18.758718490600586, 17.19881820678711, "s to answer the following question: Are more c urrent smoke alarm \nstandards in statewide minimum building and residential codes associated with improved fire \noutcomes? To answer this question, we examine the relationship between the smoke alarm \n"] [18.740577697753906, 17.215234756469727, "dopted those standards into their statewide \nbuilding codes. Further, because building codes are rarely retroactive, the proportion of a state\u2019s \nhousing stock built after the code was adopted serves as a reasonable proxy for the proportion of \nhouse"] [18.737333297729492, 17.217723846435547, "tandards. \n23 We are unable to do a within-sta te analysis for two reasons. First, individual localities sometimes have additional \ncode requirements beyond the state level, and there is no datab ase documenting how thes e local codes change over \nti"] [18.73393440246582, 17.2225399017334, "mes increased. The increase in low-severity \nfires (i.e., fires confined to t he object of origin) is surpris ingly large. An incre ase in the number \nof low-severity fires would not be s urprising if there was a co rresponding decrease in high-\nseve"] [18.737178802490234, 17.217655181884766, "rtion of houses subject to statewide \nminimum residential building code updates correla tes with stati stically significant reductions \n(or increases) in the number of f ires, injuries, or fatalities reported to NFIRS. We speculate that \nthese res"] [18.760791778564453, 17.19690704345703, "t o f 2,389 for Q2 (only asked if the respondent \nanswered \u201cYes\u201d to Q1), 2,386 ou t of 2,389 for Q3 (only asked if the respondent \nanswered \u201cYes\u201d to Q1), and 2,484 out of 2,488 for Q4. \nAs we speculated previously, one reason we find no evidence of"] [18.758913040161133, 17.19870376586914, "by events such as by certain cooking acti vities\u2014are also common. A \nhomeowner might disable a smoke alarm to prevent these nuisance alarms, such as by removing \nthe smoke alarm batteries. Our ALP survey found that more than one-third of households "] [18.766069412231445, 17.191226959228516, "g code updates is correlated with statistically significant reductions \n(or increases) in the number of reported fir es, injuries, or fa talities. We specul ate that these \nresults may reflect the largest gains having occurred prior to 2003 and the "] [18.762025833129883, 17.1938533782959, "s an extension of its general fire efforts through the \nNational Fire Research Laboratory. NIST WUI work appears to be motivated in part by large \nwildland fires that occurred in the 1990s and early 2000s, such as the 1991 Oakland Hills Fire, the \n2"] [18.76666259765625, 17.190420150756836, "of test methods and apparatuses, such as the NIST \u201c Dragon,\u201d\n which generates \nstandardized firebrands for use in tests. \nAnother line of effort is collecting data on historic fires, ty pically in the immediate aftermath \nof the fire when data are be"] [18.765554428100586, 17.191377639770508, "rand-driven ignition. M ost notably, the ten firebran d generators used during IBHS \nexperiments are based on the des ign of the NIST Dragon, with mo difications to automate fuel \ndelivery (Standohar- Alfano et al., 2017, p. 14). To motivate th e nee"] [18.75617027282715, 17.19820213317871, " focused on requirem ents for structures and other development (e.g., camps) in \nforests. In 1953 it was renamed Fi re Prevention Standards for H omes and Camps in Forested \nAreas, in 1962 it was renamed Rec ommended Good Practice for Hom es and Camp"] [18.753646850585938, 17.198680877685547, "and \nInternational Fire Code by miti gating the hazard of wildfires t hrough model code regulations, \nwhich safeguard the public health and safety in all communities , large and small\u201d \n(ICC, 2014, p. iii). \nIWUIC is a model code providing requireme"] [18.766298294067383, 17.18976593017578, " codes. In 1997, ICC and NFPA agreed to c ollaborate on fire codes, but by 1999 t he agreement had ended in \nlawsuits between the two organi zations and real ignments of them . In the aftermath IC BO acquired full rights to IFCI \ncodes, and IFCI appa"] [18.761655807495117, 17.194263458251953, "enced those SDO\u2019s efforts since at least the late 1990 s. Past NIST work specifically \nfocused on WUI codes and standards by leveraging NIST researche r participation on SDO \ncommittees and sharing NIST resear ch results in forums such as NIST-led w"] [18.753053665161133, 17.20016098022461, "N/A 2015\u20132017d \nASTM Various standards Subcommittee E05.14 on \nQuantification of Exterior \nFire Exposures Member N/A As of 2019e \nISO N/A (technical report \nin development) ISO Technical Committee \n92 Working Group 3 (ISO/TC 92/WG 14) on \nLar"] [18.74325942993164, 17.21259117126465, "d Codes \n \nEstimating the causal impact of standards and codes in reducing wildfire damages, injuries, \nand fatalities is difficult for several reasons. First, complia nce with and enforcement of building \ncodes may vary. Second, it is not always c"] [18.74730110168457, 17.206029891967773, " \nthe design of buildings that ignited with those that survived. Collection of such data could greatly improve the development of WUI standards identifying specific b uilding designs that support \nhousing survivability in wildfires. \nPrevious Studies"] [18.7436580657959, 17.212831497192383, "d versus only 18 percent of the homes built prior to 2008. \nThe Kasler and Reese analysis i s illuminating since it used a l arge number of observations \nfrom a complete population of str uctures. An important limitati on of their analysis is that it"] [18.739965438842773, 17.21590232849121, "re smoke and unburned can opies may obscure aerial views \n(see Kolden and Wiesberg, 2007, pp. 23\u201324, 29\u201330). Errors in th e fire perimeter seem less \nlikely once the fire has been c ontained, especially in develope d areas, where houses are closely "] [18.74022674560547, 17.215959548950195, "ounts and Damage Lev els of Houses in the 2018 Camp Fire \n Year Built \nBefore 2008 2008 or Late r\nPermanent homes: undamaged 1,790 138 \nPermanent homes: partially damaged 401 31 \nPermanent homes: destroyed 9,525 143 \nPermanent homes: total 11,716 312"] [18.74226951599121, 17.214197158813477, "may be correlated with factors \nthat affect survivability be yond building construction or desig n. Factors such as topography, \nvegetation, and housing density (which can depend on lot size) all affect the probability of a \nhome\u2019s survival, and thes"] [18.745344161987305, 17.210527420043945, "area are largely assessed \nto be very high risk, while most of Paradise is high to very hi gh risk. Areas directly east and west of Paradise, where \nmany of the more isolated homes t end to be located , are largely assessed as moderate risk . CAL FI"] [18.741071701049805, 17.215173721313477, "ty (Marangh ides, et al., 2015). These studies \nwere further validated when the C amp Fire was observed as sprea ding from structure to structure \n(Curwen and Serna, 2018). \nHowever, low density can also be associated with risks. Syphard et al. (20"] [18.73903465270996, 17.216318130493164, "ors with \ndifferent outcomes that fell ac ross cell boundaries. Another st rategy suggested by a reviewer that could be pursued \n \n55 Figure 6.6. Density of Single-Family Housing \n \nNOTES: Density is calculated as the number of single-family hou ses"] [18.744403839111328, 17.209091186523438, "uals. We refer to these \ntwo approaches as a \u201cstatic\u201d mode l and a \u201crecursive\u201d model. We present both approaches \nbecause neither is inherently superior to the other. \nThe static model treats the unobs erved local risks proxied by n eighboring houses"] [18.739059448242188, 17.216236114501953, "r observation, the probit must be calculated using a simultaneous \nequations approach, which essentially iterates over possible co efficient values until it converges \non a stable solution. The main benefit of this approach is that it accounts for c"] [18.741252899169922, 17.214874267578125, " s urvivability between the 1950s \nand 2000s, then a reduction in survi vability in the 2010s. As shown in Figure 6.1, there are fewer \nhouses on which to base estimates prior to 1940 and after 2010. The standard errors on the static \nmodel are espec"] [18.740224838256836, 17.21592903137207, "nstruction (beyond those \nrequired by codes) may change over time in ways that may be cor related with fire risk. \nFor example, a Headwaters Ec onomics/IBHS report on building wil dfire-resistant homes \nrecommended installing weed- and erosion-contro"] [18.742435455322266, 17.213842391967773, "n \nthe Waldo Canyon Fire (Maranghide s et al., 2015). However, this strong correlation between \nneighboring houses\u2019 outcomes could also reflect neighboring hou ses sharing other high-risk \ncharacteristics. Collecting a nd analyzing additional data "] [18.740676879882812, 17.215778350830078, " in our hypothetical estimate) is similar to that of the \nsingle-family homes examined in our analysis. \nTable 6.3 shows that, under these assumptions, the static model estimates the damage \naverted to be $ 600 million if all houses had the same"] [18.755802154541016, 17.19978141784668, "des over time have led \nto (or occurred alongside) changes in building designs and mate rials that have improved the \nsurvivability of houses to fire. However, our results do not find a statistically significant increase in survivability following th"] [18.758752822875977, 17.196910858154297, "activit ies \nNIST research is also instrumental in the development and desig n of standardized tests that \nare used to systematically eva luate technologies and to confirm compliance with standards. \nIndeed, the need for nationally s tandardized met"] [18.766077041625977, 17.19129180908203, "d n eeds-driven approach to selecting resear ch topics, and \nits credibility for conducti ng objective, high quality research make it a crucial contributor in the \ndevelopment of fire safety sta ndards. If NIST were to become un able to perform it"] [18.765426635742188, 17.191457748413086, "rns, please contact Nelson Bryner, Chief of the\nNIST Fire Research Division (nelson.bryner@nist.gov) or Ben Miller, co-project leader at\nRAND (bmiller@rand.org). Thanks in advance for taking a few moments to help us with thisimportant work.\n1.\nHave y"] [18.778432846069336, 17.177656173706055, "oke Alarms\nUsing Scattered Light, Transmitted Light or Ionization (2010)\nNEMA SB-11: Guide for Proper Use of System Smoke Detectors\nNFPA 72: National Fire Alarm and Signaling Code\nNFPA 101: Life Safety Code\nNFPA 1141: Standard for Fire Protection Inf"] [18.72490119934082, 17.21771812438965, "ncident data repor ted in the National Fire Incident \nReporting System (NFIRS) to depict fire activity in non-reporti ng cities.\u201d48 We apply an approach \nthat is similar in spirit, although ours is designed to ensure \u201crepresentativeness\u201d at the indiv"] [18.705488204956055, 17.237770080566406, "90 percent of the 2017 NFIRS records to a \ndepartment, and 75 perc ent of departments to at least one NFIRS record. Of the departments \nthat we can match to NFIRS records , we are able to identify or estimate a headquarters zip code \nfor almost all"] [18.68194580078125, 17.255107879638672, "92 4,066 342.5 \nPercentage owne r-occupied 62% 58% 271.9 \nPercentage vacant 16% 20% 398.4 \n Department Percentage that are a local department 98% 92% 480.1 \nPercentage that are the pr imary agency 33% 17% 663.7 \nPercentage that are a purely volun"] [18.730119705200195, 17.22347640991211, "the number of \ninjuries and fatalities, from th e department level to the state level. The propensity scores \ncalculated in Step 1 of our analysi s are used to construct the probability weights used in this \naggregation.54 Because states vary consid"] [18.736181259155273, 17.21949005126953, "nalysis of the \npotential impact of WUI standards. \n74 Figure B.1. Outliers in the Number of Fires per Capita \n \n \n \nis arbitrary and used for examp le purposes). Some observations clearly stand out as separate \nfrom the rest. For the highest seve"] [18.7371883392334, 17.218753814697266, " r esults for injuries and fata lities with outliers included. Here \nthe coefficients on the number of firefighter injuries per capi ta are larger but still statistically \ninsignificant. The results are again otherwise similar. \nTable B.2. No Stat"] [18.739070892333984, 17.217239379882812, "ires per c apita had radically decreased \nprior to 2003, there is still a slight decrease over time and n otable year-by-year variation in the \nnumber of fires. Year fixed effects ensure we separate safety i mprovements experienced by all \nstates fro"] [18.739377975463867, 17.216997146606445, "ary indicators for the decade in which a house was built, an indicator for whether the home is \npermanent versus manufactured, and measures of \u201cdensity\u201d (the n umber of surrounding homes). \nWe estimate this probit model in two different ways, each o"] [18.739431381225586, 17.21703338623047, "h house, all variables are \nzero except for the decade in which the house was built, which is 1. For example, a house that is \nbuilt in 1984 has \ud835\udc35\ud835\udc48\ud835\udc3c\ud835\udc3f\ud835\udc471980 \u0bdc\u0d4c1, and all other variables are zero. \nThe analysis discussed in Chapter 6 showed that newer h"] [18.748371124267578, 17.208499908447266, "relatively straig htforward. If den sity were not \nincluded separately, the impacts would likely increase the impo rtance of the spatial lag term, \nthereby exaggerating the positive feedback loop. \n \n "] [18.76336097717285, 17.19374656677246, "d Products Using a n Oxygen Consumption Calorime ter,\u201d webpage, undated c. \nAs of November 1, 2019: https://www.astm.org/Standards/E1354 \n\u2014\u2014\u2014, \u201cASTM E2632/E2632M-13 Standar d Test Method for Evaluating the Under-Deck Fire \nTest Response of Deck Mater"] [18.75472068786621, 17.19939422607422, "o logy, \n1455-1, 2008. As of April 2021: https://www.nist.gov/publications/performance-home-smoke-alarms -analysis-response \n-several-available-technologies \nBukowski, Richard W., Thomas E . Waterman, and W. J. Christian, Detector Sensitivity and \nS"] [18.757631301879883, 17.197277069091797, "1986, pp. 445\u2013448. \nC.F.R.\u2014 See Code of Federal Regulations. \nCleary, Thomas G., Improving Smoke Alarm Performance \u2013 Justification for New Smoldering \nand Flaming Test Performance Criteria , NIST Technical Note 1837, Gaithersburg, Md.: \nNational Ins"] [18.744871139526367, 17.205339431762695, ", February 2 020. As of April 22, 2021: \nhttps://www.nfpa.org/-/media/File s/News-and-Research/Fire-stati stics-and-reports/ \nEmergency-responders/osfdprof ile.pdf and https://www.nfpa.org//-/media/Files/News-and \n-Research/Fire-statistics-and-re por"] [18.7471923828125, 17.20333480834961, "ural-Strength-Ex ecutive-Summary_IBHS.pdf \n88 Insurance Institute for Business & Home Safety\u00ae, \u201cPost-Hurrican e Investigations,\u201d webpage, \nundated a. As of April 22, 2021: \nhttps://ibhs.org/wind/post -hurricane-investigations/ \n\u2014\u2014\u2014, Rating the Stat"] [18.74568748474121, 17.203981399536133, "nce , July 7\u20139, 1999, A lbury, N.S.W., pp. 219\u2013225. \nL\u00f6w, Petra, \u201cThe Natural Disaster of 2018 in Figures: Losses in 2018 Dominated by Wildfires \nand Tropical Storms,\u201d Munic h RE, August 8, 2019. As of April 17, 2020: \nhttps://www.munichre.com/topi"] [18.747940063476562, 17.203750610351562, "ber Exposure Zones Using a WUI \nHazard Scale , Gaithersburg, Md.: National In stitute of Standards and Techno logy, Technical \nNote 1748, January 14, 2013. \nMaranghides, Alexander, William Mell, Karen Ridenour, and Derek McNamara, Initial \nReconnaiss"] [18.755186080932617, 17.198514938354492, "ttps://www.nfpa.org/-/media/File s/News-and-Research/Fire-stati stics-and-reports/ \nDetection-and-signaling/Task-Group-on-Smoke-Detection-Followup- Final-Report-July \n-2009.ashx?la=en \n\u2014\u2014\u2014, \u201cNFPA 1141: Standard for Fire Protection Infrastructure fo r"] [18.743385314941406, 17.20732879638672, " and Other L ocal Agencies) F ire Hazard Se verity Zone Maps and \nAdopted State Responsibility Ar ea Fire Hazard Severity Zone Map s,\u201d webpage, undated. \nAs of March 26, 2020: \nhttps://osfm.fire.ca.gov/division s/wildfire-planning-engineerin g/wild"] [18.746353149414062, 17.204517364501953, "ompt roller General of the United S tates, \nWashington, D.C.: Government Accountability Office, PSAD-76-173 , 1976. \nhttps://www.gao.gov/assets/120/117465.pdf \nStandohar-Alfano, Christine D., Heather Estes, Tim Johnston, Mu rray J. Morrison, and Tan"] [18.76538848876953, 17.192411422729492, "Gaithersburg, Md.: \nNational Institute of Standards and Technology, NIST BSS 179, 2 003. As of September 23, \n2021: https://www.nist.gov/publications/building-a nd-fire-research-nb snist-1975-2000 "] [16.066205978393555, 14.450845718383789, "Public Health and Soft Power: The Republic of Korea\u2019s Initial COVID-19 Response and Its Implications for Health Diplomacy BOUEY ET AL.$19.50During the early days of the coronavirus disease 2019 (COVID-19) \npandemic in 2020, the Republic of Korea (ROK"] [16.066421508789062, 14.44792366027832, "rofit, nonpartisan, and committed to the \npublic interest. To learn more about RAND, visit www.rand.org.\nResearch Integrity\nOur mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of qual"] [16.064224243164062, 14.448841094970703, "onal relationship for additional insights and guidance on the analysis. The Korea Foundation provided the funding for the project from 2021 to 2022. The research will be of value to policymakers who are interested in the subject of strengthening soft"] [16.066434860229492, 14.450191497802734, "educe conflicts. In this report, we identify the characteristics of the ROK government\u2019s initial response to COVID-19 and assess how these characteristics might be translated into soft power assets despite the limitations and risks of health diplomac"] [16.066570281982422, 14.451448440551758, "tic tools, establish response plans, and secure human resources for the epidemic control even before the country\u2019s first outbreak. 2. A centralized hierarchical response system to coordinate pandemic resource allocation and risk communication. As soo"] [16.066394805908203, 14.45019245147705, " leverage its success with the initial response to COVID-19 to demonstrate soft power assets that span multiple domains identified by a theory-based soft power index Soft Power 30, including (1) digital resources and technological advancement, (2) pr"] [16.066394805908203, 14.45016098022461, " power through civil society and governmental exchange programs. The ROK\u2019s success in the COVID-19 response illustrates that the democratic system does not necessarily cause disputes over public health mandates. Decentralized civil organization excha"] [16.06614112854004, 14.450082778930664, "VID-19 ......................................................................................... 7\tSix Features of the Initial Response to COVID-19 ................................................................................... 8\tA Sensitive Pand"] [16.065887451171875, 14.449453353881836, "....................................... 26\tConclusion ............................................................................................................................................... 28\t ix Appendix. Methodology ......................."] [16.05864143371582, 14.446418762207031, "idence rate of COVID-19 until the fall of 2020, when the pandemic entered a new stage, with vaccines in the last stages of clinical trials and new variants of the virus spreading. The ROK government\u2019s proactive \u201cthree T\u201d strategy for nonpharmaceutica"] [16.06418228149414, 14.448835372924805, "soft power asset analysis by examining the cultural and health system foundations of the response. Chapter 5 provides policy recommendations. Our approach included a comprehensive literature review of the response in the ROK and a few other Asian co"] [16.063968658447266, 14.44990062713623, "ndex, SP30 added digital media and combines analysis of standard databases and a multicountry polling score. The global polling focuses on subjective impressions of foreign policy, friendliness, culture, technology products, cuisine, livability, and "] [16.0634765625, 14.448180198669434, " States should invest in global health to \u201cstrengthen fragile and failing states, to promote social and economic progress, and to protect U.S. security\u201d (Global Health Europe, 2010). Western democratic allies are not the only nations that have recogn"] [16.064319610595703, 14.448590278625488, "oercion (Shakeel et al., 2019). Similarly, some countries lauded China\u2019s medical team, vaccine, and mask diplomacy efforts during COVID-19 (e.g., Serbia, Italy, Spain, and Netherland), but the efforts caused controversy in others (e.g., Turkey, becau"] [16.066293716430664, 14.449816703796387, "t overall soft power ranking (SP30, 2019).2 According to the SP30 index, between 2016 to 2019, the ROK improved its government subindex related to effectiveness and individual freedoms. Meanwhile, the country\u2019s extensive tourism campaign, led by K-po"] [16.064619064331055, 14.449942588806152, "omestic product contracted by only 1 percent, compared with 5.3 percent in Japan, 3.7 percent in the United States, and 11.2 percent in the United Kingdom. The overall unemployment rate increased 1 percent relative to the estimated rate before the pa"] [16.066051483154297, 14.449675559997559, "ntine and screening at the country\u2019s border expanded, while epidemiologic studies were conducted to trace the contacts of the index case (Moradi and Vaezi, 2020). By January 30, 2020, when WHO first labeled COVID-19 as a public health emergency, the "] [16.066373825073242, 14.449996948242188, "ed; and level 4, the nationwide response system is activated. See Moradi and Vaezi, 2020. 10 distancing, and quarantine (Lee and Lee, 2020). As a result, no national lockdown was initiated, and localized lockdowns were implemented only in highly in"] [16.066057205200195, 14.44997501373291, "pacity had been high pre\u2013COVID-19, and some even considered this to be overcapacity. The ROK\u2019s national health insurance system provides disproportionate reimbursement for the testing in clinical settings, which protects the robust testing infrastruc"] [16.060962677001953, 14.464558601379395, "ing Pandemic Information for the Public Infection Risk to Potential Contacts Contacts Tracing Detection of Imported Border Control and Tracking Voluntary or Involuntary Isolation Cellular Broadcasting Service Artificial Intelligenc"] [16.066577911376953, 14.451258659362793, "erted into temporary clinics as accommodation support centers (also called community treatment centers, residential treatment centers, or living treatment centers) (Yang, Kim, and Hwang, 2020; Kang et al., 2020). Foundations of Success The literature"] [16.066490173339844, 14.451451301574707, "at the ROK\u2019s pandemic response system pre\u2013COVID-19 received higher scores than those of Indonesia and United States in many items. The table also highlights the ROK\u2019s superb readiness in its emergency operation programs and activation mechanisms; its"] [16.067033767700195, 14.450843811035156, " Dynamic listening and rumor management 4 4 4 SOURCES: WHO, 2016; WHO, 2017a; WHO, 2017b; attribute wordings adapted from these sources. NOTES: The scores are 1 = No capacity: Attributes of a capacity are not in place. 2 = Limited capacity: Attrib"] [16.066858291625977, 14.45144271850586, "ith MERS; significant economic power; and a governing style that includes strict penalties for policy violations were contributing factors. Other reports support the ROK\u2019s success in establishing transparent and effective government-public communica"] [16.065988540649414, 14.450778007507324, "Other Asian Countries As a comparison, we also looked into India and Indonesia\u2019s approaches to COVID-19 to reflect on the challenges and barriers for disease containment. Our comprehensive literature review did not provide many in-depth studies on th"] [16.065919876098633, 14.450017929077148, "s, competent government communication and centralized command, a relatively well-trained government and public health workforce, a collective yet democratic culture, and resilience in health care capacity during a crisis. Many of these features could"] [16.066801071166992, 14.450566291809082, "search \u2022 Transferring technology and donating digital devices \u2022 Contributing to regional supply and infrastructure \u2022 Concerns exist about government violation of citizens\u2019 privacy. \u2022 This can be perceived a market coercion or competition. \u2022 Digital "] [16.066648483276367, 14.45054817199707, " could be viewed as working against personal freedom and would not be desirable in some countries. \u2022 Explanations should target the rationale for the collective actions during COVID-19. Engagement activities COVID-19 prompted the ROK to be more engag"] [16.06641960144043, 14.450248718261719, "ss friendliness, and capacity for innovation. One highlight of the ROK\u2019s initial success in responding to COVID-19 is the ample supply of testing kits before the first outbreak in February 2020. The speed of testing kit development, approval, and pro"] [16.066364288330078, 14.450371742248535, " East Asia). However, highlighting such cultural attributes in countries that focus on individual freedom may risk backlash. In stakeholder interviews, experts pointed out that the ROK\u2019s success in technology development and industrialization is wel"] [16.066574096679688, 14.4501953125, "he pharmaceutical and medical device industries, and international collaborations over the long term. Regarding the second concern, while soft power may be on the main agenda of the Ministry of Foreign Affairs, other ministries (Ministry of Health an"] [16.06670570373535, 14.449562072753906, "nd centralized coordination in the face of the COVID-19 pandemic\u2019s destructive path in 2020. The ROK\u2019s COVID-19 response model, which is based on the confluence of communal culture, a strong public health foundation, and democratic institutions, offe"] [16.067556381225586, 14.450789451599121, "edical devices. Vaccine and medical supply manufacturers can collaborate with regional partners to expand vaccine capacity and establish the ROK as a global vaccine production hub. The government can assist multilateral organizations in engaging with"] [16.063892364501953, 14.44979476928711, "presenting the will of the people, and those that favor the rule of law. - While government-sponsored civil organization exchange programs can benefit from the involvement of ROK embassy support, a decentralized civil society engagement strategy can"] [16.005382537841797, 14.4219388961792, "related keywords (limit to title or abstract), including \u201claboratory testing,\u201d \u201csurveillance system,\u201d \u201ccontact tracing,\u201d \u201cpublic communication,\u201d and \u201cquarantine.\u201d The PubMed search for material related to COVID-19 responses after the year 2020 retur"] [16.06661033630371, 14.451598167419434, "nd sought feedback after we shared a preliminary draft of findings and the policy recommendations. Experts from India and Indonesia also provided information to supplement the limited literature we could collect. This method ensured that the literatu"] [16.061429977416992, 14.44883918762207, " 2022, we followed up with experts via emails and collected their feedback on our preliminary analysis and their opinions on our policy suggestions. We then used selective coding to analyze the qualitative data from follow-up interviews to develop ou"] [16.0635986328125, 14.448752403259277, "World in Data, undated. As of July 26, 2022: https://ourworldindata.org/coronavirus Demir, Emre, \u201cChina\u2019s Wavering COVID-19 Vaccine Diplomacy in Turkey,\u201d webpage, Global Voices, August 13, 2021. https://globalvoices.org/2021/08/13/chinas-wavering-co"] [16.063962936401367, 14.449292182922363, "OVID-19 Outbreak: A Real-Time Analysis,\u201d International Journal of Environmental Research and Public Health, Vol. 17, No. 24, December 21, 2020. Kang, JaHyun, Yun Young Jang, JinHwa Kim, Si-Hyeon Han, Ki Rog Lee, Mukju Kim, and Joong Sik Eom, \u201cSouth "] [16.06416893005371, 14.448668479919434, "nter on Public Diplomacy, May 2021. McGinnis, Michael D., and Elinor Ostrom, \u201cSocial-Ecological System Framework: Initial Changes and Continuing Challenges,\u201d Ecology and Society, Vol. 19, No. 2, 2014. Monocle, \u201cSoft Power Survey 2017/18,\u201d video, Dec"] [16.064008712768555, 14.44866943359375, " Soft Power 30, \u201cSouth Korea: 2019 Overview,\u201d webpage, 2015\u20132019. As of July 26, 2022: https://softpower30.com/country/south-korea/ SP30\u2014See Soft Power 30. Verma, Raj, \u201cChina\u2019s \u2018Mask Diplomacy\u2019 to Change the COVID-19 Narrative in Europe,\u201d Asia Europe"] [11.527924537658691, 5.35629940032959, "Prepared for the City of CharlotteSAFE Charlotte\nAlternative Response Models and Disparities in \nPolicing\nMOLLY M. SIMMONS, DANIEL TAPIA, RICHARD H. DONOHUE, DENIS \nAGNIEL, MATTHEW L. MIZEL, LISA WAGNER, AMANDA CHARBONNEAU, DANIELLE SOBOL\nCORPORATION"] [11.533431053161621, 5.352299690246582, "and Accountability for Everyone, a report published by a team of city council members, the city manager, city leaders, and city government staff (City of Charlotte, 2020).\n1 The three SAFE recommendations addressed in this report are \n\u2022 Recommendatio"] [11.513572692871094, 5.359955310821533, "Council members, the city manager, city leaders, and city government \nstaff, contained six proposed recommendations (City of Charlotte, 2020). The SAFE Charlotte recommendations were created with the purpose of improving the quality of public safety "] [11.515909194946289, 5.361647129058838, "ord and Bjerregaard, 2014), many of the alternative response models concentrate on mental health services. Several police departments provide specialized training and deploy crisis intervention teams (CITs) of frontline officers directly to provide c"] [11.509756088256836, 5.363266944885254, " a map of the number of flagged calls by neighborhood (numbers on the map represent neighborhood statistical areas): \nFigure S.1. The Number of Flagged Calls (Relating t o Substance Abuse, Mental Health, and \nHomelessness) in Each Neighborhood , with"] [11.50776481628418, 5.363770961761475, "ilot of civilian responders for low-risk, \nlow-priority calls): Approximately $1.4 million to $1.85 million for the first year. \n \n4 Respondents were asked about varying levels of specialized civilian models and provided input on a range o f \nconsid"] [11.495915412902832, 5.378262996673584, " six months during the \npilots and at the completion of the pilots. \n\u2022 In addition to the recommended programs, Charlotte needs to develop a strong triage \nmodel to identify individuals in crisis. This is just one aspect of the continuum of care fo"] [11.069868087768555, 5.754166126251221, "imilar schedule or patrol area and giving those with the most similar profiles higher weights. We then estimated regressions with relevant control variables to identity each officer\u2019s unique coefficient that \ndescribes the extent of their deviation f"] [11.01606559753418, 5.801815032958984, "tion of \nCharlotte \n\u2022 Lower corresponding rate of being stopped for Asian drivers \ncompared with White drivers \n\u2022 Higher rate of being stopped for Black drivers compared with White \ndrivers, when rates are computed with respect to the population of "] [11.044004440307617, 5.77903938293457, "rienced a use of force compared to White arrestees was inconclusive. \n\u2022 Lower odds of Hispanic arrestees to experience a use of force relative to non -Hispanic arrestees \nSeverity of force \u2022 When force was used against a pedestrian or driver , the"] [11.463003158569336, 5.413067817687988, " data. The ability to connect CAD events to \nuse-of-force incidences would facilitate analysis of uses of force. This includes validating \ndata entry between different data set s to ensure that the correct information is available \n(e.g., linked use-"] [11.519649505615234, 5.3605875968933105, "affic \nstops and enforcement to focus on crash reductions and moving violations can reduce disparities, improve public safety, and enable a move away from aggressive or zero-\ntolerance models, as appropriate. More details on these interventions can b"] [11.512856483459473, 5.361613750457764, "..................................................................................................................... 10 \t\nStakeholder Input and Implementation Considerations ...................................................................... 30 \t"] [11.512011528015137, 5.364450931549072, ".................................................................................... 100 \t\nPerformance Measures ..................................................................................................................... 102 \t\nJob Descriptio"] [11.484086036682129, 5.3885674476623535, "of Flagged Calls (Relating to Substance Abuse, Mental Health, and \nHomelessness) in Each Neighborhood, with the Top 20 Neighborhoods Identified ............ vii\t\nFigure 2.1. Routine-Priority Calls by Hour of the Day .................................."] [11.018949508666992, 5.798701286315918, "Figure 3.6. Histogram of Officer Coefficients, Stopped White Individuals ................................. 78\tFigure 4.1. Pilot Timeline ........................................................................................................... 110\tF"] [11.041280746459961, 5.77964973449707, "................................................................................................................................ 22\t\nTable 2.13. Flagged Call Volume and Proportion for the 20 Neighborhoods with the Most \nFlagged Calls ................"] [11.01379108428955, 5.802240371704102, " Stop by Race/Ethnicity, White Community \nMember and No-Action Stops as Baseline ........................................................................... 59\t\nTable 3.15. Odds Ratios for Result of Pedestrian Stop by Race/Ethnicity, White Community "] [11.50765609741211, 5.368825435638428, " Top Ten NSAs for Priority 5 Calls, 2015\u20132020 .......................................................... 89\t \n xx Table 4.2. NSAs with Highest Average Homelessness, Substance Abuse, and Mental Health \nLow-Priority Calls per Week, 2015\u20132020 .........."] [11.004948616027832, 5.808194160461426, "sults ............................................................................. 133\tTable C.9. Contraband Discovery Rate, Pedestrian Results ....................................................... 134\tTable C.10. Contraband Discovery Rate, Vehicl"] [11.515142440795898, 5.364894390106201, "................. 158\tTable C.31. Logistic Regression, Officer Characteristics and Citations .................................... 159\tTable C.32. Logistic Regression, Officer Characteristics and Arrests ....................................... 160\tTab"] [11.52765941619873, 5.35573148727417, " in securing witnesses in the aftermath of a 2020 mass shooting event (Foster, 2020), and videos that appear to show CMPD officers intentionally cornering protesters and firing tear gas on them during a summer 2020 protest highlight these tensions (K"] [11.531713485717773, 5.350705623626709, "mmitted to the hospital, and patients are \nsometimes restrained inside the police vehicle. This process introduces an interaction with the carceral system and could be traumatic for patients, some of whom have willingly checked in for care (Knopf, 20"] [11.546140670776367, 5.346534252166748, "s, we also conducted a literature review on alternative response models for individuals in crisis. \n2.2. Background on Alternative Response Models \nTo develop recommendations for Charlotte and draw on existing knowledge about crisis \nresponse, we c"] [11.516962051391602, 5.3586626052856445, " MCAT pilot to interagency communication and dialogue, particularly the ability to utilize the systems and software of multiple agencies to compare criminal justice and health care records when dispatching to the scene of an emergency. The biggest ba"] [11.541234970092773, 5.347812652587891, "l., 2021).\n6 This program is still in a pilot phase. \nIn some cases, mental health crisis response units respond to calls for service that involve co-\noccurring substance use disorders and/or homelessness (Reuland, 2010), or they take on calls and \n"] [11.524331092834473, 5.355556488037109, "d Community Responders for Equity, Safety, and \nService (CRESS) composed of peer specialists to respond to \npolice calls; additional details unclear. \nFort Worth , Texas Low-level \nincidents First group of responders trained and deployed in 2021 to"] [16.14168930053711, 9.84156608581543, "ope, 2020). The lessons from the existing research helped us to execute this study and shaped our recommendations. \n2.3. Methods for Recommendations 2 and 4 \nWe approached Recommendations 2 and 4 by conducting a formative evaluation. A \nformative "] [11.512351036071777, 5.364785194396973, "wed the call code in the computer-aided dispatch (CAD) system. The first step \nconsisted of identifying the CAD code for the call for service. This was done by \nexamining the TYPE_CODE_ORIG_DESC (the type of the call code by its original description)"] [15.11595344543457, 13.48084545135498, "oject, and snowball sampling is when additional participants with particular knowledge \nrelevant to the project are identified during the course of research (Yin, 2015). We worked with \nthe city to identify the purposeful sample. We then ask ed enrol"] [11.491400718688965, 5.39221715927124, "by a primary coder, with spot checks by an experienced coder. \nWe also used the interviews, targeted Google searches, and two community tools (the ONE \nCharlotte Health Alliance website and NC211.com) to develop an asset map of mental health, \nsubst"] [11.474095344543457, 5.381972789764404, "es, with the frequency and percentage of all routine-priority calls, are included. \n \n \n 12 Table 2.4. The 20 Most-Frequent R outine -Priority ( Priority 5) Call Types, with F requency and \nPercentage \nCall Type Total Number of \nRoutine Calls P"] [11.475707054138184, 5.386427879333496, "in the number or proportion of calls by day of the week \nor by month. See Figures 2.2 and 2.3. In each figure, the top panel shows the number of routine-priority calls, and the bottom panel shows the proportion of all calls on that day of the week or"] [11.480534553527832, 5.38862943649292, "riginal Call Type Low-Risk \nPercentage Priority \nEscalation \nPercentage Percentage That \nRequired \nMultiple Units Total Calls \nIllegal parking 85.12 3 0.048 14.349 28,991 \nFound property 83.78 0.071 15.36 5 14,032 \nNotify 82.677 4.578 12"] [11.48664665222168, 5.389476776123047, " \nAssist medic 985 1.1% \n \nCalls flagged as potentially related to mental health were overwhelming ly welfare checks. \nSee Table 2.10. All call types accounting for more than 1 percent of calls flagged for mental health are included. \n 22 Table 2."] [11.493120193481445, 5.391644477844238, "ikely in the afternoon, particularly on Monday. \n \n 25 Figure 2.8. Flagged Calls (Relating t o Substance Abuse, Mental Health, and Homelessness) by \nHour of Day and Day of Week \n \nFlagged calls tended to be more frequent during warm-weather months"] [11.522783279418945, 5.358287334442139, "tion climate and identify barriers and facilitators to implementation. This section is divided into two subsections. First, we will discuss our findings \non civilian/co-response models for mental health, homelessness, and substance use, and then we w"] [11.52294921875, 5.368422031402588, "his has been applauded by community members; however, it was noted that they are not available 24 hours a day. Furthermore, these individuals are likely to be needed at night, but they currently work only during the day. \nBecause of this tension, ou"] [11.56530475616455, 5.333676338195801, "h as musicians and athletes, discuss mental illness and crisis intervention and share a nonemergency number in an effort to disseminate information about CPCRT. \nAnother major issue in Charlotte, which community organizations who provide services ca"] [11.512258529663086, 5.357993125915527, "y are not available 24 hours a day is problematic. Respondents reported that \nthis meant that even those who know about CPCRT teams can be reluctant to request them through 911 because they know that there is going to be a delay. Furthermore, limitin"] [11.51342487335205, 5.36079740524292, "re were some potential benefits to civilian responders, there \nwere also potential problems. In this section, we will discuss the model of civilians who respond \n 34 to low-risk situations. We identified several themes. Most prevalent were concerns "] [11.511910438537598, 5.362569332122803, "s stigma within CMPD. As one participant stated, \u201cSome police feel \neither you\u2019re a badge or you\u2019re not. So, we need to show civilians can do stuff too and can represent the department in a great way. So, house them together, so sworn can see amazing"] [11.585203170776367, 5.392284870147705, "Our search focused on crisis services and accessible ongoing support services for mental health needs (80 resources), substance abuse disorders (47 resources), and housing and homelessness services (41 resources). We did not include private practices"] [11.542825698852539, 5.360757350921631, "e fall into the early \nintervention area of the continuum. Seventy-six of these resources provide counseling services and support groups, and roughly one-third of these are offered through private, for-profit organizations or individuals. Although it"] [11.519868850708008, 5.366063594818115, "ovides a mix of services in vivo, meaning in the setting and context in which problems arise, as opposed to in a clinical setting [Phillips et al., 2001]). Charlotte has a limited number of transition support resources, with two providers of ACT and "] [11.081080436706543, 5.749879837036133, "aged an established framework that uses an internal benchmarking approach for identifying outlier officer behavior. Briefly, this approach evaluates a given officer by comparing them with a weighted combination of all other officers, where the weight"] [11.049454689025879, 5.777638912200928, "termine whether any individual is acting on racial bias. Racial bias is an issue that has been identified as problematic in police\u2013community member contact. That said, disparities can, in principle, be estimated. \nWe cannot rule out the possibility "] [11.027791976928711, 5.792969226837158, "tation in the \npopulation when controlling for neighborhood context (e.g., crime, poverty)? \nx. Is the frequency of pedestrian stops by perceived race/ethnicity equivalent to the proportion of those races/ethnicities represented in the community when"] [11.041107177734375, 5.779086112976074, " make no difference in the numbers of drivers being stopped, then that \nwould suggest that there is no disparity. \nFinally, for question v, we analyzed the yield rates of searches by different perceived racial \ngroup; yield rates are taken as proxies"] [11.015089988708496, 5.801915645599365, "gistic Stop data, CAD data, quality -\nof-life data \nPoint viii. Racial disparities in rate of \nconsent given to search Binary logistic Stop data, CAD data, quality -\nof-life data \nPoint ix. Racial disparities between the \nnumber of vehicles stops"] [11.03350830078125, 5.785563945770264, " of use-of-force incidents during police stops, we also evaluated the \nuses of force on individuals who were arrested. This decision was based on the understanding \nthat use of force during stops represents a small proportion of all uses of force and"] [11.05724811553955, 5.773041725158691, " variable\u2014here, White versus non-White identity for arrestees.\n10 When the two groups have similar values for all variables we \ndecide to control for, we consider the data balanced. The specific matching technique we use is coarsened exact matching, "] [11.090639114379883, 5.743832111358643, "ddress Outliers Who Could Exhibit Bias \nOur methodology described here has been employed in other cities for outlier detection. We \nemployed an internal benchmarking method to identify officers who were outliers compared with \ntheir peers in terms"] [11.085667610168457, 5.732718467712402, "rom the group. The first method is through \nweighting more- similar observations higher with propensity score weighting, while the second method is to include \nadditional variables in regressions to control for the influence of other factors (e.g. , "] [11.012709617614746, 5.802908897399902, "r rate of being stopped for Black drivers compared with White drivers, \nwhen rates are computed with respect to the population of the \nneighborhood where the stop took place \n\u2022 Lower corresponding rates for Asian d rivers and drivers of other \nraces"] [11.021732330322266, 5.796544075012207, "of force relative to \nnon-Hispanic arrestees \nSeverity of force \u2022 When force was used against a pedestria n or driver, there was a greater \nprobability that lethal force (firearms) or less -lethal force (tasers, batons, \nsprays) was used instead of "] [11.015626907348633, 5.799957275390625, "es of experiencing the outcome as White \nindividuals. If the OR for use of force corresponding to Asian motorists is estimated to be 1.50, it \ncan be interpreted as follows: When stopped, the odds of an Asian individual being subject to a \nuse of for"] [11.012482643127441, 5.803123950958252, " which different racial/ethnic groups were subjected to stops, \nwe conducted several analyses. The first analyses used Poisson regression to estimate how the rate of stops differed between racial/ethnic groups after accounting for the neighborhood ch"] [11.018964767456055, 5.801268100738525, "ian residents. \n \n13 Two neighborhoods were missing racial/ethnic population data altogether . Among the rest, five neighborhoods (1 \npercent ) had 0 White population, 27 (6 percent ) had 0 Black population, 49 (11 percent ) had 0 Hispanic populat"] [11.011800765991211, 5.802905559539795, "th respect to all city residents of a particular racial/ethnic group, and then we analyzed rates with respect to residents of a particular racial/ethnic group within the neighborhood of the stop. Full results are given in Tables 3.5 and 3.6. \nWe est"] [11.009933471679688, 5.805491924285889, "cal to the analysis of all stops (vehicle and pedestrian) above. We \n 55 include the tables for vehicles stops here in Tables 3.7 and 3.8. All effect estimates and \nconclusions are similar to the analysis above. \nTable 3 .7. Rates of Vehicle Stops b"] [11.007109642028809, 5.806361198425293, "statistical significance . CIs \nare in parentheses. \n* We included Native Americans in the other/u nknown category in regressions given their small sample \nsize. \nFrequency of No-Action Stops \nFor this analysis, we focused on stop data to analyze t"] [11.008383750915527, 5.806327819824219, ": We used c lustered standard errors by NSA. Bolded text indicates statistical \nsignificance . CIs are in parentheses. \n* We present Native Americans as a category separately here but included them with the \nother/u nknown category in regressions g"] [11.011775970458984, 5.802841663360596, " Hispanic \n 59 individuals had 20.0 percent lower odds (95-percent CI 12.7\u201326.6) of receiving a written \nwarning rather than no-action stop and 1.550 times the odds (95-percent CI 1.454\u20131.653) to receive a citation rather than a no-action stop compa"] [11.011177062988281, 5.801614284515381, "iven small sample size. \nRequests to Search D uring S tops \nIn total, White motorists received a total of 1,230 requests for consent to search out of a total \nof 134,487 total stops that could be linked to CAD data, corresponding to 0.91 percent of "] [11.00501537322998, 5.807328701019287, "dications that the type of search was \u201cConsent,\u201d but we had no indication from the request data that consent to search was requested. Conversely, there were many instances where a consent to search was requested but a different search type was listed"] [11.008294105529785, 5.805483818054199, "16) \nNative American 14 5 45.0% NA \nWhite 3,182 1,421 44.7% NA \nNOTES: We used c lustered standard errors by NSA. Bolded text indicates statistical significance . CIs are in \nparentheses. \n* We present Native Americans as a category separately"] [11.009275436401367, 5.803224086761475, "47 (0.455 \u20135.256) \nBlack 259,983 206 1.944 \n(1.301\u2013\n2.905) 1.599 (1.060 \u20132.411) \nHispanic 49,722 21 1.023 \n(0.574\u2013\n1.822) 1.167 (0.651 \u20132.089) \nOther/ unknown 9,763* 2 0.649 \n(0.154\u2013\n2.741) 1.001 (0.236 \u20134.241) \nNative \nAmerican* 320 0 NA N"] [11.015222549438477, 5.801090240478516, "rors because all males and females across all duplicates shared the same age. For arrest data, we identified 2,657 nonunique rows on the basis of subject demographics out of the total arrest data set of 95,793. To justify the merger of these two data"] [11.031457901000977, 5.786163330078125, "nstruct the 95% CIs. \n \n17 This could be problematic for our conventional logistic regression analysis if the accurac y of data entry is \ncorrelated with other variables (e.g. , race, age, type of crime) because this would ultimately produce a biase"] [11.016806602478027, 5.798520565032959, "e interactions where force was used, those involving White civilians were the \nleast likely to involve more-than-physical force (21 percent of 600 force episodes) and the least \nlikely to involve lethal force (0.7 percent). The proportion of incident"] [11.010116577148438, 5.801896095275879, "1 16 51.6% 28.02 (11 .66\u2013\n44.66) 3 9.7% 8.43 (2.41 \u2013\n22.93) \nWhite ** 601 123 20.5% \u2013- 4 0.7% \u2013- \nNOTES: CI s are in parentheses. Bolded text indicates significance . \n* Grouped with \u201cOther\u201d in logistic regression models. \n** Reference group ."] [11.024757385253906, 5.7925567626953125, "plaints was estimated to increase by about 16 percent (95-percent CI 12\u201321). These rates were virtually unchanged when adjusting for neighborhood characteristics. \nRacial/ Ethnic Profiling Co mplaints in Communities \nWe examined all of the descripti"] [11.062141418457031, 5.765017509460449, "threshold near the center of the distribution, most of the officers we identified as outliers would be \u201cfalse discoveries\u201d or not truly outliers. Our threshold would identify the number of cases that have a fdr of less than 0.20. \n \n18 While this me"] [11.012591361999512, 5.803013801574707, "is area is Asian ) and Westover \n(18.8 percent of the stops of Asian drivers by this outlier group took place in Westover; 3.3 percent of the population in this area is Asian ). This should also serve to convey the point that \nalthough this method is"] [11.005781173706055, 5.8068928718566895, "up took place here; 17.1 percent of the population in this area is Hispanic), South (19.8 percent of the stops of Hispanic drivers by this outlier group took place here; 7.5 percent of the population in this area is Hispanic), and Hickory Grove (18.9"] [11.012372970581055, 5.8034281730651855, "anic drivers. For White individuals, we detected 17 outliers, 15 of whom stopped more White drivers than their peers. For the two outliers who stopped fewer White drivers than \ntheir peers, most of their stops occurred in Eastway (53.2 percent of th"] [11.009333610534668, 5.804895877838135, "1 9.389 0.149 0.594 \nCentral 58.919 24.744 4.734 6.851 0.027 0.585 \nAirport 18.559 60.795 3.103 14.497 0.001 0.574 \nSouth 70.808 8.672 9.618 7.520 0.241 0.476 \nProvidence 70.233 20.311 3.008 4.092 0.009 0.463 \nMetro 1"] [11.00456714630127, 5.806161880493164, " 292 \n(1.2%) 14,836 \n(63%) 2,142 (9.1%) 692 (2.9%) 3,964 (16.8%) \nAvg. \n(882) 1,703 (1.7%) 2,549 \n(2.6%) 7,346 (7.5%) 599 \n(0.6%) 27,721 \n(28.4%) 13,679 \n(14%) 10,174 \n(10.4%) 33,702 (34.6%) \nLow \n(2) 4 (0.5%) 3 (0.4%) 31 (4.2%) 19 \n(2"] [11.007987976074219, 5.803834438323975, "or stops often occur when an outstanding warrant for the stopped driver is discovered. Asian officers (OR 1.719, 95-percent CI 1.341\u20132.202) and Black officers (OR 1.3, 95-percent CI 1.174\u20131.439) more often issued a citation as a result of a stop comp"] [10.993992805480957, 5.817141056060791, "14 0.821 0.753 0.895 18 0.943 0.567 1.567 \nOfficer, \nmale 10,764 1.328 1.22 1.446 191,571 0.806 0.763 0.85 229 0.854 0.515 1.415 \nOfficer, \nWhite 8,395 138,969 179 \nOfficer, \nfemale 929 15,990 21 \nOfficer \nage 0.976 0.972 0.981 "] [11.346354484558105, 5.522907257080078, " Policies and Strategies That Could Be Affecting Disparities \nGiven our identification of statistically significant racial/ethnic disparities, we considered \nwhether any policies or strategies could be driving these results. We reviewed CMPD\u2019s curren"] [11.475627899169922, 5.405025005340576, "anctity of life is consistent with the Police Executive Research Forum\u2019s first guiding principle on use of force (Police Executive Research Forum, 2016). However, CMPD might want to reconsider the use of the term warrior, as it could inoculate office"] [11.505428314208984, 5.370397090911865, "kely to \nlead to significant cost savings from reducing patrol staffing. In fact, depending on the efficiency with which nonsworn staff clear specific calls, reallocation efforts could lead to a cost increase stemming from fielding additional staff. "] [11.505298614501953, 5.368275165557861, " are based on information and data from stakeholders, as well as on our analysis. Our primary recommendation related to SAFE Charlotte\u2019s Recommendations 2 and 4 is to establish a pilot program that, if successful, could be tailored for expanded use i"] [11.505921363830566, 5.368481636047363, "ng property damage, or other property crimes. However, some Priority 5 calls with a higher likelihood to escalate might be best left to sworn officers, even if they are relatively low priority (e.g., intoxicated individuals, suspicious persons or veh"] [11.504522323608398, 5.364480495452881, "tempted to separate themselves from the police department have not been successful at coordinating response services and avoiding jail or hospitalization for community members (Witzberger and Megas-Russell, 2020). \n 89 Geographic Location for Pilot"] [11.508370399475098, 5.360838890075684, "kers with feedback from community representatives. \nTable 4.2. NSAs with Highest Average Homelessness, Substance Abuse, and Mental Health Low -\nPriority Calls per Week, 2015 \u20132020 \nHomelessness \nNSA Divisions Neighborhood Count Approx imate \nCa"] [11.503748893737793, 5.3695573806762695, "d in the development of the cost-benefit analysis for the pilot programs. \nTable 4.3. Program Inputs and Change Relative to Status Qu o \nInput Projected Change Considerations \nPersonnel Savings \u2022 Salary and benefits \n\u2022 Shifts covered \n\u2022 Number "] [11.505199432373047, 5.366928577423096, "ority 5 call, assuming twice the status quo response duration (148 minutes). This scenario is also likely when there is a two-person civilian response team handling a call for service. In co-responder programs, \nsuch as CPCRT and others across the co"] [11.50503921508789, 5.350594520568848, " a two -person nonsworn \nteam (Blick et al., 2021). \n29 City stakeholders stated that police investigative technicians would have a salary similar to the proposed \nnonsworn responders . \n 94 Table 4.5. Wages by Scenario Relative to Status Quo ($/Ca"] [11.457523345947266, 5.344351768493652, " to two civilians \n 95 responding in place of one officer. Scenarios 1 and 2 then lend useful information for planning \npurposes. Under Scenario 1, where two civilians respond and take the same amount of time as an officer, the costs are higher, lea"] [11.492474555969238, 5.342323303222656, "addition, community/police relations improve with the interactions from a Community Service Officer answering \nnon-violent calls. It is a softer approach for the community to receive basic police services such as completing \nreports, information req"] [11.508277893066406, 5.338755130767822, "following (City of Ithaca and Tompkins County, 2021): \n\u2022 $75,500 salary and benefits for each Ithaca Community Solutions Officer (includes $500 \nfor uniform), exact number of officers to be determined \n\u2022 $70,320.18 salary and benefits for civilian st"] [11.504684448242188, 5.363781929016113, "cost is additional time spent rather than hiring of \nadditional staff. CMPD will need to consider whether additional officers are required to meet increased call load associated with hiring of additional clinical staff. \nc A SAFE presentation notes"] [11.501116752624512, 5.360598564147949, "wheelchair lifts) \n\u2022 Maintenance \n\u2022 Sprinter crew vans start at $41,375 (Mercedes -Benz, 2021) \nResponse duration Potential savings \u2022 Shorter response duration in Denver pilot (25 vs. 34 minutes; \nBlick et al., 2021 ) \nJail time Savings \u2022 No c"] [11.492741584777832, 5.361501693725586, "talization and crime \nvictimization \nMetro areas in \nMidwest (Washington \nState Institute for \nPublic Policy, 2019; \nWashington State Institute for Public Policy, 2014 )\n Benefit to cost ratio = $1.16, or \n$201 per person \u2022 Specific to psychiatric"] [11.502248764038086, 5.365016460418701, " estimates from cities with long-standing programs provide concrete information about ongoing costs and sustainability that may might be incorporated in a simple tally of cost information. \nAdditional Considerations for Cost -Benefit Analysis \nThe C"] [11.50993824005127, 5.363327503204346, "bined with outputs from the early stages of the pilot, should guide this effort in the future. \nHowever, our interviewees indicated that enmeshing mental health providers within the \ncommunities they serve is essential. This means that it would be b"] [11.522063255310059, 5.35694694519043, "partment of Recreation and Human Services, 2021), and relevant academic articles (Bailey et al., 2018; Currier, Fisher, and \nCaine, 2010; Dyches et al., 2002; Scott, 2000; Guo et al., 2001). These are supplemented by the \nmaterials and data provided "] [11.508734703063965, 5.361494541168213, "-level training for the clinician roles. \nA review of other similar models, co-response models, and interviews highlighted the need \nfor team members to have knowledge and ties to Charlotte and the neighborhoods in which they will work, strong commun"] [11.516629219055176, 5.358642101287842, "ch include a \nreporting/discussion of cases. CAHOOTS safety training includes scene awareness, risk identification, \ncommunication with work partners, radio communication, defensive driving, de -escalation, self -\ncare/clinical debrief, intuition, an"] [11.512168884277344, 5.360478401184082, " team options and \ndefinitions . \n600 Operations Clear ly incorporat e all new models into operations . \n800-001 Use of Public Records and \nDepartment Information Clarify whether civilian responders can access records . \n800-002 Media Relations Cl"] [11.515411376953125, 5.3538336753845215, ", Texas, uses a crisis call diversion program (Houston Police Department, undated), in which calls come in to 911, but specially trained staff have the ability to handle and assist callers.\n34 The Vera Institute for Justice also outlined how \nservice"] [11.502212524414062, 5.368017196655273, "his engagement. For example, we included time at the beginning of the pilot in case new radios and vehicles need to be procured. During the first six time units, Charlotte and CMPD should also make the public aware of the programs being piloted. The "] [11.507769584655762, 5.365927696228027, " areas, these \nunits should start with ten to 12 personnel each. Our estimates show that teams could \n \n 111 handle between 81 and 105 calls per week. These figures should be consistently \nevaluated and monitored as the program matures. \n\u2022 The volume"] [11.516901969909668, 5.354223251342773, "and education for other sworn and nonsworn staff; and convene a citizen advisory committee to assist with \nimplementation decisions. These efforts are expected to take approximately six months. \nFollowing this period, we suggest an initial time frame"] [11.38776969909668, 5.488861083984375, "e police outcomes of interest (e.g., use of force, complaints) could not be connected to CAD event data. Although it is possible to link some CAD events and arrests to use-of-force incidents, not all were an exact match. Establishing some internal me"] [11.490368843078613, 5.384727478027344, " clarify policies or set guidelines so that current and future officers are less likely to demonstrate outlier behavior. This would enable a feedback cycle in which CMPD is consistently monitoring officers, addressing outlier behavior, and establishi"] [11.49152946472168, 5.3774094581604, "devices as a condition of their release as they await trial. These persons are suspects in crimes that often involve violence; shifting these duties could present a threat to public safety. Lastly, the Passenger Vehicles for Hire Office generally sup"] [11.52270221710205, 5.357867240905762, ". More details on these interventions can be found in RAND\u2019s Better Policing Toolkit (Hollywood et al., 2018).\n36 These interventions can assist CMPD in focusing on crime and public safety while also \nimproving relations with and engaging the communi"] [11.51355266571045, 5.361258506774902, "ndations of the SAFE Charlotte report was to develop a model to \nconvert low-ris k sworn duties to nonuniform units. To address this recommendation, we are \nworking with Charlotte to create safe roles for nonuniform representatives to respond to lowe"] [11.524609565734863, 5.354509353637695, "are not? \no Walk me through what they a re doing now. \n\u00a7 How common are they? \no What has been the community response? \no Walk me through how you would like to see them function from a practical perspective \n \n4. How would you like the city to e"] [11.514347076416016, 5.36016321182251, "ric or \nfamily intervention and can assist officers or families with involuntary commitments.] \n \n2. [POLICE, first ask: Do you work with Community Policing Crisis Response Teams?] What are \nyour thoughts on Community Policing Crisis Response Teams? "] [10.992024421691895, 5.816376209259033, "wledge \no Individual characteristics \no Intervention characteristics \no Outer settings \no Inner settings \no Process \n\u2022 General implementation \no Overall thoughts/perspective/experience/knowledge \no Individual characteristics \no Intervention "] [10.989996910095215, 5.8206586837768555, "r age 1.012 1.002 1.023 \nDriver male 1.226 0.916 1.64 \nOther reason 1.061 0.569 1.977 \nSafe movement 0.607 0.298 1.237 \nSeat belt 0.491 0.111 2.175 \nSpeeding 0.708 0.412 1.216 \nStoplight/stop sign 0.889 0.5 1.582 \nVehicle equipment 0.803 0.483 "] [10.993929862976074, 5.826383590698242, "rime rate , patrol division 0.952 0.863 1.049 \nViolent crime rate , patrol division 0.708 0.381 1.314 \nN = 191,998 \nMcFadden\u2019s R -squared = 0.432 \n \n 127 Figure C.1 presents the results of our coarsened exact matching for Black arreste"] [11.007471084594727, 5.836375713348389, "ns\ncrimeDisorderly Conduct\ncrimeDistribution Drugs, Controlled Substances\ncrimeDriving While Impaired\ncrimeHit and Run, Traffic FatalitycrimeLiquor Violation\ncrimeMurder & Non \u2212negligent Manslaughter\ncrimeNon \u2212aggravated Assault\ncrimePossession, Drug"] [10.988058090209961, 5.822939872741699, "iolent_div\n0.0 0.1 0.2 0.3\nAbsolute Standardized\nMean Difference\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\n\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\u25cf\n\u25cf\n\u25cfAll\nMatched \n 131 Table C.6. Results of Logistic Regression , White Arrestees and Force, Matched Data \nVariable Est"] [10.990446090698242, 5.820383071899414, "ic 1.3277 0.6633 2.6576 \nOther 4.9918 0.6173 40.3689 \nPedestrian age 0.9871 0.9699 1.0045 \nPedestrian male 0.4694 0.2617 0.842 \nCrime in progress 1.8054 1.0582 3.0802 \nOther reason 0.4919 0.2893 0.8362 \nJob density 0.9912 0.9783"] [10.990939140319824, 5.8190741539001465, " \nSeat belt 0.2808445 0.2300314 0.3428821 \nSpeeding 0.1761901 0.1552195 0.1999939 \nStoplight/sign 0.1252887 0.1090538 0.1439405 \nVehicle equipment 0.1436072 0.128227 0.1608322 \nVehicle regulatory 0.1673259 0.1514644 0.1848484 \nJob de"] [10.991026878356934, 5.819108486175537, " equipment 1.407447 0.9611296 2.06102 \nVehicle regulatory 1.676189 1.144428 2.455034 \nJob density 0.9941746 0.9864953 1.001914 \nEmployment rate 0.9891163 0.9693219 1.009315 \nHousehold income 1.000003 0.999999 1.000007 \nPublic nutriti"] [10.990156173706055, 5.821248531341553, "026707 \nHispanic population (%) 0.9825777 0.9405823 1.026448 \nWhite population (%) 0.9629205 0.9226955 1.004899 \nIntercept 2.705183 0.0071585 1022.279 \nNo action taken (Base \noutcome) \nN 2,919 \nMcFadden\u2019s R -squared 0.2138 \n \n "] [10.990653038024902, 5.819627285003662, "8364 2.0782866 \nYear, 2018 1.6661202 1.5190788 1.8273947 \nYear, 2019 1.9600431 1.7479300 2.1978963 \nYear, 2020 1.2494282 1.1219752 1.3913594 \nDisorder call rate 0.9997452 0.9991220 1.0003689 \nEmployment rate 0.9990581 0.9866683 1.011"] [11.000828742980957, 5.811619281768799, "n \nVariable Estimated Odds Ratio Lower Bound Upper Bound \nAsian 0.383 0.337 0.436 \nBlack 1.942 1.690 2.233 \nHispanic 0.989 0.868 1.127 \nOther 0.705 0.600 0.829 \nFebruary 0.929 0.904 0.955 \nMarch 0.934 0.904 0.964 \nApril 0.860 0.831 0.891 \n"] [10.988438606262207, 5.820650577545166, "91020e -02 2.054681e -01 \nBlack 2.066522e+00 1.614129e+00 2.645707e+00 \nHispanic 6.620365e -01 4.788457e -01 9.153100e -01 \nOther 4.322486e -01 2.617512e -01 7.138034e -01 \nFebruary 1.323864e+00 1.015536e+00 1.725802e+00 \nMarch 1.051136e+0"] [10.98947811126709, 5.82161283493042, "pline 6 0.913 0.645 1.292 \nOther reason for stop 1.226 0.675 2.226 \nSafe movement 1.714 1.094 2.684 \nSeat belt 1.585 0.745 3.371 \nSpeeding 1.686 1.112 2.558 \nStoplight/sign 1.725 1.107 2.689 \nVehicle equipment 1.302 0.852 1.992 "] [10.988518714904785, 5.822138786315918, " \nDaylight 0.991 0.985 0.997 \nSpline 1 1.001 0.988 1.015 \nSpline 2 1.025 1.004 1.046 \nSpline 3 1.015 0.993 1.036 \nSpline 4 1.002 0.986 1.018 \nSpline 5 1.012 0.987 1.039 \nSpline 6 0.996 0.984 1.008 \nN 74,254 \nMcFadden\u2019s R -"] [10.996196746826172, 5.82705545425415, "opulation (%) 0.993 0.984 1.003 \nYouth population (%) 1.01 1.003 1.016 \nVacant land (%) 0.993 0.982 1.003 \nPublic nutrition assistance 1 1 1 \nHousehold income 0.999 0.993 1.005 \nJob density 1.009 0.997 1.021 \nEmployment rate 0.99"] [10.987859725952148, 5.825249195098877, "1.010 \nPublic nutrition \nassistance 0.997 0.975 1.019 \nProperty crime rate 0.993 0.984 1.002 \nViolent crime rate 1.010 0.994 1.026 \nN 2,760 \nMcFadden\u2019s a djusted \nR-squared 0.3692194 \n \n \n 159 Tables C.31 through C.35 present the logistic "] [10.990622520446777, 5.820506572723389, "isance violations 1.002 0.999 1.005 \nProperty crime rate 0.999 0.998 1.001 \nDisorder call rate 1 1 1 \nViolent crime rate 1.007 0.999 1.014 \nN = 450,680 \nMcFadden\u2019s a djusted R -squared = 0.120 \n \n \n 161 Table C.33. Logisti c Regr"] [10.992441177368164, 5.818101406097412, "003 0.003 \nTable C.35. Odds Ratios, Officer Characteristics, Complaints, by Source and Type \n External Complaint Arrest, Search, Seizure Use of Force \n Odds \nRatio \nEst. Lower \nBound Upper \nBound Odds \nRatio \nEst. Lower \nBound Uppe"] [11.557414054870605, 5.361084461212158, "\nCenter for Emotional Health New Beginning Sanctuary NC \nCharlotte Community Health Clinic New Beginnings of Southern Piedmont \nCharlotte Rescue Mission New Leaf Adolescent Care \nChrist Centered Community Counseling One Love Services \nCo-Depe"] [11.578300476074219, 5.3459296226501465, "m Urban League of Central Carolinas \nRHA Health Services Urban Ministry Center \nS&H Youth and Adult Services (SHYAS) With Friends Youth Shelter Services Emergency \nShelter Program \nSafe Alliance Women of Hope New Living \nSelf Advocates of Meck"] [11.592466354370117, 5.323496341705322, "ness: Evidence-Based Models and Promising Practices, Washington, D.C.: Urban Institute, October 2020. As of June 18, 2021: https://www.urban.org/sites/default/files/publication/103158/ alternatives-to-arrests-and-police-responses-to-homelessness.pdf "] [11.734406471252441, 5.2086358070373535, "enburg Police Department, \u201cCMPD Crisis Intervention Team (CIT),\u201d YouTube \nvideo, September 20, 2016. As of June 18, 2021: https://www.youtube.com/watch?v=nGkgGZFb7nA&t=31s \nCharlotte-Mecklenburg Police Department, \u201cCommunity Wellness: Community Polic"] [11.764575004577637, 5.1914520263671875, "Files/Departments/ Drys/21%20DRHS%20Person%20in%20Crisis%20ERA%20format%20Plan%20FINAL%20020321.pdf \nCity of San Francisco Office of the Mayor, \u201cSan Francisco\u2019s New Street Crisis Response Team \nLaunches Today,\u201d November 30, 2020. As of June 18, 2021:"] [11.860554695129395, 5.140605449676514, "y Epidemiology, Vol. 7, No. 1, January 20, 2020, p. 3. \nFort Worth Police Department, \u201cCCPD Budget Documents & Quarterly Reports,\u201d undated. As of \nDecember 13, 2021: https://police.fortworthtexas.gov/CCPD/ccpd-quarterly-reports \nFoster, David, Incom"] [11.589518547058105, 5.339450836181641, "e_Of_Force%2007102020%20v3.pdf \nIrwin, Amos, and Betsy Pearl, \u201cThe Community Responder Model: How Cities Can Send the \nRight Responder to Every 911 Call,\u201d Center for American Progress , October 28, 2020. As of \nJune 18, 2021: https://www.americanprog"] [11.797199249267578, 5.178255558013916, " \nIssues Brief, San Francisco Department of Public Health, February 2021. As of June 18, 2021: https://www.sfdph.org/dph/files/IWG/SCRT_IWG_Issue_Brief_FINAL.pdf \nMercedes-Benz, \u201cSprinter,\u201d 2021. As of December 14, 2021: \nhttps://www.mbvans.com/en/s"] [12.162881851196289, 4.96710205078125, " Unit Stakeholder Report, \nCharlotte, N.C., 2021. \nRahr, Sue, and Stephen K. Rice, From Warriors to Guardians: Recommitting American Police \nCulture to Democratic Ideals, Washington, D.C.: National Institute of Justice, April 2015. As \nof June 18, 20"] [12.838504791259766, 4.4771037101745605, "l of Darkness and Investigating Disproportionate \nImpact in Policing: When Researchers Disagree,\u201d Police Quarterly, Vol. 24, No. 1, March 2020, pp. 55\u201373. \nStarr, Sonja B., \u201cTesting Racial Profiling: Empirical Assessment of Disparate Treatment by \nP"] [11.735820770263672, 5.269883155822754, "of Labor Statistics, \u201cSocial and Human Service Assistants,\u201d last updated April 9, \n2021. As of June 18, 2021: https://www.bls.gov/ooh/community-and-social-service/ social-and-human-service-assistants.htm \nU.S. Census Bureau, \u201cAmherst Town, Hampshire "] [12.302864074707031, 20.254377365112305, "Prepared for the California Commission on Health and Safety and Workers\u2019 \nCompensationPosttraumatic Stress \nin California\u2019s Workers\u2019 \nCompensation System\nA Study of Mental Health Presumptions for \nFirefighters and Peace Officers Under \nSenate Bill 5"] [12.294540405273438, 20.260923385620117, "ebate \nsurrounding the rebuttable presum ption that posttraumatic stres s disorder (PTSD) among first \nresponders is work-related and thus eligible for full workers\u2019 compensation benefits. The main \ntasks of the mixed-methods evaluation are to (1) p"] [12.319743156433105, 20.241090774536133, ", and Gary Briggs at RAND for helping to \nimplement NIOCCS securely in the RAND computing e nvironment. We also wish to thank DIR \nleadership and staff for providi ng the opportunity and financial support needed to carry out this \nstudy\u2014particularly"] [12.320891380310059, 20.281734466552734, "ing cause\u201d of th e injury and need not be the \nsole or primary cause (CHSWC, 2004). For psychiatric injuries w ithout an accompanying \nphysical injury, however, section 3208.3 of the Labor Code esta blishes a much higher \nevidentiary bar. In most cir"] [12.324369430541992, 20.282997131347656, " passage, there were major evidence gaps \nrelated to how PTSD prevalence varies across occupations, how P TSD and other mental health \nconditions were being handled in the workers\u2019 compensation syst em, and how the bill potentially \naffects costs to "] [12.302814483642578, 20.193389892578125, "mong First Responders \nTo estimate the prevalence of m ental health conditions and suicidality in California\u2019s first \nresponder workforce, we analyzed seven years (2013\u20132019) of dat a from the California Health \nInterview Survey (CHIS). The C HIS is "] [12.29931354522705, 20.247514724731445, "revalence of mental health conditions that might obscure the harmful \nimpacts of workplace exposure to traumatic events for first res ponders. \nClaims Involving PTSD in the Workers\u2019 Compensation System \nTo understand how PTSD and other mental healt"] [12.342962265014648, 20.32695960998535, "s job-related. Mental health pro viders who treat first responders \nfelt that it often is feasible t o prove that a mental health condition is job-rela ted for first \nresponders and cited a number of reasons, which we discuss in C hapter 5. These in"] [12.296664237976074, 20.281021118164062, "rior evidence, mental health stigma and a fear of professional consequences were identified as major barriers to care-seeking. All first responders \ninterviewed indicated that thei r departments did not have the n ecessary behavioral health \nsupport"] [12.23326587677002, 20.23976707458496, "irst responders\u2019 workers \u2019 compensation claims was \n$14,076. \n\uf0b7 In the five years from 2020 to 2024, under an assumption of hig h PTSD incidence rates \n(comparable to rates of those deployed in Iraq and Afghanistan) with intermediate \nassumptions abo"] [12.300655364990234, 20.284069061279297, "e for Californi a to revisit the questions examined in this study at some \nfuture time that is closer to the expiration of the SB 542 pres umption\u2014perhaps in 2023. \nThat would allow analysis of the system after the COVID-19 pand emic has (we hope) \n"] [12.308579444885254, 20.292179107666016, "d promoting \nworkers\u2019 compensation claims, f irst responders suffering from p osttraumatic stress would be \nmore likely to receive high-qualit y care when it was needed, be fore untreated PTSD resulted in \npermanent disability, early r etirement, or "] [12.30355167388916, 20.256572723388672, "iders should be consulted to \nidentify and evaluate various avenues for improving access to m ental health treatment for first \nresponders\u2014avenues that also focus on providing treatment more quickly (such as contractual \nagreements with unions, depar"] [12.29310417175293, 20.217899322509766, "C Centers for Disease Control and Prevention \nCHIS California Health Interview Survey \nCHSWC \nCPI-U Commission on Health and Safety a nd Workers\u2019 Compensation \nConsumer Price Index for All Urban Consumers \nDIR (California) Departmen t of Industrial "] [12.259395599365234, 20.22684669494629, "...... ................... 45 \n4. PTSD in California\u2019s Workers\u2019 Compensation System........... ................................................. 49 \nOverview of Workers\u2019 Compe nsation Claims Process ................................................."] [12.134443283081055, 19.913022994995117, "nges in Number of W orkers\u2019 Compensation Claims Filed ............................................. 126 \nPotential Changes in Workers\u2019 Co mpensation System in Response t o Claims ................................... 129 \nRetroactive Application of S"] [12.221936225891113, 20.21485137939453, ".................................................. 52 \nFigure 7.1. Annual Spending in 2020\u20132024 for Peace Officer PTSD Claims: SB 542 \nHigh-Incidence Scenario Versus Pre-SB 542 Status Quo .................................................. 136 \nFi"] [12.289739608764648, 20.23468017578125, "............................................. 66 xix Table 4.6. Employment Status at the Time a Claim Was Reported, by Involvement of \nAnxiety/Trauma Disorders, by Occupation .........................................................................."] [12.183833122253418, 20.11366081237793, " \nTable 7.7. Number of First Responde rs Seeking Treatment and Fil ing Workers\u2019 \nCompensation Claims Annually If Nothing Changes ............... .......................................... 132 \nTable 7.8. Annual Workers\u2019 Compensation Claims Filed fo"] [12.299851417541504, 20.247703552246094, "ponders \nwith Claims Involving Anxiety/Trauma Disorders, by Occupation a nd Type of \nClaims Administrator .......................................... ................................................................ 177 \nTable C.8. Paid Indemnity an"] [12.33907699584961, 20.25522232055664, "e study goals, we conducted a mixed-methods eval uation, combining a \nnumber of quantitative and qualita tive research tasks. Quantita tive analyses included the use of \nhousehold survey data to estimate the prevalence of mental dist ress and suicida"] [12.347654342651367, 20.327856063842773, "\uf0b7 RQ3: Are claims by firefighter s and peace officer s for mental h ealth conditions denied \nunder circumstances w here the condition app ears to be job-relat ed but the employee \nhas/d difficulty prov ing that fact, and is/was the rate of denial sta"] [12.251691818237305, 20.267881393432617, "the retroactive application of the rules set forth in SB 542? P lease separate out firefighter \nand peace officer estimated costs. \nWhile we chose to organize our res earch report by theme, rather than following the ordering \nof the research question"] [12.351503372192383, 20.323169708251953, "thin and support fire \nand police departments (i.e., chiefs and claims administrators). Using 12 years of workers\u2019 \ncompensation information-system claims data, we describe the ty pes of claims filed by first \nresponders as well as the initi al and "] [12.353160858154297, 20.331520080566406, "sent stakehold er perspectives on how to \nimprove first responders\u2019 access to mental health providers and on general improvements to \nthe workers\u2019 compensation system as it relates to mental health conditions and claims. \nChapter 9 concludes by rec"] [12.291400909423828, 20.27069854736328, "dard of \nevidence required for psychiatri c injuries to be compensable, w hich was originally adopted in \n1989 as part of the Margolin-Bill Greene Workers\u2019 Compensation Act of 1989, succeeded in \ncontrolling medicolegal costs by reducing the volume "] [12.308956146240234, 20.297685623168945, " intended effects, we expect to see higher claim volumes, fewer claim denials, and, most importantly, more frequent and timely receipt of mental health care by \nfirst responders dealing with pos ttraumatic stress. While direc t evidence showing how c"] [12.302480697631836, 20.28922462463379, "ity benefits. \nUnlike other presumptions for public safety workers that were e stablished in Labor Code \nSections 3212 and 3213, the presumption for PTSD established in section 3212.15 will expire in less than five years without further leg islative "] [12.343804359436035, 20.277978897094727, "related mental health injuries and conditions across \nCalifornia. By doing so, we hoped to provide context and insigh t for the quantitative assessment \nof the prevalence and job-relatedn ess of mental health conditio ns among first responders. As ou"] [12.372180938720703, 20.32782745361328, " we obtained, in consultation \nwith DIR, claims data with i njury dates from 2010 to 2019 for c laims submitted to employers \nthat were fire departments or pe ace officer organizations. For each such employer, we calculated \nthe volume of all claims"] [12.361174583435059, 20.29535484313965, "and High Denial Rates for \nMental Health Claims High Proportion of Mental Health Claims \nand Low Denial Rates for \nMental Health Claims \nNorthern C A 1 Fire and 1 Police Department 1 Fire and 1 Police Department \nSouthern C A 1 Fire and 1 Police D"] [12.36777400970459, 20.326438903808594, "partmen t, a claims administrator who s upported the department, a \nmental health provider most use d by first responders in the dep artment, and at least one first \nresponder with a mental health workers\u2019 compensation claim who worked in the departm"] [12.354808807373047, 20.323963165283203, "ers and peace officers focused on their experiences with needing \nhelp for job-related injuries a ssociated with mental health sym ptoms; their ability to \naccess and pay for mental health support via workers\u2019 compensation; the types of mental \nhealt"] [12.519974708557129, 20.21540069580078, " tments. We stopped recruitment of \nan applicants\u2019 attorney after five contact attempts. \nConcurrently, we also recruite d and interviewed all of the 13 f irst responders who were \nreferred to us as being interest ed in the study; this included six f"] [12.71646785736084, 20.13423728942871, "h stakeholder \ngroup. After this initial coding e xercise, we compared the diff erences between the two coders\u2019 \napplication of codes to the int erview text and obtained the fol lowing pooled kappa coefficients: \n0.86, indicating \u201cvery good\u201d coder ag"] [12.487000465393066, 20.27534294128418, "sponder employers. \nWe held the first TAG meeti ng (virtually) on October 13, 2020, before interviews started, to \nallow for input and feedback on the overall design and approach . The meeting was structured \nwith an agenda and included pres entation"] [12.298669815063477, 20.371219635009766, " to participate (we had thr ee explicit department/chief refusals out of 24). As such, first \nresponders from our participati ng departments likely had a diff erent overall experience (again, at \nleast a little) than those i n nonparticipating depart"] [12.314289093017578, 20.196048736572266, "to address many of the research \nquestions. We analyzed data from two household surveys to characterize the prevalence of \nmental health conditions and sui cidality among first responders and workers in similar \noccupations. We also used adminis tra"] [12.373832702636719, 20.2009220123291, "t \nof six survey items that asks respondents about the frequency w ith which they have experienced \ndifferent mental health symptom s over the past 30 days (e.g., \u201c During the past 30 days, about \nhow often did you feel hopeless\u2014all of t he time, mos"] [12.234030723571777, 20.00934410095215, "\nalso produced similar estimates of suicide attempts in the CHIS , but very few respondents in \nfirst responder occupations re ported any history of attempted suicide, and we considered these \nestimates too imprecise to be very informative: we pres"] [12.217044830322266, 20.17156982421875, " of denials reported \non the SROI. 20 Finally, we use claims from the Medical Bill Payment files of t he WCIS to measure medical \nspending, to examine patterns of medical bill denials, and, mos t important, to identify which \nworkers have PTSD that "] [12.283455848693848, 20.231109619140625, "r claims in 2020 is sharply limited \n(to ten months, at most, for claims filed in January). The COVID-19 pandemic, furthermore, dramatically altered non-emergenc y health care use, reduced acc ess to in-person care, and \nincreased the use of telehea"] [12.280291557312012, 20.214962005615234, "uding categories such as depressive disorders, other mood disorders, and personality disorders: the CCS and CCSR code s used in this definition are l isted in Table 2.2. This definition \nwas chosen to provide some estimates of the frequency of claims"] [12.280718803405762, 20.21045684814453, " f or deriving the diagnosis code lists necessary to identify the \nvarious presumption-covered cond itions that we examine. The CCS R algorithm was developed \nfor ICD-10 codes after AHRQ determ ined that the structure of CCS was not optimal for the "] [12.266241073608398, 20.151552200317383, "o lifeguards. Because \nthis presumption does not apply broadly to peace officers or fi refighters, we omit this presumption from our study. \nThe use of medical claims to ascertain whether a worker suffers from specific health \nconditions is necess"] [12.430455207824707, 19.866369247436523, "t employers are pr edominantly self-insured, we \nfound very few fully insured cla ims by firefighters and peace o fficers (2.9 percent), and we do \nnot report estimates for fully insured claims. \nBecause it is somewhat complex t o identify claim reve"] [12.520071029663086, 19.791969299316406, " Drivers \nand EMTs Emergency Medical Technicians and Paramedics \nEmergency Medical Technicians \nParamedics \nAmbulance Drivers and Atten dants, Except Emergency \nMedical Technicians 29-2040 \n29-2042 \n29-2043 \n53-3011 3400 9110 \nPeace Officer \nComparis"] [12.43139362335205, 19.850149154663086, "refighters and peace officers that were composed of multiple occupations. We used data from the Occupational Information Network (O*Net) survey administered by the US DOL to rank occupations based on their similarity to firefighters and peace officer"] [11.871037483215332, 19.094390869140625, "loyers, including th ose at the local-government level who employ most first \nresponders in California. A relat ed missing-data problem is tha t many claims with a FROI do not \nhave any medical bills in the WCIS, while many medical bills in earlier "] [12.273870468139648, 20.23595428466797, "Similar limitations rule out the Medical Expenditures \nPanel Survey Household Component , which also captures diagnosis codes but includes only very \ncoarse occupation categorie s on the public-use files. \nThe K6 was not designed to measur e PTSD, s"] [12.28211784362793, 20.239471435546875, "mitations to the WC IS analysis as well\u2014most notably that we can ascertain the \npresence of PTSD or other medical conditions only when workers seek care for those conditions \nin the workers\u2019 compensation system. Our case-ascertainment app roach incl"] [12.28802490234375, 20.211246490478516, "nd show the \nprevalence estimates of suici dal ideation by occupation. This i nformation answers research \nquestions 1 and 2: \n\uf0b7 RQ1: Do firefighters and peace officers have a higher incidence of traumatic stress \ninjuries than non-public employees "] [12.283147811889648, 20.212526321411133, "name PTSD to PTSI, to address the perceived stigma of having \nthis diagnosis and help diminish barriers to care. The rational e for this change was that the \u201cD\u201d (for \u201cdisorder\u201d) in \nPTSD is believed to increase stigma and discourage treatment-se ekin"] [12.292397499084473, 20.20549774169922, "chs, and Ehlert, 1998). 32 A number of studies have documented rates of PTSD among firefig hters after sentinel events, \nsuch as terrorist attacks or othe r mass casualty events Berning er et al. (2010a, 2010b) reported an \nelevated prevalence of PTS"] [12.316582679748535, 20.170618057250977, "d peace officers has not \nuniformly found elevated suicid e rates, however. Findings on oc cupation-specific suicide rates \nvary, in part because studies have used different methods and estimated different quantities. \nBroadly speaking, epidemiologis"] [12.334718704223633, 20.072467803955078, "pations 27.4 [26.9, 27.9] 7.7 [7.5, 8.0] NOTES: Adapted from Peterson et al. (2020). a Statistically higher than the population rate (all industries or occupations) based on 95-percent confidence interval (CI) of the industry or occupational group r"] [12.309128761291504, 20.231603622436523, "t an \nelevated risk of suicide compared with other male workers. Howe ver, the worrisome finding that \nwomen in protective service occu pations do have an elevated sui cide rate calls for further \nresearch to examine whether those rates among peace o"] [12.288025856018066, 20.227022171020508, " to \u201cperceived\u201d \nstigma, or a fear of ostracism. F indings from the National Como rbidity Survey (NCS) suggest \nthat individuals with PTSD ma y not seek treatment largely becau se they do not perceive a need \nfor services. For example, ove r 60 perce"] [12.308624267578125, 20.260210037231445, "ers, it was common to witness a shooting incid ent; some reported also \nseeing accidents caused by driving u nder the influence, plane c rashes, mass-murder incidents, \nand lethal-force encounters. Fir efighters described exposure to a variety of tra"] [12.308180809020996, 20.240886688232422, "neys noted tha t first responders often respond ed to multiple traumatic \nincidents, especially shootings or other violent events. Being involved in incidents where there \nwas violence toward the first r esponder was most common among p olice officer"] [12.279669761657715, 20.200542449951172, " go ing to bed . . . . It is compounded by \nsleep deprivation because you have to respond to calls [on the job]. This leads to heightened \nanxiety and awareness. Every 911 call, it is like adding a file to your rolodex. We are constantly \nin scenar"] [12.318331718444824, 20.18964958190918, "alth provider who treats firefighters (FS-MH02) 39 In short, our interviews confirmed previous research findings that both firef ighters and \npeace officers are frequently expos ed to traumatic events; the nature of their work also makes \ncumulativ"] [12.34814453125, 20.129247665405273, "lifornia \nworkforce are immediately appa rent. While 46 percent of all wor kers in California are female, \nonly 15 percent of first responders are female. First responder s are also younger than the average \nworker in California, with somewhat fewer"] [12.312968254089355, 20.15854263305664, ". NH/PI = Native Hawaiian/Pacific Islander. 42 composition of first responders also differs from the overall C alifornia workforce, with higher \nproportions of White Non-Hispanics and Black Non-Hispanics and lower proportions of \nHispanics and Asian "] [12.316444396972656, 20.19239044189453, " h insurance, compared with \n91 percent of comparison occupa tions and 80 percent of security guards. Peace officers are more \nlikely to be White Non-Hispanic ( 53 percent) than those in thei r comparison group (48 percent), \nsecurity guards (23 pe"] [12.317828178405762, 20.193952560424805, "evalence of serious mental di stress (1.2 percent) than their comparison group (2.3 percent) or \nambulance drivers and EMTs (4.1 percent). Peace officers, similarly, have a lower estimated \nprevalence of serious mental distress than their comparison "] [12.313151359558105, 20.13617706298828, " evalence of suicidality\u2014measu red primarily as any lifetime \nhistory of suicidal ideation\u2014by o ccupation. First responders ar e less likely (4.3 percent) than \nthose in comparison occupations (9.5 percent) to ever have experienced suicida l ideation"] [12.312422752380371, 20.19581413269043, "Firefighters and \nComparison Groups Peace Officers and Comparison Groups All \nWorkers \nOccupation First \nResponders First \nResponder \nComparators Firefighters Firefighter \nComparators Ambulance \nDrivers and \nEMTs Peace \nOfficers Peace Officer \nComp"] [12.345881462097168, 20.14354133605957, "mortality rates among firefighters and peac e officers or by higher suicide mortality rates among \nother protective service occupations with substantial female employment. Estimat es from household survey data that \nare representative of California s"] [12.256579399108887, 20.282732009887695, " worriso me limitation is that first \nresponder suicides are known to be differentially underreported (compared with other \noccupations). This underreportin g has been attributed to corone rs and medical examiners \nmisrepresenting the cause of dea t"] [12.423227310180664, 20.40630531311035, "ra wing on a review of the rules and \nregulations pertaining to workers\u2019 compensation claims filing, we look at the mechanics and \ntimelines involved in filing and pr ocessing mental health claim s within the larger workers\u2019 \ncompensation system. We "] [11.608097076416016, 18.261783599853516, "tus (see \nFigure 4.1). \nFigure 4.1. Workers\u2019 Compensation Claims Process \n \nSOURCE: Based on California Depart ment of Industrial Relations, 2016. \nClaims can be filed using a Divi sion of Workers\u2019 Compensation ( DWC) DWC-1 form \n(Department of Indu"] [11.644230842590332, 18.221296310424805, " attorney who works to represent the worker, can appeal the decision to the \nWorkers\u2019 Compensation Appeals Board (WCAB). The WCAB then makes a final determination \non the claim. See Figure 4.2 for an overview of the multiple st eps embedded within t"] [12.359804153442383, 20.34140396118164, "ms administrator has up to \n90 days after a claim is filed to either deny or accept it. We interviewed first responders and \napplicants\u2019 attorneys as well as department stakeholders about their experiences with mental \nhealth claims that are de lay"] [12.356468200683594, 20.33969497680664, "es about finances and work st atus, stigma related to having a \nmental health claim, family stre ss, and family issues that could lead to divorce. As one \napplicants\u2019 atto rney commented, \nThe workers\u2019 compensation system is so destructive to mental "] [12.347698211669922, 20.333219528198242, " QME denied or disagreed with the mental health diagnosis \ngiven on the claim or because the Q ME or claims administrator d enied its job-relatedness. This \nviewpoint was more common among a pplicants\u2019 attorneys who represented predominantly peace \no"] [12.350932121276855, 20.31789207458496, "r both fire and polic e departments. One police officer \nstated, \nThese claims adjustors run a business, and part of their job an d strategy is to deny things. People \nbelieve you are going to get denied. What happens if you get in to a fight with th"] [12.349599838256836, 20.337890625, "two \nto 15 months and was roughly six months (median). This compared with the three - to four-month \ntimeframe of filing to acceptance for the two mental health cla ims that were not denied. The first \nresponders interviewed had comp licated, drawn-"] [12.357900619506836, 20.331743240356445, "or prior mental health treatment (not \nfor the current injury) were documented, that this was often us ed to prove that the current mental \nhealth diagnosis was not job-related. Appli cants\u2019 attorneys did raise issues of a lack of medical \nmental "] [12.355988502502441, 20.3375301361084, "\u00a0\nWe also asked claims administra tors health professionals and ch iefs of departments whether \ntheir experience was for mental health claims to be filed alone or combined with physical. \nPrimarily we heard from all thr ee groups that mental health c"] [12.35091781616211, 20.331954956054688, "ders to repor t true claims of mental health issues. \nThe majority of those departments were police departments. One claims administrator asserted, \nIf the claim is for police officers and firefighters, we do not really need to prove anything \nabou"] [12.352997779846191, 20.33608055114746, "fterwa rds that they cannot pay for \ntreatment . \u2014Northern California mental health pr ovider who treats peace officers (PN-MH02) \nSome mental health providers i ndicated that this directive came from the department chiefs. \nA mental health pr ovid"] [12.308005332946777, 20.27396011352539, " the job (establishing job-relatedness) \nand that the diagnosis provided w as appropriate. If mental heal th providers do not supply \nsufficient documentation for a diagnosis, claims administrators usually request that the injured \nworker schedule a"] [12.291972160339355, 20.012556076049805, "erage, th ose who file workers\u2019 \ncompensation claims tend to be older and thus have an age distr ibution that is more comparable \nwith other occupations. Geographic differences across occupatio ns are also more muted among \nworkers who file workers\u2019 "] [12.291876792907715, 20.148578643798828, "ter \nComparators Ambulance \nDrivers and \nEMTs Peace \nOfficers Peace Officer \nComparators Security \nGuards Correctional \nOfficers All \nWorkers \nDemographics \n% Female 13.8% 17.6% 5.4% 8.1% 36.0% 18.5% 32.8% 28.3% 26.7% 44 .0% \nMean Age 40.4"] [12.299013137817383, 20.21466064453125, "66 152, 965 30,819 37,910 2,930,923 \nNOTES: Authors\u2019 calculations , 2008\u20132019 WCIS. Other Infectious Diseases = Lyme disease, meningitis, or tuberculosis. MRSA = Me thicillin-resistant Staphylococcus aureus. \nSample is limited to observations for wh"] [12.28892993927002, 20.202299118041992, "en largely by \nclaims involving cancer, heart di sease, and, to a lesser extent , low back impairments and hernias. \nFor peace officers (22 percent of claims involving presumption conditions, compared with \n18 percent for their comparison g roup, 17"] [12.287354469299316, 20.185632705688477, " \nPhysical Only 92.2% 92.9% 94.8% 95.7% 97.1% 91.1% 90.5% 93.9% 81.7% 93.4% \nMental Only 1.0% 1.4% 0.8% 0.6% 0.6% 1.0% 2.2% 1.8% 2.9% 1.4% \nMental and Physical 0.2% 0.3% 0.2% 0.3% 0.1% 0.2% 0.3% 0.6% 0.1 % 0.4% \nCumulative, N ot Otherwise \nClassi"] [12.295321464538574, 20.232402801513672, "termination basis, though note that the WCIS does \nnot distinguish post-termination cla ims (a legal term of art fo r claims that are filed\u2014sometimes \nin bad faith\u2014following an involunta ry job separation) from clai ms filed after job separation \nf"] [12.270655632019043, 20.212770462036133, "9 WCIS. Sample is limited to observations for which ther e are valid occupation codes; wo rkers\u2019 compensation data is sourced from a \nclaims administrator who reports indemnity benefits on at least 15 percent of the total FROI subm issions and has "] [12.271013259887695, 20.234634399414062, "fferences in benefit rece ipt between claims filed with \nTPAs and claims filed with self-ad ministered employers. In gene ral, TPAs appeared to be much \nmore likely to pay indemnity benefits than self-administered em ployers, which may suggest that \n"] [12.268540382385254, 20.226945877075195, "ministered Total Self-Insured, \nTPA Self-Insured, \nSelf-\nAdministered Total Self-Insured, \nTPA Self-Insured, \nSelf-\nAdministered Total \n% Receiving Settled Indemnity Benefits \nNarrow: PTSD 30.7% 3.0% 20.6% 29. 4% 0.0% 13.8% 31.0% 5.7% 24.0% "] [12.30636215209961, 20.247312545776367, "han the 20-percent rate estimated for the peace officer compar ison group and the 17-percent rate \nestimated for security guards. Co rrectional officers had a claim denial rate (25 percent) that was \nclose to, and not statistically d ifferent from, t"] [12.284074783325195, 20.240253448486328, "ace officers). Denial rat es for other conditions covered by \npresumptions were lower than for mental health conditions. \n73 Table 4.9. Proportion of Claims Initially Denied (Any Final Disposition), by Involvement of PTSD, \nAnxiety/Trauma Disorders,"] [12.332808494567871, 20.219314575195312, "ement 28.1% 15.9% 21.1% An\ny Indemnity 42.5% 37.8% 44.8% \nNot Denied \nTD 40.7% 37.4% 42.4% \nPD 35.3% 26.4% 40.0% \nSettlement 21.1% 12.9% 25.5% \nAny Indemnity 56.3% 52.3% 58.4% \nAnxiety/Trauma Disorder Claims \nDenied \nTD 14.1% 17.4% 13.2% \nPD"] [12.333444595336914, 20.278284072875977, " injuries only. Remaining claims involving anxiety and trauma-related disorders were mostly filed as cumulative injuries not otherwise classified (13.5 percent of firefighter claims and 15 percent of peace officer claims), with a small number filed a"] [12.26285457611084, 20.205841064453125, "lving PTSD. \nThroughout the workers\u2019 compensation system, most claims (57 pe rcent) involving anxiety and \ntrauma disorders entered the system as physical-only claims. Cl aims from firefighters and peace \nofficers were less likely (51 percent each) t"] [12.347986221313477, 20.323993682861328, "iscusses the i ssues involved in proving the job-r elatedness of mental \nhealth conditions listed on first responder claims. We first de scribe the perspectives of \nmental health professionals rega rding the feasibility of provin g or disproving the "] [12.360939025878906, 20.336673736572266, "related \n79 (i.e., that an injury arose out of employment or happened durin g the course of employment, \nAOE/COE) and learned what elements are necessary to establish t hat job-relatedness. \nAll of the mental health profe ssionals we interviewed ind"] [12.353201866149902, 20.336103439331055, " is a huge change in their be havior from before to when they \nfile the claim. If it is documen ted just like other injuries, previous mental health treatment is not a \nproblem. The main thing about pr oving job-relatedness is when t he person got tr"] [12.340214729309082, 20.32699203491211, "ts who were we ll into their careers, who \nneeded mental health treatment because of the cumulative stress of exposure to trauma over time. \n(See Chapter 6 for further disc ussion about the timing of menta l health treatment for first \nresponders.) "] [12.355456352233887, 20.33513832092285, "any mental health providers that they themselves do not \nalways keep records with the deta ils needed for workers\u2019 compen sation claim requests. Claims \nadministrators also said that re ports from mental health profes sionals were lacking, citing a "] [12.3540620803833, 20.341028213500977, " firefighters (FN-MH01) \nOne mental health pr ovider pointed out the irony in the workers \u2019 compensation system that \nchildhood history is not an issue when it is a physical injury claim for a first responder. They \nstated, \nI see a lot of back and k"] [12.344093322753906, 20.329843521118164, " with anymore. \u2014Northern California mental health provider who treats peace officers (PN-MH10) \nThe experience of establishing the job-relatedness of mental he alth conditions was largely \nsimilar among all of the mental health professionals in this"] [12.361754417419434, 20.348146438598633, "e a mental \nhealth provider who says the me ntal health claim is not work-re lated, but that is not that common. \nWith sufficient medical professional support from documentation , we usually pick it up and \naccept the mental health claim. \u2014Southern C"] [12.348681449890137, 20.33804702758789, "m \nearlier. \u2014Northern California claims admini strator for peace officers (PN-CA12) \nClaims administrators also raise d the issue that firefighters a nd police officers alike need to \nreceive treatment from mental health providers within the worke "] [12.339544296264648, 20.3262996673584, "ightmares, where it is hard to see if it is job-\nrelated. Prior to 2020, police officers can be bringing somethi ng up from five to six years ago. So, \nwe have to look at the situation at that time when they were ge tting treatment. It is equally as "] [12.3366060256958, 20.328641891479492, "licants\u2019 Attorneys \nApplicants\u2019 attorneys also ela borated on their experiences prov ing and disproving job-\nrelatedness and explained how things may change within the cont ext of the SB 542 presumption. \nMost applicants\u2019 attorneys men tioned that, "] [12.32066535949707, 20.315717697143555, "nied. But now with the presumption, it makes it easier \n87 because I need to only get medical reports. When there was not the presumption, then there was \nmuch more to do and to substantiate with documentation. Without the presumption, I have to "] [12.262798309326172, 20.216279983520508, "as \ncolumn totals in Table 5.1). \nFor firefighter claims involving P TSD, the denial rate is drama tically higher for TPA claims \n(31 percent) than for those of self-administered employers (17 percent). Similar patterns are \nobserved for other presum"] [12.25635814666748, 20.223169326782227, "idence; record s were submitted by claims admin istrators who had reliable repo rting of SROI records and had at least one \nmedical bill reported. Estimates are weighted to be representat ive of all FROI filed with complet e records and with occupa"] [12.269373893737793, 20.233036041259766, "ally higher for claims \nthat are initially denied (25 percent of initially denied PTSD claims versus 20 percent of initially \naccepted PTSD claims), while even starker differences are obser ved for settlements: while \n20 percent of initially denied "] [12.254158020019531, 20.216093063354492, "emnity 46.9% 28.2% 39.9% 40.3% 20.6% 31.6% 49.0% 31.5% 4 2.9% \nNot Denied \nTD 34.3% 7.8% 17.4% 33.5% 9.5% 16.8% 34.6% 6.8% 17.7% \nPD 32.6% 18.4% 23.4% 29.6% 18.5% 21.6% 33.5% 18.4% 24.3% \nSettlement 24.9% 0.3% 9.0% 18.0% 0.2% 5.4% 27.2% 0.4%"] [12.372248649597168, 20.250513076782227, "oyers, which again stands in contrast to patterns of benefit receipt among other presumption claims filed by firefighters or other presumption claims filed by peace officers that are handled by TPAs. When we look at all claims filed by peace \nofficer"] [12.307634353637695, 20.264772415161133, "o make sure they get the be st care they can get and \ncontinue to do the job for our city. Internally, it makes it a lot easier. \u2014Northern California \nclaims administrator for firefighters (FN-CA01) \nI think it makes a difference if a department is "] [12.341292381286621, 20.2957706451416, "y firefighters (or peace officers) that are subject to presumptions of compensability? NOTE: As part of the response to this question, the contractor should analyze the denial rates of claims subject to presumptions of compensability, whether denial "] [12.33743667602539, 20.316022872924805, "ecific traumatic exposures, cumulative exposure to traumatic events, or retraumatization. Rigorous preemployment psychological screening was cited as a reason why new-onset mental health conditions among first responders could be attributed to employ"] [12.351358413696289, 20.33414077758789, " First, they indicated that workers\u2019 compen sation claims need to define a \nspecific incident and to be file d within the year of the incide nt/injury. The fact that most first \nresponders are slow to seek car e and tend to \u201cgut it out\u201d also prolongs"] [12.351624488830566, 20.34161949157715, " across claims administrators from depart ments with high and low denial \nrates of mental health claims. Specifically, claims administrat ors for departments with low denial \nrates indicated that first res ponder employment training and selection rul"] [12.278541564941406, 20.237573623657227, "TSD is not included there specifically. They indicated that in time, once there are more cases, these detail s will be clarified. \nIn response to research ques tion 3, we found from the WCIS data that claims involving \nmental health were much more l"] [12.392716407775879, 20.366451263427734, "e tried \nto minimize the scope for bias due to data-quality differences by excluding from our sample of \nWCIS data any data from claims administrators that report suspi ciously low volumes of \nindemnity claims (a symptom of unreliable SROI reporting"] [12.349214553833008, 20.341856002807617, "t doing so would create \nsuch a perception, especially in the eyes of their peers or sup ervisors, that they were not able to \ndo their jobs. Many of these worke rs also noted that they were afraid of losing the ir jobs if they \nsought mental health "] [12.34625244140625, 20.336557388305664, "ere they do not \nlet the powers that be know that they are seeking mental health treatment on their own. Usually \nwhen it relates to alcohol or drug use, the firefighter or poli ce officer want to keep it quiet out of \nfear that their department wou"] [12.341068267822266, 20.334522247314453, "n do not provide follow- up care or resources in the \nensuing weeks, potentially m aking the problem worse. \nIn all departments interviewe d, workers had access to an EAP pr ogram that was typically \nused as the first line of treatment for injured wo"] [12.34970474243164, 20.336572647094727, "ovider, and they told me to work out and e at healthy . . . I am never getting \nthat type of help again. You have to know if the person is comp etent with firefighters or police \nofficers. \u2014Northern California firefighter (FN-FR01) \nThey had me conta"] [12.340274810791016, 20.327110290527344, "e intensive programs that required significa nt funds, typica lly provided by \nthe department, and time off of work. A few departments belonged to a program that provided \nfirst responders and their families access to mental health resources through"] [12.339566230773926, 20.333484649658203, " ider who treats peace officers (PN-MH01) \nChiefs reported that their depa rtments had the necessary behavi oral health supports for their \nfirst responders but said ther e was work yet to be done to addr ess the stigma associated with \n104 accessin"] [12.336852073669434, 20.33296775817871, "re department until recently; \nI\u2019d say in about the last year. I know other people that are go ing now to see the mental health \nprovider on contract. Now we can talk about mental health and t he stress of our jobs. Nobody \ntalked about it before. It"] [12.336442947387695, 20.325429916381836, "ok for ou tward signs of stress. \u2014Southern \nCalifornia police chief (PS-DC01) \nRecognition of Trauma Within Departments \nDepartment chiefs discussed the a bility of their departments an d themselves to recognize \ntrauma in their first responders . N"] [12.334696769714355, 20.331968307495117, " incident-\nspecific, the captains, fire chiefs, and other firefighters und erstand the differences in behavior of \ntheir fellow firefighter to know how that has affected a particular firefighter. Or the firefighter \nthemselves can request that they s"] [12.33016300201416, 20.32681655883789, "s no downside. I learn \nthrough incidents. \u2014Southern California fire chief (FS-DC04) \nDepartment representatives identified two major sources of stigma that kept first responders \nfrom accessing and seeking care; namely, pride and fear of losi ng the"] [12.33979320526123, 20.320589065551758, "n California peace officer \n(PS-FR11) \nWe as police officers don\u2019t ask for help; people ask us for help. Police officers are used to getting \nasked for help. \u2014Northern California peace officer (PN-FR03) \nA firefighter expounded, \n108 It is a sign "] [12.329171180725098, 20.304828643798828, "were veterans. \nA third of the first responders ( split across firefighters and peace officers) had also used mental \nhealth treatment in the past (un related to the claimed incident ). The PTSD-specific care provided \nto the first responders we inte"] [12.325207710266113, 20.25727081298828, "be the r easons why respondents with unmet needs for mental health and \nsubstance use care did not recei ve treatment. The CHIS allows r espondents to name one or more \nof four specific reasons, whic h we grouped into two (non-exclusive) categories. "] [12.330262184143066, 20.272268295288086, ".2% 2.3% 20.9% 23.2% 0 .0% 17.8% \nStigma (Not Comfortable OR Someone Found Out) 36.3% 38.4% 3.9% 39.5%\n*** 57.2%** 83.1% 39.7%** 36.9%** 29.3% 39.5% \nNot Comfortable 29.7% 33.9% 3.2% 36.0% 53.3% 67.9% 36.1% 36.9% 29.3% 29.4% \nSomeone Found Out 11.1%"] [12.338631629943848, 20.319093704223633, "any peace officers \nnamed cost as a barrier to receiving mental health and substanc e use treatment. We were also \nsurprised by the sharp contras t between the proportion of firef ighters and peace officers who \nnamed stigma as a reason for not r ece"] [12.33808422088623, 20.317975997924805, "a physic al injury. Of those workers whose claims were denied, half \nsought the needed mental health treatment before receiving the denial, and half started after. This \naddresses research question 7 about the timing of treatment and denied claims."] [12.34432601928711, 20.333152770996094, "health providers indicate d that on rare occasions, a first responder used employer-\nsponsored health insurance for me ntal health treatment. This wa s possible only when an injured \nworker did not yet have an accepted workers\u2019 compensation claim , h"] [12.34432601928711, 20.32921028137207, "ere initially inve stigated. Given the difficulty with getting claims accepted and \nthe long delays between filing and getting a final adjudication, nearly all injured workers we \ninterviewed opted to pay for thei r mental health care through s elf-"] [12.277732849121094, 20.231212615966797, "ls for psychiatric care to \ntreat PTSD even after a claim wa s accepted. To e xplore whether claims for men tal health \nconditions were more likely to be denied than cla ims on other t ypes of injuries, we used \nmedical billing data to summarize bil"] [12.236525535583496, 20.202232360839844, "n Charges on Denied Bills as % of Mean Charges, Mental Healt h \nDiagnosis 14.0% 16.9% 12.6% \nMean Paid Amount at 24 Months, Ment al Health Diagnosis on Bills \n(Intermediate Definition) $2,032 $2,418 $1,889 \nMean Paid Amount as % of Mean Char ges, M"] [12.280611038208008, 20.24633026123047, "lving mental health conditions frequently also \ninvolve physical injuri es, which means not all the bills includ ed in the statistics reflect mental \nhealth care. For this reason, T able 6.2 also reports charges, denials, and payments on bills with "] [12.336868286132812, 20.310392379760742, "out whether others thought they could do th eir jobs, whether they would lose \ntheir jobs, and whether others in the department (including the ir very close colleagues) would \nview them negatively. Quantitat ive estimates show that about 12 percent"] [12.350753784179688, 20.34784507751465, "ces tended to \nsupport first responders participa ting in intensive treatment, such as PTSD retreats, and provided \naccess to a confidential app for t reatment support (for first responders and their families). Most \nfirst responders, however, said t"] [12.329626083374023, 20.31850814819336, "lth treatme nt than firefighters (although pea ce officers may have received \nmore intensive avenues of car e), delayed their care by not seek ing treatment right away, or \nsimply chose to \u201cgut it out.\u201d \nFurther, we heard that the worker s\u2019 compensat"] [12.23716926574707, 20.240751266479492, "effect as well as the costs asso ciated with retroactive applica tion of the rules of SB 542. We \nillustrate the possible degree of variability in the estimated costs, due to changes in assumptions \nabout the true incidence rate of PTSD; the impact "] [12.23009204864502, 20.22886848449707, "1,950 $33,594 $47,209 $42, 200 $33,240 $40,089 $57,192 $3 3,843 $50,830 \nAnxiety/Trauma Disorders $43,20 1 $23,142 $37,399 $40,002 $31,582 $37,989 $44,470 $20,794 $37,161 \nCancer $29,865 $29,591 $29,805 $26,591 $23,862 $26,147 $32,362 $32,042 $32,280"] [12.230757713317871, 20.226926803588867, "irst responders. This dramatic cost difference needs to be \ninterpreted with caution, how ever, as we discuss below. \nTable 7.1 indicates some other im portant facts about benefit co sts associated with claims \ninvolving PTSD. Paid benefits are prima"] [12.243152618408203, 20.22318458557129, "rovide more details on the costs associated with specific categories of \nindemnity benefits in Table C.8. \nTable 7.1 contains one last impor tant finding, which is that in itial claim denials are \nassociated with much lower amount s of paid benefits"] [12.246525764465332, 20.24233055114746, "hly prevalen t health conditions (including \ncancer, heart disease, and back pa in). We saw in Chapter 4 that claims involving PTSD very \nfrequently involve multiple injuries or health conditions: the incremental cost of adding PTSD to \na workers\u2019 co"] [12.235410690307617, 20.23587989807129, " of Claims \u00d7 Cost per Claim, \nwhere \n126 Number of Claims = Number of Fir st Responders \u00d7 PTSD Incidence Rate \u00d7 Probability of \nSeeking Care for Those with P TSD \u00d7 Probability of Filing a Work ers\u2019 Compensation Claim for \nThose Seeking Care, \nand \nC"] [12.267868041992188, 20.175182342529297, "al Government, BLS OES Estimates \nOccupation and Level of Government 2020 Employment \nPeace Officers \nState 8,953 \nLocal 68,897 \nTotal (State + Local) 77,850 \nFirefighters \nState 4,380 \nLocal 29,550 \nTotal (State + Local) 33,930 \nSOURCE: OES es"] [12.275474548339844, 20.245834350585938, "ncidence, treatment- seeking, and recovery estimates and generates annual \nprevalence in each year. We then calculated the change in estim ated prevalence in each year . After ten years, the rate \nof change dropped to zero, and t he resulting prevale"] [12.252914428710938, 20.24715805053711, "filing) that \nwould result from elimination or reduction of cost- and stigma-related barriers. \nWorkers\u2019 Compensation Filing Scenarios \nWe considered three potential changes in how peace officers and firefighters with PTSD \nmight file workers\u2019 compe"] [12.219239234924316, 20.219261169433594, "initial denial rates of \nclaims for PTSD. Table 7.5 summarizes the denial rates for each scenario. Scenario A assumes \nthat there will be no change in t he initial denial rates, so we used the rates described above \n(Chapter 4). Scenario B assumes "] [12.230027198791504, 20.233858108520508, "se incidents. However, they \nmight still seek reimbursement for PTSD care that was not cover ed by workers\u2019 compensation at \nthe time. \n131 Workers\u2019 Compensation Claim Payment Estimates \nAs we describe in Chapter 4, there are three components for w"] [12.227102279663086, 20.223087310791016, "because of differences in budget imp acts. We include estimates for \neach of the filing scenarios described in Table 7.4: (1) all wh o would not seek care because of \nstigma (peace officers) or access (firefighters) would seek car e and file workers\u2019"] [12.141738891601562, 20.123798370361328, "ce \nofficers will file 5,715 workers\u2019 compensation claims over the next five years (compared with 855 \nif there is no change in the f iling rate), and firefighters wil l file 1,385 (compared with 410 if there \nis no change in the filing rate). The"] [12.219355583190918, 20.210147857666016, " (5%) \nPeace Officers State 402 239 292 131 182 182 \n(5% Incidence Rate) Local 3,099 1 ,838 2,252 1,012 1,405 1,405 \nFirefighters State 327 55 304 35 282 282 \n(11.5% Incidence Rate) Local 2, 207 378 2,056 242 1,904 1,904 \nNOTES: WC = workers"] [12.213812828063965, 20.234477996826172, "2 NA NA \nHigh Incidence Rate \nPeace Officers State All who seek carea $71,892,633 $75,418,333 $78,591,463 \n(5% Incidence Rate) Elimination of barriersb $94,250,576 $99,010,271 $103,064,826 \n Partial elimination of \nbarriersc $51,730,429 $54,19"] [12.230973243713379, 20.23653793334961, "ge costs of claims re porting mental health as the \nnature of the injury at the time the claim was initially filed (Table 7.6). As discussed above, we \nestimated costs using this subset of PTSD claims to examine whe ther the high costs of PTSD \nclaim"] [12.225152015686035, 20.233497619628906, " benefits and settlements on first responders\u2019 PTSD claims \ntotaled $63,049. In comparison, the average cost of paid benefi ts for all first responder workers\u2019 \ncompensation claims was $14,076. We note that other presumption conditions, many of whic"] [12.21477222442627, 20.23996925354004, "6,131,214 \nFirefighters State Elimination of barriersa $3,169,496 \n(11.5% Incidence Rate) Partial elimination of barriersb $1,995,821 \n All who seek carec $16,613,523 \n Local Elimination of barriersa $18,492,550 \n Partial elimination of barriersb "] [12.223520278930664, 20.227750778198242, "nonfederal peace officers and 87 percent of nonfederal \nfirefighters in California. The range of uncertainty is very large, however: Over the 2020\u20132024 period, plausible \nassumptions about incidence rates and behavioral responses could result in ave"] [12.229480743408203, 20.23554229736328, "e yearly statewide \nnumber of claims involving PTS D prior to SB 542 to be 80 firefi ghter claims and 168 peace \nofficer claims. Under an interme diate scenario\u2014a scenario in wh ich the true PTSD incidence \nrate among first responders is similar to t"] [12.230156898498535, 20.235788345336914, "PTSD who did not seek t reatment due to stigma or access \nwill file. We assumed that only medical costs for claims with a PTSD diagnosis would be \n142 reimbursed retrospectively. If there is a reduction in barriers to treatment and if the denial ra"] [12.30676555633545, 20.294334411621094, "ially accep ting claims that would have been \ninitially denied under the pre-SB 542 status quo. In general, the difference we observed between the average cost of accepted and denied claims reflects both th e causal effect of claim denial \n(i.e., How"] [12.329229354858398, 20.349084854125977, "en a big differen ce with the passing of SB 542 prim arily because of the preamble of \nthe bill, as it in itself will he lp reduce the stigma associate d with PTSD and seeking treatment. \nThis was just by passing the presumption itself . \u2014Northern Ca"] [12.311068534851074, 20.304079055786133, "support firefighters have b een getting train ing that has b een paid for by the union. It has \nbeen longer than a year, for abou t 3 years that we have had tha t peer support run through the \nunion . \u2014Southern California fire chief (FS-DC04) \nPerspe"] [12.307785987854004, 20.293655395507812, "ed in seeking care for themselves. The problem is that no one \nwants to file the claims. . . . The best part of SB 542 is that it really makes first responder s, \nfirefighters, and police officers feel supported and heard. Tha t will help them reach "] [12.320245742797852, 20.311908721923828, "tion would change the volume of \nworkers\u2019 compensation mental health claims. While some departme nt chiefs and claims \nadministrators thought the presum ption would increase the numbe r of PTSD claims, a few others \nthought that, ultimately, it would"] [12.321680068969727, 20.311735153198242, "think, that is a tough pill to have to swallow. \u2014Northern California claims administrator for \npeace officers (PN-CA01) \nIn addition to impacts on the claims volume, several department chiefs noted improvements \nin the claims process due to t he pre"] [12.318754196166992, 20.306652069091797, "ry and undo pain and suffering as well as fina ncial hardship to these men and \ntheir families. . . . The bottom line is this: It has been far more cost-effective to have PTSD \nallowed as a presumptive injury s o that the expenses of (1) QMEs, (2)"] [12.374736785888672, 20.371723175048828, "or example, EAP \nand then, if need be, to their medical group health. \u2014Northern California mental health provider \nwho treats firefighters (FN-MH01) \nIn addition to difficulties with rei mbursement, many mental health providers noted difficulty \nget"] [12.33117961883545, 20.329633712768555, " All five \nof these departments discussed a history of suicides or other a cute events that prompted chiefs \nand other officials to create mechanisms to get first responders care quickly, without having to \ngo through workers\u2019 compensation. A mental"] [12.310598373413086, 20.297578811645508, "t the presumption woul d increase non-job-related cla ims, but nearly all departments \nnoted that the presumption has helped move claims through the s ystem faster. Having a healthy \nworkforce was noted as being amo ng the biggest cost-savers that r"] [12.268202781677246, 20.250320434570312, "here are poten tial arguments against continuing the presumption in \nSB 542. It could be costly to state and local government, altho ugh there is a lot of cost \nuncertainty due to uncertainty a bout the true prevalence of PTS D. It is also not clea"] [12.308225631713867, 20.301395416259766, "e officers, but it is unclear \nwhether they are covered by t he presumption in SB 542. \nUnlike other workers\u2019 compensation presumptions for public safety workers in the California \nLabor Code, the presumption established by SB 542 will expire i n les"] [12.341919898986816, 20.335851669311523, " Claims Process \nFurther in-depth study into sever al aspects of the workers\u2019 com pensation system is needed. \nBetter information about claims ad ministrator practices could b e used to develop more detailed \nguidelines as to what information should "] [12.338090896606445, 20.333438873291016, "al health delivery s ystem facing first responders is based on a limited number of \ninterviews and cannot be assumed to represent a statewide avera ge. That said, it should not be \nsurprising that first responders suffering from PTSD reported g rea"] [12.337474822998047, 20.325057983398438, "ttention to the composition of mental health prov ider networks in group health, \ncould help reduce the fragmentation of payers that was so delet erious to first responders with \nPTSD. \nThe ultimate goal of SB 542 was not just to provide workers\u2019 co "] [12.300811767578125, 20.23866844177246, "policym akers might consider \nproviding funding for the CHIS t o add items specifically measur ing PTSD (e.g., the PCL, known \n157 as the PTSD checklist) (Bovin et al., 2016; Weathers et al., 19 93; Weathers et al., 2013a; \nWeathers et al., 2013b); "] [12.299911499023438, 20.271778106689453, "e \nmortality rates from the CDC do not show that male firefighters or peace officers are at elevated risk of \nsuicide compared with the overall male workforce. Women in protective service occupations did have elevated suicide mortality rates compared"] [12.332874298095703, 20.26520347595215, "TSD is statistically significantly higher for firefighters (0.9 percent of workers\u2019 compensation claims) than for workers in comparable occupations, including ambulance drivers and EMTs (0.5 percent). For peace officers, results are mixed. Conditiona"] [12.36820125579834, 20.332096099853516, "ion was job-related, or in cases where there was no prior treatment or diagnosis? A: In-depth interviews with firefighters, peace officers, mental health providers, applicants\u2019 attorneys, and claims administrators indicated that receipt of a PTSD dia"] [12.231024742126465, 20.236400604248047, "vered by ESI, and the belief that ESI would not pay bills for potentially work-related health \nconditions. \nRQ11: What might the costs to state and local governments be for each of the next five years now that SB 542 is \nin effect? Please separate "] [12.23225212097168, 20.235637664794922, "etroactive claims would result in payment of medical \ncare benefits, but not in new indemnity benefits , state and local governments collectively might have \nexpected to pay an average of $13 million per year for peace officer claims and $2.6 million"] [12.372551918029785, 20.295032501220703, "ence and inform how future first responders obtain \ncare for mental health problems. The interview is totally confi dential and separate from your employment, \nso I won\u2019t be involved in your interview. \n \nWould you be interested in findin g out mor"] [12.349945068359375, 20.333349227905273, "tal health support for \nemployees? Is this any different as it rel ates to a traumatic e vent that occurr ed for several \nfirefighters/peace officers? How long has this been the approac h at your department? \nRQ3,5 3. In your opinion, does your depa"] [12.346321105957031, 20.328161239624023, "e alth insurance? What is \nyour experience? \nRQ6,7,10 6. What are your thought s on how to reduce denied clai ms for mental health provision for a \nfirefighter/peace officer? \n Claims Administrators \nRQ5,7,10 1. What are the main rea sons for denyin"] [12.384208679199219, 20.292158126831055, "we \ndrew department chiefs, mental health providers, and claims adm inistrators for interviews. \nCategories of characteristics in cluded the type of department ( i.e., fire or police), the rate of \nmental health claim denials (i.e ., high or low), t"] [12.411200523376465, 20.236347198486328, "ty \nUrban 3 3 50% 43% \nRural 3 4 50% 57% \nLocation \nNorthern California 3 4 50% 57% \nSouthern California 3 3 50% 43% \nDepartment Denial Rate fo r Mental Health Claims \nHigh 3 4 50% 57% \nLow 3 3 50% 43% \nYears as First Responder (Mean) 20"] [12.358237266540527, 20.240774154663086, "s or fidgety? \n4. How often did you feel so depre ssed that nothing could cheer you up? \n5. During the past 30 days, about how often did you feel that ever ything was an effort? \n6. During the past 30 days, about how often did you feel worthless? \nIn"] [12.389121055603027, 20.24811363220215, "ey think they might \nneed it. Please respond with a \u201cyes\u201d or \u201cno\u201d to tell me whether each statement applies \nto your reason for not seeing a professional. \n\uf0b7 You were concerned about the cost of treatment. \n\uf0b7 You did not feel comfort able talking wi"] [11.722079277038574, 19.04341697692871, "unts for the NHIS\u2019s complex survey design. \nStatistical Inference \nUsing the weights described above , we conducted tests for stati stical significan ce for both the \nbinary outcome variables (seri ous or moderate mental distress) and the continuous "] [11.492883682250977, 19.02827262878418, "(3) self-insured, self-administered. In the empirical work, indicator variable s were created using the following logic: An individual was \nconsidered to be fully insured if they were not self-insured, as define d by an indicator variable \nsourced di"] [12.299044609069824, 20.107383728027344, "atory disorders \n(nature-of-injury code 65); poiso ning\u2014chemical, other than meta ls (nature-of-injury \ncode 66); poisoning\u2014metal (nature-of-injury code 67); dermatiti s (nature-of-injury code \n68); radiation (nature-of-injury code 70); all other occ"] [12.292380332946777, 20.16585922241211, " 4,235 372 124 73,936 \nTable C.3. Prevalence of Serious or Moderate Mental Distress by Occupation, Gender, and Age, 2013\u20132019 CHIS \nOccupation Group First Responders and \nComparison Groups Firefighters and \nComparison Groups Peace Officers and \nC"] [12.267975807189941, 20.175846099853516, "6% 36.9% \nN (Unweighted) 1,170 819 2,056 238 236 494 935 583 1,565 \n \n175 Occupation First Responders Firefighters Peace Officers \nClaims \nAdministrato r Type Self-Insured, \nTPA Self-Insured, \nSelf-\nAdministered Total Self-Insured, \nTPA Self-Insure"] [12.271828651428223, 20.19805335998535, "tal Only 1.0% 1.4% 0.8% 0.6% 0.6% 1.0% 2.2% 1.8% 2.9% 1.4% \nMental + Physical 0.2% 0.3% 0.2% 0.3% 0.1% 0.2% 0.3% 0.6% 0.1% 0.4% \nCumulative, N ot Otherwise \nClassified 6.7% 5.4% 4.3% 3.4% 2.1% 7.7% 7.0% 3.6% 15.2% 4.7% \nN (Unweighted) 115,347 285,11"] [12.253279685974121, 20.22100257873535, " at 24 Months, Mental Health Diagnosis on Bills (Intermediate \nDefinition) 18.9% 34.0% 25.1% 17.6% 36.3% 27.1% 19.1% 32.7% 24.3% \nMean Count of Denied Bills as % of Mean Bill Count, M ental Health \nDiagnosis on Bills (Intermediate Definition) 17.3% 3"] [12.227506637573242, 20.217294692993164, " total FR OI submissions and has complete \nmedical bill data. \n \n180 Supplementary Resu lts for Chapter 7 \nTable C.8. Paid Indemnity and Medical Benefit Cos ts for First Responder Claims Involving PTSD, by Benefit Type \n First Responders Firefighte"] [12.540299415588379, 19.765625, " Context \nMeasures \nAs discussed in Chapt er 2, we used survey d ata on working condi tions and job demands \nfrom the Occupational Informatio n Network (O*Net) program to se lect occupations to \ncompare with peace o fficers and firefighter s. To iden"] [12.553220748901367, 19.797075271606445, "49-9096, 47-4041, 47-2111, \n47-2121, 49-9071, 49-9097, \n53-3011, 49-1011, 37-1012, \n47-4021, 47-2031, 47-2152, \n49-2022, 47-2011, 53-7121, \n17-3029, 49-9099, 47-4051, \n47-5013, 53-7071, 13-1041, \n53-1000, 33-9011, 53-2022, \n33-1011, 11-9199, 39-4031,"] [12.545099258422852, 19.786033630371094, "game wardens; millwrights; \nother health care practitioners \nand technical occupations; \naircraft pilots and flight \nengineers; wind-turbine \nservice techni cians; heating, \nair-conditioning, and refrigeration mechanics and \ninstallers; riggers; haza"] [12.550484657287598, 19.797792434692383, "icians; \nsurveying and mapping \ntechnicians; transportation, \nstorage, and distribution \nmanagers; business \noperations specialists; all \nother \n \n186 Occupational \nGroup (as used \nin this report) SOC Occupation Titles SOC Codes Census Occupation "] [12.570159912109375, 19.81096649169922, ", 1965, 6765, 6750, 1430, 3830, \n7360, 3540, 9030, 7440, 7315, 7560, 6720, \n6355, 7600, 9110, 6360, 7340, 7000, 4210, \n6230, 6700, 6440, 7020, 6210, 9740, 1550, \n7630, 6730, 6800, 9650, 0565, 9000 \n \n187 Occupational \nGroup (as used \nin this report"] [12.550840377807617, 19.808700561523438, "sors of \nmechanics, ins tallers, and \nrepairers; miscellaneous life, physical, and social science \ntechnicians; occupational \nhealth and safety specialists; \nmorticians, undertakers, and \nfuneral arrangers; health and \nsafety engineers, except \nminin"] [12.565786361694336, 19.80937385559082, "\ngroundskeeping workers; \ntransportation, storage, and \ndistribution managers; \nfirst-line supervisors of \nconstruction trades and \nextraction workers; business \noperations specialists, all \nother; first-line supervisors of \nlaw-enforcement workers;"] [12.390109062194824, 19.702606201171875, " \nElectronic Mail 4.15 3.83 3.49 3.81 0.35 \nContact with Others 4.62 4.52 4.66 4.34 0.28 \nTelephone 4.37 4.49 3.90 4.15 0.21 \nFace-to-Face Discussions 4.72 4.74 4.30 4.57 0.16 \nLetters and Memos 3.20 3.26 3.14 3.17 0.03 \nPhysical Work Conditions "] [12.395827293395996, 19.70534324645996, "nce \n(firefighter minus \nall occupations \nmean) \nImpact of Decisions on Coworkers or Company \nResults 4.26 4.22 4.38 3.84 0.42 \nFrequency of Decisionmaking 4.25 4.18 4.31 3.84 0.41 \nPace Determined by Speed of Equipment 2.07 2.30 1.59 1.93 0.14 \nSt"] [12.389004707336426, 19.73247718811035, "ipment, Such \nas Breathing Apparatus, Safety Harness, Full \nProtection Suits, or R adiation Protection 2.84 2.09 1.22 1.37 1.69 1.15 \nIndoors, Not Environmentally Cont rolled 3.26 3.39 2.39 2.38 2.3 1 0.95 \nExposed to Contaminants 3.70 3.54 3.08 3.07"] [12.399906158447266, 19.7425594329834, "2.95 3.05 3.42 2.71 3.10 \u20130.15 \nDegree of Automation 1.91 2.13 1.60 2.01 2.16 \u20130.26 \nPace Determined by Speed of Equi pment 1.26 1.68 1.22 1.63 1.93 \u20130.67 \nNOTES: Mean O*Net Work context r esponses for peace officers and comparison groups examined i"] [12.240472793579102, 20.275890350341797, "on 6.4 [data set], Min neapolis, Minn.: IPUMS, 2019. \nAs of June 22, 2021: https://doi.org/10.18128/D070.V6.4 \n198 Bovin, M. J., B. P. Marx, F. W. Weathers, M. W. Gallagher, P. R odriguez, P. P. Schnurr, and \nT. M. Keane, \u201cPsychometric Properties o"] [12.20119857788086, 20.275798797607422, "ty , \nlast update January 26, 2021. As of September 9, 2021: \nhttps://www.dir.ca.gov/dwc/DWCForm1.pdf \nDepartment of Veterans Affairs a nd Department of Defense, \u201cVA/D OD Clinical Practice \nGuideline for the Management of Posttraumatic Stress Disord"] [12.242202758789062, 20.114072799682617, "o. 4, February 15, 2016, \npp. 737\u2013744. As of June 25, 2021: https://www.ncbi.nlm.nih.gov/pubmed/26890595 \nJahnke, S. A., W. S. Poston, N. Jitnarin, and C. K. Haddock, \u201cHealth Concerns of the U.S. Fire \nService: Perspectives from the Firehouse,\u201d Amer"] [12.24753475189209, 20.214746475219727, "7376669 \nKubiak, S. P., M. L. Beeble, and D. Bybee, \u201cUsing the K6 to Ass ess the Mental Health of Jailed \nWomen,\u201d Journal of Offender Rehabilitation , Vol. 48, No. 4, 2009, pp. 296\u2013313. \n\u201cLabor Code 5402: Division 4. Workers\u2019 Compensation and Insuran"] [12.244794845581055, 20.27430534362793, " As of June 30, 2021: https://www.ncbi.nlm.nih.gov/pubmed/31971929 \nProchaska, J. J., H. Y. Sung, W. Max, Y. Shi, and M. Ong, \u201cVali dity Study of the K6 Scale as a \nMeasure of Moderate Mental Dist ress Based on Mental Health Trea tment Need and \nUtil"] [12.24991226196289, 20.162443161010742, "2, 2003. \n204 Tiesman, H. M., S. Konda, D. Hartl ey, C. Chaumont Menendez, M. Ridenour, and S. Hendricks, \n\u201cSuicide in U.S. Workplaces, 2003\u20132010: A Comparison with Non-W orkplace Suicides,\u201d \nAmerican Journal of Preventive Medicine , Vol. 48, No. 6,"] [12.202289581298828, 20.374483108520508, ", D . S. Herman, J. A. Huska, and T. M. Keane, \u201cThe PTSD Checklist: \nReliability, Validity, and Diagnostic Utility,\u201d Annual Meeting of ISTSS , San Antonio, Calif., \n1993. \nWeathers, F. W., B. T. Litz, T. M . Keane, P. A. Palmieri, B. P. Marx, and P. "] [12.987516403198242, 4.271470546722412, "OBJECTIVE ANALYSIS.\nEFFECTIVE SOLUTIONS.\nReducing Deaths in Law\nEnforcement Custody\nIdentifying High-Priority Needs for the Criminal Justice System\nBY DUREN BANKS, MICHAEL G. PLANTY, MADISON FANN, LYNN LANGTON, DULANI WOODS, MICHAEL J.\nD. VERMEER, BR"] [12.99210262298584, 4.260632514953613, "t occur in law\nenforcement custody to provide necessary context to understand law\nenforcement's role.\nSupport more-reliable and comprehensive reporting to existing systems\nthat rely on law enforcement participation by allocating resources to data\npro"] [14.712151527404785, 8.611944198608398, "Sponsored by Ascendium Education GroupEvaluation of the Minnesota \nDepartment of Correction\u2019s Career Navigators Program\nFinal Report\nLOIS M. DAVIS, MICHELLE C. TOLBERT, SUSAN TURNER\nCORPORATIONFor more information on this publication, visit www.rand."] [14.710055351257324, 8.61204719543457, "incarcerated individuals.\nThe Minnesota Department of Corrections (MNDOC) recognized a key gap in its education strategic \nplan\u2014the lack of career navigators\u2014and conceived the Career Navigators (CN) program to address this gap. The Ascendium Educatio"] [14.707891464233398, 8.616615295410156, " of Justice \nfor their thoughtful review of this report.vSummary\nIntroduction\nCareer navigators assist individuals with college and training opportunities when they return to the commu -\nnity and at the front end of the corrections process (while the"] [14.712006568908691, 8.614041328430176, "ted with other state staff in its design of the CN program, those who \noversaw the EMPLOY\n1 and transition coordinator programs felt that they should have been more involved \nin identifying gaps in services, determining how best to avoid duplication,"] [14.717698097229004, 8.615334510803223, " to include a greater emphasis on supporting transition to postsecondary education after release. The CN supervisor also hoped the career navigators could begin supporting the American Job Centers in the facilities. However, the CN program was unable"] [14.714689254760742, 8.615923881530762, "ntation and by the early termina -\ntion of the program. As a result, we were unable to conduct a robust outcomes evaluation of the CN pro -\ngram. Although we were unable to measure the effectiveness of the CN program in the context of no signifi -\nca"] [14.710354804992676, 8.619216918945312, "oject Timeline ....................................................................................................... 13\nCareer Navigators ..................................................................................................... 13\nPro"] [14.711901664733887, 8.61573600769043, "............................................................... 35\nProcess Evaluation Findings ......................................................................................... 35\nComparison of the MNDOC\u2019s Career Navigators Program with Othe"] [14.71366024017334, 8.611873626708984, "programs that align with their interests and that will enable them to earn certificates or degrees in their chosen fields. In recent years, career navigators have been increasingly viewed as being an important part of correctional education, particul"] [14.711112976074219, 8.614094734191895, "als and Approach\nThe process and outcomes evaluations assessed the implementation of the CN program, including who \naccessed career navigator services, how successful incarcerated individuals were in developing education and CTE plans and in completi"] [14.72179126739502, 8.614480972290039, "ll its female offenders at this facility. \nMoose Lake/Willow River\u2022\n Cu\nstody level: Level 3 medium, Level 2 minimum\n\u2022 Th\nere are more than 1,000 male inmates at a Level 3 medium security prison off Highway 73 in \nMoose Lake and another 180 minimum-s"] [14.724993705749512, 8.597668647766113, "ed post-release recidivism. The outcomes evaluation involved working closely with MNDOC to identify key outcome measures and to undertake data collection for the outcomes study. The primary outcomes of interest post-release from prison were (1) emplo"] [14.728558540344238, 8.61378288269043, "erating over a stable period of time, with outcomes examined for a robust sample. We were, however, able to document key implementation experiences and challenges and provide short-term outcome information for a number of program participants.\nRoad M"] [14.735745429992676, 8.61303997039795, "e used for the \noutcomes evaluation results presented in Chapter Five. Specifically, we present the descriptive statistics on the background characteristics of the CN program participants and the comparison group.\nMethods\nFor the comparison of backgr"] [14.733880996704102, 8.613393783569336, " The vast majority of CN program participants were not married (92.2 percent). Almost all CN program participants had completed a secondary education degree, with almost three-quarters having a postsecondary degree. Although the CN program was provid"] [14.738774299621582, 8.611891746520996, "r of CN program participants \nwere represented in the four groups defined as low, medium, high, and very high (Table 2.2).4 CN program \nparticipants have substantial prior records. More than half had 12 or more total convictions, with almost \nhalf ha"] [14.737550735473633, 8.608414649963379, "nt \n(MNDOC, undated-b).The Sample9TABLE 2.2\nBackground Characteristics\u2014Risk, Commitment County, and Offense Categories: Career \nNavigator Program Participants and Comparison Group\nGroup\nCN Program \nParticipants \n(N = 373)Comparison \n(N = 298)Total "] [14.728536605834961, 8.615118026733398, "Offense category sexual indicator (n, %) 0.13362\n0. No 319 (85.5%) 242 (81.2%) 561 (83.6%)\n1. Yes 54 (14.5%) 56 (18.8%) 110 (16.4%)\nOffense category drug indicator (n, %) 0.03692\n0. No 296 (79.4%) 255 (85.6%) 551 (82.1%)\n1. Yes 77 (20.6%) 43 (14.4%"] [14.715688705444336, 8.613624572753906, "ncluding implementation challenges and lessons learned.\nContext on Career Navigators Program \nProject Timeline\nFigure 3.1 shows the project timeline, including when the career navigators were hired and trained and when \nCN services began and ended.\nC"] [14.714184761047363, 8.612517356872559, "es, creating partnerships to further expand the employer base in several different industries, and facilitating job placement.\n1 MCEC is the organizational structure for teaching and learning in the MNDOC.FIGURE 3.1\nProject Timeline\nDecember 2018\nJan"] [14.714344024658203, 8.611834526062012, " Education staff and other career navigators to support at-risk participants. Serve as the primary liaison between MNDOC Education, DEED, DHS, Minnesota state, and employer partners to ensure that expectations, goals, and objectives are synchronized."] [14.707889556884766, 8.612726211547852, "in most meetings by conference call or reviewed meeting minutes. Several months after being hired, the career navigators received cell phones and laptops, which helped them collect data and communicate with their students who were in the community.\nR"] [14.710609436035156, 8.615720748901367, " provide students with the career navigator\u2019s business cards. After release, the student was expected to call the career navigator. If that did not happen, the career navigator called them. After the initial phone call, the career navigators were req"] [14.718232154846191, 8.611114501953125, "ors began working in the facilities and community. Because of COVID-19, however, most of the qualitative data collected came from the career navigators\u2019 experiences in the facilities.\nConception\nAs mentioned earlier in this chapter, MNDOC Education c"] [14.709432601928711, 8.616620063781738, "integration process at the facilities and with other staff. For instance, the education staff at the facilities had to be reminded that the career navigators were part of the education program and not a separate service.\nDespite these challenges, sta"] [14.703863143920898, 8.629106521606445, "ctional facilities, with \nthe goal of serving up to 650 participants per year. \n4 No employment code covered this type of position within the MNDOC.Evaluation of the Minnesota Department of Correction\u2019s Career Navigators Program: Final Report20workin"] [14.70676326751709, 8.616252899169922, "Chapter Five, only 44 percent of CN program participants had been released by August 2020, when the CN program effectively ended.\nPromising Features of Career Navigators Program\nDespite the early implementation challenges, the CN program was beginnin"] [14.708203315734863, 8.61522388458252, " providers, who recognize the value of academic and career counseling in helping students navigate the postsecondary education system. In addition, several states have also implemented these types of programs for incarcerated students. We examined ho"] [14.699740409851074, 8.541470527648926, "w the attention of researchers and practitioners, who have documented the need for career navigators and developed resources to support these roles.\nLegislation\nThe Second Chance Act was first passed in 2007 and reauthorized in 2018 as part of the Fi"] [14.694869995117188, 8.617086410522461, "nsure access to necessary workforce investment activities and supportive services, using, where feasible, computer-based technologies; and (B) to provide job, education, and career counseling, as appropriate during program participation and after job"] [13.877477645874023, 8.982532501220703, "t they were most successful when they customized their services to the labor market and an individual\u2019s needs; had knowledge of education and training options; formed partnerships with community-based organizations, colleges, and employers; and were "] [14.700990676879883, 8.6139554977417, "gram, \nwhich was designed for youth and young adults, also documented the importance of providing case management and support with navigating education, workforce development, and social services (Cramer et al., 2019).\nCareer Navigator Resources\nTo s"] [14.703553199768066, 8.614967346191406, "ment in criminal activity.\n\u2022\n Ja\nils to Jobs initiative: Launched in 2018 and expanded in 2019, Jails to Job was created by the New York \nCity mayor\u2019s office to provide counseling support and tailored programming in the jail that continues after rele"] [14.70772647857666, 8.613790512084961, "eeds. For example, coordinators may provide additional support to those identified as \u201cunderearners,\u201d meaning they are not making a living wage. \nHIRE staff also focus on developing and maintaining strong relationships with employers. As noted \non th"] [14.688310623168945, 8.621424674987793, "eentry education navigators. The navigators are responsible for helping students achieve their education and career goals. They also serve as a liaison between the students, prison staff, and community college staff. In prison, the navigators work wi"] [14.706986427307129, 8.616520881652832, " lack access to \ncritical services and supports and may be less likely to continue their education. When Knoth and Fumia wrote their report, colleges in the seven highest-return counties had navigators. According to the SBCTC policy associate who was"] [14.702018737792969, 8.612992286682129, "sponsibilities, and Hiring and Training Practices\nCommon In-Prison Roles and \nResponsibilitiesCommon In-Community Roles and \nResponsibilitiesCommon Hiring and Training \nPractices\n\u2022 Provide academic and career \nc\nounseling.\n\u2022 En\ngage students in devel"] [14.761124610900879, 8.61556339263916, "d Bender, 2010).\nApproach\nOur outcomes analysis examined those individuals who had been released from prison as of August 2020. Table 5.1 shows the percentage of the CN program participants and a comparison group who had been released.\nBy August 2020"] [14.773250579833984, 8.622296333312988, " than 5 percent of all \nparticipants were returned to custody within six months of release. At one year, 8.5 percent of the CN program participants had been returned to prison, compared with slightly less than 12 percent of the comparison group. The "] [14.74392318725586, 8.59089183807373, "er of individuals, the reported employment quarter fell during the time that the person was in prison for \nthe most recent incarceration. We did not include those earnings in our analyses.\n2 These percentages of participants who were employed and the"] [14.732829093933105, 8.603179931640625, "5,797.2 (14,520.92) 12,995.6 (12,428.97)\nMedian 9,643.0 12,133.0 10,095.0\nRange 62.0; 63,220.0 104.0; 57,455.0 62.0; 63,220.0\nEmployment post-release (year 1 wages) with zeros0.69762\nN 165 60 225\nMean (SD) 6,674.8 (10,522.00) 7,635.3 (12,784.47) 6,93"] [14.705686569213867, 8.615257263183594, "fying gaps in services, determining how best to avoid duplication, and leveraging existing resources. Some staff members felt that the career navigators should have focused primarily on education rather than employment because employment assistance w"] [14.72459888458252, 8.61298656463623, " This, in turn, had implications for the outcomes analysis.\nDelays in implementing the CN program had implications for the full implementation of the CN model. \nAlthough the grant period began in 2018, the six-month delay in hiring (as a result of ad"] [14.728667259216309, 8.61013412475586, "mpared with slightly less than 12 percent of the comparison group. The type of prison return was similar for both groups. Less than 10 percent returned in the first year after release; the vast majority of those were supervision returns. Individuals "] [14.714533805847168, 8.611990928649902, "ITION PURPOSEThis position will work in a team setting utilizing primary partnerships with other state \nagencies, including DEED, DHS, and Minnesota state; it will also partner with MNDOC departments, including reentry, parole, case management, MINNC"] [14.714076042175293, 8.610920906066895, " state; it will also partner with MNDOC departments, including reentry, parole, case management, MINNCOR EMPLOY, and Transitions.\nThis position exists to provide advanced, comprehensive career planning, job search, and goal setting \nwith many offende"] [14.713689804077148, 8.61082649230957, " employer data and participant employment data. Create high levels of communication with employment groups and other state agencies on the benefits of hiring exoffenders. Work with partnering agencies and MNDOC Education, DEED, and the Transitions, a"] [14.715104103088379, 8.611091613769531, " Priority Time Discretion\n \n A 40\n% A \nAdvising and participant case management: Use expertise in state agency programs and resources to make appropriate referrals for all participant"] [14.714227676391602, 8.612258911132812, "and maintain documentation and reposts that meet reentry grant guidelines. \nF. Mo\nnitor monthly progress reports, provide necessary follow-up, and enter required data into \nthe MNDOC electronic system as appropriate. \nG. Cr\neate program policies and "] [14.71458911895752, 8.611183166503906, "d development purposes. \nE. Re\nports for duty as scheduled. Uses time wisely. Minimizes all types of waste and is conscious \nof costs. DEED Description for the Career Navigator Position45Responsibility Statement\nWorkplace values: Every individual is "] [14.715056419372559, 8.61099624633789, "behavioral \ninterventions, community resources navigation, and employment acquisition and retention techniques\n3.\n Kn\nowledge of WorkForce Center services\n4. Kn\nowledge of the DHS program resources and services\n5. Kn\nowledge of DEED and community res"] [14.74365520477295, 8.601642608642578, "ctly to the Education Director at the home facility and indirectly to the MNDOC Director of Career Technical Education at Central Office. Informal consultations occur as needed with seeking advice or gaining approval on such matters as how to effecti"] [14.762094497680664, 8.576578140258789, "es) \nwith zeros0.7174b\nN 165 60 225\nMean (SD) 2,196.7 \n(3,582.31)2,395.0 \n(4,314.87)2,249.6 \n(3,782.48)\nMedian 0.0 0.0 0.0\nRange 0.0; 19,394.0 0.0; 16,369.0 0.0; 19,394.0\nEmployment post-release (third quarter) (n, %) 0.7233a\n0. No 103 (62.4%) 39 ("] [14.760973930358887, 8.578601837158203, "ort52CN \n(N = 165)Comparison \n(N = 60)Total \n(N = 225) p value\n0. No 165 (100.0%) 60 (100.0%) 225 (100.0%)\nEmployment sector (year 1 post-release): construction \n(n, %)0.2023a\n0. No 83 (91.2%) 24 (82.8%) 107 (89.2%)\n1. Yes 8 (8.8%) 5 (17.2%) 13 (1"] [14.761750221252441, 8.57168960571289, "ional, scientific, and technical services (n, %)0.6444\na\n0. No 159 (96.4%) 57 (95.0%) 216 (96.0%)\n1. Yes 6 (3.6%) 3 (5.0%) 9 (4.0%)\nEmployment sector (year 1 post-release): management of companies and enterprises (n, %)0.3895\na\n0. No 90 (98.9%) 28 "] [14.760101318359375, 8.577984809875488, "ration (n, %)\n0. No 91 (100.0%) 29 (100.0%) 120 (100.0%)\nEmployment sector (year 1 post-release) with zeros: public administration (n, %)\n0. No 165 (100.0%) 60 (100.0%) 225 (100.0%)\nEmployment post-release (first and second quarters) \n(n, %)0.7163"] [14.75938892364502, 8.566390037536621, "loyment sector (first and second quarters \npost-release) with zeros: wholesale trade (n, %)0.1727a\n0. No 160 (97.0%) 60 (100.0%) 220 (97.8%)\n1. Yes 5 (3.0%) 0 (0.0%) 5 (2.2%)\nEmployment sector (first and second quarters post-release): retail trade "] [14.756677627563477, 8.563389778137207, "ond quarters post-release): administrative and support and waste management and remediation services (n, %)0.3641\na\n0. No 45 (59.2%) 18 (69.2%) 63 (61.8%)\n1. Yes 31 (40.8%) 8 (30.8%) 39 (38.2%)\nEmployment sector (first and second quarters post-relea"] [14.726384162902832, 8.5729398727417, "RRS Correctional Adult Reentry Education, Employment, and Recidivism \nReduction Strategies\nCOVID-19 coronavirus disease 2019 \nCTE career technical education\nDEED Department of Employment and Economic Development\nDHS Minnesota Department of Human Serv"] [14.78635311126709, 8.513957977294922, "t, and Michael Rocque, The Predictive Performance of the Minnesota Screening Tool Assessing \nRecidivism Risk (MnSTARR): An External Validation , St. Paul, Minn.: Minnesota Department of Corrections, \nNovember 2019. As of December 29, 2021: https://mn"] [14.762675285339355, 8.488643646240234, "ncarceratedinWashingtonPrisons.pdf\nLewis-Charp, Heather, Issue Brief: Moving Justice-Involved Individuals into Employment: Michigan\u2019s M-CAM \nExperience , Oakland, Calif.: Social Policy Research Associates, September 2017. As of October 4, 2021: \nhttp"] [14.731067657470703, 8.518034934997559, "10publ199.pdf\nPublic Law 113\u2013128, Workforce Innovation and Opportunity Act, July 22, 2014. As of January 5, 2022: \nhttps://www.govinfo.gov/content/pkg/PLAW-113publ128/pdf/PLAW-113publ128.pdf\nPublic Law 114\u2013224, Strengthening Career and Technical Educ"] [6.1515278816223145, 16.440317153930664, "Can Adaptive Reuse of \nCommercial Real Estate Address the Housing Crisis in Los Angeles?\nAppendixes\nJASON M. WARD, DANIEL SCHWAM\nCORPORATIONFor more information on this publication, visit www.rand.org/t/RRA1333-1 .\nAbout RAND\nThe RAND Corporation is "] [6.0473246574401855, 16.456836700439453, " expanding the housing supply that \nincludes increasing the production of both publicly funded affordable h ousing and market -rate \nhousing, incentivizing increased density for infill housing projects, doubling down on such \ninnovations as modular h"] [6.026304721832275, 16.438079833984375, "......... 8 \nData Sources and Taxonomy of Commercial Real Estate ................................ ................................ ........ 8 \nConstructing Our Analysis Data Sets ................................ ................................ .."] [6.032562732696533, 16.42997169494629, ".... 66 \nReferences ................................ ................................ ................................ ................................ ..... 67 \n \n vi Figures and Tables \nFigures \nFigure A.1. Distribution of Vacancy Rates Amon"] [6.034200668334961, 16.445711135864258, " ................................ ................................ .......................... 60 \nTables \nTable A.1. Mean Characteristics of Underutilized Commercial Real Estate in Los Angeles ...... 15 \nTable B.1. Common City of Los Angeles Multi"] [6.032532215118408, 16.448646545410156, "ta cut we use is to restrict our attent ion to properties in Los \nAngeles County. The other restrictions we incorporate relate to characteristics that we \nhypothesize to be more likely to make a property amenable to adaptive reuse (AR). We list each"] [6.022212982177734, 16.435483932495117, "cal \narea in our analysis. Apart from mean travel time to work, our variables of interest can simply be \nsummed across all census tracts to yield a value for the CPA or other municipal area. A similar \nprocedure is performed for the microdata extra"] [6.023641109466553, 16.4317626953125, "the meaning of vacancy is different for hotel/motel properties versus office \nand retail properties. For this class of properties, vacancy rates measure the available rooms at a \npoint in time. Furthermore, the hotel/motel sector has experienced a "] [6.033977031707764, 16.398475646972656, "ood . Within the \nboundaries of the City of Los Angeles , we use subareas called CPAs. These areas are \ngeographies defined in the City of Los Angeles \u2019s General Plan Land Use Element that are used \nto establish neighborhood -specific goals and plan"] [6.0337748527526855, 16.422527313232422, "each. Although these municipalities (e.g., Torrance, Inglewood, El Segundo) are \ntechnically \u201ccontained \u201d by the narrow strip of Los Angeles linking the Port of Los Angeles to the core of the city, \nwe viewed them as less integrated into the geograp"] [6.053805351257324, 16.460344314575195, "(83,364) \nNumber of observations 796 777 677 318 425 276 \nNumber of stories 2.0 2.6 1.5 2.2 2.8 1.8 \nStandard deviation (1.2) (1.6) (0.8) (1.5) (1.8) (1.0) \nNumber of observations 796 785 696 319 430 284 \nYear built 1962 1972 1971 1966 "] [6.047574520111084, 16.46161651611328, " Can Have Lower Development Costs \nHigh housing production costs in Los Angeles have been highlighted as an important \nlimitation on future economic growth and an impediment to social mobility (Nichols, 2019; \nWoetzel et al., 2019) . Factors behind"] [6.0437798500061035, 16.45844078063965, " the inclusion of restrictive labor \nregulations that has led to the recent failure of numerous housing -related bills (Tobias, 2021) . \nLacking this so rt of streamlining, developers interested in pursuing the AR of CRE may need \nto rely, instead, "] [6.040587425231934, 16.46181297302246, "30 beds under \nthe R4 use and must be a minimum of 600 feet from another shelter outside the Central City CPA). See Los Angeles \nCity Planning, 2020, for more details. \n \nIn many cases , however, a change of use, even to a permitted residential u"] [6.042129039764404, 16.46478843688965, "ible for). Properties acquired for the purpose of \ndemolition and new construction may not be used in this manner. \nOther Incentives May Increase the Feasibility of an Adaptive Reuse Project \nPrograms aimed at incentivizing denser housing or more -"] [6.062275409698486, 16.467214584350586, "ng development. Such coalitions have successfully defeated numerous state -level \nupzoning measures , including the controversial SB 50, which failed to pass in 202 0 (Koseff, \n2020). \nCRE conversion may sidestep both of these strains of opposition. "] [6.0386128425598145, 16.460424423217773, "nable to reach through email or phone messages. \nThe group we interviewed over this period comprised \n\u2022 three Los Angeles \u2013based architects \n\u2022 one Los Angeles \u2013based structural engineer \n\u2022 one Los Angeles \u2013based developer of market -rate projects"] [6.0087361335754395, 16.44603157043457, "ince spreading the fixed costs of any AR project across more units will reduce per -unit \ncosts (as is also the case for new construction projects). However, differences in \nacquisition price and num erous other factors may affect the viability of sp"] [5.975197792053223, 16.46823501586914, "ility upgrades. Existing utilities in commercial buildings will usually require \nsubstantial upgrades. Affected systems often include electrical service, fire and domestic \nwater pumps, f ire hydrants, sewer service , and heating, ventilation, and ai"] [6.017801284790039, 16.460044860839844, "struction costs \nand the diversion of the entire developer fee into the p roject allowed for this project to be \ncompleted. Another expert who has worked on numerous projects in DTLA suggested \nthat a building code change that accompanied the 2000 Lo"] [6.044999599456787, 16.474973678588867, "nt \napprovals for nonconforming conditions in a building, reducing delays and redesigns. \n\u2022 High levels of coordination among team members. Multiple interviewees also stressed the \nneed for a much greater than normal level of interaction and commu"] [6.033181190490723, 16.46017837524414, "ified as \u201chomeless\u201d under the federal McKinney -Vento Homeless Assistance \nAct (National Center for Homeless Education, undated) \u2014may complicate conversions of these \nproperties into permanent housing. A potential upside of this phenomenon is that m"] [6.083486557006836, 16.498645782470703, "t by a requirement that the average unit size \nof an AR project be 750 square feet. Figure B.1 demonstrates the effe ct of such an average size \nrequirement by tracing out a curve that relates the number of 450 -square-foot units included in a \n100-u"] [6.042158603668213, 16.45785903930664, "450 Square Foot Units \n(Out of 100)\nSize of Remaining Units Required to Meet 750 Square Foot Average 28 without provisions for parking but quickly discovered that this was not an issue at all in terms of \nfinding tenants for the h ousing. Research o"] [6.333860874176025, 16.67820930480957, "arth of larger projects and that these projects affected by the \nagreement had construction costs that were approximately 15 percent higher than projects not \naffected by the agreement. To increase the c omparability of the projects used in this anal"] [6.383121013641357, 16.713916778564453, "since the former units are simply larger , meaning \nthat each unit costs more in materials. The inclusion of this variable along with the \nnumber of units in each project also effectively controls for the overall size of the project , \nsince the actu"] [6.311864852905273, 16.658525466918945, "terest rate of various \nbond funding programs (for example, Proposition HHH \u2013funded projects were eligible for \na 50 percent interest rate reduction). \n\u2022 Controls for the target population types of a project. Specific characteristics of \nsupportive"] [6.053692817687988, 16.469831466674805, "ese project s primarily use buildings that had some history of serving as housing or \nquasi-housing (two were apartment buildings in poor condition, two were small hospital -related \nfacilities, and one was originally a school that had also served as"] [6.007493019104004, 16.421098709106445, ", Southgate, Downey, \nBellflower, Norwalk, Santa Fe Springs, La Habra Heights, La Mirada, Norwalk, Lakewood, \nCompton, Hawaiian Gardens, Southgate, Mayw ood, Commerce, Paramount, Artesia, and \nCerritos; and parts of unincorporated L os Angeles Count"] [6.033681392669678, 16.450557708740234, " excludes class A properties . \nFigure C.2 . Sale Prices for Studio Apartments and Equivalent Area in Office Properties \nPanel A. Western Los Angeles Panel B. Central Business District Panel C. Southeast Los Angeles \n \nSOURCE : Author cal"] [6.0549211502075195, 16.440458297729492, "by about 40 percent, from an average rate of about 6.5 percent to 9 \npercent by late 2020.15 There is evidence of a broadly similar pattern in retail vacancies, but the \nmagnitude is about ha lf the size, or about 20 percent (an increase from about 5"] [6.0418925285339355, 16.45411491394043, "effects of COVID -19 on \nthe utilization of different types of CRE. Hotel and motel vacancies reflect significant declines in \nrevenue and a higher probabili ty of fiscal distress in this property sector (Singh, 2021) . Increases \nin office vacancies"] [6.035963535308838, 16.451112747192383, "9. Retail \nreal estate prices are likely to continue to decline because of the pandemic (especially apparel, \nconsumer electronics, and furniture ) with a continued increase in brick-and-mortar closures \n(Wahba, 2021) . \nHotel and m otel properties "] [6.062804222106934, 16.4630126953125, "se as interim or permanent housing \nfor people experiencing homelessness under the state of California \u2019s Project Homekey. \nWe note again that this approach to generating an analysis sample is crude and that th e \ncomplexity that is typical of many "] [5.997967720031738, 16.44976806640625, "nt, high -quality transit , and other \namenities, as well as addressing historic patterns of discrimination through downzoning and \nother means that have reduced social and economic opportunities for racial and ethnic minorities \nand low-income indiv"] [6.0103759765625, 16.442232131958008, "le) ; average commute time to work Greater proximity to high -quality transit and \nlower commute times will reduce vehicle \nmiles traveled. \nAccess to jobs -rich areas Number of workers per square mile Higher numbers of worker per square mile \nin"] [6.029371738433838, 16.43450355529785, "socioeconomic opportunities for residents. It is notable tha t most of the \nProject Homekey acquisitions we identify are within these transit corridors, reflecting the fact \nthat this criterion is part of the points system used in awarding this fundi"] [6.0252275466918945, 16.435869216918945, "buted across areas, so certain CPAs in our analysis may have relatively high transit \nridership, while many others reflect nearly 100 percent car commutes. To the extent that transit \nusers experience longer commutes because of the mode of transport"] [6.036919593811035, 16.445093154907227, " lower than \ncurrent rents. Using Zillow rental cost data for City of Los Angeles single -family plus \nmultifamily properties from the beginning of 2017 (the midpoint of the time span of our Cens us 48 Bureau data) to September 2021, we calculate t"] [6.018117904663086, 16.427221298217773, "rea comprising thousands of luxury high -rise condominium properties. 49 density for each of the 43 CPAs and municipalities to generate a single i ndex that allows these \ngeographies to be ranked by this simple proxy measure of area resources and "] [6.013252258300781, 16.421789169311523, "he distribution of underutilized CRE \noverlaid on a map of Los Ang eles County subdivisions. \nFigure E.5. Distribution of Underutilized Real Estate at the County Subdivision Level, by Mean \nTravel Time to Work \nPanel A. Hotel/ Motel Properties "] [4.389317512512207, 18.102205276489258, "r this study. I will share their contact information with you via email, text, or verbally, \nwhichever you prefer. \n \n[Information to be provided: \nThe RAND Human Subjects Protection Committee can be reached toll -free at (866) 697 -5620 or by \nem"] [6.041802406311035, 16.460132598876953, "ing over lays? \n \n3. What challenges in putting together funding are unique to adaptive reuse projects \nrelative to new construction? \na. Potential probes: Are traditional sources of funding like LIHTC credits available \nonce rezoning has been secu"] [6.255924224853516, 16.465517044067383, "Areas Previously Reserved for Single -Family Homes, \u201d The Oregonian , August 13, 2020. \nAs of November 30, 2021: \nhttps://www.oregonlive.com/portland/2020/08/portland -changes-zoning-code-to-allow-\nduplexes-triplexes-fourplexes -in-areas-previously "] [6.26725435256958, 16.456218719482422, " Reject Turning Parking Lot into 500 \nHousing Units, \u201d San Francisco Chronicle , October 28, 2021. \nDuara, Nigel, \u201cNewport Beach Was Supposed to Build 2 Affordable Units in 8 Years \u2014Why So \nLittle?\u201d CalMatters , January 8, 2021 . As of October 14, 2"] [6.313239097595215, 16.4167537689209, "view of Proposition HHH , Los Angeles: \nLos Angeles Office of the Controller, October 8, 2019. As of October 13, 2021: \nhttps://lacontroller.org/audits -and-reports/high -cost-of-homeless-housing-hhh/ \nLall, Jessica, Marie Rumsey, Shane Phillips, an"] [6.422043323516846, 16.263046264648438, " -2020-greater-los-angeles-homeless-count-results \nManson, Steven, Jonathan Schroeder, David Van Riper, Tracy Kugler, and Steven Ruggles, \nIPUMS National Historical Geographic Information System: Version 16.0 [data set], \nMinneapolis, Minn.: IPUMS, "] [6.274704933166504, 16.459434509277344, ", Mills Act Program Application \nGuide 2019 , Los Angeles: City of Los Angeles, January 2019. As of November 30, 2021: \nhttps://planning.lacity.org/odocument/e822f19f -4756-40c8-8e41-\n27bed9057bc1/2019% 20Mills%20Act%20Application%20Guide_FINAL_1.pd"] [6.288837432861328, 16.4523868560791, "dix D : \nHistoric Preservation , Washington, D.C., January 28, 2016 . As of February 25, 2022 : \nhttps://westladraftmasterplan.org/documentation/draft -master-plan \nWahba, Phil, \u201cUBS Sees Another 80,000 U.S. Stores Closing by 2026, \u201d Fortune, April 5"] [12.907219886779785, 4.503515720367432, "Police Killings: Road Map of Research Priorities for Change\nIn this report, RAND Corporation researchers summarize what is currently known \nabout killings committed by police officers in the United States and identify existing \nevidence about various"] [13.859591484069824, 4.601401329040527, "pursue transparency in our research engagements through our commitment to the open \npublication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to \nensure intellectual independence"] [13.905044555664062, 4.221046447753906, " \ndisruptive technologies on risk and security. For more information about the RAND Center for Global Risk \nand Security, visit www.rand.org/international/cgrs.html or contact the director (contact information is pro -\nvided on the webpage).\nRAND Soc"] [12.908631324768066, 4.498752593994141, "ice violence more broadly) from a critical mass of agencies. This \nlack of data has a domino effect on research, restricting the topics that can be assessed and the rigor with \nwhich such assessments can be done. Without better evidence, the ability "] [12.904930114746094, 4.5112152099609375, "med at reducing police violence.\nResearch Priorities\nIn each of our five main focus areas\u2014data and reporting, training, policies, technology, and consequences \nfor officers\u2014and at the foundational level, we identified several priority research topics"] [12.90673542022705, 4.500234127044678, "for research on this topic. Also at the foundational stage is data: Before the Summaryviistate of research on police killings can truly be improved, data collection by agencies on these behaviors\u2014\nregardless of the legality or reasonableness of an in"] [12.920154571533203, 4.482907295227051, "t effects on police violence and killings to further reduce an agency\u2019s number of incidents \ninvolving police violence.\n14. Clarify the role of policies in governing technology use, including a focus on technology \nimplementation.\nTechnology 15. Cons"] [12.91219711303711, 4.497655868530273, "................................................................................. 1\nPrevalence of Police Killings ............................................................................................. 2\nWhen Are Police Killings Legitimate, Le"] [12.908219337463379, 4.508852958679199, "sequences ....................................................................................... 39\nWhat We Know ............................................................................................................ 39\nWhat We Don\u2019t Know .."] [12.910035133361816, 4.498961925506592, "ding police leadership and decisionmaking. Sherman, 2018, identified some of the most \ncommonly recommended interventions for police killings (body-worn cameras [BWCs], de-escalation train -\ning, implicit bias training, early intervention systems, an"] [12.90963077545166, 4.488892555236816, " of the term use of force exists, it has been used to refer to a range of behaviors, from \nverbal commands to serious injury or death. With the recent scrutiny on incidents in which excessive force \nhas been used, some scholars have described use of "] [12.961030960083008, 4.334399700164795, "heir aftermath. Chapter Two provides more detail on this issue. Despite significant data challenges, several \nmajor efforts have been undertaken to collect nationwide counts of and basic details about police killings, \nallowing estimates of prevalenc"] [12.914448738098145, 4.486743450164795, "ns happen and how to reduce them, we must first \nrecognize that not all violence used by officers against civilians, or even all fatal police shootings of civil -\nians, are excessive, wrongful, or criminal. As Bittner, 1974, described, \u201cPolice are em"] [12.913503646850586, 4.491595268249512, "faced by the officers\u201d (Alonso, 2018). The Graham case fur -\nther clarified that, because \u201cofficers are often forced to make split-second judgments\u2014in circumstances that Police Killings: Road Map of Research Priorities for Change4are tense, uncertain"] [12.924002647399902, 4.464433193206787, " of force itself, and often prior to the subject\u2019s noncompliance, \nresistance, or other physical actions upon which the use of force is immediately predicated.\u201d\nThese conclusions suggest that an extensive number of factors go into officer decisionmak"] [12.912737846374512, 4.488626003265381, "ons. \nTo narrow the scope of the literature search to the most relevant sources, we identified five high-priority \nthematic groups\u2014or focus areas\u2014that captured the most published research and the most commonly dis -\ncussed topics regarding police kil"] [12.92013931274414, 4.501094341278076, "viewees were identified from \nthe research team\u2019s professional networks; for additional interviewees, we used snowball sampling based on \nrecommendations from previous interviewees. The interviews were semistructured, following a unified topic \nguide"] [12.903450012207031, 4.505382537841797, "on, however, we identified three issues that are threaded through -\nout most of the literature we reviewed and that are central to understanding police violence in the United \nStates today: racial inequalities, traditional policing culture, and polic"] [12.912066459655762, 4.49337100982666, "accuracy\u2014or lack thereof\u2014in police records in which race and ethnicity are recorded. Often, the race or eth -\nnicity of people who come into contact with police is simply not recorded. When it is recorded, the listed race \nor ethnicity is likely base"] [12.860323905944824, 4.624110221862793, "outcomes: \u201cPolicing as a response to crime \nproblems is in itself a policy decision that has implications for communities\u201d (Weisburd and Majimundar, \n2018).\nPolice Culture\nPolice culture and police unions can work in tandem to frustrate reform effort"] [12.878286361694336, 4.571130752563477, "; Cunningham, Feir, and \nGillezeau, 2020), although this attention to unions is relatively recent (Harris and Sweeney, 2021). Police schol -\nars have argued that some elements of police culture\u2014especially those that prevent officer accountability\u2014\nca"] [12.905708312988281, 4.507988452911377, "e more \naccountability. For example, in Boston, the mayor-elect campaigned on police reform in 2021 and aims to \nmake changes in union contracts, which expired in 2020, to force structural change in the police department \n(McDonald, 2021).Police Kill"] [12.874425888061523, 4.550477027893066, "rmative) where changes can be made and their implications for racial inequities.\n2. Conduct research on aspects of law enforcement that teach and reinforce traditional police cul -\nture and norms and on how reform efforts might overcome resistance st"] [12.953044891357422, 4.364279270172119, "mmission on Civil Rights provided recom -\nmendations to the Federal Bureau of Investigation (FBI) to properly collect and make available information \non police violence. This urgent call from the field has remained consistent (White, 2016). Clear dis"] [12.963228225708008, 4.292705059051514, "ng programs. \nThe analysis found that nearly half of police killings were not captured by existing federal monitoring sys -\ntems. It confirmed the accuracy of crowdsourcing estimates that the actual number of killings in 2014 and \n2015 by police was "] [12.960762023925781, 4.3171772956848145, "time lag between data collection and publication, making it not useful to agencies; and the lack of \nproper data collection capabilities and uniform standards. Several interviewees claimed that although previ -\nous similar efforts have failed, they h"] [12.971725463867188, 4.302259922027588, "Texas, Colorado, and Maine also require agencies to submit use-of-force data. Interviewees recommended \nthat other states replicate these efforts. We heard that, of the states with a data mandate, Texas may have the \nbest data in the country. \nWe spe"] [12.9595365524292, 4.328834056854248, "\nupon way to measure use of force (Shjarback, 2018). Because of this, with the exception of some states with Police Killings: Road Map of Research Priorities for Change16TABLE 2.1\nComparison of Publicly Available Databases Reporting Police Killings\nM"] [12.959084510803223, 4.340683937072754, " enforcement officer acting in the line of duty.Data and Reporting17advanced state-level data collection efforts, it is very difficult to compare statistics across agencies. The lack \nof consistency in measurement of use-of-force research is concerni"] [12.921404838562012, 4.468099594116211, "Agenda Priorities and Recommendations\n1. Explore additional data sources and data that could provide a more reliable representation of a \npolice violence incident.\n \u2013One possibility of additional data sources is that body-camera footage (Peeples, 202"] [12.956632614135742, 4.391223907470703, " involved. Overall, there is not enough pressure from police department leadership to pro -\nvide complete and correct data.\n3. Put more effort into collecting data on nonfatal police violence. \n \u2013Often the difference between a fatal and a nonfatal ou"] [13.13162899017334, 4.377213954925537, "most likely to be encountered in the real world (Dayley, 2016). \nRecent work has found that officers\u2019 physiological responses during stressful situations can affect their \ncognition and behavior, but, over time, officers can learn to adapt to the str"] [12.910837173461914, 4.606564521789551, "horrible.\u201d\nExperts identified implicit bias training as a popular current focus in many departments. Although lim -\nited, the research on implicit bias training has thus far found a change in officer attitudes after the training, \nbut no difference "] [12.725955963134766, 5.054606914520264, "ilians to feel a sense of moral alignment with officers, which enhances police \nlegitimacy . . . and thereby promotes cooperation and compliance\u201d (Terrill, Paoline, and Gau, 2016). One \nelement of procedural justice involves giving citizens a chance "] [12.902383804321289, 4.50275993347168, "in certain situations, such as if a suspect was fleeing or if the suspect had stolen \na car (Phillips, 2015). There was a positive correlation between officers who felt that it was acceptable to use \nverbal force (i.e., to swear at a suspect) and off"] [12.939698219299316, 4.522636413574219, " for improvement in current training approaches. Perhaps the emphasis in training on use of \nforce and not de-escalation is part of the explanation for the high level of police shootings. It is no surprise, \nthen, that all of the interview participan"] [13.101110458374023, 4.443981647491455, "making skills. \n \u2013Evaluate scenario-based training, in which officers are put through realistic role-playing exercises in \nwhich they must make choices about how to respond to the types of incidents they may face. \n \u2013Explore possible transferrable le"] [12.886813163757324, 4.522434234619141, " developmental disabilities (Wright, 2016), mental health \nchallenges, and other conditions should be included in officer training\n \u2013More-realistic, scenario-based training could improve officer performance but needs more develop -\nment and research "] [12.901132583618164, 4.492616653442383, "olicies in agencies across the United States (Oba -\nsogie and Newman, 2017; Sinyangwe, 2016; Alonso, 2018; Jennings and Rubado, 2017; Garrett and Stoughton, \n2017; PERF, 2016). The reviews agree that there is very little consistency in use-of-force p"] [12.900147438049316, 4.496403694152832, "ty of human life . . . at the heart of everything an agency does\u201d (PERF, 2016, p. 34). That report also \nadvised that while agencies do not have to create policies that are stricter than the Graham standard, they \nshould. Thirteen of the principles "] [12.898218154907227, 4.489989280700684, "ies identified by Campaign Zero have a great deal of overlap with PERF\u2019s guiding principles. \nCampaign Zero conducted an analysis of the impacts of these policies on police killings in 91 agencies and \nfound that the two policies with the greatest im"] [12.902541160583496, 4.490562915802002, "es found that this lack of definition made it harder to identify these use-of-\nforce incidents in event reviews and made it easier for officers to obscure such actions within reports. This \nis likely true of departments across the country with vague "] [12.902921676635742, 4.501802921295166, "on drawing a weapon are \nnecessary for fully understanding police killings and how to reduce them (Wheeler et al., 2018)\u2014especially \nwith regards to understanding whether and the extent to which racial bias plays a role in police killings. The \nautho"] [12.90361499786377, 4.505737781524658, " Policies29to disrupt. The findings about addressing networked misconduct echo the discussion in Walker, 2018, on the \nuse of administrative policy to chip away at the police culture in support of greater officer accountability.\nFurther working to ch"] [12.890951156616211, 4.49578857421875, "lice killings but also demands more-specific knowledge about how these \npolicies are implemented and how they work. Campaign Zero and other policy review studies thus present a \nstarting point for additional research into specific policies, their imp"] [12.890372276306152, 4.502152919769287, "we get agencies to change their policies? A great deal of agency resistance to change is related \nto official agency policies: Because Constitutional bare minimums for use of force are a low bar, and agencies \nare not required to abide by a standard "] [12.885839462280273, 4.496204853057861, " easy-to-use forms. Research is needed on how such policies Policies31should be written and implemented and how best to gain officer compliance with such reporting \npolicies.\n2. Identify the mechanisms by which specific policies reduce officer use of"] [12.941374778747559, 4.45946741104126, "-race pairs of \npolice were the least intimidating and threatening to citizens, reducing officer perceptions that force \nis necessary, and that pairing experienced and inexperienced officers together can reduce use of force. \nPolicies that formalize "] [12.934957504272461, 4.4710564613342285, " models, taking advantage of the staggered \nrollout of BWCs across U.S. law enforcement agencies. Of the three models, two indicated significant reduc -\ntions in civilian fatalities as a result of BWC adoption. In addition, we are aware of one non\u2013pe"] [12.926826477050781, 4.517062664031982, "2019, based on observations and interviews shows that at least \nsome officers view electroshock weapons as alternatives to lethal force, including in situations where they \nbelieve lethal force would have been justified. At the same time, the study f"] [12.939026832580566, 4.453814506530762, "her a suspect has a weapon, officers rely on the information provided by dispatch. Incorrect dispatch \ninformation may thus lead to unnecessary use of force or a shooting. Despite evidence from these studies, \nthey were both conducted in experimental"] [12.933125495910645, 4.464104652404785, "tal context mentioned \nabove. The first is differences in levels of cross-stakeholder integration and cooperation in relation to BWC \nimplementation (which can affect the outcomes themselves); the second is differences in methodologies and \ndefinitio"] [12.900897026062012, 4.480950832366943, "of the \nimplications of the paper by Ba and Grogger, 2018, is that training seems to matter, although this is a sugges -\ntion based on use of force not involving firearms.\nWhat are the circumstances of less-than-lethal use of force and its potential "] [12.929725646972656, 4.468616008758545, " use and effectiveness varies \nby officer or unit types.\n \u2013Future research studies should conduct analyses at a more granular level\u2014i.e., at a level smaller than \ndepartment-wide analyses. This approach would ascertain whether it is possible that cer"] [12.9066801071167, 4.512524604797363, "orce used, and progression of the \nencounter since its initiation or since the officer\u2019s dispatch. \n6. Clarify the role of policies in governing technology use, including a focus on technology imple -\nmentation.\n \u2013Future studies should also examine t"] [12.914068222045898, 4.4944376945495605, "nvolved: (1) Prosecutors are reluc -\ntant to charge police officers, (2) grand juries are reluctant to indict, (3) trial juries rarely convict officers, and \n(4)\u00a0judges punish convicted officers comparatively lightly (Rose, 2018).\nIt is extremely dif"] [12.827495574951172, 4.8784003257751465, " of civilian oversight are increasingly used to monitor and review police departments. \nIn addition to internal review mechanisms, law enforcement agencies are also increasingly subject to various \nforms of civilian oversight (Ali and Pirog, 2019; St"] [12.902092933654785, 4.511091709136963, "atic assessments of their effectiveness, both in general and specifically with respect to \npolice violence (Stageman, Napolitano, and Buchner, 2018; De Angelis, Rosenthal, and Buchner, 2016). A \nreview of these boards (Decker and Shjarback, 2020) ide"] [12.90369987487793, 4.514225959777832, "bar for justifying officer actions. In this regard, individual states can adopt their own standards of reason -\nable use of force, as was recently done by California (Commission on Peace Officer Standards and Training, \nundated). Understanding the po"] [12.906712532043457, 4.5111799240112305, " \u25a0abolishing qualified immunity or introducing higher standards (Christman, 2017; Cover, 2016)\u2014\nfor instance, some locations are passing laws limiting qualified immunity and/or requiring officers \nto pay part of settlements out of their own pockets ("] [12.91614818572998, 4.482576370239258, "ufficient, reliable, and systematically collected data that \ncan be compared with data from other agencies. Before the state of research on police killings can truly be \nimproved, data collection by agencies on these behaviors\u2014regardless of the legal"] [12.90703010559082, 4.445694923400879, "rm efforts might overcome resistance stemming from culture and norms.\n3. Conduct research on the role of unions in preventing accountability to agency policies and in shaping \nthe outcomes of cases involving police killings.\nData 4. Explore additiona"] [12.91253662109375, 4.478861331939697, "ous research will allow police executives to better select approaches that are best for \ntheir department, using solid evidence in their decisionmaking.\nOutlook\nThe preceding sections offer a number of research recommendations that can shed light on "] [12.900625228881836, 4.510385513305664, "or \nagenciesConsequences\n\u2022 Role of prosecutors in \noutcomes after unjusti/f_ied \npolice killingsPolice Killings: Road Map of Research Priorities for Change46the agency or to make the agency look bad. In some instances, even when the leadership of pol"] [12.908669471740723, 4.503927230834961, "nal important lever is pressure on local elected officials, who nominally oversee police departments \nand are thus in a position to push for change in police practices and policies. Pressure on local officials can \nalso lead to changing of the police"] [12.912007331848145, 4.4909162521362305, " (Graham, 2021) has threatened to shift attention away from discussions on police reform. \nSome cities even increased police budgets after publicly committing to taking a hard look at police resources \nand need (Covert, 2021). So, while progress has "] [12.886096954345703, 4.500397205352783, "magazine/newspaper sources will be included.\n\u2022 Only publications since 2018 will be included.\n\u2022 Non-empirical sources will be included.\n\u2022 Only sources focusing on the United States will be included.\n\u2022 If not describing an actual executed policy chang"] [12.923871040344238, 4.451842308044434, " OR sheriff OR cop OR cops OR policeman OR policewoman \nOR policemen OR policewomen)\n\u2022 Google Scholar Search 9: fatal AND (police OR sheriff OR cop OR cops OR policeman OR policewoman \nOR policemen OR policewomen)\n\u2022 Google Scholar Search 10: deadly A"] [12.933213233947754, 4.4306230545043945, "ssociation of Chiefs of Police\nLEMAS Law Enforcement Management and Administrative Statistics\nNUFDC National Use of Force Data Collection\nNVDRS National Violent Death Reporting System\nNYPD New York Police Department\nPERF Police Executive Research For"] [12.857418060302734, 4.582508087158203, "nie, Jonathan, and Christy E. Lopez, \u201cKeeping Each Other Safe,\u201d Police Quarterly , Vol. 20, No. 3, 2017, \npp. 295\u2013321. \nAspinwall, Cary, and Simone Weichselbaum, \u201cColorado Tries New Way to Punish Rogue Cops,\u201d The Marshall \nProject , December 18, 2020"] [12.995792388916016, 4.3431782722473145, "=gscholar&cbl=1336360\nBuehler, Emily D., State and Local Law Enforcement Training Academies, 2018\u2014Statistical Tables (NCJ 255915) , \nWashington, D.C.: Bureau of Justice Statistics, 2021. As of July 24, 2020: \nhttps://bjs.ojp.gov/sites/g/files/xyckuh"] [12.874007225036621, 4.5395989418029785, "21: \nhttps://www.cityofws.org/DocumentCenter/View/16499/4-Line-item-adopted-budget-w-notes-Police-FY-21\nCivil Rights Division, The Civil Rights Division\u2019s Pattern and Practice Police Reform Work: 1994\u2013Present , \nWashington, D.C.: U.S. Department of "] [12.86844539642334, 4.557986736297607, "ing the Use of Force: De-Escalation Training for Police Officers , thesis, Monterey, Calif.: Naval \nPostgraduate School, 2016. As of July 24, 2020: \nhttps://calhoun.nps.edu/bitstream/handle/10945/50529/16Sep_Dayley_Eric.pdf?sequence=1&isAllowed=yPol"] [12.87211799621582, 4.545106887817383, "Agency \nPolicies on Conducted Energy Device Use and Police Use of Lethal Force,\u201d Police Quarterly , Vol. 17, No. 4, 2014, \npp. 328\u2013358. \nFisk, Catherine L., and L. Song Richardson, \u201cPolice Unions,\u201d George Washington Law Review , Vol. 85, 2017, \np. 71"] [12.894145011901855, 4.501136779785156, ", Nancy La Vigne, Jennifer Yahner, and Amanda Geller, The Science of \nPolicing Equity: Measuring Fairness in the Austin Police Department , Washington, D.C.: Urban Institute, 2016. \nAs of October 20, 2021: \nhttps://www.urban.org/sites/default/files/"] [12.863988876342773, 4.544081687927246, "olice Use of Force: \nData Quality Concerns and the Potential (Mis)Use of Statistical Evidence to Address Police Agency Conduct,\u201d \nCriminal Justice Policy Review , Vol. 27, No. 5, 2016, pp. 455\u2013479. \nHollis, Meghan E., \u201cMeasurement Issues in Police Us"] [12.900931358337402, 4.499164581298828, "thal Force: Remedying Shooter Bias with Marial Arts Training,\u201d Law & \nContemporary Problems , Vol. 79, No. 3, 2016, pp. 145\u2013172. \nLevin, Benjamin, \u201cWhat\u2019s Wrong with Police Unions?\u201d Columbia Law Review , Vol. 120, No. 5, 2020, \npp. 1333\u20131402. \nLin, Y"] [12.890169143676758, 4.534804821014404, "Journal of Quantitative Criminology , 2021, pp. 1\u201332. \nMoyer, Michael, Police/Citizen Encounters: An Examination of Less Lethal Weapons, Their Effectiveness, and \nOfficer Decision Making, Fayetteville, Ark.: University of Arkansas, Fayetteville, 2015"] [12.881988525390625, 4.534156322479248, "learinghouse/ \nOIG-NYC-Police_Use_of_Force_in_New_York_City.pdf\nPhillips, Scott W., \u201cPolice Recruit Attitudes Toward the Use of Unnecessary Force,\u201d Police Practice & Research , \nVol. 16, No. 1, 2015, pp. 51\u201364. \nRichardson, Joseph B., Christopher St"] [12.87122917175293, 4.553613185882568, "Officer \nDecision-Making and Force Used or Avoided in Arrest Situations: Tulsa, Oklahoma and Cincinnati, Ohio Police \nUse of Force Narrative Data Analysis Report , Cincinnati, Ohio: International Association of Chiefs of Police/\nUniversity of Cincinn"] [12.834503173828125, 4.704407215118408, "cy: Procedural Justice, \nUse of Force, and Occupational Culture,\u201d in Mathieu Deflem, ed., The Politics of Policing: Between Force and \nLegitimacy , Bingley, UK: Emerald Group Publishing, 2016, pp. 59\u201376. \nThomas, Kyle J., Peter A. Collins, and Nichol"] [12.868206977844238, 4.561479091644287, "ly Force: Reexamining the Importance of \nAdministrative Policy,\u201d Crime & Delinquency , Vol. 47, No. 1, 2001, pp. 131\u2013151. \n\u2014\u2014\u2014, \u201cTransactional Encounters, Crisis-Driven Reform, and the Potential for a National Police Deadly Force \nDatabase,\u201d Criminol"] [13.278688430786133, 4.003778457641602, " Alexander Coppock, Evaluating the Effects of Police Body-Worn \nCameras , Washington, D.C.: The Lab@ DC, 2017. As of July 24, 2020: \nhttps://bwc.thelab.dc.gov/TheLabDC_MPD_BWC_Working_Paper_10.20.17.pdf\nZimring, Franklin E., \u201cHow Many Killings by Po"] [6.058137893676758, 16.463830947875977, "CORPORATIONResearch Report\nJASON M. WARD, DANIEL SCHWAM\nCan Adaptive Reuse of \nCommercial Real Estate Address the Housing Crisis in Los Angeles?\nAdaptive reuse (AR) refers to the repurposing of a building for a new, more valuable use \nwhile preservin"] [6.039858818054199, 16.459718704223633, "rojects (Hernandez, 2018). \u2022 Los Angeles County Supervisors Hilda Solis \nand Kathryn Barger in February 2021 pro-posed that the county develop a list of unde-rutilized CRE that could be rapidly trans-formed into both temporary and long-term housing f"] [6.042273044586182, 16.46417808532715, "tel/motel properties are primarily located in lower-ranked areas, whereas office properties are more common in higher-ranked areas. \n QInsights from a series of expert interviews with architects, developers, and engineers with AR experience \nsuggest "] [6.042696952819824, 16.46419906616211, "ing, convert-ing an old warehouse into a dining hall, converting a hotel into housing, etc. In this report, we focus solely on the adaptive reuse of commercial build-\nings for residential purposes . More specifically, \nwe consider three types of comm"] [6.060078144073486, 16.463756561279297, "nd publicly funded affordable housing. This dual focus is motivated by the fact that RHNA hous-ing goals are distributed according to the following household income levels used by the U.S. Depart-ment of Housing and Urban Development: very low income"] [6.0485711097717285, 16.460834503173828, "ple index of socioeconomic and environmental factors. Section 5 looks at characteristics of AR policy through the lens of existing and proposed policies in Los Angeles, concluding with additional factors that may warrant further attention when creati"] [6.055776119232178, 16.461627960205078, "ugh the state\u2019s Project Homekey initiative. Across the state, 94 hotels were purchased in 2020 and 2021 for this purpose, with 28 of these in the Los Angeles region (California Department of Housing and Community Develop-ment, 2021).\n3 Early evidence"] [6.043886184692383, 16.464263916015625, "ewis, 2021).\nA 2021 report projected that, across the United \nStates, 20,000 housing units associated with AR proj-ects would come online in 2021 (Ciuntu, 2021). The same report estimated that AR projects representing another 52,700 units will start "] [6.0377726554870605, 16.4603271484375, "sting building to be \nused in the calculated project value (or basis ), \nwhich determines the maximum award that \ncan be applied for. This is not the case when an existing building is slated for demolition. \n\u2022 Other streamlining legislation could inc"] [6.041865825653076, 16.467021942138672, "ution\n \u2013 remediating structural deficiencies, such \nas water damage to below-grade walls, 8the presence of asbestos or lead paint, and \nunpermitted past additions or alterations that are not code compliant.\n\u2022 Although historic building status can qua"] [6.053486347198486, 16.4752197265625, "1 provides a breakdown of the numbers of \nunderutilized CRE properties by type according to these two geographies, the total square feet of these properties, and two scenarios estimating the number of units that each property type could yield if full"] [6.039546012878418, 16.46463394165039, "dings and $69 for residen-tial buildings (Preservation Green Lab, 2016). This amounts to 60 percent cost savings for commer-cial projects and 26 percent savings for residential projects.\nAdditional evidence on recent costs related to \nconverting hote"] [6.050055980682373, 16.469345092773438, "er unit in total, or approxi-mately $62,000 per unit in conversion costs on top of an acquisition cost of just under $200,000 per unit (Tingerthal, 2021a). One affordable housing devel-oper we interviewed estimated that the total per-unit development"] [6.054693698883057, 16.469820022583008, "ents that were not clear at the start of the project. Using construction \ncosts as the outcome, we found that AR projects cost 48 percent less than new construction projects ($164,000 less per unit).11Assessing Adaptive Reuse Feasibility \nUsing Marke"] [6.040657043457031, 16.460859298706055, "Central Business District) to $185,000 per unit (West Los Angeles). These gaps suggest that a developer could spend up to this amount per unit on conversion costs (includ-ing any fees or profit) if these units could later be sold at current market pr"] [6.029708385467529, 16.453237533569336, " office properties except perhaps in lower-cost areas, such as the Southeast Los Angeles submarket (and, even then, only for the development of studio units). FIGURE 1\nPrice Differences Between Multiunit Re sidential and Commercial Real EstateSale \u2013 "] [6.022829532623291, 16.433406829833984, "eduction goals (Bed-sworth, Hanak, and Kolko, 2011). Fully accounting for these factors may justify the use of significant incentives or subsidies to produce housing in these high-resource areas. \nTo provide evidence on how the distribution \nof under"] [6.012787342071533, 16.421913146972656, "sOffice Building Area\nRetail \nPropertiesRetail Building Area \nSquare \nFeetPercentage \nof TotalSquare \nFeetPercentage \nof TotalSquare \nFeetPercentage \nof Total\nWestwood 92 1 5,700 0.1 8 150,912 1.1 6 137,983 0.1\nWest Los Angeles 88 3 27,600 0.7 26"] [6.037896156311035, 16.447982788085938, "35,050 0.9 5 91,005 0.7 4 83,778 2.9\nSouth Los Angeles 21 33 236,200 6.1 3 144,407 1.1 6 78,585 0.3\nSOURCE: Author calculations using CoStar, U.S. Census Bureau, and City and County of Los Angeles data.Table 2\u2014Continued16the city\u2019s focus on this area"] [6.0369415283203125, 16.448728561401367, "third of the floor area of the associated room or space below it.\n\u2022 The application of alternate building codes \nand code interpretation for qualifying projects that provide greater flexibility in satisfying, for example, fire and safety requirements"] [6.0338263511657715, 16.456148147583008, " construction. However, these standards are all written to provide (in the words of the Division 85 code) a \u201creasonable level of safety to the building occupants . . . in conformance with the provisions of California Health and Safety Code Section 17"] [6.044344902038574, 16.46075439453125, "loping approaches to use these rankings \nto incentivize privately funded projects might prove \nmore difficult, since investors in a given project may not place specific value on the more abstract socioeconomic characteristics of a project. However, u"] [6.059053897857666, 16.45570182800293, "of \nprojects that could produce needed market-rate hous-ing potentially being abandoned because of these requirements. The creative use of purely incentive-based mechanisms, such as time-limited property tax abatements (which would likely require sub"] [6.033130168914795, 16.44986343383789, " a detailed descrip-tion of the data and the regression models used.\n8 We employ apartment size data from Chen, 2019, and Balint, \n2018, using 450 square feet for studio apartments, 725 square \nfeet for one-bedroom apartments, and 1,150 square feet "] [6.1011810302734375, 16.457448959350586, "ounty the task of planning \nfor more than 340,000 units of housing for \u201cabove-moderate \nincome\u201d households (those earning more than 120 percent of the \narea median income level) over the next eight years (Southern \nCalifornia Association of Governmen"] [6.094264984130859, 16.466012954711914, "from 2017 \nto 2021 in Los Angeles using a common set of funding sources, \nmaking them subject to many common cost-drivers, including \ncity regulations and planning requirements, regional labor and \nmaterials costs, and several funding source\u2013specific"] [6.267994403839111, 16.433622360229492, "2021. \nBrown, Eliot, \u201cCasualty of Cities\u2019 Resurgence: The Suburban \nOffices Left Behind,\u201d Wall Street Journal , February 8, 2016. \nCalifornia Department of Housing and Community \nDevelopment, \u201cFinal Homekey Awards,\u201d data set, accessed on October 13, "] [6.297452449798584, 16.464075088500977, "Making It Work: Legal Foundations for Administrative Reform of California\u2019s Housing Framework,\u201d Ecology Law Quarterly, Vol. 47, No. 4, 2020, pp. 973\u20131060.\nFrazier, Mya, \u201cWhen No Landlord Will Rent to You, Where Do \nYou Go?\u201d New York Times Magazine , "] [6.258679389953613, 16.471158981323242, "ewis, Rebecca C., \u201cDueling Proposals to Convert Commercial \nProperties into Housing,\u201d City & State New York , April 2, 2021. \nAs of October 12, 2021: https://www.cityandstateny.com/policy/2021/04/dueling-proposals-to-convert-commercial-properties-int"] [6.284432888031006, 16.44890785217285, "g Supply and Strengthen Accountability, Highlights Comprehensive Strategy to Tackle Housing Crisis,\u201d press release, Oakland, Calif., September 28, 2021b. As of January 31, 2022: https://www.gov.ca.gov/2021/09/28/governor-newsom-signs-legislation-to-i"] [6.333003997802734, 16.378400802612305, "to End Homelessness, August 2021a. As of October 7, 2021: https://endhomelessness.org/wp-content/uploads/2021/08/Best-Inn-H2H-Case-Study_8-4-21.pdf\n\u2014\u2014\u2014, \u201cC a s a L u n a , N a t i o n a l C o m mu n i t y R e n a i s s a n c e (C O R E) \nand U"] [6.2318854331970215, 16.452392578125, "n, Tim Ward, Shannon Peloquin, Steve Kling, \nand Sucheta Arora, Affordable Housing in Los Angeles: Delivering \nMore\u2014and Doing It Faster , McKinsey Global Institute, \nNovember 2019. As of October 7, 2021: https://www.mckinsey.com/industries/public-and"] [6.056328773498535, 16.455364227294922, "s earning 30 percent \nto 80 percent of area median income and for the creation of 197,000 units for \nfamilies earning more than that amount. Meeting this goal would require the \nproduction of more than 100,000 homes per year over the next eight years"] [15.019671440124512, 22.978200912475586, "Sponsored by the Mayor\u2019s Office for Economic OpportunityEvaluation of Mental Health \nFirst Aid in New York City\nAppendixes\nEUNICE C. WONG, MICHAEL STEPHEN DUNBAR, DANIEL SICONOLFI, \nANTHONY RODRIGUEZ, CHESTER JEAN, VANESSA N. TORRES, \nROSEMARY LI, M"] [14.993648529052734, 22.952356338500977, "ment of Corrections (DOC) \n5. Department of Education (DOE) \n6. Department of Health and Mental Hygiene (DOHMH) \n7. Department of Homeless Services (DHS) \n8. Department of Housing Preservation and Development \n9. Department of Information Technology "] [14.989457130432129, 22.947481155395508, " a \nmental health problem or crisis to seek \nprofessional help 1 2 3 4 \nf Assisted a person who was dealing with a \nmental health problem or crisis to connect \nwith community, peer, and personal supports 1 2 3 4 \ng Become aware of my own views and "] [14.945147514343262, 22.896547317504883, "Jay has been so desperate, he has been thinking of ways to end his life. \n What, if anything, do you think is wrong with Jay? Please type your answer below. [PROGRAMMER: OPEN-ENDED. ALLOW 500 CHARACTERS] SCENEA2 The next few questions contain stateme"] [14.985932350158691, 22.94307518005371, " community feel that \nseeking treatment for mental health challenges \nis a sign of personal failure. 1 2 3 4 5 \nk Most people in my community think less of \nsomeone with a history of mental health \nchallenges. 1 2 3 4 5 \n \nMHG2 How confident do you"] [14.9909086227417, 22.9484920501709, "ollowing questions ask about your workplace. Please indicate how much you agree or \ndisagree with each statement. \n \n \nStrongly \nDisagree Disagree Neither \nAgree \nnor \nDisagree Agree Strongly \nAgree Not \nApplicable \na I feel comfortable util"] [14.96937370300293, 22.923032760620117, " be most interested in learning more about? Please rank \nthem in order by entering 1, 2 and 3. \n1. Additional intervention skills \n2. Grief/bereavement \n3. Coping skills \n4. Domestic violence/intimate partner violence \n5. Eating disorders \n6. Effecti"] [14.952831268310547, 22.905593872070312, "ther (specify) \n \n[PROGRAMMER: SELECT ALL THAT APPLY] DEM10 Are you Hispanic or Latino? \n1. Yes \n0. No \n \n[PROGRAMMER: SELECT ALL THAT APPLY] \nDEM11 Which of these groups best represents your race? (Select all that apply) \n1. American Indian or Alask"] [14.983320236206055, 22.9400577545166, "nything, do you think is wrong with Jay? Please type your answer \nbelow. \n Open -ended free \nwrite-in \nKnowledge of referral \nresources I know wh ere I can refer individuals for help with their emotional or mental \nhealth challenges, including alco"] [14.963027000427246, 22.92172622680664, " self -harm? \n . . .encouraged to get professional mental health treatment? \nReach Within Social \nNetwork For each type of person, please indicate how many people you have used \nMental Health First Aid skills with in the past 6 months? \n A fri"] [14.988252639770508, 22.94594383239746, "ion s \nPerceptions of \nFuture Training \nNeeds I could use additional training to apply MHFA skills in my workplace 1 = Strongly \ndisagree; 5 = \nStrongly agree I could use additional training in other mental health skills/topics (different \nthan "] [14.946808815002441, 22.902313232421875, " or crisis Asked a person \nwhether they are \nconsidering killing \nthemselves Actively and \ncompassionately \nlistened Offered basic \u201cfirst \naid\u201d and \nreassurance Assisted with \nseeking \nprofessional help Assisted with \nconnecting to \ncommunity \ns"] [14.95724868774414, 22.91317367553711, " . \u201d (response options , never to frequently). Dichotomized for analysis as 1 = occasionally or \nfrequently, 0 = never or rarely . \nCI = confidence interval. MHFA = Mental Health First Aid. OR = odd s ratio. \n(--) denotes no follow -up contrast tes"] [14.95560359954834, 22.912555694580078, " Offered basic \u201cfirst \naid\u201d and reassurance Assisted with \nseeking professional \nhelp Confidence in \nhelpingb Knowledge of \nreferral \nresourcesc \n Main effect p -value \nGroup contrasts (OR, 95% CI) \nAgency affiliation p = 0.35 p = 0.59 p = 0.04"] [14.951746940612793, 22.90784454345703, "Public safety/ criminal justice -- -- -- 0.63 (0.34, 1.16) -- \n \nSOURCE: RAND MHFA web survey, summer 2021 . \n 25 NOTE: This table shows estimates of associations between agency affiliation and agency group characteristic variables and responden t"] [14.94898509979248, 22.904695510864258, "% 60.31% 59.24% \nAnother identity 66.10% 37.29% NR 62.71% 66.10% 62.71% \nSexual orientation \nStraight 67.54% 29.58% 86.86% 67.95% 64.51% 63.49% \nOther sexual orientation 71.33% 30.12% 89.16% 67.47% 65.78% 66.99% \nRace/ e"] [14.949541091918945, 22.905305862426758, "ntly \nFluent in a language \nother than English 69.68% 30.74% 88.52% 68.76% 65.64% 66.42% \nSOURCE: RAND MHFA web survey, summer 2021 . \na \u201cAs a result of the Mental Health First Aid training, I have . . . \u201d (response range : never to frequent"] [14.944206237792969, 22.899736404418945, " -- -- -- (ref) -- \nBronx -- -- -- 1.58 (1.20, 2.10)** -- \nBrooklyn -- -- -- 1.04 (0.80, 1.34) -- \nOther/unknown -- -- -- 1.11 (0.82, 1.50) -- \nQueens -- -- -- 0.98 (0.74, 1.30) -- \nStaten Island -- -- -- 1.17 (0.74, 1.87) -- \nEducation p "] [14.939997673034668, 22.89561653137207, "1.04) 0.86 (0.57, 1.3 0) -- -- -- -- \n26\u201335 0.96 (0.75, 1.23) 0.78 (0.61, 1.01) -- -- -- -- \n50\u201364 1.02 (0.83, 1.25) 1.03 (0.84, 1.25) -- -- -- -- \n65+ 0.63 (0.47, 0.84)** 0.67 (0.49, 0.93)* -- -- -- -- \n \n \nSexual orientation p = 0.1"] [14.947037696838379, 22.902799606323242, "ely and \ncompassionately \nlistened Offered \u201cfirst aid\u201d \ninformation and \nreassurance Assisted with \nseeking professional \nhelp Assisted with using \npersonal, peer, or \ncommunity support \n Main effect p -value \nGroup contrasts (OR, 95% CI) \nEnglis"] [14.952207565307617, 22.908475875854492, "42) 0.52 (0.36, 0.74)*** \nNon-Hispanic Black only\u2009\u2009 -- 1.27 (1.00, 1.60)* 1.30 (1.03, 1.64)* 1.71 (1.32, 2.22)*** 0.91 (0.70, 1.19) \nNon-Hispanic NH/PI only\u2009\u2009 -- (not estimated)\u2009 (not estimated) (not estimated) (not estimated)\u2009 \nNon-H"] [14.964973449707031, 22.921403884887695, "ent at all to very confident). Dichotomized for \nanalysis as 1 = very confident, 0 = fairly confident, slightly confident, or not confident at all.\u2009 \nc \u201cI know where I can refer individuals for help with their emotional or mental health challenges,"] [15.033376693725586, 22.992565155029297, "t some community members did not participate? \n Effectiveness \n8. What aspects of MHFA have been most helpful in your community? \n9. In general, do you know whether and how your community members have used their MHFA knowledge and skills? [Remind par"] [15.011590957641602, 22.970434188842773, "ctured Protocol for Post-Implementation Evaluation with Participants (RE -AIM, \n2021) \n \nPrior to the interview: \n\u2022 Review the consent forms with all participants and provide hard copies of the \nconsent form for individuals\u2019 personal records. \n\u2022 Co"] [15.010237693786621, 22.969881057739258, " health knowledge/attitudes/stigma within your \nagency? \n14. How has MHFA changed staff awareness of mental health resources available to clients, to City employees, and to New Yorkers in general? \n Implementation \n15. The 8-hour training was offe"] [15.005683898925781, 22.96440887451172, "Sponsored by the Mayor\u2019s Office for Economic OpportunityEvaluation of Mental Health \nFirst Aid in New York City\nEUNICE C. WONG, MICHAEL STEPHEN DUNBAR, DANIEL SICONOLFI, \nANTHONY RODRIGUEZ, CHESTER JEAN, VANESSA N. TORRES, \nROSEMARY LI, MICHELE ABBO"] [15.032682418823242, 22.992021560668945, "rofits, and community-based organizations in 2015 to support the mental health of all New Yorkers through 54 priority initiatives. One of these initiatives involved the provision of in-person Mental Health First Aid (MHFA) trainings, first to staff a"] [15.026570320129395, 22.985855102539062, "ations of the evaluation plan. We would like to acknowledge Annie Chen (who assisted with Chinese translation) and Ninna Gudgell (who assisted with Spanish translation) for their contributions to study recruitment materials for the focus groups. Addi"] [15.029529571533203, 22.988758087158203, " suspended. \nDuring the March 2020 COVID-19 shutdown, planning for an independent evaluation of the \nMHFA program was underway but had not yet been launched. In November 2019, the Mayor\u2019s Office for Economic Opportunity (NYC Opportunity), in collabo"] [15.020346641540527, 22.978492736816406, "re (16 percent), law enforcement/public safety (2 percent), other (26 percent), or no occupation (15 percent). Because city agency employees were prioritized for MHFA training and were a primary group of interest (because of OCMH\u2019s focus on changing "] [15.030007362365723, 22.98894500732422, "ty]) \n\u2022 city agency employee frontline staff (participation was only possible from the Human Resources Administration/Department of Social Services, a city agency with high survey response rates). \nA total of five focus groups (four CBO groups and on"] [15.019129753112793, 22.978315353393555, "A skills. \n\u2022 Most survey respondents (90 percent) were correctly able to identify depression \nsymptoms from a vignette, but performance on a general knowledge test of MHFA \ncontent was low (50 percent on average), indicating room for improvement in s"] [15.052709579467773, 23.012516021728516, "of CBOs viewed MHFA as well-aligned with their organizational and \nprogramming priorities, and some alluded to cultural shifts within their organizations. \n\u2022 Mental health stigma was identified by focus group participants as a potential barrier to \n"] [15.031583786010742, 22.99081802368164, "ed with those who had completed MHFA training more recently (within the past \ntwo years), respondents who had completed training three or more years ago were less likely to engage in certain helping behaviors (e.g., active listening, assistance with"] [15.04276180267334, 23.001859664916992, "f mandatory training could be explored further with a range of stakeholders with distinct vantage \npoints (e.g., city leadership, MHFA implementors, city agency leadership, city agency \nstaff, and agency clients). The three city agency employee focus"] [15.05490779876709, 23.014787673950195, " their \ncommunities. \nOverall Acceptability of MHFA Training Was High, But Areas for Further Cultural \nAdaptation Were Identified \n\u2022 Survey respondents indicated overwhelmingly favorable attitudes toward MHFA training \nwith respect to its utility, co"] [15.031429290771484, 22.99064826965332, "ss. xiii Although those who had completed training three or years ago were less likely to engage \nin certain helping behaviors compared with those who had completed training within the \npast two years of the survey, the continued application of many "] [15.023199081420898, 22.981746673583984, "............................ 3 \t\nReport Structure ........................................................................................................................................ 4 \t\nChapter 2. Methods ......................................."] [15.007214546203613, 22.966035842895508, "................................................................................................................ 30 \t\nWhat Was the Impact on Mental Health Service Use Among Recipients of MHFA? ........................... 32 \t\nWhat Was the Impact of "] [15.009355545043945, 22.967681884765625, "and Comp arisons with \nCommunity -Based Trainees ............................................................................................................. 50 \t\nUse of MHFA Skills ................................................................."] [14.979454040527344, 22.935958862304688, "........................................................................................... 63\t\nSummary of Sociodemographic and Community Group Differences .................................................... 64 \t\nAge ..............................."] [15.042154312133789, 23.001731872558594, "n ...................................................................................................... 87 \t\nMaintenance .............................................................................................................................."] [15.011165618896484, 22.969999313354492, "ified Needs and Fortify \nHelping Behaviors ........................................................................................................................ 97 \txvii Assess Whether MHFA or Similar Trainings Could Serve as a Promising Tool to "] [15.005712509155273, 22.9643611907959, " ..... 30\t\nFigure 3.5. Types of Individuals with Whom Respondents Used MHFA Skills in the Past \nSix Months ............................................................................................................................ 31\t\nFigure 3.6. P"] [15.016572952270508, 22.975677490234375, "ferences in Perceived Future Training Needs by Agency Affiliation and \nCharacteristics ....................................................................................................................... 59\t\nTable 5.1. Differences in Confidence, K"] [15.009218215942383, 22.968032836914062, " of suicide or harm, listen nonjudgmentally, give reassurance and information, encourage appropriate professional help, and encourage self -help and other support strategies (Forthal et al., 2022). \nMHFA has a standard adult course that focuses on ho"] [15.031749725341797, 22.9910888671875, "s a limitation in the research literature (Hadlaczky et al., 2014; Narayanasamy et al., 2018). A systematic review of mental illness stigma interventions in the workplace (which included MHFA) noted the lack of high-quality evidence (e.g., lack of RC"] [15.038459777832031, 22.997426986694336, "ortunity), in collaboration with \nDOHMH and OCMH, commissioned the RAND Corporation to conduct an independent evaluation of the MHFA program. At the time of the COVID-19 shutdowns, planning for a full-scale evaluation of NYC\u2019s MHFA trainings was unde"] [15.033857345581055, 22.99296760559082, "ings from focus groups conducted with CBOs and a city agency involved in facilitating MHFA training. \nIn Chapter 3, the individual-level impact of MHFA and training needs are examined by \naddressing the following questions: \n\u2022 How are trainees curre"] [15.040694236755371, 22.999649047851562, "ctivities: a web-based survey of those who had received training since the \nprogram\u2019s launch in 2015 and a series of focus groups composed of community leaders and select staff from a city agency. This chapter describes the methodological decisions a"] [15.01123332977295, 22.969532012939453, "nt) and those who had no work affiliation (23 percent). Community-based trainees also represented a variety of occupational fields, including mental health and social services (19 percent), education (17 percent), health care (16 percent), and law en"] [15.011178016662598, 22.970186233520508, " survey assessed MHFA training-related outcomes that have been widely documented in \nthe literature (Hadlaczky et al., 2014; Morgan, Ross, and Reavley, 2018). Specifically, the \nprimary MHFA training-related outcomes include trainees\u2019 mental health k"] [14.995392799377441, 22.954267501831055, "asured with a single item that has been found to be longitudinally \npredictive of subsequent application of MHFA skills (Morgan, Ross, and Reavley, 2018). \nSelf-perceived impact of MHFA on helping behaviors measures the frequency with which \ntrainees"] [14.987792015075684, 22.94686508178711, " within trainees\u2019 social networks, respondents were asked to \nindicate in the past six months the number of people they applied MHFA skills to for six types of \nmembers within their social network (e.g., friend/family member, neighbor) (Ashoorian e"] [15.001151084899902, 22.959732055664062, "resentative survey of U.S. adults that was sponsored by the American Psychiatric Association (American Psychiatric Association, 2020). Items measured levels of comfort with discussing mental health with coworkers and supervisors and seeking mental he"] [15.009925842285156, 22.968170166015625, "encies, agency affiliation was \ntreated as a single categorical variable (i.e., affiliations were treated as mutually exclusive). Individuals who indicated being affiliated with multiple agencies were re-coded as \u201cmultiple agencies.\u201d Data for agencie"] [14.98412036895752, 22.94248390197754, "blic safety /criminal justice \nDepartment of Information \nTechnology & \nTelecommunications (DoITT) Medium Low Housing /transportation/infrastructure \nDepartment of Probation (DOP) Medium Medium Public safety/criminal justice \nDepartment of Tran"] [15.024771690368652, 22.982818603515625, " for analysis as Bronx, Brooklyn, Manhattan [reference category], Queens, Staten Island, or other). \nAnalyses \nWe first examined item-level univariate descriptive statistics (means; frequencies) to \ncharacterize participant responses in the pooled s"] [15.016572952270508, 22.974945068359375, "ttan, 20 versus 21 percent Queens, 4 versus 4 percent Staten Island, 14 versus 12 percent other), gender (78 versus 73 percent female), and ethnicity (24 versus 27 percent Hispanic). \nHowever, differences were observed with respect to age distributi"] [15.049214363098145, 23.008882522583008, "ty? \n\u2022 How, if at all, have community members who have been trained in MHFA shared their MHFA knowledge or skills with other community members who did not \nreceive MHFA training? \n\u2022 How has MHFA changed mental health \nknowledge/attitudes/stigma wit"] [15.03916072845459, 22.9888916015625, "ion. Recruitment emails to Latinx community leaders included both English and Spanish translations, and emails to Chinese community leaders included both English and Simplified Chinese translations. Following these initial emails, RAND staff also att"] [15.044912338256836, 22.99517059326172, "based leaders (July 2021) 11 4 4 4 \nLatinx community leaders (August 2021) 10 4 3 3 \nLGBTQ+ community leaders (September 2021) 7 5 3 3 \nHRA/DSS agency staff (November 2021) 4,995 14 5 3 \na Invitations were sent by email from NYC governmental/age"] [15.126442909240723, 13.617144584655762, "taff debriefs held after each focus group, and review of the final transcripts (Guest, MacQueen, and Namey, 2012; McMahon and Winch, 2018; Nowell et al., 2017; Braun and Clarke, 2006). Together, this process generated theory-based codes (i.e., codes "] [15.004571914672852, 22.963159561157227, "use among recipients of MHFA? \n\u2022 What was the impact of MHFA on trainees\u2019 well -being? \n\u2022 How are training experiences (i.e., time since completed training; MHFA trainer status, number of MHFA courses completed; receipt of additional non-MHFA mental "] [14.996166229248047, 22.9541072845459, "HFA required for job \nYes 814 30.85 \nNo 1,722 65.25 \nI don \u2019t know/not sure 103 3.90 \nOccupation \nMental health and social services 586 22.21 \nFaith based 86 3.26 \nEducation 558 21.14 \nHealth care 371 14.06 \nLaw enforcement/public safety"] [15.006983757019043, 22.965763092041016, "le and administrative data across most sociodemographic variables of interest. For example, survey respondents were well matched to trainees represented in administrative data in terms of borough of home residents, gender (e.g., survey: 78 percent fe"] [14.96265983581543, 22.920995712280273, "gh (home residence) \nBronx 16.29 17.68 \nBrooklyn 28.57 29.58 \nManhattan 17.32 15.11 \nOther 13.83 12.29 \nQueens 20.12 20.91 \nStaten Island 3.87 4.42 \nMissing 0.00 -- \nSOURCE S: RAND MHFA web survey, summer 2021, and DOHMH administrative data . "] [14.99174690246582, 22.95026397705078, "ercent) agreed or strongly agreed that most people in their community think less of someone with a history of mental health problems. \nHelping Behaviors \nRespondents reported on their confidence in helping others with a mental health problem, \nwhich"] [14.998780250549316, 22.957477569580078, "and assess for risk of suicide or harm; listen nonjudgmentally; give reassurance and information; \nencourage appropriate professional help; encourage self -help and other support strategies . For more information on \nthe MH FA Action Plan, see Mental"] [14.996757507324219, 22.956212997436523, "th whom trainees use MHFA to help others in the community, \nrespondents reported on their recent interactions with individuals who had a possible mental \nhealth problem, as well as their application of various MHFA skills with different types of indi"] [14.996455192565918, 22.955537796020508, "ighbor or someone from my communityCo-worker/someone who I see as part of my jobClient/someone I provide services as part of my jobFriend/family member\n% respondents32 Table 3. 3. Estimated Num ber of Individuals with Whom Respondents Used MHFA Ski"] [14.989913940429688, 22.9486083984375, "ting rarely (12 percent) or never (6 percent) using skills to help themselves. Many respondents (39 percent) also endorsed having frequently (20 percent) or occasionally (19 percent) used MHFA skills or knowledge to get counseling or therapy for thei"] [14.999722480773926, 22.958232879638672, "th respect to the types of mental health training \nreceived, which could be associated with variations in MHFA training-related outcomes. For example, individuals in occupations that are often characterized by the receipt of professional education in"] [14.967053413391113, 22.92416763305664, "gnificantly more likely to report being very confident in helping someone with a mental health problem (OR = 3.67, 95% CI 2.56\u20135.25, p < 0.001), to endorse knowledge of referral resources (OR = 1.70, 95% CI 1.06\u20132.72, p < 0.05), and to endorse occasi"] [14.988338470458984, 22.946582794189453, "ector) was significantly associated with confidence, \nknowledge of resources, and helping behaviors. Although the magnitude of differences varied slightly across specific outcomes, individuals in nearly all job types/fields show ed consistently \nlowe"] [14.942439079284668, 22.900142669677734, "\nGroup contrasts (OR, 95% CI) \nOccupation type (employment \nsector) p = 0.001 p < 0.0001 p < 0.0001 p < 0.0001 p = 0.003 \nMental health and social \nservices (ref) (ref) (ref) (ref) (ref) \nFaith based 0.64 (0.32, 1.28) 0.85 (0.5 0, 1.45) 0.39"] [15.011674880981445, 22.970863342285156, " related to mental health literacy could be augmented to best meet the needs of New Yorkers. This section provides information regarding respondents\u2019 perceptions of MHFA training and future training needs. \nPerceptions of MHFA Training \nRespondents"] [15.001599311828613, 22.960432052612305, "meone in distress, and more than two-thirds (68 percent) occasionally or frequently offered first aid information and reassurance. Despite the fact that virtually all trainees had completed city-sponsored MHFA training more than one year prior to com"] [15.00400161743164, 22.962909698486328, "lem in the past six months. This is slightly higher than rates of such contacts reported in other studies of MHFA trainees. For example, among government employees in Australia, Kitchener and Jorm, 2004, reported that approximately 72 percent of MHFA"] [14.996891021728516, 22.955806732177734, "Being \nOver 80 percent of survey respondents endorsed occasionally or frequently using information \nfrom MHFA training to support their own well-being. Of significant note, approximately 40 percent indicated obtaining counseling or therapy for their "] [15.016072273254395, 22.975311279296875, "cency of MHFA Training \nWere Associated with a Greater Likelihood of Applying MHFA Skills, But Employer-\nRequired MHFA Training Was Unrelated to Skill Application \nAttaining certification as a MHFA trainer, completing more than one MHFA course, and "] [15.01702880859375, 22.976116180419922, "dorsed Community Mental Health Stigma as a Problem \nAlthough most respondents did not endorse beliefs that mental health problems reflect \npersonal weakness (i.e., suggesting low personal stigma), perceptions of community attitudes \ntoward mental he"] [15.028839111328125, 22.988330841064453, "s correctly identified symptoms of depression after completing online MHFA training. \nHowever, performance in this study on other training-related targets indicated potential room \nfor improvement. For example, on a test of MHFA knowledge correspond"] [15.000150680541992, 22.9588680267334, "n the ongoing application of MHFA and related skills to help others in their communities. 47 Chapter 4 . Survey Results Among Subset of City Agency \nEmployee Respondents \nBecause of OCMH\u2019s focus on changing the culture of government agencies, pro"] [15.000627517700195, 22.959026336669922, "sion 1.29 \nDepartment of Veterans\u2019 Services <1.0a \nDepartment of Corrections <1.0a \nDepartment of Housing Preservation and Development <1.0a \nDepartment of Information Technology & Telecommunications <1.0a \nDepartment of Probation <1.0a \nDepartm"] [15.002901077270508, 22.96153450012207, " transportation/infrastructure \nHuman Resources Administration \n(HRA) Large Medium Health, community, social, or human \nservices \nOffice of Labor Relations Large Medium Other \nPolice Department (NYPD) Large Medium Public safety/criminal justice "] [14.99642562866211, 22.954994201660156, "ks. \nFinally, we assess differences in use of MHFA skills among city agency employee \nrespondents by agency affiliations and agency characteristics. To address questions related to differences in MHFA training-related outcomes across city agencies a"] [14.998452186584473, 22.957338333129883, "1 5.36 \nOffered a distressed person basic \u201cfirst aid \u201d \nlevel information and reassurance about mental \nhealth problems 22.37 44.55 18.58 14.51 \nAssisted a person who was dealing with a \nmental health problem or crisis to seek professional help 24."] [14.993534088134766, 22.952280044555664, "lls with clients in social services or health care settings), we also explored whether groups differed by self-reported occupation type to help contextualize findings related to use of MHFA skills with different types of individuals. City agency empl"] [14.98793888092041, 22.946800231933594, "02). Compared with individuals affiliated with agencies that provide \nhealth, community, and social/human services (reference category), respondents were significantly less likely to endorse being very confident in helping others with a mental healt"] [15.004220008850098, 22.96292495727539, " those who worked in agencies focused on education (OR = 0.65, 95% CI 0.49\u20130.88, p = 0.005), housing, transportation, and infrastructure (OR = 0.33, 95% CI 0.18\u20130.61, p = 0.0003), public safety/criminal justice (OR = 0.54, 95% CI 0.30\u20130.97, p = 0.04)"] [15.00883674621582, 22.96741485595703, "gh their employer. In contrast, fewer city agency employee respondents \u2014but notably more than one in ten (11 percent)\u2014indicated concerns about employer retaliation or fear of being fired if they were to seek mental health care. 57 Figure 4. 3. City A"] [15.000624656677246, 22.9593505859375, "kely to \nagree or strongly agree that they could discuss mental health openly and honestly with coworkers (OR = 0.59, 95% CI 0.42\u20130.82, p = 0.002). \nPerceived Need for Additional Training \nTo assess the extent to which city agency employee responden"] [14.982336044311523, 22.940914154052734, "Department of Housing Preservation and \nDevelopment -- -- \nDepartment of Information Technology & \nTelecommunication -- -- \nDepartment of Parks & Recreation (DPR) -- -- \nDepartment of Probation (DOP) -- -- \nDepartment of Transportation (DOT) -- "] [14.97821044921875, 22.937070846557617, " \nAmong those affiliated with a city agency, more than half of respondents indicated that they \nfelt comfortable discussing mental health with coworkers (65 percent) and supervisors (58 \npercent). Similarly, most indicated that they would feel comfor"] [15.054738998413086, 23.01384735107422, "dose agencies may be less inclined to want more training because training principles are infused throughout the organization. It is also possible that individuals in higher-dose agencies have greater access or exposure to refresher trainings or relat"] [15.000555992126465, 22.95928382873535, "a survey of educators in both rural and urban settings, Moon, Williford, and Mendenhall, 2017, found that 96 percent of respondents reported that they were likely or very likely to encounter students with mental health issues in their work, and 97 pe"] [14.967070579528809, 22.923845291137695, "or multiple tests. Additionally, we conducted sensitivity analyses to examine whether group differences \npersisted after accounting for training and occupation-related factors (see Chapter 3). As detailed in Chapter 3 of this report, the effective su"] [14.954679489135742, 22.911457061767578, "kely to report being very confident compared with those who identified as non-Hispanic White. With respect to 65 knowledge of resources (agree or strongly agree with the statement \u201cI know where I can refer \nindividuals for help with their emotional "] [14.941631317138672, 22.898775100708008, "Group Differences Adjusting for Training and \nOccupation-Related Covariates \nTo assess whether sociodemographic group differences from bivariate models persisted after \naccounting for training and occupation-related factors found to correlate with MH"] [14.931913375854492, 22.88846778869629, "al/ \nstraight -- -- -- -- -- \nOther sexual \norientation -- -- -- -- -- \nGender identity p = 0.02 p = 0.36 p = 0.06 p = 0.21 p = 0.96 \nWoman (ref) -- -- -- -- \nAnother \nidentity 0.74 (0.36, 1.53) -- -- -- -- \nMan 0.69 (0.52, 0.90)** -- -- --"] [14.973145484924316, 22.930776596069336, "hic group variables and respondents \u2019 self-perceived frequency of engaging in helping \nbehaviors \u201cas a result of Mental Health First Aid training, \u201d confidence in helping others with a mental health problem, and knowledge of mental health treatment o"] [15.044256210327148, 23.0040340423584, "onal help). Hispanic and Black respondents were also more likely than their non-Hispanic White counterparts to agree that MHFA training address es topics important to their \ncommunity. Moreover, compared with respondents who identified as non-Hispan"] [15.039993286132812, 22.996423721313477, "address the specific needs of their communities in a culturally appropriate manner. These findings should be considered in the context of some limitations. For example, respondents differed from the broader population of trainees on some characterist"] [15.047955513000488, 23.006587982177734, "mi -structured focus groups, one for each population, guided \nby the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) domains. These domains are described in more detail in Table 2.3 (Chapter 2) and were used to organize the f"] [15.055185317993164, 23.015352249145508, " subsequently contacted MHFA coordinators to implement the training in their community. \nStakeholders in the Chinese, African American, and SGM groups explicitly described how \noffering MHFA training was aligned with their organizations\u2019 existing mis"] [15.058072090148926, 23.01546287536621, "their hope was that the MHFA training would allow trained community members and volunteers to serve as a \u201cfirst step\u201d and \u201ca bridge\u201d to formal services: \nthey can be able to give better suggestions, and they encourage them [persons \nwith mental heal"] [15.058802604675293, 23.018638610839844, ", I think it \u2019s still \u2014for a short time we \u2019ll have to change the thousand years \nof these cultural barriers is not that easy. So we try to open up the dialog to \nencourage people, as many a s we can, to participate in the event. Of course, there \nar"] [15.054424285888672, 23.013235092163086, "ty leaders described how trainees were using MHFA-related knowledge and skills. \nThey also identified specific aspects of MHFA training that they or their community members \nperceived to be helpful or unhelpful. \nTrainees \u2019 Use of MHFA Knowledge and"] [15.062971115112305, 23.022926330566406, "e on.\u201d They continued, \u201cWe\u2019re \nable to use a label and say this is what it is. It\u2019s mental health.\u201d Similarly, a Latinx community leader explained, \u201cIdentificamos muchas cosas que quiz\u00e1s antes, nosotros dir\u00edamos, \u00ab\u00bfqu\u00e9 es lo que est\u00e1 pasando?\u00bb.\u201d [\u201cWe"] [15.074112892150879, 23.033506393432617, "hat the difference between depression, \nschizophrenic, you know, bipolar and all of those things made it a little \u2014it was \nhelpful for them to understand when their \u2014especially when their family \nmembers got a diagnosis, they could kind of put \u201cOh, t"] [15.059122085571289, 23.01896095275879, "al for diffusion was cited by one leader in the African American community as a motivator for offering MHFA training to their constituents. \nOther aspects of diffusion were also identified. For example, an African American leader \ndescribed conductin"] [15.061174392700195, 23.02104949951172, "ations in families, and the workshops created \u201cel canal de apertura\u201d [\u201can opening channel\u201d] to talk about mental health. \nLeaders from the SGM community perceived that MHFA had empowered staff to better \nserve their organizations\u2019 clients. As one lea"] [15.073780059814453, 23.033981323242188, ". So they knew the topic and had empathy with the people, and they had\u2014 They were very flexible. . . . So they selected the staff very well. ] \nIn one case, a leader from the Chinese community noted that some trainers would benefit \nfrom a less \u201ctech"] [15.058622360229492, 23.018260955810547, " that their constituents were unlikely to be accessing web sites that advertise the trainings, and they recommended \u201ccreando alianzas con todas las organizaciones de las ciudades donde van a presentar estos talleres y las organizaciones hacer la invi"] [15.058696746826172, 23.018783569335938, "ing like that. It could last two or three hours. It would make \nit easier for the people to participate. ] \nA leader from the Chinese community said that they had initially planned to offer the standard \neight-hour training but ultimately offered it "] [15.071961402893066, 23.031696319580078, "ese lines, a leader from the Chinese community group expressed a desire for 84 more \u201ccase stud[ies]\u201d during the training, which would \u201chelp people to understand the theory of \nthe situations,\u201d although it was not clear whether this was referring to m"] [15.056266784667969, 23.015853881835938, "roups overwhelmingly asked for more MHFA trainings and were hopeful that MHFA 85 would eventually resume. As described earlier, SGM leaders expressed a desire for more \nculturally tailored MHFA, if it were to be offered in the future. \nLeaders in the"] [15.061436653137207, 23.020362854003906, "omes, and participation barriers and facilitators. We remind 86 readers that findings from this group represent the perspectives of only three staff members; \ntherefore, they should be generalized to other agency employees with extreme caution. \nMoti"] [15.021576881408691, 22.980697631835938, "nd then the agency as an organization could follow up by identifying and codifying best practices for working with clients. Finally, to promote participation in future MHFA-like initiatives, one of the participants pointed out the advantage to 87 \u201ca "] [15.051504135131836, 23.010272979736328, "that the dual-trainer approach led to clashes in style. One of them elaborated: \nthe way their style comes across, like, or the way that the information comes \nacross or is delivered to you, it\u2019 s like, it \u2019s totally different. . . . one is believab"] [15.057823181152344, 23.017967224121094, "ligned with Community Organizations\u2019 Needs \nLeaders of community organizations in all four populations were aware of long-standing \nmental health needs in their communities, and this was a significant motivator to offer MHFA \ntraining to their commun"] [15.056229591369629, 23.01620101928711, " al., 2017) and as articulated by \ncommunity leaders, stigma and shame are barriers to accessing mental health treatment. Prior \nresearch suggests that aspects of stigma, specifically negative attitudes toward help-seeking and greater self-stigma, ar"] [15.061137199401855, 23.020729064941406, "demic-\nrelated disruptions to community activities and resource constraints. If MHFA or similar trainings are offered again in the future, city implementors might consider engaging communities in developing formal maintenance plans. For example, impl"] [15.061366081237793, 23.021535873413086, "y integrated other ministry activities in the course of the MHFA training day and offered breakfast and lunch as part of the training. There may be other considerations or supports (e.g., providing child care resources) that would promote participati"] [15.050041198730469, 23.009641647338867, "d for \nvideoconference trainings (e.g., for persons who could not travel, or persons with compromised immune systems). For context, we consider this finding in light of what is known from prior research examining differences in MHFA delivery and the "] [15.047006607055664, 23.006263732910156, "Participants Identified Priority Areas for Future Trainings and Other \nResources \nLeaders in the Chinese, Latinx, and African American communities all desired a continuation \nof MHFA trainings, and SGM leaders also expressed a desire for MHFA trainin"] [15.027793884277344, 22.987085342407227, " participants did not appear to know each other prior to \nparticipation, and therefore they may have been uncomfortable or unwilling to spontaneously disclose how training impacted their own mental health. We did not explicitly ask workers about the "] [15.024808883666992, 22.984092712402344, "orted using the \nknowledge or skills learned in MHFA to help support their own well-being. This paralleled feedback from some focus group participants, who felt that MHFA training had a positive impact on their personal well-being. These findings are"] [15.056410789489746, 23.016403198242188, "n-focused agencies. \nCommunity \nMHFA trainings were offered in multiple CBOs and other publicly accessible venues \nthroughout the city in order to maximize training accessibility and extend the reach of MHFA to \nall New Yorkers, including those from"] [15.004256248474121, 22.9637451171875, " of MHFA training in their native language was a major facilitator of MHFA\u2019s success in their communities. In this respect, focus group feedback revealed potential opportunities to improve reach and perceived benefits of MHFA training in diverse comm"] [15.008075714111328, 22.967437744140625, "\u2022 Survey respondents presented with documented mental health needs, with over 50 percent reporting needing help for emotional or mental health problems in the past year and 8 percent meeting criteria for serious psychological distress in the past 30 "] [15.056679725646973, 23.016740798950195, "respondents indicated the presence of community stigma\u2014\nagreeing that their community thinks less of someone with a history of mental health problems and that seeking treatment is seen as a sign of personal weakness. \n\u2022 CBO leaders in the focus group"] [15.058745384216309, 23.018774032592773, "arency and reproducibility. A range of adaptation frameworks exist, and these \ntypically share common steps (Escoffery et al., 2019). The most relevant frameworks for \nadaption of MHFA training in this context may be those frameworks that explicitly "] [15.01438045501709, 22.97379493713379, "hifting community norms around mental health. Social \nmarketing campaigns have gained traction as a tool to counter public stigma, but \nreductions in stigma tend to be strongest among persons reporting awareness of the \ncampaign rather than among the"] [15.041884422302246, 23.000532150268555, "d to design and apply survey weights, the use of an English-language\u2013only survey, and the closing of the survey when the target number of community-based trainee respondents was reached. Although the survey sample was broadly representative of the po"] [15.036812782287598, 22.995559692382812, "rying \nexposure to MHFA training, as well as population-level outcomes (e.g., workplace absenteeism \nand climate; community rates of unmet mental health need and discrimination). \nSeveral limitations are specific to the focus groups. First, participa"] [15.019560813903809, 22.978734970092773, "orks, organizations, and communities that are primed to recognize and come to the aid of those who are in need of assistance. The positive findings must be tempered by the fact that this evaluation is limited in its ability to causally link the self-"] [14.979394912719727, 22.938705444335938, "-MFANYC, 2018. As of June 7, 2022: https://www.rand.org/pubs/research_reports/RR2497.html \nBanh, M. K., J. Chaikind, H. A. Robertson, M. Troxel, J. Achille, C. Egan, and B. J. Anthony, \n\u201cEvaluation of Mental Health First Aid USA Using the Mental Hea"] [14.97024154663086, 22.929317474365234, "pp. 1\u201310. \nCrisanti, A. S., L. Luo, M. McFaul, H. Silverblatt, and C. Pyeatt, \u201cImpact of Mental Health First \nAid on Confidence Related to Mental Health Literacy: A National Study with a Focus on Race-Ethnicity,\u201d Psychiatric Services, Vol. 67, No. 3"] [14.998856544494629, 22.958053588867188, "e with a 20-Year Review,\u201d Frontiers in Public Health, Vol. 7, 2019, p. 64. \nGrant, J. Busby, C. P. Bruce, and P. J. Batterham, \u201cPredictors of Personal, Perceived and Self-\nStigma Towards Anxiety and Depression,\u201d Epidemiology and Psychiatric Sciences"] [14.997662544250488, 22.957019805908203, "g Messages in New \nZealand\u2019s Like Minds Campaign and Its Effect on Stigma,\u201d Social Marketing Quarterly, Vol. 27, No. 2, June 2021, pp. 82\u201398. \nKessler , R. C., P. R. Barker, L. J. Colpe, J. F. Epstein, J. C. Gfroerer, E. Hiripi, M. J. Howes, S. \nL. "] [15.002461433410645, 22.961610794067383, "tal Health Systems, Vol. 3, No. 1, September 7, 2009, p. 19. 110 Mohatt, Nathaniel Vincent, Robert Boeckmann, Nicola Winkel, Dennis F. Mohatt, and Jay \nShore, \u201cMilitary Mental Health First Aid: Development and Preliminary Efficacy of a \nCommunity Tra"] [15.010002136230469, 22.968524932861328, "hief Technology Officer, \n2018. \nNYC Mayor\u2019s Office of ThriveNYC, \u201cThriveNYC: Promoting Mental Health for All New \nYorkers,\u201d 2021. \nOlfson, Mark, Shuai Wang, Melanie Wall, Steven C. Marcus, and Carlos Blanco, \u201cTrends in \nSerious Psychological Distr"] [15.000670433044434, 22.957929611206055, "cial Determinants of Mental \nHealth Among New York City Adults, New York: New York City Department of Health and Mental Hygiene, 2019. \nWang, Philip S., Patricia Berglund, Mark Olfson, Harold A. Pincus, Kenneth B. Wells, and \nRonald C. Kessler, \u201cFai"] [17.318727493286133, -0.08432469516992569, "CORPORATION\nSAMUEL PETERSON, BRIAN A. JACKSON, DULANI WOODS, ELINA TREYGER\nFinding a Broadly \nPractical Approach for \nRegulating the Use of \nFacial Recognition by \nLaw EnforcementResearch ReportFinding a Broadly \nPractical Approach for \nRegulating th"] [17.3137149810791, -0.07812107354402542, "gislators and policymakers, criminal justice offi -\ncials, and society in general that should be understood, and further developments need to include efforts to \nmaximize the benefits of such technology while limiting the potential risks. This report"] [17.383543014526367, -0.14984716475009918, "Approach for Regulating the Use of Facial Recognition by Law Enforcementivofficer, Clearview AI). We would also like to thank our peer reviewers, Kristin Warren from RAND and \nKatie Kinsey from the Policing Project, who provided valuable feedback tha"] [17.394222259521484, -0.1615283489227295, "uracy complicated by the true positive not \nbeing included in the gallery (testing always includes correct answer)?\n\u2022 What is the additive or interactive effect of human and algorithm error on overall accuracy?Finding a Broadly Practical Approach for"] [17.389724731445312, -0.155528262257576, "s That Might Come from \nFacial Recognition Use\n\u2022 Could FR use change police investigations by overemphasizing video evidence or diminishing other \ninvestigative skills to solve crimes?\n\u2022 Could the community view FR results as definitive or reduce rep"] [17.378070831298828, -0.14666885137557983, " .................................................................................. 24\nWhat Happens After the Facial Recognition Search? ............................................................... 34\nLegal and Ethical Implications of Facial Rec"] [17.37761116027832, -0.14524033665657043, " ............................................................................... 15\n 3.1. Three Groups with Perspectives on Facial Recognition .................................................. 22\n 3.2. Factors in the Facial Recognition Search Proc"] [17.398656845092773, -0.16424232721328735, " willingness to exercise constitutional rights (e.g., because of \nfears of state surveillance and the abuse of power), the potential for FR systems\u2019 errors to lead to miscarriages \nof justice, and analyses that have suggested that biases embedded in "] [17.399580001831055, -0.1635330319404602, " resources if technology acquisition efforts are disrupted or canceled; may \ncreate societal harms from lack of restriction on inappropriate use of these technologies, given uncertainty in \nmanagement structures and oversight; and may sacrifice the o"] [17.393634796142578, -0.16110759973526, " to address \nthose concerns effectively. \nThis report is intended as a first step in accomplishing those goals. We examine, objectively, the various \ndimensions along which use of FR for law enforcement purposes can be considered. We also summarize \n"] [17.393815994262695, -0.1603795439004898, "o note that each of the above methods of identification\u2014both the primary and \nsecondary\u2014has accuracy limitations that we will not discuss further in this report. \nFR can be viewed as a key advancement in methods of identification, with characteristic"] [17.38990592956543, -0.15863941609859467, "e database, FR algo-\nrithms calculate the similarity in faces represented by pairs of images. Early geometry-based approaches \nplotted points on faces (see Figure 1.2) to measure the distances between facial features. Recent advances \nhave used deep-"] [17.39165496826172, -0.15972815454006195, "ion)\n\u2022 Many \n(identification/ \nsurveillance)Probe image\n\u2022 One (verification/ \nIdentification)\n\u2022 Many \n(surveillance)Review\n\u2022 Trained examiner\n\u2022 Peer review\n\u2022 Decision\n\u2022 Submission of \nanother image FR comparison and \nsimilarity scoresIntroduction: Th"] [17.387178421020508, -0.15373167395591736, "inding a Broadly Practical Approach for Regulating the Use of Facial Recognition by Law Enforcement6fidence score at which they would like the software to return results. This is set typically to limit the number \nof false positives. The software can"] [17.395658493041992, -0.15972720086574554, "survey show that those who trust the police more also support police using FR technologies (see \nFigure 1.4). When there is lower trust among the community members, there is also lower acceptance of the \nuse of these technologies (dark blue in Figure"] [17.39635467529297, -0.16248896718025208, "g and how \nFR could exacerbate both. In the most extreme application, a law enforcement organization, if given access to \na large-enough network of cameras equipped with FR, could track everyone\u2019s public movements extensively \nand with much less effo"] [17.387107849121094, -0.1556350588798523, "gh-trust respondents\nLow-trust respondents\nHigh-trust respondents\nLow-trust respondentsIntroduction: The Use of Facial Recognition by Law Enforcement9historical reasons, there are racial disparities in arrests and therefore an overrepresentation of r"] [17.379487991333008, -0.1490246206521988, "bout \nthe practical implications of small differences in accuracy (e.g., 0.06 percent or lower depending on the \napplication).12 Questions of how well these tests generalize to real-world conditions also need to be answered. \n12 Testing of demographi"] [17.391597747802734, -0.16351091861724854, "moratoria are often temporary. Indeed, of the two states that had enacted full bans, Vir -\nginia has recently enabled use through regulation (the other state being Vermont). \nWhere FR is allowed, a more standardized approach would be of interest to a"] [17.398527145385742, -0.165280282497406, "tant features of different types of FR use; the risks, benefits, and trade-\noffs; and policy guidelines that might address those risks. This description is intended to reflect the state of \nknowledge and practice at present, in an effort to summarize"] [17.401166915893555, -0.16722342371940613, " Law Enforcement12Broader Concerns About Pervasive Surveillance and Artificial Intelligence \nThe technological capability to surveil large areas or track people across several areas using FR or other sur -\nveillance technologies already exists today."] [17.393352508544922, -0.16029348969459534, "e questions as part of RAND\u2019s ongoing American Life Panel survey, which periodically surveys a nation -\nally representative panel of Americans. In particular, we were interested in how trust in law enforcement \nmight be affected by people learning th"] [17.389404296875, -0.15831321477890015, "eir applications \nby individuals and organizations. A use case is defined generally as an example application of a technology or \nsystem to perform a specific task or achieve a specific goal (see, e.g., Brush, 2022). Often applied in the devel -\nopme"] [17.396154403686523, -0.16220732033252716, "volve a system of inputs and outputs involving both human decisions (e.g., as influ-\nenced by policy, training, and experience) and FR software (e.g., data inputs, algorithm quality, software \nsettings). The entire system involved in any given use of"] [17.39987564086914, -0.16133590042591095, "ddresses) of romantic interests, ex-partners or their \nnew partners, and celebrities. Officers could use the technology to identify both personal information and \npersonal locations or travel patterns, clear examples of misuse. Finally, another clear"] [17.396331787109375, -0.1608334630727768, "igh-resolution images, \nmeaning that there are multiple potential ways to enhance an image, and it would not be clear which is cor -\nrect (Menon et al., 2020). Thus, the choices made in image modification could vary with unknown impact \non the final "] [17.3981876373291, -0.1575135737657547, "count for. \n2 In this case, the FR algorithm would return the top-ranked results in terms of similarity or confidence score. This might be \nused in an exploratory way but could return low-quality results. \n3 We borrowed the label for this category fr"] [17.395200729370117, -0.16066452860832214, "s (repeat); and providing private security, safety at \npublic events, and safety in public spaces\u2014including automated CCTV and movement tracking, police body \ncameras, and student-attendance tracking. \nUse and Misuse Cases in the Current Study\nMany o"] [17.4062442779541, -0.17543691396713257, " 2.1\nHypothetical Use Cases for Interviews with Subject-Matter Experts\nType Description\nInvestigative use for theft CCTV images of a jewelry theft suspect are captured from multiple private businesses in the \nsame area. Police use multiple still imag"] [17.400318145751953, -0.16412866115570068, "olars ( n = 5), researchers or oversight officials with expertise on FR use by \nlaw enforcement ( n = 3), and FR software company representatives ( n = 4). \nRecruitment \nWe used a combination of independent outreach, referrals from existing contacts,"] [17.395299911499023, -0.162098228931427, "ne to many, or many to many? \nData sharing What type of data are being shared? With whom and for what purposes? \nPracticality Would other means of identification be overly burdensome, or is the situation time \nsensitive? What other biometric identifi"] [17.39681625366211, -0.1611686497926712, "ntifying individuals and concerns from civil \nsociety groups stems partly from different emphases on the risks and benefits of using FR. Legal and policy \nactions in reaction to FR use or proposed FR use can respond to those risks and benefits, seeki"] [17.394865036010742, -0.15936937928199768, "\ncentage of crimes for which a suspect is identified and arrested is quite low (e.g., homicide clearance rates \nare near 50 percent nationally and decreasing over time; Braga and Dusseault, 2018; Ousey and Lee, 2010; \nRodricks, 2021). However, the us"] [17.395402908325195, -0.16295582056045532, "e of FR, risks mostly outweigh any benefits. These \nindividuals fall into two groups: individuals whose photo is taken in a particular location and submitted to a \nFR system for identification and the larger number of people whose photos are included"] [17.397035598754883, -0.16140232980251312, "ot necessarily require malfeasance by investigators. Mental biases \ncan lead individuals to seek out information that confirms or reinforces their existing beliefs and theories, and such biases \ncould shape how investigators collect and use data in c"] [17.40052032470703, -0.1574822962284088, ", and \nincreases resources to the criminal justice system. Perceptions of or actual misuse or wrongful arrests could \nnegatively shift societal approval. Some less serious types of crime may disproportionately be committed by \npoor or marginalized gr"] [17.395523071289062, -0.16157115995883942, "citated or missing carries similar risks \nand benefits. One key question for this group is whether FR results can be used against the subject being \nscanned (e.g., the subject has an open warrant). This also applies to victims, witnesses, and associa"] [17.395061492919922, -0.16527412831783295, "s are chosen and that features of the photos themselves are similar (e.g., lighting, pose, size), so as \nto reduce the chances of a false identification, although there are arguments that selecting lineups by similar \nfacial features using FR could i"] [17.39551544189453, -0.1619926244020462, "oint often means that less intrusive means have been explored or are determined to be likely to fail. Concerns about whether FR use by law enforcement is justified across a variety of \nsituations:\n\u2022 Will police use FR for minor crimes?\n\u2022 Will FR use "] [17.385629653930664, -0.15515604615211487, "any searches that are worth distinguishing. First, with aggrega -\ntion, law enforcement is using archival or stored data to search many unknown faces and compare them to \ngallery images. In this case, law enforcement might be going back through video"] [17.403907775878906, -0.15532249212265015, "e of the search moves from one-to-one, to one-to-many, to many-to-many applications, the \nlevel of individualized suspicion decreases, and FR is then being used more as a dragnet than a focused tool \nthat maximizes the benefit of its use. Additionall"] [17.39212417602539, -0.15891550481319427, "lice by efficiently establishing subject identity, possibly improv -\ning officer safety, or ensuring that the right person is released from custody. \nDespite substantial improvements in accuracy since even the late 2010s, there are still areas that n"] [17.395090103149414, -0.1609039157629013, "k, and \nWhite, 2019). Some of research in this area notes the importance of confidence judgments in assessing the \nquality of the positive identification and finds that facial examiners are more consistent as a group, suggest -\ning the importance of "] [17.39520263671875, -0.16138921678066254, "of our interviewees, however, had reserva-\ntions about making image alterations beyond cropping and basic image edits, such as brightness, contrast, \nand sharpness. Making more-drastic changes, such as closing mouths, opening eyes, or mirroring image"] [17.392807006835938, -0.1605873703956604, "negative \nidentification rate) but produce weaker results because a top result can be returned that would not have met \nthe threshold had it been applied (Grother, Ngan, and Quinn, 2017). This is because although the top-ranked \ncandidate may be corr"] [17.362680435180664, -0.13015729188919067, "t answer)?\n\u2022 What is the additive or interactive effect of human and algorithm error on overall accuracy?Finding a Broadly Practical Approach for Regulating the Use of Facial Recognition by Law Enforcement32Accuracy: Sources of Bias \nConcerns about t"] [17.3978214263916, -0.15939471125602722, "n\n\u2022 Contains preexisting biases (e.g., disparities in arrests)\nProbe images\n\u2022 Potentially more likely to reflect crimes committed in public\n\u2022 Potential disparities in CCTV placement \nHuman \ndecisionmakingImage submission\n\u2022 Requires deciding which ima"] [17.39510726928711, -0.16038626432418823, "erns about accu -\nracy (Grother, Ngan, and Hanaoka, 2019a). The larger the gallery, the likelier that more nonsuspects will \nshow up in FR searches and the lower the accuracy. Moreover, larger databases mean that more people will be \nmatched on a mul"] [17.39410400390625, -0.16114214062690735, "eir images from the internet, when companies collect these data, they remain at a level of permanence that \nprevents individuals from being in control of their image. \nA key question for data sources, particularly when it comes to size, is the exact "] [17.395597457885742, -0.16261319816112518, "nding the Landscape of Concerns35subject.13 In this application, the first step will be to look for any other supportive or disqualifying informa -\ntion, including, but not limited to, whether the subject has a twin, whether the subject was out of to"] [17.412261962890625, -0.17343807220458984, "everal steps, such as legislation, policy, training, and checks and balances (e.g., internal auditing, external auditing). \n14 Ongoing tests in London do not appear to have shown improvement (Rollet, 2022). Concerns about what happens after police us"] [17.378190994262695, -0.1880255490541458, "some police departments have come under \nscrutiny for using FR on protestors, leading to concerns about retaliation, due-process violations, and First \nAmendment violations.16 This also recalls the previous discussion on the scope of the search or th"] [17.35438346862793, -0.22776907682418823, "stitutes a search, \nand is therefore subject to the reasonableness standard, depends in part on whether it violates \u201creasonable \nexpectations of privacy\u201d ( Katz v. United States , 1967). Fourth Amendment jurisprudence has long held that \ngovernment\u2019s"] [17.39617919921875, -0.16367673873901367, "in court without \nthat expert\u2019s appearance ( Melendez-Diaz v. Massachusetts , 2009; Bullcoming v. New Mexico , 2011). Similarly, \nintroducing FR evidence, which could contain statements describing the results of FR analysis by the indi -\nvidual that "] [17.387001037597656, -0.1585591733455658, "rors that also have higher confidence. Jackson (2019) explores this idea, but more research is needed, \nas is more research on human-machine interactions and how they affect decisionmaking (Peeters, 2020). \nA second due-process concern FR raises is r"] [17.394990921020508, -0.1633549928665161, "he Due Process Clause calls for a preliminary judicial inquiry into \nthe reliability of that eyewitness identification. Understanding the Landscape of Concerns39defendant. Some cases (e.g., People v. Beckley , 2010) have rejected photographs from the"] [17.39578628540039, -0.16259749233722687, " \nspecific individuals and their locations, which makes tracking and surveillance applications more efficient \nand increases risks of pervasiveness. If these data are kept long term, there would be historical records for law \nenforcement to access at"] [17.39875602722168, -0.1598285287618637, "of potential matches is more invasive than just having your image \nincluded in a search. Next, most people are not aware that their images are included in gallery data, and there \nare questions about whether there should be automatic notice. There ar"] [17.40487289428711, -0.15420040488243103, " FR searches, meaning that \nFR use is more easily tracked and authorized users can develop more-specialized expertise. \nData Quality\nNext, data-quality variation is a potential concern. There is little known about how image quality, the most \nimporta"] [17.400909423828125, -0.16020280122756958, "us on, leading them to overlook other potential suspects or types of informa -\ntion that could aid the investigation. Unintentionally, continued reliance on FR could lead to diminishing \ninvestigative skills over time. If a large part of the job is u"] [17.397991180419922, -0.16186940670013428, "R, developing policies that balance the \nrisks and benefits of FR use by law enforcement will likely be a location- and jurisdiction-specific endeavor. \nIn this chapter, we present a road map for developing that path\u2014looking at the different componen"] [17.400577545166016, -0.16523152589797974, "nterviews. The options fall \nbroadly into the categories shown in Figure 4.1, with community approval being an overarching factor for the \nother categories. Different options in each category are responsive to different concerns about risks affect -\n"] [17.398231506347656, -0.1639430671930313, " consequences if \nimplementation deviates \nfrom intent\nCommunity buy-in pre-FR implementationCan support\naccountabilitySupports\nappropriate \nuseDeveloping a Policy Road Map to Help Navigate the Landscape of Concerns About Facial Recognition45the basi"] [17.395896911621094, -0.16233959794044495, " the more intangible effects (both on direct victims and others around them, such as their families) \nof violent crimes is more difficult. Nonetheless, estimates done by a variety of methods can provide some \ninsight. Figure 4.2 shows approximate val"] [17.43258285522461, -0.19882650673389435, "e means that there is a reasonable basis based on the totality of circumstances to believe that a crime \nhas been committed or evidence of a crime exists. Probable cause is required for searches or arrests. FIGURE 4 .2\nRelative Estimates for the Cost"] [17.396713256835938, -0.1625860333442688, "ement \nhas sought to identify large numbers of individuals present in a given area\u2014from mass detentions during \nprotests where there were some violent participants to the use of geofence warrants to identify all of the \ncell phones present in an area"] [17.398130416870117, -0.16495758295059204, "on data and, therefore, the ability to track specific vehicles visiting locations that reveal \npotentially sensitive information about their owners.8 \nProhibitions or restrictions on the scope of FR use could therefore be elements of a policy approac"] [17.398605346679688, -0.1634962111711502, "\n9 Reportedly, some states have prohibited the combination of FR with police body-camera footage, which would be a broad-\nscope application with officers moving among the population in many areas during the course of their daily activities (Slaight \n"] [17.39616584777832, -0.16438250243663788, "fit of a specific case being closed being better positioned to assess the overall benefits \nand risks of use.10\nCentralized decisionmaking about use can also help support external accountability, since patterns of \nuse and misuse could be more easily"] [17.396282196044922, -0.1635485291481018, "ecurity and Bureau of Justice Assistance, U.S. Department of Justice (2017, p. 17) for a reflec-\ntion of some of these issues in a model policy document.\n13This is the level of external control proposed in Lynch, 2019, and similar to the enacted Mass"] [17.40262794494629, -0.1570841670036316, "oth from practical constraints, including the \nconditions in which a photo of a criminal incident was recorded or the quality of the camera doing so, 16\nbut also from manipulation of photos by users before submission (e.g., mirroring a partial photo,"] [17.409072875976562, -0.15377584099769592, "in the outcome of FR systems, since there may be racial, socioeconomic, and other factors that \naffect the likelihood of an individual being arrested (and therefore photographed at booking) during an \nencounter with police (Slaight and LeCloux, 2020)"] [17.399219512939453, -0.16268333792686462, "\nthe results) and how results should be returned (number and ranked or unranked) are important factors, but \ndifferent agencies appear to be using different approaches. \nWith the development of independent testing, quality levels for different algori"] [17.404447555541992, -0.15454383194446564, "ner knowing that some of the individuals returned by the system committed crimes \npreviously may create a confirmation bias and skew the examiner\u2019s assessment of whether those individuals \nmatch the photo associated with the new criminal incident. An"] [17.420238494873047, -0.14459961652755737, "or retrospective tracking \nof one\u2019s movements and activities could chill important activities and degrade individual rights. Retention of \njust FR matches is potentially problematic from a risk perspective, since not retaining the associated images \n"] [17.414432525634766, -0.15259584784507751, "stan -\ndards for the types of action that can be taken at different levels of match quality or certainty\n\u2022 limits on how long individuals\u2019 photos can be stored in FR databases used in the jurisdiction and how \nlong data on matches from past searches "] [17.402557373046875, -0.1572093963623047, "stored (e.g., security), managed, shared, retained, and purged. \nThis would provide critical feedback as to how well this biometric information is being handled and uncover \npotential risks in the data life cycle. Accuracy audits might select a rando"] [17.39662742614746, -0.16383519768714905, " to whatever path a jurisdiction has set for use of FR, there should be conse -\nquences for straying from that path. Without some consequence associated with policy violation, there is real \nrisk that the perceived benefits to individual officers or "] [17.399150848388672, -0.16345344483852386, "dministered may effectively regulate officer use of FR, it may not have significant \nexternal trust value if skeptical audiences cannot see its results.23\nAny discussion of the regulation of law enforcement use of technological or other capabilities "] [17.423547744750977, -0.1784081906080246, "nd when police should use FR is public concern that the \nrisks of such use may outweigh its benefits, what the public knows about law enforcement utilization of FR \nand whether the public authorizes or approves of that use matter. Members of the publ"] [17.401283264160156, -0.1651521772146225, "p. 7, \nemphasis added).Policy and law should define\n\u2022 what the penalties are at both the individual and agency levels when use deviates from approved use \ncases\n\u2022 what types of exigent circumstances justify relaxation of jurisdiction-level restrictio"] [17.450899124145508, -0.11072946339845657, "d not utilize FR: Then, inappropriate use would become a substantial liability \nfor such cases, balancing out any perceived value that using FR could let investigators close the case \nmore quickly. Disclosing the quality of matches could also manage "] [17.4000301361084, -0.16352412104606628, "s mistrust and opposition to the technology. However, more-substantial \ncommunity involvement in authorizing FR use, as well as development of the ground rules for its use, could \n31 Although not framed in the context of transparency or making their"] [17.399885177612305, -0.16343647241592407, "y being measured in FR use?), trans -\nferring inequity (e.g., do the data being used have embedded inequity?), exacerbating inequitable harms (e.g., \nis FR used in a way that enhances current inequities?), or compromising inequity oversight (e.g., ar"] [17.432214736938477, -0.17821992933750153, "ays that maximize benefits and \nminimize risks, along with careful review to ensure that these regulations were upheld. This narrowing could \nconsist of limiting FR to investigating serious crimes, increasing the level of authorization required, redu"] [17.397628784179688, -0.16206517815589905, "imit susceptibility to improper interpretation or application of FR results. The next section (green section) \naddresses some of the features of FR systems as they are applied in law enforcement settings, which always \ninclude a combination of comput"] [17.397613525390625, -0.16231593489646912, "gencies use FR. Moreover, were there accepted standards, software companies could create \nsoftware, interfaces, and settings that adhere to those standards and could not be manipulated by individual \n1 Stanford University\u2019s Institute for Human-Center"] [17.372434616088867, -0.15335215628147125, "forcement, but it would theoretically be a valuable alternative method \nof remote biometric identification in cases in which there is no usable image of a suspect\u2019s face or could be \ncombined with FR to strengthen identification. Object recognition, "] [17.397611618041992, -0.16228772699832916, "sted above (A, B, C). In this order, the question about FR systems were presented \nbefore questions about trust in police. The second group received the questions about police using FR sys -\ntems first, followed by the question on trust in police (sp"] [17.42606544494629, -0.1872960478067398, " priority of this section):\n\u2022 What are the necessary regulatory or oversight elements that should govern the use of this technology? \n \u2013Would certification be a potentially useful route to ensure ongoing regulation? \n \u2013What about limits to access? \n "] [17.33668327331543, -0.10652714222669601, "g/en/latest/news/2021/06/scale-new-york-police-facial-recognition-revealed/\nangus mcdiarmid, \u201cJoseph C Ilacqua,\u201d October 28, 2012. As of January 20, 2023: \nhttps://www.flickr.com/photos/angusmcdiarmid/8130830700\nAnwarul, Shahina, and Susheela Dahiya,"] [17.327253341674805, -0.09702584892511368, "\nthe Impact of Citizen Complaints and Crime Rates on Drug Arrests,\u201d Criminology and Public Policy , Vol. 11, \nNo. 4, November 2012.\nFacial Identification Scientific Working Group, \u201cPublished Documents,\u201d webpage, undated. As of September 4, \n2022: \nht"] [17.33111572265625, -0.10037772357463837, "meras-\nbc9036918ae0 \nGoldberg, Rebecca Darin, \u201cYou Can See My Face, Why Can\u2019t I? Facial Recognition and Brady ,\u201d\u00a0HRLR Online , \nVol. 5, 2020.\nGRC World Forums, \u201cCan European Regulators Stop Clearview AI?\u201d May 27, 2022. As of January 10, 2023: \nhttps:"] [17.323244094848633, -0.09358803182840347, "ala, and Li Fei-Fei, \u201cEvaluating Facial Recognition Technology: A \nProtocol for Performance Assessment in New Domains,\u201d Denver Law Review , Vol. 98, 2020.\nHoward, John J., Laura R. Rabbitt, and Yevgeniy B. Sirotin, \u201cHuman-Algorithm Teaming in Face Re"] [17.30326271057129, -0.0725603923201561, "Vol. 39, No. 4, 2022.\nKahn, Jeremy, \u201cAfter Roe, Fears Mount About A.I.\u2019s Ability to Identify Those Seeking Abortions,\u201d Fortune , \nJune 28, 2022. \nKatz v. United States , 389 U.S. 347 (1967). \nKindt, Els J., \u201cTransparency and Accountability Mechanisms"] [13.41276741027832, 3.716503620147705, "e Effectiveness of an Acoustic Gunshot Location System in \nSt. Louis, MO,\u201d\u00a0Policing: A Journal of Policy and Practice , Vol. 6, No. 1, 2012.\nMares, Dennis, and Emily Blackburn, \u201cAcoustic Gunshot Detection Systems: A Quasi-Experimental Evaluation \nin "] [17.331579208374023, -0.1022886410355568, "itimacy and Social Networks on Active Gun Offenders,\u201d\u00a0Journal of Criminal Law and \nCriminology , Vol.\u00a0102, No. 2, Spring 2012.\nPayal, Parekh, and Mahesh M. Goyani, \u201cA Comprehensive Study on Face Recognition: Methods and \nChallenges,\u201d Imaging Science "] [17.32860565185547, -0.09827610105276108, " Baltimore \nSun, March 9, 2021. \nRodriguez, Roger, \u201cFacial Recognition: Art or Science?\u201d Vigilant Solutions, undated. As of September 2, 2022: \nhttps://www.sheriffs.org/sites/default/files/Whitepaper%20Facial%20Recognition.pdf\nRollet, Charles, \u201cLondo"] [17.325836181640625, -0.09505091607570648, "Ester Gonzalez-Sosa, and Julian Fierrez, \n\u201cDeepFakes Detection Across Generations: Analysis of Facial Regions, Fusion, and Performance Evaluation,\u201d \nEngineering Applications of Artificial Intelligence , Vol. 110, April 2022. \nTurner v. United States "] [13.916841506958008, 4.18621826171875, "leted his Ph.D. in criminal justice at the University of Cincinnati.\u00a0\nBrian A. Jackson is a senior physical scientist at the RAND Corporation. His research focuses on homeland \nsecurity, criminal justice, and emergency preparedness. Jackson received "] [6.580160140991211, 15.990300178527832, "CORPORATIONResearch Report\nJASON M. WARD, RICK GARVEY, SARAH B. HUNTER\nRecent Trends Among the \nUnsheltered in Three Los Angeles Neighborhoods\nAn Annual Report from the \nLos Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) Project"] [6.582939147949219, 15.977046966552734, "bservation period, these activities did not result in longer-term decreases in the overall levels of unsheltered people, vehicles, and encampments. \n QOur counts and Los Angeles Homeless Services Authority (LAHSA) annual point-in-time count data from"] [6.595126628875732, 15.974125862121582, "c-tive allocation of resources for addressing the city\u2019s homelessness crisis.\nStudy Geography\nFor this study, we selected three neighborhoods\u2014Hollywood, Skid Row, and Venice\u2014partly because of their historically high rates of unsheltered home-lessness"] [6.562572002410889, 15.99013900756836, "ull 4and Venice. We alternated the timing of these counts \nbetween early-morning hours (6 to 9 a.m.) and night-time hours (9 p.m. to midnight) to allow us to assess whether there was significant variation in population counts depending on the time of"] [6.579505920410156, 15.954495429992676, "ility Criteria\nEach potential respondent was screened for eligibil-ity with two questions. The first question was taken from the LAHSA demographic survey and asked where the individual had spent most of their nights over the past 30 days. The second "] [6.589666843414307, 15.972383499145508, "ce by using signs suggesting the vehicle was not being regularly moved (such as low tire pressure) and other signals, such as having covered windows, fogged up windows, or large amounts of possessions in or around the vehicle. Additionally, several o"] [6.59077787399292, 15.972636222839355, "spent most of the \npast 30 nights. If a screened individual answered that they had been staying in one of our specified infor-mal shelter types (a car, van, RV, tent, or makeshift structure), then we asked them how many people they shared this shelte"] [6.586299419403076, 15.976418495178223, "ltipliers are not directly compara-ble, but we reproduce the relevant LAHSA multipliers alongside the more aggregated LA LEADS multipli-ers to give a sense of how they compare with one another. In general, our multipliers are slightly larger than the"] [6.58695650100708, 15.976696014404297, "n the relative shares of individuals, cars, vans, RVs, tents, and make-shift shelters. For example, if an area were counted and found to have 90 individuals and 10 tents and we applied a multiplier for the tents of 1.5 (suggesting that every other te"] [6.589600086212158, 15.97903060913086, "ounting t he weeks \nof our study period beginning with the last week of September 2021, the date of our first enumeration of Skid Row. The annual p ercent-\nage change value given in the table is scaled from the change-per-week point estimate to refle"] [6.581876277923584, 15.981356620788574, "ge share of each category of informal shelter (cars and vans, RVs, or tents and m akeshift \nshelters) in our enumerations by neighborhood across the 12 months of data collection. The \u201cUnadjusted\u201d column presents the act ual sum \nof individuals and "] [6.579852104187012, 15.984010696411133, "January 2022February 2022March 2022April 2022 May 2022 June 2022 July 2022\nAugust 2022\nSeptember 2022October 2022\nUnadjusted count Range of adjusted estimates11FIGURE 4\nSkid Row Unsheltered Population\nCOVID-19 testing operation in area on day of enum"] [6.593310356140137, 15.973273277282715, "nt); in Hollywood and Venice, one-quarter of respondents reported that their current spell was drawing individuals to the area from elsewhere and \npotentially drawing individuals onto the streets from the considerable stock of permanent support-ive h"] [6.6129326820373535, 16.00588607788086, "(81 percent) among respondents in Skid Row. The length of these TABLE 3\nDemographic Characteristics of Survey Participants (percentages)\nParticipant CharacteristicAll\n(N = 418)Hollywood\n(n = 104)Skid Row\n(n = 211)Venice\n(n = 103)\nAge\n18\u201324 5 5 2 9*25"] [6.597524642944336, 15.970451354980469, "ods for each category by creating indicator variables for membership in each group (e.g., age 18\u201324) and regressing each indi cator variable on indica-\ntor variables for the Hollywood and Venice neighborhoods (with Skid Row as the omitted neighborhoo"] [6.6020917892456055, 15.973753929138184, " homeless in Los Angeles 40 38 38 43\nFactors that prevented housing move-in\nNever contacted for move-in 44 36* 47 45\nLack of privacy 40 49* 38 35\n+\nHousing safety 35 45* 31 33+\nPaperwork issues 29 31 27 29Hours or curfew 25 23 23 33*\nHousing location"] [6.585582733154297, 15.974624633789062, "tistically significantly different from Hollywood at the 90-percent confidence level are indicated with a plus sign (+). \na Of respondents not answering \u201cyes\u201d to this question, one-half (5 percent of the total) answered \u201cmaybe\u201d in a similar pattern "] [6.595772743225098, 15.967459678649902, "provide follow-up for housing placements because of the forced relocation of people experiencing home-lessness (Cohen, Yetvin, and Khadduri, 2019). About 40 percent of respondents were concerned with a lack of privacy offered in the housing options a"] [6.593795299530029, 15.972742080688477, "ey is conducted in each neighborhood only over a few days. Thus, leaving aside any differences arising from the use of weighting, the LAHSA data may more strongly reflect short-term population characteristics while the LA LEADS data may reflect longe"] [6.595613479614258, 15.948790550231934, "mates of age shares differ in several \ncases. For example, our share of survey respondents who were 18 to 24 years old in Venice was more than double the LAHSA estimate. On Skid Row, we surveyed considerably fewer 25- to 54-year-olds and more individ"] [6.590903282165527, 15.982294082641602, "nsus tracts as our blocks), matches that are exact over multiple census tracts (where, for example, three to six census tracts might equal two of our blocks), and very close area matches across multiple LA LEADS sub-geographies or census tracts where"] [6.5927653312683105, 15.970803260803223, "o better understand the extent of such mecha-\nnisms affecting the accuracy of the annual count, we generated small-area comparisons of our own count data occurring prior to and following the LAHSA PIT count data collected in late Febru-ary 2022. Our "] [6.629659175872803, 15.932421684265137, "191203, and 191204 in Hollywood\n020406080100120140160Individuals\nJanuary February March April May0510152025303540Cars and vans\nJanuary February March April May\n05101520RVs\nJanuary February March April May020406080100120140160180Tents and makeshift sh"] [6.591499328613281, 15.971948623657227, "s, and RVs. The LAHSA count for tents in these tracts is similar to our count from around one month before but sig-nificantly higher than our result from approximately one week later. However, it is possible that such a discrepancy could be explained"] [6.590856075286865, 15.974044799804688, "eks. \nWe observe a similar pattern for the area \nimmediately to the south, shown in Figure 9. Again, the discrepancy for cars and vans may relate to a similar modest geographic difference in the com-parison areas (LA LEADS geography is similarly slig"] [6.590909481048584, 15.974413871765137, " match except that we count one block farther north to Marine Street west of Sixth Avenue and Ozone Street between Lincoln Boulevard and Sixth Avenue.LA LEADS LAHSA\nFIGURE 12\nComparison of LA LEADS and LAHSA Unadjusted Count Data for Census \nTract 2"] [6.589958667755127, 15.9739990234375, "informal overnight shelter. However, this distinction is unlikely to explain the higher number of RVs (26 versus our surrounding counts of 7 and 15), which are much more likely to actually be overnight shelter, conditional on being on the street in t"] [6.58560037612915, 15.98044490814209, "being used as shelter. \nThese comparisons also suggest potentially \nimportant differences in the way tents are counted (for example, whether long, contiguous makeshift shel-ters are counted as a single unit or multiple segments and how tents obviousl"] [6.580049514770508, 15.99051284790039, "peated \nenumerations suggest that outlier events\u2014such as \ncleanup activities, inclement weather, or other one-\noff occurrences\u2014can meaningfully influence esti-mates of this hard-to-track population. \nOur exploration of multiple approaches to the \napp"] [6.583919048309326, 15.979989051818848, "\nhousing receipt may yield large dividends in \nhousing those most in need.Notes\n1 We also included the Veterans Row encampment along San \nVicente Boulevard in front of the West Los Angeles Veterans Affairs campus in our early survey and enumeration "] [6.556269645690918, 16.025590896606445, "IT on \nthese nights also likely leads to a large, systematic undercount \nbecause of the increased likelihood that people will attempt to \nshelter out of sight for increased protection from the elements \n(Boone, 2019). 30LeGras, Christopher, \u201cI Partic"] [6.513162612915039, 16.094606399536133, "e, Seung Choi, et al., \u201cInitial Item Banks and First Wave Testing of the Patient-Reported Outcomes Measurement Information System (PROMIS) Network: 2005\u20132008,\u201d Journal of \nClinical Epidemiology , Vol. 63, No. 11, 2010, pp. 1179\u20131194.\nCenters for Dise"] [6.56734561920166, 15.984962463378906, "D Corporation, RR-A1890-3, 2023. As of \nJanuary 20, 2023: https://www.rand.org/pubs/research_reports/RRA1890-2.html\nWeare, Christopher, Counting the Homeless: Improving \nKnowledge of the Unsheltered Homeless Population , Goldman \nSchool of Public Pol"] [6.584452152252197, 16.00753402709961, "w.rand.org/about/research-integrity.\nRAND\u2019s publications do not necessarily \nreflect the opinions of its research clients and sponsors. \n is a registered \ntrademark.\nLimited Print and Electronic Distribution Rights\nThis publication and trademark(s) c"] [6.564383029937744, 15.955272674560547, "Sponsored by the Lowy Family GroupRecent Trends Among the \nUnsheltered in Three Los Angeles Neighborhoods: An Annual Report from the Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) Project\nAppendixes\nJASON M. WARD, RICK GARVEY,"] [6.576445579528809, 15.97049331665039, "systematic effort to monitor changes in the number of people living unsheltered over a full year, helping to bolster what is captured by the annual Los Angeles County point-in-time count, which provides a snapshot in time of this population. The rese"] [6.593558311462402, 15.970321655273438, " the project. We also thank Heather Schwartz at RAND and Nichole Fiore at Abt Associates for providing peer review for this report. \n \n v Contents, Figures, and Tables \nContents \nAbout This Report ................................................"] [6.590170860290527, 15.976407051086426, "Poinsettia\nRecreation\nCenterBarnsdall\nArt Park\nWilshire\nCountry ClubN. Fuller Ave.N. Fuller Ave.N. Martel Ave.N. Vista St.\nRomaine St.190401\n18920 1 189201\n.e.....Fountain Ave.190402 1190301 b\n191204191203191301a9 a\n191301 b\n191000c\n1910000aa00191520"] [6.578843593597412, 15.9651460647583, "/22 (PM) 341 82 32 80 74 145 754 1,054 834 \n02/17/22 (AM) 213 76 25 84 62 110 570 842 705 \n03/16/22 (PM) 294 108 30 66 64 98 660 939 749 \n04/11/22 (AM) 339 95 37 98 53 90 712 995 776 \n05/18/22 (PM) 338 86 32 88 71 92 707 987 769 \n06/09/22 (AM) "] [6.512484550476074, 15.87653636932373, "191 85 60 33 45 654 995 804 \n08/23/22 (PM) 269 173 56 57 31 80 666 1,007 792 \n09/15/22 (AM) 226 166 64 52 28 65 601 917 737 \nTable B.4. Enumeration Totals by Category: Veterans Row \nDate and Time People Cars and Vans RVs Small Tents Medium Ten"] [6.600780487060547, 15.972208023071289, " Annual Report from the Los Angeles Longitudinal Enumeration and Demographic Survey (LA \nLEADS) Project , RAND Corporation, RR -A1890 -2, 202 3. As of January 15, 2023: \nhttps://www.rand.org/pubs/research_reports/RRA1890 -2.html 8 Table C .1. Full "] [6.597583770751953, 15.971894264221191, "on tests differences between Venice \nand Hollywood (omitting Hollywood). Results for Hollywood and Venice that are statistically signif icantly different from \nSkid Row at the 90 -percent confidence level are indicated with a star (*). Results for V"] [6.598048210144043, 15.969084739685059, "\npercent confidence level are indicate d with a plus sign (+). 11 Table C.3. Housing Needs and Preferences of Survey Participants , with Recoded \u201c Other\u201d \nResponses Included (percentages ) \nNeed or Preference All \n(n = 430) Hollywood \n(n = 104) "] [6.599169731140137, 15.974469184875488, "liness 50 49 51 49 50 \nNegative interactions with staff 42 35 41 50+ 42 \nHours or curfew 35 40* 29 44* 33 \nOther rules 26 23 26 30* 33 \nOthera 4 5 2 8* 0 \nNOTE: Mutually exclusive percentages may not sum to exactly 100 due to rounding. We perform"] [6.600154399871826, 15.965619087219238, "s stopped you from moving into housing in \nLA?\u201d (see the row labeled \u201cFactors that prevented housing move -in\u201d in Tables 5 and C.3) on answering \u201cyes\u201d to \nthe question , \u201cSince you have been homel ess in LA, have you been offered housing?\u201d Mutually"] [9.524077415466309, 23.7669734954834, "Sponsored by Adagio HealthA Needs Assessment \nof Women Veterans in Western Pennsylvania\nFinal Report to Adagio Health\nDANA SCHULTZ, SUSAN L. LOVEJOY, KAYLA M. WILLIAMS, KERRY \nLINDQUIST, TEAGUE RUDER\nCORPORATIONFor more information on this publicatio"] [9.528116226196289, 23.770830154418945, "er understanding of the needs of women veterans and the extent to which these needs are being met will help veteran-serving organizations provide the best support possible to women who served. \nAdagio Health, a health care provider based in Western "] [9.523334503173828, 23.76445770263672, "hose of men, and women veterans \nalso differ in significant ways from their nonveteran counterparts. Few studies have explored these variations, and this has translated to potentially missed opportunities to improve support for women during and after"] [9.526960372924805, 23.75586700439453, "r complicate women veterans\u2019 treatment needs. \nOur assessment of the needs of women veterans in Adagio Health\u2019s service area drew on \nnational and regional survey data and patient data from Adagio Health. We supplemented this information with a revie"] [9.540265083312988, 23.740802764892578, "nuary 2018 \nand April 2022 differed somewhat from the nonveteran women in its service area. Specifically, they tended to be older and higher earning than their nonveteran counterparts and were more likely to be White and married. However, the two gro"] [9.527132987976074, 23.758806228637695, "Q -9), which assesses depression \nseverity, and the Cut down, Annoyed, Guilty, and Eye -opener Adapted to Include Drugs (CAGE -AID) tool, which \nassesses substance use. p = 0.001 for any positive SBIRT prescreen; n ot significant (n.s.) for any pos"] [9.521482467651367, 23.7684383392334, "o Health service area face in navigating services and benefits and accessing the support they need. Interviewees noted that these challenges are often interconnected. For example, women veterans who are unable to access adequate care for mental healt"] [9.522675514221191, 23.766742706298828, "d them or to address the needs of women veterans specifically. \nOpportunities to Address Challenges and Improve Supp ort for Women \nVeterans \nSince launching its Women Veterans Initiative in 2018, Adagio Health has made strides in \naddressing the c"] [9.529930114746094, 23.770648956298828, "s for reproductive health care and increase its own capabilities for providing and referring for infertility care. \nProvide Multiple Channels to Ensure That Women Veterans Are Aware of Available \nServices and Supports \nWomen veterans noted that thei"] [9.525626182556152, 23.766273498535156, "es veteran engagement training to providers and staff, but there are still opportunities to improve the identification of women veterans with trauma histories through routine screenings and to ensure seamless care transitions to strengthen trust when"] [9.526211738586426, 23.76789093017578, ".................................................................................................. 15 \t\nChapter 3. Needs Assessment Components and Approach ........................................................... 19\t\nLiterature Review ..........."] [9.528029441833496, 23.76497459411621, ".......................................................................... 61\t\nChallenges Faced by Women Veterans ................................................................................................... 62 \t\nOpportunities to Improve Suppo"] [9.529621124267578, 23.760587692260742, "gure 5.1. Marital Status of Women Served by Adagio Health ............................................. 36\tFigure 5.2. Family Size of Women Served by Adagio Health ................................................ 36\tFigure 5.3. Family Income of Women"] [9.528217315673828, 23.754199981689453, ".............................. 42\tTable 5.10. Pregnancy Testing for Women Served by Adagio Health ................................... 45\tTable 6.1. Resources in the Adagio Health Service Area for Women Veterans ..................... 48\tTable 6.2. Men"] [9.52368450164795, 23.764781951904297, "............................................... 134\t\nTable B.5. Characteristics of Substance Use Disorder Facilities in the \nAdagio Health Service Area .......................................................................................... 137\t\nT"] [9.528051376342773, 23.74757194519043, " 2022). Furthermore, as of 2017, women who served in the post-9/11 era accounted for more than one-third of all women veterans (see Figure 1.1). 2 Figure 1.1. Service Era Percent age of Women Veterans \n \nSOURCE: Features data from National Center "] [9.520381927490234, 23.764535903930664, "owever, these rates are lower than for nonveteran women, 13.7 percent of whom live in poverty \n(National Center for Veterans Analysis and Statistics, 2019). \nIn terms of health status, veteran women nationally reported having more days of poor \nphysi"] [9.51992130279541, 23.764896392822266, "of the health status of veterans, VA conducted a \n2012\u20132014 follow-up study of Gulf War\u2013era veterans (Dursa et al., 2019). Among women veterans who had deployed during that conflict, the most-prevalent physical health conditions 61%\n30%\n25%22% 21% 20"] [9.520503997802734, 23.765562057495117, "s), and health care utilization (Creech et al., 2021). \nFor the reproductive health of veteran women, there is mixed evidence on whether women \nveterans have higher rates of stillbirth, miscarriage, birth defects, and other birth outcomes than nonve"] [9.520792007446289, 23.762216567993164, "ith annual estimates of PTSD ranging from 11 to 20 percent (National Center for \nPTSD, undated). Both military women and men have experienced combat trauma, an important predictor of both PTSD and depression. Almost 75 percent of Iraq and Afghanistan"] [9.520206451416016, 23.76473045349121, "al support exacerbated mental health problems, particularly for those with complex trauma histories (Scoglio et al., 2022). Another study noted the challenges women veterans face in engaging with social support networks because of mental health issue"] [9.536465644836426, 23.752458572387695, " progress (Pub. L. 117-135, 2022). \nDespite these efforts, women veterans continue to have unmet health care needs, including \nfor mental health and family planning services. \nVeteran women are less likely than veteran men to receive evidence-based "] [9.522778511047363, 23.764619827270508, "nt rate for veteran women \nwas 4.2 percent, which is lower than the rate for both veteran men and nonveteran women (Diaz , \n2022). Confounding factors, such as MST and IPV, are related to worse occupational functioning for veteran women compared with"] [9.524412155151367, 23.764360427856445, "sent a greater proportion of \nthe military population than the general population (10.7 percent versus 4.2 percent), there is \nlittle information about this population of women veterans (Lehavot and Simpson, 2013). Some studies have examined whether "] [9.523402214050293, 23.766878128051758, "\nAdagio Health asked the RAND Corporation to conduct a community health needs \nassessment to characterize the needs of women veterans in the Adagio Health service area, the extent to which existing services and supports meet their needs, gaps in the "] [9.52448844909668, 23.773027420043945, "lth to launch its Women Veterans Initiative in 2018. The initiative has four primary objectives: \n\u2022 to make Adagio Health a significant provider of non-VA health care for women veterans \nin the areas it serves \n\u2022 to position Adagio Health as part of"] [9.522631645202637, 23.76760482788086, "h care with physical health care \nservices for all patients, but it was motivated in large part by the needs of women \nveterans. Staff were trained in the Screening, Brief Intervention, and Referral to \nTreatment (SBIRT) model, as well as motivationa"] [9.523971557617188, 23.766420364379883, " vet centers, which provide counseling and intervention for veterans and service \nmembers who have deployed to a combat theater or experienced MST, including many \nwho are otherwise ineligible for VA care. \nOutreach, Education, and Awareness \nRegiona"] [9.525825500488281, 23.7666015625, "ssess the local availability and capacity of different programs, services, and supports for women veterans. Finally, we describe our approach to the qualitative assessment of women veterans in the Adagio Health service area. \nLiterature Review \nIn o"] [9.527960777282715, 23.76177978515625, "tinuous variables and chi-squared tests for categorical variables. \nPatient Data Analysis \nAdagio Health provided us with deidentified individual-level data from its Enterprise \nPractice Management and electronic health record systems. \nThis combi"] [9.516938209533691, 23.75898551940918, "dagio Health \nservice area. \n\u2022 United Way of Southwestern PA 211 is an online search engine for resources available in Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Mercer, Washington, and Westmoreland counties. It includ"] [9.524906158447266, 23.74856948852539, "nt identification and recruitment, capacity, needs of women veterans, barriers to providing services, coordination of services, client engagement with services, and advocacy. \nWe then conducted phone interviews with 12 women veterans. Adagio Health "] [9.548786163330078, 23.68488883972168, ".0001 . \n \nVeteran women in the Adagio Health service area are less often White than nonveteran \nwomen (81.5 percent versus 89.7 percent), whereas the percentages of Hispanic or Latino are similar between the two groups (see Table 4.2). This racial a"] [9.540375709533691, 23.71059799194336, "f rounding . Missing, refused, or unknown not shown. \np < 0.0001. \nThere are no differences in the employment status of veteran and nonveteran women in the \nAdagio Health service area. Fifty-seven percent of veteran women and 55 percent of nonvete"] [9.544713020324707, 23.68593978881836, "n \nWomen Veteran \nWomen Nonveteran \nWomen \nHearing difficulty 2.5% 0.8% 3.7% 2.6% 13.7% 12.3% \nSelf-care difficulty 3.2%a 0.8% 3.6% 3.2% 11.3% 10.0% \nVision difficulty 4.1%b 1.3% 4.0% 2.7% 4.8% 7.0% \nIndependent living difficu"] [9.53409194946289, 23.73366355895996, "and April 2022, Adagio Health served 26,736 women, including \n890 women veterans. The data in the table and figures presented here are the deidentified \nindividual-level data that Adagio Health provided and include the entire January 2018 to April 2"] [9.571683883666992, 23.699983596801758, ". Race and Ethnicity of Women Served by Adagio Health \nRace and Ethnicity Veteran Women Nonveteran \nWomen \nRacea \nWhite alone 86.0% 81.3% \nBlack or African American alone 11.5% 13.2% \nAsian alone 0.3% 0.9% \nAmerican Indian or Ala"] [9.535721778869629, 23.732994079589844, "e 50 and over age group had a single visit. We also looked at counts of patients and visits by month and quarter and did not see any strong trends across the two groups. There was a small uptick in veteran utilization around COVID-19, but that appear"] [9.531039237976074, 23.7424259185791, "em visit. \na p = 0.014. \nb p = 0.040. \nc p = 0.004. \n Initial birth control methods were similar for veteran women patients and nonveteran women \npatients (see Table 5.6). About 22 percent of both groups used oral contraceptives, a patch, or a \nv"] [9.533793449401855, 23.74308967590332, "ve health \neducationb 26.6% 36.9% \nSmoking cessation counseling 10.2% 12.0% \nPregnancy options counseling 3.5% 4.4% \nOther counselingc 22.1% 28.8% \na p = 0.026. \nb p < 0.001. \nc p < 0.001. \n Around 38 percent of veteran women patients ha"] [9.540181159973145, 23.737512588500977, " screened positive on the PHQ-9 43 with a score of 10 or higher. For the CAGE-AID questionnaire, similar percentages of veteran \nand nonveteran women patients received a clinically significant score of two or higher. \nFigure 5.5. Positive Behavioral"] [9.52131175994873, 23.76240348815918, "counseling during an Adagio Health visit. Thirty-one percent of women patients with a positive pregnancy test had at least one prenatal visit at Adagio Health. \nWe also looked at contraceptive care for women patients who had a negative pregnancy tes"] [9.526664733886719, 23.766826629638672, ", the regional resources in the inventory are either exclusively for \nveterans and their family members or are programs or organizations that serve broader populations but offer veteran-specific programs (see Appendix B, Table B.1). Of the 63 resourc"] [9.534409523010254, 23.77418327331543, "le 6.1. Resources in the Adagio Health Service Area for Women Veterans \nCategory Types of Services Number of \nRegional \nPrograms or \nProviders Number of \nNational \nOnline \nResources \nMental health and \nsubstance use Treatment facilities; suici"] [9.522793769836426, 23.764495849609375, " facilities. Furthermore, completion of the surveys on which the data are based is entirely voluntary, so some facilities may not be represented, or their responses may not be complete. The survey results indicated that, of the 138 mental health trea"] [9.52851390838623, 23.772932052612305, "e an hour of their time each week to provide free counseling sessions to \nservice members and their families as part of the Military and Veterans Program. \nPotential clients may submit a request for an in-person, telephone, or video meeting; \nreview "] [9.530618667602539, 23.7758846282959, "eriences, Trips, and Gifts for Veterans \nThis group of 25 programs and services includes those that we deemed lower priority for \nreferrals by Adagio Health care navigators for various reasons, such as a low probability of \nselection for the program"] [9.521692276000977, 23.764249801635742, "auma in the women veteran population emerged as a salient theme. This includes not only high rates of MST but also combat trauma and other types of traumas encountered before, during, or after military service. This history of trauma and possibly rel"] [9.524138450622559, 23.76631736755371, " being implicitly given that message when a veterans\u2019 service organizations offered her the application for auxiliary rather than the regular membership when she inquired about joining. Another stakeholder said , \u201cWe\u2019re kind of \ninvisible. Women don\u2019"] [9.525786399841309, 23.77032470703125, "facilities would not serve them, \u201cI thought, I\u2019m not going to file a claim. Claims were for guys who lost their arms or legs.\u201d \nThe group of women veterans we interviewed learned through word of mouth from other \nveterans that VA care may be an optio"] [9.524789810180664, 23.766727447509766, "w to help us care for you better?\u201d to open space for women veterans to request any accommodations they may need or find helpful without specifically asking them to retell\u2014and perhaps reexperience\u2014traumatic events from their past. Another recounted wi"] [9.523517608642578, 23.7664794921875, " identified by stakeholders is growth in nontraditional families seeking housing support, including family units with adult children and/or grandchildren. Single-room occupancy emergency housing programs are often unable to support women veterans and"] [9.523670196533203, 23.766096115112305, "fy women veterans who may be in need; ensure they are made aware of services that can support them and their families; and engage them in these programs, services, and support. This is often a highly personalized, labor-intensive process that many or"] [9.52783203125, 23.7696590423584, "g on-site child care or supporting telehealth appointments with an \niPad, hot spot, or other resources to promote widespread internet access. One woman veteran said that she would have taken advantage of telehealth but she did not own a working compu"] [9.526741981506348, 23.76495933532715, "ts for those age 50 and older (24.6 percent versus 20.4 percent). When it came to behavioral health screenings conducted during office visits, veteran women patients were more likely to respond positively on the SBIRT prescreening than nonveteran wom"] [9.523565292358398, 23.76588249206543, "ny of the national online resources align with the issues and challenges faced by women \nveterans. The inventory includes 32 national online resources that focus on employment and career development, 31 that offer individual and family support, 20 th"] [9.523277282714844, 23.760618209838867, "atients with resources and services in the community through outreach activities and strategic partnerships with veteran-serving organizations. With these efforts, Adagio Health made strides toward addressing the issues and challenges that women vete"] [9.507949829101562, 23.73673439025879, "f available resources combined with trust issues. Through its Women \nVeterans Initiative, Adagio Health has made strides in establishing relationships with veteran-serving organizations, such as PAServes, VA vet centers, and VLP. Despite these effort"] [9.52583122253418, 23.763412475585938, " the qualitative assessment, we learned that it is important to recognize that partner agencies may face challenges with staff turnover and continuity of care, which might interfere with their ability to effectively serve their clients. Adagio Health"] [9.526437759399414, 23.762874603271484, "\nMany women veterans lack knowledge about services and supports available to veterans. \nWith transition support that was overwhelming, not individually tailored to their needs, or many \nyears in the past, there can be a vacuum in women veterans\u2019 awar"] [9.554978370666504, 23.73401641845703, " could \npartner with another agency to provide activities, such as cooking or yoga classes, at Adagio Health office locations. For example, Adagio Health could partner with the Veterans Yoga \nProject to offer yoga classes at an Adagio Health locatio"] [9.528938293457031, 23.77046012878418, "erans with mentors (e.g., eMentor, VETS\u2014Beyond the Uniform, American Corporate Partners, and Stand Beside Them), assist ing with resume preparation (e.g., Military \nand Veterans Appreciation Trust Foundation, O*NET Online\u2014Military Crosswalk, and Skil"] [9.537123680114746, 23.720386505126953, " time to build \ntrusted relationships with underserved populations. \n\u2022 Systematic, ongoing data collection will help identify unmet needs and gauge the progress of improvement efforts. \n\u2022 Explore additional opportunities to solicit input and feedback"] [9.577226638793945, 23.543386459350586, "6% 11.6% 8.1% \nDivorced 13.1% 12.9% 23.1% 11.9% 11.7% 22.5% 72 Women in \nthe United States Women in the Adagio Health Service Area \nCharacteristic All Nonveterans Veterans All Nonveterans Veterans \nHousehold Type \nMarried"] [9.582986831665039, 23.503704071044922, " 3.7% 7.2% 5.0% 5.0% 8.9% \nAge 40 \u201364 \nHearing \ndifficulty 2.2% 2.2% 3.9% 2.6% 2.6% 3.7% \nSelf-care \ndifficulty 2.8% 2.8% 3.7% 3.2% 3.2% 3.6% \nVision difficulty 2.7% 2.7% 3.3% 2.7% 2.7% 4.0% 74 Women in \nthe Unite"] [9.587393760681152, 23.48810577392578, "usehold 49.7% 49.7% 44.9% \nCohabiting -couple household 2.5% 2.5% 3.0% 76 Women in Allegheny County \nCharacteristic All Nonveterans Veterans \nNo spouse or partner 30.8% 30.7% 34.3% \nHousehold Size \n1 or more under 18 26.2% 26."] [9.587068557739258, 23.48687744140625, " private coverage 19.2% 19.1% 30.1% \nNo health insurance coverage 3.4% 3.4% 2.7% \nSOURCE: Features data from the five -year ACS data file (2016 though 2020) from \nU.S. Census Bureau, undated. \nNOTE: Some percentages do not sum to 100 because"] [9.586675643920898, 23.490121841430664, "% 78.2% 74.9% \nMean percentage of income spent on \nhousing 21.8% 21.8% 22.8% \nDisability Status \nAge 20 \u201339 \nHearing difficulty 0.4% 0.4% 0.0% \nSelf-care difficulty 0.7% 0.7% 0.0% \nVision difficulty 1.5% 1.5% 0.0% \nIndependent "] [9.58767318725586, 23.48431396484375, ".0% \nHousehold Size \n1 or more under 18 30.8% 30.9% 17.8% \nAverage household size 2.68 2.68 2.84 \nAverage family size 3.11 3.11 2.99 \nAverage number of children 0.51 0.52 0.39 \nEducational Attainment \nLess than 9th grade 0.0% 0.0% "] [9.588132858276367, 23.47768211364746, "dated. \nNOTE: Some percentages do not sum to 100 because of rounding. \n \n 87 Table A.5. Characteristics of Women Veterans in Fayette County \n Women in Fayette County \nCharacteristic All Nonveterans Veterans \nAge \n20 to 24 years 6.2% 6."] [9.584134101867676, 23.498918533325195, "ion difficulty 2.2% 2.2% 0.0% \nIndependent living difficulty 5.4% 5.4% 0.0% \nAmbulatory difficulty 3.2% 3.2% 0.0% \nCognitive difficulty 7.4% 7.4% 0.0% \nAge 40 \u201364 \nHearing difficulty 2.8% 2.8% 0.0% \nSelf-care difficulty 5.2% "] [9.586959838867188, 23.485116958618164, " Attainment \nLess than 9th grade 0.0% 0.0% 0.0% \n9th\u201312th grade, no diploma 6.5% 6.6% 0.0% \nHigh school graduate 40.2% 40.4% 28.9% \nSome college, no degree 16.4% 16.4% 20.2% \nAssociate \u2019s degree 11.3% 11.2% 22.0% \nBachelor \u2019s "] [9.586941719055176, 23.485227584838867, "acteristic All Nonveterans Veterans \nAge \n20 to 24 years 6.2% 6.2% 4.1% \n25 to 34 years 12.7% 12.7% 10.8% \n35 to 44 years 13.2% 13.2% 11.5% \n45 to 54 years 16.8% 16.8% 19.8% \n55 to 59 years 9.8% 9.8% 8.8% \n60 to 64 years 1"] [9.586769104003906, 23.485551834106445, " \nAge 40 \u201364 \nHearing difficulty 2.1% 2.0% 8.4% \nSelf-care difficulty 2.7% 2.7% 3.0% \nVision difficulty 2.8% 2.8% 1.9% \nIndependent living difficulty 6.3% 6.2% 9.6% \nAmbulatory difficulty 9.1% 9.1% 11.2% \nCognitive difficulty "] [9.586806297302246, 23.486093521118164, "raduate 37.8% 38.0% 21.8% \nSome college, no degree 19.8% 19.6% 33.7% \nAssociate \u2019s degree 11.3% 11.4% 7.0% \nBachelor \u2019s degree 15.9% 15.8% 23.1% \nGraduate or professional degree 8.3% 8.3% 9.8% \nMissing or unknown 1.8% 1.8% 1.8%"] [9.587038040161133, 23.487089157104492, "5 to 34 years 13.5% 13.6% 3.6% \n35 to 44 years 14.3% 14.4% 7.5% \n45 to 54 years 16.8% 16.7% 24.4% \n55 to 59 years 9.9% 9.8% 13.6% \n60 to 64 years 9.9% 9.9% 10.4% \n65 to 74 years 15.4% 15.4% 17.0% \n75 to 84 years 8.4% 8.4% 1"] [9.58696174621582, 23.485876083374023, "care difficulty 2.9% 3.0% 0.6% \nVision difficulty 3.0% 3.0% 0.6% \nIndependent living difficulty 6.1% 6.1% 0.9% \nAmbulatory difficulty 9.5% 9.6% 6.3% \nCognitive difficulty 6.1% 6.2% 2.8% \nAge 65+ \nHearing difficulty 12.5% 12."] [9.586729049682617, 23.486644744873047, " degree 17.2% 17.1% 23.7% \nAssociate \u2019s degree 9.2% 9.2% 9.4% \nBachelor \u2019s degree 13.3% 13.3% 9.7% \nGraduate or professional degree 8.0% 8.0% 11.3% \nMissing or unknown 3.3% 3.4% 0.0% \nHigh school graduate or higher 91.5% 91.4% "] [9.585752487182617, 23.491254806518555, " \n25 to 34 years 12.7% 12.7% 10.1% \n35 to 44 years 13.4% 13.3% 26.5% \n45 to 54 years 17.3% 17.2% 26.2% \n55 to 59 years 10.3% 10.3% 12.5% \n60 to 64 years 9.6% 9.6% 10.7% \n65 to 74 years 15.4% 15.5% 5.5% \n75 to 84 years 9.9% 1"] [9.589250564575195, 23.474504470825195, "40 \u201364 \nHearing difficulty 3.4% 3.4% 5.5% \nSelf-care difficulty 3.5% 3.5% 9.6% \nVision difficulty 3.3% 3.3% 1.5% \nIndependent living difficulty 7.1% 7.1% 10.5% \nAmbulatory difficulty 12.1% 11.9% 30.0% \nCognitive difficulty 7.9"] [9.587392807006836, 23.48328971862793, "Less than 9th grade 0.0% 0.0% 0.0% \n9th\u201312th grade, no diploma 5.3% 5.4% 1.5% \nHigh school graduate 46.7% 46.9% 34.6% \nSome college, no degree 14.8% 14.8% 20.5% \nAssociate \u2019s degree 10.8% 10.8% 17.8% \nBachelor \u2019s degree 12.5% 12"] [9.58728313446045, 23.483118057250977, "ndiana Counties \n Women in Armstrong and Indiana \nCounties \nCharacteristic All Nonveterans Veterans \nAge \n20 to 24 years 10.2% 10.3% 0.0% \n25 to 34 years 12.7% 12.7% 10.9% \n35 to 44 years 13.0% 13.0% 13.3% \n45 to 54 years 15.9% "] [9.567673683166504, 23.572620391845703, "2.4% 6.6% \nAmbulatory difficulty 1.5% 1.5% 0.0% \nCognitive difficulty 3.3% 3.3% 6.6% \nAge 40 \u201364 \nHearing difficulty 2.7% 2.7% 2.3% \nSelf-care difficulty 2.2% 2.2% 0.0% \nVision difficulty 3.6% 3.5% 18.5% \nIndependent living d"] [9.52820110321045, 23.78143310546875, "ng \nArmstrong County \nVeterans Affairs Helps veterans and their survivors file claims for state and \nfederal veteran benefits Armstrong \nBalanced Heart Healing \nCenter \u2022 Offers group and individual health education and \nhealing services by ment"] [9.535715103149414, 23.787954330444336, "ois Vet Center \u2022 Offers confidential free help for veterans, service \nmembers, and their families in a nonmedical setting \n\u2022 Includes counseling services for such needs as depression, PTSD, and the psychological effects of \nMST \n\u2022\n Offers a Women \u2019"] [9.531250953674316, 23.784568786621094, "utic needs Allegheny \nJefferson County Veterans \nAffairs Provides referrals for benefits, employment, financial \nassistance, mental wellness and substance use, \nposttraumatic stress, and more Jefferson \nLawrence County \nCommunity Action \nPartners"] [9.533819198608398, 23.787006378173828, "Provides homes in Pittsburgh to help homeless \nveterans with transitional housing All \nPennsylvan ia CareerLink Connects veterans with employment representatives at any \nof the statewide Pennsylvania CareerLink offices to receive free job counselin"] [9.5368013381958, 23.77924346923828, "he greater Pittsburgh and Western Pennsylvania area \nthroughout their transition and after Allegheny \nVenango County Veterans \nAffairs Provides referrals for benefits, employment, financial \nassistance, mental wellness and substance use, \nposttraum"] [9.523980140686035, 23.77451515197754, "egheny Health Network Department of Psychiatry Pittsburgh Allegheny \nEast End Behavioral Health \nHospital Pittsburgh Allegheny \nGlade Run Lutheran Services Pittsburgh Allegheny \nJefferson Hospital Behavioral Health Inpatient Clairton Alleghe"] [9.522473335266113, 23.774322509765625, "llsville Fayette \nFamily Behavioral Resources Outpatient Mental Health Clinic Uniontown Fayette \nSouthwest Behavioral Care, Inc. \nUniontown Fayette \nCornerstone Care Waynesburg Waynesburg Greene \nCornerstone Care Mount Morris Mount Mor"] [9.524136543273926, 23.76852798461914, " \nPartial hospitalization or day treatment 18 \nFederally Qualified Health Center 10 \nPayer or payment information \nCash or self -payment 73 \nMedicaid 76 \nMedicare 64 \nState -financed health insurance plan other than Medicaid 68 \nPrivate healt"] [9.523147583007812, 23.77450180053711, "burgh Allegheny \nUPMC McKeesport Hospital \nMcKeesport Allegheny \nUPMC Mercy Hospital Acute Medical Detox Pittsburgh Allegheny \nUPMC Western Psychiatric Hospital Narcotic Addiction Treatment Program Pittsburgh Allegheny \nVA Pittsburgh He"] [9.523642539978027, 23.7703914642334, "id \nSociety \nFranklin Venango \nFamily Services and Children \u2019s Aid \nSociety Oil City Venango \nOil Region Recovery \nFranklin Venango \nDeerfield Centers for Addictions \nTreatment Warren Warren \nFamily Services of Warren County Warren "] [9.544536590576172, 23.79053497314453, "0 \nFederally certified opioid treatment program 15 \nCognitive behavioral therapy 68 \nIndividual counseling 69 \nGroup counseling 68 \nFamily counseling 66 \n12-step facilitation 56 \nBrief intervention 54 \nContingency management and motivational i"] [9.545432090759277, 23.797975540161133, "mprehensive \nprocess of medical care, rehabilitation, and professional development \nArmy Resilience \nDirectorate Provides policy, resources, and capabilities for soldiers and U.S. Army \nleaders to increase their r esilience and readiness \nArmy Wom"] [9.54205322265625, 23.79483985900879, "eer transition advice \nand resources (online mentoring program) \nEsposas Militares \nHispanas USA Armed \nForces Supports Hispanic military spouses through awareness and information in \nSpanish about everything that surrounds them in the military tha"] [9.549966812133789, 23.80491828918457, "ry -friendly \nemployers by industry, function, and location \nHire Heroes USA Provides free employment assistance to help veterans and military spouses \nget hired, and helps companies hire and retain them \nHire Veterans Connects veterans with civi"] [9.537528991699219, 23.794727325439453, " \u2022 Offers a blog for service members and veterans to help them take \nadvantage of their military benefits and achieve financial independence \n\u2022 Offers articles on military life, including military pay and bene fits, \ninsurance, money management, and"] [9.551263809204102, 23.80506134033203, " \nobtaining VA benefits and participating in local and national issues pertaining \nto all women veterans \nNetwork of Care for \nVeterans, Service Members, and Their \nFamilies Provides an interactive web portal for service members, veterans, their \nf"] [9.549515724182129, 23.8070068359375, ", and support \nProject Welcome Home \nTroops Provides techniques for stress relief, greater health, and well -being and \nempowerment to improve the quality of life for returning veterans and their \nfamilies \nPurple Heart Foundation \u2022 Supports prog"] [9.547789573669434, 23.800949096679688, "agement, referral services, and temporary \nfinancial assistance for housing to veterans facing homelessness \n\u2022 Provides an opport unity for a veteran to meet with staff at a location \nconvenient for the veteran \nSplunk Offers access to e -learning"] [9.557841300964355, 23.81245994567871, "to the U.S. Court of \nAppeals for veterans \u2019 claims \nVeterans Employment and \nTraining Service Offers employment service s, programs, and resources to help veterans, \nservice members, and military spouses get jobs \nVeterans in Pain \u2022 Provides a na"] [9.559081077575684, 23.823318481445312, "njured in Combat Offers peer support groups, retreats, military sexual trauma intensive therapy \nretreats, workshops, summits, and more in partnership with Challenge \nAmerica \nWomen Veterans Call \nCenter Provides a call center dedicated to answeri"] [9.552123069763184, 23.806949615478516, "are gifted homes \nCanines for Service Provides veterans from all conflicts with service -connected mobility \nchallenges, PTSD, TBI, and MST with highly trained service dogs at no \ncost or promotional consideration \nFreedom Hunters Offers therapeu"] [9.57221794128418, 23.822444915771484, "o teach fly -fishing and fly -tying techniques to \ndisabled service members and veterans \nSierra Club \u2014Military Outdoors Provides veterans with the opportunity to get outdoors when they return \nhome after service \nSisterhood 4 Vets Provides vacati"] [9.59676742553711, 23.85026741027832, "r health care professionals \nVA Blind Rehabilitation \nServices Supports blind and low -vision veterans and active -duty service members \nin regaining their independence and quality of life to enable their \nsuccessful integration into family and com"] [9.555432319641113, 23.808815002441406, "ervice- connected disabilities to build, remodel , or purchase an adapted \nhome \nVA Suicide Prevention Helps veterans find local mental health and suicide prevention resources, \nfamily and friends connect to care and resources for coping with a suic"] [9.492865562438965, 23.732398986816406, "ance Abuse and Mental Health Services Administration \nSBIRT Screening, Brief Intervention, and Referral to Treatment \nSTI sexually transmitted infection \nTBI traumatic brain injury \nUMPC University of Pittsburgh Medical Center \nVA U.S. Department of "] [9.523873329162598, 23.763736724853516, "Sciences, Vol. 3, No. 2, 2017. \nCreech, Suzannah K., Carey S. Pulverman, Jennifer N. Crawford, Ryan Holliday, Lindsey L. \nMonteith, Keren Lehavot, Jennifer Olson-Madden, and Ursula A. Kelly, \u201cClinical Complexity in Women Veterans: A Systematic Review"] [9.521800994873047, 23.761653900146484, "ison B., Ines Poza, Vivian Hines, and Donna L. Washington, \u201cBarriers to \nPsychosocial Services Among Homeless Women Veterans,\u201d Journal of Social Work Practice in the Addictions, Vol. 12, No. 1, 2012. \nHenry, Meghan, Tanya de Sousa, Caroline Roddey, S"] [9.467488288879395, 23.70895004272461, "w American Security, November 17, 2015. \nLehavot, Keren, Jodie G. Katon, Jessica A. Chen, John C. Fortney, and Tracy L. Simpson, \u201cPost-\nTraumatic Stress Disorder by Gender and Veteran Status,\u201d American Journal of Preventive Medicine, Vol. 54, No. 1,"] [9.517070770263672, 23.756174087524414, "st updated September 7, 2022. \nOffice of People Analytics, 2021 Workplace and Gender Relations Survey of Military Members: \nOverview Report, U.S. Department of Defense, September 2022. \nOrshak, Jennifer, Lacey Alexander, Andrea Gilmore-Bykovskyi, and"] [9.517845153808594, 23.757474899291992, "visible Wounds of War: Psychological and Cognitive \nInjuries, Their Consequences, and Services to Assist Recovery, RAND Corporation, MG-720-CCF, 2008. As of February 26, 2023: https://www.rand.org/pubs/monographs/MG720.html \nU.S. Census Bureau, \u201cAmer"] [0.8907703161239624, 12.28282642364502, "Sponsored by Westlands Water DistrictGrowing Toward a \nLow-Carbon Future\nEstimating Greenhouse Gas Emissions in \nCalifornia\u2019s Westlands Water District\nMICHELLE E. MIRO, NIDHI KALRA, JONATHAN LAMB, NIHAR CHHATIAWALA\nCORPORATIONFor more information on"] [0.8678695559501648, 12.285346984863281, "work has been informed through structured collaboration with Westlands staff and key interested parties. This report will be of interest to Westlands and other irrigation and agricultural districts in California, as well as various natural resources "] [0.8926336169242859, 12.282294273376465, "ount for the most and least GHG emissions? \n\u2022 How do GHG emissions from crop production and related land uses change under climate change? \n\u2022 How would changes in crop production and related land use practices impact GHG emissions and key resource tr"] [0.8528594374656677, 12.300371170043945, "............................................................................................................................ iv\t\nFigures.................................................................................................................."] [0.8955750465393066, 12.284008026123047, "............................................................................................. 36 \t\nChapter 4. Conclusions ................................................................................................................. 39\t\nImplicatio"] [0.8950502872467041, 12.277158737182617, "or Irrigation from Groundwater Wells ........................................................... 27\tTable 2.7. Model Validation of GWP Outputs ............................................................................. 29\tTable 3.1. Average Annual "] [0.9007995128631592, 12.275404930114746, " and sequestering carbon dioxide (CO 2) when land is converted to and from \ncropland or grassland, and from carbon stocks stored in those lands, resulti ng in net emissions of approximately 12.1 \nMTCO2e q. The net emissions are the sum of fluxes in f"] [0.9061633944511414, 12.273890495300293, "ent of Conservation, undated). \nCalifornia crop emissions have already declined over time, in part because of (1) a reduction \nin acres cultivated, resulting in a decrease in synthetic fertilizer use, and (2) an uptake of drip and sprinkler irrigatio"] [0.8774933815002441, 12.284573554992676, "gy, and climate\u2014and addressing them requires a cross-sectoral approach to policy and planning. Furthermore, prioritizing and implementing changes in agricultural practices must account for future uncertainty that would affect the trade-offs presented"] [0.8963679671287537, 12.280195236206055, "tural GHG emissions and strategies to reduce emissions. Chapter 3 presents findings of our integrated model, and Chapter 4 offers conclusions and recommendations for California agriculture and water management based on our findings. \n 5 Chapter 2."] [-0.26634910702705383, 12.64030933380127, "round the world, in such works as Johnson et al., 2016; Dyer et al., 2017; Halverson et al., 2012; De Gryze, 2011; Necpalova, 2016; Weiler et al., 2017; Lemma et al., 2021; Sanz-Cobena et al., 2017; and Afroz et al., 2021. \nConsidering Future Uncerta"] [0.8825914859771729, 12.285880088806152, "ied a number of alternative practices that might reduce GHG emissions from Westlands, as shown under \u201cPolicy Levers\u201d in Table 2.2. We also identified a number of metrics relevant to Westlands to evaluate these options (see \u201cPerformance Metrics\u201d in Ta"] [0.8831713795661926, 12.288227081298828, "d land use practices that are most similar to current conditions in \nWestlands. The baseline scenario assumes no change in the mix of crop types and no expansion or reduction in land used for solar energy generation. To be able to isolate the relativ"] [0.8310728669166565, 12.308908462524414, "e and Precipitation Values for GCMs and Clima te Scenarios \n \nLand Use Model \nOverview \nEmissions from soil and field management practices were estimated with a dynamic Land \nUse Model adapted from the Intergovernmental Panel on Climate Change (I"] [0.867416262626648, 12.303962707519531, "ng of native grassland, or kept fallowed), and an equal area assumed to be permanently fallowed. All crop characteristics required to simulate the carbon and nitrogen cycle per IPCC guidelines, including assumptions related to crop yield, were either"] [0.8905087113380432, 12.284354209899902, "or each crop, we gathered estimates of the carbon, nitrogen, and lignin content of above- and below-ground dry mass, as well as any trimmings or deadfall, to calculate nutrient inputs each period (shown in Table 2.3). Soil carbon was divided between "] [0.8940743803977966, 12.288948059082031, "re uniform across the district each year (silt and clay composition were not utilized in the model calculations). The net change across all three pools results in a positive or negative carbon \nflux in units of carbon, which, following IPCC guideline"] [0.904193103313446, 12.273993492126465, "ndergo some form of rotation to maintain soil health and \nimprove crop yield. Because these vary by grower, year, and other conditions outside of our \nmodeling framework, we applied a crop rotation scalar to emissions to account for reductions in emi"] [0.9151125550270081, 12.264402389526367, "ed data carry their own assumptions around data \nrelevance (for example, crop yields vary with time, agricultural practices, etc.), we attempted to pull as many data from similar sources as possible. Unless explicitly described in the \u201cModeling Alter"] [0.9085045456886292, 12.267284393310547, " Acreage Category Lifespan\u1d43 \n(years) Annual \nIrrigation \nMonths\u1d43 Annual \nIrrigation\u1d47 \n(AF) Equipment \nEmissions\u1d43 \n(lbs./acre ) Annual Fertilizer \u1d43 \n(lbs. \nnitrogen/ acre) Yield\u1d9c \n(lbs./acre ) \nBroccoli 1 4 1.8 5,148 170 16,000 \n(U.S. Departme"] [0.9090462327003479, 12.268040657043457, "we used the following hierarchy for yield estimates: \n1. yield reported by Westlands (Cartwright, 2022) \n2. recent yield figures from Fresno County Department of Agriculture, 2020 \n3. California-specific yield from U.S. Department of Agriculture Nati"] [0.9291348457336426, 12.26107120513916, "iang and Noble, \n2019) 7.5% \nOnions ( fresh) 4,636 0 1,043 43.0% 38.2% 3.2% \n(Geissler, 2016) 0.5% 0.5% 15.1% \nSweet corn 15,867 0 5,829 47.1% 47.1% 0.8% \n(Liang and Noble, \n2019) 0.6% \n(Liang and Noble, \n2019) 0.7% \n(Liang and Noble,"] [0.9070069789886475, 12.269540786743164, "7,572 37,861 2,095 46.0% 46.0% 0.4% 0.4% 1.1% 28.0% \nOats 3,113 0 2,077 43.0% 38.2% 3.0% \n(University of \nArizona, 2022) 0.7% \n(Liang and Noble, \n2019) 0.8% \n(Liang and Noble, \n2019) 4.7% \nCherries 1,448 8,690 378 47.5% 46.6% 0.9% "] [0.11580131947994232, 12.400861740112305, "om historical data and management practices. It is intended to capture (1) the \ncrop water demand and resulting energy use from pumping for irrigation and (2) fluctuations in water available for irrigation and, thus, the irrigated acreage of Westland"] [0.6992573738098145, 12.36915111541748, "\nIn addition to reporting the annual water supply and demand, the Water Use Model passes \nkey information to the other two models. The amount of groundwater and surface water used in a given year is passed to the Energy Use Model to calculate emissio"] [0.85292649269104, 12.291348457336426, "er is used and 270,000 AF of groundwater is used under the current-state scenario, the average water EF is calculated in Equation 1. \n \n(0\n.38)\u2219(504)+(0.62)\u2219(9.7)=\t197.5\tlbs\tCO#\tAF%\" (1) \nFarm Fuel Consumption \nUC Davis Cost Studies, 2022, includes"] [0.8988971710205078, 12.278987884521484, "rbon intensity of the California grid is then estimated by Equation 3, where CI is \ncarbon intensity. \n\ud835\udc36\ud835\udc3c&)&*+!,-\n)./=\ud835\udc41\ud835\udc3a%&\u2217450)&*+!,-\n)./\t+(1\u2212\ud835\udc41\ud835\udc3a%&)\u22177)&*+!,-\n)./ (3) \n \nTo calculate the offset of solar for Westlands, we used Equation 4, where \ud835\udc46\ud835\udc36\ud835\udc3c i"] [0.9113970398902893, 12.276741981506348, " those authors validated their own results based on previously measured California data because of the similarities in climate between Greece and California. The study by Steenwerth et al., 2015, simulates wine grape cultivation in Central California"] [0.828420877456665, 12.317649841308594, "d is assumed to remain \nfallowed. The restoration case converts the land to a composite native grassland. Each \nsolar case converts the area from fallowed to utility-scale solar in the indicated year \n(2025, 2035, or 2045). \n\u2022 Energy use options: Thi"] [0.8948127627372742, 12.27824592590332, "cycle processes. During dry years, less precipitation is available, and CVP allocations may be reduced. This requires more land to be fallowed or more water to be pumped from groundwater if crop water demands exceed available water supply. Fallowing "] [0.905811607837677, 12.277230262756348, "re \npositive when tree crops turn over. On average, this results in net positive emissions under the assumptions of this model, but CO\n2 emissions are likely sensitive to the initial and final age \ncomposition of orchards. We can also see that per-ac"] [0.8654376864433289, 12.310698509216309, "ertain crops. However, if all farms in the district moved from current tillage practices to a no-till system, net emissions would be reduced to approximately 70,000 MtCO2eq annually. According to our model, this reduction would not require changes in"] [0.8967862725257874, 12.282395362854004, "d or no tillage might have additional benefits in the reduction of crop water \ndemand, but modeling these was beyond the scope of this study. \n 38 as opposed to 2033 in the current system. Solar 2035 only provides marginal emissions \nreductions, an"] [0.8953915238380432, 12.282309532165527, " in this study was further expanding solar in the district by converting a portion \n \n16 We account ed only for future climate change and future changes in the carbon intensity of California\u2019s electricity \ngrid. Other future sources of change were no"] [0.9014266133308411, 12.27833366394043, "es are not altered. It suggests that introducing no-till tillage practices can significantly reduce emissions by retaining more carbon in soils and reducing the amount of on-farm equipment needed for full tillage. This practice, according to our \n \n1"] [0.9138687252998352, 12.272449493408203, " to the crops shown in this study, such as processing tomatoes, rotations of row crops could result in emissions reductions of around 25 percent or more. Each of these strategies offers additional co-benefits for agriculture and the environment not c"] [0.9203321933746338, 12.276759147644043, "ic \nlightning, the decomposition of prior crop residues, animal droppings, and applied fertilizers. However, this is typically in the form of nitrites (NO\n2-) and ammonia or ammonium (NH 3, NH 4+) \nthat cannot be used directly by plants. Nitrifying b"] [0.9281979203224182, 12.25499153137207, "JV South; \nFresno County 2018 Yes Cited cost study is current and geographically comparable. \nPistachios Baldwin et al., 2020 SJV South 2020 Yes Cited cost study is current and geographically comparable. \nPima cotton Hutmacher et al., 2012a S"] [0.9311162829399109, 12.25435733795166, "92 No There is no current comparable cost study or alternative \nsource, so an older study was applied. \nPomegranates Day, Klonsky, and \nMoura , 2010 SJV South 2010 No There is no current comparable cost study or alternative \nsource, so an older s"] [0.8723369240760803, 12.268675804138184, "ramento \nValley 2015 Yes Estimates combine data from both cost studies, utilizing a \nrepresentative value across both studies when possible. \n \n 47 Abbreviations \nAF acre-feet \nCDFA California Department of Food and Agriculture \nCH 4 methane \nCO"] [0.9301655292510986, 12.255285263061523, "t Hembree, Craig E. Kallsen , Giulia Marino, Blake Sanden, Themis J. Michailides, Florent Trouillas, Daniele \nZaccaria, Linda Harris, and Donald Stewart, Sample Costs to Establish and Produce Pistachios, University of California Agriculture and Natur"] [0.924626886844635, 12.260201454162598, "s Greenhouse Gas Inventory,\u201d \nwebpage, September 6, 2021b. As of February 7, 2023: https://ww2.arb.ca.gov/sites/default/files/ghg-inventory-doc/doc/docs3/3c4_agsoilmanagement_direct_cropresiduenitrogen_n2o_2019.htm \n 51 California Climate Investment"] [0.9244001507759094, 12.263551712036133, "house Gas Inventories, 2019. \nChao Liang, Joshua P. Schimel, and Julie D. Jastrow, \u201cThe Importance of Anabolism in \nMicrobial Control over Soil Carbon Storage,\u201d Nature Microbiology, Vol. 2, No. 8, 2017. \nChristensen, Libby O., Ryan E. Galt, and Aliss"] [0.931082546710968, 12.254456520080566, "isleading Trends in Sustainability Attributes of No-Till,\u201d Global Change Biology, Vol. 26, No. 6, 2020. \nDay, Kevin R., Karen M. Klonsky, and Richard L. De Moura, Sample Costs to Establish and \nProduce Pomegranates, U.C. Cooperative Extension, 2010. "] [0.931304931640625, 12.25289535522461, "roduce Table Grapes\u2014Scarlet Royal-Mid-Season Maturing, University of California Agriculture and Natural Resources Cooperative Extension, Agricultural Issues Center, UC Davis Department of Agricultural and Resource Economics, 2018b. As of February 7, "] [0.9352220296859741, 12.25239086151123, "ram, Josh Davy, Glenn Nader, Karen Klonsky, and Don Stewart, \nSample Costs to Establish or Reestablish and Produce Pasture, U.C. Cooperative Extension, 2015b. As of February 7, 2023: https://coststudyfiles.ucdavis.edu/uploads/cs_public/b2/a9/b2a91349"] [0.9313129782676697, 12.253026008605957, "ricultural Issues Center, UC Davis Department of Agricultural and Resource Economics, 2017a. As of February 7, 2023: https://coststudyfiles.ucdavis.edu/uploads/cs_public/65/6c/656ce5fa-f4f9-4e95-99fe-a01c1ea8a7a4/2017peachsvsjv-ecling-final_draft2.pd"] [0.9321922063827515, 12.252967834472656, " from US Grain Farms,\u201d\u2009Journal of Crop Improvement, Vol.\u200930, No. 4, 2016. \nJuhos, Katalin, and L\u00e1szl\u00f3 T\u0151kei, Carbon Content of the Biomass of Vineyards and Orchards in \nHungary: An Assessment Based on Large-Scale Field Measurements, Case Studies and "] [0.9497761726379395, 12.271615982055664, "lik , Ashish A., Somak Chowdhury, Veronika Schlager, Anna Oliver, Jeremy Puissant, Perla \nG. M. Vazquez, Nico Jehmlich, Martin von Bergen, Robert I. Griffiths, and Gerd Gleixner, \u201cSoil Fungal:Bacterial Ratios Are Linked to Altered Carbon Cycling,\u201d Fr"] [0.9229851365089417, 12.263310432434082, "eet Orange Tree Growth,\u201d Journal of the American Society for Horticultural Science, Vol. 131, No. 1, 2006. \nMuhammad, Saiful, Blake L. Sanden, Bruce D. Lampinen, David R. Smart, Sebastian Saa, \nKenneth A. Shackel, and Patrick H. Brown, \u201cNutrient Stor"] [0.9309215545654297, 12.258309364318848, "erry as Influenced by Timing of \nFertilizer Application,\u201d Scientia Horticulturae, Vol. 126, No. 1, August 2010. \nSanden, Blake L., Bruce A. Roberts, Stephen R. Kaffka, Karen M. Klonsky, and Richard L. De \nMoura, Sample Costs to Produce Safflower, U.C"] [0.932644784450531, 12.25095272064209, "adedf/tomatofrmktsj07.pdf \nSutter, Steve, Ron Vargas, Steve Wright, Karen Klonsky, and Pete Livingston, Sample Costs to \nProduce Double Cropped Barley in the San Joaquin Valley, U.C. Cooperative Extension, 1990. As of February 7, 2023: https://costs"] [0.9304207563400269, 12.25827407836914, "\u201cCarbon to Nitrogen Ratios in Cropping Systems,\u201d 2011. \nU.S. Department of Energy Alternative Fuels Data Center, \u201cAverage Fuel Economy by Major \nVehicle Category,\u201d webpage, February 2020. As of August 3, 2022: https://afdc.energy.gov/data/10310 \nU.S."] [0.931772768497467, 12.25322151184082, "ing Practices and Technologies over a 10-Year (2005\u20132015) Timeframe,\u201d International Journal of Life Cycle Assessment, Vol. 25, 2020. \nWright, Steven D., Robert Hutmacher, Karen M. Klonsky, and Richard L. De Moura, Sample \nCosts to Produce Wheat for G"] [17.395950317382812, 8.130764961242676, "Prepared for the Los Angeles County Probation DepartmentPromising Services for \nJustice-Involved Youth\nA Scoping Review with Implications for the Los \nAngeles County Juvenile Justice Crime Prevention Act\u2014Appendixes\nD. MICHAEL APPLEGARTH, P\u2019TRICE JONE"] [17.390960693359375, 8.17776870727539, " (JJCC), which comprises stakeholders from county agencies, city agencies, and community-based organizations. In 2019, the Probation Department selected the RAND Corporation to provide evaluation and technical assistance services related to JJCPA-fun"] [17.06205940246582, 7.8733038902282715, "nile delinquen*\u201d OR \u201cjuvenile detention\u201d OR \u201cjuvenile \nprobation\u201d OR \u201cjuvenile corrections\u201d OR \u201cjustice-involved youth\u201d OR \u201cjuvenile offender*\u201d OR \u201cdelinquen*\u201d OR \u201ccourt-involved youth\u201d OR \u201cjuvenile crime\u201d ) OR KW ( \u201cjuvenile justice\u201d OR \u201cjuvenile de"] [17.06119728088379, 7.8329877853393555, "uptive\u201d OR \u201cexternaliz*\u201d OR \u201coppositional\u201d OR \u201cdefiant\u201d OR \u201cviolen*\u201d OR \u201csubstance use\u201d OR \u201csubstance abuse\u201d OR \u201csubstance dependence\u201d OR \u201cdrug use\u201d OR \u201cdrug abuse\u201d OR \u201cdrug depend*\u201d OR \u201caddict\u201d OR \u201cco-occurring disorder*\u201d OR \u201crisk* behavior\u201d OR \u201cat-"] [17.02780532836914, 7.839337348937988, " OR \u201cdelinquen*\u201d OR \u201ccourt-involved youth\u201d OR \u201cjuvenile crime\u201d ) OR AB ( \u201cjuvenile justice\u201d OR \u201cjuvenile delinquen*\u201d OR \u201cjuvenile detention\u201d OR \u201cjuvenile probation\u201d OR \u201cjuvenile corrections\u201d OR \u201cjustice-involved youth\u201d OR \u201cjuvenile offender*\u201d OR \u201cdel"] [16.96046257019043, 7.758109092712402, "est practice*\u201d or \u201cevaluat*\u201d or \u201cprogram evaluat*\u201d) OR \nKW\n (\u201cevidence-based practice*\u201d or \u201cbest practice*\u201d or \u201cevaluat*\u201d or \u201cprogram evaluat*\u201d) \nAND \nTI (\u201cRecidiv*\u201d OR \u201cReoffen*\u201d OR \u201cDesist* \u201d OR \u201cRisk*\u201d OR \u201cOutcome\u201d) OR SU (\u201cRecidiv*\u201d \nOR \u201cReoffe"] [17.017223358154297, 7.819619178771973, "pout*\u201d \nOR \u201cexpelled\u201d OR \u201cgang involvement\u201d) \nAND \nTI (\u201cevidence-based practice*\u201d or \u201cbest practice*\u201d or \u201cevaluat*\u201d or \u201cprogram evaluat*\u201d) \nAND \nTI (\u201cRecidiv*\u201d OR \u201cReoffen*\u201d OR \u201cDesist* \u201d OR \u201cRisk*\u201d OR \u201cOutcome\u201d) OR SU (\u201cRecidiv*\u201d \nOR \u201cReoffen*\u201d "] [17.02847671508789, 7.836448669433594, "\u201cat risk youth\u201d OR \u201cproblem youth\u201d OR \u201ctruan*\u201d OR \u201cexpulsion\u201d OR \u201csuspension\u201d OR \u201cdrop* out\u201d OR \u201cdropout*\u201d OR \u201cexpelled\u201d OR \u201cgang involvement\u201d) \nAND \nDocument Title, Publication Title, Subject Heading: (\u201cevidence-based practice*\u201d or \u201cbest practice*"] [17.024843215942383, 7.818420886993408, " A., and \nKathleen J. Bergseth, \u201cThe \nImpact of Reentry Services on Juvenile Offenders \u2019 Recidivism, \u201d\n \nYouth Violence and Juvenile \nJustice, Vol. 6, No. 3, July 2008, \npp. 295\u2013 318. Care coordination Youth with existing \nout-of-home \nplacement s \u2022"] [17.011438369750977, 7.822984218597412, "si -\nexperimental Justice \nWright, Emily M., Ryan Spohn, \nand Michael Campagna, \n\u201cResponding to Crossover \nYouth: A Look Beyond Care coordination Youth in the juvenile \njustice and child welfare system \u2022 Treatment (n = 210) \n\u2022 Comparison (n = 425) "] [17.009279251098633, 7.825719356536865, "ve Justice Interventions \non Recidivism Outcomes Among \nJuvenile Offenders, \u201d Youth \nViolence and Juvenile Justice, \nVol. 15, No. 4, October 2017, \npp. 465\u2013 480. Diversio n Youth diverted from \njuvenile court \u2022 Restorative justice \n(n = 284) \n\u2022 Comp"] [17.015104293823242, 7.843104362487793, "(n = 179) \nDembo, Richard, Jennifer \nWareham, and James Schmeidler, \u201cEvaluation of the \nImpact of a Policy Change on Diversion Program Recidivism and Justice System Costs: 12 -\nMonth Follow -Up,\u201d Journal of \nOffender Rehabilitation, Vol. 41, \nNo. 3, "] [16.981332778930664, 7.795832633972168, "erred to \njuvenile court \u2022 Treatment (n = 143), \n\u2022 Comparison (n = 143) RCT Justice, other \nKethineni, Sesha, and Jonathan \nA. Grubb, \u201cAn Evaluation of \nRedeploy Illinois on Juvenile Diversion Youth (medium to \nhigh risk), nonviolent offenses\n \u2022"] [17.041812896728516, 7.860175609588623, "Stephanie Bontrager, \nKristin Winokur Early, Gregory Hand, and Steven Chapman, \u201cJuvenile Justice Interventions: \nSystem Escalation and Effective \nAlternatives to Residential \nPlacement, \u201d Journal of Offender \nRehabilitation, Vol. 52, No. 5, \n2013, pp"] [17.015201568603516, 7.834109306335449, "etention Overreliance, \u201d Journal of \nJuvenile Justice, Vol. 5, No. 2, \nFall 2016, pp. 12\u201330\n. Diversion Youth who violated \ncommunity supervision\n \u2022 Treatment (n = 121) \n\u2022 Comparison (n = 124) Quasi -\nexperimental Justice \nVose, Brenda, and Kelly"] [16.98702621459961, 7.807772159576416, "olved youth \n(n = 93) \n\u2022 Non\u2013gang- involved youth \n(n = 315) Quasi -\nexperimental Justice \nCelinska, Katarzyna, Hung -En \nSung, Chunrye Kim, and \nMargret Valdimarsdottir, \u201cAn \nOutcome Evaluation of \nFunctional Family Therapy for Family intervention "] [17.033546447753906, 7.8426313400268555, " James \nSchmeidler, Amy Hartsfield, and \nWerner Wothke, \u201cPsychosocial \nFunctioning Among Juvenile \nOffenders 12 Months After Family Empowerment Intervention, \u201d Journal of \nOffender Rehabilitation, Vol. 32, \nNos. 1\u20132, 2000c, pp. 1\u201356\n. Family interve"] [17.017045974731445, 7.840079307556152, "nal \nreferral \u2022 Treatment (n = 81) \n\u2022 Comparison (n = 85) RCT Mental health \nHenggeler, Scott W., Elizabeth \nJ. Letourneau, Jason E. Chapman, Charles M. Borduin, \nPaul A. Schewe, and Michael R. \nMcCart, \u201cMediators of Change \nfor Multisystemic Ther"] [16.97945213317871, 7.8091535568237305, "on for first -Time \nJuvenile Offenders: \nComparisons with Probation and \nDropouts on Recidivism, \u201d \nJournal of Commu nity \nPsychology, Vol. 32, No. 2, \n2004, pp. 177\u2013 200. Family intervention Youth with first -time \noffenses \u2022 Treatment (n = 267) "] [17.032011032104492, 7.890895843505859, "\u201cFamily \nIntegrated Transitions: A Promising Program for Juvenile Family intervention Youth incarcerated \nwith co -occurring \nsubstance use and mental health disorders and released on parole\n \u2022 Treatment (n = 105) \n\u2022 Comparison (n = 169) Quasi -\nexp"] [16.991741180419922, 7.814312934875488, "ally Supported Interventions to Reduce Adolescent Sexual Risk Behavior: A Randomized \nControlled Trial, \u201d Journal of \nAdolescent Health, Vol. 67, \nNo. 1, July 2020, pp. 53\u201360\n. Health -focused Justice- involved \nyouth \u2022 Treatment (n = 125) \n\u2022 Comp"] [17.009511947631836, 7.828479290008545, "ease Interview \nSkills of Adolescent Males in a \nJuvenile Residential Treatment Facility, \u201d Journal of Applied \nBehavior Analysis, Vol. 53, \nNo. 4, September 2020, \npp. 2303\u2013 2318\n. Other Youth in a juvenile \nfacility who have been adjudicated of a"] [17.027896881103516, 7.822315216064453, "ulu \u2019s Girls \nCourt, \u201d Women and Criminal Problem -solving \ncourts and other court \ninterventions Adolescent girls in \njuvenile court \u2022 Treatment (n = 60) \n\u2022 Comparison (n = 70) Quasi -\nexperimental Justice, other 32 Citation Program Type Po"] [17.0124568939209, 7.806332111358643, "tcome Study, \u201d Justice \nQuarterly, Vol. 33, No. 2, 2016, \npp. 291\u2013 318\n. Problem -solving \ncourts and other court \ninterventions Youth in drug court \u2022 Treatment (n = 686) \n\u2022 Comparison (n = 686) Quasi -\nexperimental Justice \nAbrams, Laura S., Sar"] [16.998920440673828, 7.805041790008545, "ommitted a serious \noffense \u2022 Full sample n = 133 \n\u2022 Justice- involved youth \n(n = 64) \n\u2022 At-risk youth (n = 69) Quasi -\nexperimental Justice \nLancaster, Chloe, Richard S. \nBalkin, Roberto Garcia, and Alexandra Valarezo, \u201cAn \nEvidence -Based Approa"] [17.014930725097656, 7.835097789764404, "ntation for Juvenile \nAlcohol and Drug Offenders, \u201d \nJournal of Offender \nRehabilitation, Vol. 43, No. 3, \n2006, pp. 49\u201372. \u2022 Did not attend presentation \n(n = 72) \n\u2022 Comparison (n = 84) \nViola, Wendy Elaine, Eric S. \nMankowski, and Mary Elisabeth "] [16.995494842529297, 7.809748649597168, "Comparative Psychotherapy Youth on probation \u2022 Treatment (n = 39) \n\u2022 Comparison (n = 31) RCT Justice 39 Citation Program Type Population Sample Size Study Design Outcome \nMeasure(s) \nCriminology, Vol. 56, No. 1, \nFebruary 2012, pp. 61\u201380"] [16.99875259399414, 7.822643280029297, "baum, Chloe A., and \nShabnam Javdani, \u201cExpressive \nWriting Intervention Promotes Resilience Among Juvenile Justice- Involved Youth, \u201d \nChildren and Youth Services Review, Vol. 73, February \n2017, \npp. 220\u2013 229. Psychotherapy Incarcerated youth \u2022 n "] [16.993309020996094, 7.8312859535217285, "ual Abuse: Journal of Research and Treatment, Vol. 18, No. 4, October 2006, \npp. 401\u2013 421\n. Psychotherapy Youth adjudicated of \nsexual offense \u2022 9 studies Meta -analysis Justice \nThoder, Vincent J., and Joseph \nD. Cautilli, \u201cAn Independent \nEvalu"] [17.03290557861328, 7.867790699005127, "l F. McCaffrey, Kirsten Becker, and Andrew R. Morral, \u201cLong- Term \nEffect of Community- Based \nTreatment: Evid ence from the \nAdolescent Outcomes Project, \u201d \nDrug and Alcohol Dependence, Vol. 107, No. 1, February 2010, \npp. 62\u201368\n. Substance use \ntre"] [17.04764747619629, 7.855081558227539, " \nwith a Substance Use Disorder: \nGender Sensitive Substance \nAbuse Intervention, \u201d Journal of \nOffender Rehabilitation, Vol. 49, \nNo. 7, 2010, pp. 479\u2013 494. Substance use \ntreatment Female youth \ncommitted to youth \ndevelopment center \nwith a subs"] [17.00166893005371, 7.828670501708984, "4. Wraparound services Youth with affective \nor psychotic \ndisorders in detention centers\n \u2022 n = 314 Observational Justice, \nsubstance \nuse, mental \nhealth, other \nMcCarter, Susan Ainsley, \n\u201cHolistic Representation: A \nRandomized Pilot Study of Wr"] [17.031862258911133, 7.879636764526367, "tember 2014, pp. 1033\u20131056. \nBaglivio, Michael T., Kevin T. Wolff, James C. Howell, Katherine Jackowski, and Mark A. \nGreenwald, \u201cThe Search for the Holy Grail: Criminogenic Needs Matching, Intervention Dosage, and Subsequent Recidivism Among Serious"] [17.04344367980957, 7.886769771575928, "y,\u201d Journal of Consulting and Clinical Psychology, Vol. 77, No. 1, February 2009, pp. 26\u201337. \nBottcher, Jean, and Michael E. Ezell, \u201cExamining the Effectiveness of Boot Camps: A \nRandomized Experiment with a Long-Term Follow Up,\u201d Journal of Research "] [17.065576553344727, 7.862915992736816, " Youth,\u201d Journal of Family \nTherapy, Vol. 41, No. 2, April 2019, pp. 251\u2013276. \nCervantes, Richard C., Karen Ruan, and Norma Due\u00f1as, \u201cPrograma Shortstop: A Culturally \nFocused Juvenile Intervention for Hispanic Youth,\u201d Journal of Drug Education, Vol. "] [17.054649353027344, 7.893898010253906, "Lisa P. Tichavsky, \u201cWhat Works for Whom? The Effects \nof Gender Responsive Programming on Girls and Boys in Secure Detention,\u201d Journal of \nResearch in Crime and Delinquency, Vol. 52, No. 1, 2015, pp. 93\u2013129. \nde Beus, Kimberly, and Nancy Rodriguez, \u201c"] [17.031221389770508, 7.881390571594238, "ustaining Families, Dissuading \nCrime: The Effectiveness of a Family Preservation Program with Male Delinquents,\u201d Journal \nof Criminal Justice, Vol. 39, No. 4, July\u2013August 2011, pp. 338\u2013343. \nDiClemente, Ralph J., Teaniese L. Davis, Andrea Swartzendr"] [17.082155227661133, 7.923216342926025, "w J., \u201cUsing Police Officers to Enhance the Supervision of Juvenile Probationers: \nAn Evaluation of the Anchorage CAN Program,\u201d Crime and Delinquency, Vol. 48, No. 1, January 2002, pp. 116\u2013137. \nGibson, Laurel P., Charleen J. Gust, Arielle S. Gillman"] [17.06060218811035, 7.894117832183838, " the Juvenile Justice System,\u201d Children and Youth Services Review, Vol. 65, June 2016, pp. 78\u201385. \nHamilton, Zachary K., Christopher J. Sullivan, Bonita M. Veysey, and Michele Grillo, \n\u201cDiverting Multi-Problem Youth from Juvenile Justice: Investigati"] [17.12552833557129, 7.976539134979248, ". Drinkard, Lynn Falletta, and Daniel J. Flannery, \u201cUnderstanding \nClinical Complexity in Delinquent Youth: Comorbidities, Service Utilization, Cost, and Outcomes,\u201d Journal of Psychoactive Drugs, Vol. 40, No. 1, March 2008, pp. 85\u201395. \nJavdani, Shabn"] [17.06220054626465, 7.897490978240967, "Jonathan A. Grubb, \u201cAn Evaluation of Redeploy Illinois on Juvenile \nReoffending,\u201d International Journal of Offender Therapy and Comparative Criminology, Vol. 65, Nos. 10\u201311, August 2021, pp. 1192\u20131223. \nKrakow, Barry, Diane Sandoval, Ron Schrader, Br"] [17.02349853515625, 7.935182094573975, "J., Scott W. Henggeler, Michael R. McCart, Charles M. Borduin, Paul A. \nSchewe, and Kevin S. Armstrong, \u201cTwo-Year Follow-Up of a Randomized Effectiveness Trial Evaluating MST for Juveniles Who Sexually. \nLeve, Leslie D., and Patricia Chamberlain, \u201cA "] [17.064172744750977, 7.902778625488281, " Donat, Jane Cheney, \nTimothy M. Fitzpatrick, and Linda Monaco, \u201cProject Back-on-Track at 1 Year: A Delinquency Treatment Program for Early-Career Juvenile Offenders,\u201d Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 39, No. 9"] [16.97591781616211, 7.899113655090332, "valuation of an \nIntimate Partner Violence Prevention Program for Adjudicated, African American, Adolescent Males,\u201d Youth Violence and Juvenile Justice, Vol. 4, No. 4, October 2006, \npp. 368\u2013385. 62 Sawyer, Aaron M., and Charles M. Borduin, \u201cEffects"] [17.038522720336914, 7.885694980621338, "tivational Interviewing for Incarcerated Adolescents \non Driving Under the Influence After Release,\u201d American Journal on Addictions, Vol. 15, \nSuppl. 1, 2006, pp. 50\u201357. \nSteiner, Benjamin, and Andrew L. Giacomazzi, \u201cJuvenile Waiver, Boot Camp, and R"] [17.03090476989746, 7.884859561920166, "athleen Kemp, Sarah Johnson, and \nLarry K. Brown, \u201cOutcomes of a Family-Based HIV Prevention Intervention for Substance Using Juvenile Offenders,\u201d Journal of Substance Abuse Treatment, Vol. 77, June 2017, pp. 115\u2013125. \nTrulson, Chad, Ruth Triplett, a"] [17.055038452148438, 7.9043049812316895, "lence and Juvenile Justice, Vol. 18, No. 4, \nOctober 2020, pp. 381\u2013394. \nYoder, Jamie, Rebecca Dillard, Lori Brusman Lovins, and Stuart Berry, \u201cEvaluation II: Risk \nOutcomes from a Specialized Treatment and Management Program for Youth Who Commit Sex"] [17.244651794433594, 8.055347442626953, "D. MICHAEL APPLEGARTH, P\u2019TRICE JONES, STEPHANIE BROOKS HOLLIDAY\nPromising Services for \nJustice-Involved Youth\nA Scoping Review with Implications for \nthe Los Angeles County Juvenile Justice Crime Prevention Act\nFrom the onset of the first juvenile c"] [17.17732048034668, 7.990568161010742, "is filed), and 54\u00a0percent of cases continued through the court (i.e., petitioned). For the peti-tioned cases, over 200,000 juveniles were adjudicated (53\u00a0percent), the equivalent of being found guilty in adult court (Hockenberry, 2022a). For those wh"] [17.297948837280273, 8.097790718078613, "re strength-based focus when engaging with youth (Kazemian, 2021). To achieve the goal of providing effective services, continued efforts are needed, not only to continue developing and testing new service models but to synthesize and disseminate our"] [17.641483306884766, 8.430087089538574, "018, 5,098 youth were under active supervision of the Pro-bation Department. This dropped to 3,538 by Octo-ber 2020 (Los Angeles Juvenile Justice Coordinating Council, 2021). Although this drop might partially reflect the effect of the coronavirus di"] [17.209178924560547, 7.9761199951171875, "ts that agencies provide details regarding the evidence base of their programming; however, agencies often make local adaptations to programs, and it could be difficult for JJCC members to determine what components of programming are evidence-based. "] [17.048608779907227, 7.862460136413574, "comes of interest \n(e.g., \u201coutcome,\u201d \u201creoffen*).\nWe limited our review to studies published \nsince the year 2000, published in English, and that included programs or samples in the United States. 5\nEmpirical studies and meta-analyses that reported \no"] [15.518952369689941, 6.6994547843933105, "or investigator independently screened an initial set of 50 articles and discussed them to achieve consensus. The inclusion and exclusion crite-ria were refined using this process, and the research team then screened a second set of 50 articles. Afte"] [17.039840698242188, 7.902965545654297, "l programs 4 \nHealth-focused programs (No subcategories) 10 \nFamily-focused interventions Multisystemic therapy 10 \nFunctional family therapy 4 \nFamily empowerment intervention 5 \nMultidimensional treatment foster care 2 \nParenting with love and limi"] [16.986019134521484, 7.814574241638184, "3)\u00a0other (i.e., those that did not neatly fit into one of the previously identified categories). A table of all included studies appears in Appendix B.\n1. Diversion Programs\nDiversion programs aim to reduce youths\u2019 formal contact with the juvenile ju"] [16.993515014648438, 7.819011688232422, "ely to reoffend during the two-year follow-up period. \nTogether, these studies suggest restorative justice \nprograms might effectively serve as alternatives to formal system involvement for youth.\n1.2. Teen Courts\nTeen courts are intended for first t"] [16.970829010009766, 7.801177501678467, "health concerns, aiming to connect youth with needed mental health services in community-based settings (i.e., treatment settings that the youth engage in while residing in the community with a parent[s] or caregiver). Three studies were quasi-experi"] [16.965070724487305, 7.803156852722168, "t\u00a0al., 2018).\nTwo other studies evaluated the effects of the \nMental Health/Juvenile Justice Diversion Project in New York. Several sites across 12 counties par-ticipated, all with the unified goals of preventing rearrest or supervision violations of"] [16.98219871520996, 7.803079605102539, "-based arrested youth. Although the rate of school-based arrest decreased by 84\u00a0percent following the program\u2019s implementation, youth who were arrested prior to the program had similar recidivism rates compared with the program youth who, instead of "] [16.99120330810547, 7.800802230834961, " to evaluate youths\u2019 needs and create a treatment plan prior to the youth\u2019s court date (Kazi et\u00a0al., 2012). Significant increases in the use of alternative sanctions (i.e., youth cases were adjourned in contemplation of dismissal dependent on youth h"] [16.98073387145996, 7.791652202606201, "quences associated with detention. \nTwo studies examined potential methods of \nenhancing standard diversion programs. In one, youth randomly assigned to receive 16 weeks of case management in addition to the standard diver-sion program saw no added r"] [17.01668930053711, 7.785275936126709, "vism. First, in a national 12\nmulti-site quasi-experimental study, youth partici-\npating in a drug court had the same or higher odds of recidivating compared with similar peers on probation (Sullivan et\u00a0al., 2016). Second, in another quasi-experiment"] [17.07729721069336, 7.7560224533081055, " significantly lower only in felony arrests rates.\nFindings from two observational studies suggest \nthat it is not uncommon for youth who participate in drug court to have, at least initially, some contin-ued substance use, with 79\u00a0percent (Hayden, 2"] [16.962074279785156, 7.813077449798584, "munity service, and group and individual therapy. Parents also participated in a group to discuss family problems. Girls in the program had statistically significant reductions in law violations and when compared with a matched sample of girls assign"] [17.001882553100586, 7.823307514190674, "studies examined the Crossover Youth \nPractice Model, which aims to identify youth with involvement in both the child welfare system and the juvenile justice system. In this model, the two agencies assess youths\u2019 needs and coordinate case manage -\nme"] [16.928571701049805, 7.7819976806640625, "onnect youth to educational, mental health, and family services that can address underlying causes of delin-quent behavior. No significant reduction in recidi-vism was observed for participating youth.\nIt can be challenging to draw conclusions across"] [16.871036529541016, 7.764576435089111, "elony arrest (Bahr, Cherrington, and Erickson, 2016).\nThe articles that used a quasi-experimental \ndesign also supported the use of CBT for reducing recidivism for justice-involved youth. For example, there is evidence that participating in CBT is as"] [16.926902770996094, 7.7849884033203125, "th in a residential or community-based setting among the observed youth that received some form of CBT treatment (Thoder and Cautilli, 2010; Yoder et\u00a0al., 2017). \nKrakow et\u00a0al. (2001) observed changes in PTSD \nsymptoms and sleep quality for girls in "] [16.942110061645508, 7.793833255767822, "ure rates of reoffending, finding that this gender-specific intervention did not decrease recidivism for detained boys or girls (Day, Zahn, and Tichavsky, 2015). \nA quasi-experimental study of boys that received \nan unspecified intensive mental healt"] [16.95645523071289, 7.799002170562744, "ment results in better juvenile justice outcomes for youth rather than no treatment at all.\n5. Psychoeducation\nThere were 16 articles that evaluated psychoeduca-tional programs. We identified three subcategories of programs, including skills training"] [16.911869049072266, 7.751162528991699, "arding observational studies, Abrams, Shan-\nnon, and Sangalang (2008) evaluated an independent living skills\u2013focused program for youth preparing to leave incarceration and found no significant relation -\nship between program participation and new off"] [16.970537185668945, 7.782855987548828, "e observational studies. In an RCT, Salazar and Cook (2006) evaluated \nan intimate partner violence\u2013prevention program administered in the community for adjudicated, predominately African American males. In the post-test assessment, results revealed "] [16.949899673461914, 7.781949520111084, "oup had significantly fewer sexual \npartners than the control group at the six-month follow-up, but only for youth who engaged in sexual activity before they were 12 years old (Donenberg, Emerson, and Kendall, 2018). There was no sig-nificant effect "] [17.228849411010742, 8.759512901306152, "\nthat there is a specific intervention approach that appears to be especially effective at addressing risky health-related behaviors, given the mixed nature of the findings and generally high-quality nature of most of the included studies.\n7. Family-"] [17.223173141479492, 8.755887985229492, "r. Similarly, Timmons-Mitchell et\u00a0al. (2006) found no significant differences between groups for substance use and externalizing behaviors but did find evidence of significantly better function-ing for youth at school or work, in the home or com-muni"] [17.156341552734375, 8.566044807434082, "dications found no significant differences between the treatment and control groups of adjudicated youth 12 months post-intervention (Sexton and Turner, 2010). \nTwo quasi-experimental studies also looked at \nthe effectiveness of FFT on recidivism. Ce"] [16.96480369567871, 7.806624889373779, "examined a community-based program for youth who are justice-involved, called Parenting with Love and Limits . This program \nprovided therapy sessions to youths and their guard -\nians, in addition to offering parenting education ser -\nvices. Compared"] [16.96457862854004, 7.803279876708984, "th youth who did not participate in the program (Trupin et\u00a0al., 2011). However, there was no significant effect on overall or misdemeanor recidivism. Finally, a gender-specific family-based delinquency intervention also seemed to significantly lower "] [16.944868087768555, 7.786813259124756, "h participating in the program are traditionally housed in a separate unit.\nTwo quasi-experimental studies examined the \neffectiveness of the Phoenix Academy program. Initially, this residential treatment program showed positive results (at three, si"] [16.951576232910156, 7.785354137420654, ", curriculum \ncompression, acknowledgement of addiction, and other factors, tended to have lower subsequent arrest rates (Mears and Kelly, 2002). Second, an experimen-tal study evaluating the effects of youth who receive an MI intervention found that"] [16.98691177368164, 7.811358451843262, "heir family, service providers, and others from the community establish a team and work to take a holis-tic approach to supporting the youth and their fami-lies (National Center for Innovation and Excellence, undated). Because these models tend to be"] [16.945236206054688, 7.780213356018066, "ing construction trade skills and working on projects (Cohen and Piquero, 2010). Youth who completed the program were more likely to graduate (58\u00a0percent compared with 18\u00a0per-cent) and had reduced recidivism rates compared with youth who did not comp"] [16.9835262298584, 7.747547626495361, "s after release. Finally, Steiner and Giacomazzi (2007) found that participat-ing in a boot camp (the Rider Program) was not asso-ciated with recidivism over a two-year follow-up.\n11. Risk-Need-Responsivity and \nPrinciples of Effective Correctional I"] [16.96242904663086, 7.796323776245117, "hnical violation but were not more likely to receive new charges. Lane et\u00a0al. (2005) conducted an RCT in which the treat-ment group received more contacts and lengthier interactions with supervision staff and found no sig-nificant differences in the "] [16.927295684814453, 7.774217128753662, "are summarized in Table 2. \nMany diversion programs were associated with \nbetter outcomes for youth, including a lower likeli-hood of future arrests, adjudications, and out-of-home placements across multiple studies. These programs used a variety of "] [16.970699310302734, 7.780206680297852, "tions (e.g., Giblin, 2002), likely because of increased oversight. Boot camps also had no significant long-term effect (e.g., Bottcher and Ezell, 2005). \nFinally, psychoeducational programs appeared \nto have mixed effects, including life skills train"] [16.883609771728516, 7.756235599517822, "grams that address criminogenic risk tended to be effective at reducing recidivism.\n\u2022 Ot\nher forms of CBT that target mental health had mixed outcomes, although certain forms of such \ntherapy appeared to effectively improve mental health.\n\u2022 So\nme oth"] [16.955711364746094, 7.8210601806640625, "study had youth \nself-report less delinquent behavior and less victimization.\nOther \u2022 On\ne study suggested that a wilderness program increased youths\u2019 feelings of self-efficacy and hope for \nthe future, but did not observe reduced recidivism.\n\u2022 An\not"] [17.195016860961914, 7.982700824737549, "ulations. Therefore, our comments on the status of the literature should be interpreted as specific to the academic literature. That said, we believe that the bulk of relevant studies will appear in the academic literature rather than in gray literat"] [17.423263549804688, 8.407516479492188, "gram, a newer program providing case management services that is currently expanding (Los Angeles County Depart-ment of Youth Diversion and Development, 2022). \nIn the category of problem-solving courts and \nother court interventions, two court-relat"] [17.024023056030273, 7.914535999298096, ". \nAnnie E. Casey Foundation, \u201cWhat Is Juvenile Justice?\u201d blog \npost, December\u00a012, 2020. As of October\u00a011, 2022: https://www.aecf.org/blog/what-is-juvenile-justice\nBaglivio, Michael, and Katherine Jackowski, \u201cEvaluating the \nEffectiveness of a Victi"] [17.05613899230957, 7.898231029510498, "tal Disorders Among Adolescents in Juvenile Detention and Correctional Facilities,\u201d Journal of the American Academy of Child and Adolescent Psychiatry, Vol.\u00a060, No.\u00a01, January 2021, pp.\u00a046\u201360. \nBehnken, Monic P., David E. Arredondo, and Wendy L. \nPac"] [17.04242706298828, 7.891722202301025, " and Bonita Veysey, \u201cEffectiveness of Multisystemic Therapy for Gang-Involved Youth Offenders: One Year Follow-Up Analysis of Recidivism Outcomes,\u201d Children and Youth Services Review, Vol.\u00a073, February 2017, pp.\u00a0107\u2013112. \nBrusman Lovins, Lori, Jamie "] [17.044050216674805, 7.889059543609619, "na Navrotskaya, Annemarie Madaras, Robert L. Rhyne, Jennifer Hettema, and Christina Phillips, \u201cPilot Study of an Overdose First Aid Program in Juvenile Detention,\u201d Health Promotion Practice, Vol.\u00a022, No.\u00a05, September 2021, pp.\u00a0638\u2013640. \nChassin, Laur"] [17.019025802612305, 7.8899126052856445, "Journal of Criminal Justice, Vol.\u00a035, No.\u00a03, May\u2013June 2007, pp.\u00a0337\u2013347. 33\nDembo, Richard, Gabriela Ramirez-Garnica, Matthew Rollie, \nJames Schmeidler, Stephen Livingston, and Amy Hartsfield, \u201cYouth Recidivism Twelve Months After a Family Empowermen"] [17.071849822998047, 7.914389133453369, " Robert G. Morris, and Jonathan W. Caudill, \n\u201cSustaining Families, Dissuading Crime: The Effectiveness of a Family Preservation Program with Male Delinquents,\u201d Journal of Criminal Justice, Vol.\u00a039, No.\u00a04, July\u2013August 2011, pp.\u00a0338\u2013343. DiClemente, Ra"] [17.063825607299805, 7.909740447998047, "y, Jessie Daniels, \nMartha Crum, Danielle C. Ompad, and David Vlahov, \n\u201cReducing Drug Use, Human Immunodeficiency Virus Risk, and \nRecidivism Among Young Men Leaving Jail: Evaluation of the \nREAL MEN Re-Entry Program,\u201d Journal of Adolescent Health, \n"] [17.087932586669922, 7.914310455322266, "ctober 2018, pp.\u00a0939\u2013953. \nGray, Doug, Kristin L. Dawson, Todd C. Grey, and William\u00a0M. \nMcMahon, \u201cThe Utah Youth Suicide Study: Best Practices for Suicide Prevention Through the Juvenile Court System,\u201d Psychiatric Services, Vol.\u00a062, No.\u00a012, December "] [17.06856918334961, 7.9106268882751465, "p.\u00a0264\u2013275. \nHenggeler, Scott W., Elizabeth J. Letourneau, Jason E. Chapman, \nCharles M. Borduin, Paul A. Schewe, and Michael R. McCart, \u201cMediators of Change for Multisystemic Therapy with Juvenile Sexual Offenders,\u201d Journal of Consulting and Clinica"] [17.197282791137695, 8.022244453430176, "Problems,\u201d Journal of Juvenile Justice, Vol.\u00a04, No.\u00a02, Fall 2015, pp.\u00a01\u201312. \nJuvenile Justice Coordinating Council, Fiscal Year 2022\u201323 \nJuvenile Justice Crime Prevention Act Funding Request Summary: JJCC-JJCPA: FY 22\u201323 Funding Requests by Service S"] [17.05414581298828, 7.898141860961914, "ril 2016, pp.\u00a0302\u2013325. \nKretschmar, Jeff M., Krystel Tossone, Fredrick Butcher, and \nBarbara Marsh, \u201cExamining the Impact of a Juvenile Justice Diversion Program for Youth with Behavioral Health Concerns on Early Adulthood Recidivism,\u201d Children and Y"] [17.232891082763672, 8.060059547424316, " Smith, and \nGordon T. Harold, \u201cMultidimensional Treatment Foster Care as an Intervention for Juvenile Justice Girls in Out-of-Home Care,\u201d in Shari Miller, Leslie D. Leve, and Patricia K. Kerig, eds., Delinquent Girls: Contexts, Relationships, and Ad"] [17.08334732055664, 7.9328789710998535, "onal Journal of Offender Therapy and Comparative Criminology, Vol.\u00a057, No.\u00a09, September 2013, pp.\u00a01107\u20131119. \nMears, Daniel P., and William R. Kelly, \u201cLinking Process and \nOutcomes in Evaluating a Statewide Drug Treatment Program for Youthful Offende"] [17.09149932861328, 7.923119068145752, "e Court Processing,\u201d last updated February 2017a. As of November\u00a08, 2022: https://www.ojjdp.gov/mpg/litreviews/Diversion_Programs.pdf\nOffice of Juvenile Justice and Delinquency Prevention, \u201cFormal, \nPost-Adjudication Juvenile Probation Services,\u201d las"] [16.98388671875, 7.854485034942627, "y 2017, pp.\u00a059\u201366. Salazar, Laura F., and Sarah L. Cook, \u201cPreliminary Findings \nfrom an Outcome Evaluation of an Intimate Partner Violence \nPrevention Program for Adjudicated, African American, \nAdo lescent M ales,\u201d Youth Violence and Juvenile Justic"] [17.054094314575195, 7.895215034484863, "gs from a Program Evaluation in Harris \nCounty, Texas,\u201d Journal o f Experimental C rimino logy, Vol.\u00a013, \nNo.\u00a02, 2017, pp.\u00a0275\u2013285. \nStein, L. A. R., Suzanne M. Colby, Nancy P. Barnett, Peter M. \nMonti, Charles Golembeske, and Rebecca Lebeau-Craven, "] [17.208255767822266, 8.026227951049805, "venile Justice, Vol.\u00a04, No.\u00a03, July 2006, pp.\u00a0219\u2013233. \nWhitaker, Laura, Sierra Smucker, and Stephanie Brooks Holliday, \nA Gap Analysis of the Los Angeles County Juvenile Justice Crime Prevention Act Portfolio , RAND Corporation, RR-1663-1, 2022. \nAs"] [17.17306137084961, 7.995532035827637, ", Jason J. Washburn, Leah\u00a0J. \nWelty, Jennifer A. Hershfield, and Mina K. Duncan, The Northwestern Juvenile Project: Overview , Office of Juvenile \nJustice and Delinquency Prevention, U.S. Department of Justice, NCJ 234522, February 2013. \nTheriot, Ma"] [13.936816215515137, 4.382509231567383, " which are approved by the county through the Juvenile Justice Coordinating Council (JJCC), which comprises stakeholders from county agen-cies, city agencies, and community-based organizations. In 2019, the Probation Department selected the RAND Corp"] [13.858423233032227, 4.604942321777344, "itment t o the op en \npublication o f our research f indings a nd \nrecommendations, di sclosure o f the \nsour\nce of funding o f published r esearch, \nand policies to ensure intellectual \nindependence. F or more i n formation, v isit \nwww.rand.org/ab"] [1.6718193292617798, 7.784618854522705, "Wanxiang Innovation \nEnergy Fusion City\nRecommendations for Developing an \nInnovation Cluster\nRafiq Dossani, Marlon Graf, Eugeniu Han\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by l"] [1.6749509572982788, 7.7970685958862305, "r Science and Technol -\nogy Park, and made recommendations on technology business incubation. In a 2012 report, RAND developed recommendations for a new innovation cluster known as the Sino-\n Sin\ngapore \nGuangzhou Knowledge City, located in Guangzhou"] [1.6703715324401855, 7.782956123352051, "and occupational safety, energy policy, science and innovation policy, space, and telecommunications.\nQuestions or comments about this report should be sent to the project leader, Rafiq \nDossani (Rafiq_Dossani@rand.org). For more information about R"] [1.6791149377822876, 7.7709879875183105, "...................... 24\nPeople and Workforce ......................................................................................... 26\nExploring Alternative Technologies ........................................................................."] [1.6854214668273926, 7.767636299133301, " the Stuttgart Region, by Sector .................................. 15\n 3.1\n. Geo\ngraphical Location of Aichi Prefecture ..................................................... 21\n 3.2\n. Abs\nolute Value of Shipments, Aichi Prefecture ..............."] [1.6742640733718872, 7.7838850021362305, "eloping an Innovation Cluster\n 4.3. Product Pricing for Both End User\u2013Facing Firms and Firms Within the Supply \nCh\nain, by Each of the Four Clusters ........................................................... 38\n 4.4\n. The In\ndustrial Organization\u2019"] [1.6723361015319824, 7.784008979797363, "t private risk capital.\n\u2022 Its s\nupport services, such as legal and financial services, are comprehensive. \n1 An ecosystem is defined as a community or cluster of connected players that is sustainable. Sustainability means that \nthe cluster is able "] [1.6696572303771973, 7.7844743728637695, "sks, and time lines. We describe suggested policies related to each sustaining factor below.\n1.\n Acc\ness to cutting-edge technology \na. WIE\nFC could establish centers of excellence (COEs), initially in collaboration with \nZJU, to be located at WIEFC."] [1.6713528633117676, 7.784124374389648, "C achieve consistently high \nstandards through advisory support.\nWhat Not to Do\nPolicies to Attract Leading Firms\nMany successful clusters contain one or more global market leaders. Such firms, either by \nthemselves or in combination with other firms"] [1.6700098514556885, 7.785028457641602, "r initial operations for a period of time at below-market costs until they are commercially viable. Incubators often contain support services, such as technical and legal services.\nThis may suggest that WIEFC should establish policies for supporting "] [1.6417263746261597, 7.806174278259277, "ties to further the businesses of its members. Specifically, \nthe BDA will (1)\n faci\nlitate the introduction of new technologies through licensing, research \nprograms, and other ways of accessing and developing intellectual property; (2) dev\nelop ta"] [1.672297716140747, 7.784702301025391, "\nBDA business development association\nBI benchmarking institute\nCARS Cluster Initiative Automotive Stuttgart\nCOE center of excellence\ne-mobil BW electro-mobility initiative Baden-W\u00fcrttemberg\nIEEE Institute of Electrical and Electronics Engineers\nIT i"] [1.6722958087921143, 7.782259941101074, "omponents that together compose a whole.\nThis is a potentially transformative project for the Group, both because of the Group\u2019s \nfinancial commitment, which is estimated at RMB 200\n bil\nlion (the Group\u2019s 2016 gross reve-\nnue is RMB 115 bil\nlion), a"] [1.670881748199463, 7.782351016998291, "echnologies across all industries. Many technology parks include community Introduction 3\nliving spaces. Yet, apart from Stanford Research Park in Palo Alto, California, and Research \nTriangle Park in Raleigh-Durham, North Carolina, few technology"] [1.6771819591522217, 7.773280143737793, " that while these so-called \u201csuccess factors\u201d may be \nnecessary to spur innovation, they may not be sufficient. There are locations that possess all of the aforementioned success factors but nevertheless failed to develop cutting-edge innovation (Fel"] [1.6722463369369507, 7.786983966827393, "cisco, even though the bankers who provided the capital were initially based in San Francisco (and who later followed their clients to Silicon Valley) (Kenney, 2000). This may have been true for the manufactur -\ning start-ups of the 1980s and 1990s, "] [1.670792818069458, 7.784736633300781, "articular topic to discuss. Such incentives have an indirect commercial benefit, and should carefully be related to the causes that need to be addressed, if they are to succeed. \nDespite the large number of such interventions, little is known about w"] [1.6710376739501953, 7.7854180335998535, "ergy Fusion City: Recommendations for Developing an Innovation Cluster\nAttributes of WIEFC\nWe list below the desired attributes of WIEFC:\n\u2022 Its w\norkforce, firms, and research centers are innovative, experimental, and technically \nsophisticated.\n\u2022 It"] [1.670639157295227, 7.784361839294434, "ter is rich with job opportunities, those taking risks at the cutting edge might find it easier to find jobs in the event of failure. However, it is not clear if there are any simple lessons for policymakers, since the building of such a culture take"] [1.6827456951141357, 7.769944667816162, " built around highly educated persons challenges \na long-held concept known as the death of distance , or the idea that digital technologies would \nenable high-quality remote working. As Silicon Valley evidently demonstrates, this has not happened, e"] [1.674236536026001, 7.779634952545166, "; and semi-structured interviews with local experts from academia, policymaking, think tanks, and industry. Further, through literature reviews, we compare and contrast our case study findings with two additional cluster models, the Taiwan high-techn"] [1.6828933954238892, 7.782351493835449, ".\nFigure 2.1 shows the gross regional product for Baden-W\u00fcrttemberg, which has grown \nsteadily since the early 1990s, with a brief decline during the 2009 financial crisis, to over 400\n bil\nlion euros in 2015. Manufacturing accounts for a substantial"] [1.6783199310302734, 7.776125431060791, "nventions of a group of automotive entrepreneurs in the late 19th century, including Gottlieb Daimler, Karl Benz, and Wilhelm Maybach. These entrepreneurs are credited with inventing the first four-wheeled cars in Europe, beginning production in 1900"] [1.6860073804855347, 7.785991668701172, "ter-Firm Networks\nThe Stuttgart region hosts a substantial share of national automotive sector employment. It is \nhome to a supplier network that is both large and sophisticated enough to supply most of the need by large manufacturers for components "] [1.6805286407470703, 7.773086071014404, "t region currently retains high-value, knowledge-intensive activities, while outsourcing the rest to regions such as Eastern Europe, Asia, and South America (Sturgeon and Van Biesebroeck, 2011). Typically, within large firms, research and development"] [1.6769911050796509, 7.776852130889893, "cisionmaking procedures and strategy formulation when it comes to exploring new products and technologies. \nTo bridge these knowledge gaps and to cope with ensuing uncertainties, policymakers \nand industry associations across the region have been wor"] [1.6763629913330078, 7.777577877044678, "holds an advanced degree, compared \nwith only 6 perc\nent in the construction sector, further emphasizing the knowledge-intensive \nnature of activities in the automotive cluster.\nAside from its high-quality vocational training institutions and trade "] [1.6771405935287476, 7.774590015411377, "0302010\n0\nAutomotive Engineering Manufacturing ConstructionUniversity degree \nVocational certification \nNo vocational training \nNot applicable \nIndustrial \nproduction16 Wanxiang Innovation Energy Fusion City: Recommendations for Developing an In"] [1.678750991821289, 7.775348663330078, "tion of the automotive sector, educate firms and entrepreneurs across the region about the challenges and opportunities from these new technological developments, and provide a platform for people from various sectors to get together and pursue inter"] [1.6899408102035522, 7.76915979385376, "hile Daimler and Porsche are operating as large, steady corporations and are concerned with long-term growth and stability, firms like Tesla, Uber, and others that have recently risen to prominence are shaking up the automotive land -\nscape and are l"] [1.6907484531402588, 7.7628068923950195, "nchoring car manufacturers, Daimler and Porsche, and the high degree of niche specialization of many local small firms, the cluster might find it difficult to adapt in the short term. These and other key strengths and weaknesses of the Stuttgart auto"] [1.6951401233673096, 7.759426593780518, "ed IT base, lack \nof connection to local IT firms\nRelated and supporting industries\u2022\n Dedi\ncated network of \nsuppliers, mainly SMEs\u2022 Soph\nisticated \ntasks and ser-vices in-cluster, routine tasks outsourced\u2022\n Str\nong dependence \non a few large firms c"] [1.6948999166488647, 7.759322166442871, "ome to several major corporations, such as Mitsubi -\nshi Aircraft Corporation in aviation, Central Japan Railway Company and Nagoya Railroad in the railway industry, Sumitomo Riko in the rubber and plastic industries, and Brother Indus-tries in the e"] [1.6897627115249634, 7.761684894561768, "ted Kingdom. In time, its engineers were able to achieve significant innovation by improving on Western designs. As important, perhaps, was the development of an advanced assembly line system known as the Toyota Production System that is considered t"] [1.688278317451477, 7.766160488128662, "r accessing advanced technologies and processes. \nSupply Chains and Inter-Firm Networks\nAichi Prefecture accounts for 40\n perc\nent of total national shipments of transportation equip -\nment and machinery. Large, horizontally integrated firms that act"] [1.6946208477020264, 7.7566399574279785, "affected Aichi\u2019s production structure as it has Stuttgart\u2019s. To meet \ndomestic content requirements and to save costs, the large producers and several of their suppli -\ners have built manufacturing plants around the world. As a result, offshore manuf"] [1.6946167945861816, 7.757673263549805, " of the traditional system. In particular, instead of buying only from long-term suppliers at prices that are sometimes above the market price, Toyota started developing relationships with key international mega suppli -\ners whose economies of scale "] [1.6981333494186401, 7.756727695465088, "loped resident engineer program that allows professionals from supplier companies to work with Toyota designers for periods between six months and three years. This program contributes to better communication between automakers and suppliers and fost"] [1.6860984563827515, 7.768218040466309, "labor, globalized large \nfirms, and networked SMEs are the major driving forces for the cluster\u2019s success. Large firms are horizontally integrated and rely on sophisticated SMEs to contribute technology- intensive critical components. However, these "] [1.6758828163146973, 7.777435779571533, "y Chain\nLarge firms tend to face the most-sophisticated users, i.e., end users or other large firms. Large \nfirms are horizontally integrated, allowing them to face a diverse variety of end-users. SMEs are of two kinds. Those supplying low-end produc"] [1.679612636566162, 7.772401809692383, "sk\u2014they deal with the most-sophisticated users, often by introducing new and untested products to clients\u2014they can manage this risk by developing a pipeline of products through their experience of clients of different types and by being responsive to"] [1.6777170896530151, 7.775615692138672, "larity is that large firms tend to be horizontally integrated. SMEs mostly deal with firms further down a supply chain that becomes less integrated as it moves downstream. The smaller the firm, the more likely it is to be specialized in a few types o"] [1.679780125617981, 7.771480560302734, "nd universities are largely seen as a source of recruiting fresh employees.\nDiscussion\nIn Aichi, as in Stuttgart, the role of large firms appears to be critical for employment in the cluster. While large firms similarly face the most market risk, the"] [1.6723277568817139, 7.780670166015625, "sponsibility of the association.Developing the Wanxiang Innovation Energy Fusion City Cluster 35\nThe organization of the Taiwan personal computer cluster into associations originated \nfrom the dominance of local SMEs that initially produced simple"] [1.6783289909362793, 7.776123046875, "ons, such as the Institute of Electrical and Electronics Engineers (IEEE). Talent \nis competitively sourced. Once recruited, individual employees take responsibility for their own professional development (Castilla et al., 2000). SMEs do not see it a"] [1.6791061162948608, 7.773993968963623, "gineering talent at the undergraduate and associate levels, while Stanford University and University of California, Berkeley, are important suppliers of graduate- and doctoral-level talent. The com -\nmunity colleges play an important role in providin"] [1.6825748682022095, 7.774911403656006, "cts for the automotive sector. Since Wanxiang Automotive is a large player in this sector, we consider its potential role in WIEFC\u2019s development. \nThe insertion of China into the automotive supply chain occurred over the past three \ndecades and was d"] [1.6855499744415283, 7.776056289672852, "dustry and with it, Silicon Valley. The automotive industry experienced a potentially \ndisruptive change with the recent arrival of firms such as Tesla, Inc. Located in Silicon Valley, Tesla\u2019s production model derives from the earlier iterations of t"] [1.6741204261779785, 7.7795329093933105, "elop to the stage where it can provide technological leadership at a global scale. However, due to its inbuilt strengths of financial support and early adoption skills and its recent investments in electric vehicle technologies, it could become a tec"] [1.6728376150131226, 7.782519340515137, "mestic firms, form an \u201canchor -\ning cluster\u201d of firms through the combined set of technologies and access to markets that they bring.\nAs we discuss below, the appropriate model for WIEFC is likely to combine elements of \neach of the models discussed "] [1.6733890771865845, 7.781102180480957, ", prosperous, and innovative urban center, Hangzhou. Hang -\nzhou is an important center for the automotive industry, as well as a center for the country\u2019s digital technology businesses (European Union SME Centre, 2015). \nHigh housing costs and the hu"] [1.6677392721176147, 7.786784648895264, "ea. This program would be managed by the BDA.\n3. Att\nract technical and innovative talent through the establishment of a jobs program to \nbe managed by the BDA. \nPolicies for Client and Vendor Development\n1. Build supply chains by linking firms withi"] [1.6693416833877563, 7.784477710723877, "dents and faculty to obtain experience in real-world engineering proj -\nects carried out at WIEFC. While the main goal of a COE is to solve difficult applied engi -\nneering problems through collaborative research and development, a COE can be an exce"] [1.6696960926055908, 7.784347057342529, "ctivities that span the higher value\u2013added activities of the supply chain (Christensen, 2013). \nAccess to clients. The BDA should develop marketing expertise in support of its member \nfirms. While firms in WIEFC should be free to conduct their own ma"] [1.6720046997070312, 7.782044887542725, " an innovative component to developing new standards. Developing the Wanxiang Innovation Energy Fusion City Cluster 45\nNote that we are recommending neither particular technology standards nor output stan -\ndards for the BI. The evolution of techn"] [1.6711726188659668, 7.781177520751953, "d with the global venture capital industry, and is the second-largest destination for venture capital after the United States (Soo, 2017). We expect that venture capital firms and other financiers will be attracted by the presence of the technology a"] [1.6683087348937988, 7.785202980041504, "ce; their ownership; and their access to human, financial, technological, and other resources. Tables 4.4 and 4.5 outline the industrial organization\u2019s access to resources and product pricing, respec-tively.\nTable 4.4\nThe Industrial Organization\u2019s Ac"] [1.6672040224075317, 7.785781383514404, "the COEs can become locations for cost-effectively adopting the latest technologies available elsewhere. For example, the use of smart robots and three-dimensional printing technologies can be tested on a shared-cost basis among the firms within the "] [1.6727889776229858, 7.80773401260376, "ionsCompetitive Association, all firmsBanks and venture capitalDeveloping the Wanxiang Innovation Energy Fusion City Cluster 49\nTable 4.8\nValue of Each Cluster to Large Firms and Small- and Medium-Sized Enterprises\nCluster Large Firms SMEs\nWIEFC T"] [1.7160001993179321, 8.951859474182129, "nd A.4 show employment in Hangzhou. The figures indicate that manufacturing \nremains significant for the economy of the city.\nThe national government has, over the past few years, intensified efforts to transition \nfrom an economy driven by investmen"] [1.6912736892700195, 9.017383575439453, "s capital funds; big data firms; and hundreds of technology-linked com -\npanies, including Kuaidi Dache, part of China\u2019s biggest taxi-hailing app, and Alibaba Group, China\u2019s largest online retailer. \nPeople and Workforce\nHangzhou\u2019s transformation fro"] [1.6717036962509155, 7.821029186248779, "entages do not total 100 due to rounding.\nRAND RR2035-A.5Ph.D.\n0.53%Graduate\n2% \nUndergraduate\n18%\nSpecialized college\n42%Other\n38% \nFigure A.6Recent Graduates Employed in Hangzhou, by Origin\nSOURCE: Hangzhou Talent Service Bureau, 2016.\nRAND RR2035-"] [1.671838402748108, 7.785922050476074, "uhang, Deqing, and Changxing, Zhejiang. Amber Energy was successfully listed on the Hong Kong Stock Exchange in 2009.\nThe renewable energy projects of the Group are concentrated in wind- and solar-power \ngeneration. Wind-power projects are located in"] [1.6716866493225098, 7.781335830688477, "ponent of WIEFC will be hosted by two national \nengineering research centers or laboratories, one national innovation center, and several dozen international entrepreneurship teams attracting more than five thousand scientific and techni -\ncal person"] [1.6787338256835938, 7.767416477203369, " as test subjects for new products and services and can be useful in anticipating future market trends. Ultimately, highly competitive regions benefit significantly from an educated, forward-looking, and demanding customer base, as it continuously ch"] [1.678182601928711, 7.775440216064453, " Pro\nfessor Daofei Li, director, Institute for Power Machinery and Vehicular Machinery, \nZhejiang University\n\u2022 Wan\nxiang Group officials63References\nAcademic Ranking of World Universities, \u201cAcademic Ranking of World Universities in Engineering/\nTechn"] [1.6584492921829224, 7.764663219451904, "l of Engineering and Technology Management , Vol. 22, No. 1, 2005, pp.\n 51\n\u201374.\nCastilla, Emilio J., Hokyu Hwang, Ellen Granovetter, and Mark Granovetter, \u201cSocial Networks in Silicon Valley,\u201d in Chong-Moon Lee, ed., The Silicon Valley Edge: A Habitat"] [1.67311692237854, 7.763017177581787, "ation: Relocating Service Provision to India,\u201d \nWorld Development , Vol. 35, No. 5, 2007, pp.\n 77\n2\u2013792.\nDossani, Rafiq, and Ashish Kumar, \u201cNetwork Associations and Professional Growth Among Engineers from India and China in Silicon Valley,\u201d American"] [1.6750397682189941, 7.775426864624023, "pgrading of Germany\u2019s Industrial Capabilities on the Horizon,\u201d Deutsche Bank Research, April 23, 2014.\nIMF WEO\u2014 See International Monetary Fund. \nInternational Monetary Fund, World Economic Outlook , Washington, D.C., 2016.\nJapan Automobile Manufactu"] [1.6603000164031982, 7.763665676116943, "17.\nLee, Chong-Moon, William F. Miller, and Marguerite Gong Hancock, The Silicon Valley Edge: A Habitat for Innovation and Entrepreneurship , Stanford, Calif.: Stanford University Press, 2000.\nLiker, Jeffrey K., The Toyota Way: Fourteen Management Pr"] [1.671511173248291, 7.768023490905762, "Asian Journal of Technology Innovation , Vol. 16, No. 2, 2008, pp.\n 83\n\u2013112.References 67\nSimon, Hermann, The Secret Winners (Hidden Champions): The Success Strategies of Unknown World Market \nLeaders [Die heimlichen Gewinner (Hidden Champions): D"] [1.6746962070465088, 7.775515079498291, "mes Higher Education World University Rankings, \u201cNagoya University,\u201d web page, 2017. As of April 30, \n2017: \nhttps://www.timeshighereducation.com/world-university-rankings/nagoya-university#ranking-dataset/589595 \nToyoda, Eiji, Toyota, Fifty Years i"] [1.6745657920837402, 7.776059150695801, "17: http://reports.weforum.org/digital-transformation/wp-content/blogs.dir/94/mp/files/pages/files/wef-dti-automotivewhitepaper-final-january-2016-200116a.pdf\nYamawaki, Hideki, \u201cThe Evolution and Structure of Industrial Clusters in Japan,\u201d Small Busi"] [-2.018359899520874, 6.6445512771606445, "SHELLY CULBERTSON, JAMES DIMAROGONAS, KATHERINE COSTELLO, \nSERAFINA LANNA\nCrossing the \nDigital Divide\nApplying Technology to the Global Refugee CrisisCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) containe"] [-2.0214104652404785, 6.6425933837890625, "s on such topics as infrastructure, science and tech -\nnology, community design, community health promotion, migration and population dynamics, transportation, energy, and climate and the environment, as well as other policy concerns that are influen"] [-2.0279786586761475, 6.637404441833496, " New Locations .................................................................... 21\nLanguage .............................................................................................. 23vi Crossing the Digital Divide: Applying Technology "] [-2.024205207824707, 6.639202117919922, ".... 67\nData Responsibility ................................................................................... 70\nBias ...................................................................................................... 74\nConflicts of Interest"] [-2.0259389877319336, 6.637320041656494, "nalysis of technology uses, needs, \ngaps, and opportunities for helping displaced people and responding agencies. Our pri -\nmary focus is on digital technologies (often referred to as information and communica -\ntion technologies) and systems that ca"] [-2.0240001678466797, 6.638321876525879, " the refugee crisis, changes in technology are resulting in changes to each entity\u2019s roles and responsibilities\u2014for example, by creating new roles, simplifying long-\n st\nanding \nroles, and altering the way that operations and programs are managed. At"] [-2.0629262924194336, 6.5982160568237305, "ier provided individual per -\nspectives on the multiple ways that refugees use technology.\nAccess to Technology\nRefugees in each of the host countries where we conducted focus groups reported that \nthey typically used mobile devices, primarily smartp"] [-2.032921314239502, 6.630491256713867, "th-based activity. Several refugees discussed using digital technology for reli -\ngious purposes, including accessing the Quran and assistance opportunities at local churches.\n\u2022\n He\nalth care. Refugees also used digital technology in seeking health "] [-2.0251004695892334, 6.641297340393066, " service is provided and the end user\u2019s experience. Value can derive from a technology\u2019s ability to meet a critical need and lower costs, as well as from such features as flexibility, familiarity, accountability, and privacy. \n\u2022\n Ke\ny resources are "] [-2.0269525051116943, 6.638205528259277, "ibe the competitive and collaborative environment that could translate to risks and opportunities.\n1 The approach is influenced by Michael Porter\u2019s five forces governing competition (Porter, 1979), except our \nfocus is on the refugees instead of on t"] [-2.024984359741211, 6.639112949371338, "oordination in the strategic investment in and use of technology, which should lead to more opportunities for private-sector engage-ment and improved aid operations. Investment in technology in refugee settings is often made without preparing for the"] [-2.025456190109253, 6.6371684074401855, "ld be conducted periodically, balancing the benefits of retaining vast data sets with the risks of securing the data.\n\u2022\n De\nvelop an ethical framework for technology in humanitarian settings. As part of the \nethical framework, develop guidelines for "] [-2.006075859069824, 6.654422760009766, "munity Services in Pittsburgh, Pennsylvania; and Ipsos in Lusaka, Zambia. \nIn addition, we appreciate the generous time and insights of the following people \nwho were interviewed for this study. In particular, we thank the following government and mu"] [-2.0214548110961914, 6.6411943435668945, "ng Network for Accountability and Performance in Humanitarian Action; Prat Panda, senior manager, East Africa lead for Accenture Development Partnerships, Accenture; Meghann Rhynard-Geil, senior adviser, Technology for Development (Digital Communitie"] [-2.044250965118408, 6.617132663726807, "fugees.\nRefugee: There are multiple categories of people who have been forcibly displaced. \nThese include the following (UNHCR, 2019b):\n\u2022\n A r\nefugee is someone who lives outside of his or her country because of a well-\nfounded fear of persecution a"] [-2.0352866649627686, 6.627554893493652, "w in these principles is an emphasis on the self-sufficiency of refugees (e.g., living in urban areas and holding jobs as opposed to staying in camps indefinitely while waiting to return home), providing assistance to host countries so they can inclu"] [-2.017101764678955, 6.645449638366699, "agement by humanitarian agencies, dissemination of information to displaced people, educational and job-matching tools, personal iden -\ntity and property rights management, distribution of humanitarian assistance, coor -\ndination among humanitarian a"] [-2.033571481704712, 6.628264904022217, "ntive for participation. \nTable 1.1\nDistribution of the Focus Groups with Refugees and Internally Displaced Persons \nLocation Focus Group #1 Focus Group #2\nBogot\u00e1, Colombia Refugees from Venezuela, \nmen and womenRefugees from Venezuela and internally"] [-2.0254709720611572, 6.637340545654297, "of stakeholders. \nLimitations\nReaders should keep several limitations in mind when considering the key findings \nand implications of this report. First, the stakeholder interviews (in which we spoke to 30 people) do not necessarily represent the full"] [-2.0243542194366455, 6.638820171356201, "ogy in refugee settings, and the roles, responsibilities, and relationships among these entities are complex. In this chapter, we draw on our literature review and stake-holder interviews to describe these main entities and their roles and responsibi"] [-1.9910904169082642, 6.6722731590271, " also developed smartphone apps that help other refugees navi -\ngate journeys, learn about services in new countries, and gain employment. Examples include Gherbtna (developed by a Syrian refugee in Turkey), Alfanus (developed by Syrian refugees in T"] [-1.9984678030014038, 6.664126396179199, "Because of these newly available tools, technology is changing aid agencies\u2019 capabilities, approaches to manag -\ning assistance, and mandates. Technology is also changing how food and housing aid is distributed, how information is used and communicat"] [-2.0241692066192627, 6.63893985748291, "d data security procedures, which we discuss in more depth \nin Chapter\u00a0Six.\nSetting terms and values regarding the use of technology in humanitarian settings. \nThe aid community sets principles for the use of technology in humanitarian settings. For "] [-2.019035816192627, 6.641908645629883, "h low connectivity .\u00a0.\u00a0.\u00a0. There\u2019s the perception that some of these techs and approaches are just being pushed by senior management as a solution to .\u00a0.\u00a0. enhance their profile.\nHost Countries\nIn addition to hosting refugees on their soil, host coun"] [-2.0244150161743164, 6.638477802276611, "overns use of personal data and privacy. Turkey limits access to refugee data to the Turkish government and the UN. Interviewees described how differences in country con -\ntexts (laws, financial infrastructure, markets, government policy) lead to var"] [-1.9994343519210815, 6.6647443771362305, "ment (discussed in more detail in Chapter\u00a0Five). The interviewees described donors\u2019 reluctance to fund technology systems, instead showing more interest in funding pilots, startups, and apps, and the interviewees attributed this inclination to intere"] [-2.026789665222168, 6.637155055999756, "ivity, and operating services. From our literature review and interviews, we found that off-the-shelf products and platforms, rather than specialized apps, are most common in refugee settings. \nDeveloping apps and platforms to meet a particular refug"] [-2.0216116905212402, 6.641767978668213, "uting to Technology in Refugee Settings 15\nConsortia\nLike-minded stakeholders have formed multiple consortia around various topics related \nto technology. Such consortia include technology companies, other private-sector com -\npanies, universities"] [-2.0258278846740723, 6.637167453765869, "usiness Education Coalition, aims to 16 Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis\nchannel corporate contributions in support of education in emergencies through \npartnerships among businesses, UN agencies, NGOs,"] [-2.0233280658721924, 6.639652252197266, "anitarian settings. One interviewee described the target as \u201cbig problems we need to solve overlaid with where innovation can help us overcome it.\u201d Roles and Responsibilities of Entities Using or Contributing to Technology in Refugee Settings 17\nU"] [-2.0251331329345703, 6.636950969696045, "pertise, funding, \ntraining, and other tools. \n\u2022 Co\nnsortia bring together different types of stakeholders to share information, \nbuild digital capacity and coordinate technical resources, and generate solutions.\n\u2022 Un\niversities provide research and "] [-2.0975050926208496, 6.564011573791504, "duce postmigra -\ntion stress (Mikal and Woodfield, 2015) and contribute to social inclusion (\n Ab\nuJarour, \nKrasnova, and Hoffmeier, 2018). When asked why refugees prioritize smartphones and internet connectivity, one of our interviewees responded, \u201c"] [-2.054396152496338, 6.606754302978516, "as WhatsApp, Viber, Skype, and Facebook Messenger, are most popular. Our interviewees empha -\nsized that these allow for international messaging and calling via Wi-Fi without requir -\ning the user to have a phone number. \nIn addition, there are techn"] [-2.064427137374878, 6.596843719482422, "t opportunities to them to get out of their constrained position.\u201d\nEstablishment in New Locations\nRefugees have used mobile communication and social media to adapt in host coun -\ntries, and humanitarian organizations have used these tools to provide "] [-2.065253257751465, 6.59576416015625, " directions, some -\nthing you cannot always find easily. It\u2019s a new life and a new environment for us. \n.\u00a0.\u00a0. Even in Jordan, they have this application where they give you information in 3D or information about the language and a lot of other things"] [-2.0858850479125977, 6.575361251831055, "which provides free app-based language instruction (Duolingo, undated). After discovering that some of the most common languages learned on Duolingo were Swedish and German, the company built several courses for Arabic speakers in an effort to help r"] [-2.0520238876342773, 6.609496116638184, "on, 2013; \u201cBrisbane to Help Asylum Seekers and Refugees \nResettle in Australia via Technology,\u201d 2017; Butcher, 2018; Transformify, undated). \nExamples include the Transformify Rebuild Lives Program (helping refugees connect with businesses), Refugee "] [-2.0520682334899902, 6.608610153198242, ", and only one-fourth of Syrian refugee children accessed kindergarten through grade 12 education in the early years of the crisis (Culbertson and Constant, 2015), although enrollment has since risen. As a result, the crisis has spawned multiple expe"] [-2.048067331314087, 6.61341667175293, "e received certificates from university partners of digital learning programs, or have completed online degree programs. \nTechnical and vocational education. Technology has both facilitated and been \nthe subject of vocational training for refugees. "] [-2.0268070697784424, 6.635356903076172, "inputs (Culbertson et al., 2016). In addition to \n Ac\ntivityInfo, individual aid organizations have developed their own software applica -\ntions (Mengel, 2018). In the United States, some refugee resettlement agencies use Apricot Software, which was "] [-2.038527488708496, 6.623472690582275, "d model when the coun -\ntry context permits (e.g., when there are functioning food markets, and shops can accept debit cards). Relying on physical distribution of commodities is the option when markets are not functioning, such as in situations of a "] [-2.0264835357666016, 6.6365275382995605, " 2017). How -\never, many applications of drones and 3D printing for physical provision of refugee aid remain in a pilot or aspirational stage. Challenges include concerns that drones distance aid recipients from providers and that people think of dro"] [-2.023808717727661, 6.63871431350708, "nt System for Foreigners, or YOBIS (UNESCO, 2018).\nData in hard-to-reach areas. Data tools also help organizations monitor programs \nin dangerous and hard-to-reach areas. Photo-sharing, screen-sharing, and Skype calls enable simulated field visits (Z"] [-2.0265777111053467, 6.636211395263672, "UNHCR has an offline registration tool called Rapid Appli -\ncation (RApp) (UNHCR, undated-f). \nHost countries also conduct biometric registration of refugees and migrants. For \nexample, Turkey\u2019s Directorate General of Migration Management registers r"] [-2.028550863265991, 6.634155750274658, "d security issues to resolve. As one interviewee said, \u201cThose negotiations haven\u2019t taken place yet and they will be dif -\nficult. .\u00a0.\u00a0. This is a very multifaceted issue, and we are only at the beginning of it. We can\u2019t tell you where it is taking us"] [-2.035111665725708, 6.627316474914551, "individual, includ -\ning identity, financial dependability, and more. A blockchain-enabled identification system could mean a back-end database similar to conventional systems, a transaction record connected to an identity already established elsewhe"] [-2.0402419567108154, 6.622071743011475, " to main -\ntain memories and identity and often use social media to establish a new identity that preserves their cultural past but also creates a sense of belonging in the host society.\nAid agencies use various technologies to coordinate and manage "] [-2.063565731048584, 6.597468852996826, "-\ntion for journeys and establishment in new locations, language, education, employ -\nment, faith-based activity, health care, identity management, and money management. Finally, we discuss what refugees said were their concerns about technology, inc"] [-2.060931444168091, 6.600281238555908, " limited data plans, so the interviewees pre-ferred to purchase their own smartphones when possible. \nSocial Media Platforms\nIn all six host countries where we conducted focus groups, the majority of refugees stated that Facebook, WhatsApp, or both w"] [-2.0705583095550537, 6.591054439544678, "vious chapter, refugees greatly value their ability to access the inter -\nnet. Yet the vast majority of refugees across all six host countries described limited or irregular access to Wi-Fi and cellular data. Common barriers were cost, lack of signal"] [-2.0856921672821045, 6.57484769821167, "Fi with family, friends, neighbors, or local business owners because the cost of owning a wireless router was too expensive for one person or one family. In the United States, Congolese refugees described sharing apps and software, such as Microsoft "] [-2.071854829788208, 6.588623046875, " -\nnology most importantly and most frequently for communication with family, friends, \nand others. In more than half of the focus groups, refugees expressed a sense of duty to share some information\u2014such as about access to services and assistance\u2014on"] [-2.06681489944458, 6.594290256500244, "r.\nRefugees from Venezuela talked about people helping and guiding them along \nthe way, employing technology: \nIn our case, obviously there is always a person who receives you. .\u00a0.\u00a0. You commu -\nnicate by any means, by apps such as WhatsApp or Facebo"] [-2.0682928562164307, 6.592965602874756, "ccess:\nOn the way, they can steal [your phone]. You can get assaulted .\u00a0.\u00a0. to get a 10-minute \ncharge, to be able to load it. But maybe it does not work for you on that trip of at least two days. . . . Then it does not work because obviously while y"] [-2.065316915512085, 6.595977783203125, "ful for learning new skills and keeping \nup to date in one\u2019s professional field. One sub-Saharan African woman in Greece stated,\nI use the tablet for some personal research. For instance, we refugees don\u2019t have \naccess to schooling. I studied medicin"] [-2.0645837783813477, 6.596466064453125, "hool in person. Syrian men in Jordan stated, \u201cI would say that going to school is better,\u201d and \u201cI think the traditional way is better.\u201d Refugees in Colombia and Zambia worried that technology was making children unfamiliar with books. \nEmployment\nRef"] [-2.0811123847961426, 6.580814361572266, "ster here. In my country, you can have your hands in the plaster all day and nothing happens. If I do it here, my hands are going to be burned. \nOther refugees who needed a specific type of software to perform tasks for \nemployers struggled to use th"] [-2.0624098777770996, 6.598814010620117, "al or professional qualifications. A man from the Middle East noted that technology helped him while traveling to safety in Greece because, \u201cbefore you make any movement, you can save your documents.\u201d Another Middle Eastern man in Greece stated, \u201cFor"] [-2.064195156097412, 6.596931457519531, "bia, stated, \u201cI got into the \n Fac\nebook \npage of an English course and there I registered and sent the application, .\u00a0.\u00a0. [but] it was currently all online and I had to pay 67,000 pesos but with a credit card here in Bogot\u00e1.\u201d The lack of the credit "] [-2.064345121383667, 6.596566677093506, "sing social media and apps for money management was common: \u201cI feel like all younger people like us use apps like Cash App or like Venmo,\u201d said one woman. Another described sending money via Facebook. A Bhutanese man explained, \u201cI send money out to N"] [-2.0625810623168945, 6.596273899078369, "d people extract all their information from them.\nRefugee women mentioned vulnerability to harassment or similar problems \nonline, such as pop-ups with sexually explicit information or photos. One woman in \nZambia said, \u201cThere are many bad things on "] [-2.063537359237671, 6.598511219024658, "an in Zambia commented that \u201cit [eats] people\u2019s money; you may use the money that is meant for food and spend it on data bundles just [to] be able to download a movie.\u201d Similarly, refugees in Bogot\u00e1, Colombia, described the anxiety that occurs when t"] [-2.0244107246398926, 6.639585971832275, "when deploying such technology. We begin by noting that these models look quite different from the traditional business models used by private industry to develop and deploy technology solutions in support of everyday needs. The driving force in the "] [-2.0243308544158936, 6.640834331512451, "ies operate in fundamen -\ntally different ways, business models apply differently to each type of organization. In the next section, we discuss these components and what we learned from the interviews about how they are applied in the refugee context"] [-2.0281054973602295, 6.635129928588867, "is used against them.\u201d We heard similar concerns regarding Syrian refugees. \nKey Resources\nResources are anything that can be used to create value, whether monetary or non -\nmonetary. In the context of developing and deploying technologies in refugee"] [-2.0239529609680176, 6.639747142791748, "outside the humanitar -\nian\u00a0sector,\u00a0like drones, and say how could we apply that for humanitarian purposes?\u201d We heard examples of both approaches. \nThe market pull occurs in several ways: Organizations conduct focus groups or \nsurveys with refugees t"] [-2.007692575454712, 6.6543755531311035, "ger, WFP personnel assessed concepts for three to six months by developing a demonstration and assessing utility and impact. If a concept was promising, they obtained funding from donor governments to develop a full-scale product or adapt an existing"] [-1.9982601404190063, 6.6513800621032715, "o maintain and sustain the training for the life cycle of the product. In the words of one interviewee, \u201cThe worst thing you can do is implement a software without a plan for training, uploading, sustaining, maintenance. .\u00a0.\u00a0. There\u2019s a lack of aware"] [-2.012887954711914, 6.651323318481445, "e a smooth and cost-effective transition.\nProfit Formula\nThe concept of profit is often frowned upon in the context of humanitarian assistance; indeed, several of our interviewees expressed discomfort with the idea, while several others noted that th"] [-2.0148870944976807, 6.648606300354004, "cies or governments provide stable longer-term funding to maintain technolo -\ngies. Other models focus on serving larger, more-affluent populations while support -\ning vulnerable populations as a small part of the business. Some approaches, such as c"] [-2.0241291522979736, 6.640989780426025, "me relevant.\nProjects driven by funding instead of needs. Donor priorities and available funding \nstreams, rather than analysis of needs, disproportionally affect what projects get pur -\nsued. Interviewees felt that donors tend to favor short-term pr"] [-2.019211530685425, 6.644603252410889, "al Refugee Crisis\nby two types of barriers. One involves different small initiatives that all try to solve the \nsame problem, competing with each other for the user base, and none attaining effi -\nciencies of scale. As a result, an organization might"] [-2.022061824798584, 6.641624927520752, "artnerships with certain government agencies. In some countries, estimating risk is difficult, given the volatilities and the complexities related to refugee populations. The challenge is com -\npounded by organizations having less authority to make d"] [-2.0266804695129395, 6.638583183288574, "usiness model for the delivery of these solu -\ntions? How do we make it appealing, compelling, fair to those implementers?62 Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis\nSeveral interviewees described how private-s"] [-2.0318949222564697, 6.632508277893066, "y in Refugee Settings 63\na framework for working together to deploy technologies efficiently while maxi -\nmizing value across multiple refugee populations and aid agencies in multiple \ncountries. \n\u2022 Le\ngal, cultural, and other issues relevant to t"] [-2.0310826301574707, 6.636929035186768, "s, and bargaining power of customers.64 Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis\n\u2022 Host country. Local regulations or attitudes in host countries affect the potential \nof a technology solution. Assessments of "] [-2.0390045642852783, 6.623649597167969, "itators that can influence the \nsuccessful deployment of technology in refugee settings. Barriers include a short-term mindset, projects driven by funding rather than needs, an emphasis on growth rather than on economies of scale, a focus on technolo"] [-2.0252954959869385, 6.637148380279541, "Coppi and Fast, 2019; Latonero et al., 2019; Raymond and Harrity, 2016). As one of our interviewees stated, \u201cIn most areas where we try to push tech, it\u2019s totally uncharted territory.\u201d Still, there are some existing starting points that the sector co"] [-2.026137113571167, 6.636483669281006, "tarian Action (Kuner and Marelli, 2017). A Privacy Interna -\ntional and International Committee of the Red Cross report lists data-related questions that organizations should consider to prevent harm in cases of technology use (Kuner and Marelli, 201"] [-2.0247271060943604, 6.638684272766113, "tar -\nian contexts (Coppi and Fast, 2019; Juskalian, 2018; Mercy Corps, 2017). Fourth, technology and data use in humanitarian settings involve many actors, as described in Chapter\u00a0Two, and each has different perspectives and roles (Raymond et al., 2"] [-2.0274839401245117, 6.635424613952637, "ers who trans -\nlate private information about refugees\u2019 health, children, behavior, and marital rela -\ntions without the organizations really knowing whether those interpreters have been sufficiently vetted. Furthermore, aid groups may not be aware "] [-2.0909903049468994, 6.569154262542725, "easures. One \ninterviewee noted that refugees can be particularly adept in protecting their own data: \u201cEvery average Syrian is very in tune with all the proxies available in the market. .\u00a0.\u00a0. Even those who are illiterate know about proxies and [virt"] [-2.0278091430664062, 6.635656356811523, "erent health care aid providers even if refugees move, ensuring that refugees receive consistent care (Latonero et al., 2019). It could also help lessen the fatigue that refugees experience from repeatedly having to provide their information and reco"] [-2.0267081260681152, 6.636587619781494, "Europol can be a particularly desirable target for breaches (\n Sc\nhiemichen, 2018; USAID, undated).\nImproper data protection can also make refugees reluctant to provide their data \nat all or trust humanitarian aid in general. Refugees\u2019 anxieties abou"] [-2.0578536987304688, 6.611380577087402, "in personal data collected from people of young ages (Latonero and Kift, 2018). Storing children\u2019s data can subject them to difficulties transitioning from aid systems to mainstream ones. On the other hand, such tracking can be impor -\ntant to childr"] [-2.031243324279785, 6.633661270141602, "possession of technology can vary by gender, age, and other factors (Latonero et al., 2019). One of our interviewees highlighted that there is no sufficient answer to the question, \u201cWhat if people are mobility impaired, or with disabilities? How do t"] [-2.0274415016174316, 6.63701868057251, "gorithms to help evaluate immigration and visa applications, \nincreasing efficiency and reducing backlog\u2014to refugees\u2019 benefit. However, the predic -\ntive analytics used to conduct risk assessments may incorporate embedded or purpose-ful biases that d"] [-2.0298306941986084, 6.634169101715088, "te-sector or organizational goals rather than solely the Ethical, Security, and Privacy Issues Related to the Use of Technology in Refugee Settings 77\nbest interests of the refugees. For instance, private companies could try to influence \ntechnolo"] [-2.02846622467041, 6.635853290557861, "technologies in this setting; the ways in which refugees perceive technology; the business models through which such technology is developed; and ethical, security, and privacy issues. We found some broad, overarching themes. First, there are multipl"] [-2.0558784008026123, 6.609035015106201, "s models (Dimarogonas, 2012). \nWe built on these models to propose a business model canvas tool tailored spe-\ncifically to the application of technology in refugee settings and that a range of stake-holders, including aid agencies, private-sector com"] [-2.0276310443878174, 6.6362080574035645, " exist at different levels of abstraction, from strategic levels through detailed implementation. Different stake-holders should use this tool in different ways:\n\u2022\n Do\nnors (including governments and foundations) and aid agencies should use this \ntoo"] [-2.021921396255493, 6.641292572021484, "st in specific ways to improve \ndigital infrastructure in their countries for their general populations, which will also improve such systems for refugees.\n\u2022\n Do\nnors (governments and foundations) and private companies should focus invest -\nments on "] [-1.9900239706039429, 6.674295902252197, "le consortia with overlapping mandates have formed to assist in contributing to technology in refugee settings, as described in Chap -\nter\u00a0Two. These circumstances lead to fragmented, disconnected investments in one-off solutions rather than systems "] [-2.0239007472991943, 6.6398820877075195, " at discounted prices or with sustainable funding models. \nImprove Technical Capacity in the Humanitarian Community\nPlanning, deploying, using, and maintaining technical solutions require technical, digital transformation, and business process reengi"] [-2.0260188579559326, 6.635745048522949, "le systems and data formats that make sharing and consolidating data difficult and costly. As a result, we suggest the following:\n\u2022\n UN\nHCR should develop data guidelines for refugee settings that can apply across \nall aid agencies. These should incl"] [-2.024885892868042, 6.638209342956543, "ptions of who benefits and who bears the risks and the alternative approaches available. Over time, there should be a way to discuss and adjudicate ethical issues regarding technology in refugee settings, such as through an entity housed at the UN or"] [-2.028146505355835, 6.633923530578613, "tive educational technology in refugee \nsettings, focusing especially on ways that allow refugee education to be scaled up even in contexts with teacher shortages. \nLooking Ahead\nThrough this study, we have found that there is a solid foundation of t"] [-2.0236833095550537, 6.6387224197387695, "lum Information Database, \u201cRegistration Under Temporary Protection: Turkey,\u201d webpage, undated. As of August 14, 2019: https://www.asylumineurope.org/reports/country/turkey/registration-under-temporary-protection#footnote3_olljd43\nBacishoga, Kasky Bi"] [-2.0196967124938965, 6.643482208251953, "t, Core Humanitarian Standard on Quality and \nAccountability , 2014. \nCoppi, Giulio, and Larissa Fast, Blockchain and Distributed Ledger Technologies in the Humanitarian Sector , London: Humanitarian Policy Group, February 2019. \nCorbett, Jennie, Cor"] [-2.01936411857605, 6.642865180969238, "an Gatzweiler, \u201cHow Tech Can Bring Dignity to Refugees in Humanitarian \nCrises,\u201d The Conversation , May 2, 2018. \nFuchs, Ben, \u201cThe Refugee Crisis: How Coders, Apps, and Technology Provide Relief,\u201d Hackernoon , \nMarch 31, 2016. \nGaffey, Conor, \u201cFive W"] [-2.0228118896484375, 6.640353679656982, "ts/files/publications/icrc-002-1067.pdf\nJames, Eric, and Laura James, \u201c3D Printing Humanitarian Supplies in the Field,\u201d Humanitarian \nExchange , No.\n 6\n6, April 2016, pp. 4\n3\u201345.\nJohnson, Mark W., Clayton M. Christensen, and Henning Kagermann, \u201cRein"] [-2.0207793712615967, 6.641807556152344, " undated. As of August 14, 2019: \nhttps://www.themigrantsfiles.com/\nMikal, Jude P., and Braden Woodfield, \u201cRefugees, Post-Migration Stress, and Internet Use: A \nQualitative Analysis of Intercultural Adjustment and Internet Use Among Iraqi and Sudane"] [-2.0237841606140137, 6.6392107009887695, "petitive Forces Shape Strategy,\u201d Harvard Business Review, Vol.\n 5\n7, \nNo. 2\n, 1979, pp. 1\n37\u2013145. \nPrinciples for Digital Development, homepage, undated. As of August 15, 2019: \nhttps://digitalprinciples.org/\nPwC, Managing the Refugee and Migrant C"] [-2.009810209274292, 6.65265417098999, " a Role in Building Social \nSolidarity Finance?\u201d United Nations Research Institute for Social Development Working Paper 2016\n-1, F\nebruary 2016. \nScriven, Kim, \u201cHumanitarian Innovation and the Art of the Possible,\u201d Humanitarian Exchange , \nNo. 6\n6, A"] [-2.0201380252838135, 6.6421403884887695, "on Their Phones in Powerful Photo Series,\u201d The Verge , March 27, 2017. \nTransformify, \u201cRebuild Lives Program: Hire Refugees and Revitalize Post-War Zones,\u201d webpage, undated. As of August 13, 2019: https://www.transformify.org/page/rebuild-lives-prog"] [-2.021615982055664, 6.640234470367432, ",\u201d webpage, undated-f. As of August 14, 2019: \nhttps://www.unhcr.org/en-us/primes.html\n\u2014\u2014\u2014, \u201cUNHCR Strategy on Digital Identity and Inclusion,\u201d undated-g. As of August 14, 2019: \nhttps://www.unhcr.org/blogs/wp-content/uploads/sites/48/2018/03/2018-"] [-2.022348165512085, 6.641177177429199, "\u2014\u2014, \u201cWorld Bank Group, UNHCR Sign Memorandum to Establish Joint Data Center on \nForced Displacement,\u201d April 20, 2018. \nZikusooka, Monica, Zinet Nezir Hassen, Alison Donnelly, and Rachel Mose, \u201cConducting \nSimulated Field Visits for Insecure Locations"] [4.897253513336182, 13.85139274597168, "CORPORATION\nInjury and Illness \nSurveillance of U.S. Agricultural Workers\nAssessment of Recommendations and Actions\nRamya Chari, Amii M. Kress, Jaime MadriganoLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained h"] [-0.4122762084007263, 13.593487739562988, " sustainability, and water resource man -\nagement and coastal protection. Program research is supported by government agencies, foun -\ndations, and the private sector. This program is part of RAND Justice, Infrastructure, and Environment, a division "] [4.892374515533447, 13.846290588378906, "................................................ 31\nTheme 1: Define and Characterize Agricultural Worker Populations at Risk ........................... 31\nTheme 2: Review Ongoing or New Data Sources for Injury and Illness Surveillance Among \nAgricu"] [4.863401889801025, 13.816601753234863, "........................ 7\n 2.1\n. Them\nes and Recommendations Inferred from the 2012 Review Report ................... 14\n 2.2\n. Act\nions Inferred from the 2012 Review Report ................................................ 15\n 3.1\n. Act\nions by Im"] [4.904196739196777, 13.85944652557373, "n .............................................................. 48\n 6.1\n. Ave\nrage Criteria Rating Scores for Actions ..................................................... 52\n 6.2\n. Ave\nrage Criteria Rating Scores for Actions, Excluding the \nDire"] [4.913158893585205, 13.86701774597168, "rkers, government workers, and self-employed workers (exclud -\ning farms with fewer than 11 employees).\n4 BLS, \u201c2015 Census of Fatal Occupational Injuries (CFOI): Current and Revised Data,\u201d web page, last updated June 23, \n2017 (see the Excel files \u201c"] [4.8358941078186035, 13.788558959960938, "e to program priorities, information quality, and action impacts). For all criteria except costs and resources, we constructed an ordinal five-point rating scale based on defined attributes of the criterion relevant to the accomplishment of an action"] [4.895949840545654, 13.850200653076172, "Recommendations and Actions Inferred from the 2012 Review Report\nRecommendation Action\nR1: Develop standard definitions \nto help improve knowledge and understanding of populations at risk of worksite exposures1.1: Develop concise definitions of popul"] [4.886836051940918, 13.84124755859375, ": Ag Center = Agricultural Safety and Health Center; NASS = National Agriculture Statistics Service; USDA = \nU.S. Department of Agriculture.xii Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions"] [4.947476387023926, 13.902974128723145, "pport through -\nout the course of this project. In addition, we also thank those individuals outside NIOSH \nwho took the time to speak with us about their views on achieving the various recommenda -\ntions and actions to improve surveillance and thus "] [4.931356430053711, 13.88591194152832, "nished.\n3 In recent years, however, the \nemployment of hired farm labor has shown some stability, hovering at 1 million workers (with some fluctuations).\n4\nAlthough the number of farms and agricultural workers has declined, the agricultural \nsector c"] [4.92938232421875, 13.883883476257324, "e the vast majority of farms in the nation.10 \nChildren (under the age of 18) working on these farms are a particularly vulnerable population for agriculture-related illness, injury, and death. In 2012, an estimated 7,780 household youth experienced "] [4.9249701499938965, 13.878029823303223, "-\ntural Injuries in the U.S.,\u201d Marshfield, Wisc., 2014.\n12 World Health Organization, \u201cPublic Health Surveillance,\u201d web page, undated.\n13 NIOSH, \u201cWorker Health Surveillance,\u201d web page, last updated June 26, 2017.Introduction and Project Background "] [4.960391521453857, 13.914616584777832, "s, employment, or production features of the nation\u2019s farms.\n20 NIOSH also provides technical support and cooperative agreement funding \n14 Centers for Disease Control and Prevention (CDC), CDC\u2019s Vision for Public Health Surveillance in the 21st Cent"] [4.93300724029541, 13.887374877929688, "injury survey (NASS) focused on adult farmers and farmworkers (\u226520 years old) on minority-operated farms\nChildhood Agriculture Injury Survey (1998, 2001, 2004, 2006, 2009, 2012, 2014)National, regionalPopulation-based injury survey (NASS) focused on "] [4.925691604614258, 13.880033493041992, "pared with 14 and older for nonagriculture work.\n23 Under \nthe parental exemption clause of the FLSA, youth of any age may be employed in any occupa -\ntion on a farm owned or operated by their parents (or people standing in place of their parents). S"] [4.932711124420166, 13.886856079101562, "arch and Practice in the U.S. Agriculture, Forestry, and \nFishing Sector , Washington, D.C.: National Institute for Occupational Safety and Health, December 2008.6 Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recomme"] [4.9319939613342285, 13.886609077453613, "d exposures associated with different production practices (e.g., tech -\nnologies or machines used, types of manual operations, pesticide and chemicals applications, and worksite tasks). These differences are challenging: In addition to creating a co"] [4.947416305541992, 13.901251792907715, "e of agricultural fatality reporting.\nGreat Plains Center for Agricultural Health\n(http://www.public-health.uiowa.edu/\ngpcah/center-projects/surveillance-of-agricultural-injuries-and-fatalities/)IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI (fatali"] [4.934837818145752, 13.890020370483398, "outh Carolina, Tennessee, and Texas. While the exemptions are concerning from a safety and health standpoint, they also decrease the utility of otherwise rich sources of occupational injury and illness data. For instance, the SOII is based on OSHA re"] [4.923229694366455, 13.877546310424805, "e, 2005.\n35 Carolyn Dimitri, Anne Effland, and Neilson Conklin, The 20th Century Transformation of U.S. Agriculture and Farm \nPolicy , Washington, D.C.: U.S. Department of Agriculture, 2005; James M. MacDonald, Penni Korb, and Robert A. \nHoppe, Farm "] [4.917713642120361, 13.8718900680542, "NIOSH to external groups. This shift may reflect the extreme uncertainty that the AgFF Program has been operating under for the past few years. \nFrom fiscal year (FY) 2012 to FY\u00a0 2017, the President\u2019s Budget proposed eliminating \nthe AgFF Program in "] [4.903618812561035, 13.857479095458984, " had made meaningful contributions to improving worker safety and health in the agriculture sector. Examples included research on respiratory health risks and musculoskeletal disorders, the establishment of the Ag Centers, and tractor safety and chil"] [4.896641254425049, 13.850845336914062, ", these recommendations were not explicitly issued. Instead the panel report discussed several surveillance-related issues faced by agriculture and offered either general directions forward or, in certain instances, specific activities to perform. Th"] [4.902079105377197, 13.856156349182129, " Agriculture, Forestry, and Fishing Program: Plan to Implement the National Academies Program \nEvaluation Recommendations , Washington, D.C., January 2011.13CHAPTER TWO\nProject Approach: Identification of Recommendations and Actions\nOur project appro"] [4.9036030769348145, 13.857681274414062, "iew of the 2008 National Academies\u2019 evaluation of the AgFF Program and the 2008 NORA\u2014the National Agriculture, Forestry, and Fishing Agenda.\n1 Table\u00a02.2 displays the actions for each recommendation. The actions may not cor -\n1 National Research Counc"] [4.899262428283691, 13.853530883789062, "heme 1: Define and characterize \nagricultural worker populations at riskRecommendation 1: Develop standard definitions to help improve knowledge and understanding of populations at risk of worksite exposures\nTheme 2: Review ongoing or new data sourc"] [4.892939567565918, 13.846962928771973, "r recently used by NIOSH) for illness and injury surveillance of agricultural workers.\nRecommendation 6 6.1. Identify feasible, desirable alternatives to five-year age groupings for child agricultural workers (<18 years old).\n6.2. Stratify data perta"] [4.8735857009887695, 13.827786445617676, " intramural and \nextramural activities has been heavily skewed toward extramural projects in the past decade. As with most federal programs, NIOSH typically has three extramural funding mechanisms at its disposal: grants, cooperative agreements, and "] [4.8839263916015625, 13.838022232055664, "dules on occupational health outcomes \namong hired farmworkers and perform specific analyses on variability of risk.\nAction 4.1 Improve the validity of the CAIS by extending the sample to include labor aggregators.\nAction 4.2 Collaborate with the NAW"] [4.880023956298828, 13.834053039550781, "nal safety and health to be scored by peer reviewers but also enabled programmatic priorities to drive award deci -\nsions among high-scoring applications during secondary council reviews. For the purposes of responding to the panel report recommendat"] [4.856686592102051, 13.811001777648926, "ion and the satisfactory version. The ideal version refers to our estimation of the types of tasks and time frames needed to either fully complete the action or ensure that implementation results in meaningful impacts. The satisfactory version refers"] [4.888082504272461, 13.84210205078125, "etailed information on crop workers, including demographics; employment and migration; earnings, benefits, and worksite characteristics; health, safety, and housing; and income and assets, social services, and legal status. NIOSH has worked with DOL "] [4.859747886657715, 13.812954902648926, "r rationale for partners, resources, and timeline estimates.\nActions Achievable Through Direct NIOSH Action\nThe last grouping includes two actions intended to change the way NIOSH currently reports \ndata on child injuries and illnesses. We elaborate "] [4.834577560424805, 13.78815746307373, "of activities). Because of the differences in the level of specificity in terms of implementation across actions, we used different approaches for generating cost estimates, depending on the action. Table\u00a04.1 summarizes these approaches. Generally, f"] [4.844836235046387, 13.798001289367676, "estimates, but we note their capture in timeline estimates. \nPartnerships\nThe two scales presented in Tables 4.2 and 4.3 were used to rate actions on the partnership criterion for resource and capability partner scenarios. The scales cover a range of"] [4.826457500457764, 13.77929973602295, "ints inhibiting partnership.\nCapability partnership scenario\n1 No existing organizations or individuals can carry out or support completing the action.\n2 Information is lacking on who the most relevant partners might be or how potential partners may "] [4.830086708068848, 13.783065795898438, "n might unfold to develop any timeline estimates.Table\u00a04.3\nInformation Availability and Accessibility Scale\nRating Information Availability and Accessibility Scenario\n1 There are no existing data or information available to address the action.\n2 Ther"] [4.8361687660217285, 13.789690017700195, "n possible but highly unlikely.3 Policy or legislative barriers exist, and it is uncertain whether they can be overcome.4 Policy or legislative barriers are minor.\nPolicy or legislative barriers exist but can be overcome without large investments of "] [4.843254566192627, 13.796525001525879, "ot fully support meeting the action (e.g., no categorization of \nworker type or farm size).\nInformation collected would suffer from severe limitations, such as small number of respondents, small \nnumber of cases, long survey intervals, limited geogra"] [4.846567630767822, 13.79941463470459, "ults to perform a descriptive assessment in which we characterized the actions in a number of ways. Questions that guided our approach included the following:\n\u2022\n Whi\nch actions are most feasible? Which are least feasible?\n\u2022 Whi\nch actions are most de"] [4.882201194763184, 13.835553169250488, "vity in our assessment approach through three \nindependent raters. Throughout the entire process, including the descriptive assessment and consequence and trade-off analysis, we followed the same procedure of individual assessments followed by group "] [4.891860485076904, 13.845932960510254, "erging technologies.\nThe panel report offered specific guidance for NIOSH regarding developing a taxonomy for \ncharacterizing populations at occupational exposure risk. Ideally, a complete understanding of who is at risk would entail the development "] [4.849441051483154, 13.803160667419434, "l contract requirements and monitor budgets; facili -\nties and equipment (e.g., computing infrastructure) to facilitate efficient research activities; and managerial and supervisory support to ensure that projects run smoothly.\nCost and resources: We"] [4.9029860496521, 13.85718059539795, "orker populations is being developed. While the potential utility of the action is great, in practice, it will be difficult to incentivize the uptake of common defi-nitions across different groups. One reason for the difficulty relates to the variabi"] [4.932122707366943, 13.886812210083008, "e two-thirds (69\u00a0percent) of all U.S. farms. However, these small farms generate less than 2\u00a0percent of total production of food and fiber.\n6 This stands in contrast to the top 6\u00a0percent of farms, which \naccounted for an estimated 75\u00a0percent of produ"] [4.887450218200684, 13.841791152954102, "ata sources for agricul -\ntural injury and illness surveillance. For more detail on the performance of action 2.1 across criteria, we refer readers to the section on action 5.2.\nRecommendation 3: Expand the scope of knowledge on hired farmworker risk"] [4.874181747436523, 13.827762603759766, "p Industries,\u201d Washington, D.C.: Pew Research Center, \nMarch\u00a026, 2015; William Kandel, Profile of Hired Farmworkers, a 2008 Update , Washington, D.C.: Economic Research \nService, U.S. Department of Agriculture, 2008.36 Injury and Illness Surveilla"] [4.893584728240967, 13.847426414489746, "ability of risk would also be useful for devel -\noping interventions to reduce injury risks. Table\u00a05.2\nAction 3.1\u2019s Implementation Plan\nActionOverall\nMechanism Resource Partner Capability Partner Resources Timeline\nAction 3.1 Partner outreach \nor dev"] [4.91094970703125, 13.864745140075684, "gricultural Occupations Under the Fair Labor Standards Act (Child Labor Bulletin \n102), Washington, D.C., June 2007.\n13 DOL, \u201cState Child Labor Laws Applicable to Agricultural Employment,\u201d web page, last updated January 1, 2017.\n14 NIOSH, \u201cChildhood "] [4.888350009918213, 13.842328071594238, "A establishes uniform confidentiality provisions across U.S. statistical agencies for information collected for statistical purposes.\n17 The goal of the law is to ensure that information provided by participants \nin data collection efforts is used on"] [4.887084007263184, 13.841363906860352, "rvey through \nthe NAWS surveys was estimated at about $2 million for a five- to six-year survey cycle, based on past interagency agreements (and assuming sample-size increases in the future). This cost covers payment to ETA and does not include labor"] [4.917478561401367, 13.871278762817383, "the future.\nRecommendation 5: Establish a comprehensive understanding of data sources relevant to \nNIOSH agricultural surveillance-related programming\nThe 2008 National Agriculture, Forestry, and Fishing Agenda provided strategic research direc-\ntion"] [4.867988109588623, 13.82179069519043, "ple data sources under a common eval -\nuation framework so that comparisons can be made and trade-offs of different approaches clearly detailed. Action 5.2 would also encompass the work carried out by the Ag Centers (see Table\u00a01.2), many of which, th"] [4.864590167999268, 13.818411827087402, "ed on Ag Center discussions and the level of evaluation performed. The low-end estimate reflects a comprehensive review of data sources, based on existing infor -\nTable\u00a05.5\nActions 2.1, 5.1, and 5.2\u2019s Implementation Plan\nActionExtramural\nMechanismRes"] [4.893312454223633, 13.846617698669434, "rveillance \ndata through better coverage of priority populations and enhanced data quality. Theme 3, how -\never, seeks to improve data utility through better analysis and communication efforts. Without proper interpretation and communication of data,"] [4.893019199371338, 13.847043991088867, " workers (<18 years old).\nThis action is easy to achieve because NIOSH is already in possession of data from the CAIS \nand has indicated that redoing statistical analyses for different age groupings is straightforward and technically simple. However,"] [4.883737087249756, 13.837560653686523, "idered to be high quality.\nAction impacts: This effort would enhance the utility of childhood agricultural sur -\nveillance data. In particular, although overall childhood injuries have declined over the past decade, injuries among children younger t"] [4.886411190032959, 13.840407371520996, "s and priorities: NIOSH AgFF Program leadership consid -\nered this action to be important.\nInformation quality: Because the CAIS is based on NASS survey procedures, the \ncollected data are considered to be high quality. While NIOSH has reported on h"] [4.882627964019775, 13.83690071105957, "formation could be provided \non an as-needed basis. However, we do not know when such a request might be made and the exact nature of such a request. There should be little cost associated with NIOSH providing the contextual information it already po"] [4.8812255859375, 13.835184097290039, "scription of Recommendations and Actions 47\npanel report.25 To mitigate these risks, the panel report encouraged NIOSH to form partner -\nships with varied groups, including OIE, IPPC, and the Codex Alimentarius Commission and \nto support partnersh"] [4.880563259124756, 13.83407974243164, "ington, D.C., \nJune 2012, p. 13.Table\u00a05.9\nAction 8.1\u2019s Implementation Plan\nActionOverall\nMechanism Resource Partner Capability Partner Resources Timeline\nAction 8.1 Partner outreach \nor developmentUSDA, NCEZID OIE, IPPC, Codex \nAlimentarius Commissio"] [4.8437089920043945, 13.797212600708008, "ter experts), develop and disseminate guidelines for widespread adoption and use, and craft a system for continuous monitoring of changes. These costs do not include mainte-nance activities, such as updating guidelines and continual monitoring.\nTimel"] [4.839484214782715, 13.792533874511719, "ect action and partnerships.) Dis -\nagreements tended to occur when raters interpreted ratings scales differently, written assess -\nments of actions across criteria were unclear, or a rater had specific knowledge pertaining to an action that presente"] [4.831274032592773, 13.784994125366211, " 4.33 4.00 4.67\n6.2: Stratify child data DA 4.17 4.33 4.00\n1.1: Develop definitions or taxonomy EXF 4.00 4.20 3.67\n5.2: Evaluate sources of surveillance data EXF 4.00 3.60 4.67\n3.1: NAWS, hired farmworker injury survey PART 3.88 3.40 4.67\n6.1: Identi"] [4.842264652252197, 13.795267105102539, "tasks and time frames that may result in lesser (compared with the ideal), but still acceptable, impacts (these two cost estimate Figure\u00a06.1\nScatterplot Showing Relationship Between Feasibility and Desirability Scores for Actions: Ideal Version (excl"] [4.837008953094482, 13.78969955444336, "known timelines it would take to establish or build partnerships and negotiate agree-ments (including data use and data-sharing) and the uncertainty about information availabil -\nity and access that could be obtained through such partnerships. While "] [4.8467278480529785, 13.800097465515137, "e types, and knowledge or use of emerging \ntechnologies.56 Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions\nAction 1.1 showed high average combined scores across all feasibility criteria, exce"] [4.844971179962158, 13.798144340515137, "mita -\ntions, poor recruitment numbers, or political or economic factors that cause administrative hardships. \nFinally, actions 3.1 and 4.1 were considered of high desirability but low feasibility because \nboth require partnership actions. In general"] [4.84298038482666, 13.796842575073242, "ng.\nThe other option for ranking is to simply use the overall achievability score, which encom -\npasses the two high-priority areas but may also include action 3.1 as high priority, based on its moderate achievability score. Action 3.1 showed high de"] [4.92064094543457, 13.875228881835938, "he CAIS PART \u2014 $1 million $1 million 1\n4.2: NAWS, child injury survey PART \u2014 ~$2 million $330K 6\n8.1: Partnerships for zoonotic disease PART \u2014 \u2014 \u2014 \u2014\nNOTE: EXF = extramural funding; PART = partnerships.59CHAPTER SEVEN\nConclusions\nAlthough it is one of"] [4.884637355804443, 13.838003158569336, "ns that had high feasibility and desirability scores:\n\u2022\n 1.1: D\nevelop concise definitions of populations at occupational exposure risk, and profile \nthem by AgFF commodity specialization, demographic factors, work organization pat -\nterns, worksite "] [4.942191123962402, 13.896516799926758, "me and Employment; Full-Time \nand Part-Time Wage and Salary Employment by Industry (SA27, SA27N),\u201d web page, undated. As of March 8, 2016: https://www.bea.gov/itable/iTable.cfm?ReqID=70&step=1#reqid=70&step=24&isuri=1&7022=5&7023=0&7001=45&7090=70\n"] [4.94108247756958, 13.895495414733887, "a.gov/amber-waves/2011/december/hired-farm-labor-held-steady/\nKandel, William, Profile of Hired Farmworkers, a 2008 Update , Washington, D.C.: Economic Research \nService, U.S. Department of Agriculture, 2008. As of August 30, 2017: \nhttp://digitalcom"] [4.935599327087402, 13.889505386352539, "12, 2017: http://www.cdc.gov/niosh/oep/agctrhom.html\n\u2014\u2014\u2014, \u201cThe National Academies Evaluation of NIOSH Programs,\u201d web page, last updated July 26, 2016. As \nof August 30, 2017: http://www.cdc.gov/niosh/nas/\n\u2014\u2014\u2014, \u201cAbout NORA: Partnerships, Research an"] [4.959669589996338, 13.909798622131348, "of August \n30, 2017: https://obamawhitehouse.archives.gov/omb/circulars_a110/\nPassel, Jeffrey S., and D\u2019Vera Cohn, \u201cShare of Immigrant Workers in Production, Construction Jobs Falls \nSince 2007: In States, Hospitality, Manufacturing and Construction"] [4.952846050262451, 13.90539836883545, "eptember 4, 2017: http://www.ers.usda.gov/topics/farm-economy/farm-household-well-being/glossary.aspx#farm\nU.S. Department of Agriculture, Economic Research Service, \u201cDistribution of Farms and Value of Production \nVaries by Farm Type,\u201d web page, las"] [11.158040046691895, 17.392427444458008, "CORPORATION\nProvider Fraud in \nCalifornia Workers\u2019 Compensation\nSelected Issues\nNicholas M. Pace, Julia PollakLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation o"] [11.23800277709961, 17.49610137939453, "nes specific aspects of the California approach that might need addressing, and offers some high-level recommendations in that light for the consideration of regulators and legislators. To inform our discussion, we reviewed academic journal articles "] [11.215352058410645, 17.48967170715332, " policy. \nQuestions or comments about this report should be sent to the project leader, Nicholas M. \nPace (nickpace@rand.org). For more information about the RAND Institute for Civil Justice, see www.rand.org/icj or contact the director at icjdirecto"] [11.214863777160645, 17.729982376098633, "................................................................... 20 \t\r \u00a0\nSocial Security .................................................................................................................................... 22 \t\r \u00a0\nThe Internal Re"] [11.132621765136719, 17.359560012817383, "............................................................ 6\t\r \u00a0\nTable 5.1. Medicaid and New York State Workers\u2019 Compensation Board Approaches .............. 46\t\r \u00a0Table 5.2. Medicaid, Labor Code \u00a7 4615, and Labor Code \u00a7 139.21 Approaches ........."] [11.141681671142578, 17.323410034179688, "applicants\u2019 attorneys. \nFraud i n the California Workers \u2019 Compensation System \nFraud can be characterized as the making of a knowingly false or fraudulent material \nstatement or material representation for the purpose of deceiving others so that th"] [11.1052885055542, 17.350582122802734, "stitution, retribution, and deterrence and that enhancing such tools would not yield significant reductions, at least in the near future, in the types of provider-driven fraudulent activities that have been the focus of media articles and policymaker"] [11.101846694946289, 17.38620948791504, "nformation-rich system, such as that in place in California for workers\u2019 compensation. The issue at hand is whether it makes sense for DIR to take the initial steps needed to deploy some sort of advanced analytics program at the present time. We beli"] [11.241958618164062, 17.092010498046875, " a work-connected injury only after \nseparation from the employment believed to have caused the disability. Postemployment claims often include allegations of cumulative trauma (CT) arising from repetitive mentally or physically traumatic activities "] [11.238344192504883, 17.026304244995117, "nsation, but, as a matter of practice, the liens\u2019 validity might not be determined until long after the case in chief is resolved, sometimes requiring relatively complex litigation over the necessity, extent, and value of what was provided to the inj"] [11.233811378479004, 17.040987014770508, "providers subject to utilization review would be unlikely to order numerous separate procedures and prescriptions with claimed values in the tens of thousands of dollars, seemingly with the expectation that a profitable compromise could still be reac"] [11.20496654510498, 17.071971893310547, "mployers in areas where inflated postemployment provider liens are not perceived to be a problem, the current options of either denying or accepting would presumably continue to be the predominant choices when evaluating new injury claims. \nWe think "] [11.201316833496094, 17.069477081298828, "aspect of the Medicaid approach is that the basis for cutting off payments is grounded \nin administrative law rather than criminal, and, as such, the determining entity need not require proof beyond a reasonable doubt. Even more critical is the fact "] [11.198509216308594, 17.07301902770996, "id rule made more sense. The New York model would certainly give DIR considerable discretion to address a variety of physician issues that go beyond mere fraud, including failures to comply with any law or regulation related to the workers\u2019 compensat"] [11.193876266479492, 17.075775146484375, "suspended from the Medicare or Medicaid program for fraud or abuse; or have had their credentials to practice medicine revoked or surrendered. Following a workers\u2019 compensation program suspension as a result of felony or misdemeanor convictions, all "] [11.194083213806152, 17.077253341674805, "ast, there is a potential that Labor Code \u00a7 139.21\u2019s special lien proceedings will void only a fraction of the outstanding liens filed \nby a provider who is later convicted and subsequently suspended. A key phrase in the statute assumes that the tain"] [11.097846984863281, 17.340471267700195, "ach time a new hunt for fraudsters and their schemes is undertaken. As such, we believe that a centralized and permanent workers\u2019 compensation fraud data unit enhances opportunities for detecting and addressing this very special species of fraud . \nS"] [11.17917251586914, 17.11434555053711, "d role of a licensing agency and without waiting for prosecutors to take the initial action. We also believe that a modified version of this policy would present an extremely useful addition to the new tools now available to administrators as a resul"] [11.134573936462402, 17.423519134521484, "nsurance, members of law enforcement, insurers, employers, labor representatives, government agency personnel, providers, third-party administrators, and applicants\u2019 attorneys. Their thoughtful comments and frank descriptions of fraud in the Californ"] [11.136728286743164, 17.375621795654297, " It depends on the attorneys who represent workers, employers, insurers, and providers to discharge their duties in an ethical and professional manner at all times so that the state avoids having to spend resources to monitor their behavior. It assum"] [11.14122486114502, 17.33594512939453, "because much of the existing delegation of responsibility to workers, providers, attorneys, and others would have to be replaced by intensive, unceasing, intrusive, and presumably costly oversight by regulators and law enforcement. For another, perha"] [11.138855934143066, 17.324291229248047, "ork. 5 Chapter Two. What Constitutes Workers\u2019 Compensation Fraud? \nCommon Types of Fraud \nIn what might be thought of as its purest form, fraud can be characterized as the making of a \nknowingly false or fraudulent material statement or material re"] [11.097043991088867, 17.392986297607422, " \n7 U.S. Government Accountability Office (GAO), 2014a, p. 40. 6 independent insurance agents), and claims adjuster fraud.8 Table 2.1 presents various examples \nof fraudulent behaviors within each of these six broad ca"] [11.13711929321289, 17.32137680053711, "associated with the person or entity identified in the category label. For example, we would still consider theft of a settlement check by a law offi ce secretary to be attorney fraud, even if no attorney \nin that office had knowledge that such an ac"] [11.138801574707031, 17.306209564208984, "hat we discuss regarding provider fraud can have a spillover effect in terms of combating other categories as well, given the need for fraudulent providers to sometimes act in concert with attorneys, workers, and others who are knowingly participatin"] [11.148653984069824, 17.28499984741211, "les and policymaker attention. For example, the California Workers\u2019 Compensation Appeals Board (WCAB) already has broad equitable powers to order restitution in the aftermath of fraud and need only apply the modest standard of proof necessary for civ"] [11.109878540039062, 17.342086791992188, "sometimes taking years to complete the path from initial investigation to conviction, and can involve complexities not always present in criminal matters related to individual claimants or employers. They can also result in stopping large-scale schem"] [11.10464096069336, 17.34731674194336, " rules or mislead others for the purpose of financial or personal gain. In recent years, these entities have all taken significant steps toward combating the problem of fraud through the use of advanced analytics, a \nrapidly developing field of infor"] [11.103654861450195, 17.3464298248291, "le, one such rule commonly noted in materials describing warning signs for possible workers\u2019 compensation fraud is that adjusters should more closely examine any claim first filed on a Monday, presumably due to an increased likelihood that the injury"] [12.62384033203125, 3.518476963043213, "pe of this report to cover all methods by which advanced analytics is conducted. Moreover, few large-scale applications of \nadvanced analytics in the private and public sectors use a single technique. A single application often uses an array of tools"] [12.891281127929688, 3.2942450046539307, "ntify (i.e., describe) clusters and patterns 14 containing similar records based on criteria that the application discovers.20 Unexpected clusters \nor patterns could suggest that a previously unknown variety of fraud scheme had developed. For \nexam"] [13.058791160583496, 3.278055429458618, "ires identifying at least some instances of fraud. In sociocentric SNA, the network as a whole is examined to identify patterns of \n \n20 Nian et al., 2016; Kou et al., 2004. \n21 Bolton and Hand, 2002. "] [14.380366325378418, 2.8848493099212646, "er social welfare systems because they automatically collect \u201caccurate, real-time, and largely labeled data\u201d in the routine course of business.\n26 There are few instances in which human beings are \n \n24 "] [11.107379913330078, 17.323680877685547, " business purposes, each source employing different formats and definitions.\n28 Indeed, one \nexperienced observer in the area of governmental use of analytics to combat fraud has noted the many challenges created by the \u201cconsiderable investment upfro"] [11.094922065734863, 17.36956787109375, "yments \n\u2022 prepayment edits: computer edits that revise or suspend all or part of a suspect claim \n\u2022 autodenial edits: computer edits that automatically deny a suspect claim without making \nany payments \n\u2022 provider revocation: elimination of a provide"] [11.076610565185547, 17.365379333496094, "ge information, and develop best practices. \n \n32 GAO, 2015a. \n33 Pub. L. 111-240, 2010, \u00a7 4241. \n34 GAO, 2012; Censer, 2012. \n35 Dickson, 2016. 19 Successes \nAccording to CMS, OIG, and GAO, FPS h"] [11.062747955322266, 17.348020553588867, ", undated. \n38 Congressional Budget Office, 2014. \n39 Sullivan, 2012; U.S. House of Representatives, 2015; Muchmore, 2016. \n40 Citizens Against Government Waste, 2015. 20 University of Minnesota has also been a vocal critic of the program\u2019s imple"] [11.10130500793457, 17.341041564941406, "verall system. States license the health care providers, establish payment policies, contract with \n \n41 Parente et al., 2012. \n42 HHS, 2016b. \n43 GAO, 2015b, p. 16. \n44 GAO, 2015b, pp. 29\u201331. \n45 GA"] [11.099092483520508, 17.35512351989746, " Administration is the target of several forms of fraud, including identity \ntheft in applications for Old-Age and Survivors Insurance and Supplemental Security Income \nand, notably, from physician-assisted fraud regarding claims for disability insur"] [11.097265243530273, 17.359159469604492, "ss or bank account numbers. Despite reportedly \npreventing $16 billion in revenue loss in 2012, the EFDS was felt to have \u201cfundamental \nlimitations in technology and design.\u201d59 In 2011, the IRS awarded SAS Institute a $6.25 million \ncontract to prov"] [11.101629257202148, 17.349685668945312, "yment Security, and Rate Bureau.65 Reportedly, the \nstate has been able to increase total annual penalty collections about fivefold as a result of using this tool.\n66 \nU.S. Postal Service employees receive the equivalent of workers\u2019 compensation bene"] [11.093392372131348, 17.393640518188477, "icare context, we could find little indication of significant dissatisfaction with how the tools are being implemented or what benefits they are achieving. In our opinion, there are no external reasons that DIR should not begin to plan for the incorp"] [11.100595474243164, 17.403785705566406, " \nproceedings associated with a single workers\u2019 compensation claim and all claims associated with a single WCAB case or proceeding can be readily identified without eyes-on effort. Similar \n \n70 See, e.g"] [11.08935546875, 17.383583068847656, "y submitted as an electronic document. DWC can no longer afford to warehouse mountains of paper forms even if it has good intentions to scan them at some future \nbut uncertain point. \nThe paper-form issue might be a minor one compared with a more pre"] [11.260661125183105, 17.10991668701172, "ential criminal investigation materials. 29 Chapter Four. Prevention: Bringing Postemployment Claims Back \ninto the System \nBackground \nSome participants at the June 2016 roundtable sessions voiced their suspicion that some \nproviders were engag"] [11.244250297546387, 17.066274642944336, "incident o r exposure, for the consequences of which \ncompensation is claimed\u201d (Labor Code \u00a7 5411). For such injuries, the maximum possible limit for filing a claim 30 realization that he or she has some sort of medical condition must also be accom"] [11.250961303710938, 17.091798782348633, "st under a year after leaving the employment, but only under the unlikely scenario that the incident or \nexposure happened on the very last day on the job. \n78 Employment Mut. L. Ins. Co. v. Indus. Acc. Comm\u2019n , 41 Cal. 2d 676 (1953). \n79 Zenith Ins"] [11.245694160461426, 17.07765007019043, "e necessary diagnosis linking the condition to the prior work would be made by a physician of the former employee\u2019s own choosing. The former employee is then required to submit the initial claim form to the employer within certain time limits after l"] [11.230749130249023, 17.044015884399414, "im with WCAB, the former employee now has an essentially unlimited right to control the identity of those providing postdenial medical care, although the expenses associated with such care would be covered only if there is a favorable result after WC"] [11.243683815002441, 17.014738082885742, "r the liens themselves is believed to be weak . And finally, \nthey implied that, in at least some instances, the claimed value of some postemployment liens when presented appear to be inappropriately inflated beyond what might be expected given the n"] [11.245641708374023, 16.9952335357666, "re service plans, publicly funded benefit programs, and the like) filed each month \nwith WCAB has more than doubled in less than two years and is now holding at about 30,000 \nper month.\n96 Not all of these liens involve postemployment claims, but mos"] [11.240571975708008, 16.99361228942871, "der the OMFS reflect policies designed to tightly control medical expenditures in California workers\u2019 compensation claims. A similar result occurs when a private health insurer pays only what it considers to be the reasonable, usual, and customary ch"] [11.237222671508789, 17.04396629333496, "it of the doubt when \nadvancing a claim for compensation, absent good-faith knowledge that the claim does not involve a covered injury. That assumption is well represented by rules about when a claim for \nCT or occupational disease can be presented "] [11.236517906188965, 17.03853988647461, "selects falls directly on the employer\u2019s shoulders because of \u201cneglect or \n \n105 A similar requirement would be in place if the former employer had a contract with a health care organization to \nprovide"] [11.254952430725098, 17.019197463989258, "al evidence, but it is hard to ignore the tale that one participant told at the \nJune 2016 roundtables. The participant described accidentally receiving a new-patient package in the mail from what might be described as a lien mill, a package that con"] [11.232217788696289, 17.04256248474121, "ontinued medical expenditures providing the proper incentives for a more aggressive defense. \nWe think that the special circumstances surrounding postemployment claims merit this type \nof option. If the complaints of some of the June panelists are ac"] [11.239044189453125, 17.041751861572266, "ights currently available to him \nor her to challenge the employer\u2019s choice of provider or the type of care being received. \nNote that we are not suggesting that Labor Code \u00a7 5402 should be amended regarding claims \nmade by current employees. There d"] [11.231893539428711, 17.03729820251465, "ll claims would be potential candidates for deny-but-control treatment. Presumably, employers would pick and choose among those candidates to target only the most-problematic providers, so the proportion of claims ultimately affected would be smaller"] [11.187478065490723, 17.107776641845703, " WCAB. A recently indicted medical management corporation\u2019s chief executive, accused of participating in kickback schemes, nevertheless advanced liens worth $58 million in payments for the same medicated \u201cpain \ncreams\u201d that were alleged to be the foc"] [11.192665100097656, 17.083545684814453, "on with other agencies and/or law enforcement.\u201d \n\u2022 Allegations and complaints are considered credible if they have \u201cindicia of reliability\u201d \nand the state has reviewed all facts and evidence carefully and acts judiciously. \n\u2022 When a determination of"] [11.205219268798828, 17.07164764404297, "termine whether to condition the sentence on, among other things, forfeiting the right to seek payment). And rights for due process would still be in place, given that Chapter Five in California\u2019s version of the Administrative Procedures Act provide"] [11.20457935333252, 17.064376831054688, "s \n\u2022 has exceeded the limits of his or her professional competence in rendering medical care \nor in conducting independent medical examinations under the law \n\u2022 has made materially false statements regarding his or her qualifications in his or her \na"] [11.177919387817383, 17.098251342773438, "\nfraud will trigger a Medicaid suspension, while a wide range of behaviors (sexual battery, for example) will constitute misconduct in New York. 46 Table 5.1. Medicaid and New York State Workers\u2019 Compensation Board Approaches \nCharacteristic Me"] [11.207844734191895, 17.063920974731445, " in managing health care provider behavior. The New York model would certainly give DIR considerable discretion to address a variety of physician issues that go beyond mere fraud, including failures to comply with any law or regulation related to the"] [11.194029808044434, 17.083051681518555, "ion until alternative care could be arranged.\n119 Our assumption is that DIR would use \nits power to suspend payment sparingly and never to the point at which wide-scale disruptions of \nthe health care delivery system would result. It should be note"] [11.187372207641602, 17.081287384033203, "ly issued by a provider who subsequently became the target of a fraud investigation. Making it clear that the taint of the original issuer follows the accounts receivable wherever they go will close that potential loophole from almost certain repeate"] [11.200732231140137, 17.060989379882812, "ional statutory language would be needed for suspending payments to not only the original provider but also to any holders of factored liens originating with that provider. \nComparison of Medicaid Approach with Recent Legislative Initiatives \nSenate "] [11.193853378295898, 17.075448989868164, "it \npertains to patient care. \n(iii) It is a financial crime that relates to the Medi -Cal program, \nMedicare program, or workers \u2019 compensation system. \n(iv) It is otherwise substantially related to the qualifications, function s, \nor duties of a "] [11.200444221496582, 17.065080642700195, " the disposition of the criminal proceeding fails to specify the disposition to \nbe made of lien filings in the workers \u2019 compensation system as set forth in \nparagraph (1), all liens pending in any workers \u2019 compensation case in any district \noffic"] [11.191034317016602, 17.0779972076416, "ave ten days to submit a written request for a hearing to argue that \nthe criteria for suspension are not applicable. \n\u2022 Requests for such a hearing would temporarily stay the suspension. \n\u2022 The hearing must be held within 30 days of the submission o"] [11.190479278564453, 17.07457733154297, "a eligible for such sanctions, but one indicator might be the number of people and entities that have been excluded (essentially a type of suspension) by the HHS OIG from participating in Medicare, Medicaid, and other federal health care programs. OI"] [11.188494682312012, 17.084203720092773, "viction and are therefore not valid \n(3) Liens generated for servi ces \nafter suspension are always \ninvalid . \nDuration of \nsanctions Until investigation determines \ninsufficient evidence of fraud or upon completion of legal \nproceedings Until d "] [11.188377380371094, 17.084278106689453, "surrendered or revoked.\u201d Although such adverse credentialing actions would not require a criminal prosecution to trigger a workers\u2019 compensation suspension, only about 100 licenses for all California providers were surrendered or revoked in 2016, and"] [11.193268775939941, 17.072309494018555, "of a medical license revocation outside California, it would appear that none of the outstanding liens filed with DWC would be voided. If California workers\u2019 compensation fraud or abuse was involved in \nthe conviction that led to the suspension, the "] [11.138593673706055, 17.308385848999023, "in California. There are obvious and 57 well-founded reasons for that high standard, given the serious implications of imposing criminal \nfines and imprisonment, but, in California, workers\u2019 compensation is part of the civil justice \nsystem and is d"] [11.101431846618652, 17.34877586364746, "of what they do is essentially undetectable by administrative or law enforcement agencies. \nPart of the reason for fraudsters\u2019 ability to hide in what is essentially plain sight is a problem \nwe noted in Chapter Three: A Balkanization of information "] [11.101534843444824, 17.351642608642578, "uired if the power and promise of advanced techniques to detect fraud and identify those who commit it are to be realized. Moreover, those data have to be easily and readily available to the analysts on an ongoing basis, without the need to repeatedl"] [11.223307609558105, 17.044095993041992, ", one in which employers have the option of denying a questionable claim \nwhile continuing to offer medical care under their control, can be applied in just those instances likely to involve certain employee-selected providers who repeatedly generate"] [11.181265830993652, 17.105897903442383, "in place to adequately notify current patients of a provider who is anticipated to be the subject of a payment suspension. And third, the decision to suspend should be closely coordinated with the efforts of district attorney staff overseeing current"] [11.138567924499512, 17.951086044311523, "w Way to Find Cheaters,\u201d Forbes, January 28, \n2016. As of July 29, 2016: http://www.forbes.com/sites/metabrown/2016/01/28/ analytics-and-the-irs-a-new-way -to-find-cheaters/#5218dbf75b8b \nCalifornia Department of Industrial Relations, Division of Wor"] [11.07079792022705, 17.47595977783203, "\u2019 Compensation Covering Uninsured Medical \nCosts? Evidence from the \u2018Monday Effect,\u2019\u201d Industrial and Labor Relations Review, Vol. 49, No. 4, 1996, pp. 690\u2013706. \nCDI\u2014See California Department of Insurance. 65 Censer, Marjorie, \u201cTwo Local Contractors "] [11.097989082336426, 17.36141586303711, "y, the Opportunity, and a Model for Change, Franklin, Tenn.: Coventry Workers\u2019 \nComp Services, May 2012. \nGAO\u2014See U.S. Government Accountability Office. \nGartner, \u201cAdvanced Analytics,\u201d IT Glossary, undated. As of November 16, 2016: \nhttp://www.gartne"] [11.098691940307617, 17.35437774658203, "\u201cInvestment in \nData Analytics by the Massachusetts Office of the State Auditor,\u201d slide deck, January 15, 2014. As of July 31, 2016: http://montgomeryaga.org/images/meeting/011514/slides_for_fraud_january_webinar.pdf \nMcBirnie, Thomas J., Report on t"] [11.09772777557373, 17.342134475708008, "elease, March 16, 2015. As of July 28, 2016: http://www.ic.nc.gov/NCICFraud-031615NewsRelease.pdf \nParente, Stephen, Brian Schulte, Allen Jost, Thomas Sullivan, and Allan Klindworth, \n\u201cAssessment of Predictive Modeling for Identifying Fraud Within th"] [11.095027923583984, 17.376344680786133, "dit/full/pdf/A-08-13-13038.pdf \nStevens, Howard, \u201cThe Downside of Denial: A California Perspective,\u201d LexisNexis Legal \nNewsroom: Workers Compensation Law, July 14, 2009. As of September 15, 2016: https://www.lexisnexis.com/legalnewsroom/workers-compe"] [11.099037170410156, 17.35462188720703, "ive Analytics System, but Needs to Define Measures to Determine Its Effectiveness , \nWashington, D.C., GAO-13-104, October 15, 2012. As of April 21, 2017: \nhttp://www.gao.gov/products/GAO-13-104 \n\u2014\u2014\u2014, Standards for Internal Control in the Federal Gov"] [11.092872619628906, 17.35171127319336, "ber 2010. As of April 21, 2017: http://www.sentencingproject.org/wp-content/uploads/2016/01/ Deterrence-in-Criminal-Justice.pdf \nYasin, Rutrell, \u201cHow MassHealth Cut Medicaid Fraud with Predictive Analytics,\u201d GCN, \nFebruary 24, 2014. As of July 26, 20"] [13.860529899597168, 2.4306676387786865, "Using Video Analytics and Sensor \nFusion in Law Enforcement\nBuilding a Research Agenda That Includes Business \nCases, Privacy and Civil Rights Protections, and Needs for Innovation\nSUMMARY\nOn July 12\u201313, 2017, on behalf of the National Institute of J"] [13.832859992980957, 2.423738479614258, "ement by monitoring officer per -\nformance and protecting officers\u2019 health and safety.\n\u2022The r\nisks of VA/SF technologies are significant, with security,\nprivacy, and civil rights protections needed if these technologiesare not to be misused or abused"] [13.818248748779297, 2.443249225616455, "eras that are monitored by an opera-tions center. \n\u2022\n The B\naltimore, Maryland, Police Department\u2019s CitiWatch, \nwhich has an operations center with several analysts moni-toring over 700 cameras (as of early 2016). The program also includes a partners"] [13.859244346618652, 2.4218404293060303, "fficers to reduce information overload\u2022 R&\nD on architectures and APIs to integrate \nVA data with RMS/CAD into unified records; should include best practices and model con-tracts in addition to technology\n\u2022\n R&\nD on having dispatch and routing \n int\n"] [13.84410572052002, 2.444154977798462, "e. Donald, Donald, and Thatcher (2016) provide a review of research on capabilities to monitor cameras. In contrast, there have been estimates that a large city agency may have access to hundreds of thousands of video feeds from all over a particular"] [13.836626052856445, 2.447082281112671, "to determine whether a cartoon robot is present based on presence of such features as cartoon claws and robot-like heads. \nImportantly, the aforementioned GPUs are capable of \nprocessing large arrays of pixels in images simultaneously. Thus, a comput"] [13.839567184448242, 2.433060646057129, "tions Subsampling Convolutions Fully connected SubsamplingInputFeature maps\nf.mapsf.mapsReduce the images or videos Classify the\nresulting\nfeatures\nOutput\nFigure 2. Example Multilayer Neural Network\nSOURCE: Salatas, John, \u201cMultilayer Neural Network,\u201d"] [13.847624778747559, 2.427708625793457, "ly classify it\u2014person, vehicle, etc.\u2014and track its move-ment on camera. Test data sets for VA of human activity, such as the Activity, Event, and Action Databases library, main-tained by Rensselaer Polytechnic Institute\u2019s Intelligent Systems Lab (und"] [13.87148380279541, 2.4408533573150635, "ore such methods are broadly implemented. Second, once these core concepts have been identified, specific R&D needs should be determined.\nMethodology\nOn July 12\u201313, 2017, on behalf of NIJ and the Priority Crimi-nal Justice Needs Initiative, the RAND "] [14.868692398071289, 1.930777907371521, " cases were developed during a facilitated discussion, with participants weighing in on inputs, activities, and desired outputs of analytic and fusion efforts with the cases built in real time. Needs \u2014defined as problems or opportunities coupled \nwit"] [13.837630271911621, 2.4403622150421143, "was designed to identify and rank needs based on the assessments of practitioners with experience in the field. Business Cases for Video Analytics and \nSensor Fusion in Law Enforcement\nTo provide an initial answer to the question of what the public \n"] [13.835761070251465, 2.4795796871185303, " officers on scene, court officers, and possibly the public. They must include explicit recognition and display of the uncertainties involved in an artificial intelligence judg-ment.\n2 Such explanations would use narratives to explain an \nalert in or"] [13.83492374420166, 2.440046548843384, "mphasized that alerts must be tailored to \nsupport later review and decisionmaking. This could be accom -\nplished at a basic level by employing pan-tilt-zoom (PTZ) in \nresponse to sensor hits, such as gunshot detection, anomalies in health telemetry,"] [13.877615928649902, 2.43318247795105, "uto-indexing\nfor a caseIncident\nsearchPrepare and distribute\nto court officers\u2022 Face detection and \nenhancement\n\u2022 Plate enhancement\u2022 Other\u2022 Face recognition\u2022 License plate \nrecognition\n\u2022 Other\n\u2022 Find \u201cinteresting\u201d video and \nsensor data for case\n\u2022 La"] [13.821357727050781, 2.435257911682129, "and case number (if applicable), searching the structured metadata would also be much faster. However, this implies the need for a standardized dictionary describing how key data about the video, and what was found on it, are to be coded. \nBusiness C"] [13.839086532592773, 2.4197771549224854, "also be neces-sary, starting with the type of incident, history of what was observed, and ability to assign speech to people and accurately transcribe it. This should ultimately take the form of narrative descriptions of the observed events. Finally,"] [13.860326766967773, 2.427813768386841, "m video and sensor data could be used to evaluate, develop, and test polic-ing strategies. There is a need for models to recognize delayed reinforcement and to test whether outcomes improve over time. Such models could also provide an experimental ca"] [13.874234199523926, 2.4323630332946777, "nts of interest for \ndiagnoses and evaluations\n- Disorder- Accidents- Crimes- OtherCount and track events of interest\n\u2022 Trend charts and control \ncharts that link to supporting labeled video and sensor data\n13include presenting the decisionmaker with"] [13.848424911499023, 2.4095427989959717, "any new VA/SF toolset deployment. Figure 9. A Conceptual Video Analytics and Sensor Fusion Processing Network\n1. Real-time monitoring 2. Post-event investigation and reporting\nMonitoring\nfor alerts\nReview alerts\nand get additional\ninformation\nAct on "] [14.144983291625977, 2.6319077014923096, "ata must not be provocative, humiliating, or exploitative. These tools should also not be used to instruct an officer to, for example, draw a gun, escalate, de-escalate, or in any other way make critical decisions for an officer in the field. \nData I"] [13.85276985168457, 2.4207088947296143, " to interfaces or exchanges between police assets and city or jurisdiction assets, as well as with training, awareness, and resources of any partnering agen-cies.15Community Partnership and Acceptance\nFinally, the panel discussed necessary procedures"] [13.922508239746094, 2.4241693019866943, "tify and reduce false positives \nover time.\n\u2022 The\nre is a general need to identify, categorize, and filter out \nevents (e.g., lengthy stretches of video and sensor feeds) that are not of interest to law enforcement. \n\u2022\n Tr\naining of VA algorithms nee"] [14.670513153076172, 1.9430614709854126, "e Tier 1 needs are in a cluster with the highest EV and include 11 needs\u201423 percent of the total needs identi-fied by the group.\nThe second type of priority need had a median importance \nscore of 9, the highest possible rating. These are high-value ("] [14.012057304382324, 2.420527458190918, "nd suspicious potential indicators of ter-rorism (Nationwide SAR Initiative, 2016).17The needs are presented in Table 1. Within categories, \npriority needs are presented in order of their expected value \nscores, with higher-scoring needs presented fi"] [13.89332389831543, 2.4247891902923584, " or relatively quickly disposed of for privacy and civil rights purposes.Facilitate the creation of a (continuously refreshed) service for cataloging and sharing data sources that can be used for training algorithms (e.g., a public library, Github.co"] [13.920241355895996, 2.4411568641662598, "rastructure\nIssue or Current Limitation Need Tier\u2013Value\nExisting data sources (e.g., LE databases) should \nbe integrated with VA systems to improve the recognition and prediction processes.Develop best practices and model contracts that consider arch"] [13.882043838500977, 2.402087926864624, "already carrying.2 \nForensics: Video archives and real-time feeds are difficult to search for operationally relevant data.Video archive searches should be coordinated with related data (e.g., CAD, weather,)2 \nMonitoring\u2014agencies: VA systems could be "] [13.8673734664917, 2.418037176132202, "oca-\ntion of objects in videos.\nComputational infrastructure\u2022\n Asse\nss different processing models for VA/SF \n(e.g., contracted cloud, government cloud).\n\u2022 As\nsemble technical advisory groups to help \nagencies considering sensor networks with VA/SF.\n"] [13.854108810424805, 2.4118919372558594, "porating the complex treatment of nuance, along with automatic detection and adjustment for changes in behav -\niors over time. VA/SF networks should also incorporate semantic search and automatic infrastructure control, with the control-rule algorith"] [13.857803344726562, 2.3638789653778076, "st-priority use case for these technolo-gies, potentially offering major benefits to society. The panel also felt that VA/SF technologies could be of great benefit in investigating crimes and major incidents, could provide major \n ti\nme-savers throug"] [14.762126922607422, 1.8286247253417969, " equaling the same benefit of prior \u201cgame changing\u201d technologies such as body armor and crime hotspot analysis. Likelihood of success was bracketed as 1 equaling about a 10 percent chance of success and 9 equaling about a 90-percent chance of success"] [14.742730140686035, 1.8744832277297974, ". These high-value needs are all marked with \u201cHV\u201d on the dendrogram. This approach also allows identifi-cation of low hanging fruit (LHF): needs that were rated very high in terms of probability of success, even if they are lower in payoff. Because t"] [13.9337797164917, 2.4320666790008545, "ions).\n1 Issue: CAD, RMS, mobile data, and VA systems are generally not interoperable with each other. Need: Integrate dispatch and routing with what is \nalready known from VA systems.251 Issue: There are limited skill sets within agencies \nto oper"] [13.91307258605957, 2.4246864318847656, "s to identify relevant evidence for the same event. Need: Conduct research into video search \nmethods that would allow similar or related videos are also returned (or immediately available). \n2 HV Issue: A large volume of collected and stored \nvide"] [13.899222373962402, 2.424720525741577, "r these systems (assess the business case).\n2 Issue: When algorithmic learning occurs, \norganizations need a way to ensure that additional learning is coevolutionary with the learning occurring within organizations and among practitioners. \nNeed: "] [13.969700813293457, 2.440512180328369, "systems to reduce bias and improve auditability (e.g., use descriptive tags and include narratives as to why a tag was assigned). \n2 Issue: There is a lack of understanding of how \nartificial intelligence can and should be applied to law enforcement"] [13.840230941772461, 2.5721452236175537, "ble A.1\u2014Continued31ENDNOTES\n1 Here, we use the term business case rather than the term use case , as \nthe latter typically means a detailed list of interactions between a user \nand a system to achieve some objective. Use cases are typically cap -\ntur"] [13.798321723937988, 2.736783504486084, "eve, Paul Bramble, and Alistair Cockburn, Patterns for Effective Use Cases , Boston, Mass.: Addison-Wesley Longman \nPublishing, 2003. \nAphex34, \u201cTypical CNN Architecture,\u201d December 16, 2015. As of \nNovember 15, 2018: https://commons.wikimedia.org/wik"] [13.862344741821289, 3.644786834716797, "John S., Dulani Woods, Andrew Lauland, Sean E. \nGoodison, Thomas J. Wilson, and Brian A. Jackson, Using Future Broadband Technologies to Strengthen Law Enforcement , Santa Monica, \nCalif.: RAND Corporation RR-1462-NIJ, 2016. As of July 10, 2017: http"] [17.25224494934082, -0.023791538551449776, "www.nytimes.com/2018/02/09/technology/facial-recognition-race-artificial-intelligence.html\nMitchell, Anna, and Larry Diamond, \u201cChina\u2019s Surveillance State \nShould Scare Everyone,\u201d Atlantic , Feb. 2, 2018. As of October 1, \n2018: https://www.theatlant"] [13.909680366516113, 3.8592875003814697, " Visualization,\u201d Deep Learning Workshop , Lille, France: 31st \nInternational Conference on Machine Learning, 2015. \nAcknowledgments\nThe authors would like to acknowledge the participation and \nassistance of the members of the expert panel listed in t"] [13.913795471191406, 4.112488746643066, " This Report\nOn behalf of the U.S. Department of Justice, the National Institute of Justice (NIJ), the RAND Corporation, in partnership with \nthe Police Executive Research Forum, RTI International, and the University of Denver, is carrying out a rese"] [13.867801666259766, 4.574977874755859, "mitted to the public interest. \nRAND\u2019s publications do not necessarily reflect the opinions of its research clients and sponsors. \nR\u00ae is a \nregistered trademark.\nRR-2619-NIJCORPORATION\u00a9 Copyright 2018 RAND Corporation\nwww.rand.orgThis publication was"] [16.24329948425293, 7.693874835968018, "CORPORATION\nImproving Outcomes \nfor Children Exposed to Violence\nSafe Start Promising Approaches \nDana Schultz, Lisa H. Jaycox, Lynsay Ayer, Claude Messan Setodji, \nAmmarah Mahmud, Aaron Kofner, Dionne Barnes-ProbyLimited Print and Electronic Dis"] [16.20779037475586, 7.665545463562012, "d build on our prior work evaluating the first round of 15 SSPA sites, reported in \n\u2022 Lisa H. Jaycox, Laura J. Hickman, Dana Schultz, Dionne Barnes-Proby, Claude Messan \nSetodji, Aaron Kofner, Racine Harris, Joie Acosta, and Taria Francois, National "] [16.25011444091797, 7.669198513031006, "ector \nat RAND_Health@rand.org. \nQuestions or comments about this report should be sent to the project leader, Dana Schultz \n(Dana_Schultz@rand.org). v Contents \nPreface ..............................................................................."] [16.202844619750977, 7.647824764251709, "17 \u0001\nOverview of the Data Collection System ........................................................................................ ... 17\u0001\nData Collection ............................................................................................."] [16.163074493408203, 7.699944019317627, "................................................................... 41 \u0001\nSummary of the Implem entation Process ......................................................................................... ...... 42\u0001\nChapter Four. Study Findings ........"] [16.213857650756836, 10.141216278076172, "..................................................... ........... 68\u0001\nProgram Capacity for Service Delivery ......................................................................................... .... 69\u0001\nStudy Limitations ........................."] [16.170766830444336, 7.6795654296875, "es\u2019 Planned Research Designs ................................................................................. 23 \u0001\nTable 2.5. Site Research Designs, Expected Effect Sizes, and Sample Sizes for Power ............. 26 \u0001\nTable 2.6. Analysis and Inferen"] [16.374576568603516, 7.736207962036133, "n\u2019s exposure to violence have been declining, in 2011, 58 percent of \nchildren in a nationally representative sample had been exposed to violence in the past year, with \n48 percent exposed to multiple types of violence (Finkelhor, Shattuck, et al., 2"] [16.203310012817383, 7.652732849121094, "provements in specific outcome domains at a particular xii site. The evaluation\u2019s intent-to-treat analysis approach involved analyses of all those who were \noffered participation in Safe Start, regardless of how much of the program they actually rec"] [16.19337272644043, 7.695257663726807, "Target \nEnrollment \nfor 80% \nPower Actual \nEnrollment \nAurora, Colo. RCT: Strategi c enhancement to an intensive \ndyadic therapy (Traum a-Focused Cognitive\u2013\nBehavioral Therapy + Let\u2019s Connect) \ncompared with Trauma-Focused Cognitive\u2013Behavioral Therap"] [16.169179916381836, 7.684970855712891, "ve medium intervention effects enrolled more families than the target needed for 80-percent power, while all of the studies that expected small intervention effects enrolled far fewer families than needed for 80-percent power to be able to detect the"] [16.16372299194336, 7.69610595703125, "parison group also improved, we found no evidence of significant differences observed in most cases between the intervention and comparison groups using difference-in-differences models. One exception was in El Paso\u2019s primary outcome, child self-cont"] [16.177526473999023, 7.689509868621826, "ion group did not improve more than the comparison group. The interventions in Philadelphia and xviSpokane operated within existing programs for families such that both the intervention and \ncomparison groups received a robust array of usual service"] [16.231374740600586, 7.685993194580078, "vailable individually online, include detailed results. xviiConclusion and Next Steps \nThe OJJDP SSPA initiative sought to improve the evidence base for interventions for CEV as \ndelivered in community settings. This important work aimed to fill a g"] [16.29298973083496, 7.709146022796631, "ted prevention approaches. Targeted services would be used for the minority of children who have prolonged adjustment problems related to violence exposure. There is a growing evidence base about what works in terms of the more-intensive services for"] [16.33071517944336, 7.71834135055542, "been evaluated to see whether they do, in fact, produce a more resilient child, family, or community. Thus, this area is ripe for additional exploration, particularly when combined with the full array of services within a public health model. Clearly"] [16.350627899169922, 7.703353404998779, "on Scale RADS-2 Reynolds Adolescent Depression Scale, 2nd ed. RCT randomized controlled trial RYDS Rochester Youth Development Study SD standard deviation SE standard error S.E.L.F. Safety, Emotions, Loss, and Future SFCR Strengthening Family Coping "] [16.36406898498535, 7.730283260345459, "hort-term risk for depression and anxiety (Lansford et al., 2002) and behavior problems (Grogan-Kaylor et al., 2008), as well as high levels of depression, anxiety, and distress in adulthood (Lindert et al., 2014). Children exposed to domestic violen"] [16.361915588378906, 7.725932598114014, "argeted prevention programs would be reserved for the minority of children who experienced violence and are also displaying some lasting adverse effects. 3Figure 1.1. Tiered Public Health Model \nTo date, most of the treatment development and research"] [16.242603302001953, 7.6915764808654785, "ain them (Wiltsey Stirman et al., 2012). Key factors related to implementation and sustainability include organizational elements, staffing, training and ongoing staff support, data systems, and ongoing fidelity monitoring and quality assurance (Fixs"] [16.21735191345215, 7.691456317901611, "lanning for quality assurance, and ensuring human subject protections. \nOverview of the Current Safe Start Sites \nLike the initial set of 15 sites, the ten SSPA sites that are the focus of this report differ by \ncommunity size, location, age range se"] [16.213809967041016, 7.6928229331970215, "y phone calls \nHonolulu, Hawaii Enhancement to an existing group therapy (Haupoa) + individualized clinical child assessment and individual \nand family therapy (modular CBT) 3\u201317 Quasi-experimental design comparing \nHaupoa + modular CBT with usual "] [16.201488494873047, 7.590798854827881, "tcomes (posttraumatic stress, depression, behavior problems, social\u2013emotional competence, school behavior and attitudes, family functioning, and caregiver mental health) data. \nFunding for implementation and evaluation was modest. Sites received up t"] [16.18622589111328, 7.585048675537109, " site to document its specific capabilities and plans in each area through an iterative process with the national evaluation team. The Green Light process also involved establishing targets for study enrollment and service delivery based on power ana"] [16.21470832824707, 7.630456447601318, "s, targeted consultation with national experts), which, in some cases, resulted in changes to sites\u2019 original implementation plans. Some 11 project leaders needed more support regarding the data collection and evaluation issues. Sites \nalso needed t"] [16.25592613220215, 7.663207054138184, "minister the measure. \n\u2022 To maximize credibility with sites and the ultimate audience for the evaluation results, the measure had been widely accepted and widely used in the field. \n\u2022 The measure or subscale of a measure adhered closely to the outcom"] [16.289854049682617, 7.671726703643799, "y 11\u201318 \nChild Substance use and gang \ninvolvement 11\u201318 \nSocial\u2013emotional competence Caregiver Child social\u2013emotional \ncompetence 0\u20132 \nCaregiver Child cooperation, \nassertion, and self-control 3\u201312 \nChild Child cooperation, \nassertion, and self-con"] [16.254655838012695, 7.651244640350342, " a different study. We again received permission from the publishers to use those existing translations. We also used our own Spanish translations from the first phase for the caregiver and child information items, the caregiver report (CR) of the Ju"] [16.22084617614746, 7.637509822845459, "through I). 16 Table 2.3. Prioritized Outcomes, by Site \nSite Caregiver \nResource and \nPersonal \nProblems Child PTSD \nSymptoms Child \nDepression Child \nBehavior and \nConduct \nProblems Child Social\u2013\nEmotional \nCompetence Child School \nBehavior and \nA"] [16.24354362487793, 7.590107440948486, " collection experience and prior training. In \nsome sites, evaluation supervisors were trained, experienced researchers who were able to draw \non their experience in conducting other longitudinal data collection efforts with children and families. At"] [16.235727310180664, 7.638470649719238, "loped its own eligibility criteria and established referral procedures with each of its referral sources. This means that sites differed a good deal from one another in terms of the initial level of need for services for children and caregiver. Once "] [16.226423263549805, 7.634970188140869, " group assignments until after the baseline \nassessment with the caregiver was complete. The SSTAR system used the stratified urn randomization procedure for group assignment that sought to equalize the groups on child age (Wei and Lachin, 1988). Bec"] [16.26048469543457, 7.629401206970215, " completed caregiver assessment. One site offered a bonus incentive of $10 for completion of each intervention session. \nFor the baseline assessments, every instrument in the caregiver assessment needed to be \ncompleted for the family to be fully enr"] [16.274791717529297, 7.583602428436279, "leted, and the status of completion of the surveys. On a monthly basis, RAND research staff reviewed assessment and service survey data and worked with sites to address any missing data or clarify any inconsistent responses. When we detected a patter"] [16.20893669128418, 7.66619873046875, "different aspects \nof implementation, including receiving referrals, enrolling families in the study, child and \nfamily status at time of enrollment, providing services, engaging families in the \nintervention, quality assurance, and costs. \n\u2022 structu"] [16.175813674926758, 7.674848556518555, "cells of the output tables in the site reports. This section gives a general overview of these strategies, with site-specific details appearing in each of the respective site reports (see Appendixes B through I). \nOverview of Site Research Designs \nT"] [16.132381439208984, 7.650768280029297, "ists. \nThus, higher levels of statistical power allow us to draw firmer conclusions about the \neffectiveness of the site\u2019s interventions. With inadequate statistical power, the results of statistical tests become hard to interpret. For example, lack "] [16.171798706054688, 7.674253463745117, "udy so as to be able to detect a clinically meaningful effect. In the Safe Start context, however, the size of the effect anticipated for some of the different site interventions was difficult to gauge because of the lack of existing research on thes"] [16.19768524169922, 7.659111499786377, "a site could have a certain amount of power to detect differences for measures used for its full sample but lower power for measures that were completed by a subsample in a particular age range. Second, we used multiple statistical tests in this stud"] [16.16163444519043, 7.708099365234375, "r the sites with large enough analytic samples, we compiled two summary dosage scores (one for dosage at six months and one for cumulative dosage up to 12 months) and, based on the distribution, created a variable to indicate whether families who rec"] [16.144115447998047, 7.65029239654541, "rvention services for five of the sites. First, we conducted descriptive statistics to examine \nchanges over time for those in the intervention group who received different levels of dosage, mostly categorized into low, medium, and high dosages, of "] [15.98780632019043, 7.511541366577148, " different between groups and \nwhether changes can be attributed to the intervention (assuming that the \ngroups are comparable) \nAt least 20 \nper group Multiple linear regressions, \nadjusting for demographics Determine whether there is an in terventi"] [16.189071655273438, 7.647127151489258, "each set of analyses, depending on the number of tests conducted. In each site report, we give information about the p-values required to determine \nsignificance. However, we also present information about nonsignificant trends observed between p < 0"] [16.18297576904297, 7.674211502075195, " \nBoys Mean \nChild \nAge, \nin \nYears Child Race and Ethnicity \nPercentage \nof Families \nwith Annual \nHousehold \nIncome of \n<$10,000 Average \nViolence \nExposures \nof the \nTarget \nChild Percentage \nof Children \nwith CRs in \nthe \nSignificant \nRange for \n"] [16.172815322875977, 7.682510852813721, "ing referrals into the comparison group. Because of implementation challenges, OJJDP decided to end Queens\u2019 formal participation in the evaluation, although the site continued to collect baseline and follow-up data on its own (as shown in the orange "] [16.191591262817383, 7.685759544372559, "nroll only 412 families in the study. \nFigure 3.3. Required Versus Actual Enro llment for Sites with Comparison Groups \n* Not included in the remainder of the analysis in this chapter because of implementation challenges. \nIn the previous two figures"] [16.176740646362305, 7.6739020347595215, "ate the enrollment process into the normal flow of activity at the shelter, which made participation easier for families. Further, because families were living at the shelter, there were multiple opportunities for outreach about the study. \nThe other"] [16.16991424560547, 7.683034420013428, "rt. This might have helped these programs to maintain contact with families throughout the study. Other sites tried these and similar strategies to improve retention but did not have the same degree of success. Worcester had difficulty tracking famil"] [16.1636962890625, 7.68140172958374, "er for each study at 0 100 200 300 400 500 600 \nWorcester Denver Detroit El Paso Aurora (child outcomes) Philadelphia Spokane ARC Spokane COS Total N needed for power \nComparison N retained \nIntervention N retained \nExpected medium intervention effe"] [16.170068740844727, 7.675300121307373, "egarding the effect size the intervention would likely have on outcomes (Aurora for intervention retention, Detroit, El Paso, and Worcester). These studies had the sample sizes needed for 80-percent power to detect the minimum observable effects orig"] [16.202592849731445, 7.673490047454834, " families. \n\u2022 family readiness for and engagement in services \n\u2212 Many sites worked to understand family concerns so as to acknowledge that families \nface a myriad of issues that require a holistic approach to care, and to communicate \nflexibility and"] [16.169771194458008, 7.681167125701904, "For example, the two programs that achieved the \nhighest enrollment rates delivered services in the community (Detroit) and the clinic \n(El Paso), whereas other programs in these same settings (e.g., Queens in a \ncommunity setting and Aurora in a cli"] [16.1734561920166, 7.690502643585205, "study was a strategic enhancement \ndesigned to test the effectiveness of Let\u2019s Connect on retention in the TF-CBT intervention. An \nexamination of the intervention and comparison groups at baseline found no differences on any of the outcome measures,"] [16.15494155883789, 7.699283599853516, "ound each estimate. \nAmong Detroit\u2019s 44 secondary outcomes, there were many statistically significant changes \nfor one or both groups after adjusting for multiple comparisons: \n\u2022intervention group only\n\u2212 At six months, the intervention group, but not"] [16.16359519958496, 7.6939592361450195, "e on Detroit\u2019s primary outcome of family conflict. We divided the intervention families into three dosage groups: low (zero to three SFP sessions), medium (four to nine SFP sessions), and high (ten or more SFP sessions). Because we expected that chil"] [16.18105125427246, 7.690887928009033, "e assessment. For both groups, we observed a 50 statistically significant improvement in scores within groups on the primary outcome variable of \nCR of child self-control, with both groups showing the expected increase in child self-control from base"] [16.148792266845703, 7.705079555511475, "on group only \n\u2212 At 12 months, the comparison group, but not the intervention group, improved on SR \nof family conflict and SR of family involvement. \n\u2022 both intervention and comparison groups \n\u2212 At six months, both groups improved on CR of total str"] [16.1578369140625, 7.694798469543457, "intervention and comparison groups in any of the dosage categories (Table 4.4). \nTable 4.4. Changes in Mean Number of Sessions, by Dosage Group, for Caregiver Report of Child \nSelf-Control in El Paso Safe Start: Six Months \nDosage Group N Baseline S"] [16.17441749572754, 7.6880106925964355, "es among the 24 secondary outcomes. There were within-group differences for \nseveral of the 27 tertiary outcomes. At six months, both groups had significantly fewer caregiver total stressors, caregiver resource problems, CRs of the child\u2019s total vict"] [16.16002655029297, 7.693171977996826, " Group N Baseline Six Months Mean \nDifference Mean SD Mean SD \nCR of child social\u2013emotional \ncompetence (ages 3\u201312) None Intervention 8 31.88 18.89 33.75 27.22 \u2014 \n Comparison 8 30.63 15.68 29.38 18.02 \nAny Intervention 12 38.75 22.58 37.08 29.35 7."] [16.16425132751465, 7.68740177154541, "se robust comparison conditions so that all families would receive some help, making the comparison condition ethical and acceptable to families in the study. However, in this case, families in the comparison groups fared nearly as well as the famili"] [16.168188095092773, 7.691431522369385, "e, and this might have made it difficult to demonstrate changes in children over time because there might not have been room to improve for children who were not experiencing many symptoms or problems at baseline. Here, services could potentially pro"] [16.169132232666016, 7.6899800300598145, "ng evidence base for this intervention. For the primary outcome in Philadelphia and for both Spokane interventions, there was significant improvement for the comparison group only. In Philadelphia, the comparison group had a significant decrease in c"] [16.17258071899414, 7.691264629364014, "ntervention effects has little meaning because we do not have enough power to detect the expected effects. \nService Utilization and Dosage \nWe also looked at the variation in service across these interventions (Table 4.8). The vast \nmajority of Auror"] [16.163593292236328, 7.692149639129639, "sage group. For Philadelphia, the statistical test comparing the two groups on changes in mean scores between baseline and six months and baseline and 12 months revealed no statistically significant difference between the intervention and comparison "] [16.164875030517578, 7.691381454467773, "ntrol), the comparison group improvement was significant. The robustness of the usual services that both intervention and comparison groups received likely played a role in the results for Philadelphia and Spokane. The interventions at these sites op"] [16.153562545776367, 7.690472602844238, "PTSD. The other two studies produced \nsmall effect size changes ranging from \u20130.15 to \u20130.20. \n\u2022 CR of positive involvement: We were able to estimate effect size changes for CR of \npositive involvement in four of the eight studies. Philadelphia and Sp"] [16.180383682250977, 7.704596519470215, "Child PTSD \nSymptoms CR of Positive \nInvolvement Caregiver \nDepression CR of Child \nSelf-Control CR of Family \nConflict CR of Child Total \nBehavior Problems \nAurora \u20130.91* \n(\u20131.33, \u20130.48)a \u20130.72* \n(\u20131.10, \u20130.34)a 0.32b \n(0.00, 0.64) \u20130.31b \n(\u20130.61, 0"] [16.16323471069336, 7.690837860107422, "ild age, child gender, child race and ethnicity, and child\u2019s exposure to violence). Among the sites, only Aurora had a small effect size for its primary outcome of CR of child PTSD symptoms when comparing the intervention group change with the compar"] [16.218843460083008, 7.690755844116211, "vidence of their effectiveness or have not been tested in real-world settings. SSPA was designed to grow the evidence base for interventions for CEV by rigorously evaluating the effectiveness of community-based programs. We conducted 11 evaluations a"] [16.20722007751465, 7.68131685256958, "h groups. For Philadelphia and Spokane, Safe Start was embedded within existing and robust programs for families, which likely made it difficult to see differential change between the groups that could be attributed to the Safe Start intervention. \nE"] [16.2294979095459, 7.687718391418457, "hing interventions \nrelevant to CEV in their settings. The sites started from different places, with some sites more \nexperienced providing behavioral health services and others starting from scratch to integrate a new type of services into an existi"] [16.212923049926758, 7.668067455291748, "imitation to the national evaluation is that the assessment battery used in the \nevaluation might not have been ideal for all sites. Despite each site implementing a different intervention, we used a common set of measures. It is possible that some o"] [16.279672622680664, 7.7062907218933105, "one might be more efficient or less costly. However, we did not include a cost analysis in the national evaluation.\n 71 Future Directions \nThe SSPA initiative set out to build the evidence base for programs for CEV. Although the \ninitiative added to"] [16.350032806396484, 7.721924304962158, " health pyramid are services for families who have been \nidentified as exposed to violence but who are experiencing only mild or moderate symptoms. Future exploration of services at this level might try to pin down the necessary ingredients for less "] [16.322248458862305, 7.713100910186768, "s well as efforts within child welfare, \njuvenile justice, and mental health systems ( Donisch, Bray, and Gewirtz, 2016). However, most \nof these models have not been evaluated to see whether they do, in fact, produce a more resilient child, family, "] [16.292247772216797, 7.684792518615723, "ne outcome domains: \n\u2022 background and contextual factors \n\u2022 PTSD \n\u2022 depression \n\u2022 behavior and conduct problems \n\u2022 family functioning \n\u2022 social\u2013emotional competence \n\u2022 school behavior and attitudes \n\u2022 violence exposure \n\u2022 caregiver mental health. \nWe"] [16.302568435668945, 7.649393558502197, "\u2014 \u2014 10 10 \nAPQ 42 42 42 42 \nFES Conflict scale \u2014 \u2014 9 9 \nViolence exposure JVQ \u2014 19 19 19 \nTotal number of items 59 78 133 184 \nNOTE: \u2014 = Measure did not apply to this age range. \n \nBackground and Contextual Factors \nCaregivers completed five measures"] [16.28216552734375, 7.669707775115967, " used the weighted-least-squares-with-adjusted-means estimator (Mplus, undated). The analysis identified a two-factor solution that was easily interpretable and resulted in high internal consistency within each factor. Namely, from the 21 items, we c"] [16.306272506713867, 7.6907877922058105, "s subscales for PTSD, depression, \nand anxiety. With permission from the developers, we used only the PTSD subscale. The TSCYC PTSD scale includes 27 items that tap things the child does, feels, or experiences (e.g., bad dreams or nightmares, being b"] [16.283138275146484, 7.665895462036133, "so been demonstrated, with correlates in the expected direction between the RADS-2 and other depression measures (Reynolds, 1998; Reynolds, 2002). In the present study, the Cronbach\u2019s alpha was 0.28. \nBehavior and Conduct Problems \nTo assess internal"] [16.27978515625, 7.602751731872559, " used IRT to create a single score for the entire age range that combined data from the two scales. The pattern of eigenvalues, predominantly strong loadings, and reasonable fit for the single-factor model provided evidence that the item set is suffi"] [16.31218719482422, 7.7022833824157715, " were then asked follow-up questions about their extent of current involvement (e.g., are you currently a member of a gang? and on a scale of 1 to 5, how far from the center of the gang are you if 1 is leadership of the gang and 5 are people who just"] [16.281261444091797, 7.6676130294799805, "of the SSIS (Gresham and Elliott, \n2008) to assess assertion, self-control, and cooperation. Questions asked how true (e.g., not true, \nlittle true, a lot true, or very true) and how important (e.g., not important, important, or critical) the child p"] [16.28035545349121, 7.664955139160156, "aregiver \nand youth self-report scale on school functioning. We also asked teenagers one question about their grades. \nCaregiver and Child Self-Reports of Child School Functioning \nWe used one scale from the BERS-2 (Epstein and Sharma, 1998) to asses"] [16.314632415771484, 7.659177303314209, "4 for inconsistent discipline, and 0.55 for corporal punishment. For child respondents, the Cronbach\u2019s alpha was 0.82 for parental involvement, 0.82 for positive parenting, 0.79 for poor monitoring and supervision, 0.61 for inconsistent discipline, a"] [16.327577590942383, 7.671014785766602, "specific values were reported. We computed a total score for each subscale, as well as a total score for the entire measure, with higher scores indicating more violence exposure on each dimension. At baseline, the survey asked about these experiences"] [16.313093185424805, 7.713088512420654, "experiences. At baseline, the survey asked about these experiences in the past year, and, on the follow-up surveys, the survey queried about the prior six months and since the prior assessment. \nCaregiver Mental Health \nWe used two measures to captur"] [16.658370971679688, 7.8783674240112305, " \u201cControlling the False Discovery Rate: A Practical and \nPowerful Approach to Multiple Testing,\u201d Journal of the Royal Statistical Society , Series B: \nMethodological , Vol. 57, No. 1, 1995, pp. 289\u2013300. \nBlaustein, Margaret E., and Kristine M. Kinnib"] [16.761999130249023, 7.887911319732666, "y P. Mannarino, and Robert A. Steer, \u201cA Multisite, \nRandomized Controlled Trial for Children with Sexual Abuse\u2013Related PTSD Symptoms,\u201d Journal of the American Academy of Child and Adolescent Psychiatry , Vol. 43, No. 4, April \n2004, pp. 393\u2013402. \nCoh"] [16.680259704589844, 7.8698225021362305, "\u201d Aggression and Violent Behavior , Vol. 13, \nNo. 2, March 2008, pp. 131\u2013140. \nFinkelhor, David, Richard Ormrod, Heather Turner, and Sherry L. Hamby, \u201cThe Victimization \nof Children and Youth: A Comprehensive, National Survey,\u201d Child Maltreatment , V"] [16.661428451538086, 7.860030651092529, "6\u2013128. \nGewirtz, Abigail H., and Jeffrey L. Edleson, \u201cYoung Children\u2019s Exposure to Intimate Partner \nViolence: Towards a Developmental Risk and Resilience Framework for Research and Intervention,\u201d Journal of Family Violence , Vol. 22, No. 3, April 20"] [16.829408645629883, 7.891485691070557, "h, Dawna Gabowitz, Margaret E. Blaustein, and Joseph \nSpinazzola, \u201cDevelopment and Implementation of Trauma-Informed Programming in Youth \nResidential Treatment Centers Using the ARC Framework,\u201d Journal of Family Violence , \nVol. 28, No. 7, October 2"] [16.722503662109375, 7.870345115661621, "herapy for Physically Abused \nChildren and Their Offending Parents: A Comparison of Clinical Outcomes,\u201d Child \nMaltreatment , Vol. 1, No. 4, November 1996b, pp. 322\u2013342. \nKroenke, Kurt, Tara W. Strine, Robert L. Spitzer, Janet B. W. Williams, Joyce T"] [16.743431091308594, 7.885932445526123, ", \u201cCognitive\u2013Behavioural \nInterventions for Children Who Have Been Sexually Abused,\u201d Cochrane Database of \nSystematic Reviews , Issue 4, October 18, 2006, Art. CD001930. \nMarvin, Robert, Glen Cooper, Kent Hoffman, and Bert Powell, \u201cThe Circle of Secu"] [16.652305603027344, 7.863570690155029, "mmunity Violence,\u201d Child Development , \nVol. 73, No. 4, July\u2013August 2002, pp. 1265\u20131282. \nPatterson, Gerald R., Marion S. Forgatch, and David S. Degarmo, \u201cCascading Effects Following \nIntervention,\u201d Development and Psychopathology , Vol. 22, No. 4, N"] [16.828350067138672, 7.977565288543701, "m Response Theory, New York: Springer, 1997, \npp. 85\u2013100. \nSastry, Narayan, and Anne R. Pebley, Non-Response in the Los Angeles Family and \nNeighborhood Survey , Santa Monica, Calif.: RAND Corporation, DRU-2400/7-LAFANS, \n2003. As of November 14, 201"] [16.921052932739258, 7.930818557739258, " for Social\u2013Emotional Behaviors , Baltimore, Md.: P. H. Brookes Pub. Co., 2002.\n \nStein, Bradley D., Lisa H. Jaycox, Sheryl Kataoka, Hilary J. Rhodes, and Katherine D. Vestal, \n\u201cPrevalence of Child and Adolescent Exposure to Community Violence,\u201d Clin"] [-1.3786016702651978, 14.261392593383789, "Landscape Survey \nto Support Flood Apex National Flood Decision Support Toolbox\nDefinitions and Existing Tools\nAaron Strong, Debra Knopman\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein a"] [-1.5402284860610962, 14.230891227722168, "first summarize definitions of resilience found in the peer-reviewed literature and government and other organizations\u2019 reports. Second, we sum -\nmarize the literature on conceptual frameworks to guide understanding and actions to build resilience an"] [-1.8777493238449097, 14.15963077545166, "............................................................................. 5\nCHAPTER TWO\nDefinitions of Terms ........................................................................................... 7\nFoundations of Resilience ..............."] [-1.4661548137664795, 14.214157104492188, "................................................. 48\nEnvironmental Assessment ..................................................................................... 49\nEmergency Management ............................................................"] [-1.6088898181915283, 14.2179594039917, "\nTables\n 2.1. Representative Definitions of Resilience ......................................................... 8\n 4.1\n. Ind\nicator Systems Reviewed in Cutter, 2016 .................................................. 28\n 6.1\n. Ris\nk Assessment Tool"] [-1.271925687789917, 14.280228614807129, "tmospheric Administration\u2019s Coastal Flood Exposure \nMapper ............................................................................................. 84\n A.\n20. STOR\nMTOOLS ......................................................................."] [-1.3507426977157593, 14.280252456665039, "ection and Restoration Authority Planning Tool ............................. 110\n A.4\n6. Ris\nk Mapping, Assessment and Planning ..................................................... 111\n A.4\n7. Geo\nrgetown Adaptation Tool Kit ....................."] [-1.3565880060195923, 14.288253784179688, "cused on resilience. In particular, the topic areas included (1)\u00a0various definitions of resilience, (2)\u00a0system-of-systems frameworks for con -\nceptualizing resilience, (3)\u00a0indicator and metric systems for resilience, and (4)\u00a0examples of how resilienc"] [-1.2592474222183228, 14.323460578918457, "screen -\ning the many self-identified DSTs, we applied several criteria to reduce the number to a man -\nageable set and focus our efforts on those that had the potential of mattering most to the Flood Apex program:\n\u2022\n field a\npplication: Was the DST "] [-1.9137847423553467, 14.154762268066406, " and its own economic composition and needs. \nAs a result, decision analysis and support frameworks and indicators need to be tailored to each individual community. Resilience thus needs to be framed in terms of the particular circumstances of each i"] [-1.2316111326217651, 14.37217903137207, "o on investments in natural and social capital that enable communi -\nties to mitigate impacts of flood events and recover more quickly.\nAt present, jurisdictions vary considerably in terms of adopting flood DSTs for use in \npreparing action plans and"] [-1.197083830833435, 14.366262435913086, "sting DSTs.\nFinally, how DSTs are disseminated to communities needs particular attention. Com -\nmunities need guidance through the decisionmaking process. The agricultural extension net -\nwork and the National Oceanic and Atmospheric Administration S"] [-1.2761270999908447, 14.307709693908691, "\nHSDC RAND Homeland Security and Defense Centerxviii Landscape Survey to Support Flood Apex National Flood Decision Support Toolbox\nIFRC International Federation of Red Cross and Red Crescent Societies\nLUCI Land Utilisation and Capability Indicato"] [-1.6649131774902344, 14.204587936401367, " but often finding it difficult to link output from these models to broader community goals and other tools in common use for land use, trans -\nportation, water resources, and other infrastructure planning. Further, different institutional and govern"] [-1.616980791091919, 14.222537994384766, " disaster management. Given the recent emphasis on resilience throughout the country, it is difficult to distinguish between simply using the term resilience to rename status quo behavior and a fundamental shift in action. We identify institutions th"] [-1.251341462135315, 14.3247709274292, "arch terms: decision sup -\nport flood , decision support tools flood , flood tools , decision support system flood , and flood decision \nmaking . Our initial search resulted in a list of approximately 100\u00a0models and tools.\nIn screening the many self-"] [-1.244153380393982, 14.324949264526367, "an the one for \nwhich it was originally designed?\n\u2022 U.S\n. application: Has the DST been implemented in the United States, or could the tool \nbe easily transported to a U.S. context?\n\u2022 usa\nbility and transparency: Could well-trained planners found in "] [-1.9162863492965698, 14.161160469055176, " have an associated approach for measuring resilience or indi -\ncators of resilience, and many reviews exist of indicators and metrics of resilience. In Chapter Four, we focus on how these metrics relate to the frameworks and how they succeed or fail"] [-2.031358480453491, 14.158523559570312, "(1)\u00a0the magnitude of a stressor, as mea -\nsured by the system\u2019s movement from one equilibrium state to another, and (2)\u00a0the length of time it takes for the system to move into homeostasis once the stressor has been removed. These ideas were first tra"] [-2.037905693054199, 14.187209129333496, "not locked into specific strategies) that have diverse resources\u201d (pp.\u00a027, 28).\nResilience Alliance, undatedEcological system\u201c[T]he capacity of a system to absorb disturbance and reorganize while undergoing change so as to still retain essentially th"] [-2.0164806842803955, 14.166346549987793, "tem from three separate \nconcepts: vulnerability, risk assessment, and adaptive capacity. All of these ideas are linked to a common goal of reducing a community\u2019s risk to external forces (Lei et al., 2014). As Miller et al., 2010, and others have not"] [-2.0611894130706787, 14.101049423217773, " stressor will reduce the distance between A and B. That is, the system has roughly the same functionality as it did prior to the disruption. The idea underlying absorptive capacity is that, if a community has made an effort to reduce the impact of a"] [-2.0662271976470947, 14.17938232421875, "dicators in Chapter Four.\nAdditionally, there has been some emphasis on the role that resilience plays in the com -\npression of the time to postevent functioning (Olshansky, Hopkins, and Johnson, 2012). From a practical standpoint, much of the fundin"] [-1.7449933290481567, 14.179459571838379, "mmunities are communities that are self-sufficient in that they do not rely on external support after an event takes place (see, for example, Hall, 2014; Anh et al., 2013; and 12 Landscape Survey to Support Flood Apex National Flood Decision Suppo"] [-1.955838918685913, 14.107980728149414, "s after a disaster occurs, there is a risk that strategies or actions to reduce vulnerabilities will be undervalued or ignored entirely. Alternatively, if the focus is solely on hazard mitigation, important capacities for the recovery process might b"] [-1.9741668701171875, 14.152393341064453, "nternational Development focuses on subsystems rather than on the system as a whole. This leaves the interdependencies that arise mostly unconsidered. In contrast, NIST explicitly has a chapter on dependencies across systems.\nFrom the Arup Internatio"] [-2.013758897781372, 14.170095443725586, " a\nbility for rapid rebound, to reestablish function quickly and avoid long-term disrup -\ntions.\nThe Rockefeller and Arup International Development lists of characteristics are very \nmuch aligned. These characteristics provide a means of developing c"] [-2.0176327228546143, 14.158313751220703, "inished capacity, using the pre-event techniques resulting in persistent dysfunction and vulnerability to future stress -\nors, or the system adapts to an altered environment. This characterization of resilience shows that resilience enters not only i"] [-1.9669710397720337, 14.132579803466797, "ocial and natural environments (although the framework could easily be adapted to incorporate such considerations). In particular, Rose develops his framework with two questions in mind: (1)\u00a0How can the economic system be modeled in order to predict "] [-1.9502216577529907, 14.1080961227417, " Toolbox\nresilience context. There are five main components to the Francis and Bekera framework (see \nFigure\u00a03.4):\n1. sys\ntem identification\n2. vul\nnerability analysis\n3. res\nilience objective-setting\n4. sta\nkeholder engagement\n5. res\nilience capacit"] [-1.9668264389038086, 14.122215270996094, "iple, as opposed to a struc-ture organized around social, economic, natural, and built systems (see Figure\u00a03.5). The start -\ning point for the Bruneau et al. analysis is that the four dimensions of resilience are technical (T), organizational (O), so"] [-1.959288239479065, 14.129841804504395, "ystems frameworks when applied to resilience are how the subsystems are segmented: along infrastructural lines (electric or water) or functional lines (e.g., social, built, natural). Additionally, how the interdependencies across systems are incorpor"] [-1.953508734703064, 14.128851890563965, " participants to engage in the decisionmaking process.\nInterdependencies within a system can matter. To determine the total effect of invest -\nments in resilience made in a subsystem, one needs to measure the direct value to that sub -\nsystem, as wel"] [-1.6734237670898438, 13.862325668334961, "ers\nThe levers are feasible actions or strategies that decisionmakers have available to reduce vul -\nnerabilities, increase resilience, or improve adaptive and other capacities. Decisionmakers can control levers, in contrast to the external uncertain"] [-1.9269418716430664, 14.170351028442383, "s:\n1.\n Defi\nne the problem.\n2. Iden\ntify feedback.\n3. Dev\nelop the model.\n4. Per\nform a sensitivity analysis.\nFirst, the problem needs to be assessed and identified. This can be accomplished by \nanswering two questions: (1)\u00a0What aspect of the system "] [-1.9065537452697754, 14.082672119140625, "n of the framework should simplify its use and highlight where touch points between systems exist rather than focusing on all the potential relationships that can take place in a community.27CHAPTER FOUR\nIndicators and Metric Systems\nMany alternative"] [-1.8698008060455322, 14.144965171813965, "ort Flood Apex National Flood Decision Support Toolbox\nTable\u00a04.1\nIndicator Systems Reviewed in Cutter, 2016\nMeasure and Source TypeaSpatial UnitbFocuscDomaindMethode\nAtlas of Social Protection: Indicators of \nResilience and Equity (World Bank, 2017)T"] [-1.878225564956665, 14.054203987121582, "nd bottom-up approaches by how the system was developed. Top-down approaches are nomothetic, and bottom-up approaches are idiographic. Top-down approaches allow for comparison across communities, whereas bottom-up approaches are spe-cifically tailore"] [-1.9256078004837036, 14.10444450378418, "pex National Flood Decision Support Toolbox\nIndicator Systems Not Considered in Cutter, 2016\nIn addition to Cutter, 2016, there are several other reviews, including Brooks, Aure, and \nWhiteside, 2014; Link et al., 2015; and Winderl, 2014. Brooks, Aur"] [-1.9458597898483276, 14.117918968200684, "e vulnerability literature that measures a system\u2019s vulnerability in the absence of considerations about exposure and hazards. A community might be vulnerable when measured using the Social Vulnerability Index (Cutter, Boruff, and Shirley, 2003), but"] [-2.027467966079712, 14.18749713897705, "ary metric of resilience. Rather than relying on simple averaging or factor analysis to provide weights, the system\u2019s actual characteristics and network could be used to form an index of resilience.33CHAPTER FIVE\nResilience in Practice\nThis chapter r"] [-2.0365817546844482, 14.208514213562012, "esilience in communities, \nincluding the use of disaster-loss data to foster long-term commitments to enhancing resilience\n\u2022\n dev\neloping and deploying tools or metrics for monitoring progress toward resilience\n\u2022 bui\nlding local, community capacity b"] [-2.0080809593200684, 14.229292869567871, "in Practice 35\nlevels of government and by firms, such as utilities and telecommunication companies. Even \nwithin the federal government, responsibilities are sufficiently distributed that fully centralized rulemaking for resilience is impractical"] [-1.9671519994735718, 14.192375183105469, " (NFIP).\nThe first objective is critical to ensure that, to inform their investment decisions, local \ndecisionmakers have as much information as possible about the risks they face. This effort is \nexplicitly intended to incorporate future risks influ"] [-2.039370059967041, 14.235284805297852, " its emphasis on preparedness \nand resilience in the United States. In 2012, the Red Cross undertook major community resil -\nience pilot efforts in New Orleans, Mississippi, Miami, San Francisco, and Denver, followed by similar programs in smaller lo"] [-1.981986403465271, 14.221100807189941, "d programs developed within the network be adopted as common practice in a much larger number of cities and other contexts.\nAlthough the 100RC program has global scope, it has a strong presence in the United \nStates. Its first two cohorts of cities ("] [-1.9627002477645874, 14.200671195983887, "is project has been discontinued, many of the ideas can be seen in the Rockefeller approach to 100RC.\nUrban Resilience Planning\nTo understand how the ideas and theory of resilience have been brought to bear on practice \nand planning, we provide a ser"] [-1.8182140588760376, 14.216367721557617, "r period. Addressing \nthese problems requires money and engineering but also close cooperation and coordination between the many agencies and private firms that are involved in one way or another with the Los Angeles water supply. The report also ide"] [-1.5435583591461182, 14.179359436035156, "orts, in some detail.\nThe report identifies multiple classes of hazards and assesses the city\u2019s vulnerability to \neach. Assessed hazards include coastal erosion; coastal storms; disease outbreaks; drought; earthquakes; extreme temperatures; flooding;"] [-1.9475399255752563, 14.215428352355957, "The Seattle postdisaster recovery framework emphasizes the difference between initial disaster response, which focuses on command and control issues and is often government-led, and disaster recovery, which is an inherently bottom-up, collective proj"] [-1.9273468255996704, 14.258594512939453, "mproves the community\u2019s overall well-being\u201d (Boulder Office of Emergency Man -\nagement, 2013, p.\u00a027).\nThe plan centralizes coordination during the recovery phase with a recovery coordinator, \nwho is part of the staff of the Boulder Office of Emergenc"] [-1.9318865537643433, 14.202957153320312, "isory Control and Data Acquisition tools, geographic information system (GIS)\u2013based data management systems, outage management systems, distribution manage-ment systems, mobile workforce management systems, and modern business analytics tools. These "] [-2.0504188537597656, 14.208714485168457, "s essential to the functioning and recovery of a modern city; second, it is illustrative of a class of cross-jurisdiction networked infrastructure systems, including telecommunications and water supply, that are often owned and operated by private-se"] [-1.2446869611740112, 14.33503532409668, "al focus rather than individual community. At present, perverse incentives might exist that stem from the way that funding occurs in such programs as the Hazard Mitigation Grant Program and the NFIP. The incentives that communities face provide an un"] [-1.2361705303192139, 14.330327987670898, "relied on the first two\u2014less stringent\u2014screening \ncriteria.\nWe consciously made a decision not to include any H&H model by itself in the absence of \na well-documented field application that illustrated its use in real-world conditions. Addition -\nall"] [-1.2281802892684937, 14.33194351196289, "hinking about the means by which decisions are teed up and made, as opposed to computational or modeling methods used to support decisionmaking.\nOur goal in segmenting the DSTs by function is to show the breadth of tools that deci -\nsionmakers have u"] [-1.216911792755127, 14.321547508239746, "luation of structural interventions. Other than Hazus, the most commonly used risk assessment tool is MIKE FLOOD, which is already part of DHI\u2019s flood toolbox (DHI MATLAB Toolbox). Table\u00a06.1 provides a summary of risk assessment tools.48 Landscape"] [-1.217564582824707, 14.334036827087402, "astructure, and \nother physical assets, other tools focus on its effects on natural systems and ecosystem services. Human and natural systems are intimately linked, so this distinction in categorization is a matter of emphasis and framing. These tool"] [-1.2199385166168213, 14.317241668701172, " tool and DST that helps to identify evacua -\ntion decision times and the potential for significant storm effects, such as wind and storm surge. HURREVAC translates live-forecast track and wind extent information into interactive maps and reports des"] [-1.129593849182129, 14.32126522064209, "rios or simulations of synthetic storms to better understand the impacts of specific projects or suites of projects. Most importantly, when multiple projects are considered, these tools allow a better understanding of the trade-offs that the decision"] [-1.171630620956421, 14.340507507324219, " consideration of alternative projects or project parameters. Many of the modeling approaches in the risk assessment category could be modi -\nfied to evaluate projects. Table\u00a06.5 lists project evaluation tools.\nIntegrated Decision Support Tools\nTools"] [-1.2386438846588135, 14.301471710205078, "en its architecture, it is likely that this tool could be adapted to explore site-specific alternatives, but it does not appear to have been used in this manner to date.\nTHESEUS DSS (THESEUS, undated\u00a0[a]) represents yet another European entry in the "] [-1.1314749717712402, 14.270142555236816, "ration, undated\u00a0(b). This decisionmaking framework uses the XLRM frame-work discussed in Chapter Three to help frame the decision problem and then uses hydro -\nlogic modeling, in the case of flood-related applications, together with uncertainty analy"] [-1.1562613248825073, 14.329577445983887, " RAND Ho Chi Minh City, Louisiana, New \nYork, Colorado River Basin\nCPRA Planning Tool RAND Louisiana\nRisk Mapping, Assessment and \nPlanningFEMA Nationwide, United StatesDecision Support Tools 55\nSummary of Findings\nRisk Identification and Assessme"] [-1.211987018585205, 14.343289375305176, "r. That is, these kinds of tools are designed to illuminate the trade-offs that decisionmakers face and combinations of interven -\ntions that might best achieve progress toward multiple public goals in the presence of a budget -\nary constraint.56 "] [-1.2141854763031006, 14.342155456542969, "sts and benefits provides a structured way to develop \nand evaluate alternatives. Many jurisdictions engage specialized engineering firms to help with the development of flood damage mitigation plans using DSSs of this sort. The Marin County (Califor"] [-0.3957632780075073, 12.762615203857422, "mitigation action database and scoring system. Although the approach was systematic, it focused strongly on its deliberative process, using computerized tools to assist with various parts of the process. The result has been well received, but the pro"] [-1.9276572465896606, 14.136260032653809, "f thousands of potential storm events to build up a detailed statistical portrait of which combinations were likely to be most in line with community goals and, often more importantly, which combinations were least likely to produce catastrophic fail"] [-1.9469741582870483, 14.1355562210083, "e resilience of the whole. The key is finding a balance between detail and parsimony to understand how different investments and dis -\nruptions cascade through the entire system. The design of the framework should simplify its use and highlight where"] [-2.0303895473480225, 14.223039627075195, "ces in information technology and control systems to build more-resilient networks that are capable of handling the extremely dynamic loads and potentially larger storms that the coming decades might bring.\nThe larger perspective provided by framing "] [-1.1769921779632568, 14.36185359954834, "recent decades, DSTs have moved from basic physical models, including maps and table-\ntop demonstrations, and informed by historical flood patterns and basic geophysical mea -\nsurements, to sophisticated hydrodynamic simulations that can produce deta"] [-1.2030504941940308, 14.381720542907715, "allow for deep exploration of flooding scenarios and uncertainty. For this reason, flood risk viewers are likely to remain fundamental tools for building risk literacy among decisionmakers and community members alike. In more-sophisticated integrated"] [-1.216846227645874, 14.309549331665039, "d Greece, Thailand, worldwide\nMotivation for development \u2022 \u201cRe\nliable flood modelling tools .\u00a0.\u00a0. enable us to analyse flood events \nand develop flood protection measures or flood mitigation strate-\ngies in the attempt to prevent the losses of human "] [-1.2165396213531494, 14.309237480163574, "Used across a variety of jurisdictions and agencies already\nPotentially valuable to DHS? Currently being used by DHS Science and Technology Directorate\nSOURCES: National Center for Computational Hydroscience and Engineering, undated; National Center "] [-1.2147823572158813, 14.308974266052246, "rea caused by riverine floods in plain settings.\u201d\n\u2022\n Vis\nualize the following:\n\u2022 Simp\nle interface\n\u2022 Flo\nod simulation graphs\n\u2022 Inu\nndation maps\nInput data requirements \u2022 Targ\net area\n\u2022 Top\nography data\n\u2022 Prec\nipitation data\n\u2022 Hyd\nrologic data\n\u2022 Econ"] [-1.2161309719085693, 14.307968139648438, "ercritical, and mixed-flow regimes. Steady and \nunsteady flows.\n\u2022 Uns\nteady-flow module handles hydraulic structures, including dam-\nbreak analysis, levee breaching and overtopping, pumping stations, navigation dam operations, and pressurized pipe sy"] [-1.2191195487976074, 14.308056831359863, "/R3\u201d (p.\u00a05).\nFunctionality \u2022\n ArcG\nIS extension\n\u2022 Req\nuires Spatial Analyst extension\n\u2022 Pro\nvides tools for visualization and risk compilation from various \nflood projection data sets\n\u2022 Use\ns existing government flood data sets\n\u2022 Too\nl modeling is li"] [-1.2169768810272217, 14.308711051940918, "k to real-time and near-real-time atmo-\nspheric, oceanic, and hydrologic information on the Internet\nInput data requirements \u2022 Met\neorological, oceanographic, and hydrologic observing station \ndata\n\u2022 Cri\ntical facilities\n\u2022 Dem\nographic and business d"] [-1.2527704238891602, 14.288187980651855, "d Decision Support Toolbox\nTable\u00a0A.13\nAdvanced Circulation\nAspect Description\nLead organization or author University of North Carolina at Chapel Hill\nLocations where applied Nationwide, United States\nMotivation for development \u2022 Hurr\nicane forecastin"] [-1.2138216495513916, 14.30897045135498, "-tion\u201d (Sustainable Coastal Communities, undated).\nFunctionality \u201cCommunityViz offers many ways to present the analysis including real time demonstrations, Internet reports, and WebShots (a dynamic presentation tool). Google Earth and SiteBuilder3D p"] [-1.1808897256851196, 14.285382270812988, "ng hazards and sea level rise. This website should be used to promote enhanced preparedness and land use planning decisions with considerations for possible future conditions.\u201d\nFunctionality Visualization of\n\u2022\n SLR (\nbathtub model, 0 to 6\u00a0ft.)\n\u2022 Con\n"] [-1.1890232563018799, 14.28397274017334, "ul visualization but limited decision support\nSOURCES: Office for Coastal Management, 2017b; Environmental Dataset Gateway, 2012.Summary Tables 83\nTable\u00a0A.18\nNational Oceanic and Atmospheric Administration Sea Level Rise Planning Tool\nAspect Descr"] [-1.214914321899414, 14.30683708190918, "rds\n\u2022 Cre\nates a collection of maps to download or share online to communi-\ncate flood exposure\n\u2022 Pro\nvides guidance for using the maps to engage community mem-\nbers and stakeholders in conversations about potential coastal flood impacts\n\u2022\n Off\ners a"] [-1.2164044380187988, 14.307512283325195, "thor FLOODsite\nLocations where applied Europe\nMotivation for development \u201c[E]nables decision makers to integrate multiple and complex relationships \nbetween natural hazards, social and economic vulnerability, the impact of measures and instruments fo"] [-1.2271947860717773, 14.300765037536621, "sion-makers weigh potential conflicts among spatially-explicit management options that involve new activities or new infrastructure.\u201d\nUser interface \u2022\n Int\neractive website\n\u2022 Simp\nle interface\n\u2022 Ove\nrlays various basic boundary maps\n\u2022 \u201c[S\n]patially-e"] [-1.2181894779205322, 14.308094024658203, " It compares the services [provided] by the current utilisation of the landscape to estimates of its potential capability, and uses this information to identify areas where change might be beneficial, and where maintenance of the status quo might be "] [-1.2157871723175049, 14.307571411132812, "applicable tool\n\u2022 Use\ns widely used GIS tools\nSOURCE: NHDES, 2012.Summary Tables 91\nTable\u00a0A.26\nWatershed Resources Registry Riparian Zone Restoration Suitability Model\nAspect Description\nLead organization or author Maryland Watershed Resources Reg"] [-1.2165902853012085, 14.308004379272461, "ous state and local sources to assist the local emergency manager\nInput data requirements \u2022\n Nati\nonal Hurricane Center\u2019s forecast advisories\n\u2022 Hur\nricane evacuation study for the county or parish of interest\nOutputs \u2022 War\nning time for evacuation\n\u2022 "] [-1.2085388898849487, 14.314574241638184, "del connections, Delft-FEWS has also been applied in a wide range of different operational situations. Examples are water quality forecasting, reservoir management, operational sewer management optimization, and even peat fire prediction\u201d (Deltares, "] [-1.2161197662353516, 14.30941390991211, "vision offices\nLocations where applied\nMotivation for development \u201cThis mission encompasses the regulation of river flow through more than \n700\u00a0reservoirs, locks, and other water control structures located throughout the Nation.\u201d\nFunctionality Integr"] [-1.2196860313415527, 14.309779167175293, "t Flood Apex National Flood Decision Support Toolbox\nTable\u00a0A.33\nFlood Integrated Decision Support System, Melbourne\nAspect Description\nLead organization or author Flood Integrated DSS\nLocations where applied Melbourne Water, Melbourne, Australia\nMoti"] [-1.2138291597366333, 14.306864738464355, "d Apex National Flood Decision Support Toolbox\nProject Evaluation\nTable\u00a0A.35\nCoastal Louisiana Risk Assessment Model\nAspect Description\nLead organization or author RAND Corporation\nLocations where applied Coastal Louisiana\nMotivation for development "] [-1.2151901721954346, 14.307412147521973, "uitability for DHS and Flood APEX\nUncertainty and climate change Full risk analysis\nPortability Designed to be used around the world\nPotentially valuable to DHS? Might be difficult for communities to use the tool to consider trade-offs but \nprovides "] [-1.2159721851348877, 14.308186531066895, "X\nUncertainty and climate change Not explicitly but through which storms are used\nPortability Yes\nPotentially valuable to DHS? Yes, ability to both visualize impacts and estimate costs\nSOURCE: USACE, undated.Summary Tables 103\nTable\u00a0A.38\nHydrologi"] [-1.213297963142395, 14.309356689453125, "ping solution for the EU Flood \nDirective. The package comprises 5\u00a0modules including flood estimation, risk and damage assessment as well as map generation\u201d (p.\u00a01)\nFunctionality \u2022\n Inc\nludes MIKE FLOOD tool\n\u2022 Han\ndles tasks of the EU Floods Directive"] [-1.3079077005386353, 14.232277870178223, "4; Nujic, 1995; Neubert, Naumann, and Deilmann, 2009.106 Landscape Survey to Support Flood Apex National Flood Decision Support Toolbox\nTable\u00a0A.41\nTHESEUS Decision Support System Software Tool\nAspect Description\nLead organization or author THESEUS"] [-1.2146310806274414, 14.306742668151855, "n of risks\n\u2022 Floo\nd area\n\u2022 Pro\nbability of inundation plot\n\u2022 Pri\noritization of risk areas\nUser interface\nSuitability for DHS and Flood APEX\nUncertainty and climate change \u2022 \u201cMD\nSF2 .\u00a0.\u00a0. can explore a large number of scenarios very quickly, \nmaking "] [-1.1919968128204346, 14.311935424804688, " objectives in many plausible futures, rather than optimal in any single best estimate of the future\u201d (p.\u00a02).\nFunctionality \u2022\n Pre\nsented as a World Bank publication\n\u2022 Use\ns XLRM analytical framework\n\u2022 X: exo\ngenous uncertainties (e.g., population, c"] [-1.215417742729187, 14.306593894958496, "rge geography\nSOURCE: Groves and Sharon, 2013.Summary Tables 111\nTable\u00a0A.46\nRisk Mapping, Assessment and Planning\nAspect Description\nLead organization or author FEMA Risk Mapping, Assessment and Planning Program\nLocations where applied Widely used"] [-1.5005931854248047, 14.170875549316406, "e, \u201cSea Level Rise Planning Tool (NOAA, FEMA, Army Corps),\u201d June 2013.ADCIRC\u2014 See Advanced Circulation.\nAdger, W.\u00a0Neil, \u201cSocial and Ecological Resilience: Are They Related?\u201d Progress in Human Geography , Vol.\u00a024, \nNo.\u00a03, 2000, pp.\u00a0347\u2013364.Advanced Ci"] [-1.6208369731903076, 14.17033576965332, ": Evaluation of State Hazard Mitigation Plans Under the Disaster Mitigation Act,\u201d Natural Hazards Review , Vol.\u00a013, No.\u00a02, May 2012, pp.\u00a0139\u2013149.\nBerry, Christine, Josh Ryan-Collins, and Tony Greenham, Financial Systems Resilience Index: Building a S"] [-0.4436771869659424, 14.373023986816406, " Central, \u201cSurging Seas,\u201d undated. As of June\u00a023, 2017: \nhttp://sealevel.climatecentral.org/\nCoastal Protection and Restoration Authority, \u201cWelcome to CPRA\u2019s Master Plan Data Viewer,\u201d undated. As \nof October\u00a01, 2016: http://cims.coastal.louisiana.gov"] [-1.4913328886032104, 14.192902565002441, "r\u00a0G. Burton, and Christopher\u00a0T. Emrich, \u201cDisaster Resilience Indicators for Benchmarking Baseline Conditions,\u201d Journal of Homeland Security and Emergency Management , Vol.\u00a07, No.\u00a01, \n2010, art.\u00a051.\nDeltares, untitled about page, undated\u00a0(a). As of Ju"] [-1.4082473516464233, 14.163162231445312, ". As of June\u00a018, 2017: \nhttps://www.fema.gov/media-library/assets/documents/23194\u2014\u2014\u2014, FEMA Strategic Plan 2014\u20132018 , Washington, D.C., July\u00a018, 2014. As of June\u00a018, 2017: \nhttps://www.fema.gov/media-library/assets/documents/96981\u2014\u2014\u2014, \u201cRegion\u00a0II Coas"] [-1.7390496730804443, 14.135619163513184, "Vol.\u00a0530, February\u00a018, 2016, pp.\u00a0307\u2013312.\nGardner, Mark\u00a0R., and W.\u00a0Ross Ashby, \u201cConnectance of Large Dynamic (Cybernetic) Systems: Critical Values for Stability,\u201d Nature , Vol.\u00a0221, November\u00a021, 1970, p.\u00a0784.\nGlobal Risk Information Platform, United "] [-1.4738181829452515, 14.180825233459473, "Fifth International Conference on Intelligent Human\u2013Machine Systems and Cybernetics , IEEE Computer Society, 2013, pp.\u00a050\u201353.118 Landscape Survey to Support Flood Apex National Flood Decision Support Toolbox\nHughes, Karl, and Helen Bushell, A Mult"] [-1.399925947189331, 14.118078231811523, "r-floodplain-section/documents/ \nflood-hazard-management-plan-update.aspxKirby, David, Flood Integrated Decision Support System for Melbourne , c.\u00a02015. As of October\u00a01, 2016: \nhttp://www.floodplainconference.com/papers2015/David%20Kirby%20Full%20Pa"] [-1.4236040115356445, 14.17173957824707, "CI\u2014 See Land Utilisation and Capability Indicator.\nMaryland Department of the Environment, \u201cFinal 2010 Integrated Report of Surface Water Quality in \nMaryland,\u201d April\u00a02, 2010. As of June\u00a028, 2017: http://www.mde.state.md.us/programs/Water/TMDL/Integr"] [-1.5679819583892822, 14.155974388122559, "San Diego, CA \nWorkshop , February\u00a011, 2015a. As of July\u00a013, 2017: \nhttps://www.nist.gov/sites/default/files/documents/el/building_materials/resilience/ \nFramework_LineNumbered_75-25_11Feb2015.pdf\n\u2014\u2014\u2014, Community Resilience Planning Guide for Buildin"] [-1.6059410572052002, 14.172706604003906, "cal Infrastructure Security and Resilience , Washington, D.C.: White House, Presidential \nPolicy Directive\u00a021, February\u00a012, 2013. As of June\u00a021, 2017: https://obamawhitehouse.archives.gov/the-press-office/2013/02/12/presidential-policy-directive-crit"] [-1.7775583267211914, 14.172186851501465, "e of Coastal Resilience Indicators\u2014A Final Report , Coastal Services Center and National Oceanic and \nAtmospheric Administration, December 2010.122 Landscape Survey to Support Flood Apex National Flood Decision Support Toolbox\nPearce, David\u00a0W., an"] [-2.0176053047180176, 14.187371253967285, "nd Michel \nBruneau, A Framework for Defining and Measuring Resilience at the Community Scale: The PEOPLES Resilience \nFramework , University at Buffalo, State University of New York, Multidisciplinary Center for Earthquake \nEngineering Research, Tech"] [-1.5233858823776245, 14.158145904541016, "gency Management, Seattle All-Hazards Mitigation Plan , July 2009. As of June\u00a019, 2017: \nhttp://www.seattle.gov/Documents/Departments/Emergency/PlansOEM/HazardMitigation/\nSeattleMitigationPlan.pdf\n\u2014\u2014\u2014, Comprehensive Emergency Management Plan: Base Pl"] [-1.4883370399475098, 14.202292442321777, "a Disaster-Resilient Community: A Guidance Note , version\u00a02, November 2009.\nUK Environment Agency\u2014 See United Kingdom Environment Agency.\nUNISDR\u2014 See United Nations Office for Disaster Risk Reduction.\nUnited Kingdom Environment Agency, Framework and "] [-1.355924367904663, 14.184064865112305, "ronmental Effects Research Laboratory, EPA/600/R-15/059, \nNovember 2015. As of July\u00a014, 2017: https://www.epa.gov/sites/production/files/2016-03/documents/wmostv2_userguide_508final.pdfReferences 125\n\u2014\u2014\u2014, \u201cExposure Assessment Models: WMOST\u00a02.0 Doc"] [-1.907747507095337, 14.096800804138184, "l, and Philippa Howden-Chapman, \u201cUnderstanding Resilient \nUrban Futures: A Systemic Modelling Approach,\u201d Sustainability , Vol.\u00a05, No.\u00a07, 2013, pp.\u00a03202\u20133223.\nZiyath, Abdul\u00a0M., Melissa Teo, and Ashantha Goonetilleke, \u201cSurrogate Indicators for Assessin"] [10.239205360412598, 4.889767169952393, "TRACY C. KRUEGER, SEAN ROBSON, KIRSTEN M. KELLER\nAn Examination of \nRecruiting and Selection Practices to Promote Diversity for Colorado State Troopers\nThe Colorado State Patrol (CSP) has recently increased investments to attract, select, and \ntrain "] [10.245078086853027, 4.887312412261963, "atives to improve recruit -\ning and selection at CSP, trends in the demographic composition of recent CSP hires, and a discussion of potential barriers to hiring qualified troopers while also diversifying the CSP workforce. The third section provides"] [10.235380172729492, 4.889532566070557, "ies\nRJP realistic job preview\nSME subject-matter expert3\n \u0224 describe current policies and practices for \nre\ncruiting and selection\n \u0224 ide\nntify potential barriers to recruiting \nand selecting a qualified and diverse set of \ntroopers.\n\u2022 We r\neviewed t"] [10.231550216674805, 4.889061450958252, " jeopardy, assisting other agencies, disaster mobilization, and crowd control. A cadet learns to formulate action plans that anticipate continuously changing circumstances and how to resolve emergencies.\n\u2022\n Att\nend training and certification courses\u00a0"] [10.235031127929688, 4.890584945678711, "econd classes of 2018 (i.e., 2018-1 and 2018-2).\n11 \nWe emphasize that timelines are specific to each class or cohort hired. Efforts are under way to shorten the duration of the background investigation. 2. Findings: Ongoing Initiatives, \nDemographi"] [5.772347450256348, 3.8146986961364746, " evaluation\u2014developed by an external consulting firm\u2014assesses basic educational skills, emotional outlook, interpersonal skills, and practical skills.\nb Candidates are given three hours and 15 minutes to \ncomplete the multiple-choice test, which is s"] [10.21882152557373, 4.887985706329346, " and two CSP commissioned officers. The interview is conducted in person or via video chat and is expected to take 15 to 25 minutes. The panel provides independent ratings on a five-point Likert scale (from 1= less desirable/poor to 5 = most desirabl"] [10.23285961151123, 4.890414237976074, "tant Contact emails In 2016, CSP designed and implemented the distribution of a standardized email to all individuals who express interest in CSP and provide their email address. This email communication offers a structured and systematic way to enga"] [10.232194900512695, 4.891537666320801, "hnic minority applicants and an increase of 17 percent-age points in racial/ethnic minority appointees. Additionally, when compared to 2014, there has been an average increase of 3 percentage points in female applicants and female appointees. \nDespi"] [10.234513282775879, 4.891109466552734, " attracted to organizations whose members are similar to themselves in terms of personality, values, interests, and other attributes, and (2)\u00a0organizations are more likely to select those who possess knowledge, skills, and abilities (KSAs) similar to"] [10.234658241271973, 4.89078426361084, "asons not to join. From our review, there has been limited investigation of propensity to apply in law enforcement.\nNature of the jobThe CSP trooper position emphasizes patrolling highways and roads, which may not appeal to everyone interested in law"] [10.2401123046875, 4.888960838317871, "ected if they have particularly strong family ties and may subsequently be less inclined to relocate. There is an emerging literature regarding the \u201cfamily-relatedness\u201d of work decisions\nl and understanding how to \nbetter promote \u201csustainable careers"] [10.23194408416748, 4.887234687805176, "t a highly qualified and diverse pool of applicants.One of the strongest factors influencing increases in organizational diversity is establishing positions with responsibility for diversity efforts.\np \na David Rollins, Executive Accreditation Report"] [10.234580993652344, 4.890805721282959, " determine the accuracy of these perceptions. In some cases, the data needed to evaluate a finding may not be available; therefore, CSP may need to initiate efforts to collect additional data. \nA review of these key findings suggests that CSP \nmay ha"] [10.235029220581055, 4.891205787658691, "sources\nHirePropensity to\napply to CSPProcess and\nresource\nmanagement\nSOURCES: Adapted from Greg Ridgeway, Nelson Lim, Brian Gifford, \nChristopher Koper, Carl F. Matthies, Sara Hajiamiri, and Alexis K. \nHuynh, Strategies for Improving O fficer Recrui"] [10.235876083374023, 4.891041278839111, "d labor market conditions.\nPolicy factors Recruiting resources \u2022 Al\nign key features of the role and CSP with marketing materials.\n\u2022 En\ngage in precision recruiting of highly qualified women and racial/ethnic \nminorities. \n\u2022 Co\nntinue building resou"] [10.244291305541992, 4.892412185668945, "nd we encourage future efforts to continue identifying best practices for using social media in order to recruit a highly qualified and diverse pool of applicants to positions in law enforcement. Propensity to Apply to CSP\nAlthough CSP has basic demo"] [10.241886138916016, 4.891347885131836, "orkers, job).29 These \nscales could be combined with other custom items for a survey that can be used to develop profiles that characterize low and high performers and describe characteristics of the job and the working environ-ment. These profiles c"] [10.235989570617676, 4.891269207000732, " target the relevant population, including the use of web-based, phone-based, and traditional paper-and-pencil surveys. \nMonitor Demographic Trends and Labor Market \nConditions\nUsing the information collected from the propen -\nsity analysis, CSP sho"] [10.236042022705078, 4.891708850860596, "tics emphasized are representative of CSP and are important to the targeted applicant pool. For exam-ple, prior research for police departments in Southern California indicated that applicants not only wanted to serve their communities but also had a"] [10.233867645263672, 4.8898491859436035, " increase perceived attrac-\ntiveness of the job and the organization, CSP should use women and racially/ethnically diverse recruiters to hold recruiting events that target female and racial/ethnic minority applicants (e.g., use a female recruiter at "] [10.236358642578125, 4.8915934562683105, "ocation of recruiting resources. 17\nAdjust Application Windows\nCurrently, when a new position at CSP is advertised, \nan individual must submit an application within 14 days. In addition to the short window to complete an application, the dates for p"] [10.229269027709961, 4.889193534851074, "net as the place where they heard about the position. Over 30 per-cent of responses contained a term related to the Colorado government website (e.g., \u201cColorado gov,\u201d \u201cColorado.gov,\u201d \u201cstate website,\u201d \u201cColorado jobs,\u201d \u201cstate agency website\u201d). Over 10 "] [10.235786437988281, 4.890900611877441, "e hired. These data could also be supplemented with open-ended com-ments from recruiters to share additional insights on the event or suggestions for future events. \nThe data collected from this type of tracking \nsystem would allow CSP to develo"] [10.22542667388916, 4.890312194824219, " in lower passing rates for a subgroup. Although lower passing rates for a subgroup does not necessarily indicate that 19\nthe test is biased, additional steps should be followed \nto ensure that each test section is related to the job. If the test sec"] [10.231046676635742, 4.890588283538818, "do not know how to gather the information requested. To address this concern, CSP could imple-ment a preliminary background assessment as an early indicator of potential issues. The Los Angeles Police Department encourages applicants to complete a pr"] [10.244897842407227, 4.888055324554443, "gible and interested in working for CSP. The results will also need updating regularly to correspond with potential changes in the demographic composition and interests of the Colorado workforce. \nTABLE 3.2\nPrioritized Project Recommendations\nPriorit"] [10.23238754272461, 4.89011812210083, ", the recruiters also conduct background investigations. \n10 Justin Mullins, 2016 Analysis Report; 2017 Recruitment, Affir-\nmative Action and EEO Plan , Colorado State Patrol, undated.\n11 The label \u201c2018-1\u201d signifies the year and training academy \ns"] [10.219361305236816, 4.887945652008057, "pendent on passing this assessment. CSP explained that this change was inspired by annual trooper requirements: Troopers are required to take an annual physical fitness test, but they are not required to pass. Nevertheless, several CSP SMEs suggested"] [10.236351013183594, 4.878303527832031, "limate,\u201d International Journal of Management , Vol.\u00a026, \nNo.\u00a03, 2009, p. 347.\n41 Adopting a longer-term perspective, we emphasize the impor-\ntance of ensuring that efforts to recruit more women and racial/ethnic minorities do not take away from the c"] [10.29948616027832, 4.892964839935303, "ce Brand Equity,\u201d Journal of the Academy of Marketing Science , Vol. 28, No. 1, 2000, \npp 128\u2013137; and Kevin Lane Keller, \u201cConceptualizing, Measur-ing, and Managing Customer-Based Brand Equity,\u201d Journal of Marketing , Vol. 57, No. 1, 1993, pp. 1\u201322.\n"] [10.292763710021973, 4.89152717590332, "an Educational \nResearch Association, 2014.\nBerry, Leonard L., \u201cCultivating Service Brand Equity,\u201d Journal of \nthe Academy of Marketing Science , Vol. 28, No. 1, 2000, pp.\u00a0128\u2013\n137.\nBreaugh, James, \u201cEmployee Recruitment: Current Knowledge \nand Import"] [10.281522750854492, 4.856861591339111, "e-74 \nGreenhaus, Jeffrey H., and Ellen Ernst Kossek, \u201cThe \nContemporary Career: A Work-Home Perspective,\u201d Annual Review of Organizational Psychology and Organizational Behavior , Vol. 1, 2014, pp. 361\u2013388.\nGreenhaus, Jeffrey H., and Gary N. Powell, \u201c"] [10.256973266601562, 4.8736371994018555, "s/monographs/MG881.html\nManhardt, Philip J., \u201cJob Orientation of Male and Female College \nGraduates in Business,\u201d Personnel Psychology , Vol. 25, 1972, \npp.\u00a0361\u2013368.\nMatthies, Carl F., Kirsten M. Keller, and Nelson Lim, Identifying \nBarriers to Diver"] [10.280677795410156, 4.879534721374512, "er Rees, Tom Jordan, and Jason Cheney, Cop Crunch: Identifying Strategies for Dealing with the Recruiting and Hiring Crisis in Law Enforcement , Washington, D.C.: National Institute of Justice, \nNCJ 213800, 2005. \nvan Saane, N., Judith K. Sluiter, Ad"] [10.32010269165039, 4.866020202636719, "n this publication, visit www.rand.org/t/RR2999.\n\u00a9 Copyright 2019 Community Oriented \nPolicing Services (COPS)About This Report\nThe Colorado Department of Public Safety continues to seek ways to improve \nrecruiting and hiring practices across its wo"] [11.319363594055176, 16.60950469970703, "Eric HellandThe Role of Health \nCare Liens in Litigation and RecoveryCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation \nof RAND intellectual property "] [11.322230339050293, 16.637638092041016, "ore and smaller liens than private lien holders.iv The Role of Health Care Liens in Litigation and Recovery\nRAND Institute for Civil Justice\nICJ was founded in 1979, and it has been dedicated to making the civil \njustice system more efficient and "] [11.31884479522705, 16.61094856262207, "ghts for Health Care Providers ................... 7\nMedicare: The 800- Po\nund Gorilla ............................................... 7\nMedicaid: The Importance of the State- Fe\nderal Partnership \nfor Liens ...................................."] [11.32237720489502, 16.61043357849121, "3.1. Breakdown of Claimants and Cases over \n1\n00 Compensation Events ............................................ 23\n3.2. Nu\nmber of Events by Category and Average Total \nPayment by Event (2008\u20132017) ........................................ 25\nA."] [11.319962501525879, 16.60431671142578, "the same rights as the Center for Medicare Ser vi\nces with \nregard to settling parties. Thus, Medicare, Medicaid, and Medicare Part\u00a0C plans now all have super lien rights.\nThis study examines how frequently health care liens appear in \nlarge litigat"] [11.318314552307129, 16.604005813598633, " \npar ti\nc u la\nr lien type dominates the recovery.\nAlthough lien rights for Medicare Part\u00a0C and Medicaid are ex -\npanding, th\nere is no evidence of a trend in the number of health care \nliens. However, our data cover only 2008\u20132017, so some care mu"] [16.05286979675293, 17.236499786376953, "nsation\nCMS Ce\nnter for Medicare Services\nERISA Em\nployee Retirement Income Security Act\nFEHBA Fe\nderal Employees Health Benefits Act\nICJ RA\nND Institute for Civil Justice\nMAIS Me\ndical Assistance Intercept System\nMDL mu\nltidistrict litigation\nM"] [11.325043678283691, 16.60211753845215, "ly aimed for mass settlement.\n Th\nere have been numerous discussions of the prob le\nms with pro -\nce\nssing a massive number of claims through a court system that has \ntraditionally been focused on providing individualized justice (see Nagareda, 2008"] [11.321224212646484, 16.6047420501709, "ple, \n un\nless the lien is resolved, it is often difficult to \n set\ntle a claim simply bec\nause the plaintiff may have liens larger than \na settlement offer, thus making the plaintiff indifferent when faced with the choice between taking the settlem"] [11.323440551757812, 16.6043643951416, "nsion of such \u201csuper lien\u201d rights into Medicaid and other statutory liens has compounded the complex -\nity of settlement (see Dixon and Kuznitsky, 2017).\nTo understand how burdensome litigants find medical liens, con -\nsider the Reno Air disaster. On"] [11.318718910217285, 16.61111068725586, "less frequently, plaintiffs themselves. Increasingly, however, not only plaintiffs and their \n la\nwyers but now defendants and third- pa\nrty \ninsurers must deal with liens against the injured parties for failure to pay child support, reimbursement f"] [11.313868522644043, 16.60173797607422, "unable to pay for some other reason, the expense falls to the secondary payer.\n3 Although the origin of the Medicare liens and King Kong analogy is somewhat obscure, \nSchmidt (2006) cites Tate and Holloway (2005) as first using this characterization."] [11.305841445922852, 16.60411262512207, "tes v. Baxter Int\u2019l, Inc. , 345\u00a0 F.3d 866, 875 (11th\u00a0 Cir. \n2003) and Thompson v. Goetzmann , 337\u00a0F.3d 489, 498 (5th\u00a0Cir. 2003) as examples of the \ndiffering approaches across cases. In Goetzmann the Fifth Cir cu\nit denied Medicare\u2019s right \nto coll"] [11.318246841430664, 16.5963077545166, ".S.C. 1395y(b)(3)(A))\u2014\n he\nnce our characterization of them as a bundle of rights.\n9 The fines can be up to $1,000 per day for failure to report or erroneous reporting. See 42 \nU.S.C. 1395y(b)(2)(B)(iii):\nIn order to recover payment made un der this"] [11.31448745727539, 16.612083435058594, "mented a three-\n ye\nar statute of limitations for CMS to pursue recovery.Background on Lien Rights for Health Care Providers 11\nthat were settled years ago\u2014 th ey we re the plaintiffs\u2019 and the plain -\ntiffs\u2019 la\nwyers prob le\nm. (Dixon and Kuz"] [11.314288139343262, 16.615280151367188, "as limited to recovering only the portion of a \n le\ngal judgment \nspecifically allocated to medical bills.11 Heidi Ahlborn of Arkansas \nwas injured in an accident and Medicaid paid for her treatment. Subse-quent to the payment, she sued the driver of"] [11.315176010131836, 16.597606658935547, " we\nre placed in a le\ngal position inferior to their counter pa\nrts\u2019 in \nMedicare. If the plaintiff \u2019s \nmedical costs had been paid by Medicare\u2014 \nan\nd not by Medicaid, as was actually the case\u2014 th\ne plaintiff would have \nclearly owed the full a"] [11.310903549194336, 16.59678840637207, " Supreme Court denied certiorari on the plaintiff\n \u2019s a\nppeal. The decision allows Part\u00a0C plans \nessentially the same rights as CMS with regard to settling parties.15 Thus, \nMedicare, Medicaid, and Medicare Part\u00a0C plans now all have super lien rights"] [11.320345878601074, 16.59641456604004, "not covered by insurance, \nand hence would only be compensated via the settlement, have highest priority. Fi na\nlly, Cali -\nfornia has a common fund rule un\nder which liens are reduced by the same percentage as the \ncontingent fee the client is bei"] [11.320547103881836, 16.598526000976562, "ly assign lien rights via contract; however, a \nnumber of states hold that a settling party can be held liable if they have knowledge of the health plan\u2019s claim before settlement. In \n th\nese \n19 Federal employees are covered by FEHBA (1959).\n20 In 2"] [11.320062637329102, 16.6003475189209, " hold \n th\nose funds as a fiduciary, for the benefit of the client and third party. \nThis duty includes a duty to notify the client and third party, and to deliver the property to the client and third party. This rule exists, in large part, to protec"] [11.322985649108887, 16.59959602355957, "r the Reno Air Show injuries would each represent a compensation event. Although each might involve hundreds of plaintiffs across multiple law firms, we aggregate the claims for the purposes of this study. The earliest claims date from 1992, although"] [11.318527221679688, 16.604175567626953, "imately 2,900 claimants and 3,500 cases, but the smallest event has only 2 claimants (and cases), while the larg -\nest has over 48,000 claimants and over 56,000 cases.\n1\nTo give a better sense of the temporal dimension of the data and \nthe size of th"] [11.323561668395996, 16.599634170532227, "er the Sample Period (96 compensation events)\nNOTES: Sample size = 96 compensation events in which the \ufb01rst case was \nresolved after January 2008. Area of symbol proportional to number of cases.\nRAND RR2393-3.1Earliest settlementJan-2008 Jan-2011 Jan"] [11.321640968322754, 16.598770141601562, "n\u2019s prominence among federal MDL cases, the larg -\nest compensation event type in the Garretson data. Exposure cases rank second in terms of number of events, ahead of device implantation cases. Interestingly, device implantation cases are the larges"] [11.319184303283691, 16.602275848388672, "ursing smaller Medicare liens that the private plans, for example, would not find lucrative to attempt to recover. Confounding this interpretation is the fact that private insurance fee schedules are generally higher than Medicare, so we would expect"] [11.303531646728516, 16.637495040893555, "xtensive recovery pro ce\nss, \nwhich includes statutory reductions for attorney fees and expenses.3 \nMedicaid, by contrast, is the second most frequent lien type, but the average Medicaid lien recovery value is less than the average Medicare lien rec"] [11.32025146484375, 16.603544235229492, "r Medicare\u2019s recovery.Figure\u00a04.4\nThe Distribution of Resolved Liens\n05101520Frequency of Occurrence\n0 0.5 12 1.5\nNOTE: Sample size = 96 compensation events.\nRAND RR2393-4.4Average number of liens per case (all types)34 The Role of Health Care Lien"] [11.317835807800293, 16.61458969116211, " This is the gross amount, so attorneys\u2019 fees (typically one-\n th\nird), expenses, \nand non\u2013 he\nalth care liens would need to be deduced from this amount \nto capture the net amount to clients. As shown in the chart, liens, on average, make up less th"] [11.321571350097656, 16.603778839111328, "s, we control for the \n6 The fixed effects are an indicator variable equal to one if the first case in the event was \nresolved in a given year (i.e., the indicator variable for year 2009 equals one if the first case for \nevent X was resolved in 2009)"] [11.323441505432129, 16.602237701416016, "The Role of Health Care Liens in Litigation and Recovery\nto resolve health care liens associated with the claim. For this reason, \nchanges in the composition of the Garretson Group\u2019s business could mask any trends. Fi\n na\nlly, it is worth reiterating"] [11.3102445602417, 16.6015567779541, "ce Supreme Court denied cert in In re Avandia in \n2013No, \n u\nnless \n th\nere is a \ncontract provision with individual insurer Varies by state and individual insurance contractNo, \n u\nnless \n th\nere is a \ncontract provision with individual insurerApp"] [11.317347526550293, 16.613508224487305, "Data for Figure\u00a04.8\nProgram Type Medicare MedicaidOther \nGovernment PLRP Private\nConsumer product 34.40 28.16 19.52 0.00 17.92\nExposure 71.48 14.31 7.09 0.17 6.96\nMalpractice 79.20 18.43 0.00 0.00 2.37\nMedical device implantation 25.78 13.42 28.42 5."] [11.320029258728027, 16.599937438964844, "Resolution Group, \u201cWhat Is a Private Lien Resolution Program?\u201d \nSeptember\u00a030, 2013. As of April\u00a030, 2018: https://web.garretsongroup.com/claimant-education-posts/claimant-education/private-lien-resolution-program\n\u2014\u2014\u2014, memo, March\u00a023, 2016.Heaton, Pa"] [11.240045547485352, 16.653854370117188, "2, 2006, pp.\u00a0469\u2013489.\nShavell, Steven, Foundations of Economic Analy si\ns of Law , Cambridge, Mass.: \nHarvard University Press, 2009.\nSMART Act\u2014 See S\ntrengthening Medicare and Repaying Taxpayers Act.\nSpier, Kathryn\u00a0E., \u201cLitigation,\u201d in A. Mitchell"] [11.635604858398438, 18.071552276611328, "SOCIAL AND ECONOMIC WELL-BEING\nWage Loss Monitoring \nfor Injured Workers in California\u2019s Workers\u2019 Compensation System\n2014\u20132015 Injury Year Findings (Second Interim \nReport)\nMichael Dworsky, Stephanie Rennane, Nicholas Broten\nSponsored by the Califor"] [11.369194030761719, 17.595840454101562, "n, motivate the need to gather an accurate and up-to-date estimate of wage loss for all injured workers in the state. \nRAND Institute for Civil Justice \nThe RAND Institute for Civil Justice (ICJ) is dedicated to improving th e civil justice system \nb"] [12.27264404296875, 18.070079803466797, "eptual Framework .......................................................................................................... ................ 12 \t\nEarnings Dynamics Through Injury for Injured and Uninjured Workers ....................................."] [12.330106735229492, 18.047199249267578, "................... 18 \t\nFigure 2.3. At-Injury Employment Rates for Injured and Control Workers ................................ 19 \t\nFigure 2.4. Trajectory of Injured to Control Earnings Ratio, 2014\u20132015 Injured Workers ......... 21 \t\nFigure 3.1. Tr"] [12.324187278747559, 18.020776748657227, ".......................................................................... 16 \t\nTable 3.1. Average Earnings Losses and Labor Market Outcomes by Year of Injury ................. 28 \t\nTable 3.2. Injured Worker Sociodemographics, Injury Characteristics,"] [12.289822578430176, 18.013389587402344, ".......... .......... 65 \t\nTable A.9b. Changes in Relative Earnings Comp ared to Overall Average, by Industry of \n Injury ....................................................................................................................... ........"] [11.663758277893066, 18.10837173461914, "portant \nobjective for workers\u2019 compensation policy. This is true for several reas ons. Above all, the \nemployment and earnings of disabled workers can reflect successful reco very, rehabilitation, or \nadaptation, and thus may be viewed as indicator"] [11.640867233276367, 18.234886169433594, " employers and self-insure as a private group or as a joint \npublic authority. \nNonfatal workplace-related injuries or illnesse s may be classified as medical-only, temporary \ndisability, or permanent disabi lity. Medical-only claims involve no lost "] [11.937909126281738, 18.18491554260254, " the number of new workers\u2019 \ncompensation claims reported to date has reached 670,000 in the 2017 injury year. \n6 About one-third of workers with paid or settled perm anent disability benefits do not receive any temporary \ndisability benefits. 3 inju"] [11.828178405761719, 18.339153289794922, ",\n8 including the \n \n7 The Workers\u2019 Compensation Rating Bureau of California, which develops rates for commercial insurers that serve \nthe California market, reports that PPD benefits were 41 pe rcent o"] [11.787814140319824, 18.255126953125, " system was \nrelatively modest between 2013 and 2014. Bills affecting benefits or compensability have largely \nfocused on peace officers, public safety workers, or narrower groups of workers (such as horse \nracing jockeys or professional athl etes). "] [11.899466514587402, 18.317190170288086, "ead, the most substantial changes to the workers\u2019 compensation system in 2014 and 2015 \nwere most likely those associated with cont inued implementation of SB 863. Increases in \npermanent disability (PD) benefits under SB 863 be gan to phase in for i"] [12.091973304748535, 18.14206886291504, "ry and increase the risk of poor labor ma rket outcomes. At the \nsame time, increased labor demand due to economi c growth means that employers may be more \nmotivated to accommodate workers after an inju ry, or that workers who end up leaving a job \n"] [11.793636322021484, 19.012067794799805, "hapter 2 of Dworsky, Rennane, and \nBroten (2018); readers interest ed in a more complete introdu ction to our methods should \nreference that study. \nData for Wage Loss Monitoring \nWe make use of several administrative data sour ces for this project, "] [11.80589771270752, 19.052675247192383, "idual-level claims data in California that captures all \nmarket segments (including self-insured and pub lic-sector employers). Given the absence of any \nmore reliable benchmark, this study will follow Dworsky et al. (2016) in treating FROI reported"] [12.1866455078125, 18.1359920501709, "concern in this report than they we re in Dworsky, Rennane, and Broten (2018). \nTo examine the potential impact of right-censori ng on the trends reported here, we used data \non the start date of indemnity be nefits to identify all claims from the 20"] [12.279074668884277, 18.42104148864746, "y benefits have not started yet and claims that have \nnot yet been filed. 11 in the Base Wage File. Both workers\u2019 compensa tion and UI are nearly universal in California, \nand so the wage and salary earnings of nearly all workers filing worker s\u2019 com"] [12.499021530151367, 18.33944320678711, "s for a shorter window of time (one year pre-injury to two years post-injury) than in the earlier study. The \nprocedures used to define consistent names are otherwise identical to those described in Dworsky et al. (2016). Name consistency flags were "] [12.485647201538086, 18.338241577148438, "ol wo rkers to the analysis ma kes it possible to rely \non much weaker assumptions than would be necessa ry if we had data on only injured workers\u2019 \nearnings. In this case, our key a ssumption is that, in the absence of the injury, the earnings of \ni"] [12.489870071411133, 18.368106842041016, "kers who have been \nlucky enough not to experience a job separation or an earnings decline for reasons unrelated to \nworkplace injury. This might seem reasonable in some employment settings with high job \n "] [12.486968040466309, 18.3633975982666, "s, effectively letting the data tell us what level of earnings growth \nor employment risk should be expected give n the experience of other workers at the same \nemployer. A valid control group such as the one used in this study allows us to isolate t"] [12.445294380187988, 18.436208724975586, " ag e, gender, self-insured status, \nand the pre-injury weekly wage.4 The pre-injury weekly wage is by far more likely than these \nother variables to be missing. A bout 11 percent of FROIs from good claims administrators are \ncasewise-deleted based "] [12.487581253051758, 18.30170440673828, "Overall % of FROI in analytic sample 72% \nSOURCE: 2005\u20132015 WCIS-EDD data. \nEarnings Dynamics Through Injury for Injured and Uninjured Workers \nTo illustrate our matching methodology, we now show the trajectories of earnings, \nemployment, and at-inju"] [12.496003150939941, 18.290658950805664, "05\u20132015 WCIS-EDD data. \nThe key assumption justifying our method for es timating earnings loss is that injured and \ncontrol workers would have contin ued to have nearly identical tr ajectories if the injury had not \ntaken place. This assumption is in"] [12.487366676330566, 18.274303436279297, "laces them at risk of workplace \ninjury). The control workers offer a data-drive n way to adjust injured worker outcomes for \nordinary labor market dynamics and t hus isolate the impact of injury. \nFigure 2.3 shows injured and control worker tr ajec"] [12.302672386169434, 18.08192253112793, "at will ultimately be filed is more complete at any given point in time than the observed population of claims that will ultimately receive indemnity benefits. This means that overall \ntrends can be estimated on a more timely basis than trends for in"] [12.451376914978027, 18.232343673706055, "s. .6.7.8.91(I/C) Quarterly Earnings\n-4 -3 -2 -1 0 1 2 3 4 5 6 7 8\nQuarter Relative to Injury\nMedical-only\nIndemnity22 Definition of Economic Outcome Measures \nWe use several different measures to char acterize outcomes for injured workers. To \nfamil"] [12.493450164794922, 18.271997451782227, " If an injured worker matche s to multiple control workers, we use the average \noutcome for the selected c ontrol workers to construct \u0bdc,\u0be7\u0bbc. Outcomes are averaged over the sample of N injured \nworkers. We note that, by construction, all groups contai"] [12.47903060913086, 18.147232055664062, " binary variable equal to one if injured worker i is employed t quarters after the quarter of injury and \nzero if injured worker i is not employed t quarters after the quarter of injury. \u0bdc,\u0be7\u0bbc is defined as the proportion of \nworker i\u2019s control worke"] [12.3505277633667, 18.041690826416016, "loss that behave differently \nfrom the overall average by running a regression interacting each subgroup with the time periods of interest in the study. These estimates capture whether particular gr oups experience changes \nthat are different from t"] [12.35072135925293, 18.035429000854492, "ady, relative at-injury employment actually \ndeclined slightly in 2014 and 2015. Relative at -injury employment during the first and second \npost-injury year was 87 and 80 percent, resp ectively, compared to 88 and 82 percent, \nrespectively, in 2013."] [12.342385292053223, 17.971403121948242, "medical-only and indemnity claims. \nWorker Characteristics and Changes in Case Mix \nTo examine the extent to which the changes (or lack of changes) in earnings losses can be \nexplained by worker characteristics rather th an economic or policy f actor"] [12.320272445678711, 17.964256286621094, " 25% 27% 27% 26% \nSOURCE: 2005\u20132015 WCIS. \nNOTE: Sample contains all injury claims in analysis sample, including medical-only and indemnity claims. \n \nto 26 percent in 2014\u20132015. As me ntioned earlier, the lower share of workers receiving \nindemnity"] [12.341583251953125, 17.957395553588867, " 16% 15% 18% 19% \nFirm Size \n1\u201310 employees 4% 4% 4% 4% 3% \n11\u201350 employees 11% 10% 10% 10% 10% \n51\u2013100 employees 7% 7% 6% 7% 7% \n101\u2013500 employees 19% 18% 18% 19% 19% \n501\u20131,000 employees 9% 9% 9% 9% 9% \n1,001\u20135,000 employees 23% 23% 23% 23% 23% \nOv"] [12.34260368347168, 18.025402069091797, " \nEarnings relative to counterfactual \nFirst post-injury year 81% 78% 76% 76% 76% \nSecond post-injury year 85% 80% 79% 80% 81% \nRelative employment \nFirst post-injury year 89% 84% 83% 84% 85% \nSecond post-injury year 90% 84% 84% 86% 88% Relative at"] [12.355755805969238, 18.027820587158203, "s explained by case-mix changes over the business cycle. The \nfact that case-mix adjusted earnings losses also fluctuated over the business cycle suggests \nthat the state of the labor mark et directly affects the post-in jury employment prospects of"] [12.286882400512695, 18.019527435302734, "s can help establish a set of agreed-upon \nfacts to inform discussion of both broad reform s and targeted interventi ons to improve worker \noutcomes. While RAND has examined factors associated with wage loss among permanently disabled workers in prev"] [12.331368446350098, 17.992687225341797, "ine, workers in that subgroup have lower relative earn ings than the average worker. \nAs described in Chapter 2, we also tested fo r statistically signifi cant differences between \ngroup-specific trends and overall average trends. These statistical t"] [12.364819526672363, 18.001834869384766, "e regression coefficients in Table A. 9a show that relative earnings for workers in \n37 firms with 11\u201350 employees increased faster than the statewide trend between 2013 and 2014\u2013\n2015, even after adjusting for multiple hypothesis testing. \nFigure 4."] [12.33035945892334, 18.004825592041016, " the \nGreat Recession. Relative earnings for lower-tenu red workers are approximately 8 percentage \npoints lower on average, with some convergence after the Great Recession. While earnings for \n39 higher tenured workers have begun to increase in 201"] [12.305854797363281, 17.965675354003906, " \nmultiple injuries have significantly lower injuries over the entire decade. The trends in earnings \nlosses are relatively flat across all of thes e subgroups, however, and we do not detect any \nstatistically signifi cant changes in 2014\u20132015. \n41 "] [12.234532356262207, 17.927886962890625, "th cumulative \ninjuries in Southern California, and so we ha ve updated these estimates through the 2015 injury \nyear to evaluate whether th ere has been any improvement. \nFirst of all, similar to Figure 4.5, Figure 4.8 demonstrates workers with cumu"] [12.334187507629395, 17.991432189941406, "er were thus essentially unchanged from the 2013 injury year. Among workers injured in \n2014\u20132015 who received indemnity benefits, earnings we re 81 percent of what they would have \nbeen in the absence of the in jury. Although injured worker earnings"] [12.423474311828613, 18.1888484954834, "ificant, and so we cannot draw the conclusion that labor market outcomes \nchanged for workers injured at very large employers. Taken t ogether, these changes in the \ncase mix are much smaller than those observed after the start of the Great Recessio"] [12.542040824890137, 18.319049835205078, " job tenure at the at-i njury firm did not match the \ninjured worker\u2019s tenure. We defined tenure as the number of consecuti ve quarters prior to \ninjury with positive earnings at the at-injury firm, leading to five tenure categories: 4, 3, \n2, 1, or"] [12.569769859313965, 18.319393157958984, "s tenure definition may, for example, lead relatively higher-ear ning workers with two \nor three quarters out of the labor market to be matched with lower earning workers with just one \nquarter out of work, which may bias earnings loss estimates for "] [12.52867317199707, 18.325851440429688, " for \ncomparison to previous RAND studies. Across the four time periods examined here, the average \nimbalance is around 1 percent of ea rnings or less. This analysis indicates that injured workers \nhad earnings that were generally within 1 perc ent o"] [12.550012588500977, 18.43115234375, "strators, and a wa ge history. The average match weight in our \nanalysis sample is 1.17, and th e largest is 15.76. In our second weighting step, we define \ncategories of workers by age, gender, region, self-i nsured status, injury year, and quartile"] [12.30184555053711, 17.995555877685547, "ilable for study in this report is incomplete. There are claims that are \ncurrently medical-only that may begin receiving indemnity benefits in the future, and there are \nalso claims that may not yet have been filed, for instance because a hea lth c"] [12.435818672180176, 18.065488815307617, " Coefficient estimates for \nthis model are shown in Table A.8. We estimate ch anges in the level of relative earnings across \nthe four time periods using the following specification: \n\u0be4\u0b38\n\u123d\u0d45\n\u0d50\u0d4c 2008\u123d\u0d45\n\u0d50\u0d4c 2010\u123d\u0d45\n\u0d50\u0d4c 2013\u123d\u0d45\n\u0be4 (1) \nIn this model,"] [12.428759574890137, 18.017356872558594, "2008\u20132009 injuries are compared to \n2005\u20132007 injuries, 2010\u20132012 injuries are compared to 2008\u20132009 injuries, 2013 injuries are \ncompared to 2010\u20132012 injuries, and 2014\u20132015 injuries are compared to 2013 injuries. The \ngroup-specific trend break c"] [12.352648735046387, 17.95013999938965, "% \nRelative employment \nFirst post-injury year 89% 84% 83% 84% 85% \nSecond post-injury year 90% 84% 84% 86% 88% \nRelative at-injury employment \nFirst post-injury year 82% 80% 78% 78% 78% \nSecond post-injury year 76% 73% 71% 72% 72% \nSOURCE: 2005\u20132015"] [12.694129943847656, 17.737157821655273, "ims in the analysis sample. \nTable A.7. Aggregate Changes in Relative Earnings \n Indemnity \nYear >= 2008 \u20130.0541 \n(0.0075) \n[0.0000]** \nYear >= 2010 \u20130.0069 \n(0.0064) \n[0.2908] \nYear >= 2013 0.0126 \n(0.0027) \n[0.0000]** \nYear >= 2014 0.0058 \n(0.0030"] [12.703361511230469, 17.737998962402344, "p-values in \nbrackets. The p-values presented above are unadjusted. ** indicates Holm-adjusted statistical significance based on \na benchmark of \u03b1 = .05. \nTable A.8d. Permanent Differences in Relative Earnings by Nature of Injury \nIndemnity \nCumulat"] [12.703476905822754, 17.761173248291016, "loyees) 0.021 \n(0.0196) \n[0.2904] \n2010*(11\u201350 employees) \u20130.0018 \n(0.0088) \n[0.8383] \n2010*(51\u2013100 employees) 0.0165 \n(0.0083) \n[0.0527] \n 66 Indemnity \n2010*(101\u2013500 employees) 0.0103 \n(0.0057) \n[0.0808] \n2010*(501\u20131,000 employees) 0.0143 \n(0.0064"] [12.7111177444458, 17.739423751831055, "2013*Agriculture \u20130.0214 \n(0.0228) \n[0.3548] \n2013*Construction \u20130.0288 \n(0.0157) \n[0.0732] \n2013*Education \u20130.0038 \n(0.0062) \n[0.5427] \n2013*Health care 0.0154 \n(0.0034) \n[0.0001]** \n2013*Manufacturing \u20130.0197 \n(0.0049) \n[0.0002]** \n2013*Other 0.023"] [12.740701675415039, 17.71276092529297, ".5004] \n2013*San Diego \u20130.0081 \n(0.0065) \n[0.2161] \n2014*Bay Area \u20130.0103 \n(0.0075) \n[0.1733] \n2014*Central Coast 0.0174 \n(0.0123) \n[0.1649] 76 Indemnity \n2014*Central Valley 0.0089 \n(0.0053) \n[0.1049] \n2014*Eastern Sierra 0.0066 \n(0.0218) \n[0.7655] "] [12.690589904785156, 17.762985229492188, " \n2010*Trunk \u20130.0022 \n(0.0033) \n[0.5101] \n2010*Upper extremities 0.0034 \n(0.0039) \n[0.3861] \n2013*Ears/hearing 0.025 \n(0.0307) \n[0.4192] \n2013*Eyes \u20130.0141 \n(0.0217) \n[0.5201] \n2013*Face \u20130.0313 \n(0.0238) \n[0.1941] 81 Indemnity \n2013*Head 0.0304 \n(0."] [12.652828216552734, 17.803617477416992, "an full tenure \u20130.0116 \n(0.0095) \n[0.2320] \n2008*Full tenure \u20130.0004 \n(0.0018) \n[0.8205] \n2010*Less than full tenure 0.0156 \n(0.0072) \n[0.0351] \n2010*Full tenure \u20130.0027 \n(0.0013) \n[0.0456] \n2013*Less than full tenure 0.0189 \n(0.0099) \n[0.0623] \n2013"] [11.351043701171875, 18.1588077545166, "5, 2018: https://www.dir.ca.gov/dwc/wcis/WCIS_tables/AggregateFRO ISROIData/AggregateFROIS\nROIData-Archive.html \nDworsky, Michael, Stephanie Re nnane, and Nicholas Broten, Wage Loss Monitoring for Injured \nWorkers in California\u2019s Workers\u2019 Compensatio"] [11.202489852905273, 18.164939880371094, "C-17-20, 2017. As of November \n15, 2018: https://www.wcrinet.org/reports/adequacy-of- workers-compensation-income-benefits-in-\nmichigan \nSeabury, Seth A., Robert T. Reville, Stephani e Williamson, Christopher F. McLaren, Adam H. \nGailey, Elizabeth Wi"] [-2.8971269130706787, 12.293915748596191, "Not Everything Is Broken\nThe Future of U.S. Transportation and Water \nInfrastructure Funding and Finance\nDebra Knopman, Martin Wachs, Benjamin M. Miller, Scott G. Davis, \nKatherine Pfrommer\nCORPORATIONLimited Print and Electronic Distribution Rights\n"] [-0.4449206292629242, 13.607802391052246, " boundaries; and understanding different types of financing\u2014public, private, and public-private partnerships. The premise is that if compel -\nling public benefits can be articulated and financial incentives properly aligned on both the public and pri"] [-2.901153326034546, 12.281572341918945, "topics, and share our findings in innovative and compelling ways. RAND\u2019s research findings and recommenda -\ntions are based on data and evidence, and therefore do not necessarily reflect the policy prefer -\nences or interests of its clients, donors, "] [-2.890634298324585, 12.29693603515625, "......................................... 41\nFindings ......................................................................................................... 46\nCHAPTER FOUR\nFederal Transportation Policy and Its Impact on Infrastructure Investment"] [-2.889350414276123, 12.299018859863281, "................. 93\nReferences ....................................................................................................... 95viiFigures and Tables\nFigures\n S.1. Total Federal, State, and Local Spending on Infrastructure, 1956\u20132014, as "] [-2.885706901550293, 12.302262306213379, "\n18. Gr\nowth in O&M Funding for Mass Transit by Source, 2000\u20132014 ...................... 26\n 2.\n19. Fe\nderal Spending Versus State and Local Spending on Water Infrastructure ............. 28\n 2.\n20. Pu\nblic-Private Partnership Investment in th"] [-2.889244556427002, 12.297842979431152, "ld focus its policies on incentivizing increased public and private spending on maintenance and modernization where it is needed. \nBut increased spending will not fix what is broken in our approach to funding and financ -\ning public works\u2014and not eve"] [-2.8916211128234863, 12.296863555908203, "al public spending on highways decreased as a percentage of \nGDP and has been relatively flat since then. Spending on mass transit, rail, water resources, and water utilities as a percentage of GDP increased or remained relatively flat between 1980 a"] [-2.8650615215301514, 12.322547912597656, "e at least 1956. The system of financing new and major rehabilitation projects through public borrowing and, to a much lesser extent, some version of public-private part -\nnerships (PPPs) is generally working for projects that fall within single stat"] [-2.8835394382476807, 12.300590515136719, "riorities, policy constraints, and regional differences. \nThough state and local governments are responsible for many pieces of this mosaic, Con -\ngress could take a number of steps in conjunction with states, local governments, and the pri -\nvate se"] [-2.8875436782836914, 12.30396556854248, "oning to a new federal system that\u00a0more effectively\u00a0links revenue collection to highway use.\nLong-Term Priorities\nTarget longer-term projects likely to produce significant national benefits. Fund transportation and water improvements that will increa"] [-2.890761137008667, 12.29775619506836, "fety, and environmental benefits and to those state and local governments that work together to identify their top priorities for federal capital spending. Federal funding would be conditional on regional sponsors securing matching funds from any com"] [-2.885842800140381, 12.298012733459473, "opportunity to make design changes in old infrastructure or rethink infrastructure concepts entirely to meet new condi -Summary and Recommendations xv\ntions. Following the lead of many states and cities, Congress should embed resilience guide-\nli"] [-2.908029079437256, 12.275769233703613, " water resource management in partnership with states, local governments, and other stakeholders; and bring the water infrastructure programs of the two agencies under the same congressional oversight. Consolidating the transportation modal administr"] [-2.888072967529297, 12.299982070922852, "tions and investment.xviiAcknowledgments\nThis project was funded in part through RAND\u2019s program of self-initiated research. We are \ngrateful to Susan Marquis, dean of the Pardee RAND Graduate School and Vice President of Innovation at RAND, and Howar"] [-2.8894717693328857, 12.299551010131836, "ic maintenance and repair of the infrastructure we already have and plans to raise enough money to keep it viable in the long term (Jaffe, 2016). \nLargely missing from the current debate are clear and compelling answers to three fun -\ndamental questi"] [-2.8916893005371094, 12.29702091217041, "rom loaning money to governments to finance construction to footing the bill in exchange for the ability to collect user fees or other benefits. (In contrast, private investors dominate infrastructure spending for energy, telecom -\nmunications, and f"] [-2.889413833618164, 12.298611640930176, "the investments it identifies will trim $4 trillion off of the U.S. gross domestic product (GDP) between 2016 and 2025. ASCE also suggests that the burden of the under -\ninvestment falls disproportionately on the most disadvantaged communities, with "] [-2.880227565765381, 12.308110237121582, "ports. ASCE\u2019s \ndefinitions of transportation and water infrastructure differ from CBO\u2019s definitions.4 Not Everything Is Broken: The Future of U.S. Transportation and Water Infrastructure Funding and Finance\nIn the United States, infrastructure has"] [-2.893982172012329, 12.293782234191895, "yors Water Council, 2007; Copeland, 2016). The federal government\u2019s role in city water supplies is minimal in the eastern United States\u2014but dominant in the western states through the massive public works projects of the U.S. Bureau of Reclamation (BO"] [-2.8939952850341797, 12.295167922973633, "ears, many advocates of increased infrastructure spending, as well as academics, have maintained that lengthy local, state, and federal environmental reviews of major projects impede construction and are a cause of underspending. They argue that \u201cstr"] [-2.8928284645080566, 12.297481536865234, "is a highly uncertain business, with an unimpressive track record (Flyvbjerg, Bruzelius, and Rothengatter, 2003). For technical reasons, cost and demand forecasts are characterized by large errors. It has been documented that where public funds are a"] [-2.888533353805542, 12.300591468811035, "National or Regional Priorities \nUnlike China or the European Union, the United States lacks a vision of how infrastructure can enhance economic growth and productivity, and, in the absence of such a vision, priori -\nties are difficult to articulate."] [-2.730950117111206, 12.315893173217773, " billion between FYs 2005 and 2014 (GAO, 2016). Further, the dollar value of damage from extreme weather events has qua -\ndrupled in real terms over the past four decades (National Oceanic and Atmospheric Admin -\nistration, National Centers for Envir"] [-2.8910293579101562, 12.297698020935059, "uence of the Sacramento and San Joaquin rivers (Rieke, 1996).\nMisallocation of Capital\nUnintended consequences of policies can lead to a misallocation of capital, whether public or private.\nBias Toward Capital Spending over Operations and Maintenance"] [-2.890281915664673, 12.298389434814453, "so, in the name of regional equity, federal funding is distrib -\nuted among regions and states using allocation formulas and, to some degree, earmarking of appropriations. \nLegal Constraints on Public and Private Capital Flows\nThe federal tax code al"] [-2.8701510429382324, 12.329895973205566, "OR and the USACE have spent the better part of the past 30 years \u201creverse engi -\nneering\u201d their major 20th century water resource projects (e.g., dams on the Colorado River, the Everglades, and the lower Mississippi River) to mitigate the damages the"] [-2.888836622238159, 12.30112361907959, "n 11\nWe first identified the features of transportation and water policies and programs that \nexert a strong influence on priority setting, project evaluation, and funding and finance. Next, \nwe examined the supply side for infrastructure. We revi"] [-2.8890914916992188, 12.299362182617188, "-sector funding where possible and to rationalize public-sector investment to meet future needs. In Chapter Six, we consider some of the more significant recent changes in policy and practices across all levels of government in the United States. Som"] [-2.880868434906006, 12.307962417602539, "Transportation and Water Infrastructure Funding and Finance\nrehabilitation of structures and equipment already in place. Operation and maintenance refers \nto the costs of providing necessary operating services (e.g., air traffic control system); mai"] [-2.894301652908325, 12.299034118652344, " either increasing costs for repair and rehabilitation or an increasing likelihood that the project will become unusable. Decisions at this stage are further complicated by the need to consider \n1 Federal support for water resource research has larg"] [-2.8939268589019775, 12.29920768737793, "ries are many different types and blends of funding options. On the public side, the \nprimary funder can be federal, state, or local government. It can also be some combination of those three or a regional authority that spans jurisdictions, such as "] [-2.891195774078369, 12.297693252563477, "ral to state level, as well as from the state to local level, contribute a portion of the total funds spent on transportation, but the majority of total money spent comes from local governments\u2019 own-source funding. \nThe proportion of spending by leve"] [-2.8887531757354736, 12.299222946166992, "on)Status of and Trends in Spending on Transportation and Water Infrastructure 19\nTrends in Public Spending on Transportation and Water Infrastructure\nCBO assembled a consistent data set on public infrastructure spending dating back to 1956, \nwhen"] [-2.8878555297851562, 12.299018859863281, "l, State, and Local Spending on Transportation and Water Infrastructure, as a Share of Gross Domestic Product, 1956\u20132014\nSOURCE: CBO, 2015, Exhibit 3, p. 10, based on data from OMB, the U.S. Census Bureau, and the U.S. Bureau of \nEconomic Analysis.\nR"] [-2.891141176223755, 12.298590660095215, " GDP22 Not Everything Is Broken: The Future of U.S. Transportation and Water Infrastructure Funding and Finance\nFigure 2.11\nPer Capita Federal, State, and Local Spending on Transportation and Water Infrastructure, 1956\u20132014\n1956\n195819601962196419"] [-2.8911828994750977, 12.298426628112793, "ure suggests that the decline is consistent with the \u201cbuilt out\u201d nature of our national highway system (Shatz et al., 2011; Mamuneas and Nadiri, 2006). Support for this view can be found in returns on invest -\n3 Because of its land management respon"] [-2.8829586505889893, 12.292428016662598, "r vehicle-mile s traveled a nd vehicle-miles traveled per person include both\npassenger and freight vehicles. \na The amounts show are based on the population residing in the United States.\nRAND RR1739-2.16Index (1980 = 100)250\n0\n2010 2005 2000 1995 "] [-2.8904473781585693, 12.29869556427002, "mmittee on U.S. Army Corps of Engineers Water Resources Science, Engineering, and Planning, 2011).\nFederal spending on water utilities, shown in the top panel of Figure 2.19, peaked in the \nmid-to-late 1970s, when it required local governments to bui"] [-2.886108636856079, 12.306139945983887, "ic combined public and private investment, and the dashed line rep -\nresents a regression model of the trend in the data. The trend appears to show that invest -\nment is rising and may eventually become more significant in the future, especially as "] [-2.8906757831573486, 12.298521041870117, " in federal funding for water and wastewater treatment infrastructure reflects congressional decisions to scale back involvement.\nTaken as a whole, evidence of federal underspending on infrastructure from a national \nperspective appears to be stronge"] [-2.888090133666992, 12.299674987792969, "ers may sometimes also be direct beneficiaries of an infrastruc -\nture project, but not always. Depending on the funding and financing mechanism used, ben -\neficiaries may also include bondholders, shareholders, and various individual and institution"] [-2.916865348815918, 12.272665023803711, "stment.\nFederal Models for Funding\nThe federal government has many ways to spend money. Congress appropriates funds directly \nto agencies that then disburse those funds themselves, through state and local governments, or through contracts, grants, an"] [-2.9131295680999756, 12.266276359558105, "Army Corps of EngineersNational Oceanic and Atmospheric \nAdministration\nHouse Committee on Natural ResourcesU.S. Bureau of ReclamationNational Oceanic and Atmospheric \nAdministration\nU.S. Fish and Wildlife Service\nHouse Committee on Energy and Commer"] [-2.8928980827331543, 12.29711627960205, "not confined to a specific project. Examples are the annual distributions from the Highway Trust Fund by DOT to states and the U.S. Department of Housing and Urban Development\u2019s Community Develop -\nment Block Grant (CDBG) Program to all 50 states and"] [-2.8910889625549316, 12.297859191894531, "nment pumps additional funding into the state revolving funds (SRFs) \neach year, although year-to-year spending has been uneven, as shown in Figure 3.1 (Gies, 2012). States review and rank proposed projects according to their own priorities and withi"] [-2.8900647163391113, 12.300310134887695, "998, Congress enacted the Transportation Infrastructure Finance and Innovation Act (TIFIA; Pub L. 105-178, Title I, Subtitle E, Chapter 1) credit program, offering federal loans, loan guarantees, and lines of credit to state and local governments to "] [-2.8899426460266113, 12.299931526184082, "erty acquisition. The first $20 million of funds were not appropriated until December 2016 (EPA, no date-c; American Water Works Association, 2016). WIFIA can provide loans to state, local, and tribal governments for all projects eligible for CWSRF a"] [-2.8905773162841797, 12.293437957763672, " are paid partially by the employer and partially by the employee, go toward the Social Security Trust Fund and the Hospital Insurance Trust Fund for use by the Social Secu -\nrity and Medicare programs, respectively. \nWhile income and payroll taxes a"] [-2.8936808109283447, 12.28951644897461, "form of lower interest payments, and mainly benefits the higher-income households that claim the tax break. Because the main incentive for purchasing these lower-yielding bonds is that the interest is tax-free, 75 percent of municipal bonds are held "] [-2.8887319564819336, 12.291451454162598, "he large upfront construction costs, which are then paid back over time using revenue from taxes or user fees. There are several ways in which this borrowing and repayment can occur. \nBonds \nLocal government bonds are effectively crowd-sourced loans "] [-2.8875677585601807, 12.294065475463867, "5 percent interest rate, the lender receives $1.05 million, assuming a term of one year. If the federal government pays 20 percent of the interest, then the state or local government that issued the bond pays only $1.04 million and the federal govern"] [-2.889336109161377, 12.297321319580078, "g costs (DOT, Federal Highway Administration, Office of Innovative Program Delivery, no date-c). \nA relatively new type of bond based on \u201cpay for performance\u201d is called an Environmental \nImpact Bond and was recently used to support a \u201cgreen infrastru"] [-2.877675771713257, 12.310447692871094, "tor pay construction costs up front in exchange for the right to collect a revenue \n15 Also see publications from the \u201cCenter for Transportation Excellence\u201d for extensive data about sales taxes used all over \nthe country for transportation funding ("] [-2.888383388519287, 12.300933837890625, "rrently in Use in the United States 43\nThe role of private finance in public infrastructure is complicated. First, as a baseline \ncondition, any owner of infrastructure, public or private, needs to be fully accountable to the \npublic in its compli"] [-2.8906702995300293, 12.298916816711426, "ansportation. It includes such approaches as transit impact fees, property tax increment financing, special assessment dis -\ntricts, and increased property taxes (Moliere, 2017).\nAn important aspect of risk sharing in PPP arrangements relates to whic"] [-2.8918681144714355, 12.30129337310791, "ugh fees\u201d (Kousser, McCubbins, and Moule, 2008), that TELs may raise borrowing costs (Poterba and Reuben, 1999), and that TELs harm overall economic growth through mechanisms such as encouraging underinvestment in infrastructure (Deller, Stallmann, a"] [-2.8877172470092773, 12.30147933959961, " there is simply the risk of building something ambitious and long-lasting in a rap -\nidly changing economy and technological environment. The amount of revenue that will flow from a project that will last for decades is difficult to predict. Estimat"] [-2.8821568489074707, 12.299654960632324, "hat cannot be easily \nmonetized through user fees or customer charges. These tend to be the projects least attractive to private investors seeking a predictable return competitive with other investment options. Mass transit projects fall into this ca"] [-2.8870763778686523, 12.299318313598633, "). Truckers have every reason to overload trucks to the point that they damage roads because doing so increases their returns in the short run (National Research Council, Transportation Research Board, 1997, pp. 24\u201325). While charging trucks directly"] [-2.8707611560821533, 12.326861381530762, "lls, 2012). The federal government does not operate, manage, or control most transporta -\ntion infrastructure. It is one actor in a transportation infrastructure network that has national consequences but, by design, is highly decentralized. Most rur"] [-2.8838353157043457, 12.29864501953125, "tion. These plans, by definition, are financially constrained, in that they must include realistic plans for funding the implementation of the projects that comprise the regional plans (DOT, Federal Highway Administration, 2017d). \nDominance of Local"] [-2.889105796813965, 12.30710506439209, "finance it.\n3 Congress clearly articulated that states were the decisionmakers and provided them with \n90 percent of the construction costs of interstate highways. In return, states agreed to build roads in compliance with a set of national standards"] [-2.8897039890289307, 12.298626899719238, "otection Act, \n2 The Lincoln Highway was conceived in 1912 and dedicated in 1913 (Lincoln Highway Association, no date).\n3 The federal Highway Trust Fund was created through the Interstate Highway Act of 1956. A 1947 map of the then-\nproposed Natio"] [-2.887767791748047, 12.294793128967285, "rtation infrastructure, includ -\ning revenues from the sale of strategic oil reserves, from repatriated corporate profits on foreign operations, or from a revamped fuel tax. One idea is a tax linked to both inflation and aver -\nage fuel efficiency. T"] [-2.8847854137420654, 12.303739547729492, "red that DOT publish systematic \nassessments of the \u201cconditions and performance\u201d of the surface transportation system. These biannual reports incorporate estimates of resources that would be required to meet anticipated needs. States are required to "] [-2.8944239616394043, 12.296242713928223, ". The physical condition of bridges improved slightly over the past few years, but, as with all classes of assets, location matters. Figure 4.1 displays a snapshot of the percentage of structurally deficient bridges, by county, for the entire United "] [-2.894648551940918, 12.297067642211914, "sment, and the ASCE, which pub -\nlishes the periodic Infrastructure Report Card , all represent deep knowledge of infrastructure \nneeds yet all are also ultimately advocates for improved infrastructure. 54 Not Everything Is Broken: The Future of U"] [-2.8196187019348145, 12.39069938659668, "ly measure current performance and state goals and objectives, \nand quantify financing needs according to these federally specified criteria. There is an evolv -\ning federal \u201ctoolbox\u201d of methods that facilitates the transition. While there is recogni"] [-2.867769956588745, 12.309725761413574, "e\nings due to changes in travel costs; and, often, environmental impacts, such as changes in air \npollutant emissions. \nCBA requires that benefits be \u201cmonetized\u201d by estimating dollar values of benefits that are \nnot usually measured in dollar terms. "] [-2.8911726474761963, 12.295872688293457, "e these projects.\n5 Some oppose CBA on grounds that include the ultimate subjectivity of the choices of economic values, and because of \nthe propensity to \u201cdouble count\u201d benefits when, for example, air quality improvements result in increased proper"] [-2.8933768272399902, 12.291470527648926, "be replaced or should be financed dif -\nferently going forward.\nImprovement of navigable waters came first when Congress in 1824 authorized the \nUSACE, formally established in 1802, to improve navigation on the Ohio and Mississippi 58 Not Everythi"] [-2.8913791179656982, 12.296262741088867, "because they have outlived their useful lifetimes and otherwise disrupt natural sys -\ntems (Wegner, 1990). To some extent, the water resource agencies\u2019 missions in the 21st century can be characterized as one of \u201creverse engineering\u201d many of their ma"] [-2.890324592590332, 12.297750473022461, "xtent. \nFor the same reasons that user fees or their equivalent are essential for maintenance of \ntransportation facilities, proper pricing of water services is critical to the sustainability of water utilities. Yet, full-cost pricing, in which life-"] [-2.895636796951294, 12.288518905639648, ". Since the early 1990s, Detroit has generally maintained its lead levels in compliance with federal standards. In 2013, Detroit canceled its arrangement with Flint after Flint\u2019s city council voted to switch to a new pipeline from Lake Huron. In Apri"] [-2.88917875289917, 12.29878044128418, "movement toward intermodal transportation planning identified in Chapter Three. \nEven though integrated water resource management is widely accepted among water pro -\nfessionals in the United States and throughout the world, actual implementation has"] [-2.8936426639556885, 12.293586730957031, " from wastewater and drinking water systems, water resource infrastructure includes dams, levees, harbors, canals, and the locks and dredged channels of navigable waterways. Capital spending for federal water resource programs has been in decline for"] [-2.891207695007324, 12.294806480407715, "stgarten and Sadasivam, 2015; Reisner, 1986).Table 5.1\nFederal Cost-Sharing for Capital and O&M by Type of Water Infrastructure \nProject PurposeMaximum Federal Share of \nConstruction (%)Maximum Federal Share of \nO&M (%)\nNavigation\nCoastal ports\n<20 f"] [-2.888124942779541, 12.2988920211792, "er markets and trading, now in limited use \nin the western United States, could lead to more efficient pricing and hence allocation of water from federal water projects, but, thus far, the idea has not taken hold because of significant technical, ins"] [-2.890599250793457, 12.295577049255371, "al Safe Drinking Water Act regulates the qual -\nity of drinking water at the tap for more than 152,000 public water systems in the United States. Ninety-seven percent of these public water systems serve communities of 10,000 or fewer people, but, in "] [-2.889409065246582, 12.298559188842773, " population growth and age of the system. Assumptions about construction costs, including the price of energy, also influence the numbers. Assessments also differ by the method used to generate the estimates. For example, the EPA\u2019s Drinking Water Inf"] [-2.882805585861206, 12.297689437866211, "2011 dollars for comparison purposes.Figure 5.3\nComparison of Needs Assessments for Water Utility Infrastructure\nSOURCES: EPA, 2013; American Water Works Association, 2012.\nNOTE: WIN = Water Infrastructure Network; AWWA = American Water Works Associa"] [-2.8860971927642822, 12.296408653259277, "WIN estimates \u201cthe cost of building, operating, and maintaining needed drinking water and wastewater facili -\nties over [2000\u20132019] approaches $2 trillion\u201d in 1999 real dollars. \nIn sum, the wide range of estimates produced from inconsistent assessme"] [-2.8935182094573975, 12.293078422546387, " projects. Principles, Requirements and Guidelines for Water and Land Related Resources Implementation Studies (PR&G), a document maintained by the Council on Environmen -\ntal Quality, establishes principles and evaluation criteria to guide federal "] [-2.8937361240386963, 12.295249938964844, "ion of water or wastewater infrastructure projects, but the federal government influences project selection indirectly through regulatory actions (e.g., court orders to force local or state action on a storm water or wastewater facility as a conseque"] [-2.8964338302612305, 12.294724464416504, "ies, for which 90 percent of investment \nhappens at the local level, largely through the use of municipal revenue bonds and property assessments. Federal water quality and drinking water laws and regulations drove much of 70 Not Everything Is Brok"] [-2.8891961574554443, 12.306327819824219, " attributes of such a policy. This is not impossible to do. A report published in 2006, known as the Eddington Report, is an example of such a long-term vision and policy statement (Eddington, 2006). While originating in the UK, the report is directe"] [-2.894488573074341, 12.293835639953613, "hese markets.\n3.\n Pr\nomote the federal role of inducing and encouraging investment in multijurisdictional \nprograms, such as those that serve intercity travel and freight transport and those that address river basins and large watersheds that cross s"] [-2.9008755683898926, 12.288476943969727, "an also be expressed through federal grant programs. Project-based \ngrants have the ability to more effectively target federal resources to the most critical needs from a national perspective. They can demand certain conditions of project submissions"] [-2.885798931121826, 12.304022789001465, "ted States for the Impacts of Climate Change ).74 Not Everything Is Broken: The Future of U.S. Transportation and Water Infrastructure Funding and Finance\ndemand that far exceeds available resources. For the FY 2016 round ($500 million available),"] [-2.9007091522216797, 12.292868614196777, "tion to plan for and implement feder -\nally assisted transportation and water projects according to their needs and priorities. DOT\u2019s Surface Transportation Program, through which states pass a substantial portion of funds to regions, has historicall"] [-2.8902673721313477, 12.299565315246582, "implify administration of currently stovepiped grant programs while increasing flex -\nibility and outcomes is likely to be worth the effort.\nThe Trump Administration\u2019s budget document for FY 2018 highlights its priority to \nremove, reduce, or better "] [-2.885328531265259, 12.283098220825195, "r Fee Pilot Program Results Summary,\u201d no date). These are increas -\ningly feasible because of developing technology, such as vehicle telematics, global positioning satellites, cell towers, and on-board diagnostics, that can report vehicle movements. "] [-2.897437810897827, 12.28862190246582, "ation, and the Investing in Manufacturing Communities Partnership. Policy Options 77\nThe policy sought to maximize economic growth and increase the cost-effectiveness of federal \nfinancial investments. It also directed agency staff and technical a"] [-2.8958628177642822, 12.292635917663574, "cent examples can be seen is the Desal Prize, sponsored by the U.S. Agency for International Development and the BOR, and the Smart City Challenge, sponsored by DOT. \nThe Desal Prize was an engineering competition to develop technologies that could d"] [-2.87902569770813, 12.308699607849121, "ecutive order, and a detailed implementation plan (U.S. Depart -\nment of Treasury and U.S Department of Transportation, Build America Investment Initiative Interagency Working Group, 2015).\nIn his first days in office, President Trump announced his i"] [-2.8864192962646484, 12.300247192382812, "r 5 percent of GDP, under current program assumptions (CBO, 2017). This projection will change depend -\ning on tax cuts and spending increases enacted in the coming years. \nDirect Federal Spending\nThe challenge for sponsors of bills authorizing direc"] [-2.8910975456237793, 12.296575546264648, "ls. In addition, they would set aside $200 million of the $1 trillion for projects of national 80 Not Everything Is Broken: The Future of U.S. Transportation and Water Infrastructure Funding and Finance\nsignificance or what they call \u201cvital infras"] [-2.890714645385742, 12.297353744506836, "t of the total $1 trillion investment will become new wages, and 10 percent will \nbecome new corporate profits.\n\u2022 Wa\nges and corporate profits will be taxed at an average rate of 28 percent (personal \nincome) and 15 percent (the capital gains tax rat"] [-2.89200496673584, 12.297348976135254, "ling properties as potential investors, but they currently invest relatively little in domestic infrastructure. This is because their long-run investment interests tend to match the long lifespans of infrastructure projects better than the investment"] [-2.9238345623016357, 12.268975257873535, "opening the door to more-effective means for alternative investors to assess and choose attractive long-term investment opportunities. In parallel with such thinking, states could also share their experiences with past PPPs to do a better job of fulf"] [-2.8878109455108643, 12.299936294555664, "ralia has been experimenting with an \u201casset recycling\u201d program, essentially a means \nof privatizing many public infrastructure systems while generating cash for local government Policy Options 83\nto invest in new infrastructure. Its success has st"] [-2.8828604221343994, 12.298312187194824, "U.S. GDP has been remarkably stable since 1956. Private funding in these areas of infrastructure is less than 3 percent of the total, nearly all of which is for rail. When federal spending has declined, state and local governments often have picked u"] [-2.892084836959839, 12.294864654541016, "percent of\u00a0capital investment (CBO, 2015). The evidence suggests that the division of responsibility among the levels of government is generally appropriate and does not warrant wholesale change. In addition, the federal government could do a better "] [-2.8935439586639404, 12.295039176940918, "ve value to different types of public assets and services. Under our system of federalism, states are empowered to make their own choices on these matters.\nSome projects may generate national economic benefits, but not commensurate revenues, \nin part"] [-2.889838457107544, 12.298744201660156, "olicy landscape. The justification for the BOR in 1902 to reclaim the Great American Desert is no longer valid. At the beginning of the 20th century, the U.S. population was 60 percent rural and 40 percent urban (U.S. Census Bureau, 1995). Now, 80 pe"] [-2.890662431716919, 12.295798301696777, "e hybrid and electric vehicles come into wider use, the decline in revenues from the sale of motor fuels will continue. To restore stability and sustainability to the Highway Trust Fund, Congress should support a robust program of pilot testing and e"] [-2.89117169380188, 12.296697616577148, "sting assets will make matters worse for local governments struggling to make payments on existing debts.\u00a0\nCongress should place its highest maintenance priorities on vital federal assets. The \nfederal government has a responsibility to properly main"] [-2.929830312728882, 12.258610725402832, "could provide technical assistance and help with tax issues and permitting processes. \nThe federal government should streamline regulatory approval processes involving \nmultiple federal agencies while honoring applicable environmental, health, and sa"] [-2.8879213333129883, 12.302003860473633, " infrastructure and Summary of Findings and Recommendations 91\nimprove building methods and materials, engineering designs, cost-effectiveness and efficiency, \nand all aspects of system operations. \nWidespread adoption of newer construction method"] [-2.855985641479492, 12.327588081359863, "ilt the Transcontinental Railroad, 1863\u20131869 , \nNew York: Touchstone, 2000.\nAmerican Public Transit Association, 2016 Public Transportation Fact Book , Washington, D.C., February \n2017a. As of September 18, 2017: \nhttp://www.apta.com/resources/statis"] [-2.8365626335144043, 12.348898887634277, "Boschetti, T., Building Oregon\u2019s Future: The Current Landscape of Infrastructure Finance in Oregon , Portland, \nOre.: Oregon Chapter of the American Planning Association, December 2014.Braun, Martin Z., \u201cMeadowlands Mega-Mall Wins Bond-Market Subsidy"] [-2.869980573654175, 12.31661319732666, " Drinking Water and Wastewater Infrastructure , Washington, \nD.C., November 2002.\u2014\u2014\u2014, \u201cOptions for Reducing the Deficit: 2014 to 2023: Eliminate the Tax Exemption for New Qualified \nPrivate Activity Bonds,\u201d November 13, 2013. As of September 18, 2017"] [-2.867204189300537, 12.320883750915527, "t Cut in TIFIA Funding Justified?\u201d Eno Transportation Weekly , \nDecember 15, 2015. \u2014\u2014\u2014, \u201cUSDOT Withdraws from Gateway Corporation,\u201d Eno Transportation Weekly , July 1, 2017. \nDay, Kakan C., Mashrur Chowdhury, Weichiang Pang, Bradley J. Putman, and Li"] [-2.8533239364624023, 12.331877708435059, "ound Zero,\u201d Center for American Progress \nwebsite, May 2, 2011. As of September 18, 2017: https://www.americanprogress.org/issues/general/news/2011/05/02/9681/reconstructing-the-muni-market-starting-at-ground-zero/\nEllis Josh, Metropolitan Planning C"] [-2.840029716491699, 12.346609115600586, "ptember 2016. As of \nSeptember 18, 2017:https://www.brookings.edu/wp-content/uploads/2016/09/gayerdrukkergold_stadiumsubsidies_090816.pdf\nGeorgetown Climate Center, \u201cState and Local Adaptation Plans,\u201d Georgetown Law School, no date. As of \nSeptember "] [-2.856250286102295, 12.327065467834473, "ey, A Review of Tax and \nExpenditure Limitations and Th eir Impact on State and Local Government in Ohio , Cleveland State University, \nMaxine Goodman Levin College of Urban Aff airs at EngagedScholarship@CSU, 2006. As of September 18, 2017:http://"] [-2.854994058609009, 12.330198287963867, "eptember 21, 2017: http://efc.web.unc.edu/2016/10/19/public-vs-private-a-national-overview-of-water-systems/\nKousser, Thad, Matthew D. McCubbins, and Ellen Moule, \u201cFor Whom the TEL Tolls: Can State Tax and \nExpenditure Limits Effectively Reduce Spend"] [-2.8578968048095703, 12.328669548034668, "ion Expansion of Panama Canal Could Reshape World \nTrade Routes,\u201d Los Angeles Times , June 24, 2016. \nMcFetridge, Scott, \u201cClimate Change Prompts Inland Cities to Raise Bridges,\u201d Journal Sentinel , June 9, 2017. \nMileage-Based User Free Alliance, webs"] [-2.842771530151367, 12.332810401916504, "te. \nAs of September 18, 2017: http://www.ncppp.org/resources/case-studies/transportation-infrastructure/union-station-washington-dc/ \nNational Economic Council and President\u2019s Council of Economic Advisors, An Economic Analysis of \nTransportation Inf"] [-2.813441038131714, 12.372036933898926, "e. As of September 18, 2017: http://www.newnybridge.com/References 103\nNewmyer, Tory, and Damian Paletta, \u201cTrump Backs Off Vow That Private Sector Should Help Pay for \nInfrastructure Package,\u201d Washington Post , September 26, 2017.\nOffice of Hillar"] [-2.8427212238311768, 12.33655071258545, "mber 20, 2017: http://energy.gov/sites/prod/files/2013/08/f2/Grid%20Resiliency%20Report_FINAL.pdf\nPublic Law 84-627, Federal-Aid Highway Act of 1956, June 29, 1956. Public Law 88-206, Clean Air Act, December 17, 1963.Public Law 91-190, National Envir"] [-2.8193862438201904, 12.35004997253418, "t (WIFIA) Program , Washington, D.C.: Congressional Research Service, R43315, April 5, \n2017.\nReisner, Marc, Cadillac Desert: The American West and Its Disappearing Water , New York: Viking, 1986. \nRestuccia, Andrew, and Nicj Juliano, \u201cWhite House Or"] [-2.8471405506134033, 12.332862854003906, "sionmakers , Santa Monica, Calif.: RAND Corporation, TL-104, December 2012. As of \nSeptember 21, 2017: https://www.rand.org/pubs/tools/TL104.html\nSouthern Environmental Law Center, \u201cTri-State Water Wars (AL, GA, FL),\u201d 2015. As of September 21, 2017: "] [-2.8453307151794434, 12.337678909301758, "tpl.com/united-states-population/table\nU.S. Code, Title 23\u2014Highways, Chapter 6\u2014Infrastructure Finance. U.S. Code, Title 31\u2014Money and Finance, Chapter 15\u2014Appropriation Accounting, Section 1502\u2014Balances \navailable.\nU.S. Code, Title 33\u2014Navigation and Na"] [-2.883943557739258, 12.306556701660156, "iatives/tifia/2016-tifia-report-congress\n\u2014\u2014\u2014, \u201cU.S. Department of Transportation Announces Columbus as Winner of Unprecedented \n$40 Million Smart City Challenge,\u201d Press Release DOT 73-16, June 23, 2016c.\n\u2014\u2014\u2014, \u201cTIFIA Credit Program Overview,\u201d January "] [-2.837106466293335, 12.348795890808105, "cial Structuring and Assessment for Public-Private Partnerships: A Primer , Washington, D.C., \nDecember 2013. U.S. Department of Transportation, Federal Highway Administration, Office of Policy and Governmental \nAffairs, Traffic Volume Trends , multi"] [-2.875808000564575, 12.309028625488281, " Gap Analysis , Washington, D.C., 2002.\n\u2014\u2014\u2014, 2015 Drinking Water Infrastructure Needs Survey and Assessment, website, 2011. As of \nSeptember 21, 2017: https://dwneeds.epa.gov/login.aspx?ReturnUrl=%2f\n\u2014\u2014\u2014, EPA Drinking Water Needs Survey and Assessmen"] [-2.8022682666778564, 12.380712509155273, "16-797, September 2016. \nU.S. Housing and Urban Development Department, \u201cCommunity Development Block Grant Program\u2014CDBG,\u201d no date. As of September 21, 2017: https://portal.hud.gov/hudportal/HUD?src=/program_offices/comm_planning/communitydevelopment/"] [-2.6588289737701416, 12.535037994384766, " Performance of Federal Permitting and Review of Infrastructure Projects, March 22, 2012.\n\u2014\u2014\u2014, Executive Order 13653, Preparing the United States for the Impacts of Climate Change , November 1, \n2013.\u2014\u2014\u2014, Executive Order 13677, Climate-Resilient Inte"] [-2.8840537071228027, 12.303882598876953, "-9971-6ISBN-10 0-8330-9971-X\n53500$35.00This report identi\ufb01es the policies that promote and deter investment in and maintenance of U.S. transportation and \nwater infrastructure. It focuses on status and trends in operations and maintenance (O&M) and "] [17.41182518005371, 8.146073341369629, "CORPORATION\nLos Angeles County \nJuvenile Justice Crime Prevention Act\nFiscal Year 2015\u20132016 Report\nTerry Fain and Susan TurnerLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This "] [17.42134666442871, 8.157772064208984, "atively mandated evaluation of the county\u2019s JJCPA programs, including analyzing data and reporting findings to the BSCC. This report summarizes the fiscal year (FY)\u00a0 2015\u20132016 findings reported to the BSCC, as well as additional program information g"] [17.374773025512695, 8.115711212158203, "le Justice Crime \nPrevention Act: Fiscal Year\u00a02007\u20132008 Report , Santa Monica, Calif.: RAND Corpora -\ntion, TR-746-LACPD, January 2010a\n\u2022 Sus\nan Turner, Terry Fain, and Amber Sehgal, with Jitahadi Imara and Felicia Cotton of \nthe Los Angeles County P"] [18.020618438720703, 9.293302536010742, "............... xxxi\nCHAPTER ONE\nBackground and Methodology ............................................................................... 1\nJJCPA in the Context of Los Angeles County Probation Department Programs ........................ 3\nState "] [18.050230026245117, 9.338151931762695, "oups and Reference Periods for JJCPA Programs ............................. 103\nB. Pro\nbation\u2019s Ranking of the Big Six Outcome Measures ......................................... 105\nC. Com\nmunity-Based Organizations That Contracted to Provide Servi"] [18.04905891418457, 9.309104919433594, "ol At-Risk \nYouths, FY\u00a02015\u20132016 ........................................................................... 60\n 2.1\n4. Out\ncomes for School-Based Probation Supervision for Middle School At-Risk \nYouths, by Cluster, FY\u00a02015\u20132016 ................."] [18.067359924316406, 9.329188346862793, "............... 18\n 2.5\n. Dem\nographic Factors for Special Needs Court and Comparison Group .................. 23\n 2.6\n. Pro\ngrams and Comparison Groups in the Enhanced Services to High-Risk/ \nHigh-Need Youths Initiative ..........................."] [18.259424209594727, 9.847972869873047, "e Costs for Special Needs Court ................................... 77Figures and Tables xi\n 3.5. Estimated Juvenile Justice Costs for Gender-Specific Community .......................... 79\n 3.6\n. Est\nimated Juvenile Justice Costs for High Risk"] [18.050216674804688, 9.314078330993652, "................... 112\n D.5\n. Out\ncomes for High Risk/High Need, FY\u00a02015\u20132016 ...................................... 113\n D.6\n. Out\ncomes for Youth Substance Abuse Intervention, FY\u00a02015\u20132016 ...................... 114\n D.7\n. Out\ncomes for Abolish "] [17.952896118164062, 9.077749252319336, ".................................................................................. 130\n F.4\n. Out\ncomes for School-Based Probation Supervision for Middle School At-Risk \nYouths, FY\u00a02015\u20132016 ........................................................."] [17.679821014404297, 8.454718589782715, "m the hall.\n3 At-risk youths are those who have not entered the probation system but who live or attend school in areas of high crime \nor who have other factors that potentially predispose them to participating in criminal activities.xiv Los Angel"] [17.714054107666016, 8.500548362731934, "les County for JJCPA programs and services. The actual final budget was $26.3\u00a0million. JJCPA funding represents roughly 15\u00a0percent of field expenditures for juve-nile justice programs, or about 5\u00a0percent of all expenditures for programming for youths"] [17.715957641601562, 8.585712432861328, "n of community service.\nAn ideal outcome would be for no program participants to be arrested, incarcerated, or in \nviolation of probation and for all to complete probation and (if applicable) restitution and com -\nmunity service. However, because, fo"] [17.76113510131836, 8.835549354553223, "e or she receives services and could therefore count that youth more than once.\nTable\u00a0S.1 lists the JJCPA programs in each initiative in FY\u00a02015\u20132016 and the number of \nparticipants who received services in each program.\nTable\u00a0S.1\nPrograms in the Thr"] [17.71358299255371, 8.923354148864746, "and Numbers of Participants for Whom Probation Reported Outcomes\nInitiative or \nProgram Participants Comparison GroupComparison-\nGroup Members\nI. Enhanced Mental Health Services\nMH 1,117 FY\u00a02014\u20132015 MH participants 1,081\nMST 74 MST-identified near m"] [17.692899703979492, 9.076752662658691, "youths. We do not determine whether a given outcome is \u201cgood\u201d or \u201cbad.\u201d We simply report whether a between-cohorts comparison shows a statistically significant difference between the two measures.\nAlthough we do have data to look at historical trends"] [17.613903045654297, 8.943431854248047, "and comparison-group youths.\n \u2013SBH\nS-PROB participants showed more-positive outcomes for four of the big six out -\ncomes.\n \u2013SBM\nS-PROB participants had significantly higher rates of completion of probation. \nThere was no significant difference betwee"] [17.576276779174805, 9.068883895874023, "results for MH participants is the finding that program participants had signifi -\ncantly fewer incarcerations than comparison-group youths and did not differ significantly on any of the other big six outcomes. The difference-in-differences analyses "] [17.64559555053711, 9.018016815185547, "it from the program, which -\never came first. Among HRHN participants, measures of family relations also improved sig -\nnificantly in the six months between program entry and exit. In the YSA program, the two supplemental outcomes\u2014percentage of youth"] [17.756549835205078, 9.065059661865234, "st program that used a contemporaneous comparison \ngroup, were significantly more positive for all supplementary outcomes (school attendance, suspensions, expulsions, and overall strength and risk scores) following program entry. For xxii Los Ange"] [18.166471481323242, 9.686707496643066, "OTE: FY\u00a02015\u20132016 in this table indicates that the FY\u00a02015\u20132016 cohort had a significantly more positive result, \nwhile FY\u00a02014\u20132015 indicates that the FY\u00a02014\u20132015 cohort had a significantly more positive result. A dash \nindicates no significant d"] [18.22323989868164, 9.80268669128418, "tice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\nEstimated Total Cost of Programs and Initiatives\nTable\u00a0S.6 shows the estimated mean baseline and follow-up costs per participant in each JJCPA \nprogram in FY\u00a02015\u20132016. The table also shows weig"] [18.229829788208008, 9.82011890411377, "735 3,547 3,923 4,290 4,082 4,498 13,297 \u2013555\nACT 15 4 27 85 48 122 6,397 \u201370\nHB 1,415 \u2013333 3,162 5,025 2,507 7,543 70 \u20133,610\nIOW 23,699 22,282 25,116 25,291 23,794 26,788 1,669 \u20131,592\nPARKS 53 \u201318 123 830 685 976 1,652 \u2013777\nSBHS-AR 188 88 287 1,257 "] [17.956321716308594, 9.15701675415039, "4 162\nCamp \u20131,400 1,667 \u201328\nCourt \u20131,404 \u2013613 \u201396\nJuvenile hall \u20134,088 \u2013628 \u2013174\nProgram \u2013621 \u20132,094 \u2013443\nSupervision \u2013315 \u201398 \u201374\nTotal \u20137,349 \u20131,563 \u2013555\nNOTE: A positive number in this table indicates that mean costs were lower in the six months a"] [17.688499450683594, 8.502154350280762, "e appropriateness of any findings based on such a small subsample. For example, of the 1,117\u00a0MH participants whose outcomes the program reported, only 142 (12.7\u00a0percent) had supplementary outcome data.\nFY\u00a02015\u20132016 was the 16th consecutive year for w"] [17.564123153686523, 8.341177940368652, "\u2019s superb editing of this and previous Juvenile Justice Crime Prevention Act reports.xxxiAbbreviations\nAB assembly bill\nACT Abolish Chronic Truancy\nADA average daily attendance\nBOC Board of Corrections\nBOS Los Angeles County Board of Supervisors\nBSCC"] [17.675498962402344, 8.452847480773926, "ods, schools, and other areas of high juve-\nnile crime\n\u2022 a str\nategy to provide a continuum of graduated responses to juvenile crime.\nIn addition, the county required that, to be funded, a program be based on approaches \ndemonstrated to be effective "] [17.73522186279297, 8.561365127563477, "paring rates between pro -\ngram and comparison groups for each outcome. A chi-square test requires that each cell of a 2\u00a0\u00d7\u00a02 table contain at least five observations.\n3 Some programs (e.g., very small programs or \nthose with very low arrest rates) di"] [17.712629318237305, 8.517760276794434, "f all expenditures for programming for youths.\nJJCPA programs are grounded in social-ecological research. The central tenet of this \napproach is that behavior is multidetermined through the reciprocal interplay of a youth and his or her social ecolog"] [17.835254669189453, 8.531883239746094, "atment group in all ways except for the receipt of treatment (i.e., the comparison group \nwould not receive any). In practice, the evaluation might not identify or measure all factors. However, in criminal justice research, researchers often match co"] [17.78720474243164, 8.68554401397705, "is weakness in mind. In particular, pre\u2013post comparisons for probation-related outcomes, such as successful completion of probation, do not take into account whether the youth was on probation prior to program entry. This can tip the scale in favor o"] [17.804439544677734, 8.714441299438477, "se to 18\u00a0years old or because Probation did not consider their level of mental illness, which would have qualified them for the program in previous years, to be severe enough after SNC changed its qualification criteria. Prior to FY\u00a02007\u20132008, histor"] [17.74448585510254, 8.624858856201172, "completion of probation, arrests, probation violations, incar -\ncerations, successful completion of restitution, and successful completion of community ser -\nvice. See Appendix\u00a0B for an explanation of this rank ordering.\nAn ideal outcome would be for"] [17.71625328063965, 8.995759963989258, "ram start.Background and Methodology 7\nDifference-in-Differences Analyses\nWhen using the previous year\u2019s program participants as a comparison group for the current \nyear\u2019s program participants, we implicitly assume that the two groups have compara"] [17.71748161315918, 8.666994094848633, "rp ost 01 23 , () () () () =+ \u00d7+ \u00d7+ \u00d7\u00d7 \nwhere outcome is the logarithm of the odds ratio for a binary outcome measure (e.g., whether arrested during the reference \nperiod), year is a binary variable coded 1 for the current year and 0 for the previo"] [17.752199172973633, 8.562309265136719, "017,\u00a0p.\u00a07). Using these historical comparison groups produces a weaker design than using one that includes a contemporaneous comparison group does.\nData Quality\nProbation extracted data used to compute outcome measures from its databases. Probation h"] [17.689878463745117, 8.48616886138916, "ang order (i.e., an order not to associate with known gang members).\nOrganization of This Report\nThe remainder of this report focuses specifically on JJCPA programs in Los Angeles County \nin FY\u00a02015\u20132016. Chapter Two details JJCPA programs and presen"] [17.735036849975586, 8.65644645690918, "ogram, ACT, was administered \nto 12,871\u00a0youths who had no involvement in the juvenile justice system. Of the remaining 20,633\u00a0youths who received JJCPA service, 13,073 (63.4\u00a0percent) were probationers, while 7,560 (36.6\u00a0percent) were at-risk youths. "] [17.711641311645508, 8.904155731201172, "obationers and At-Risk YouthsSBHS-AR 3,511\nSBHS-PROB 1,905\nSBMS-AR 1,231\nSBMS-PROB 85\nTotal 33,504\nNOTE: We determine the number of participants in a given program by who received services during the fiscal \nyear, which lasted from July\u00a01, 2015, to J"] [17.615201950073242, 8.90113353729248, "icipants. We statistically matched routine probationers used as members of comparison groups for SBHS-PROB and SBMS-PROB to program participants. MH reported outcomes only for participants who received treatment services. See Appendix\u00a0A for more deta"] [17.514686584472656, 8.858955383300781, "records for dispositions are sometimes incomplete, so, for some probationers, we cannot determine whether they completed probation or had probation violations. Sample sizes for sup -\nplemental outcomes might be considerably smaller because, for insta"] [17.455657958984375, 8.71419906616211, "use disorders, then develops individual treatment plans. In conjunction with treat -\nment providers, probation officers and case managers supervise the youths. An evaluation of the program found that it provides an important service and coordinating "] [17.571226119995117, 8.997995376586914, "\nWe base the supplemental outcome for the MH program on mean scores on the BSI. \nLeonard\u00a0R. Derogatis developed the BSI (Derogatis and Melisaratos, 1983) to reflect the psy -\nchological distress and symptom patterns of psychiatric and medical patient"] [17.596385955810547, 9.041047096252441, "ar comparisons of program outcomes. In many instances, counties have no expectation that program outcomes will improve from year to year, given that no signifi cant changes are expected in the program and/or the youth served by the program. Th us, "] [17.303808212280273, 8.89739990234375, "revious year to the current year. A negative value in \nthat column indicates a reduction, while a positive value shows an increase, in the difference in differences.\nMultisystemic Therapy\nMST is an intensive family- and community-based treatment that"] [17.317230224609375, 8.909329414367676, "ighly individualized and comprehensive basis. MST practitioners are available 24\u00a0hours per day, seven days per week, and provide services in the home at times convenient to the family. This approach attempts to circumvent barriers to service access t"] [17.36687469482422, 8.948282241821289, "e six months following program entry for MST \nparticipants. For comparison-group youths, we measured big six outcomes during the six months following the date of nonacceptance into the MST program. We measured supplemen -\ntal outcomes for MST partici"] [17.145631790161133, 7.712887763977051, "2015\u20132016 Report\nEvidence Base for the Program\nIn April 2000, the U.S. Department of Justice (DOJ) reviewed four then\u2013recently developed \nadult mental health courts in Fort Lauderdale, Florida; Seattle, Washington; San Bernardino, California; and Anc"] [17.168224334716797, 7.777651309967041, "e juvenile courts actually had a sig -\nnificant advantage over adult courts because therapeutic intervention is more consistent with the general approach to juvenile justice. The juvenile drug court model was soon generalized to address concerns othe"] [17.537569046020508, 8.976088523864746, "eeds Court and Comparison Group\nFactor SNC ( N\u00a0=\u00a025) Comparison Group ( N\u00a0=\u00a024)\nMean age, in years 15.2 15.5\nGender, as a percentage\nMale 64.0 62.5\nFemale 36.0 37.5\nRace and ethnicity, as a percentage\nBlack 24.0 29.2\nWhite 16.0 16.7\nHispanic 60.0 54."] [17.57652473449707, 9.075274467468262, "other supplemental outcome was statistically significant between the two groups.\nIn the MH program, the only one in this initiative that used the previous year\u2019s par -\nticipants as a comparison group, difference-in-differences analysis agreed with a "] [17.627866744995117, 8.755206108093262, "l success and healthy social development.\nSchool-, park-, and housing-based DPOs refer female participants to gender-specific ser -\nvices. The DPOs rely on the Los Angeles Risk and Resiliency Checkup (LARRC) to assess criminogenic risk and need facto"] [17.546184539794922, 8.705100059509277, "(such as friends, relatives, neighbors, and church \nmembers)\n\u2022 pro\ngrams that tap girls\u2019 cultural strengths rather than focusing primarily on the indi -\nvidual girl (e.g., building on Afrocentric perspectives of history and community relation -\nships"] [17.586503982543945, 9.000201225280762, "omparison group for the current year\u2019s GSCOMM participants consists of GSCOMM participants whose outcomes we reported for the previous year (FY\u00a02014\u20132015), with the goal of them performing at least as well in the current year as they did in the previ"] [17.387062072753906, 9.125765800476074, " 0.23 0.771 0.394\u20131.510\nIncarceration 0.63 0.79 0.97 0.75 \u20130.38 1.613 0.310\u20138.404\nCompletion \nof probation0.00 22.86 2.74 26.03 \u20130.43 \u2014 \u2014\nCompletion of restitution9.09 39.13 8.62 21.05 17.61 2.274 0.303\u201317.059\nCompletion of community service0.00 26.0"] [17.254629135131836, 9.075216293334961, "ly and other parts of the participant\u2019s environment. It focuses on school attendance and per -\nformance, parenting skills, and family functioning. The SLC is designed as a set of program enhancements to supplement services for HRHN participants. The "] [17.195575714111328, 8.774024963378906, "eam, along with program staff. MTFC parents implement a structured, indi -\nvidualized program for each participant, designed to simultaneously build on the partici -32 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016"] [17.323108673095703, 9.113855361938477, "uired for high-risk and high-need parolees unless they broker services through a host of community resources (Altschuler and Armstrong, 1994; Wiebush, McNulty, and Le, 2000).\nThe employment component of the HRHN program draws from Guide for Implement"] [17.416383743286133, 9.131532669067383, "trument used to measure family relations.\nOutcomes\nFor outcome analyses, we examined 1,237\u00a0 HRHN participants from FY\u00a0 2015\u20132016 and 1,275\u00a0program participants whose outcomes we reported in FY\u00a02014\u20132015. The FY\u00a02014\u20132015 cohort showed significantly h"] [17.589059829711914, 9.067811012268066, "e value shows an increase, in the difference in differences.\na Difference is statistically significant ( p < 0.05).\nDifference-in-differences analyses produced results slightly different from those of a \nsimple comparison between the two cohorts. We "] [17.424196243286133, 9.152074813842773, "ded to enhance self-control. Specific techniques include exploring the positive and negative consequences of continued use, self-monitoring to recog -\nnize drug cravings early on and to identify high-risk situations for use, and developing strate-gie"] [17.514101028442383, 9.172518730163574, "ome measures on the performance of 200\u00a0YSA participants in FY\u00a02015\u20132016 \nand 156 in FY\u00a02014\u20132015. Diff erences between the two cohorts were not statistically signifi -cant for any of the big six outcomes, thus meeting program goals of no diff eren"] [17.557851791381836, 9.112553596496582, " 0.904 0.051\u201316.166\nCompletion of restitution17.17 21.10 5.49 21.51 \u201312.09 0.274a0.079\u20130.948\nCompletion of community service0.96 10.34 0.94 12.04 \u20131.72 0.827 0.045\u201315.136\nProbation violation8.09 18.00 2.38 19.53 7.24 0.251 0.060\u20131.052\na Difference is"] [17.8714656829834, 8.826149940490723, "or the population of probationers and at-risk youths in the schools. A secondary goal is to enhance protective factors through improved school per -\nformance. The program identified the 85\u00a0targeted neighborhoods as the most crime-affected neighborhoo"] [17.990201950073242, 8.8330717086792, "d were statistically significant ( p\u00a0<\u00a00.05), meaning \nthat the performance of JJCPA participants differed significantly from that of comparison-group youths or from their baseline measures.\n9 Sample sizes indicated are for the entire pro -\ngram and "] [18.0305118560791, 8.835138320922852, "Base for the Program\nAn OJJDP paper, Truancy: First Step to a Lifetime of Problems (Garry, 1996), cites truancy as an indicator of and \u201cstepping stone to delinquent and criminal activity\u201d (p.\u00a01). The paper notes that several studies have documented t"] [17.9909725189209, 8.845458984375, "omes six months before and six months after program entry. \nWe measured the supplemental outcome, school absences, in the six months before and after \nentry into the program.\nOutcomes\nFor outcome measures, we examined 6,397\u00a0 ACT participants. Consist"] [17.809476852416992, 8.941167831420898, "follow-up periods, we do not present a figure \nillustrating outcomes for ACT.Current JJCPA Programs and FY\u00a02015\u20132016 Outcome Measures 43\nmance, decreasing the youth\u2019s involvement with delinquent drug-using peers, and increasing \nassociation with p"] [17.686967849731445, 9.198203086853027, "15 and FY\u00a02015\u20132016. Those hous-\ning sites had received JJCPA services in previous years.44 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\nOutcomes\nFor outcome measures, we compared the baseline and follow-u"] [17.668058395385742, 9.21555233001709, "al communi -\ncation\n\u2022 rec\nognition: distribution of participants\u2019 writing to parents, schools, libraries, government \nofficials, and the general public.\nEvidence Base for the Program\nMany juvenile detainees have reading and writing levels significant"] [17.685823440551758, 9.1936674118042, "IOW program met program goals for five of the big six outcomes and exceeded the program goal for arrests.\nThe mean number of SIRs six months after program entry (or in the last 30\u00a0days of the \nprogram, whichever came first) were significantly lower i"] [17.839017868041992, 8.714495658874512, "vice providers, and the Probation Department collaborate to provide after-school enrichment programs and supervision for youths on formal probation, as well as at-risk youths, in selected locations in the 85\u00a0school service areas. These after-school e"] [17.830812454223633, 8.717391967773438, "ool, sports, and work; and (3)\u00a0successfully navigate the various rules and socially accepted routines required in a vari -\nety of settings (J.\u00a0Hawkins and Catalano, 1992; Connell, Aber, and Walker, 1995). Implicit in this perspective is the recogniti"] [17.883441925048828, 8.710831642150879, "s by enforcing conditions of probation and by daily \nmonitoring of school performance (attendance, performance, and behavior)\n\u2022 pre\nventing arrest and antisocial and delinquent behavior by at-risk youths\n\u2022 hol\nding probationers and at-risk youths and"] [18.197185516357422, 9.029640197753906, "ram\u2019s call for case-management interventions that\n\u2022\n asse\nss the probationer\u2019s strengths and risk factors\n\u2022 emp\nloy strength-based case-management interventions\n\u2022 add\nress both risk factors and criminogenic needs\n\u2022 emp\nloy evidence-based treatment in"] [18.186059951782227, 9.040207862854004, "try and the term following program entry. We compared strength and barrier scores at program entry and six months later.\nOutcomes for School-Based Probation Supervision for High School At-Risk Youths\nFor outcome analyses, we compared 1,765\u00a0SBHS-AR an"] [18.198389053344727, 9.03150749206543, "dicates that no one in the cluster had the indicated outcome.\nDifference-in-Differences Analyses for School-Based Probation Supervision for High School \nAt-Risk Youths\nSBHS-AR uses program participants from the previous year as a comparison group, so"] [18.19057846069336, 9.009920120239258, "score weighting to obtain weights for comparison-group youths so that \ntheir characteristics matched those of the program participants. We included only probationers with valid data on all vari -\nables in creating weights for the comparison group. Be"] [18.168472290039062, 9.054544448852539, " risk scores 56 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\ndecreased signifi cantly, from a mean of 7.3 at program entry to 3.6 six months after entering \nthe program. Strength scores also increased sig"] [18.156557083129883, 9.077094078063965, "ams.Current JJCPA Programs and FY\u00a02015\u20132016 Outcome Measures 59\nTable\u00a02.15\nComparison of School-Based Probation Supervision for Middle School At-Risk Youths in FY\u00a02015\u20132016 and Those in FY\u00a02014\u20132015\nFactor FY\u00a02015\u20132016 ( N = 730) FY\u00a02014\u20132015 ( N "] [18.20662498474121, 9.033113479614258, "61\nFigure\u00a02.14\nOutcomes for School-Based Probation Supervision for Middle School At-Risk Youths, by Cluster, FY\u00a02015\u20132016\nNOTE: A missing bar for a cluster indicates that no one in the cluster had the indicated outcome.\nTable\u00a02.16Means, Differences i"] [18.211589813232422, 8.995736122131348, " used the appropriate \nweights for the comparison group. None of the differences between the two groups was statis -\ntically significant. The standardized bias estimates were very low for all variables in the model, the highest being 0.03254 for gang"] [18.184926986694336, 9.04017162322998, "pants also had significantly lower risk scores (4.5 versus 6.8) and higher strength scores (13.2 versus 7.3) six months after entering the program than at program entry. SBMS-PROB participants were significantly more likely than comparison-group yout"] [17.76026725769043, 9.111225128173828, "and IOW showed signifi cant improvements in supplemental outcomes as well.\nTh ree of the programs in this initiative\u2014IOW, SBHS-AR, and SBMS-AR\u2014used the pre-\nvious year\u2019s program participants as comparison groups. For IOW and SBMS-AR, diff erence-i"] [18.232179641723633, 9.816205024719238, "venile justice costs. Probationers, by contrast, might have been under supervision prior to program entry and might have also incurred other juvenile justice costs. This implies that JJCPA programs that predominantly target probationers are more like"] [18.25944709777832, 9.858501434326172, " the cost of juvenile hall for those who spend time in the halls, the cost of juve-nile camp for those assigned to camp, and the various costs associated with arrests and court appearances. In our analysis of overall JJCPA costs, we have attempted to"] [18.37036895751953, 9.98391056060791, "2,430\nGSCOMM 770 796,081 1,034\nHRHN 1,653 4,601,554 2,784\nYSA 231 1,051,606 4,552\nEnhanced School- and Community-Based Services 23,490 14,454,609 615\nACT 12,871 414,229 32\nHB 182 780,526 4,289\nIOW 1,940 165,431 85\nPARKS 1,765 1,479,266 838\nSBHS-AR 3,"] [18.323808670043945, 9.938423156738281, "n camp cost approximately $772.32 (Bryant, 2016). It estimated routine probation supervision to cost $7.41 per day (Bryant, 2016). The rates in FY\u00a02015\u20132016 have increased from those of FY\u00a02014\u20132015 because of a variety of factors, including increase"] [18.303049087524414, 9.92254638671875, "ys the youth attended school in the follow-up period than in the baseline period. The total cost was the sum of these individual costs, and the number of units was a mean over all program participants. Because of missing data for some components, tot"] [18.306440353393555, 9.941615104675293, "he cost is more evenly distributed among participants in the program.\nEstimated Costs for Mental Health Screening, Assessment, and Treatment\nTable\u00a03.2 shows the estimated juvenile justice costs for the MH program. The only part of the MH program admi"] [18.325435638427734, 9.97994613647461, ".80 621 0 2.65 2,043 0 \u20131,422 0\nCourt 4,875.92 Appearance 1.16 5,666 4,876 1.46 7,110 4,876 \u20131,444 0\nJuvenile hall 842.20 Day 11.19 9,423 0 16.20 13,644 1,684 \u20134,221 \u20131,684\nProgram 19.05 Day 0.00 0 0 28.29 539 362 \u2013539 \u2013362\nSupervision 7.41 Day 107.4"] [18.296689987182617, 9.933302879333496, "geles \nCounty JJCPA program. The 25\u00a0participants in this program spent no time in camp in either period. Driven primarily by the huge reduction in juvenile hall days, estimated total costs were only $1,383 higher in the follow-up period than during t"] [18.314159393310547, 9.966736793518066, "CPA Participants 79Table\u00a03.5\nEstimated Juvenile Justice Costs for Gender-Specific Community\nJuvenile \nJustice CostUnit Cost, in \nDollars UnitBaseline Follow-Up Difference, in Dollars\nUnitsMean, in \nDollarsMedian, in \nDollars UnitsMean, in \nDollars"] [18.333473205566406, 9.991783142089844, " cost was higher after entering the program than before entering. Dollar amounts are in 2015 dollars.82 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\ndefine the follow-up period for IOW participants as the "] [18.321346282958984, 9.973207473754883, " for IOW participants averaged $23,699 in the baseline period and $25,291 in the follow-up, a difference of $1,592 per participant.\nEstimated Costs for After-School Enrichment and Supervision\nAs noted above, for JJCPA programs that target primarily a"] [18.327062606811523, 9.98444652557373, "ian\nArrest 2,106.60 Arrest 0.79 1,661 2,107 0.45 945 0 716 2,107\nCamp 772.32 Day 1.68 1,295 0 2.06 1,589 0 \u2013294 0\nCourt 4,875.92 Appearance 1.22 5,971 4,876 1.45 7,073 4,876 \u20131,102 0\nJuvenile hall 842.20 Day 16.59 13,969 1,684 17.29 14,563 842 \u2013594 8"] [18.328693389892578, 9.992822647094727, "le hall, and program administration. Program costs were relatively modest ($1,317 per participant), and school attendance improved. Overall follow-up costs were $162 more than baseline costs.\nEstimated Costs for School-Based Probation Supervision for"] [18.301559448242188, 9.95466423034668, " 0 1,257 1,070 \u20131,069 \u20131,070\nNOTE: A positive number in a difference column indicates that the cost was lower in the six months after beginning the program than in the six months before \nbeginning. A negative number indicates that the cost was higher"] [18.295692443847656, 9.931671142578125, ",628 2,107 0.20 431 0 1,197 2,107\nCamp 772.32 Day 0.00 0 0 0.00 0 0 0 0\nCourt 4,875.92 Appearance 0.73 3,546 4,876 0.36 1,773 0 1,773 4,876\nJuvenile hall 842.20 Day 4.00 3,369 0 7.98 6,718 0 \u20133,349 0\nProgram 3.98 Day 0.00 0 0 172.18 1,345 1,406 \u20131,34"] [18.233659744262695, 9.820637702941895, " total number who received JJCPA services in FY\u00a02015\u20132016, a large percentage of both are in the ACT program. ACT, whose primary goal is improved school attendance, exclusively targets at-risk youths who have virtually no involve-ment with the juveni"] [18.24434471130371, 9.828401565551758, "4 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\na large number of at-risk youths, saw the bulk of its expenses in program costs, whereas its \ncosts for arrests and camp were lower in the six months after pa"] [17.712617874145508, 8.898439407348633, "pant can \nreceive services from more than one initiative and from multiple programs, within or across initiatives, and concurrently or consecutively. Probation counts a given youth as a participant within each program from which he or she receives se"] [17.550546646118164, 9.0021390914917, "rams, particularly those targeting only at-risk youths, the largest contribu -\ntor to total juvenile justice cost was the cost of administering the JJCPA program itself.\n \u2013Com\nparing costs in the six months following program entry and those from the "] [17.594980239868164, 9.151468276977539, "ograms. A simple comparison between the two HRHN cohorts showed no significant difference in arrest rates at either baseline or follow-up. However, a difference-in-differences analysis revealed that the FY\u00a02015\u20132016 participants showed a significantl"] [17.791606903076172, 9.040931701660156, "ee of the programs in this initiative\u2014IOW, SBHS-AR, and SBMS-AR\u2014used the pre-\nvious year\u2019s program participants as comparison groups. For IOW and SBMS-AR, difference-\nin-differences analyses agreed with a simple comparison of rates for all outcomes. "] [17.721446990966797, 9.118802070617676, "articipants significantly improved their school attendance after program entry.\nOutcomes of Simple Comparisons Between Cohorts\nFor seven Los Angeles County JJCPA programs (GSCOMM, HRHN, IOW, MH, SBHS-AR, SBMS-AR, and YSA), the county evaluates outcom"] [17.858686447143555, 9.254825592041016, "received.Table\u00a04.1\nResults from Simple Comparisons in Programs That Used the Previous Year\u2019s Cohorts as Comparison Groups\nProgram Arrest IncarcerationCompletion of \nProbationCompletion of \nRestitutionCompletion \nof Community \nServiceProbation \nViolat"] [18.032974243164062, 9.448808670043945, "016 \u2014 \u2014 \u2014 \u2014 \u2014\nIOW FY\u00a02015\u20132016 \u2014 \u2014 \u2014 \u2014 \u2014\nMH \u2014 \u2014 \u2014 \u2014 \u2014 \u2014\nSBHS-AR FY\u00a02014\u20132015 \u2014 n.a. n.a. n.a. n.a.\nSBMS-AR \u2014 \u2014 n.a. n.a. n.a. n.a.\nYSA \u2014 \u2014 \u2014 FY\u00a02014\u20132015 \u2014 \u2014\nNOTE: FY\u00a02015\u20132016 in this table indicates that the FY\u00a02015\u20132016 cohort had a significantly"] [17.718185424804688, 8.540091514587402, "ting statewide juvenile jus -\ntice data systems. Reports will also include a summary or analysis of how grant funded pro -\ngrams have or may have contributed to or influenced the countywide data that is reported.\nThe current outcome reporting require"] [18.057138442993164, 8.888540267944336, " youths (program participants) as 1. We then use these weights to compare the mean values of the two groups on each of the independent variables. If the treatment and comparison groups show similar mean values when we apply the weights, subsequent an"] [17.68800926208496, 8.551051139831543, "ation.\n4.\n inc\narceration: Like arrest, incarceration is a valid indicator of delinquency and recidi -\nvism. However, incarceration can also be used as a sanction for case-management pur -\nposes, and courts often impose incarceration as a sanction to"] [17.453065872192383, 9.401280403137207, " Individual Treatment and \nTraining (SPIRITT) Family ServicesSubstance abuse treatment 1, 5\nStar View Children and Family Services Home-based HRHN, female 1\nHome-based HRHN, male 2, 4\nTarzana Treatment Centers Substance abuse treatment 3, 5Table C.1\u2014"] [17.501300811767578, 9.491897583007812, "measured supplemental outcomes during the last complete academic period before the youth entered the program and during the first complete academic period after the youth entered the program.\na Difference is statistically significant ( p\u00a0<\u00a00.05).BSCC"] [17.52218246459961, 9.512667655944824, "8 9.54 1,237 125 9.80 1,275\nCompletion of probation245 22.39 1,094 306 26.52a1,154\nCompletion of restitution233 26.42 882 248 26.33 942\nCompletion of community service203 23.88 850 234 26.50 883\nProbation violation130 11.88 1,094 162 14.04 1,154\nSupp"] [17.534950256347656, 9.430444717407227, "e and during the six months after the youth \nentered the program. We measured the supplemental outcome during the 180\u00a0days before and the 180\u00a0days \nafter the youth entered the program.\na Difference is statistically significant ( p\u00a0<\u00a00.05).116 Los "] [17.52397346496582, 9.525310516357422, "nrichment and Supervision, FY\u00a02015\u20132016\nMandated \nOutcomeBaseline Follow-Up\nNumber Percentage Sample Size Number Percentage Sample Size\nArrest 3 0.18 1,652 6 0.36 1,652\nIncarceration 1 0.06 1,652 3 0.18 1,652\nCompletion of probationn.a. n.a.\nCompleti"] [17.514846801757812, 9.52326774597168, "ion331 34.95a947 12 0.96 1,210\nCompletion of restitution151 27.11a557 186 20.38 911\nCompletion of community service80 15.01\na533 5 0.55 879\nProbation violation47 4.96 947 62 5.13 1,210\nSupplemental OutcomeBaseline Follow-Up\nNumber Mean Sample Size Nu"] [17.552785873413086, 9.513521194458008, "dle School Probationers, FY\u00a02015\u20132016\nMandated \nOutcomeProgram Comparison\nNumber Percentage Sample Size Number Percentage Sample Size\nArrest 7 15.91 44 133 28.52 466\nIncarceration 2 4.55 44 38 8.07 466\nCompletion of probation4 12.12a33 5 1.20 444\nCom"] [17.61296272277832, 9.491674423217773, " Participants\nNumber Percentage Sample Size Number Percentage Sample Size\nArrest 1 2.78 36 2 5.88 34\nIncarceration 0 0.00 36 0 0.00 34\nCompletion of \nprobationn.a. n.a.\nCompletion of restitutionn.a. n.a.\nCompletion of community servicen.a. n.a.\nProba"] [17.642166137695312, 9.476093292236328, "mple Size % Sample Size\nArrest 0.00 13 \u2014 0 0.00 21 \u2014 0 8.33 36\nIncarceration 0.00 13 \u2014 0 0.00 21 \u2014 0 0.00 36\nCompletion of \nprobationn.a. n.a. n.a. n.a. n.a.\nCompletion of restitutionn.a. n.a. n.a. n.a. n.a.\nCompletion of community servicen.a. n.a. n"] [17.80511474609375, 9.256579399108887, "letion of community service0.00 2 15.38 13 \u2014 0 0.00 1 3.33 3\nProbation violation0.00 3 0.00 19 0.00 5 0.00 1 0.00 5\nNOTE: \u2014\u00a0=\u00a0No one was assigned restitution in this cluster.133APPENDIX\u00a0G\nProbation\u2019s Form for Measuring Family Relations\nThis appendix "] [17.5976505279541, 8.514518737792969, "on \n Family Criminality \n Identify Family Criminality \n Economic Limitations \n \nTOTAL CHECKS TOTAL CHECKS \n \n \nTOTAL STRENGTHS (SUM TOTAL CHECKED NUMBERS) TOTAL RISKS (S"] [17.314132690429688, 8.132219314575195, "TAL RISKS (SUM TOTAL CHECKED \nNUMBERS) 139Bibliography\nAB\u00a01913\u2014 See California State Assembly, 2000.\nAB\u00a01998\u2014 See California State Assembly, 2016.\nActon, Sgt. Jeffrey\u00a0K., Los Angeles County Sheriff\u2019s Department, email to the authors, November\u00a04,"] [17.35169792175293, 8.140021324157715, "ounty Juvenile Justice Crime Prevention Act: Fiscal Year 2015\u20132016 Report\nCalifornia Attorney General, \u201cCJSC Statistics: Crimes and Clearances,\u201d undated web page. As of February\u00a07, \n2017: \nhttp://oag.ca.gov/crime/cjsc/stats/crimes-clearances\nCalifor"] [17.20387840270996, 8.029584884643555, " Lisbeth\u00a0B. Schorr, and Carol\u00a0H. Weiss, eds., New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts, Washington, D.C.: Aspen Institute, 1995, pp.\u00a093\u2013126. As of February\u00a07, 2017: http://eric.ed.gov/?id=ED383817\nCottle, Ci"] [17.32797622680664, 8.085088729858398, "eports/RR268.html\n\u2014\u2014\u2014, Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2012\u20132013 Report , Santa Monica, \nCalif.: RAND Corporation, RR-624-LACPD, 2014. As of February\u00a07, 2017: \nhttp://www.rand.org/pubs/research_reports/RR624.html"] [17.159509658813477, 8.013586044311523, " Peters, and Associates and Northwest Regional Educational Laboratory, Guiding Principles for \nPromising Female Programming: An Inventory of Best Practices , Rockville, Md.: U.S. Department of Justice, \nOffice of Justice Programs, Office of Juvenile "] [17.104875564575195, 7.91407585144043, ".\nHuddleston, West, and Douglas\u00a0B. Marlowe, Painting the Current Picture: A National Report on Drug Courts \nand Other Problem-Solving Court Programs in the United States , Washington, D.C.: National Drug Court \nInstitute, July 2011. As of February\u00a07,"] [17.09156036376953, 7.935837745666504, "drugcourts_review.pdf\nMorley, Elaine, Shelli\u00a0B. Rossman, Mary Kopczynski, Janeen Buck, and Caterina Gouvis, Comprehensive \nResponses to Youth at Risk: Interim Findings from the SafeFutures Initiative\u2014Summary , Washington, D.C., \nNovember 2000. As of "] [17.26012420654297, 8.052523612976074, ", Handbook of Family Therapy , New York: Brunner/Routledge, \n2003, pp.\u00a0323\u2013348.\nSkowyra, Kathleen\u00a0R., and Joseph\u00a0J. Cocozza, Blueprint for Change: A Comprehensive Model for the \nIdentification and Treatment of Youth With Mental Health Needs in Contac"] [17.200946807861328, 8.033692359924316, " Counseling, Regent University, \u201cLos Angeles County \nSocial Learning Model,\u201d presentation to the Los Angeles County Probation Department, Downey, Calif., 2005.\nWestermark, Pia Kyhle, Kjell Hansson, and Martin Olsson, \u201cMultidimensional Treatment Foste"] [9.147477149963379, 4.4622802734375, "CORPORATION\nCan an Informative Letter \nReduce Gun Crime and Be Cost-Effective?\nA Study of Los Angeles\nPriscillia Hunt, Layla Parast, Gabriel WeinbergerLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein ar"] [13.823869705200195, 4.389753341674805, "s deciding whether to implement a similar program. \n RAND Justice Policy \nThe research reported here was conducted in the RAND Justice Policy Program, which spans \nboth criminal and civil justice system issues with such topics as public safety, eff"] [9.147809028625488, 4.465522289276123, "geles ....................................................................................... 8\t\r \u00a04. How We Studied Effects on Gun Crime and Program Costs ..................................................... 9\t\r \u00a0\nEffect on Crime Methodology ....."] [9.160614013671875, 4.471930027008057, ".................................................................................. 8\t\r \u00a0\nFigure 4.1. Process of Letter Program Included in Cost Analysis ................................................ 10\t\r \u00a0\nFigure 5.1. Daily Hours Spent by City Att"] [9.11455249786377, 4.452803611755371, "rimes. \nFurthermore, local, state, and federal governments have limited resources, so considering the \nbenefit-cost of a program to society compared with other programs can be one way of deciding \nwhether to select a program. \nStudy Intervention Back"] [9.137636184692383, 4.452470302581787, "atch, we tested whether there was any difference in firearm violence rates \nbetween Los Angeles and the control group after the letter program was implemented (2013 and \n2014). A number of robustness checks were performed to test the sensitivity of r"] [9.058060646057129, 4.4272990226745605, "t able to access these data through the Bureau of Alcohol, Tobacco, Firearms and \nExplosives or California\u2019s Department of Justice for purposes of this study. \n x Acknowledgments \nThis study would not have been possible without the time and effo"] [9.112112998962402, 4.452663421630859, "rney\u2019s Office initially publicized the program by mail to new handgun \npurchasers in two high-crime neighborhoods of Los Angeles. The letter for this pilot project was \nsent to a random subset of individuals making new handgun purchases during the te"] [9.095178604125977, 4.447921276092529, "prohibited from \npossessing one, including someone with a known mental disorder. Furthermore, it emphasized that if a child gained access to the handgun and injured himself, herself, or others, the gun owner was subject to criminal prosecution. \nOur"] [9.082939147949219, 4.442986488342285, "thers who commit the crimes, or who themselves quickly transfer the weapon again. 0\t\r \u00a01\t\r \u00a02\t\r \u00a03\t\r \u00a04\t\r \u00a05\t\r \u00a06\t\r \u00a07\t\r \u00a08\t\r \u00a09\t\r \u00a010\t\r \u00a0\nBoston\t\r \u00a0\nSan\t\r \u00a0Antonio\t\r \u00a0\nFresno\t\r \u00a0\nFort\t\r \u00a0Worth\t\r \u00a0\nLas\t\r \u00a0Vegas\t\r \u00a0\nLos\t\r \u00a0Angeles\t\r \u00a0\nAlbuquerque\t\r \u00a0"] [9.126201629638672, 4.45906400680542, "mmunity suffering, but those mortgage payers receiving the letter about the \nhigh proportion of compliers were less compliant. Similarly, a letter experiment aimed at \nreducing the inappropriate provision of Schedule II controlled substances by \u201cover"] [9.131952285766602, 4.4572601318359375, "n of the effect of the letter on city-level firearm violence and the costs and \nbenefits of the program. \n \n 6 2. Data on the Los Angeles Citywide Gun Letter Program \nAlthough the first full month of the program was January 2013, the Los Angeles "] [9.128963470458984, 4.454596042633057, "\n7/7/2014 \n8/7/2014 9/7/2014 \n10/7/2014 11/7/2014 \n12/7/2014 \n1/7/2015 \n2/7/2015 \n3/7/2015 \n4/7/2015 \n5/7/2015 \n6/7/2015 \n7/7/2015 \n8/7/2015 Number of handguns purchased Thanksgiving Christmas \nC \n g \n\u201cBlack Friday\u201d \n 8 3. Gun Crime in the City of L"] [9.118925094604492, 4.446558475494385, "ly a single-unit group to test whether the letter program \n\u201cinterrupted\u201d the gun crime time series in Los Angeles. We used a monthly data set starting in \nOctober 2008 and ending in December 2015, and tested whether there was an interruption to the \n"] [9.20491886138916, 4.488134860992432, "roughout the process, we \ninterviewed staff to determine the direct costs (labor time spent and the equipment used) . \nAdditionally, we obtained documentation of indirect costs (overhead expenses) associated to the \nLos Angeles City Attorney\u2019s Office"] [9.213715553283691, 4.493814468383789, "m of higher taxes to hire someone or \npurchase specific software, for example. Therefore, results of this cost study can be understood \nas the amount of resources shifted away from other work they would have been doing toward \nthis firearm letter pro"] [9.213530540466309, 4.4933600425720215, "s) in \n2013 for government paralegal and legal assistants in the Los Angeles \u2013Long Beach\u2013Santa Ana \narea of $21.61 (Bureau of Labor Statistics, 2014). This was then multiplied by the overhead rate \nof the Los Angeles City Attorney\u2019s Office, 26 percen"] [9.233964920043945, 4.496371269226074, "e needs. \nTime Resources Spent \nFigure 5.1 shows that the time spent for the key personnel during the first stage was seven to \n11 hours per day, which then fell to 3.5 to six hours and 2.5 to four hours for the second and third stages, respectivel"] [9.212618827819824, 4.491714954376221, "sed for a letter program. On the one hand, while the cost per letter for Stage 2 and \nStage 3 are similar when fewer letters are sent (Low), the change in cost increases at a higher \nrate for Stage 3 than Stage 2 when more letters are sent out ( Usua"] [9.136687278747559, 4.464378356933594, "ver, the individuals who opened another person\u2019s \nmail may have violated the privacy of gun buyers in these cases. We are not able to quantify \nthese costs and benefits to the telephone line for the Los Angeles City Attorney\u2019s Office and the public, "] [9.116872787475586, 4.462907791137695, "-term and the \nshort-term models for the letter\u2019s effect on crimes in the city with alternative ITSA \nspecifications. \nFor the short-term model, we found an immediate decline in robberies committed with \nfirearms after implementation of the letter p"] [9.112393379211426, 4.464996337890625, " it may be the case that the program \nindeed had no effect on gun crime, it is also possible that we simply do not have the statistical \npower required to detect the effect on aggregate behavior. On the one hand, if the number of gun \ncrimes committe"] [9.118733406066895, 4.434255599975586, "e confidence in \nthe results of comparing our control group with Los Angeles (see the Appendix). This raises an \ninteresting question: Why? We can see that the mean values of all the matching variables are \nsimilar between Los Angeles and a synthetic"] [9.193730354309082, 4.483696460723877, "ty of Los Angeles. \nHowever, even an effect too minor to detect using our methods might justify the gun letter \nprogram. Given that the cost of the program is fairly low, it is possible to see how even minor \neffects could easily result in the benefi"] [9.150551795959473, 4.468451023101807, "rage in crime reduction (i.e., we would achieve the same $24.19 benefit-\ncost ratio). Using the findings shown in Table 7.1, this amounts to the prevention of \napproximately 19 robberies, 15 aggravated assaults, or fewer than one homicide per year. "] [9.168246269226074, 4.4689226150512695, " FBI and U.S. \nDepartment of \nJustice, 2014b \nAggravated assault Total number of known aggravated assault ; aggravated \nassault is distinguished from regular assault by whether there \nis a weapon involved FBI and U.S. \nDepartment of \nJustice, 2014a"] [9.052194595336914, 4.429974555969238, "er with this model (specifically the use of the rate as the outcome), we also tested another approach of estimating the effect on the \nchanges in crime rates using the count outcome and first differences. Specifically, our outcome is \na count variab"] [9.124098777770996, 4.4646897315979, "d recent simulation \nwork has shown this approach can lead to spurious findings (Schell and Griffin, 2017), so it is unclear that this is a reliable result. \nThe difference models found results of a similar direction. Model II indicated that there wa"] [9.130202293395996, 4.451477527618408, "bove with equation [1]). We remind the reader that this is a first-\ndifferences result, which means that because there was the initial drop in crime because of the \nletter, the number of robberies committed with a firearm remained lower in every mont"] [9.162858963012695, 4.447669982910156, "y. \nWe focused our analyses on cities in the United States with populations over 500,000 in at least \none year since 1980 . The data are for law enforcement agencies serving these city jurisdictions. \nThis selection criterion of jurisdictions with "] [9.055130004882812, 4.368454456329346, "d more similar to other reports: \nWeights were either zero or a small subset of cities received positive weigh ts. \n \n8 For clarity in reading this report, we do not present our findings from the annual "] [9.149099349975586, 4.446161270141602, "ot would have a line drawn at zero for every time point before the intervention, and then a positive or negative gap at the time of intervention and beyond (if the intervention was effective). \nWe show this result in Figure 6.1 of this report, which"] [8.382364273071289, 4.334925174713135, "l, M., C. Christian, and J. Slemrod, \u201cDo Normative Appeals Affect Tax Compliance? \nEvidence from a Controlled Experiment in Minnesota,\u201d National Tax Journal, Vol. 54, No. 1, 2001, pp. 125\u2013138. As of May 1, 2017: https://www.ntanet.org/NTJ/54/1/ntj-v"] [8.441293716430664, 4.286164283752441, "rch Can Tell Us About Investing in \nPolice, Santa Monica, Calif.: RAND Corporation, OP-279-ISEC, 2010. As of May 1, 2017: https://www.rand.org/pubs/occasional_papers/OP279.html \nHepburn, L., M. Miller, D. Azrael, and D. Hemenway, \u201cThe U.S. Gun Stock:"] [8.457910537719727, 4.248630046844482, " No. 1, 2011, pp. 103\u2013109. \nRidgeway, G., G. L. Pierce, A. A. Braga, G. Tita, G. Wintemute, and W. Roberts, Strategies for \nDisrupting Illegal Firearm Markets: A Case Study of Los Angeles, Santa Monica, Calif.: RAND Corporation, TR-512-NIJ, 2008. As"] [13.452836990356445, 3.728508710861206, "ce: Compliance Effects of Informational and \nInterpersonal Justice,\u201d Social Justice Research, Vol. 19, No. 3, 2006, pp. 345\u2013364. \nWright, J. E., \u201cThe Trayvon Martin Effect: Estimating the Effect of the Trayvon Martin Shooting \non Reading Performance"] [6.935155391693115, -1.1210793256759644, "SOCIAL AND ECONOMIC WELL-BEING\nAfter the Grand Opening\nAssessing Cannabis Supply and Demand in \nWashington State\nBeau Kilmer, Steven Davenport, Rosanna Smart, \nJonathan P. Caulkins, Gregory Midgette\nPrepared for the Washington State Liquor and Cannab"] [6.979944705963135, -1.0874937772750854, "intended audience for this report is decisionmakers in Washington State tasked with \nshaping cannabis policy. The methods applied herein should also be of interest to researchers and analysts in other jurisdictions that have implemented or are consid"] [6.875358581542969, -1.1706289052963257, " 26\t\nEstimating the Amount of Cannabis Consumed by User Type .............................................................. 28\t\nEstimating Cannabis Consumption in Washington State, FY 2017 ........................................................ 32"] [6.851824760437012, -1.1930028200149536, "... 17\tTable 2.8. Flower and OPM Lot: Production Volume (MT), Semiannual .............................. 19\tTable 2.9. Extract Ingredients: Production Volume (kg), Semiannual ................................... 20\t\nTable 2.10. Extract Ingredients: THC"] [6.883559226989746, -1.1629291772842407, "rces by Washington residents. Using data from Washington\u2019s traceability system, the authors estimate that approximately 26 metric tons (MT) of THC were sold in the licensed retail stores in Washington from July 1, 2016, through June 30, 2017. About 1"] [6.893059730529785, -1.1541774272918701, "To inform its earlier efforts, the Washington State Liquor and Cannabis Board (WSLCB) asked the RAND Corporation and BOTEC Analysis to estimate the size of the cannabis market circa 2013. Much has changed since then, and the WSLCB asked for an update"] [6.876082897186279, -1.1706591844558716, "rocannabinol (THC) \nand cannabidiol (CBD) content of cannabis products, as THC is the primary psychoactive ingredient in cannabis, and CBD may mediate some of the effects of THC (see, e.g., Englund et al., 2017). Cannabinoid content is measured eithe"] [6.873517990112305, -1.1732476949691772, ", Washington\u2019s producers were restricted to 70 percent of these canopy limits, raised to 100 percent by the beginning of 2017.\n1 These tiers do \nnot specify a given growing method (indoor, greenhouse, or outdoor), although generally smaller (Tier 1) "] [6.87807035446167, -1.1693674325942993, "s in the traceability system can be classified as (a) plant material, (b) lotted \nplant material, (c) an \u201cingredient\u201d produced from lotted material, which will later be converted to a retail product, or (d) a retail product, which is produced from in"] [6.882526397705078, -1.1640597581863403, "\nWax CO 2 \nHash Oil Kief Food -Grade \nSolvent \nExtract Hash Bubble \nHash Infused \nCooking \nOil Infused \nButter/Fat Total \nExtract for \ninhalation 235,512 66,293 10,946 10,317 9,435 5,313 18 6 337,840 \nSolid edible 3,563 2,395 85 5,129 29 5 413"] [6.874271869659424, -1.172263741493225, "tion (the remaining 36 percent of the time), as is the case with marijuana mix and infused cooking oil. \nWe can complement this picture of the supply chain flow by adding another chart, this time \nlinking products with arrows that point \u201cupstream\u201d t"] [6.9050774574279785, -1.1475383043289185, "versions\u201d reports each time an item is converted from one product to a downstream product. The \u201cdispensing\u201d table holds information relating to the sale of products at retail. \u201cPlants\u201d and \u201cplant derivatives\u201d track information related to the status o"] [6.8939738273620605, -1.1532577276229858, "ng\u201d table, which is filled with reports from retailers and appears to be fairly clean. This imbalance in data quality across the two sources makes it difficult to make an \u201capples-to-apples\u201d comparison of production and retail sales volume, and theref"] [6.8694748878479, -1.1761149168014526, " there any way in the dataset to identify which formula has been used for which observations. This inhibits estimation of THC or CBD content for these products, and therefore also for the total net weight of cannabinoid content produced or sold in Wa"] [6.8697614669799805, -1.1765607595443726, "ijuana extracts for inhalation, marijuana mix package, and marijuana mix infused), this method is the simplest. Each product\u2019s THC and CBD test scores are retrieved from its associated potency test (linking via the \u201cinventoryparentid\u201d); monthly and a"] [6.871268272399902, -1.175088882446289, "d, lastly, to flexibly capture features of the \u201cproductname\u201d text field, a term frequency\u2013inverse document frequency (TF-IDF) matrix constructed from the \u201cproductname\u201d text field and reduced to 50 principal components. \nBy summing together valid obs"] [6.873636722564697, -1.1728254556655884, "ed system. We do not present data on cannabinoid content of OPM, which is never tested at the lot stage; instead, that material will be tested further downstream before conversion to a final product, e.g., as marijuana mix before conversion to mariju"] [6.873259544372559, -1.1729656457901, ".6 3.8 5.4 \nBubble hash 43.2 55.1 57.2 60.2 1.7 2.3 1.9 \nHash 48.2 41.3 62.1 59.0 1.2 1.5 2.0 \nFood-g rade solvent extract 21.7 51.9 56.1 62.9 1.0 2.2 1.2 \nKief 19.5 34.5 38.5 39.1 0.2 1.8 2.1 \nMarijuana mix \u2014 15.7 17.5 19.0 0.7 0.7 0.6 \nInfused "] [6.878397464752197, -1.1685024499893188, "pectively, in 2017). THC content among liquid edibles appears to have been flat since 2016, while estimated THC content in solid edibles has increased consistently since 2015. 16 Table 2.6. Average Estimated THC Content (mg) in Edibles \n 2015 2016 "] [6.876161575317383, -1.1692278385162354, "data are missing from the plant derivatives table prior to November 2015. 17 accurate data points, any values above the 99th percentile of the distribution of OPM weights \nwere removed from analysis. \nMarijuana harvests show very strong seasonal tr"] [6.884912967681885, -1.1613575220108032, "ures products\u2019 total weight (grams) before packaging. This \nvalue appears alongside childweight, so an entry for usable marijuana with childweight = 10 and childusableweight = 350 indicates ten different retail packages, each containing 3.5 grams of "] [6.8992533683776855, -1.1481192111968994, "ases when this might not be accurate. First, a processor might have combined several 15-pound OPM \nlots into a single larger lot before converting them into a downstream product, though this seems rare. Second, the \nweight of some child products in a"] [6.872714996337891, -1.1734180450439453, " 170 369 388 491 728 979 1,136 \nKief 279 225 250 482 250 294 733 \nInfused cooking oil 19 190 242 187 237 249 253 \nInfused butter /fat (solid) 70 80 124 132 163 227 181 \nHash 4 26 86 127 187 177 160 \nBubble hash 10 28 32 123 81 116 127 \nTable 2.10. E"] [6.885605335235596, -1.160125494003296, "olume (kg) \nYear Usable Marijuana Extract for Inhalationa Marijuana Mix Infusedb Marijuana Mix Packageb \n2014 3,023 \u2014 \u2014 \u2014 \n2015 34,819 \u2014 75 506 \n2016 85,000 6,610 1,327 2,349 \n2017 126,191 12,855 3,421 2,758 \na Product weight not reported until"] [6.900753498077393, -1.1775635480880737, "9 6,106 11,902 \nSolid edible 58 1,209 3,217 4,837 \nMarijuana mix infused \u2014 12 735 2,611 \nMarijuana mix package \u2014 126 908 1,658 \nLiquid edible 17 330 836 1,180 \nMarijuana -infused t opicals 0 45 188 355 \nCapsule \u2014 \u2014 3 165 \nTincture \u2014 \u2014 7 55 \nSupp"] [6.881989002227783, -1.1659173965454102, "e marijuana 300 1,639 3,932 5,658 8,313 9,686 11,527 \nExtract for inhalationa \u2014 \u2014 551 1,265 2,331 3,872 4,138 \nMarijuana mix infused \u2014 \u2014 10 59 182 356 556 \nMarijuana mix package \u2014 \u2014 49 109 255 326 263 \nSolid edibleb 5 22 41 65 99 116 135 \nLiquid e"] [6.878958702087402, -1.1644675731658936, "e timing of which corresponds with the issuance of a memo establishing a federal policy of nonenforcement against medical cannabis patients (Ogden, 2009). This upward trend seems to have leveled off beginning in 2012/2013 but then increased again in "] [6.8751397132873535, -1.167662262916565, "me use is acknowledged. Unknown; could be greater or less \nthan 1.0. \n \nWe have no reason to believe that the values for Adjustments 1, 2, and 4 have changed much \nover the past five years. Adjustment 3\u2014misreporting by people who are successfully s"] [6.8994059562683105, -1.1461610794067383, "al data. While NSDUH collects information from respondents on the exact number of use days in the past month (and in the past year), RDAS confidentiality restraints limit detailed reporting of the frequency of cannabis use. To maintain protections of"] [6.873732089996338, -1.1689634323120117, "lower products, with the fastest growing market segment being extracts for inhalation. However, to learn more about the patterns of cannabis consumption, we must look \n \ndays [280,000 \u2013 (32,000 + 55,000 + 16, 000 + 17,000 + 26,000 + 122,000) = 12 ,0"] [6.877015113830566, -1.167422890663147, "le, and more than 50 percent reported using an oil cartridge for a vape pen in the past year. \n \n10 A comparison of respondent demographics for these web surveys and NSDUH are presented in appendix Table \nA.6. 32 Table 3.2. Share of Respondents Re"] [6.864779949188232, -1.1776844263076782, "rs Web survey Triangular \n(1.3, 1.6, 1.9) \nRatio of grams per day for DND versus once -per-month \nusers Based on Kilmer et al., \n2013 Uniform [2, 3] \nNOTE : See text for clarification of sources and assumptions. \n \nFigure 3.4 displays the f"] [6.8765058517456055, -1.1671065092086792, "s into MTs of THC. Our \nbaseline estimate applies the same THC level used to make the conversion for the store sales: 20 percent. However, flower obtained from the illicit market may be of lower potency than what is sold in the stores. Indeed, the ac"] [6.880163669586182, -1.1642587184906006, "e average to \n16% THC 250 16 10 59 \nIf we didn\u2019t make any adjustments to \nNSDUH 200 20 10 59 \nNOTES : Column D = (26 \u00b4 (1\u2013C)) / (A \u00b4 B). WA = Washington. \n \nNone of those parameters is known with certainty, so the remaining eight rows of Table 4."] [6.891578674316406, -1.155420184135437, "nd 60 percent. \n \n \n 37 5. Concluding Thoughts \nAgencies regulating cannabis need good information about the size of their cannabis market \nand how it is changing. This can help them make informed decisions about several items ranging \nfrom licen"] [6.921637058258057, -1.1288655996322632, "on residents\u2019 total THC consumption appeared to grow, \nprogress at shrinking the illegal markets\u2019 volume is smaller than these proportions might suggest. For example, if total THC consumption grew by 40 percent over a period when the illegal 38 mark"] [6.874377250671387, -1.1717358827590942, "cts that are particularly efficient at delivering THC gain or lose market share. Tracking trends in THC consumption might be of greater relevance to those studying public health outcomes. \nFinally, by making its traceability system publicly availa"] [6.871579170227051, -1.1779370307922363, "32 19.31 19.96 \nInfused Cooking Oil 1.88 6.75 22.94 16.57 \nInfused Dairy Butter or Fat in Solid Form 5.17 8.85 7.37 6.54 \nKief 16.51 15.32 17.85 18.24 \nMarijuana Mix NA 7.88 9.14 8.51 \nMarijuana Extract for Inhalation 21.44 19.51 26.50"] [7.028170585632324, -1.0407042503356934, "au Kilmer, \u201cBig Data on a Big New Market: Insights from Washington State\u2019s Legal Cannabis Market,\u201d International Journal of Drug Policy, \nVol. 57, July 2018, pp. 86\u201394. \nCole, James, Deputy Attorney General, \u201cGuidance Regarding Marijuana Enforcement,"] [6.97505521774292, -1.083858847618103, "tional Survey on Drug Use and Health Restricted-Use Data Analysis System. \nSAMHSA\u2014See Substance Abuse and Mental Health Services Administration. Smart, Rosanna, Jonathan P. Caulkins, Beau Kilmer, Steven Davenport, and Greg Midgette, \n\u201cVariation in Ca"] [4.638294219970703, 8.038500785827637, "CORPORATIONThe Enemy of Good\nEstimating the Cost of Waiting for \nNearly Perfect Automated Vehicles\nNidhi Kalra and David G. GrovesLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. "] [4.643627166748047, 8.051198959350586, "port RAND Model of Automated Vehicle Safety (MAVS): Model Documentation , which describes in \ndetail the model used for the analysis described in this report.\nRAND Science, Technology, and Policy\nThis research was conducted in the RAND Science, Techn"] [4.641940593719482, 8.061820030212402, "rous gift to help RAND research and outreach teams extend the impact of completed research.\nSupport for this project is also provided, in part, by the income earned on client-\nfunded research, and by the generous contributions of the RAND Justice, In"] [4.716464042663574, 8.294046401977539, "ed \nVehicles for Consumer Use? .................................................................... 31\nReferences ............................................................................................. 33viiFigures and Tables\nFigures\n 3.1. MA"] [4.696667671203613, 8.356500625610352, " when it comes to humans versus machines, but these values and beliefs can be informed by science and evidence. In this report, we seek to provide such evidence by addressing the question of how safe HAVs should be before they are introduced. We used"] [4.7399516105651855, 8.238910675048828, "e same improvement cannot be achieved equally quickly in laboratory or simulation settings. Savings are smallest when the opposite conditions hold.\nSecond, what does the evidence suggest about the conditions that lead to small \ncosts from waiting for"] [4.791239261627197, 8.207586288452148, "s even deadlier\u2014with 37,461 fatalities (NHTSA, 2017). U.S. motor vehicle crashes can pose economic and social costs of more than $800 billion in a single year (Blincoe et al., 2015). Moreover, more than 90 percent of crashes involve driver-related er"] [4.728454113006592, 8.219779968261719, " concern for the transportation industry, policymakers, and the public.\n4 Assessing safety requires considering two issues: How \nshould HAV safety be measured, and what threshold of safety should be required before HAVs are made publicly available? I"] [4.734063148498535, 8.232608795166016, "s would still cause many crashes, injuries, and fatalities\u2014albeit fewer than their human counterparts. This may not be acceptable to society. A large body of research suggests that peoples\u2019 willingness to accept technological risk is governed by fact"] [4.751914024353027, 8.224319458007812, "cy that waits to deploy HAVs only once \ntheir safety performance is either 75 percent or 90 percent better than that of the aver -\nage human driver (we call these options Improve75 and Improve90 , respectively). 4 The Enemy of Good: Estimating th"] [4.881773948669434, 8.072368621826172, " drivers behind the wheel. Table 2.1 shows each level\u2019s description taken directly from the SAE International taxonomy (in italics) and our simplified interpretation.\nConsistent with Federal Automated Vehicles Policy (NHTSA, 2016b), we use the \nterm "] [4.874839782714844, 7.996706962585449, "d by \nfunctions that automate both steering and acceleration, such as lane-keeping and adaptive cruise control; the human driver is responsible for monitoring the environment and intervening whenever needed. \nAutomated driving system performs the ent"] [4.7652997970581055, 8.272522926330566, " improve safety\u2014for example, for coordinating vehicle movement through an intersection (Najm, Toma, and Brewer, 2013; Eccles et\n al\n., 2012).\nRau, Yanagisawa, and Najm (2015) describes a method for identifying the types \nand potential number of curre"] [4.753884315490723, 8.284085273742676, "overlook important ways in which new technologies could add to crashes. This could occur if technology erodes human drivers\u2019 skills or attention, technology is vulnerable to cybersecurity failures that lead to new types of crashes, or HAVs simply per"] [-0.38835975527763367, 12.74886417388916, " over time; the timing, rate, and extent of HAV adoption and diffusion throughout the fleet; and the initial safety of HAVs and how much and how quickly it improves. Accurately predicting safety outcomes is fraught with complications because such fac"] [-0.41477614641189575, 12.734521865844727, "runs models over hundreds or thou -\nsands of different sets of assumptions to describe how plans perform in many \n pla\nusible \nconditions. Unlike, for example, Monte-Carlo analysis, which attaches probabili -\nties to those assumptions to estimate exp"] [4.704890251159668, 8.35019302368164, "onomic costs, or other safety mea -\nsures. For simplicity and because of the particular attention paid to road deaths, we measure safety by the number \nof fatalities and the fatality rate.Figure 3.1\nMAVS Inputs and Outputs\nRAND RR2051-3.1Inputs\nVMT\n1"] [4.695183753967285, 8.36608600616455, " by policy as 25% \n(Improve75) or 10% (Improve90) \nof the benchmark fatality rate\n8. Fin\nal HAV fatality rate Uncertain; constant, defined by initial fatality rates under \nImprove75 and Improve90\n9. HAV m\niles needed to reach 99% \nof\u00a0final HAV fatali"] [4.6877617835998535, 8.377596855163574, "ficult to calculate and visualize in the results.\n4 A Latin Hypercube Sampling procedure ensures that all variables are sampled uniformly across their entire range \nand that the combinations of values across the variables are randomly selected (Salte"] [4.723094940185547, 8.324920654296875, "tes have declined significantly since the 1950s, there has \nbeen a plateau over the past decade and an increase in recent years (Bureau of Transpor -\ntation Statistics, 2016). Based on the estimates of the safety benefits of driver assistance systems"] [4.726823329925537, 8.349235534667969, "nt of HAV use, which we measure \nat the point of full diffusion. To begin with, some percentage of non-HAV driving in the baseline future will ultimately be replaced by HAVs (MAVS input\n 4). \nThis is \ndeeply uncertain, and we explore anywhere from 50"] [4.688645362854004, 8.375936508178711, " defines it in terms of the \ncumulative number of miles of postdeployment HAV driving needed to improve from an initial to a final fatality rate (MAVS input\n 9). Th\nere is little real-world evidence that \nwould help bound this number. As of December "] [4.695799350738525, 8.36258602142334, "er these latter policies. This means that HAVs under Improve10 would reach target safety performance at the same time as or sooner than under Improve75 or Improve90. Thus, the soonest HAVs can be introduced under these latter policies is when they al"] [4.688414096832275, 8.372796058654785, "90 is defined by each \npolicy. As noted earlier, the best possible HAV fatality rate is uncertain, but, for sim -\nplicity, we assume that the very definition of \u201cnear perfection\u201d approaches a practical limit to HAV performance. Thus, HAVs under these"] [4.6957550048828125, 8.361795425415039, "ehicles\nFigure 4.1\nEnsemble Difference in Cumulative Lives Saved over 15 Years for 500 Cases\nRAND RR2051-4.1\nDifference in cumulative fatalities200,000\n150,000\n0 500100,000\n50,000\n0\n400 300 200 100\nCasesImprove10 saves > 50,000 more lives than Improv"] [4.694971084594727, 8.387519836425781, "ce in cumulative fatalities. The figure shows that all of these futures have a 23\n per\ncent or larger increase in VMT as a result of HAV use (horizontal axis) and \nrequire 1 trillion miles or more of driving to achieve a 75-percent improvement in fat"] [4.697303771972656, 8.369174003601074, "lay in introducing HAVs under Improve75a \n(used to calculate Initial year of HAV introduction)8 0\u201315\n3 Improve10 Years to full diffusion of HAVs under Improve10 37 20\u201350\n3 Improve75 Increase in pace of HAV adoption under Improve75a \n(used to calcula"] [4.691406726837158, 8.367810249328613, "itions, and those savings can be significant\u2014tens of thousands to hundreds of thousands of lives. The savings are particularly large when HAVs under Improve10 are adopted quickly. Conversely, the more stringent policies save more lives only when HAVs"] [4.694668769836426, 8.359021186828613, "r term, the difference in VMT and therefore cumulative fatalities is smallest in futures in which HAVs are intro -\nduced under both policies nearly simultaneously. Figure\n 4.8 s\nhows that this gener -\nally occurs when (1) th\ne number of miles it tak"] [4.717727184295654, 8.35057544708252, "emain in operation. Nevertheless, our analysis reveals that these factors are not the primary drivers of dif -\nferent outcomes between these policies. \nTo summarize, in the longer term, more lives are cumulatively saved under an \nImprove10 policy tha"] [4.725230693817139, 8.28165054321289, " does this imply for policies governing the introduction of HAVs for con -\nsumer use?30 The Enemy of Good: Estimating the Cost of Waiting for Nearly Perfect Automated Vehicles\nWhat Does the Evidence Suggest About the Conditions That Lead to \nSmall"] [4.736783981323242, 8.257823944091797, "g gains that some might consider \u201cnear perfect\u201d may take much more effort and time than reaching better-than-average human perfor -\nmance, which may itself be still out of reach. \nSecond, there is no reason to believe that the value of real-world dri"] [4.622702121734619, 8.043323516845703, "servations Exploring a Year\u2019s Change , \nCambridge, Mass.: Massachusetts Institute of Technology AgeLab, White Paper 2017-2, 2017. As of September 12, 2017: http://agelab.mit.edu/sites/default/files/MIT%20-%20NEMPA%20White%20Paper%20FINAL.pdf\nAnderson"] [4.6597185134887695, 8.007411003112793, "blue.lib.umich.edu/bitstream/handle/2027.42/78178/ \nDeCicco_AutoEfficiencyHorizon_Sept2010.pdf?sequence=1Dietvorst, Berkeley J., Joseph P. Simmons, and Cade Massey, \u201cAlgorithm Aversion: People \nErroneously Avoid Algorithms After Seeing Them Err,\u201d Jo"] [4.699686527252197, 7.963411808013916, "3-MCF, 2017. As of September 12, 2017: https://www.rand.org/pubs/research_reports/RR1673.html\nFischhoff, Baruch, Paul Slovic, Sarah Lichtenstein, Stephen Read, and Barbara Combs, \u201cHow Safe Is \nSafe Enough? A Psychometric Study of Attitudes Towards Te"] [4.6542887687683105, 8.028287887573242, "mental Change , Vol.\n 17\n, No. 1, 2\n007, pp. 73\n\u201385. \nHarper, C., C. Hendrickson, S. Mangones, and S. Constantine, \u201cEstimating Potential Increases in Travel with Autonomous Vehicles for the Non-Driving, Elderly and People with Travel-Restrictive Me"] [4.632823944091797, 8.172980308532715, "ny Miles of Driving Would It Take \nto Demonstrate Autonomous Vehicle Reliability? Santa Monica, Calif.: RAND Corporation, RR-1478-RC, 2016. As of September 12, 2017: http://www.rand.org/pubs/research_reports/RR1478.html\nKoopman, Philip, and Michael W"] [4.628238201141357, 8.023134231567383, "NE , Vol.\n 8, N\no. 2, e\n52669, 2013.\nNajm, Wassim G., Samuel Toma, and John Brewer, Depiction of Priority Light-Vehicle Pre-Crash Scenarios for Safety Applications Based on Vehicle-to-Vehicle Communications , Washington, D.C.: U.S. \nDepartment of Tra"] [4.667368412017822, 8.023882865905762, " Neurauter, and J. F. Antin, Advanced Crash Avoidance Technologies (ACAT) Program\u2014Final Report of the GM\u2013VTTI Backing Crash Countermeasures Project , Washington, D.C.: U.S. Department of Transportation, \nDOT HS 811 452, August 2011.\nPetit,\n J.\n, and "] [4.65502405166626, 8.055387496948242, "/files.shareholder.com/downloads/ABEA-4CW8X0/2238129554x0x913801/ \nF9E5C36A-AFDD-4FF2-A375-ED9B0F912622/Q3_16_Update_Letter_-_final.pdfWalden, Greg, \u201cOpening Statement of Chairman Greg Walden,\u201d hearing on \u201cSelf-Driving Cars: \nRoad to Deployment,\u201d U."] [4.7152018547058105, 8.277905464172363, "uman drivers\u2014what some might consider nearly perfect. We \ufb01nd that, in the long term, under none of the conditions we explored does waiting for signi\ufb01cant safety gains result in fewer fatalities. At best, fatalities are comparable, but, at worst, wait"] [13.088658332824707, 0.7508665919303894, "Law Enforcement Efforts to Fight the \nOpioid Crisis\nConvening Police Leaders, Multidisciplinary Partners, \nand Researchers to Identify Promising Practices and to Inform a Research Agenda\nSean E. Goodison, Michael J. D. Vermeer, Jeremy D. Barnum, Dula"] [13.109966278076172, 0.746793806552887, "romo -\ntion opportunities.\n\u2022 Provide same-day, low-barrier access to treatment with a medication-first model of care.\n\u2022 Provide syringe services to reduce associated harms and create treatment intervention opportunities.\n\u2022 Use syndromic surveillance "] [13.080408096313477, 0.7284547090530396, "opioid crisis, law enforcement officers experience additional physical dangers, mental trauma, and stressors. Needs related to officers\u2019 mental health were seen as pressing, and participants gave high priority to strategies such as providing mental h"] [13.047229766845703, 0.7028620839118958, " dramatic spike in heroin-related over -\ndose deaths in 2010. The deadliest wave of the epidemic began in 2013, with the introduction of synthetic opioids into the illicit drug supply. Today, synthetic opioids\u2014primarily fentanyl and its analogs\u2014remai"] [13.072386741638184, 0.7204664945602417, " the epidemic (addressed in a keynote speech given by then\u2013Attorney General Jeff Sessions), the science of addiction and treatment, law enforcement\u2013led efforts to combat opioids, key areas of cooperation among governmental and community stakeholders,"] [13.07536792755127, 0.7184587121009827, "pioid Crisis released a report detailing a broad variety of recommendations to address opioid use, addiction, and its consequences (White -\nhouse.gov, undated; Christie et al., 2017). The report acknowl -edges that effective solutions to a crisis of "] [13.067947387695312, 0.7280206084251404, "f food or by engaging in sexual activity. Under normal circumstances, the amount of dopamine in the body is naturally regulated by another chemical, gamma-aminobutyric acid (GABA). However, opioids bind to the part of the nerve that reduces GABA rele"] [13.084010124206543, 0.7356626987457275, "motions and physical illness after a period of time without using opioids. Repeated opioid use interferes with the brain\u2019s reward system by impairing an individual\u2019s ability to experience pleasure. This compounds compulsive opioid use as individuals "] [13.0890474319458, 0.7424952387809753, "ructured to include panels focusing on key topics related to law enforcement\u2013driven responses to the crisis. The topics of interest were identified based on literature review and discussions among RAND, PERF, and NIJ experts. Each panel included a se"] [13.07496452331543, 0.740515947341919, "arolina Harm Reduction Coalition [NCHRC], undated). As emergency first responders, law enforcement officers can rapidly administer naloxone, especially in rural jurisdictions where emergency medical services might not be as readily available (Davis e"] [13.071694374084473, 0.7416210174560547, "s also have been shown to strengthen the relationship between law enforce -\nment and members of the community (Wagner et al., 2016). Fewer studies have examined the efficacy of law enforcement serving as an entry point to treatment. One nonrandomized"] [13.078767776489258, 0.7367133498191833, "prehensive partnership among law enforcement, commu -\nnity organizations, researchers, and the Washington/Baltimore High Intensity Drug Trafficking Areas (HIDTA) program. The goal of the initiative is to address the basic causes of drug use, rooted i"] [13.074923515319824, 0.7418100833892822, "ted by another law enforcement expert, a naloxone deployment functions as a \u201chandshake\u201d with individuals with OUD and helps to build trust and rapport with officers, creat -\ning an entry point for treatment or other services either in the moment or w"] [13.08878231048584, 0.7459404468536377, "including methadone, buprenorphine, and naltrexone, so that they can create an individualized treatment plan that will be most effective for them. Attendees argued that it is counterproductive for law enforcement to arrest individuals for possession "] [13.078469276428223, 0.7399685382843018, "tant part of law enforcement \nnaloxone programs. Often, law enforcement agencies work with 9local or state partners or nonprofit organizations to implement \nthese programs. For example, the Deaths Avoided with Nalox -\none (DAWN) program was developed"] [13.09123706817627, 0.7445533871650696, "takeholder coordination. \nThis panel featured the following five presentations:\n\u2022 Baltimore City Health Department and Law Enforce -\nment Collaborative Efforts, by Matthew Stefanko, Balti -\nmore City Health Department\n\u2022 RxStat\u2014Applying the NYPD\u2019s Da"] [13.087295532226562, 0.7384771108627319, "ans who would prevent crime) to note that coordination of public health and public safety efforts can start with considerable common ground. Central to overdose fatality reviews is the belief that overdoses are pre -\nventable through comprehensive in"] [13.096571922302246, 0.7492823004722595, "ome unfocused. In the context of the opioid epi -\ndemic, attendees asserted that the primary indicator of success that stakeholders should pursue is reducing overdose deaths. Although the attendees generally agreed, one participant noted that an excl"] [13.0694580078125, 0.7149363160133362, " that information to encourage individuals with OUD to take precautions that could reduce harm and prevent overdose. However, attendees noted that information sharing can sometimes be limited by the Health Information Portability and Accountability A"] [13.060039520263672, 0.7067038416862488, "me into contact with drugs contain -\ning fentanyl, extremely powerful synthetic opioids with a high likelihood of causing overdose (Pagane et al., 1996; Burgess, Barnhart, and Checkoway, 1996; Herbert et al., 2006; Collaboration was discussed as the"] [13.089516639709473, 0.7197121977806091, "ics exposure, especially with the increasing opioid and fentanyl trends. He noted that the danger is often thought of as occurring at the scene, but it also can extend through the chain of custody to transport, packaging, testing, storage, and eventu"] [13.081938743591309, 0.7199957370758057, "e topic and that standardized case reporting is necessary to better track the scope of the problem . Although participants were unaware \nof any confirmed reports of officer fatalities from accidental opioid exposure, they acknowledged that appropriat"] [13.097010612487793, 0.6904593110084534, "\nopioid epidemic. With the constant introduction of new drugs, forensic laboratories are on the front lines in terms of assess -\ning the shifts in drug use trends and their consequences. These substances are identified through samples submitted by la"] [13.12073802947998, 0.6294412612915039, "r \nProtection.\nAlthough having officers trained to use field identification \nkits has been in place in Phoenix, Arizona, since 2000, these \nkits did not allow for presumptive testing for opioids until after 2012, according to Crump. With support from"] [13.096556663513184, 0.6854513883590698, "opes. New technology can aid in the process, but much of \nthe knowledge required to remain current is acquired through outside partnerships and communication with other laborato -\nries, content analysis of websites catering to drug users, and the pee"] [13.104354858398438, 0.7562814950942993, " partnerships, and communities.\nPublic health experts stressed the value of this approach, \ncommenting that there is a common misperception that indi -\nviduals with OUD will seek out substances of higher potency. Panelists noted that studies tend to "] [14.731670379638672, 1.734955072402954, "etailed notes on the cards as they talked in order to capture their reason -\ning on or reservations about a strategy or action category from the discussions. Participants were encouraged to move freely among the tables and, ultimately, to vote by pla"] [14.658103942871094, 1.7069134712219238, "all differences in the actual prioritization scores. Instead, we use a clustering algorithm to identify natu -\nral groupings of high, medium, and low priorities among the items being prioritized. For this event, when we clustered all of the needs int"] [13.278664588928223, 0.8686767816543579, " needs that are perceived to have barriers related to inadequate resourcing, inadequate technology, potential community and stakeholder concerns, or legal and regulatory issues. These are important strategies that should be priorities for additional "] [13.258734703063965, 0.8558140993118286, "recognize emerging drug crises.\n5 \nAlthough participation and group composition remained \nlargely constant during the panels and subsequent discussions, many participants departed from the workshop before the final prioritization session. The worksho"] [13.112351417541504, 0.7528941631317139, "that Table 2. The 13 High-Priority Needs, by Category\nCategory Related High-Priority Need\nOverdose response and treatment promotion \u2022 Broaden the use of MAT in the general population and increase accessibility.\n\u2022 Promote nonenforcement police outreac"] [13.11617660522461, 0.7570748329162598, "nication among stakeholders and useful methods for carrying out syndromic surveillance. Participants noted the need to establish relationships and communicate with diverse groups. Parties could use social media to provide information to the community"] [13.156371116638184, 0.7844357490539551, "5.6\n22.2\n33.3\n2.3\n22.9\n59.4\n14.8\n25.962.0\n42.5\n25.9\n39.0\n78.1\n11.1\n63.9\n55.6\n97.7\n68.6\n25.0\n63.0\n66.719.0\n6.9\n22.1\n33.3\n13.9\n11.1\n8.6\n15.6\n22.2\n7.4Resolve ba rriers Research , replicate , and evaluate results Disseminate and promote broad a pplicatio"] [13.14216423034668, 0.7572951316833496, "lder concerns received no votes, participants nevertheless made mul -\ntiple suggestions about means to address community and stake -\nholder concerns. Participants particularly suggested addressing community attitudes that would seek to keep facilitie"] [13.110013008117676, 0.7437256574630737, "r studying, research, and communication could be helpful. \nCreate a trauma awareness early warning system for \nlaw enforcement stress exposure . This need was derived from \nthe discussion following the panel on officer safety. Participants primarily "] [13.124385833740234, 0.7619156241416931, "eceived enough total votes to place them in the top tier, they stand out because of this apparent suggestion from many participants that they might not be ready for implementation and barrier resolution until further research is carried out. \nExplore"] [13.109274864196777, 0.7500969767570496, " the opioid crisis will be a focus on connecting individuals with OUD to the medications that can treat the disorder. A strong body of evidence suggests that MAT is an effective means to treat OUD and reduce harm from opioid abuse as a long-term solu"] [14.727051734924316, 1.7160670757293701, "re published on the topic. At the time of the invitations, panelists were pro -\nvided with a brief description of the workshop\u2019s focus areas.\nPrioritization of Needs\nAs we described in the main body of the report, to prioritize the needs provided in "] [13.073430061340332, 0.7377357482910156, "can Society of Addiction Medicine, Public Policy Statement: Definition of Addiction , Chevy Chase, Md., April 12, 2011. As of \nJuly\u00a023, 2019: https://www.asam.org/resources/definition-of-addiction\nASAM\u2014 See American Society of Addiction Medicine.\nBec"] [13.074018478393555, 0.7491198182106018, "of July\u00a023, 2019: https://www.whitehouse.gov/sites/whitehouse.gov/files/images/ \nFinal_Report_Draft_11-1-2017.pdf\nClifasefi, Seema L., Heather S. Lonczak, and Susan E. Collins, \n\u201cSeattle\u2019s Law Enforcement Assisted Diversion (LEAD) Program: Within-Su"] [13.069945335388184, 0.7287923693656921, "ncreases in Synthetic Opioid\u2013Involved Overdose Deaths\u201427 States, 2013\u20132014,\u201d Morbidity and Mortality Weekly Report\n, Vol. 65, No. 33, August 26, 2016, pp. 837\u2013\n843.\nGreen, Traci C., Nickolas Zaller, Wilson R. Palacios, Sarah E. \nBowman, Madeline R"] [13.062121391296387, 0.7290555238723755, " undated. As of July\u00a023, 2019: https://www.leadbureau.org\nLEAD National Support Bureau\u2014 See Law Enforcement Assisted \nDiversion National Support Bureau. Lee, Joshua D., Edward V. Nunes, Jr., Patricia Novo, Ken Bachrach, \nGenie L. Bailey, Snehal Bhat"] [13.05941104888916, 0.7601187825202942, "page, undated. As of August\u00a01, 2019: http://www.ncai.org/initiatives/partnerships-initiatives/ \nncai-opioid-initiative\nNational Institute on Drug Abuse, \u201cOpioids,\u201d webpage, undated. As \nof July 23, 2019: https://www.drugabuse.gov/drugs-abuse/opioid"] [13.067750930786133, 0.7350134253501892, "n and Recovery Initiative, \u201cOur Law \nEnforcement Partners,\u201d webpage, undated\u00a0b. As of July\u00a023, 2019: https://paariusa.org/our-partners\nPolice Executive Research Forum, Building Successful Partnerships \nBetween Law Enforcement and Public Health Agenci"] [13.064390182495117, 0.7266320586204529, ". As of July\u00a023, 2019: https://www.cbp.gov/newsroom/video-gallery/video-library/ \nfentanyl-real-deal\nU.S. Department of Health and Human Services, Office of the \nSurgeon General, Facing Addiction in America: The Surgeon General\u2019s Report on Alcohol, "] [13.92112922668457, 4.1806840896606445, "chnology policy, criminal justice, \nnational security, and emerging technologies and innovation. His recent research involves the policy, procedure, and technology needs of criminal justice agencies, development planning and program evaluation in the"] [13.9296875, 4.0698347091674805, "University of Denver, is carrying out a research effort to assess and prioritize technology and related needs across the criminal justice community. This initiative is a component of NIJ\u2019s National Law Enforcement and Corrections Technology Center (N"] [0.7151749730110168, 13.439021110534668, "Robust Stormwater \nManagement in the Pittsburgh Region\nA Pilot Study\nJordan R. Fischbach, Kyle Siler-Evans, Devin Tierney, Michael T. Wilson, \nLauren M. Cook, Linnea Warren May\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis documen"] [0.7162229418754578, 13.436991691589355, "ing challenge of stormwater management in the \nPittsburgh metropolitan region. The City of Pittsburgh and other municipalities in Allegheny County, Pennsylvania, face significant challenges in meeting water-quality requirements and upgrading their ag"] [0.7182196378707886, 13.47165298461914, "............................................................... ix\nSummary .............................................................................................. xi\nAcknowledgments ..........................................................."] [0.9744383096694946, 13.495376586914062, "y Levers Considered in This Pilot Study ...................................................... 59\nPreliminary Strategy Cost Assumptions ........................................................... 65\nResults from Screening Comparisons ............."] [0.7436858415603638, 13.297484397888184, "...................................................... 42\n 3.5. Comp\narison of Average Monthly Overflow, 2003 Typical Year and Recent \nHistorical ................................................................................ 43\n 3.6. Map of Re\ncen"] [0.756858766078949, 13.398508071899414, "ar (Mgal.) .............. 33\n 3.3. Summ\nary Statistics for Three Precipitation Scenarios (Main Rivers \nPlanning Basin) .......................................................................... 39\n 3.4. Rece\nnt Historical Simulated Overflows Compa"] [0.7457409501075745, 13.428383827209473, "ferred to as a sanitary sewer overflow (SSO). More than 9\u00a0billion gallons \n(Bgal.) of sewer overflow in a typical year have led to violations of the U.S. Clean Water Act (33 U.S.C. 1251), along with state and county public health laws.\nAdding to the"] [0.7478923797607422, 13.460224151611328, "roximately \n9.5\u00a0Bgal. of CSOs and SSOs can occur each year. Given the negative effects on water quality, ecosystems, and public health from these overflows, the U.S. Environmental Protection Agency in 2008, working with its state and local partners, "] [-0.37775835394859314, 12.713607788085938, "udy Uses a Participatory Approach and Robust Decision Making \nMethods\nThe study is based on a participatory decision support framework and method for \nimproving decisions under deep uncertainty called Robust Decision Making (RDM). RDM is an iterative"] [0.21793437004089355, 13.089446067810059, "plore \nhow the system might respond to plausible future scenarios reflecting the number of future wastewater customer connections, land-use changes, or climate change. All of these results are based on a \u201cfuture without action,\u201d in which the current "] [0.7096189260482788, 13.308756828308105, "ual rainfall and slightly less intense daily storms.\n\u2022 Land u\nse: Three land-use scenarios were developed reflecting no population \ngrowth (Current Land Use), moderate growth (Southwestern Pennsylvania Com -\nmission [SPC] Growth), and high growth (2x"] [0.7768559455871582, 13.32905101776123, "ute to overfl ow increases but that no single factor is dominant. Th e extent of increased vulnerability depends on the assumptions, but it ranges from 1.5 to 4.2 Bgal./year in additional overfl ow volume (11 to 13.7 Bgal./year in total) when comp"] [0.9884846210479736, 13.495922088623047, "s the names and assumptions used for each GSI strategy. \n\u2022\n Inflo\nw and infiltration (I&I) reduction: I&I is the result of an aging sewer \nsystem with leaks in manholes and pipes, as well as some cases in which buried streams flow directly into the "] [1.0068155527114868, 13.512426376342773, "verflows by 25 percent, while treatment expansion together with cleaning of the main intercep -\ntors reduced overflows by 34\u00a0percent. I&I strategies alone reduced total overflow 5 to 19 percent, and GSI strategies reduced overflows 5 to 21 percent. T"] [1.0123357772827148, 13.50843620300293, "itial set of assumptions used in strategy screening that are similar to those applied in other recent research. 480 MGD = treatment plant expansion; Clean = deep-tunnel interceptor cleaning.\nRAND RR1673-S.34.0 6.0 8.0 10.0 12.0 14.0\nTotal overflow (B"] [1.0347838401794434, 13.512690544128418, "4 to $1.59 per gallon, with many scenarios above the reference value of $0.35 per gallon. Strategies including treatment plant expansion alone or together with interceptor cleaning, by contrast, yield good cost-effectiveness performance across the fu"] [1.0142978429794312, 13.513599395751953, "above (poor) the threshold of $0.35 per gallon. \nUsing statistical algorithms and visualization tools, several key drivers were iden -\ntified common to both strategies: (1) future climate uncertainty (represented as average annual rainfall); and (2) "] [0.9867281317710876, 13.498697280883789, "ible future changes, by contrast, shows that source \nreduction with GSI is more cost-effective in higher-rainfall scenarios . Of course, \nall strategies show improved cost-effectiveness with more rainfall, but the relative cost-\nefficiency improvemen"] [1.0024826526641846, 13.515746116638184, "r regional stormwater management. The analysis shows that large-scale investments in source reduction could help reduce overflow but with a wide range Summary xxv\nof uncertainty regarding cost-effectiveness and relative strategy performance. It al"] [0.7089987397193909, 13.431962966918945, "s as part of an adaptive plan. Our analysis is suggestive, but not yet conclusive, about what a robust and adaptive strategy might entail.xxviiAcknowledgments\nThis pilot study was possible only through active and sustained engagement with many \npartn"] [0.6290311813354492, 13.430434226989746, "throughout the research effort, overseeing workshop logistics and countless revisions to the draft manuscript. Robert Lempert and Debra Knopman served as RAND co\u2013principal investigators, overseeing all three urban climate adaptation pilot efforts, an"] [0.7335710525512695, 13.445228576660156, "The study builds on recent RAND efforts to support improved deci -\nsionmaking in response to climate and other uncertainties (e.g., Fischbach et al., 2015) and is one of three pilot studies centered around a new framework for urban adaptation 2 Ro"] [0.7446228265762329, 13.431341171264648, " somewhere in the system, drain -\ning a mix of untreated stormwater and wastewater into one of the three rivers. Some portions of the county have sanitary sewer overflows (SSOs), where wastewater flows \n1 In addition, there is a fourth river, the Yo"] [0.7089991569519043, 13.433975219726562, "t, inadequate stormwater drainage (Balingit, 2013). Some municipalities regularly face rainfall flooding, which can damage homes, businesses, and municipal infrastruc -\nture and can increase the risk of landslides.\nThe Pittsburgh region\u2019s stormwater "] [0.8681374192237854, 13.465435981750488, " the proposed inclusion of \u201csource reduction\u201d\u2014that \nis, investments to reduce or prevent groundwater or stormwater from entering the existing sewer system \u201cat the source,\u201d thereby freeing up capacity and reducing overflows. Source reduction approache"] [0.9578150510787964, 13.497507095336914, "lowing:\n\u2022\n How mig\nht the region\u2019s vulnerability to future stormwater runoff and sewer over -\nflow change with a changing climate and population patterns?\n\u2022 To what e\nxtent could CSOs and SSOs be reduced using innovative approaches, \neither in curren"] [0.7469424605369568, 13.423993110656738, " of stormwater and wastewater simula -\ntion models originally developed by ALCOSAN to support quantitative scenario anal -\nysis. Appendix C details the technical inputs and methods applied to develop scenarios for this study. In Appendix D, we descri"] [0.7435956001281738, 13.436229705810547, "fl ow through Allegh-\neny County. Figure 2.1 shows a map of the 25 watersheds within the county\u2019s border. \nHowever, urbanization and the region\u2019s long history with natural resource extraction and heavy industry have taken a major toll on the health "] [0.7243425846099854, 13.427735328674316, "ovide conveyance to the treatment plant. However, when the capacity of the system is overwhelmed, typically during wet weather events, a mixture of untreated stormwater and sewage overflows from the system and is released into a river or stream. Impo"] [0.7357221841812134, 13.431157112121582, ".\n Overflows in Pittsburgh and other ALCOSAN communities are high, but \nthey are comparable to those in older American cities with combined sewer systems. \nMilwaukee, Wisconsin, has a similar-sized system, for example, and previously faced \n8 to 9 "] [0.7263306379318237, 13.453193664550781, "l ratepayers (3 Rivers Wet Weather, undated-a). \nALCOSAN has similarly initiated meetings involving policymakers, managers, \nand engineers to facilitate municipal coordination on green infrastructure projects. These meetings served to highlight the v"] [0.7226895093917847, 13.457293510437012, "cted to prevent more than 5 Bgal. of wastewater from reaching waterways each year, yielding systemwide reductions in CSO and SSO volumes of 56\u00a0 percent and 90\u00a0percent, respectively. ALCOSAN estimated that ratepayers could face rate increases of appro"] [0.7214506268501282, 13.447827339172363, "gion: A Pilot Study\nconsent orders and agreements with PADEP. Municipalities facing CWA compliance \nviolations participated with ALCOSAN in the creation of the WWP to help ensure that it would address all wastewater issues facing the service area (AL"] [0.8123464584350586, 13.454767227172852, "lems, and considers potential solutions for follow-up in Phase II. The final plan will focus on developing a model ordinance for stormwater management and other key elements highlighted in Phase I, but it could also contribute to subsequent Regional "] [0.9246640801429749, 13.482259750366211, "es Stitt of PWSA, August 16, 2016.18 Robust Stormwater Management in the Pittsburgh Region: A Pilot Study\nStormwater Source Reduction and Green Stormwater Infrastructure \nAs noted in the previous section, one approach under active consideration fo"] [-0.20297455787658691, 12.937442779541016, "ver -\nflow control plans (USEPA, 2014), and the approach is being studied and implemented at scale as part of LTCPs or other climate adaptation efforts in other major metro -\npolitan areas, including Philadelphia; Seattle; Washington, D.C.; and New Y"] [-0.3721155524253845, 12.712300300598145, "ation to systematically consider how outcomes could vary across a wide range of plausible assumptions about the future. \nRDM then uses statistics and visualizations to investigate the resulting large data -\nbase of model runs and help identify those "] [0.7316119074821472, 13.432938575744629, "olicy choices) to consequences (change in risk) and used visualization tools to help the stakeholders envision vulner -\nabilities and trade-offs, engage in an iterative process of \u201cwhat if\u201d with the data, and deliberate with one another over decision"] [0.6524697542190552, 13.502669334411621, "management were also actively conducting or supporting local planning efforts. This group included experts from ALCOSAN; PWSA; \n3 Rivers Wet Weather; Michael Baker Jr., Inc.; CDM Smith; Mott MacDonald; Landbase Systems; and Ethos Collaborative. Othe"] [0.4489256739616394, 13.587286949157715, "around urban stormwater management within Allegh -\neny County. We employed the XLRM process first set forth in Lempert, Popper, and Bankes (2003) to organize the conversations and relevant outputs. In the XLRM abbreviation, M stands for the goals to "] [0.7696859836578369, 13.474920272827148, "e workshops was reducing flood risk to resi -\ndents and property, either from events that exceed system capacity (e.g., basement \nbackups, manhole overflows) or from stormwater flow itself on hillsides and in valleys during severe rainfall events. Pa"] [0.8238542675971985, 13.471195220947266, "ants identified a range of policy levers that could address these goals. These included traditional gray infrastructure (tunnels, pipes, treatment, and storage); stormwater source reduction via GSI or through improved repair, retrofitting, opera -\nti"] [0.8694821000099182, 13.478163719177246, "nt could dramatically alter the \nrange of feasible solutions for local and regional planners. \nFinally, some participants noted that some proposed stormwater policy levers, \nparticularly stormwater GSI, have not yet been tested or proven at a large s"] [0.7146415114402771, 13.536542892456055, "s broad scope to identify a set of discrete analysis steps that \ncould be accomplished within the time frame and resources of this pilot study. The XLRM elements bolded in Table 2.1 represent those that we were able carry forward into the technical a"] [0.7537810206413269, 13.378490447998047, "study, we employ RDM with currently available \nsimulation modeling tools. The process to translate this scope into a series of techni -\ncal inputs for the analysis is briefly described, along with analysis results, in Chapters Three and Four, with mo"] [0.7209343910217285, 13.32111644744873, " inputs related to population growth and land use and present sewer overflow results across these scenarios in turn. All overflow scenarios are then combined to show the complete uncertainty analysis, and we high -\nlight a handful of system outfalls "] [0.7699065208435059, 13.3611478805542, " ALCOSAN models will also exist in the adapted models used in this analysis . This is an important limitation \nin this context, as simulation modeling to support urban stormwater, wastewater, and water-quality planning is a challenging and evolving s"] [0.7506634593009949, 13.3380765914917, "equires more than \n50 central processing unit (CPU)-hours, which can be completed in roughly a 24-hour span when using a server or multicore computer that can run several basin models simultaneously. To scale the study to be able to test many variabl"] [0.7756608724594116, 13.339457511901855, "LCOSAN\u2019s original modeling assumptions. \nTable 3.2 summarizes the annual volume of sewer overflows by planning basin \nsimulated in the RAND model after the bias correction is applied. These results closely match ALCOSAN\u2019s Existing Conditions modeled "] [0.2167462259531021, 13.172687530517578, "lated for the vulnerability analysis. \n1 The RDM literature sometimes uses the term future to describe a specific realization or mapping of assump -\ntions to consequences. This is distinguished from a \u201cscenario\u201d or \u201cdecision-relevant scenario,\u201d whi"] [0.7220048904418945, 13.334686279296875, "nsider long-term climate change effects on their systems.\nRecent Local Investigations Rely on a \u201cTypical Year\u201d Approach\nAllegheny County\u2019s weather is influenced from systems moving from the Gulf of Mexico, Canada, and the U.S. Central Plains.\n Mean y"] [0.12227945029735565, 12.685481071472168, "ded and main -\ntained by 3 Rivers Wet Weather (undated-a). In this case, the 1 km\n2 of observed pre-\ncipitation data was reformatted and used directly as inputs for the SWMM models for the years 2004 to 2013.\nClimate Downscaled Hydrology\nAdditional c"] [0.6451331973075867, 13.237346649169922, "longer. The Higher Total Rainfall scenario, alterna -\ntively, uses the MM5I-HadCM3\n3 simulation. This scenario projects the largest increase \nin total annual rainfall and slightly less-intense daily storms than the Higher Intensity Rainfall scenario."] [0.7015445232391357, 13.234733581542969, "s of average rainfall or frequency of intense storms, and it is too soon to tell which of these futures might be more or less likely to occur.\nFinal Climate Scenarios\nThe resulting outputs from the downscaling analysis are two climate-adjusted precip"] [0.751750111579895, 13.304986000061035, "fecting sewer over -\nflows. Using the adapted modeling system described earlier, we evaluated annual over -\nflows from the 2003 Typical Year and the subsequent decade (2004 to 2013) (Recent Historical), holding wastewater customer connections and lan"] [0.7356774806976318, 13.283500671386719, "timate. The /f_itted annual trend is 0.08 inches/year (0.01, 0.15) and is statistically signi/f_icant at the 95-percent con/f_idence level.\nRAND RR1673-3.2\n1954\n19561958\n1960\n196219641966\n1968\n197019721974\n1976\n197819801982\n19841986\n198819901992\n1994"] [0.7678629755973816, 13.308332443237305, " at cur-Figure 3.4\nRainfall and Overfl ows by Month, 2003 Typical Year and Recent Historical\nRAND RR1673-3.40 1 2 3 4 5 6 7 8 9 10\nMonthly rainfall (inches)012345678Overflow (Bgal./month)\nNOTE: Monthly rainfall volumes represent the unweighted avera"] [0.7377409338951111, 13.304685592651367, "native storm patterns to better estimate plausible future vulnerability.Figure 3.6\nMap of Recent Historical Overfl ows by Outfall\nNOTE: Circles represent CSO outfalls; diamonds show SSO outfalls. Selected outfalls, including interceptor\nrelief over/"] [0.7581488490104675, 13.323856353759766, "en combined with other scenario dimensions because of computing costs. \nAs described in Appendix C, we developed a fixed additive term at the outfall \nlevel based on a comparison of ALCOSAN modeled results and then applied the same additive term to e"] [0.6910215616226196, 13.288476943969727, "se regulations could help to limit or avoid increases in impervious cover in Allegheny County municipali -\nties, essentially reducing the likelihood of such scenarios as SPC Growth or 2xPGH. \nPopulation Growth Projections\nThe first step in creating t"] [0.7227597236633301, 13.300950050354004, "2 8 723 10\nLO/GR 306 321 5 335 9\nMR 3,900 4,251 9 5,300 36\nSM 429 466 9 535 25\nTC 119 139 17 144 21\nUA 1,432 1,507 5 1541 8\nUM 866 944 9 948 9\nTotal 7,709a8,340 8 9,526 24\na Totals are slightly different from ALCOSAN WWP because of methodology differ"] [0.7480902671813965, 13.310198783874512, " All Simulated Scenarios\nTh e fi nal step in this analysis of vulnerability was to simulate all combinations of the \nscenarios described earlier. Average annual overfl ow volumes are shown in Figure 3.10, using the same format as prior results.\nWh"] [0.764808177947998, 13.304762840270996, "ll 13.7 1.1 12.69.5\nCSO SSO\nNOTE: The vertical gray line shows the estimated total over/f_low using Current Connections, Current Land \nUse, and the 2003 Typical Year rainfall for visual comparison purposes. 52 Robust Stormwater Management in the "] [0.7857783436775208, 13.321928977966309, "l. For convenience, we will use this scenario for selected results through the remainder of this chapter. \nFigure 3.12 shows the change occurring at each outfall between the baseline (Cur -\nrent Connections/Current Land Use/Recent Historical) and thi"] [0.7897756099700928, 13.32016372680664, "r points with darker red shades indicate outfalls likely to disproportionately contribute \nto future overflows. The top pane shows all outfalls, while the bottom pane provides a zoom and \nhighlights 12 outfalls contributing a substantial fraction of "] [0.729049026966095, 13.295671463012695, " 8 648 1\nHigher Total \nRainfall665 9 669 4\nSPC Growth Recent \nHistorical635 4 653 1\nHigher Intensity \nRainfall682 12 657 2\nHigher Total \nRainfall699 15 683 6\n2xPGH Recent Historical 728 19 683 6\nHigher Intensity \nRainfall778 28 684 6\nHigher Total \nR"] [0.9733741879463196, 13.498682975769043, "tify and test a range of proposed planning-level strategies intended to improve system function or reduce the flow of stormwater into the system during rainfall events. In Chapter Five, we then evaluate a promising subset of these strategies across t"] [0.973676323890686, 13.48400592803955, "d \nStakeholder Advisors during participatory workshops and sensitivity testing conducted by the modeling team. \nHowever, there were various policy levers not evaluated in this pilot study because \nof time and resource limitations. These included most"] [1.0002309083938599, 13.50992202758789, " is sized for 1.5 inches of rain -\nfall). Results from a sensitivity analysis (Appendix D) show a significant perfor -Comparing Source Reduction and Wastewater Policy Levers 61\nmance improvement with \u201chigh-flow\u201d sites (i.e., high loading ratio). B"] [0.9665907025337219, 13.492332458496094, "ay not be realistic. Such an aggressive strategy would likely \nneed to deploy a variety of technologies beyond bioretention alone, and all installa -\ntions would be subject to slope, soil, and other engineering conditions. These strategies would requ"] [0.9875304698944092, 13.504510879516602, " originally targeted for gray infrastructure, Washington, D.C., plans to use GSI to control nearly 500 impervious acres to manage stormwater by 2030 (District of Columbia Water and Sewer Authority, 2015). In the coming years, cities with substantial "] [0.9760884642601013, 13.497685432434082, "as of the system with separate stormwater and wastewater pipes). The levels of assumed I&I reductions are shown in Table 4.3, where R1, R2, and R3 are the short-, medium- and longer-term RDII responses (see Appendix D).64 Robust Stormwater Managem"] [1.0006985664367676, 13.50161075592041, "; we do not consider the cost of ongoing operations and maintenance (O&M) or the expected service life of a project, both of which are important for accurately assessing the full \u201clife-cycle\u201d cost of a strat -\negy. O&M costs were excluded because of "] [1.0084811449050903, 13.50809383392334, "cost green roofs. \nI&I Reduction Capital Costs\nTable 4.4 also shows the I&I cost assumptions used in this analysis. The pipe repair costs are based on cost data from actual repair efforts in the region (ALCOSAN, 2015a), and manhole repair costs were "] [1.0296902656555176, 13.530128479003906, "n the Existing Conditions model and the average-year pre-\ncipitation (modified in 2003). All screening strategies are evaluated relative to the FWOA model results. \n\u2022\n GSI: Th\nere are five variations of GSI; the assumptions and parameters of those \ns"] [0.9261480569839478, 13.44206714630127, "RR1673-4.20 2 4 6 8 10\nTotal overflow (Bgal./year)ID\n0\n1\n2\n3\n4\n5\n6\n7\n8\n9\n1011\n12\n13\n14\n15\n16\n17\n18\n19\n20\n21\n22\n23\n24\n25\n26\n27\n28\n29\n30Name\nFWOA\nGSI-10\nGSI-20\nGSI-40\nGSI-40-HI\nGSI-40-AOP\nI&I Low (8%)\nI&I Low (6%)\nI&I Mid (8%)I&I Mid (6%)\nI&I High (8%)"] [0.9964600205421448, 13.498688697814941, "g the treatment plant is expected to reduce overflows by 2.5 Bgal./year \n(26-percent reduction), and expanding the treatment plant and removing debris from the main interceptors reduce overflows by 3.3 Bgal./year (a reduction of 34\u00a0percent). These st"] [1.0047001838684082, 13.502227783203125, "ed strategy reduces 5.9 Bgal./year in overfl ows\u201417 percent less than the total of the \nthree strategies in isolation. \nFigure 4.4 shows results for the same set of 30 screening strategies, where the \nx-axis and y-axis are the total system CSO and S"] [1.017480492591858, 13.513954162597656, " greatest overflow reduction at the lowest cost. Results show the following:\n\u2022\n GSI (S\ntrategies 1 through 5): Assuming $304,000 per impervious acre \ncontrolled,3 the total cost of GSI strategies that control 10 to 40 percent of DCIA \nwithin the comb"] [0.9789609313011169, 13.49967098236084, "example, Strategies 19 and 23 provide roughly the same overflow reduction (4.3\u00a0Bgal./year), but Strategy 23 is expected to cost nearly $1.3\u00a0billion less. \nConclusion\nIn this chapter, we formulated a set of regional, planning-level source reduction st"] [0.9865301847457886, 13.504996299743652, "nitial planning-level source reduction \nstrategies considered in this analysis is able to eliminate SSO volumes, and most still yield substantial remaining CSO volumes and average hours in overflow per year. Incorporating future uncertainty only exac"] [0.9926877617835999, 13.523151397705078, "ward in the application of high-performance computing for stormwater scenario analysis, but our ability to explore additional scenarios and strate-gies was nevertheless limited by the cost of these computing resources. As a result, in this portion of"] [0.9681094884872437, 13.478127479553223, " runoff area that is tributary to the GSI. Given the substantial uncertainty associated with GSI in terms of flow reduction when implemented at a high number of sites across the region, these two scenarios were developed as bounding cases to help cha"] [1.0074348449707031, 13.515328407287598, "ins relatively constant at 0.4 to \n0.5 Bgal./year with Higher Intensity Rainfall. \nBy contrast, the performance of GSI-20 remains constant or declines slightly \nacross land-use scenarios with greater impervious cover. For example, the overflow reduc"] [0.8873105645179749, 13.349157333374023, "cal \n(2013)12.7 11.9 0.8 11.5 1.3 0.4\n2xPGH Higher Intensity \nRainfall (2038)13.6 12.0 1.6 11.6 2.0 0.4\n2xPGH Higher Total Rainfall \n(2038)14.0 12.5 1.5 12.1 1.9 0.4\nNOTE: Table shows Future Connections wastewater customer scenario results only. All "] [1.0062960386276245, 13.509566307067871, "ansion and cleaning the main intercep -\ntors, reduces overflows to 6.2 to 9.4 Bgal./year (a reduction of 3.3 to 4.7 Bgal./year) across the uncertain scenarios, a further reduction of 800 to 900 Mgal./year compared with Strategy 12. Coupling treatment"] [1.0157713890075684, 13.54318904876709, "more targeted and refined approach in PWSA analysis, focusing on priority sewersheds and developing more detailed design concepts, likely explains the difference in performance.84 Robust Stormwater Management in the Pittsburgh Region: A Pilot Stud"] [1.0155768394470215, 13.514281272888184, "pe of policy lever. These uncer -\ntainties are briefly summarized in the following section, and the uncertain factors and Robust Decision Making Strategy Comparison 85\nranges chosen are discussed in detail in Appendix D of this report. Table 5.3 p"] [1.0112216472625732, 13.506291389465332, "pipe repair costs are based on three data sources; the low and mid-values are \nbased on cost data from actual repair efforts in the region (ALCOSAN, 2015b), and \nthe high value is the default for 8-inch pipes in the Philadelphia Water Department (Phi"] [1.0367094278335571, 13.530080795288086, "in \nsupport of RDM analysis and scenario discovery (Bryant and Lempert, 2010; Groves and Lempert, 2007; Lempert, Popper, and Bankes, 2003). We developed a 100-point LHS sample across the cost uncertainty dimensions listed in Table 5.3 and included se"] [1.020707130432129, 13.5097017288208, "eduction for a regional sewer system like ALCOSAN\u2019s. Over a long period of implementation (ten to 20 years), costs could plausibly end up at the lower end because of technological improvement, evolving best practice, and econo -\nmies of scale. Altern"] [1.027345061302185, 13.511858940124512, "s, across all scenarios, the overfl ow reduction achieved by a treatment plant expansion is always or nearly always highly cost-eff ective, even in scenarios in which expansion costs are up Figure 5.3\nCost-Effectiveness for Selected Strategies, All"] [1.055757999420166, 13.54051685333252, "clude interceptor cleaning and yield similarly very wide cost-effectiveness ranges. \nStrategy 27, to which we refer as the Combined Source Reduction Strategy through \nthe remainder of this discussion for convenience, includes a treatment plant expans"] [1.0221904516220093, 13.510076522827148, "llustration. The figure includes regret in terms of over -\nflow reduction (y-axis) and cost-effectiveness (x-axis) for each of the eight remaining strategies. Points are sized to show the median remaining overflows with the strat -\negy in place. An i"] [1.0344070196151733, 13.523314476013184, "pear above the upper-right corner of the plot area and are \nomitted for clarity.\nRAND RR1673-5.40.00 0.02 0.04 0.06 0.08 0.10 0.12 0.14 0.16\nMedian cost-effectiveness regret ($/gal. reduced)0.00.51.01.52.02.53.03.5Median overflow reduction regret (Bg"] [1.0223647356033325, 13.51622200012207, "or average GSI capital cost per impervious acre controlled. The areas highlighted in yellow show the set of assumptions that that yield acceptable cost-effectiveness, with the dashed red lines showing the specific thresholds identified in part with s"] [1.0348589420318604, 13.532356262207031, ".57.0Total overflow (Bgal./year)\n0.10 0.50Cost-effectiveness ($/gal.)Robust Decision Making Strategy Comparison 95\nTh is pattern changes when we look at the climate scenarios with plausible future \nrainfall increases (bottom half of plot). Here, "] [1.0288175344467163, 13.524273872375488, "s, identify which \nuncertain factors were most often leading to cost-effectiveness results in excess of $0.35 per gallon (Figure 5.5, red-shaded region). For this strategy, the results showed that a similar subset of uncertainties\u2014in this case, avera"] [1.0315786600112915, 13.533519744873047, "t Decision Making Strategy Comparison 97\nFigure 5.7\nScenario Discovery Results for a Combined Source Reduction Strategy (Strategy 27)\n$41576%\nRAND RR1673-5.7150 200 250 300 350 400 450 500 550 600\nAverage GSI cost per impervious acre (2016 $ thous"] [0.9796768426895142, 13.491756439208984, "tion in scenarios with more rainfall, they could yield long-term benefits and investment value. Conversely, if rainfall volumes are not increasing or cost and per -\nformance targets cannot be achieved, source reduction might not \u201cpay off\u201d well when c"] [0.9706723690032959, 13.498617172241211, " program focused on high-inflow areas of the separated sewer system, or combinations of both\u2014appear to yield notable overflow reduction ben -\nefits that can be cost-effective under plausible future assumptions. Cost-effectiveness of treatment expansi"] [0.797896146774292, 13.2899169921875, "have grown in the past decade, with sewer overflows increasing from approximately 9.5 Bgal./year in a 2003 Typical Year simulation to a ten-year average of 11 Bgal./year for 2004 to 2013, when holding other system characteristics constant. These incr"] [1.0584967136383057, 13.534055709838867, "mpervious cover in the combined sewer area over addressing potential new growth.\nExpanding WWTP capacity or cleaning existing deep interceptors could \nrepresent low-regret, near-term options. Next, we identified and tested a range of \nproposed plann"] [1.0266610383987427, 13.524024963378906, "e of cost-effectiveness from $0.11 per gallon to $0.67 per gallon. \nNone of the strategies combining treatment plant expansion with intercep -\ntor cleaning and source reduction fully eliminates sewer overflows. This analysis tested a wide range of pr"] [0.9809602499008179, 13.491020202636719, "$353,000).\nRainfall uncertainty is also a key driver for a Combined Source Reduction Strat -\negy. As with Strategy 2, this strategy is increasingly cost-effective as average annual rainfall increases and the climate scenario becomes more adverse. Str"] [0.9670864939689636, 13.49653434753418, "ate, population growth, or land-use changes. Infrastruc -\nture planning and design based only on a 2003 Typical Year could yield a system that is not resilient to these changes, meaning that overflows could still occur regularly even after these inve"] [1.0235652923583984, 13.533821105957031, "general, help support continued progress toward regional collaboration on \nstormwater planning.\nSource reduction could help reliably reduce overflows, but additional \nresearch is needed to fully define a long-term, adaptive strategy. This analysis su"] [1.0124276876449585, 13.519004821777344, "e the full range of uncertainty associated with current \nsystem vulnerability or future strategy performance. Our results are based on a limited \nnumber of uncertain factors and scenarios evaluated. Although we modeled more than 500 unique scenario a"] [0.9681494235992432, 13.490338325500488, "ake into account the timing or phasing of proposed investments, the expected service life of projects, O&M or detailed project life-cycle costs, or ratepayer affordability\u2014all of which limit the utility of the strategy comparisons and cost-effectiven"] [0.721792995929718, 13.442520141601562, "ongahela\nUSEPA U.S. Environmental Protection Agency\nWPAC Watershed Plan Advisory Committee\nWWP Wet Weather Plan113References\n3 Rivers Wet Weather, homepage, undated-a. As of March 20, 2017: \nhttp://www.3riverswetweather.org/\n\u2014\u2014\u2014, \u201cAbout the Wet Weat"] [0.6936222314834595, 13.445023536682129, "etWeatherPlan/\nDraftWWPFullDocument/tabid/176/Default.aspx\n\u2014\u2014\u2014, \u201cAppendix C: GSI Cost Literature Review,\u201d Starting at the Source: How Our Region Can \nWork Together for Clean Water , Pittsburgh, Pa., 2015a.\n\u2014\u2014\u2014, Starting at the Source: How Our Region "] [0.6952984929084778, 13.44542407989502, "ndated. As of March 21, 2017: \nhttp://city.milwaukee.gov/commoncouncil/District10/ \nStormwater-and-Sewer-Capacity.htm#.V9mN6xRu7iQ\nCollins, T., J. Kline, K. Vallianos, and C. Fox, Ecology and Recovery: Allegheny County , Pittsburgh, \nPa.: Studio for"] [0.5699376463890076, 13.443045616149902, "eveloping Key Indicators for Adaptive Water Planning,\u201d Journal of Water Resources Planning and Management , \nVol. 141, No. 7, 2015.116 Robust Stormwater Management in the Pittsburgh Region: A Pilot Study\nGroves, David G., Jordan R. Fischbach, Eva"] [0.6040751934051514, 13.442465782165527, "r Public Policy and Economic Development, \u201cA Primer on Home Rule,\u201d Wilkes-Barre, Pa., 2009. As of March 20, 2017: http://www.institutepa.org/PDF/Research/APrimeronHomeRule0809.pdf\nKansas City, Missouri, Water Service Department, Overflow Control Prog"] [0.6717051267623901, 13.442407608032227, "alchange.gov/\nMichael Baker Jr., Inc., Allegheny County Stormwater Management Plan Phase 1 Report , Moon \nTownship, Pa., December 2014. Milly, P., J. Betancourt, M. Falkenmark, R. Hirsch, Z. W. Kundzewicz, D. Lettenmaier, and R. J. \nStouffer, \u201cStatio"] [0.6881006360054016, 13.444378852844238, "ce Conference, Charlotte, N.C., April 28\u201329, 2014. As of March 20, 2017: http://www.cisa.sc.edu/ccrc/pdfs/2014/Presentations/ \nODonnell_Assessing%20Cost%20Effectiveness%20of%20Green%20Infrastructure.pdf\nOffice of the Mayor William Peduto, \u201cStatement"] [0.694567859172821, 13.440291404724121, "www.elibrary.dep.state.pa.us/dsweb/Get/Document-108470/2700-BK-DEP4494.pdf\nTarr, J. A., and T. F. Yosie, \u201cCritical Decisions in Pittsburgh Water and Wastewater Treatment,\u201d \nin J. A. Tarr, ed., Devastation and Renewal: An Environmental History of Pitt"] [-0.4582062065601349, 13.308083534240723, "13. \nVolkening, Aaron, photo of bioswale, Flickr, 2010.\nWalker, W., M. Haasnoot, and J. Kwakkel, \u201cAdapt or Perish: A Review of Planning Approaches for \nAdaptation under Deep Uncertainty,\u201d Sustainability , Vol. 5, No. 3, 2013, pp. 955\u2013979. \nWater Envi"] [0.7354519963264465, 13.441207885742188, "e the trade-offs among them.\n This research is intended to support improved stormwater, wastewater, and climate \nresilience planning in the Pittsburgh region. The intended audience includes local government \nagencies and regional authorities addressi"] [11.342890739440918, 17.74376678466797, "SOCIAL AND ECONOMIC WELL-BEING\nAccess to Medical \nTreatment for Injured Workers in California\nYear 3 Annual Report\nKandice A. Kapinos, Cheryl K. Montemayor\nPrepared for the California Department of Industrial RelationsThe RAND Corporation is a resear"] [10.330770492553711, 19.004255294799805, "............................. ................................ ................................ ................................ . ix \nAcknowledgments ................................ ................................ ................................ "] [10.30526351928711, 19.063209533691406, ".................... .............................. 19 \nMean Payment per Claim ................................ ................................ ................................ .................... 19 \nOther Access Measures ....................."] [10.479366302490234, 18.8442325592041, " ....................... 12 \nTable 3-3. County -Level Descriptive Statistics ................................ ................................ ............ 14 \nTable 3-4. Summary Statistics, by Detailed Type of Service ..........................."] [10.293432235717773, 19.06226348876953, "eral practice (n = 4,879). \n \n1 In the Year 2 report, we analyzed some of the Version 2.0 data, but the California Department of Industrial \nRelations had converted the data back to Version 1.0 (see K"] [10.453680992126465, 18.826309204101562, "a Division of Workers\u2019 Compensati on \nE&M evaluation and management \nED emergency department \nMD medical doctor \nNPI National Provider Identifier \nNPPES National Plan and Provider Enumeration System \nPCP primary care provider \nTIN Taxpayer Iden"] [10.396249771118164, 18.950706481933594, "ividual practitioners (e.g., in the case of a large physician practice or delivery system). \nIndividual practitioners occasionally bill under multiple TINs. Thus, using the NPI will result in \nlarger counts of providers . \nThe structure of Version 2"] [10.355973243713379, 18.869775772094727, " that we \nmight expect DIR and DWC to have the most influence in affecting for workers with workplace \ninjuries, because these measures typically include rules and regulations imposed by payers \nsystemwide. Process measures reflect aspects of the "] [10.417946815490723, 18.974376678466797, "o a bill line \nrecord\u2014provided in a given calendar year. Then, any access measures at the provider level \nwould include all providers that delivered a med ical service within the calendar year. Similarly, \nany access measures using this approach at "] [10.317361831665039, 19.02029037475586, "tic Sample Size \n \n2016 \nService year sample \nNumber of claims 705,979 \nNumber of bill lines 16,548,253 \nNumber of providers 76,950 \nInjury year sample \nNumber of claims 393,839 \nNumber of bill lines 10,740,977 \nSOURCE: RAND analysis"] [10.17995834350586, 19.056501388549805, " are listed in Figure 3-17 \n\u2022 type of service ; categories are based on place of service and procedure codes on the bill \nand bill line records that are listed in Figure 3-58 \n\u2022 county and region of the state ( see Figure 3-3 for regions ). \n "] [10.23338794708252, 19.04772186279297, "spitals, \nambulatory facilities (surgical and physical therapy), durable medical equipment suppliers, optometrics, home \nhealth, and orthotics supplie rs. 8 Figure 3-1. Number of Providers , by Specialty \n \nSOURCE: RAND analysis of WCIS Medical B"] [10.255840301513672, 19.05437660217285, "ment of Insurance , Workers\u2019 Compensation Research and Evaluation \nGroup, 2018) . The Texas rate is lower than California\u2019s , but this is partly because the \ndenominator in that analysis was \u201ctreating physicians ,\u201d whereas we are using all treating"] [10.254048347473145, 19.06096649169922, "we also examin ed the \nnumber of bill lines or medical services per provider over the course of the year. On average, \nproviders delivered 208.1 medical services per year across all specialties. In Figure 3-2, we \npresent the average number of medic"] [10.255345344543457, 19.070255279541016, "claim in 2016, however, were other surgery and dental providers , at $3,830 \nand $3,017, per claim, respectively. Pathology had both the lowest total annual payment per \nprovider and the lowest average pay ment per provider , at $1,074 and $123, res"] [10.3578519821167, 18.96558380126953, " \nResults by Geography \nNumber of Providers \nIn Figure 3-3, we show the total number of providers with claims in 2016 (blue bars) and the \npercentage of all WC medical bills (claims) for injured workers treated in California (red \nsquares) with"] [10.277292251586914, 19.066011428833008, "13,871 $1,661 \nSacramento 5,282 38,710 7.33 $15,607 $2,130 \nSan Benito 270 1,168 4.33 $5,455 $1,261 \nSan Bernardino 5,530 55,371 10.01 $16,725 $1,670 \nSan Diego 7,576 65,203 8.61 $20,327 $2,362 \nSan Francisco 4,265 31,024 7.27 $13,782"] [10.20947551727295, 19.11899185180664, "d all injured workers \nwith an injury in 2016 for 12 months . First, we show the number of claim s with each type of \nservice (blue bars) and the percentage of all claims with each type of service ( red squares) in \nFigure 3-5. Ninety-four percent of"] [10.254717826843262, 19.15087890625, ", o steopathic manipulative treatment \n\u2022 other: alcohol and drug abuse treatment; composite measures; diagnostic radiology services; \ndiagnostic/screening processes or results; enteral and parenteral therapy; outpatient prospective payment \nsystem"] [10.303956031799316, 19.149822235107422, " Distribution of the Number of Days Between Injury and First E&M Visit with a PCP \n \nSOURCE: RAND analysis of WCIS Medical Bill data, Version 2 .0 from 2016 . \n 21 4. Discussion and Summary \nThis study, as mandated by Section 5307.2 of the Califo"] [10.270262718200684, 19.010868072509766, " . The specialty and provider type categories \nwere not exactly comparable across the two samples (we have tried to group them roughly by \nshading groups together) . For example, because we broke out all nonprac titioner services into the \n\u201call othe"] [10.256680488586426, 19.063081741333008, " provider 22% \nAnesthesiology 3% \nFamily medicine/general practice 5% \nMD general provider 10% \nInternal medicine \u2013 general 0.4% \nOther MDs 2% \nInternal medicine \u2013 cardiology 0.5% \nPhysician specialist 12% \nInternal medicine \u2013 onco"] [10.225577354431152, 19.112049102783203, "ology had the lowest total annual \npayment per provider and the lowest average payment per claim , at $1,074 and $123, \nrespectively . \n\u2022 There was significant variation by region and county across all measures. \n\u2022 Ninety-four percent of claims inc"] [9.869688987731934, 19.106910705566406, "ogy Tests'; \nelse if (97010 <= proc_num <= 97799) and ^(97151 <= proc_num <= 97158) then tos_detail = 'Physical \nMedicine and Rehab Evals'; \nelse if (97810 <= proc_num <= 97814) then tos_detail = 'Acupuncture Procedures'; \nelse if 98925 <= proc_nu"] [9.74501895904541, 19.11077308654785, "en tos = 'Prosthetics/Or thotic Procedures'; \nelse do; \ntos = 'Other'; \nif 'A0021' <= procedure_cd <= 'A0999' then tos_detail = 'Ambulance'; \nelse if 'A4206' <= procedure_cd <= 'A8004' then tos_detail = 'Medical And Surgical Supplies'; \nelse if "] [10.754701614379883, 18.460744857788086, "ia Health Care Foundation, California Physicians: Who They Are, How They Practice , \nCalifornia Health Care Almanac, August 2018. As of June 6, 2019: \nhttps://www.chcf.org/wp -\ncontent/uploads/2018/08/CAPhy siciansAlmanacWhoTheyAre2017.pdf \nCalifor"] [11.139569282531738, 18.181209564208984, "2016 Update , Oakland, Calif., August \n24, 2017. As of May 21, 2019: \nhttps://www.wcirb.com/sites/default/files/documents/ \n170824_ca_wc_med ical_agg_pymt_trends_report.pdf \n "] [-4.918610572814941, 16.21868133544922, "Benjamin Lee Preston, Tom LaTourrette, James R. Broyles, R. J. Briggs, \nDavid Catt, Christopher Nelson, Jeanne S. Ringel, Daniel A. WaxmanUpdating the Costs \nof Compliance for California\u2019s Hospital Seismic Safety StandardsCORPORATIONFor more informa"] [-4.927922248840332, 16.227033615112305, "f compliance, the affordability of the legislation for hospitals, and the exploration of policy alternatives that could reshape how SB 1953 is implemented in the future. In addition, we identify the various factors that influence how hospitals priori"] [-4.920009136199951, 16.22107696533203, "ew .................................................................................................................................... 1 \t\nStudy Objectives ............................................................................................"] [-4.920165538787842, 16.21905517578125, ".................................................................................... 44\t\n6. Affordability of SB 1953 Compliance for California Hospitals .......................................... 46\t\nMethods for Characterizing Hospital Financial Dist"] [-4.919735908508301, 16.219457626342773, "................... 90\t\n9. Summary of Findings and Recommendations ..................................................................... 93\t\nFindings ..................................................................................................."] [-4.923009872436523, 16.223112106323242, "................................................................. 22\t\nTable 4.3. SB 1953 Compliance Status, by Hospital Building (as of September 2018) .............. 22\tTable 4.4. Key Factors Influencing Hospital Decisionmaking on SB 1953 Compliance"] [-4.9218621253967285, 16.221479415893555, " passage of SB 1953, hospitals have been assessing the implications of the legislation for their business planning and implementing structural and nonstructural upgrades to comply with the standards. These upgrades have been expensive for hospitals. "] [-4.926320552825928, 16.22637176513672, "al project advisory committee, composed of \nhospital representatives, former hospital executives, and consulting engineers, for their \nparticipation and willingness to provide their perspectives on the scope of the study and key issues associated wit"] [-4.922583103179932, 16.22174072265625, "h \nother hospitals.7 \nThe damage to hospitals highlighted their continued vulnerabilities to seismic events and the \npotential health and safety issues that could arise because of damaged hospitals. In particular, the \n "] [-4.925788402557373, 16.225175857543945, "tions, service provision, and the health and well-being of Californians. On the other hand, in the event of a major seismic event, there is a public benefit to having hospitals that can remain operational and continue to provide health care services."] [-4.925130844116211, 16.225452423095703, "earch pathways: \n\u2022 First, this study represents an update to two prior studies conducted by the RAND \nCorporation (published in 2002 and 2007 by the California HealthCare Foundation).\n11 \nThis update analyzes the likely magnitude of the costs of both"] [-4.922345161437988, 16.22374725341797, "xt decade. This includes identification of the \nkey factors that hospitals must weigh in determining how and when to undertake seismic compliance projects. \nChapter 5 presents updated cost estimates for compliance with SB 1953. We focus on post-\n202"] [-4.924091339111328, 16.223466873168945, "ailable for download at www.rand.org/t/RR3059. 5 2. Study Background \nHistory of Hospital Seismic Safety Legislation \nOrigins of the Alfred E. Alquist Act \nThe modern incarnation of seismic building standards for California hospitals dates back"] [-4.929274082183838, 16.228851318359375, "ar Policy Change Implications \n1973 Alquist Act passed Required new acute care hospitals to be designed and constructed to \nremain standing and operational after a major seismic event. Administration \nof the new requirements was delegated to OS H"] [-4.924468517303467, 16.22416114807129, "akers to conclude that additional steps were needed to enhance the seismic resilience of California hospitals. A key observation was that hospitals built after the 1973 Alquist Act generally performed well structurally, although they experienced nons"] [-4.9190168380737305, 16.21883773803711, ", 2030 \nSPC-5 Buildings in compliance with the structural provisions of the Alquist \nHospital Facilities Seismic Safety Act and reasonably capable of providing \nservices to the public following strong ground motion May be used beyond \nJanuary 1, 20"] [-4.925693988800049, 16.225727081298828, ".\n18 \nThis led OSHPD to pursue a more refined classification of hospital buildings, reducing the \nnumber of SPC-1 buildings by half.19 In 2010, OSHPD implemented an emergency regulation \nthat raised the threshold for SPC-1 classification, which allow"] [-4.923159599304199, 16.22299575805664, "l be on meeting this next level of compliance associated with the SPC-2 buildings within hospital facilities\u2014many of which were constructed in the 1950s, 1960s, and 1970s and pose nontrivial challenges to structural upgrades. \nConcerns in recent yea"] [-4.901313781738281, 16.20149040222168, "uires enhanced resilience of laboratory areas, pharmaceutical services, radiological services, and central and sterile supply areas. Meanwhile, NPC-4 focuses on architectural, mechanical, and electrical equipment. To reduce vulnerability to disruptio"] [-4.918326377868652, 16.218467712402344, " flexibility with NPC requirements. \nJust as SPC-4D provided a mechanism for greater flexibility in bringing SPC-1 and SPC-2 buildings into compliance, OSHPD\u2019s most recent policy modification is the introduction of a new NPC category\u2014NPC-4D (see Tabl"] [-4.922118663787842, 16.22181510925293, "ia Building Standards Code Update for the California Hospital Association , \nSacramento, Calif.: Office of Statewide Health Planning and Development, 2018. \n 12 departments at both remained open.26 Although not directly transferable to the Califor"] [-4.925740718841553, 16.227285385131836, "ents Canceled at Anchorage Area Hospitals,\u201d \nAlaska Public Media, November 30, 2018. \n27 J. Gillengerten, \u201cEstimated Cost of Structural R etrofits,\u201d paper presented at the SB 1953 Seismic Compliance \nMeeting, California Healthcare Association, Sacr"] [-4.924627780914307, 16.22433090209961, "to hinder the ability of hospitals to keep pace with trends in health care practice, particularly \nthe shift toward greater use of outpatient services. \n\u2022 The 2007 report also identified some policy alternatives, including continuing with \nbusiness-a"] [-4.918078422546387, 16.218507766723633, "mer hospital executives, and private-sector structural engineers. The committee convened via conference call every other week and served to provide high-level input on key compliance-related issues of concern to hospitals, provide technical clarifica"] [-4.92342472076416, 16.22349739074707, "osts of SB \n1953, assessing those social costs was beyond the scope of this analysis. Given that most hospital revenue in California comes from Medicare, Medi-Cal, and private health insurers using established reimbursement schemes, providers cannot "] [-4.925349712371826, 16.22476577758789, "ress common barriers to \ncompliance, enhance flexibility in achieving compliance, and reduce overall costs of compliance. \nIn so doing, we first examined approaches to seismic resilience for other types of critical infrastructure (Chapter 7), followe"] [-4.924291610717773, 16.22518539428711, "ire costs of SB 1953 implementation, and hospitals have to pay those costs up front. Benefits are realized only if there is a significant seismic event, and it is not clear whether the potential future benefits of being able to continue to operate wi"] [-4.919153213500977, 16.218339920043945, "ed that the focus of SB 1953 on general acute care hospitals does not fully account for this trend. Rather, this focus creates path dependence around inpatient infrastructure and reduces opportunities to make investments in other delivery models. The"] [-4.920254707336426, 16.21974754333496, "of California hospital buildings are noncompliant with respect to NPC requirements than with SPC requirements. \nGiven the above, hospital representatives frequently noted that the dominant benefit generated by \nseismic regulations is likely the prev"] [-4.921358585357666, 16.220670700073242, "equire some seismic upgrade, with 815 (26 percent) requiring SPC upgrades and 1,951 (63 percent) requiring NPC upgrades. \n \n \n \n35 OSHPD , \u201cHospital Building Data,\u201d data set, accessed September 2018. \n3"] [-4.922521114349365, 16.22198486328125, "ors Influencing Hospital Decisionmaking on SB 1953 Compliance Strategies \nDecision Factor Implications \nCommunity needs The needs of communities with respect to demand for different types of \nhealth care services influence long- term hospital bus"] [-4.924863338470459, 16.22382354736328, " communities. This emphasis on serving communities creates obligations for hospitals to consider the effects of SB 1953 compliance on their ability to meet identified community needs. For example, seismic construction projects that disrupt service pr"] [-4.9226531982421875, 16.221548080444336, "include mandatory improvements associated with compliance with other building codes (see \u201cCode Requirements,\u201d below), but they may also be voluntary improvements. For example, hospitals may choose to pursue actions to modernize the facilities and ser"] [-4.921270370483398, 16.221275329589844, "Budgeting, Accounting and Financial Management , \nVol. 23, No. 1, 2011, pp. 31\u201368. \n39 One exogenous pressure that all hospital businesses face regardless of ownership type is the continuing change s \nto government reimbursement rates and policies"] [-4.920258045196533, 16.219532012939453, "epartments and health care services to new locations, the need to complete work in active areas of the hospital can nevertheless be a significant source of disruption. For example, completing NPC work in active operating rooms necessitates either tak"] [-4.923520088195801, 16.22601318359375, "tion for available contractors and labor. This could drive up the costs of construction, above what has been witnessed historically, and therefore the costs of compliance. \nThe anticipation of future cost increases could ultimately influence the typ"] [-4.922545433044434, 16.220502853393555, "on for seismic compliance cannot be isolated from other types of additional construction work associated with a seismic project, because the two are inherently linked. This creates incentives for hospital owners to undertake other types of constructi"] [-4.923122406005859, 16.222869873046875, "direct costs. \n\u2022 Forced retrofit: In the absence of opportunities to acquire new land or rebuild in place, \nthe options available to hospitals may be limited to retrofitting existing noncompliant \nbuildings. The pursuit of this option assumes that th"] [-4.937700271606445, 16.24083709716797, "monitoring projects to ensure \nthat construction proceeds in accordance with the building code. Necessary changes to the plan that are encountered during construction may trigger a change order, which requires approval by OSHPD. As noted by hospital "] [-4.924633026123047, 16.22591209411621, "ther hand, such a delay tactic can be risky if greater flexibility fails to materialize. As a consequence, hospitals have taken different strategies with respect to how proactive they have been in achieving compliance. Some hospitals made early inves"] [-4.924221038818359, 16.229875564575195, "other activities and whether the project accomplishes all of the seismic upgrading needed. \n \n55 Although SPC-3 and SPC -4 buildings are compliant with SB 1953, these categories are for particular types"] [-4.930331230163574, 16.230554580688477, "te has not been verified by the hospitals themselves. \n \n56 This means moving services and operations a round the hospital to allow access to areas requiring construction \nwork . \n57 These are constructi"] [-4.932782173156738, 16.232234954833984, "d 1.5 \u00b4 box height (i.e., the difference between the 75th and 25th percentiles ) with \nmaximum and minimum data points as bounds. See Table 5.1 for information about data sources . \nAdjustments to Cost Data \nThe SPC retrofit cost estimates are fo"] [-4.93163537979126, 16.231168746948242, "h nonseismic-related code requirements, such as access for disabled persons, seismic upgrading sometimes leads to larger and fewer rooms. And, often, hospital owners choose to change the size and number of beds or rooms for other reasons. For all the"] [-4.932411193847656, 16.232072830200195, " \nWithout \nbeds 14 $507,277 $3,615,237 $10,334,482 \nNOTE: See Table 5.1 (row 3) for information about data sources . \n \nTable 5.3. NPC -2 to NPC -5 Retrofit Costs from Sample Data \nBuilding \nGroup Number in \nSample Cost per Building \n NPC"] [-4.931587219238281, 16.233097076416016, "nation of the two is impossible to determine a priori. Representatives for many hospitals we met with noted that they are still engaged in an extended decisionmaking process and have yet to develop upgrade plans. \nIn light of this uncertainty, we dev"] [-4.934574127197266, 16.23396110534668, "lding \nSPC SPC- 2 with \nbeds 322 27,255 $462,155 \u2014 $12,596,034,525 $39,118,120 \nSPC SPC- 2 with \nno beds 309 \u2014 \u2014 $3,615,237 $1,117,108,233 $3,615,237 \nSPC Total SPC \ncosts 631 \u2014 \u2014 \u2014 $13,713,142,758 $21,732,397 \nNPC NPC-2 and \nSPC-2 519 \u2014 \u2014 0.50 "] [-4.945740699768066, 16.244762420654297, "s 309 \u2014 \u2014 $51,449,244 $15,897,816,246 $51,449,244 \nTotal SPC -2 \nreplacement 631 \u2014 \u2014 \u2014 $99,537,071,127 $157,744,962 \nSPC >2 and NPC -1 \nor 2 (retrofit) 1,220 \u2014 \u2014 $4,838,497 $5,902,966,340 $4,838,497 \nTotal cost \u2014 \u2014 \u2014 \u2014 $105,440,037,467 \u2014 \nEsc"] [-4.950182914733887, 16.253414154052734, "acement\u2014we can examine total costs in terms of the relative proportions of \nthese two approaches used. Figure 5.2 uses a simple linear interpolation to show the statewide escalated total cost of compliance as a function of the proportion of complianc"] [-4.930788993835449, 16.23590660095215, "lifornia would eliminate the need for these assumptions. The seventh assumption refers to neglecting cases in which hospitals are unable to make the investments needed to comply with SB 1953 and are compelled to close buildings rather than attain com"] [-4.9164276123046875, 16.245006561279297, " rooms have windows, larger diagnostic and test facilities). In this perspective, some portion of costs for projects nominally attributed to seismic compliance is actually part of a background trend of \n(nonseismic) capital reinvestment spending to o"] [-4.92356538772583, 16.223796844482422, "\nhospital\u2019s resilience to earthquakes and reduce the risk of earthquake damage immediately reducing hospital capacity and services offered in the wake of a major seismic event. However, the financial stress imposed by its requirements could also forc"] [-4.9251627922058105, 16.228778839111328, " 47 \u2022 improving occupancy rates by improving referral networks and market visibility \n\u2022 shifting toward a greater mix of outpatient services \n\u2022 changing the coding of services\u2014i.e., upcoding\u2014to receive higher reimbursement rates \n\u2022 delaying capital i"] [-4.9334025382995605, 16.233417510986328, "ation can inform current and future policy assessment of hospital seismic requirements in an effort to balance seismic safety, affordability, and adverse effects on the populations served. 48 Methods for Characterizing Hospital Financial Distress \n"] [-4.928927421569824, 16.22871971130371, " 50 teaching \n \n62 We estimate that approximately 75 percent of California hospitals currently have credit ratings from Moody\u2019 s, \nFitch, or S&P. It is normal for fiscal entities below a certain size to"] [-4.9306111335754395, 16.230989456176758, "n particular or the hospital industry at large, as researchers \n \n66 Langabeer , 2006. \n67 Z. H. Ramamonjiarivelo, \u201cIs Privatization the Solution to the Financial Distress of Public Hospitals? \u201d Academy "] [-4.977269649505615, 16.277341842651367, "nprofit groups. Not-for-profit hospitals may benefit from philanthropic funds from other community organizations or private donors, and public hospitals can tap into tax revenue and other sources of public funds. Additionally, hospitals have a public"] [-4.934171676635742, 16.236745834350586, "in the short term to invest in aging assets. \n\u2022 Days cash on hand indicates the strength of financial reserves relative to operating costs, \nanother measure of short-term liquidity. Days in accounts receivables is a measure of the \nefficiency of col"] [-4.928447723388672, 16.2268123626709, " The resulting financial \ndata can be mapped to 406 of the 418 general acute care hospitals for which OSHPD provides building-level data.\n85 \nCurrent Status of California Hospital Finances \nCalifornia hospitals exhibit a wide degree of financial he"] [-4.929482460021973, 16.228242874145508, " 70% 80% 90% 100%\nAll Hospitals (406)\nCAH (34)\nPrivate- MHS (225)\nPrivate- Non-MHS (71)\nPublic - Non-Healthcare District (19)\nPublic - Healthcare District (38)\nAcademic (11)\nHigh Medi-Cal (170)Severe Financial Distress Potential for Financial Distres"] [-4.926229953765869, 16.22575569152832, "hospital districts that often effectively lack these public-sector benefits. Hospital districts are special districts unique to California that do not have other sources of revenue and, more important, struggle from a lack of visibility to convince v"] [-4.9198808670043945, 16.22262954711914, "icult; \nsmall size \nPublic\u2014 \nnon\u2013health \ncare district 100 100 100 Contributors: Owned by strong fiscal \ninstitutions; a ccess to other public funds \noutside hospital revenue \nAffordability of Seismic Requirements \nThe seismic retrofit requirement"] [-4.925191402435303, 16.224754333496094, "ties have well over 50 percent of hospital beds that are associated with noncompliant hospitals. Thirty-one percent of California \n \n88 The OSHPD cost utilization data did not provide the number of beds "] [-4.932613372802734, 16.232192993164062, "El Dorado 2 224 100% 50% 22%\nHumboldt 5 275 100% 28% 21%\nImperial 2 268 100% 0% 0%\nKings 1 230 0% 0% 0%\nMadera 2 464 23% 0% 0%\nMarin 4 458 90% 13% 29%\nMerced 2 230 19% 0% 0%\nMonterey 4 793 100% 12% 34%\nNapa 2 352 100% 41% 54%\nNevada 2 166 100% 37% 78"] [-4.923092842102051, 16.231685638427734, "onal costs would significantly increase the overall cost impact and long-term liabilities on hospitals\u2019 balance sheets, as discussed in the prior chapter. We expect this would further exacerbate the impact on certain types of hospitals, noted below. "] [-4.92617654800415, 16.225360870361328, "s $25.3B 81,414 $311K \nCAH $0.9B 1,467 $647K \nPrivate, MHS $16.0 B 50,280 $318K \nPrivate, n on-MHS $4.9B 14,624 $336K \nPublic, n on\u2013h ealth care district $0.9B 6,993 $130K \nPublic, h ealth care district $2.5B 5,145 $481K \nAcademic $1."] [-4.928358554840088, 16.227882385253906, "l types using published financial distress assessment methods that have recently been applied to acute care hospitals. The affordability research we presented shows that current and SB 1953\u2013imposed financial distress have a tendency to affect certain"] [-4.927602767944336, 16.230493545532227, "ly, deferment of capital investments in new 63 buildings or technologies would indirectly present an opportunity cost to patients who \notherwise could have benefited from such investments. It is impossible for us to predict \nwhether hospitals will t"] [-4.862576961517334, 16.16640853881836, "ormed this role, and in select cases individual actors (large water and energy utilities, for example) have performed their own vulnerability assessments. The impetus to make necessary modifications has involved a mix of legislative mandates to make "] [-4.874283313751221, 16.17576789855957, "of the Federal Energy Regulatory Commission, Bureau of Reclamation, and Army Corps of Engineers. The vast majority of these structures were built 50 to 100 years ago, before engineering and construction practices evolved to mitigate seismic risk. \nDa"] [-4.88808012008667, 16.190147399902344, "ts where necessary. For local government or utility-owned dams, DSOD does not mandate retrofitting but instead exercises its power to force dam operators to lower water levels to acceptable risk levels, which serves as an impetus by effectively reduc"] [-4.868027210235596, 16.17220115661621, "rea and Southern California metropolitan regions. For the Bay Area, major pipelines carrying water from the Sierra Nevada mountains cross East Bay fault zones on their way to providing water to 4 million Bay Area residents, and multiple reservoirs si"] [-4.885239124298096, 16.18867301940918, "mentioned necessary conditions. In this case, there are few to no capacity limitations for comprehensive vulnerability screening, given that each entity owns the responsibility for managing its infrastructure and has sufficient expertise (or access t"] [-4.90606689453125, 16.20644760131836, "smically active areas are vulnerable to collapse or major damage in an earthquake.\n108 California has been more proactive than other states and the federal government, \nhaving adopted seismic design practices in the early 1970s following the 1971 San"] [-4.900402545928955, 16.20009422302246, "l highway funds (28 percent), and proposition bonds (8 percent) was used to allocate the cost burden between individual users and the state and federal governments.\n113 The state bridge program, costing $2.8 \nbillion, was funded by a mix of propositi"] [-4.9128499031066895, 16.21633529663086, "9. \n 71 consequences similar to if many hospitals in a region had extremely reduced capacity or were \nrendered useless after a major seismic event. \nMultiple past efforts within the legislature have failed to introduce statewide retrofit \nprograms"] [-4.919358730316162, 16.22199249267578, " Control Board, \u201cStudy Session on Consideration of Tenant Protections and Costs Associated \nwith the City of Santa Monica \u2019s Mandatory Seismic Retrofit Program ,\u201d letter from Tracy Condon to the Rent \nControl Board commissioners, October 12, 2017 . "] [-4.917449951171875, 16.218475341796875, "nd other sectors is in the ability to finance the necessary retrofit projects. \nFirst, before discussing individual project financing, a comment is warranted on overall \nsector costs. As has been noted within the hospital industry, total costs are qu"] [-4.921004295349121, 16.220829010009766, "ment managerial actions that generate higher profit margins to increase funding for infrastructure projects, but this may be insufficient. In regard to public financing, only a handful of hospitals across California owned by state, county, or municip"] [-4.922414302825928, 16.222240447998047, "nd on a variety of infrastructure, services, and other institutions. Hurricane Maria in Puerto Rico in 2017 and similar experiences show that interruptions in access to more-routine care for chronic conditions can significantly elevate morbidity and "] [-4.925143718719482, 16.22704315185547, "t illustrate a range of policy instruments.\n129 \nAs a benchmark for comparison, we begin by assessing the status quo. Next, we analyze four \nbroad sets of alternative policy options that policymakers may adopt to achieve the goals of SB 1953 while a"] [-4.928759574890137, 16.23104476928711, "y 2030, hospital \nbuildings that are not in substantial compliance with these standards (SPC-2 buildings) must be retrofitted (typically to SPC-4D or higher standards), demolished, replaced, or converted to nonacute use. Failing that, hospitals then "] [-4.936700344085693, 16.235904693603516, "riving these decisions. \nDistributional Effects and Equity \nHospitals bear all the initial outlays for SB 1953 projects under the status quo.\n133 Other things \nbeing equal, financially stressed hospitals are more at risk for exiting the general acu"] [-4.919680595397949, 16.21965980529785, "odels \nOne way to reduce the impact of seismic events on patients and encourage more hospitals to \ninvest in seismic improvements is to lower the costs of SB 1953 to hospitals by spreading them more broadly among beneficiaries of the policy. Arguabl"] [-4.919921875, 16.219425201416016, "e used to support retrofits, new construction, or both. \nReducing the cost of financing investments in seismic retrofits and new construction is \nanother way to reduce the costs to hospitals and facilitate greater seismic safety investment on their "] [-4.931596755981445, 16.230867385864258, "ich $576 million remained outstanding. \nGiven that data gathered for this research show that a single hospital retrofit project has costs on the order of $100 \n 81 expanded program. As we noted, Cal-Mortgage is presently available to public and no"] [-4.938678741455078, 16.239503860473633, "t Ending November 30, 2018 , \nSacramento, 2018. \n142 More generally, this type of program would benefit only hospitals that have not yet met the requirements of SB \n1953. Some might argue that such a policy is unfair because it rewards hospitals tha"] [-4.925722599029541, 16.22660255432129, "als in Los Angeles County were evacuated after the Northridge earthquake, regional capacity proved adequate to absorb this loss. On an ongoing basis, hospitals \n \n143 Chang and Jacobson, 2010. 83 with "] [-4.925710678100586, 16.22671890258789, "o postearthquake health care that includes consideration of nonhospital resources. \nAs a third alternative, policymakers could create a market akin to a pollution cap-and-trade \nsystem to drive the allocation of regionally tailored compliance requir"] [-4.926850318908691, 16.225725173950195, "ations to address equity concerns and secure buy -\nin from market participants. In either trading system, regulators would need to consider the time horizon of the \nunderlying rights and requirements. Would the rights be of a one -shot nature, with "] [-4.930436134338379, 16.229028701782227, "lization policies would first need to determine both the optimal size and scope of each region and the number of compliant beds that each region requires. Although the regional structure implied by the Hospital Preparedness Program\u2019s cooperative agre"] [-4.938495635986328, 16.23681640625, "iance. Administrators would then need to spend resources to ensure smooth adoption and best use of the options this policy presents. \nUnder a bilateral trading system in particular, policymakers would need to give some \nattention to antitrust concer"] [-4.936173439025879, 16.236867904663086, "their normal capital replacement \nschedule \n\u2022 customize deadlines based on project characteristics by type or complexity of the \nbuilding project \n\u2022 allow rolling deadlines for sequencing construction or retrofitting of multiple buildings \non the sam"] [-4.932314872741699, 16.232515335083008, " comply. Alternatively, policymakers could instead determine the maximal time they are willing to extend hospitals to retrofit for SB 1953. \nOther Considerations \nTiming-flexibility options have at least two implications beyond hospitals. First, ext"] [-4.926332473754883, 16.22479820251465, " In practice, the effectiveness of such a policy depends on the expected time saved per project. Estimating potential time saved presents substantial challenges and makes calibrating this policy to achieve a desired level of response highly impractic"] [-4.92692232131958, 16.225440979003906, "these costs would fall as well. Additionally, hospitals would benefit by spending less time shut down for retrofits or by bringing new hospitals online sooner. \nFeasibility \n The fact that OSHPD has recently undertaken other process changes demonstr"] [-4.927006244659424, 16.22661781311035, "he others. Rather, each \nalternative has its advantages and disadvantages relative to each other and to the status quo. The relative magnitude of the advantages and disadvantages, however, is difficult to assess at this point because it would depend "] [-4.957387924194336, 16.259010314941406, "buildings. By placing cost estimates of SB 1953 in a larger policy context, this study provides a foundation for a discussion of how policy can effectively ensure the seismic resilience not just for California\u2019s hospitals but the state\u2019s health care "] [-4.930619239807129, 16.231760025024414, " old buildings from service. Requiring hospitals to link the timing of these actions to imposed deadlines in 2020 and 2030 reduces the flexibility of hospitals to make capital investments when and where they will be most advantageous. Synchronizing c"] [-4.927191734313965, 16.2309627532959, " while the higher value assumes that all hospitals replace their SPC-2 buildings with new construction. However, because hospitals will pursue a mix of retrofit and new construction, neither value is realistic. Rather, the actual cost will fall somew"] [-4.930642127990723, 16.230422973632812, "tified as experiencing severe financial stress. After including in the analysis of financial stress the potential costs of SB 1953 compliance that individual hospitals might incur, the proportion of hospitals with some or severe financial stress incr"] [-4.9292893409729, 16.229124069213867, "is report does not make specific policy recommendations regarding whether SB 1953 \nshould continue to be implemented as is, altered to change how the costs of seismic resilience are \ndistributed throughout society (e.g., use of public subsidies), or "] [-4.92223596572876, 16.22177505493164, " with hospitals to maintain compliance with legislative requirements of SB 1953 while pursuing opportunities to address common barriers to compliance. Such collaborative relationships between OSHPD and hospitals enable \n "] [-4.9219770431518555, 16.22166633605957, "d the Hospital Building Safety Board to advise \nOSHPD on the implementation of the Alquist Seismic Safety Act and act as a board of \nappeals for hospital facilities in regard to seismic safety and fire and life safety issues. 1973 \nSB 961 This legi"] [-4.9264631271362305, 16.226852416992188, "s bill permitted a hospital to receive an additional two-year extension to the January 1, \n2008 deadline on top of the existing two-year extension. It also reopened the window for \nhospitals to qualify for the up -to-two-year extension available to"] [-4.922675609588623, 16.222614288330078, "f the bill and required the application to include a timetable, as specified. 2015 \nAB 908 This bill authorized a hospital in the Tarzana neighborhood in Los Angeles that received \nspecified extensions to request an additional extension, as specifi"] [-4.913583755493164, 16.213233947753906, "018. As of March 20, 2019: \nhttps://mavensnotebook.com/2018/01/03/earthquake-resilience-southern-californias-water-distribution-systems/ \nBabbitt, Donald H., Improving Seismic Safety of Dams in California, Sacramento: California \nDepartment of Water"] [-4.924598217010498, 16.224241256713867, "Program,\u201d webpage, June 2014. As \nof March 20, 2019: http://www.dot.ca.gov/hq/paffairs/about/retrofit.htm \nCalifornia Department of Water Resources, \u201cLake Perris and Perris Dam Projects,\u201d webpage, \nundated. As of March 20, 2019: https://water.ca.g"] [-4.92175817489624, 16.221662521362305, "ction 15097.125) to Chapter 1 of Division 12.5 of, the Health and Safety Code, Relating to Building Standards, and Making an Appropriation Therefor, September 21, 1994. As of March 20, 2019: http://www.leginfo.ca.gov/pub/93-94/bill/sen/sb_1951-2000/s"] [-4.903507709503174, 16.203575134277344, "ch 20, 2019: \nhttp://www.catc.ca.gov/programs/prop1b/lbsra/docs/LBSRA_guidelines_052908.pdf \nCapps, C., D. Dranove, and C. Ody, \u201cThe Effect of Hospital Acquisitions of Physician Practices \non Prices and Spending,\u201d Journal of Health Economics, Vol. 59"] [-4.896716594696045, 16.196945190429688, "hronicle.com/bayarea/article/Crews-topping-off-Calaveras-Dam-shoring-up-Bay-13245983.php \nGillengerten, J., \u201cEstimated Cost of Structural Retrofits,\u201d paper presented at the SB 1953 \nSeismic Compliance Meeting, California Healthcare Association, Sacr"] [-4.92721700668335, 16.227306365966797, " \nRecovery and Closure: Managerial Incentives and Political Costs,\u201d Journal of Public \nBudgeting, Accounting and Financial Management, Vol. 23, No. 1, 2011, pp. 31\u201368. \nMallett, William J., Nicole T. Carter, and Peter Folger, Earthquake Risk and U.S."] [-4.917713165283203, 16.217403411865234, " March 20, 2019: https://www.healthcaredesignmagazine.com/architecture/californias-wise-retreat-seismic-overreaction/ \nPublic Law 111-148, Patient Protection and Affordable Care Act, March 10, 2010. As of \nDecember 27, 2018: \nhttps://www.govinfo.gov/"] [-4.922658443450928, 16.222375869750977, "mergency Response,\u201d in John F. Hall, ed., \nNorthridge Earthquake, January 17, 1994: Preliminary Reconnaissance Report, Oakland, \nCalif.: Earthquake Engineering Institute, 1994, pp. 87\u201393. As of March 20, 2019: http://www.desastres.hn/docum/crid/Sept"] [-4.931354522705078, 16.231103897094727, "o exacerbate this stress. There are options for providing regulatory relief or flexibility to hospitals: public subsidies to share the costs of compliance or reduce financi ng costs, additional flexibility in compliance deadlines, \nnew standards for "] [-0.6952059268951416, 12.400031089782715, "Developing a Robust \nWater Strategy for Monterrey, Mexico\nDiversification and Adaptation for \nCoping with Climate, Economic, and \nTechnological Uncertainties\nEdmundo Molina-Perez, David G. Groves, Steven W. Popper, \nAldo I. Ramirez, Rodrigo Crespo-E"] [-0.6855114102363586, 12.408327102661133, "nagement strate-gies that account for climate change.\nAbout RAND Social and Economic Well-Being\nRAND Social and Economic Well-Being is a division of the RAND Corporation that \nseeks to\u00a0actively improve the health and social and economic well-being of"] [-0.7003211379051208, 12.36859130859375, "............................................................................... 1\n1.2. Challenges and Opportunities for Monterrey\u2019s Water System .............................. 3\n1.3. Questioning an Ambitious Pipeline Project for Monterrey ........."] [-0.694135308265686, 12.377079963684082, ". Lessons for Water Planning in Latin America .............................................. 66\nAPPENDIXES\nA. Robust Decision Making Methodology ..................................................... 69\nB. Integrated Assessment Model .............."] [-0.6902669072151184, 12.349472999572754, "............................................. 11\n 2.\n2. Sc\nope of RDM Analysis ................................................................ 12\n 2.\n3. Su\npply Sources for Monterrey .......................................................... 15\n 2"] [-0.6852878332138062, 12.352686882019043, "d be inappropriate unless Monterrey experiences very high-demand growth and extremely adverse local climate conditions in the long term. \nThe second phase of our research project\u2014described in this report\u2014built upon \nthe tools initiated during the fir"] [-0.6754705905914307, 12.35053825378418, "nt sequence that meets Monterrey\u2019s water planners\u2019 reliability objective while minimizing investment costs. The resulting database is a rich set of cases showing how different assumptions about uncertain future conditions trigger the implementation o"] [-0.647616982460022, 12.341245651245117, "o options fall into three groups. The first, with low cost-regret levels but high reliability regret, are portfolios that rely on small-scale and low-cost projects. The second group, with high reliability but high cost regret, includes portfolio alte"] [-0.6845719218254089, 12.351778984069824, "hich water demand is lower than 14.6 cubic meters per second (m\n3/s) and the scenarios under which water \ndemand is higher than 19.1 m3/s is US $4 billion. This reinforces the message that sig -\nnificant savings may be achieved if water demand is man"] [-0.6780076622962952, 12.352849006652832, "collaboration with many part -\nners whose collective contributions, support, and feedback proved invaluable. We \nthank and acknowledge Eugenio Clariond Reyes-Retana and Alfonso Garza-Garza, presidents of Fondo de Agua Metropolitano de Monterrey (FAMM"] [-0.6938477158546448, 12.355063438415527, " [Monterrey Water and Sewage Services]\nRDM Robust Decision Making1CHAPTER ONE\nWater Planning in Monterrey: Future Uncertainties and \nPolitical Gridlock\n1.1. Introduction \nMonterrey, located in Mexico\u2019s northern state of Nuevo Le\u00f3n, is the country\u2019s t"] [-0.6878567934036255, 12.362089157104492, "no longer possible to predict the potential effects of climate change on the basins from which the city\u2019s water supply is drawn (L\u00f3pez-Garcia, Man-zano, and Ramirez, 2017).\nIn response to such challenges, the Fondo de Agua Metropolitano de Monterrey "] [-0.6946839690208435, 12.341815948486328, "supply. \nFigure 1.2\nHistorical Growth in Water Demand in Monterrey, 1980\u20132015\nNOTES: Time series of historical water demand in Monterrey. The vertical axis denotes mean yearly water \ndemand in m3/s. The horizontal axis denotes the historical record c"] [-0.6935980319976807, 12.355180740356445, " distant ecosystem. As a result, the prospect of the project was met with strong opposition by different actors within the local water-planning community.\n3 In response, proponents of the project emphasized the urgent \n3 We use the term \u201cMWP [Monterr"] [-0.693116307258606, 12.362822532653809, "ategy for Monterrey\u2019s Water Plan. \nMonterrey needs a robust, adaptive water-management strategy to ensure that the \nwater needs of the region are met even as these needs remain deeply uncertain. This strategy must also use limited public resources wi"] [-0.6785224080085754, 12.374065399169922, "formance. Chapter Four describes in detail different options to improve the long-term performance of the water system and the robust, adaptive plan that was identified and incorporated into Monterrey\u2019s latest water plan. Chapter Five summarizes the s"] [-0.3831925690174103, 12.737629890441895, "t of assumptions about a deeply uncertain future may well prove \ninadequate or even harmful if another future comes to pass.\nComplications arising from deep uncertainty appear to be undermining previous \nconsensus in many policy areas on what constit"] [-0.4259583055973053, 12.702592849731445, "velopment and comparison, as described in Figure 2.1 and Appen -\ndix A. RDM begins with a decision-framing step in which the key uncertainties, deci -\nsion options, performance measures, and models are defined. This information is gen -\nerally gather"] [-0.6332162022590637, 12.410426139831543, "hat had three objectives: (1) Describe the man -\ndate and scope of the study; (2) communicate relevant findings; and, most important, (3) engage in a constructive discussion with participants regarding how to improve the study and make it more releva"] [-0.6674563884735107, 12.374494552612305, "n RDM \nanalysis, using the XLRM framework (X = uncertainties, L = options and strategies, R = model relationships, M = performance measures). In this framework, the cat -\negory uncertainties (X) represents exogenous factors over which the decisionma"] [-0.6795718669891357, 12.353053092956543, "ate level, these options could be placed into two groups: \n(1) infrastructure options that expand the current system\u2019s supply capacity by exploit -Table 2.2\nScope of RDM Analysis\nUncertainties (X)\n1. Water-demand drivers\n\u2022 Ec\nonomic growth \n\u2022 Popu\nl"] [-0.6880815625190735, 12.355330467224121, "te a solution but instead to provide decisionmakers with much better strategic insight into their near-term options and how to modify their adaptation strategies for the medium and long terms. See Section 2.5 for more elaborations on the performance "] [-0.6727365255355835, 12.340991973876953, "storical water demand from 1981 to 2016 and a set of plau -\nsible future demand projections through 2050. The future projections are derived from a detailed exploratory analysis of plausible future water demand using an econometric water-demand model"] [-0.6961781978607178, 12.340786933898926, "\nprobability. Higher probabilities are associated with lower constant flows that can be delivered, lower probabili -\nties are associated with higher flows that can be delivered. Table 2.3\nSupply Sources for Monterrey\nSource Sustainable Supply (m3/s) "] [-0.7107471227645874, 12.329894065856934, "he aquifers present challenging geological compositions (i.e., limestones, shales, and karstic stones) and locations that could potentially produce less water than anticipated, as the risk of fracture is higher. At the same time, based on the city\u2019s "] [-0.6995012164115906, 12.346534729003906, " the cost and reliability attributes can be favorable as part of a portfolio of water-management options. Furthermore, as costs decline with grow -\ning technological efficiency, desalination projects become increasingly favorable. Thus, trends in des"] [-0.6949986815452576, 12.34427547454834, "of options that could be \nimplemented to expand the city\u2019s water infrastructure. Over the course of this study, we interacted closely with local stakeholders to define and characterize a comprehensive list of such options for inclusion in the MWP. Th"] [-0.6700629591941833, 12.307594299316406, " of the options would complement one another (e.g., an injec -\ntion well and new groundwater wells), while others depend on interdependent water sources (e.g., Cuchillo II Dam, La Libertad Dam, and Tunnel San Francisco II) or are affected differently"] [-0.6840589642524719, 12.323620796203613, "he study.\n2.4.1. Traditional Water-Management Options \nTable 2.4 lists the complete set of infrastructure options considered, excluding tariffs. Each option is described in terms of its total investment cost\u2014including both con -\nstruction and operati"] [-0.7042739987373352, 12.329805374145508, "roject 148 100 48 1 3 3 2 3 3\nLa Libertad Dam 184 160 24 1.5 3 3 2 3 3\nCuchillo II Dam 460 352 107 5 3 2 2 2 3\nVicente Guerrero Dam 796 619 177 5 3 2 3 2 3\nPanuco Aqueduct 1,354 1,113 241 5 2 1 3 2 3\nDesalination plant in Matamoros 1,406 1,055 351 5 "] [-0.7046845555305481, 12.336515426635742, "We developed a tariff optimization tool for exploring an alternative tariff sched -\nule. This tool first estimates the price-demand elasticity for potable water across dif -\nTable 2.5\nMonterrey\u2019s Water-Tariff Segments and Shares of Consumption\nSegmen"] [-0.6604817509651184, 12.321894645690918, " identify the conditions under which a water-system configuration (i.e. infrastructure and regulations) does not meet the management objectives and to compare the perfor -\nmance of alternative strategies in the near, medium, and long terms. In this s"] [-0.553514301776886, 12.421576499938965, "me. An econometric autoregressive distributed lag (ARDL) demand model is \nused to define the demand projections in a way that accounts for variation across time and geography. Similarly, a Markov autoregressive hydrological model (MARHM) is used to g"] [-0.6631617546081543, 12.357104301452637, "jections with the \n54 hydrological projections for a \u201cfull factorial\u201d design of 648 futures. Next, for each of these 648 futures, random values of groundwater assumptions are combined (rang -\ning between 70 and 130 percent of the current estimate) t"] [-0.5675379037857056, 12.38936996459961, "s. The third experimental design allows for the direct comparison of experimental design 1 and experimental design 2 under two alternative policy levers sets: one that considers only infrastructure investments and another that expands this original s"] [-0.4684433043003082, 12.419876098632812, " set of futures reflecting uncertainty. The results of these simulations are examined to identify the main drivers of vulnerability. In the optimal strategies stage (described in Chapter Four), the IAM calculates the optimal portfolio of options acro"] [-0.6874200105667114, 12.335063934326172, "erable otherwise. \nAs an example, Figure 3.1 shows projected total water demand for Monterrey over \ntime (line) and sources of supply (colored stacked bars) for a future in which demand growth is projected to grow slower than current trends (e.g., fi"] [-0.6899809837341309, 12.331338882446289, " -\nability level of Monterrey\u2019s current water system for each plausible future for the first experimental design described in Chapter Two. Recall that this design is built around uncertainties in demand, hydrology, and groundwater availability. Figur"] [-0.6874169707298279, 12.303190231323242, "nd groundwater availability (panels). The color legend describes the estimated level of reliability. The \u201cx\u201d indicates results in which reliability is below 97 percent. cms = cubic meters per second. Higher groundwater availability Lower groundwater "] [-0.6786841154098511, 12.329246520996094, "uencing of these elements, as well as data inputs into each component.Medium-term\nsignpost\nconditions\nMedium-term\ncontingent \noptionsLong-term\nsignpost\nconditions\nLong-term\ncontingent \noptionsPortfolio of\nlow-regret, \nnear-term\noptions\n2016\u20132026 2027"] [-0.7031353712081909, 12.313775062561035, "ld set for our analysis. At the same time, this example also shows that the cost of meeting this threshold increases as higher water-demand scenarios are faced\u2014from US $154 million under the water-\n1 By definition, those courses of action that perfor"] [-0.6786017417907715, 12.309257507324219, "liability objective cannot be achieved, even with all projects implemented. \nTable 4.3 summarizes the percentage of times that an option is implemented in \nthe optimal portfolio across the full set of futures, disaggregated by the implementa -\ntion p"] [-0.6881727576255798, 12.326539039611816, "folios Across Futures Ensemble, by Time and Change in Water Demand and Flow\n2016\u20132026 2027\u20132038 2039\u20132050\nWater-Demand Growth Levels\nLow Medium High Low Medium High Low Medium High\nMonterrey Country \nGroundwater WellWetter conditions 100% 72% 96% 10"] [-0.6941373944282532, 12.302093505859375, "he results shown in Table 4.2 provide only partial guidance for which options would be low regret in the first period. While one approach might be just to include the options that appear most often in the near term (left panel of Table 4.2), this wou"] [-0.6783571839332581, 12.292685508728027, " procedure yields nine different low-regret portfolios that could be \nimplemented during the first decision period (Table 4.6).\nThere are important differences among these near-term portfolios, as they are \ntailored toward different futures. For inst"] [-0.6934038996696472, 12.310941696166992, "Groundwater \nWellLa \nLibertad \nDamShallow \nWells: La \nUnionWW \nInjection \nWell Project\nObispado \nGroundwater Well27% 25% 21% 8% 17% 16% \u201310% 6% 100%\nLa Libertad Dam22% 27% 29% 24% 28% 29% \u201321% 21% 9% 100%\nLa Union Shallow Wells19% 25% 29% 18% 23% 48%"] [-0.6915433406829834, 12.314238548278809, "rn, allows us to identify a Pareto frontier in the first decision period\u2014in this case, the set of points that define the trade-off surface along which any improvement on cost regret would entail more reliability regret and vice versa.\nFigure 4.2 show"] [-0.6884143948554993, 12.319292068481445, "t combine La Libertad Dam, efficiency, and groundwater options (i.e., P1, P2, P3, and P5) but also a project portfolio that relies only on the Cuchillo II Dam (P6). Thus, these groups describe fundamentally different approaches to executing near-term"] [-0.6469886302947998, 12.384800910949707, "n in the second and third deci -\nsion periods and, as a result, fewer options for adaptation. In contrast, if Monterrey\u2019s water planners decide to implement one of the low cost-regret alternatives, there might be greater supply vulnerability in the n"] [-0.5175164341926575, 12.53576946258545, "al deci -\nsions with decision nodes that denote a decision to be made on an uncertain factor. For choosing the best split, the algorithm computes two statistics: (1) entropy, which measures how homogenous class values are (i.e., purity of the end-nod"] [-0.6558458805084229, 12.317378997802734, "cribes the main attributes of the different options, presents the near-term portfolio analysis, presents the decision trees for each near-term portfolio, and summarizes the reliability for the selected robust adaptive strategy. \nMonterrey water plann"] [-0.6990481615066528, 12.322202682495117, "%) = 100\nNo actionCost (million US $) = 0Reliability (%) = 100\nPanuco aqueduct\nVicente Guerrero DamCuchillo II DamWW Injection Well ProjectCost (million US $) = 2,758Reliability (%) = 100Enhancing the Resilience of Monterrey\u2019s Water System Through a "] [-0.6883792877197266, 12.337132453918457, "ld suffice for meeting the reliability objectives in the second period. This desalination investment would also be appropriate if demand grows at a medium level or if demand grows at a medium-high level and groundwater availability turns out to be co"] [-0.6993150115013123, 12.316730499267578, "est represented by the time interval that a drought affects these sources. If the duration during which these basins remain below historical mean conditions is sufficiently large, then more projects are needed for meeting Monterrey\u2019s water plan -\nner"] [-0.6972483992576599, 12.322409629821777, "00\nNo action\nCost (million US $) = 0Reliability (%) = 100\nNo actionCost (million US $) = 0Reliability (%) = 99Efficiency\nCost (million US $) = 100 Reliability (%) = 100\nEfficiencyCost (million US $) = 100 Reliability (%) = 100Desalination plantEffici"] [-0.6920122504234314, 12.331805229187012, "aptive strategy than P6.\nFinally, the implementation costs estimated at each decision node in both adap -\ntive plans reveal the huge economic opportunity that exists in managing water-demand growth. For instance, in the case of the adaptive strategy "] [-0.6919125318527222, 12.328080177307129, " basins (cms)Vulnerability\ncondition\nVulnerable\nNot vulnerable60 Developing a Robust Water Strategy for Monterrey, MexicoFigure 4.8\nMonterrey Adaptive Water Plan Based on P2 Under an Alternative Tariff Schedule\nDemand (cms) <= 14.16\nDemand (cms) > "] [-0.6834011673927307, 12.324005126953125, "er-demand \nscenarios considered, as seen in Figure 4.8. These differences are more evident in the long term. For example, if demand is low, medium-low, or medium, the number of projects required for meeting the reliability objective is lower than in "] [-0.6881765127182007, 12.342214584350586, "ovide to other water-planning initiatives in Latin America. \n5.1. An Adaptive Master Plan: Robust Options and Critical Signposts \nWe estimated reliability levels of Monterrey\u2019s current water system across a diverse set \nof uncertainties regarding f"] [-0.6920194625854492, 12.3462553024292, "ing in the network\u2019s efficiency is also an important element for robustness of the system. \nFor the medium- and long-term evolution of Monterrey\u2019s water system, we find \nthat vulnerabilities are best addressed from an adaptive planning perspective. "] [-0.6810340285301208, 12.35428237915039, "y without adequate computational tools. To better analyze other project proposals, such as increasing forest cover, permeable pavements, and urban densifica -\ntion, it would be necessary to develop new tools and integrate these aspects into the IAM d"] [-0.6877582669258118, 12.34688663482666, "he system\u2019s reliability, other criteria\u2014such as water- distribution inequality and environmental impacts of project alternatives\u2014can be explicitly considered as performance metrics. \n5.3. Lessons for Water Planning in Latin America \nThe water-plannin"] [-0.39441347122192383, 12.728053092956543, "rities across alternatives, which can be conducive to the development of more cost-effective and robust expansion strategies. 69APPENDIX A\nRobust Decision Making Methodology\nRDM uses a number of techniques to conduct analyses when deep uncertainty is"] [-0.4004116654396057, 12.710196495056152, " we are assessing. There may be opposing views difficult to refute with the information available and so this too can become a matter for RDM analy -\nsis. Finally, we need to be able to assess different outcomes that we may observe with different ass"] [-0.39539727568626404, 12.641927719116211, "ices for Monterrey\u2019s water infrastructure across many futures. This is described in more detail in section 2.7 of this report. \nCases may be generated to model a wide range of proposed candidate strategies \nacross many different plausible futures. Th"] [-0.4181141257286072, 12.685076713562012, "ically those \nscenarios that make a difference in discriminating among the choices before us. The \n\u201cboxes\u201d proposed by the data-mining algorithms in effect provide precise descriptions of stressful future scenarios that are meaningful for the decisio"] [-0.39916372299194336, 12.725179672241211, "de-offs among alternative adaptive strategies. Robust Decision Making Methodology 73\nStep 5: New Options and Strategies\nIn response to analysis in steps 2\u20134, additional options and futures and strategies may \nbe defined. For example, the initial c"] [-0.6203305721282959, 12.334054946899414, "gle consumer over time. In this study, as a result of our collabora -\ntion with SADM, the panel data used for estimating the model compose the full set of SADM\u2019s consumer-demand records from January 2012 to December 2015.\n1 \nThese records were also s"] [-0.655139148235321, 12.390624046325684, "l station data relevant to the \ndifferent water-supply sources. The contributing basins for each one of the proposed project alternatives were delimited through the Thiessen polygons spatial weighting method and the available isohyetal information. \n"] [-0.7105404734611511, 12.357841491699219, "e and water-supply 78 Developing a Robust Water Strategy for Monterrey, Mexico\nenhancing alternative considered in this study. RiverWare uses physical-balance equa -\ntions and discrete equations to describe the interrelation between river basins, "] [-0.6914348006248474, 12.36438274383545, ". (2018c). \nDynamic Optimization Engine\nWe developed also a dynamic optimization model that estimates the best investment \npath for a specific combination of future circumstances. This optimization routine is forward looking as it identifies the best"] [-0.648038923740387, 12.380910873413086, "bed in the previous paragraphs is an \nextremely useful computational laboratory to be used in the context of a RDM analy -\nsis. On the one hand, the water-demand and hydrological models allow the exploration of diverse potential demand and supply con"] [-0.687440037727356, 12.337158203125, " of the group. Additionally, we split these aggre-gated hydrological-change scenarios into three periods matching the dynamic optimi-zation decisions (near term [2016\u20132026], medium term [2027\u20132038], and long term \n[2039\u20132050]) and also added further"] [-0.6805455684661865, 12.43496036529541, "a metropolitana,\u201d Monterrey, Mexico: Fondo de Agua Metropolitano de Monterrey, 2017b.\nDeser, Clara, Adam Phillips, Vincent Bourdette, and Haiyan Teng, \u201cUncertainty in Climate Change \nProjections: The Role of Internal Variability,\u201d Climate Dynamics , "] [-0.4973880648612976, 13.266927719116211, "David G., Robert J. Lempert, Debra Knopman, and Sandra H. Berry, Preparing for an \nUncertain Future Climate in the Inland Empire: Identifying Robust Water-Management Strategies , \nSanta Monica, Calif.: RAND Corporation, DB-550-NSF, 2008. As of April "] [-0.5058332681655884, 13.22354793548584, "st \nDecision Making , Washington, D.C.: World Resources Institute, 2011. \nLempert, Robert J., Steven W. Popper, and Steven C. Bankes, Shaping the Next One Hundred Years: New Methods for Quantitative, Long-Term Policy Analysis , Santa Monica, Calif.: "] [-0.6969428658485413, 12.509105682373047, ", J. Ross, C 4.5: Programs for Machine Learning , San Mateo, Calif.: Morgan Kaufmann, \n1993. \nRam\u00edrez, A., L. Herrera, S. Ram\u00edrez, and D. G\u00f3mez, \u201cModelaci\u00f3n estoc\u00e1stica de precipitaciones,\u201d \n2018a. \nRam\u00edrez, A., L. Herrera, S. Ram\u00edrez, D. G\u00f3mez, E. T"] [-0.6906795501708984, 12.377346992492676, "wakkel, \u201cDeep Uncertainty,\u201d in Saul I. Gass and Michael C. Fu, eds., Encyclopedia of Operations Research and Management Science , 3rd ed., New York: \nSpringer, 2013, pp. 95\u2013402. SOCIAL AND ECONOMIC WELL-BEING\nwww.rand.org\nRR-3017-FAMM 9 781977 402745"] [12.69742488861084, 13.816710472106934, "SOCIAL AND ECONOMIC WELL-BEING\n2018 National Survey of \nHealth Attitudes\nDescription and Top-Line Summary Data\nKatherine Grace Carman, Anita Chandra, Sarah Weilant, Carolyn Miller, \nMargaret Tait\nPrepared for the Robert Wood Johnson Foundation\n Limit"] [12.694914817810059, 13.783271789550781, "measure detail, technical reports, and other infor -\nmation, can be found at www.cultureofhealth.org (RWJF, undated). \nResearchers from RAND and RWJF jointly conducted the research reported here; the \nreport is intended for individuals and organizati"] [12.900501251220703, 14.094545364379883, ".............................................................................................. 11\nSurvey Sample ................................................................................................... 11\nCombining Sample Data ..........."] [12.939648628234863, 14.356792449951172, "......................................... 28\nQ7. You said the following programs are a top priority. Of these which would you consider \nto be the highest priority? Of these which would you consider to be the lowest priority? ...... 29\nQ8. Please in"] [12.935686111450195, 14.361809730529785, "4d. When Americans living in rural communities need health care, do you think it is \neasier or harder for them to get the care they need than it is for those who live in urban areas, or is there not much of a difference?\n .........................."] [12.929811477661133, 14.379613876342773, "............................................ 50\nQ23. Has the poor health of another person affected your life on an ongoing basis for any \nextended period of time? ............................................................................... 50\nQ"] [12.710066795349121, 13.839356422424316, " challenge like a plant closure, major \nincident of community violence? ....................................................................... 55\nQ33a. If yes: As a result of this event, were you temporarily or permanently displaced from \nyour hom"] [12.697385787963867, 13.826567649841309, "n Action Framework and selected measures to advance these goals. The Action Framework and 35 measures were selected as a means of defining, operationalizing, and measuring the United States\u2019 progress toward this goal.\nThis report describes the 2018 R"] [12.883686065673828, 14.014577865600586, "cription and Top-Line Summary Data\nally representative internet panels whose members are recruited via probability-based sampling \nmethods. Both provide computers and internet connections for respondents who do not have them at the time of panel recr"] [12.69611644744873, 13.83106803894043, "eristics of the sample. The weighted results are pre-sented separately for each panel sample and for the total. xiiiAcknowledgments\nWe appreciate reviews of Scott Keeter (independent) and Kirsten Becker (RAND). We thank \nLarry L. Bye, Alyssa Ghirarde"] [12.623336791992188, 13.796762466430664, "n areas specifically. These action areas and drivers work toward the outcome area of a Cul -\nture of Health: improved population health, well-being, and equity . The outcome area is the key \nresult of activities in each action area. We briefly outlin"] [12.646466255187988, 13.79983139038086, "ction area includes three drivers: the built and physical environment, the social and economic environment, and related policies and governance that support healthier communities. \nAction Area 4 focuses on strengthening the integration of health serv"] [12.712274551391602, 13.860441207885742, "ure of Health mea -\nsures. However, in the context of making health a shared value, there were large gaps in our 4 2018 National Survey of Health Attitudes: Description and Top-Line Summary Data\nunderstanding of the perspectives of individuals liv"] [12.712339401245117, 13.862187385559082, "ing so, we drew on findings from broader stakeholder-engagement efforts undertaken as part of the larger Culture of Health development (Acosta et al., 2016; Martin et al., 2017). Second, we reviewed relevant literature and surveys to identify potenti"] [12.702710151672363, 13.88878059387207, "easure Whether We Are Moving Toward a Culture of Health: Assessing Action Area 1, Making Health a Shared Value\nExpectations to Track \nOver time in a Culture of Health, more U.S. adults would:Domains\nWhat are the types of things we need to know to as"] [12.726495742797852, 13.953551292419434, "ces on health (e.g., peer, family, \nneighborhood, and workplace drivers of health); values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health;"] [12.713383674621582, 13.862236976623535, "concepts from the review. \nIn addition, we reviewed surveys, concept scales, and model questionnaires previously known to the team. Table 2.2 lists surveys that we identified through this process that contributed to the design of this survey. We revi"] [12.704309463500977, 13.84427261352539, "Health (Wellness Forum Health, 2017) Not applicable\nPersonal Health Experience Scale Alyssa T. Brooks et al. (Brooks et al., 2013) 2013\nSense of Community Index Community Science (Chavis, Lee, and Acosta, 2008) Not applicable\nNOTE: Items shown as not"] [12.730765342712402, 13.887839317321777, " to better align with our Culture of Health Action Framework and drivers. If we could use existing measures, we looked at available psy -\nchometric properties, including reliability and construct validity, though the latter was often not available fo"] [12.915266990661621, 14.04875373840332, "y, we also include the ques -\ntion number from the previous survey. \nSurvey Length\nThe resulting survey contained 34 questions, some with subquestions or multiple parts. The median time to complete the survey was between 18 and 19 minutes.\nRandomizat"] [12.930602073669434, 14.07210636138916, "d importance\nReligion and spirituality Q22 2 and 5 Health status and experience with \nhealth and importance\nImpact of others health Q23 2 and 5 Health status and experience with \nhealth and importanceSurvey Overview 13\ndata set. Respondents in bot"] [12.87873649597168, 14.02734661102295, "ealth status and experience with \nhealth and importance\nLive in other country Q34 2 and 5 Health status and experience with health and importanceTable 2.3\u2014continued14 2018 National Survey of Health Attitudes: Description and Top-Line Summary Data\n"] [12.87352180480957, 14.022784233093262, "weighting, a statistical \nadjustment. To create weights to match the distribution of characteristics in our sample as closely as possible to that of the population from the 2018 Current Population Survey (CPS), we used a raking algorithm, following t"] [12.847960472106934, 13.996859550476074, "ng for smartphones, our survey contained sev -\neral large tables\u2014for example, for Question 1, which asked the respondent to rate many differ -\nent things on one screen. These tables can be difficult for respondents using smartphones, and we cannot be"] [12.726840019226074, 13.876431465148926, "of the action area making health a shared value . Then, \nwe specifically used the survey to collect data for three of the 35 national Culture of Health measures. All measures are associated with the action area making health a shared value .\nAlthough"] [12.863503456115723, 13.980624198913574, "pectation for Well-Being\nThis measure provides insight on the current landscape of public opinion and attitudes regard -\ning community investment in health and well-being. We calculated this measure using Ques -\ntions 2 through 6, which asked respond"] [12.945544242858887, 14.084619522094727, "d good diet (Chavis, Lee, and Acosta, 2008).\nFor our measure, we separately calculated a score for each of the two subscales. Each \nscale contains six questions. We measured the membership subscale with items A through F of Question 17. The emotional"] [13.01188850402832, 14.157870292663574, "f Health Attitudes: Description and Top-Line Summary Data\nRecognized Influence of Physical and Social Factors on Health\nQ1. Here is a list of some things that may affect people\u2019s health and well-being. Please rate \neach on a scale from 1 to 5 where 1"] [12.986978530883789, 14.140389442443848, "08)3.5 4.5 23.7 34.3 33.6 0.4\nTotal 3.6 4.5 23.4 34.4 33.3 0.7\nL. Income\nSample 1 (No Effect) 2 3 45 (Very Strong \nEffect) Missing\nALP ( n = 2,479) 4.0 6.3 22.0 35.0 32.1 0.6\nKnowledgePanel \n(n = 4,708)4.4 7.8 29.0 31.5 26.9 0.4\nTotal 4.2 7.5 27.8 3"] [13.018203735351562, 14.122157096862793, "n 1.7 1.8 1.7\nNeighborhood options for healthy food and exercise 0.4 1.5 1.3\nExamples set by people around you 1.0 0.9 0.9\nHousing quality 1.7 0.6 0.6\nAmount of social support 0.7 0.4 0.5\nWhere a person lives 0.5 0.5 0.5\nCommunity safety 0.2 0.4 0.4\n"] [13.109004974365234, 14.196943283081055, "ople do not have to always rely on cars\nor\nMaking sure that there is public transportation, sidewalks for walking, and bike lanes available so that people do not have to always rely on cars\nNote on randomization: Half of the sample received the first"] [13.085564613342285, 14.183557510375977, "y \nfoods are \nfor sale at \naffordable \nprices in \ncommunities \nwhere they \nare not.Making sure \nthat there are \nsafe, outdoor \nplaces to \nwalk and be \nphysically \nactive in \ncommunities \nwhere there \naren\u2019t any.Making sure \nthat there \nis decent \nhou"] [13.01483154296875, 14.235272407531738, "to do more to make sure that everyone has [\u2018an equal\u2019/\u2019a fair and just\u2019] opportunity to be healthy\nSampleStrongly \nDisagreeSomewhat \nDisagreeNeither Agree \nNor DisagreeSomewhat \nAgree Strongly Agree Missing\nALP ( n = 2,479) 3.1 4.2 13.9 31.6 46.5 0.6"] [13.001945495605469, 14.223322868347168, "Panel \n(n = 4,708)2.3 5.7 20.7 39.6 30.9 0.8\nTotal 2.1 6.4 19.4 39.9 31.3 0.9\nE. Being educated is a result of the choices you have made\nSampleStrongly \nDisagreeSomewhat \nDisagreeNeither Agree \nNor DisagreeSomewhat \nAgree Strongly Agree Missing\nALP ("] [13.009119987487793, 14.166083335876465, " of the sample saw Q13a and half saw Q13b.\nSampleLocal \nGovernmentsState \nGovernmentsFederal \nGovernmentsNo Government \nCan Lower This \nNumber Missing\nALP ( n = 1,226) 22.8 11.7 19.3 45.6 0.5\nKnowledgePanel \n(n = 2,319)15.7 14.8 16.6 51.1 1.7\nTotal 1"] [13.033580780029297, 14.130099296569824, "nts who selected each item as a top three \nreason for longer life expectancy. \nAccess to a good education\nSample Not Selected Selected\nALP ( n = 2,479) 83.4 16.6\nKnowledgePanel ( n = 4,708) 85.0 15.0\nTotal 84.6 15.4\nAccess to health careSample Not Se"] [13.037625312805176, 14.132669448852539, "ate who will address this issue\nSample Very WillingSomewhat \nWillingNeither Willing \nNor UnwillingSomewhat \nUnwilling Very Unwilling Missing\nALP ( n = 2,479) 38.0 21.4 21.9 5.8 10.6 2.3\nKnowledgePanel \n(n = 4,708)30.6 23.0 28.2 6.1 10.5 1.6\nTotal 33."] [13.006852149963379, 14.12695598602295, "008).\nNOTE: The order of Questions 17A\u201317P was randomized for each respondent.42 2018 National Survey of Health Attitudes: Description and Top-Line Summary Data\nB. I can recognize most of the members of this community\nSample Not at All Somewhat Mo"] [13.023460388183594, 14.139472007751465, "t of this community for a long time\nSample Not at All Somewhat Mostly Completely Missing\nALP ( n = 2,479) 18.3 27.8 30.8 19.7 3.4\nKnowledgePanel \n(n = 4,708)15.6 32.7 32.7 17.7 1.2\nTotal 16.2 31.4 32.3 18.4 1.6\nSOURCE: Sense of Community Index (Chavi"] [13.002410888671875, 14.164088249206543, "r community. For each, please indicate what impact (positive, negative, or no impact) this group has on the health of your community. If the impact is both positive and negative, please indicate whether the overall impact is more positive or negative"] [12.999905586242676, 14.139817237854004, "\nTotal 40.1 57.5 2.4\nB. Voted for or against a candidate for public office because of his/her position on other issues such as \neducation, public safety, or community funding\nSample Yes No Missing\nALP ( n = 2,479) 57.5 39.9 2.6\nKnowledgePanel ( n = 4"] [13.010092735290527, 14.188632011413574, "ES: RAND and RWJF.\nQ21. Would you say that in general your health is excellent, very good, good, fair, or poor?\nSample Excellent Very good Good Fair Poor Missing\nALP ( n = 2,479) 10.5 37.5 33.6 13.4 2.5 2.5\nKnowledgePanel (n = 4,708)10.3 36.0 36.7 12"] [12.970595359802246, 14.114879608154297, "th issue or condition or because of disability?\nSample Yes No Missing\nALP ( n = 2,479) 15.2 82.3 2.5\nKnowledgePanel \n(n = 4,708)12.0 86.4 1.5\nTotal 13.2 85.0 1.8\nSOURCES: RAND and RWJF.\nQ28. Is there a place that you usually go to when you are sick"] [12.974849700927734, 14.095047950744629, " lives]\nSample Covered Not Covered Not Sure Missing\nALP ( n = 2,479) 14.1 72.4 8.3 5.2\nKnowledgePanel \n(n = 4,708)13.9 77.9 6.8 1.4\nTotal 14.5 75.5 7.2 2.7\nTRICARE or other military health care, including VA health care\nSample Covered Not Covered Not"] [12.950356483459473, 14.053767204284668, "o Missing\nALP ( n = 2,479) 28.1 69.4 2.5\nKnowledgePanel \n(n = 4,708)23.9 74.6 1.6\nTotal 25.0 73.2 1.9\nSOURCES: RAND and RWJF.\nQ33a. If yes: As a result of this event, were you temporarily or permanently displaced from \nyour home or community?\nSampl"] [12.862296104431152, 14.032591819763184, "1.2 0.3 0.2 0.2 0.0 0.0\na The period indicates true 0 (rather than a number that has been rounded down to 0.) \nRespondents by Level of Family Income, in Dollars\nSampleLess Than \n10,000 10,000\u201324,999 25,000\u201349,999 50,000\u201374,999 75,000\u201399,999100,000 or"] [12.703994750976562, 13.834481239318848, "s/research_reports/RR1391.html\nCenters for Disease Control and Prevention, 2010 Behavioral Risk Factor Surveillance System Questionnaire , \nNovember 18, 2009. As of January 4, 2016: \nhttp://www.cdc.gov/brfss/questionnaires/pdf-ques/2010brfss.pdf\n\u2014\u2014\u2014,"] [12.707423210144043, 13.836370468139648, "al \nAlignment and the Use of Incentives Can Promote a Culture of Health: Stakeholder Perspectives , Santa Monica, \nCalif.: RAND Corporation, RR-1889-RWJ, 2017. As of February 13, 2019: https://www.rand.org/pubs/research_reports/RR1889.html\nNational A"] [12.718419075012207, 13.853586196899414, "Johnson Foundation.\nU.S. Bureau of Labor Statistics, American Time Use Survey: 2013 Results , Washington, D.C., June 18, 2014. As \nof January 6, 2016: \nhttp://www.bls.gov/news.release/archives/atus_06182014.htm\nU.S. Census Bureau, \u201cCurrent Population"] [4.98683500289917, 22.358591079711914, "Examining Civic \nEngagement Links to Health \nFindings from the Literature and \nImplications for a Culture of Health\nChristopher Nelson, Jennifer Sloan, Anita Chandra\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and tradem"] [4.988159656524658, 22.357248306274414, "cross various (mostly nonhealth) disciplines, is still mostly formative in terms of research rigor, and involves complex rela -\ntionships among actors at the local, regional, national, and interna -\ntional levels. Furthermore, much of the empirical r"] [4.988592147827148, 22.35602569580078, ".......... xix\nCHAPTER ONE\nBackground ........................................................................ 1\nCHAPTER TWO\nMethods ............................................................................ 7\nCHAPTER THREE\nHealth and Voting Part"] [4.988110065460205, 22.356874465942383, "........ 3\nFigures\n 1.1. Culture of Health Action Framework .............................. 2\n 2.1. Literature Search Process ............................................ 8\nTables\n 5.1. Summary of Findings from Intervention Studies ............... "] [4.987796783447266, 22.357603073120117, "s in knowledge that might point to possible investment opportunities in new research?\nThis narrow focus is intended as a building block for additional \nreviews and analyses describing and characterizing the full range \nof interventions, social moveme"] [4.998793601989746, 22.346111297607422, "ate this may be related to differences in social stigma (e.g., the extent to which individuals are deemed responsible for their condition), sophistication of pressure groups formed around a condition, and more general differ -\nences in national cultu"] [4.988940238952637, 22.35630226135254, "nd just a few studies on civic engagement related to religious organizations. Perhaps most importantly, although there is a reasonable body of emerging evidence linking individual civic engagement to individual health, there is little attention to da"] [4.988654136657715, 22.35654067993164, "onsoring conferences, forums, and networks to provide venues in which researchers can collab -\norate (specifically around shared data sets, as mentioned above) and more actively contribute articles to build the literature base. \n\u2022 Support collaborati"] [4.9885640144348145, 22.35636329650879, "eclaiming health as a shared priority. RWJF iden -\ntified three drivers of change needed to make progress in this Action Area: (1) mindset and expectations (how the U.S. public views and pri -\noritizes health, well-being, and related investments); (2"] [4.99060583114624, 22.354591369628906, "collective \naction through movement in perspective, shared narrative, and cultural meaning\u201d (Chandra et al., 2016)\u2014in other words, this action requires a change in mindset among other cultural shifts. A mindset shift in health is currently most evide"] [5.00034236907959, 22.345136642456055, "ng and characterizing the full range of interventions, social movements, and other efforts that use civic engagement as a tool for addressing the social determinants of health was beyond the scope of this initial study. These elements also are key to"] [4.9862799644470215, 22.359180450439453, "political science, and other social sciences. Each term was paired with \u201chealth\u201d and \u201cwell-being.\u201d This yielded a total of 1,329 results, from which two members of the team independently identified 157 articles for data abstraction, most of which wer"] [4.9868245124816895, 22.358644485473633, "information about the links between civic engagement and health outcomes in the most rigorous studies available to date. \nDuring our title vetting, articles were included in the \u201cpossibly \nrelevant\u201d bucket if there was any indication that they might "] [4.982336044311523, 22.36316680908203, " exploring whether the nature of the conclusions differed across quality ratings. 11CHAPTER THREE\nHealth and Voting Participation\nWe begin with key findings from studies related to voting participa -\ntion and health. Most of these studies focus not "] [4.959822654724121, 22.385669708251953, "ld Development Study, a longi -\ntudinal study of all people living in Ireland and Britain who were born in one week in March 1958 examined correlates of voting in the 1979, 1987, and 1997 elections (sample sizes were 8,463, 6,653, and 6,782, respecti"] [4.975082874298096, 22.37053871154785, "r than men, because they are, on average, widowed and live alone at an earlier age than men, and because women live longer and are typically younger than their husbands. Also, older \n1 This is also one a few studies we located that explored the rela"] [4.978745460510254, 22.366947174072266, " explicit comparison of the effects of \npoor health on voting with other forms of civic participation. S\u00f6derlund and Rapeli (2015) analyzed a 2012\u20132013 cross section of more than Health and Voting Participation 15\n8,000 respondents to the European"] [4.9741950035095215, 22.37141227722168, "008 U.S. presidential election. After adjusting for sociodemographic characteristics and some health-related confounding factors, they found that individuals with cancer diagnoses are more likely to vote, while those with heart disease diagnoses are "] [4.979791641235352, 22.365856170654297, "ealth\nSome studies focus specifically on the health-voting connection in the \ncontext of behavioral and mental health. The next sections summarize those findings, starting with behavioral choices. \nVoting and Health Behaviors\nThere are three studies "] [4.978677272796631, 22.367023468017578, "duals taking precau -\ntions to reduce health risks, including HIV risk. This is important in a population that could be considered less healthy and marginalized and perhaps less likely to engage given prior study findings on poor self-reported health"] [4.9517927169799805, 22.39383888244629, "s, wave 2 had 14,738 respondents, and wave 3 had \n15,197 respondents.20 Examining Civic Engagement Links to Health\ncommunity engagement might have mental health benefits for youths, \nand that depression might reduce later civic engagement in adult"] [4.974801063537598, 22.370967864990234, "t the low voting rate among psychiatry inpatients and individuals with mental illness might be the result of issues of access, administrative issues (e.g., lack of an identity card), lack of knowledge, and neglect from political candidates because of"] [4.977701187133789, 22.367910385131836, "e relationship between regional turnout rates in Finland (district level) and the United States (state level) from 1995 to 2015 with measures of local influenza prevalence. In both countries, regression models sug -\ngested that influenza outbreaks we"] [4.98330020904541, 22.362199783325195, "ed inequality amplifies psychosocial comparisons up and down the hierarchy. This suggests that socioeconomic inequality in voter turnout is associated with poor self-rated health, independent of both income inequality and state median household incom"] [4.98512601852417, 22.36055564880371, "es, civic engagement is conceptualized as part of \nthe broader construct of social capital. However, we include only those studies that contained a clear and specific measure of civic engage -\nment as a part of the broader social capital construct. F"] [4.983835697174072, 22.361618041992188, "\norganization or any group concerned with the environment, pollution, and related issues. Using data from the 1974 and 1994 versions of the Alameda County Study ( n = 6928), the authors prospectively analyzed \nthe association between 1974 volunteeris"] [4.985047340393066, 22.360795974731445, "that \u201crather than having a contextual influence on health, the benefi -\ncial properties of social capital can be found at the individual level.\u201d Similarly, a global analysis of adults older than age 50 by Van Groezen, Jadoenandansing, and Pasini (201"] [4.984673023223877, 22.361309051513672, "ture. For instance, Veenstra\u2019s (2000) analysis of 534 observations from a 1997 cross-sectional study of adults in Saskatchewan, Canada, found that an engagement index (including voting, writing letters to editors, and paying attention to community is"] [4.98919677734375, 22.356346130371094, "lder were less likely to be hypertensive but more likely to have lipid dysregulation than nonvolunteers. Gold et al. (2002), in turn, used cumulative data from \nthe U.S.-based General Social Survey for 1986\u20131990 (put out by the Centers for Disease C"] [4.987878799438477, 22.357553482055664, "volunteering was a stronger predictor for physical activity than \u201cother volunteering,\u201d perhaps because environmental vol -\nunteering could require more-active outdoor engagement. Two addi -32 Examining Civic Engagement Links to Health\ntional artic"] [4.985422134399414, 22.36009979248047, "nxi -\nety and depression) after controlling for sociodemographic variables. CMD was measured using the General Health Quesionnaire-12, which includes three constructs of anxiety, social dysfunction, and loss of confidence. Similarly, Buck-McFayden et"] [4.9840312004089355, 22.361705780029297, "rs also noticed a theme of political participation \u201cas a component of empowerment for minority groups in general.\u201d\nFinally, a study by Acevedo, Ellison, and Xu (2014) suggests that \nthe effect of civic engagement on health can be indirect. In a 2004 "] [4.986485958099365, 22.358915328979492, " the mediating role of sense of community and empowerment. Social well-being was measured using the Mental Health Continuum Short Form. The authors found that group membership, other than in recreational groups, is associ -\nated with higher social we"] [4.98839807510376, 22.357494354248047, "trust decreased significantly and then rose (i.e., were most discrep -\nant from each other across the study) and had the strongest association with high scores on a \u201ccontribution\u201d scale that included community leadership, service, helping behaviors, "] [4.95924711227417, 22.38642120361328, " family and community during adoles -\ncence predicted greater likelihood of voting, community volunteer ser -\nvice, involvement in social action groups, and a better sense of civic trust. At a broader contextual level, exposure to community violence "] [4.9876813888549805, 22.35789680480957, "mbership in civic organizations were associated with lower neighborhood death rates (for ages 45\u201364) for total mortality and heart disease mortality for whites and blacks; no association was found with cancer mortality.\nIn another study, Cutlip, Bank"] [4.989381313323975, 22.355709075927734, "omote civic engage -\nment and/or to help realize the health benefits of engaging civically. We include only studies that explicitly seek to estimate an interven -\ntion\u2019s effects. Therefore, we do not seek to include the full range of studies that des"] [4.98312520980835, 22.362483978271484, "Brown et al., 2017).\nIn another study, Dabelko-Schoeny, Anderson, and Spinks (2010) \npiloted an intervention in 2008 in a Midwestern city in the United States to promote civic engagement in adults with functional limita -\ntions. Subjects came from a "] [5.026597023010254, 22.31859588623047, "effects of these participation-increasing measures. \n1 More information on this scale is available online at the Positive Psychology Center\u2019s \nwebsite (undated).44 Examining Civic Engagement Links to Health\nCivic Engagement Interventions to Impro"] [4.9902873039245605, 22.355426788330078, " indirect effects (such as affordable housing). The authors concluded that community organiz -\ning\u2013based interventions designed and led by community stakeholders could identify environmental and policy solutions to address structural inequities relat"] [4.98983907699585, 22.35607147216797, "e social support among youths. The authors argue that youths with more social support and meaningful participa -\ntion are more healthy in general. Conducted in Kansas, the campaign started in 1998, targeted adults, and provided information about and "] [4.988881587982178, 22.356639862060547, "get populations vary in demographic background; therefore, more work is needed to determine how well these interventions might work across a more-diverse population mix. 48 Examining Civic Engagement Links to Health\nInterventionTarget \nPopulation"] [4.988162517547607, 22.35735321044922, "nity into tan -\ngible actions that could lead to new partnerships, improvements in the health conditions found in communities, and the degree of integration among health services and systems. However, the evidence base linking civic engagement and he"] [4.985329627990723, 22.360340118408203, "f Civic Engagement\nHealth Outcome Voting Civic Engagement\nPhysical health 10 20\nMental health 9 13\nPatient populations 2\nCommunity health 4 4\nWell-being 0 9\nAdolescents 0 8Discussion 53\nfindings (e.g., Chola and Alaba, 2013) (see Table 6.2). Moreo"] [4.984314918518066, 22.361528396606445, "cess, (2) the lack of participation leads to underrepre -\nsentation and a lack of policies that benefit those with depression, and (3) the lack of beneficial policy outcomes perpetuates the experience of depression. And so it repeats. \nIf true, and d"] [4.98405647277832, 22.361751556396484, "t \nwith this viewpoint\u2014for example, physical disability, which may 56 Examining Civic Engagement Links to Health\nincrease the private costs and burdens of participation, has been shown \nin some studies to be related to lower voting turnout (Schur "] [4.983911037445068, 22.361875534057617, "e teen and early adult years. There is reason to believe that stigma can apply to health behaviors, such as smoking (Albright et al., 2015; Denny and Doyle, 2007). However, the nature of this relationship might be mediated by culture, as is sug -\nges"] [4.9857258796691895, 22.359880447387695, "disease \nbut not from cancer (Lochner et al., 2003). There is also some evi -\ndence that the nature of the health\u2013civic engagement connection might vary by social group, as blacks with low education and cancer are more likely to turn out than well-e"] [4.985474586486816, 22.359477996826172, "esearch is needed that leverages longitudinal designs to unpack causal relationships and further elucidate how health experience and voting behavior evolve over time. In addition, further analyses on how the health status of a community, and not simp"] [4.973756313323975, 22.372129440307617, ", environments, and community power structures (and, in turn, can be causally linked \nto health outcomes) is needed. \n\u2022 Support the development and sustainment of multi- \ndisciplinary communities of practice. Similarly, work in this area involves a"] [4.985420227050781, 22.36017608642578, ": The Role of Participation\u201d\nAbu-Ras (2013) \u201cAmerican Muslim Physicians\u2019 Public Role Post-9/11 and \nMinority Community\u201d\u201cEmpowerment: Serving the Underserved\u201d\nAcevedo, Ellison, and Xu (2014)\u201cIs It Really Religion? Comparing the Main and Stress-Buffer"] [4.986021518707275, 22.35958480834961, "Illness Experience in the United States\u201d\nBuck-McFadyen (2018) \u201cSocial Capital and Self-Rated Health: A Cross-Sectional Study of the General Social Survey Data Comparing Rural and Urban Adults in Ontario\u201d\nBulanda and Jendrek (2016)\u201cGrandparenting Role"] [4.987617015838623, 22.357933044433594, " Civic Engagement in Young Adulthood\u201d\nEmerson et al. (2014) \u201cPerceptions of Neighbourhood Quality, Social and Civic Participation and the Self-Rated Health of British Adults with Intellectual Disability: Cross-Sectional Study\u201d\nFang et al. (2018) \u201cHap"] [4.989872455596924, 22.354921340942383, "c Participation\u201d\nLeedahl, Sellon, and Gallopyn (2017)\u201cFactors Predicting Civic Engagement among Older Adult Nursing Home Residents\u201d\nLenzi et al. (2012) \u201cFamily Affluence, School and Neighborhood Contexts and Adolescents\u2019 Civic Engagement: A Cross-Nat"] [4.986944198608398, 22.358659744262695, "on Turnout in 30 Countries\u201d\nMattila et al. (2018) \u201cSick Leave from Work and the Voting Booth? A Register-Based Study on Health and Turnout\u201d\nMcAllister (2008) \u201cPublic Support for Democracy: Results from the Comparative Study of Electoral Systems Proje"] [4.984954357147217, 22.360595703125, "on in Political Organizations: The Role of Generativity and Its Impact on Well-Being\u201d\nSeyfang (2003) \u201cGrowing Cohesive Communities One Favour at a time: Social Exclusion, Active Citizenship and Time Banks\u201d\nShin and McCarthy (2013)\u201cThe Association Bet"] [4.985476016998291, 22.3602237701416, "ngagement, Community Size, and Recall of Health Massages\u201d\nWagenaar et al. (2000)\u201cCommunities Mobilizing for Change on Alcohol: Outcomes from a Randomized Community Trial\u201d\nWakefield et al. (2001)\u201cEnvironmental Risk and (Re)action: Air Quality, Healt"] [4.984606742858887, 22.361068725585938, "nal Self-rated \nhealthCivic \nengagementCivic engagement \nnot related to \nbetter health\nBartkowski \nand Xu (2007)\u201cReligiosity and \nTeen Drug Use \nReconsidered: \nA Social Capital \nPerspective\u201dU.S. Cross-sectional Alcohol use Civic \nengagementHigher c"] [4.986137866973877, 22.359474182128906, "e (2014)\u201cConnection \nBetween \nAdolescent\u2019s \nExposure to \nCommunity \nViolence and \nFuture Civic \nEngagement \nBehaviors During \nTheir Young \nAdulthood\u201dU.S. Longitudinal Exposure to \ncommunity \nviolenceCivic \nengagementExposure to \nviolence \nassociate"] [4.979773044586182, 22.36626434326172, "ts \nwith Intellectual \nDisability: Cross-\nSectional Study\u201dUK Cross-sectional Self-rated \nhealthCivic \nengagementHigher civic \nengagement \nrelated to better \nhealth among \nthose with and \nwithout intellectual \ndisabilities\nFang et al. (2018) \u201cHappine"] [4.983790874481201, 22.361970901489258, "ngagement \nrelated to better \nhealth\nKelleher et al. (2002)\u201cIndicators of \nDeprivation, Voting \nPatterns, and \nHealth Status at \nArea Level in the \nRepublic of Ireland\u201dIreland Cross-sectional Self-rated health Voting Higher voting rates \nrelated to "] [4.954423427581787, 22.39218521118164, "agement \nIndicators Association\nMattila et al. (2013) \u201cHealthy Voting: \nThe Effect of Self-\nReported Health \non Turnout in 30 \nCountries\u201d30 European \ncountriesLongitudinal Self-reported \nhealthVoting Better health \nassociated with \nhigher voter \nturn"] [4.98460054397583, 22.361083984375, "nsome et al. (2016)\u201cSocial Capital Is \nAssociated with \nLate HIV Diagnosis: \nAn Ecological \nAnalysis\u201dU.S. \n(New York)Cross-sectional HIV diagnosis Civic \nengagementCivic engagement \nrelated to lower rates of late HIV \ndiagnosis94 Examining Civic"] [4.985323905944824, 22.360334396362305, "th health \nVeenstra (2002) \u201cSocial Capital \nand Health (Plus \nWealth, Income \nInequality and \nRegional Health \nGovernance)\u201dCanada \n(Saskatchewan)Cross-sectional Mortality Civic \nengagementHigher civic \nengagement \nrelated \nto lower \nmortalityDetai"] [4.986279487609863, 22.359315872192383, "ion Africaine , Vol. 27, No. 2, 2013, pp. 188\u2013202. As of \nAugust 1, 2019: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84905057688&doi=10.11564%2f27-2-440&partnerID=40&md5=705030165f69f647449fd1acbabf5274\nBallard, P. J., L. T. Hoyt, and M. C. "] [4.986989974975586, 22.3585147857666, "olitical Science Review , Vol. 84, No. 2, 1990, \npp.\u00a0377\u2013393. References 101\nBolton, M., I. Moore, A. Ferreira, C. Day, and D. Bolton, \u201cCommunity \nOrganizing and Community Health: Piloting an Innovative Approach to Community Engagement Applied to "] [4.989395618438721, 22.356313705444336, " Young People: Understanding Pathways from Civic Participation to Social Well-Being,\u201d Voluntas , Vol. 26, No. 1, 2015, pp. 24\u201344. \nCollins, C. R., and S. Guidry, \u201cWhat Effect Does Inequality Have on Residents\u2019 Sense of Safety? Exploring the Mediating"] [4.987158298492432, 22.358423233032227, "opment , Vol. 42, No. 4, 2018, \npp.\u00a0425\u2013433.\nFinlay, A. K., and C. Flanagan, \u201cAdolescents\u2019 Civic Engagement and Alcohol Use: \nLongitudinal Evidence for Patterns of Engagement and Use in the Adult Lives of a British Cohort,\u201d Journal of Adolescence , V"] [4.986176490783691, 22.359447479248047, "e Around the World , Cambridge, UK: Cambridge University Press, 2003. \nJennings, M. Kent, and Richard G. Niemi, Generations and Politics: A Panel Study of Young Adults and Their Parents , Vol. 68, Princeton, N. J.: Princeton University \nPress, 2014. "] [4.98502254486084, 22.360774993896484, "Classroom Climate: The Mediating Role of Self-Efficacy,\u201d Journal of Applied Developmental Psychology , Vol. 41, 2015, pp. 8\u201318. \nMarquez, B., P. Gonzalez, L. Gallo, and M. Ji, \u201cLatino Civic Group Participation, Social Networks, and Physical Activity,"] [4.985070705413818, 22.360763549804688, "hers/psychological-well-being-scales\nRamlagan, S., K. Peltzer, and N. Phaswana-Mafuya, \u201cSocial Capital and Health \nAmong Older Adults in South Africa,\u201d BMC Geriatrics , Vol. 13, No. 1, 2013.\nRansome, Y., S. Galea, R. Pabayo, I. Kawachi, S. Braunstein"] [4.985803127288818, 22.359846115112305, "e First South African National Income Dynamics Study,\u201d Journal of Affective Disorders , \nVol.\u00a0144, No. 1\u20132, 2013, pp. 101\u2013105. \nUrbatsch, R., \u201cInfluenza and Voter Turnout,\u201d Scandinavian Political Studies , \nVol.\u00a040, No. 1, 2017, pp. 107\u2013119. Van Groe"] [4.985661029815674, 22.360071182250977, "of August 1, 2019: http://www.ncbi.nlm.nih.gov/pubmed/23629592\nZhu, L., \u201cHealing Alone? Social Capital, Racial Diversity and Health Care \nInequality in the American States,\u201d American Politics Research , Vol. 45, No. 6, \n2017, pp. 1059\u20131087. \nZiegenfu"] [14.902327537536621, 2.8086631298065186, "CORPORATION\nFuture-Proofing Justice\nBuilding a Research Agenda to Address the Effects \nof Technological Change on the Protection of \nConstitutional Rights\nBrian A. Jackson, Duren Banks, Dulani Woods, Justin C. Dawson\nAs changes occur in society, fit"] [14.827741622924805, 2.76454496383667, "s of the panel included require -\nments for best practice and training develop -\nment, addressing such issues as criminal justicedata quality and its implications for individuals\u2019rights; evaluation work to better understand howanalytic tools (such as"] [14.87039566040039, 2.788814067840576, "t data from those devices? The correct answer to such questions is not obvious, but what is clear is that simple analogies between new and old technologies are likely not enough to understand their implications. For example, it might be easy to make "] [14.864582061767578, 2.7872533798217773, "enforcement through the issuance of warrants and determining the length and nature of punishment for an individual in the correctional system\u2014our focus broadened to explore questions of how technological change might affect the protection of individu"] [14.879623413085938, 2.789619207382202, " to shape trial outcomes (Davis, 2013).\nAs discussed earlier in the context of virtual presence, \nwhen it comes to protecting individuals\u2019 rights, a single tech-nology may produce positive effects, negative effects, or both. For example, significant "] [14.784286499023438, 2.7575559616088867, "rovide government might begin to affect individual behavior and infringe on freedoms protecting expression, association, and political action (see Kaminski and Witnov, 2015) .\nTo move beyond these contemporary examples, we devel-\noped a framework for"] [14.784247398376465, 2.6680662631988525, "ntire business models rely on wresting data about individuals from their control in order to sell the information\n \u2014for e\nxample, for \ndelivering targeted advertising or building customer profiles for commercial purposes.4Next, we identified personal"] [14.806957244873047, 2.743748188018799, "y, we defined a class of the wider societal technology \necosystem to capture the fact that sensors are being installed in a wide variety of public places\u2014not just by government but by private property owners\u2014for security and other purposes. The more"] [14.789652824401855, 2.73337459564209, "rns about the following:o\n fair\nness (e.g., in analytic tools)\no influ\nence (e.g., whether virtual simulations might \ninfluence juries beyond the facts of the case)\no effec\ntiveness (e.g., whether virtual presence \nmeets justice objectives as well as"] [14.765118598937988, 2.7769694328308105, "ls\u2019 (e.g., purchasers, other occupants, and visitors) knowledge or understanding.\n\u2022\tTechnologies (e.g., voice-command systems) may monitor constantly and send data to external businesses\u2019 systems for analysis. \nVehicle-integrated technologies\u2022\n Conn\n"] [14.59674072265625, 2.8415937423706055, "ore the meeting date, we sent panel members a back-\nground document and pre-workshop questionnaire that drew on the research team\u2019s review of published literature on these issues. The materials were structured using different categories of rights\u2014the"] [14.819710731506348, 1.8543899059295654, "dividuals\u2019 rights. To \nprovide structure to the set of identified needs, we asked the panel members to rank each need based on its expected benefit (how important they thought it would be if the need was met) and the probability of success of actuall"] [14.371905326843262, 2.9719252586364746, "at were identified, the research team also identified five key overarching themes.\n2 Although the \nworkshop was framed to explore both challenges and opportuni -\nties that new technologies present to the protection of indivi -\ndual\ns\u2019 rights, the gre"] [14.433260917663574, 2.960441827774048, "y problems and responding more effectively to deter and solve crimes when they occur, and these initiatives are now broadly accepted in many departments (Police Executive Research Forum, 2013; Ratcliffe, 2016). As alluded to in the introduction, the "] [14.401899337768555, 2.8908286094665527, "With data-sharing, inaccuracy can travel\u2014because of either objective inaccuracy from data-entry errors or more-\n subj\nective \ninaccuracy from how uncertain information is recorded.4 And \nwhen data are copied and ingested into many separate data sets,"] [14.62696361541748, 2.8254737854003906, ", 1987). Academic stud-ies have shown that although some risk assessment tools have reasonable levels of predictive power, results from others are much less predictive, and some assessment tools show different rates of false positives and negatives f"] [14.754515647888184, 2.734123945236206, ", Joh, 2016, p. 40) but also for forensics tech -\nniques and data sets (e.g., National Research Council, 2009, pp.\u00a0273\u2013274; Murphy, 2007), and even physical devices used by law enforcement for collecting data (e.g., Liebow, 2010).\nDuring the panel\u2019s "] [14.792607307434082, 2.771601915359497, " how people see themselves; for example, people spend money on virtual goods that exist only in online systems and see such goods as part of their effort to define their own identities (see, for example, Koles and Nagy, 2012; Nagy and Koles, 2014). M"] [14.795655250549316, 2.62977933883667, "nd will continue to provide protections against self-incrimination. We are already at a point where several programs are unbreakable.\u201d\n\u2013 Panel Memberet al., 2015, p. 58), although they also indicated that what is \nshared on social media is \u201cless auth"] [14.768046379089355, 2.639674663543701, "text of lifelogging\u2014research has sug-gested that using these technologies has had an effect on how their users think, what information they remember, and where \nthey remember it. Studies have suggested that given connec-tivity to extensive resources"] [14.752634048461914, 2.65385103225708, " Internet adver-tisements to help shape sales messages. Biometric data from personal fitness devices can also be analyzed to make inferences about individuals\u2019 emotions or activities. Data collected from a personal fitness tracker has already been us"] [14.774737358093262, 2.6975836753845215, "nd no longer part of their \u201cpapers and effects?\u201d The case of a technology that is implanted within a person would seem to cross that line and be more appropriately viewed as part of the person rather than something they own or possess. But how far be"] [14.800682067871094, 2.7334988117218018, " should have walked the 15 miles to the grocery store? In practical terms, his other choice was basically not to eat or go to the doctor .\nIn the criminal justice system, the third-party doctrine \ngoverns government access to data that individuals h"] [14.797022819519043, 2.5933003425598145, ", at least for some people, may take the place of person-to-person phone calls, capturing communication in written form that might have once been conveyed verbally in a way that was not routinely stored.\n11 The revealing nature \nof these streams of c"] [14.787949562072754, 2.6341419219970703, "use become ubiquitous in products\u2014for example, all automobiles are equipped with black boxes that record driving behavior and performance, or future intelligent transportation systems capture such data themselves (see Douma, Garry, and Simon, 2012)\u2014t"] [14.77174186706543, 2.6927690505981445, "t before involved actions that were much more clearly invasive\u2014and generally required warrants. For instance, access to smartphone location logs provides data similar to physical surveillance of a person or installation of a tracking device on the pe"] [14.759331703186035, 2.803238868713379, "e \nto the top tier\u2014fundamentally examining how the validity of \nthe third-party doctrine may shift given the increasing require-ment for disclosure of data to third parties and addressing the pressures that social media use by varied criminal justice"] [14.93249225616455, 2.772493600845337, "without \nmassive disclosure of data to third parties. This is especially important given that modern life necessitates individuals turning over large amounts of data about themselves to others.\nTier 2 \u2022\n Crea\nte improved mechanisms (e.g., educational"] [14.831344604492188, 2.7016565799713135, " argue about a defendant\u2019s emotional state during an alleged crime, what do judges, prosecutors, and defense counsel need to know to sufficiently understand how electronic devices compile, store, and process data? When varied types of data are brough"] [14.847214698791504, 2.6934735774993896, "ec -\ntions related to ESI has focused on how to effectively apply the existing rules of evidence. Frieden and Murray (2011) argue that counsel should draw analogies between the source of ESI and the most similar, non-ESI or traditional source of evi "] [14.832849502563477, 2.665414571762085, "he need for stronger knowledge in the legal system \nregarding such digital evidence is known, and there is no short-age of courses and opportunities for continuing legal education on such topics. For example, the National District Attorneys Associati"] [14.873982429504395, 2.6938483715057373, "otected hinges on whether judges and counsel are suf-ficiently informed about ESI to appropriately and effectively apply that guidance. Such knowledge is critical to challenge the admissibility of electronic evidence resulting from poor chain of cust"] [14.866628646850586, 2.7972943782806396, "rants at all parts of the process. This is especially important given the role of prosecutors and judges in issuing warrants and of defense attorneys in challenging search and seizure of new technological data.\n\u2022\n Deve\nlop best practices and qualific"] [16.218652725219727, 2.9606454372406006, "at night. We would like to bring all of this together for you. Please put on the headsets next to each of your seats.\nThe jurors put on the virtual reality headsets, which \ncover their eyes and ears. The reenactment begins.\nProsecutor: What you are s"] [16.23253059387207, 2.9466843605041504, "he country for hearings that are presumed to not affect the outcome of a case, such as hearings to determine bail, waive right to a jury trial, receive a jury verdict, enter a plea, sentence a defendant, and conduct post-conviction and parole reviews"] [16.249980926513672, 2.959291458129883, " during the study period, which was significantly greater than the 13-percent increase in bond amount experienced by the control group of felony defendants who appeared in person for bail hearings (Diamond et al., 2010). Research on the use of remote"] [16.17546844482422, 2.9712812900543213, "urtrooms through-out the country, innovators are developing technologies that push further into virtual space, and these might be used in courtrooms in the future. For instance, advances in technology are under way to support more-realistic virtual r"] [16.203351974487305, 2.9633901119232178, " Feigenson, 2006, and refer-ences therein; Nemeth, 2011, and references therein). With advances in video game technologies, simulation capability \n\u201cThese new technologies \nare [computer graphics] on steroids. The more real and personal interpretation"] [14.818602561950684, 2.7911107540130615, "to do so by identifying research needs to understand and mitigate potentially negative effects of technology on the protection of individuals\u2019 rights and by identifying and exploring how new technologies could aid in protecting those rights. During t"] [14.670774459838867, 2.858793258666992, "ariety of such resources are available. As a result, some of the best practices identified in the workshop\u2019s research agenda are likely already available, while others still need to be developed. For example, because telepresence and video\n-\nconfe\nre"] [14.460575103759766, 2.852227210998535, " quality and reliability with retention and use as articulated by the panel.\nBeyond best practices, the panelists also identified needs \nrelated to educating various actors in the criminal justice sys-tem to better take on the complexities of new tec"] [14.820547103881836, 2.7982263565063477, "ers).\nFundamental Research\nBecause many of the issues discussed dur-ing the panel covered technologies that are still developing, related shortfalls in knowledge on several issues will require \nfundamental research to inform future decisions. The top"] [14.818887710571289, 1.9313654899597168, " where data volume has been a core issue in considering e-discovery in commercial and other types of cases (Pace and Zakaras, 2012). Just as a large volume of information can complicate the inves -\ntigation and prosecution of a case (see, for example"] [14.990835189819336, 2.742816686630249, "e top-tier needs, but panel members felt that these issues were somewhat more difficult to solve or that the solutions were more difficult to implement.\nWithin that second tier, needs fell into each of the three \nresearch agenda categories, including"] [14.801275253295898, 2.7412643432617188, "ation is ensuring that justice processes protect the rights of individuals guaranteed in the Constitution. While not the only vector of change in society, technology can be a powerful force, with the potential to transform what is possible for citize"] [14.885720252990723, 2.824291944503784, "ets of organizational behavior to find evidence of misbehavior that would otherwise be hidden. But maintaining balance in the effects of technology on individuals\u2019 rights and protection of due process within the justice system is challenged by resour"] [14.86136245727539, 2.8267877101898193, "and emerging technologies and the different categories of rights they may affect.1\nSocial media platforms have created opportunities for inappropriate activities, such as attorneys, judges, and jurors \u201cfriending\u201d each other. Some media platforms (e.g"] [14.782572746276855, 2.881618022918701, "ce system participants on modern electronic technologies and scientific evidence. 1\nCriminal justice agencies are creating, collecting, storing, and reusing data that are of questionable quality. Once recorded, such data lose their full context, ofte"] [14.857966423034668, 2.8033432960510254, "ot be fully explained by the human analysts who apply them.Develop best practices related to what level of certainty is necessary from automated algorithms for different justice system applications (e.g., probable cause, evidentiary purposes) and wha"] [14.848787307739258, 2.7745752334594727, ", integrating motor vehicle records, welfare records, and follow-up programs).2 None\nThe nearly ubiquitous availability of online and social media has dramatically increased the potential for inappropriate extrajudicial research by jurors and other p"] [14.884450912475586, 2.805574655532837, "urt proceedings.Create standards to quickly and transparently assess the authenticity of converted and admitted video evidence. 333Problem or Opportunity Associated Need TierRelated \nTheme(s)\nBody-worn technologies (e.g., fitness trackers) \nmay broad"] [14.754186630249023, 2.632932662963867, "equential decisions that affect individuals. In the credit context, however, provisions of the Fair Credit Reporting Act provide consumers access and procedures to dispute contents of their credit file that they believe are inaccurate.\n5 Both analyst"] [14.875479698181152, 2.7444515228271484, "t the telephone stations.\n16 For discussion of this issue in the legal literature, see, for example, \nHenderson, 2006\u20132007; Spencer, 2013; and Kerr, 2009.\n17 Authenticating data must also consider the possibility that evidence \non a person\u2019s device w"] [14.698145866394043, 3.14350962638855, "ors or corrections\u201d (Code of Federal Regulations, 2015).\n25 For a discussion of this issue, see, for example, Bushway and \nSmith,\u00a02007.\n26 For examples of recent debates about the tools\u2019 fairness, see discus-\nsion from a variety of perspectives in Ja"] [14.687331199645996, 3.1635637283325195, "I, No. 3, 20\n11. As of December 12, 2016: \nhttp://jolt.richmond.edu/v17i3/article9.pdf\nBarry, Nicholas, \u201cMan Versus Machine Review: The Showdown \nBetween Hordes of Discovery Lawyers and a Computer-Utilizing Predictive-Coding Technology,\u201d Vanderbilt "] [14.771671295166016, 3.0909175872802734, "cus.gov/sites/default/files/documents/Draft_Best%2520Practices%2520Video%2520Hearings_10-09-14_1.pdf\nChauriye, Nicole, \u201cWearable Devices as Admissible Evidence: \nTechnology Is Killing Our Opportunity to Lie,\u201d Catholic University Journal of Law and Te"] [14.707441329956055, 3.153651475906372, "stiglione, Giuseppe Cattaneo, \nGiancarlo De Maio, and Mario Ianulardo, \u201cAutomated Construction of a False Digital Alibi,\u201d in A M. Tjoa, Gerald Quirchmayr, Ilsun You, and Lida Xu, eds., Availability, Reliability and Security for Business, Enterprise a"] [14.430517196655273, 3.3360755443573, "2016: \nhttp://www.okbar.org/members/BarJournal/archive2008/Mararchive08/obj797esi.aspx\nElectronic Privacy Information Center, \u201cAlgorithms in the Criminal \nJustice System,\u201d web page, undated. As of December 12, 2016: https://epic.org/algorithmic-tran"] [14.763980865478516, 3.07755184173584, "38Heintz, Michael E., \u201cThe Digital Divide and Courtroom Technology: \nCan David Keep Up With Goliath?\u201d Federal Communications Law Journal , Vol.\n 54, N\no. 3, 20\n02, pp. 567\n\u2013589.\nHenderson, Stephen E., \u201cBeyond the (Current) Fourth Amendment: Protecti"] [14.677057266235352, 3.1204710006713867, "ngs: Legal and Empirical Issues and Directions for Research,\u201d Law and Policy , Vol.\n 28, N\no. 2, \n20\n06, pp. 211\n\u2013227.\n\u201cJuries \u2018Could Enter Virtual Crime Scenes\u2019 Following Research,\u201d BBC News, May 24, 2016. As of December 12, 2016: http://www.bbc.co"] [14.600478172302246, 3.266284227371216, "After Underdahl,\u201d Minnesota Journal of Law, Science, and Technology , Vol.\n 11, N\no. 2, \n20\n10, pp. 853\n\u2013875. As of December 12, 2016: \nhttp://scholarship.law.umn.edu/mjlst/vol11/iss2/15\nLogan, Wayne A., and Andrew Guthrie Ferguson, \u201cPolicing Crimin"] [14.709335327148438, 3.167513132095337, "Practices.ashx\n\u2014\u2014\u2014, \u201cJury Managers\u2019 Toolbox: Best Practices to Decrease \nUndeliverable Rates,\u201d 2009b. As of December 12, 2016: http://www.ncsc-jurystudies.org/~/media/Microsites/Files/CJS/Toolbox/Undeliverable%20Best%20Practices.ashx\nNational Legal A"] [14.534104347229004, 3.1897106170654297, "ivacy-age-smartphone\nR.A. Malatest and Associates Ltd., Evaluation of the Bail Reform Pilot \nProject, Peace Region and Surrey , March 31, 2010 .\nRatcliffe, Jerry H., Intelligence-Led Policing , 2nd ed., Abingdon, \nOxon, UK: Routledge, 2016.\nRaynes-Go"] [14.747885704040527, 3.004103422164917, "More from the #Jury Box: The Latest on Juries and Social Media,\u201d Duke Law & Technology Review , Vol.\n 12, N\no. 1, 20\n14, pp. 64\u2013\n91.\nSt. Eve, Amy J., and Michael A. Zuckerman, \u201cEnsuring an Impartial Jury in the Age of Social Media,\u201d Duke Law & Techn"] [14.719576835632324, 2.97945499420166, "lem/Villasenor, John, \u201cWhat You Need to Know About the Third-Party Doctrine,\u201d The Atlantic , December 30, 2013. As of August 26, 2016: \nhttp://www.theatlantic.com/technology/archive/2013/12/what-you-need-to-know-about-the-third-party-doctrine/282721/"] [13.893284797668457, 4.239118576049805, "urt system and criminal justice overall. We would also like to acknowledge the contributions of Martin Novak and Steve Schuetz of the National Institute of Justice. James Anderson of the RAND Corporation provided advice and assistance in legal elemen"] [13.917947769165039, 4.158034801483154, "officer on afloat and ashore assignments in Miami, Fla.; New London, Conn.; and Baltimore, Md.\nJustin C. Dawson is a senior research scientist at RTI International. His research focuses on courts and corrections, criminal justice, and inter -\nnationa"] [13.86374282836914, 4.598623275756836, "ations do not necessarily reflect the opinions of its research clients and sponsors. \nR\u00ae is a \nregistered trademark.\nRR-1748-NIJCORPORATION\u00a9 Copyright 2017 RAND Corporation\nwww.rand.orgThis publication was made possible by Award Number 2013-MU-CX-K00"] [2.9840023517608643, 16.496009826660156, "The Cost and Affordability \nof Flood Insurance in New York City\nEconomic Impacts of Rising Premiums and \nPolicy Options for One- to Four-Family Homes\nLloyd Dixon, Noreen Clancy, Benjamin M. Miller, Sue Hoegberg, \nMichael M. Lewis, Bruce Bender, Sama"] [2.997251510620117, 16.51826286315918, " the national level. Congress instructed the Federal Emergency Management Agency (FEMA) to develop an affordability framework in light of legislation that directs FEMA to gradually eliminate certain program subsidies and to collect additional program"] [2.950496196746826, 16.514789581298828, "...................................................................................... 1\nPurpose of This Study ................................................................................. 2\nStudy Approach ......................................"] [2.9446866512298584, 16.541149139404297, "............................................................. 54\nCanarsie ............................................................................................. 54\nGerritsen Beach and Sheepshead Bay ..........................................."] [2.9080240726470947, 16.53098487854004, "....................................................................... 119\nTo What Extent Is Purchasing Flood Insurance Burdensome for Households \nLiving in One- to Four-Family Homes in the Study Area? ............................... 119\nHow Might"] [2.754065990447998, 16.518972396850586, " U\nnder PFIRM Versus 2007 FIRM for Properties in \nHigh-Risk Zones of the 2007 FIRM ................................................. 42\n 3.4. Difference B\netween Structure Elevation and PFIRM BFE in the Study Area ..43\n 3.5. Premium Pro\njections U"] [3.0363855361938477, 16.73176383972168, "............................................................. 82\n 6.1. Structure f\nor Income-Based Subsidy .................................................. 91\n 6.2. Alternati\nve Versions of the Income-Based Subsidy Design ........................"] [2.8515279293060303, 16.537446975708008, "tructure C\nharacteristics for Premium Example .................................... 36\n 3.3. Rates from th\ne NFIP April 2015 Rate Schedule ..................................... 37\n 3.4. Premiums fo\nr the Example Structure .........................."] [3.0402567386627197, 16.774404525756836, " Burden\u2013Based Subsidy: Program Outcomes \nwith Full Participation ................................................................. 99\n 6.8. Design 2: Enr\nollment and Program Cost Under Different \nProgram Participation Assumptions ................"] [2.987389326095581, 16.644624710083008, "ehold Income and Household Net Worth .......... 149\n D.1. Fraction of I\nncome Spent by One- to Four-Family Households in the Study \nArea on the Components of PITI, Owner-Occupied Residences Only ......... 153\n D.2. Fraction of I\nncome Spent on PIT"] [2.9541783332824707, 16.491365432739258, "ions, with a focus on one- to four-family homes in areas of the city that are at high risk of flooding (the study area):\n1.\n To what extent i\ns purchasing flood insurance burdensome for households living \nin one- to four-family homes in the study are"] [2.900722026824951, 16.52765655517578, "s than 40 percent of the households living in them are low income, and the percentage of low-income households is substantially higher in some of the five subareas examined. A considerable number of one- to four-family structures face substantial flo"] [2.7873501777648926, 16.493854522705078, "at flood insurance is burdensome for 64 percent of extremely and very low\u2013income households and for 41 percent of low-income households. The proportion of households for which flood insurance is burdensome varies across the five subareas, with the hi"] [2.754807949066162, 16.487056732177734, " some policyholders are \noffset by charging higher rates to other policyholders. Although this cross-subsidy does not come from outside the \nprogram, it nevertheless is a subsidy for certain policyholders. Table S.1\nMedian Premium in Flood Insurance "] [2.7889468669891357, 16.5362491607666, "into an 8-inch increase in BFE across the study area. We estimate that such an increase in BFE would cause the average full-risk rates projected using the PFIRM to increase by approximately 10 percent across the study area as a whole. However, more w"] [2.791429281234741, 16.496610641479492, "n the study area, resulting in defaults rising from roughly just more than 300 per year to roughly 450 per year, or 1.5 percent of homes with mort -\ngages per year. Most of these defaults will be in the high-risk zones of the 2007 FIRM. \nTable S.2\nDe"] [3.048250198364258, 16.77478790283203, " larger benefits are delivered to the target popu -\nlation by this design, even though the program cost is substantially less than that for the income-based subsidy (design 1). One downside of the housing burden\u2013based sub -\nsidy is the extra informat"] [3.0393264293670654, 16.780309677124023, " occurs, is reimbursed for deductible payments that exceed $2,000; benefit reduced for moderate- and middle-income households\n4. Mitigation loans and grants Grants for the low-income households and low-interest loans for moderate- and middle-income "] [2.9899890422821045, 16.651927947998047, "nd the 2015 NFIP rate schedule \nwith pre-FIRM rates.\nb Assumes that flood insurance premiums are based on the PFIRM and the 2015 NFIP rate schedule \nwithout pre-FIRM rates or grandfathering.\nc Does not include administrative cost.Summary xxv\nfinan"] [2.999008893966675, 16.480854034423828, " \nCity Mayor\u2019s Office of Recovery and Resiliency for providing intellectual leadership throughout the course of the project. They also played key roles in efforts to encourage residents to participate in the study and helped us obtain data from other"] [2.999221086502075, 16.454174041748047, " draft report. Elizabeth Asche, Claudia Murphy, and Andy Neal at FEMA provided helpful feedback on interim findings. The report is a better product because of their efforts. \nAt RAND, statisticians Stephanie Kovalchik and Michael Robbins designed the"] [2.9772019386291504, 16.494552612304688, "andy struck New York City on October 29, 2012, with devastating conse-\nquences. It highlighted the importance of programs and policies that promote greater resilience to flood events. Flood insurance is an important part of this resilience strat -\neg"] [2.964003086090088, 16.481121063232422, "levant not only to New York City, but also to the United States \nas a whole. Congress recognized the challenges that the phase-out of subsidies could create for households and directed Federal Emergency Management Agency (FEMA) to study \u201cmethods of e"] [2.9757916927337646, 16.365859985351562, "Beach, and Hamilton \nBeach in Queens)\n\u2022 Rockaway Pe\nninsula (in Queens)5\n\u2022 East Shore, Staten Island (South Beach, Midland Beach, New Dorp Beach, and Oakwood).\nMap\ns showing the location of these subareas are provided in the discussion of our \nfindin"] [2.9077041149139404, 16.464101791381836, ", so findings on the distribution of properties by residency are based on the 615 households completing the survey. In contrast, data from the EC are required to project flood insurance premiums, and thus premium projections are based on the 485 prop"] [2.92807674407959, 16.517295837402344, "result from sea level rise (SLR). It also examines the effects of these rate increases on housing burden. \nWhile Chapters Two and Three focus on the study area as whole, Chapter Four \nexplores how the results vary across the five study subareas. \nCha"] [2.8724913597106934, 16.476472854614258, "are in \nthe high-risk zones of the 2007 FIRM (A, AE, AO, V, and VE zones) with the remain -\ning properties newly mapped into the high-risk zones by the PFIRM.3 \nA high percentage (84 percent) of the one- to four-family structures in the study \narea w"] [2.824692487716675, 16.457870483398438, "Flood Insurance in New York City 9\ntures are eligible for \u201cpre-FIRM construction rates\u201d from the NFIP, or \u201cpre-FIRM\u201d \nrates for simplicity (FEMA, 2015a, p. RATE-2).4 Pre-FIRM rates are on average less \nthan actuarially based rates for the structur"] [2.9374444484710693, 16.486949920654297, "eas. Because all 48,100 properties are represented, \nconfidence intervals are not necessary.\nc Based on the study sample with complete surveys ( N = 615).\nd Based on the study sample with ECs ( N = 485).Table 2.1\u2014Continued10 The Cost and Affordabi"] [2.8599600791931152, 16.498756408691406, "ally affect the rental market. \n9 The BFE is the elevation water reaches in a flood that occurs with a 1-percent annual chance.\n10 For structures with basements, structure elevation is measured from the top of the basement floor. For struc -\ntures wi"] [3.0990235805511475, 16.774452209472656, "ds 95% Confidence Interval\nTotal owner-occupied residences 42,700 100% 40,800\u201344,100 \u2014\nHousehold size (persons)\n1 6,100 14% 4,800\u20137,600 11\u201318%\n2 12,100 28% 10,300\u201314,000 24\u201333%\n3 6,400 15% 5,100\u20138,000 12\u201319%\n4 9,000 21% 7,400\u201310,900 17\u201325%\n5 3,700 9%"] [3.0997538566589355, 16.787874221801758, "edian income in our sample is $74,500, which is higher than the median income for all households in New York City ($53,782 in 2016 dollars) (U.S. Census Bureau, undated[a]). It should not be surprising that median income for New York City homeowners "] [3.0706188678741455, 16.76066017150879, "vides income cutoffs for these income categories (which vary by house-hold size) in the New York, New York Metro Fair Market Housing Area. \nTable 2.3 shows that just less than 20 percent of households in owner-occupied, \none- to four-family homes in "] [2.9925410747528076, 16.644559860229492, ") 7,200 17% 5,800\u20138,900 14\u201321%\nHigher income (> 165% of AMI) 10,000 23% 8,300\u201311,900 20\u201328%\nLow income and below \n(\u2264 80% of AMI)16,800 39% 14,800\u201318,900 35\u201344%\nNOTE: These values are based on a sample of 569 owner-occupied residences. Categories may"] [2.8956124782562256, 16.48004722595215, "P \npolicies were accurately assigned to property parcels. They found a match rate of 88 percent, suggesting that the \nestimate in that study may overstate the actual take-up rate. \n13 Kousky (2016) finds that the majority of the increase in flood ins"] [2.960184097290039, 16.61563491821289, "hat take-up rate increases as \nhousehold income increases, particularly for 2016. The relatively large confidence inter -\nvals, however, prevent any firm conclusions. We will return to the relation between take-up rate and housing burden (the last se"] [2.8621628284454346, 16.587295532226562, "ximately 45 percent carry the maximum $100,000 \noffered by the NFIP.\nThe relation between building coverage and structure replacement cost is one \nindicator of the extent to which property owners are protected from flood losses. The \nNFIP policy appl"] [2.800121545791626, 16.48845100402832, "s in the study sample with a flood insurance policy as of December 31, \n2014 (N = 775).RAND RR1776-2.3Percentage of policies\n1\u201350 51\u2013100 101\u2013\n150151\u2013\n200201\u2013250251\u2013500501\u2013750751\u20131,000>1,000Building coverage \nStructure replacement cost The Affordabili"] [2.779606342315674, 16.500581741333008, " increased c\nost of compliance (ICC) premium + \n deductible\n adjustment + \n reserve fun\nd assessment + \n federal poli\ncy fee + \n HFIAA su\nrcharge. \nSpecifically, the premium in the PMF does not include the reserve fund assess -\nmen"] [2.819042921066284, 16.500288009643555, "s much higher than the $1,120 average for the elevation-rated structures.\n24 A surprising 10 percent of policies are PRPs\u2014\nsurprising because PRPs are not available in high-risk areas. A likely explanation is that the flood zone was incorrectly state"] [3.0437870025634766, 16.760677337646484, "inition back to the National Housing Act of 1937. \nThe regulations promulgated pursuant to this act originally offered public housing to families with incomes less \nthan five to six times the rent. This rule was quickly changed to limit maximum rent "] [3.065534830093384, 16.774742126464844, "ity Department of Finance. Careful efforts were made not to double-count property taxes and insurance payments escrowed in the mortgage. Consistent with common terminology in the lending industry, we refer to these costs collectively as PITI (mortgag"] [3.0598649978637695, 16.764440536499023, ". Six households that report \nannual household income of less than $20,000 and have a PITI ratio greater than 2.5 but less than 4.1 are not shown on this chart.RAND RR1776-2.4\nPITI ratio\n200 100 0 300PITI ratio = 0.4Cutoff for \nmiddle-incomehousehold"] [3.0439980030059814, 16.750070571899414, "lds with PITI ratios above 0.4 do not have flood insurance, and purchasing flood insurance would only increase their PITI ratio further above 0.4. Consequently, flood insurance is also burdensome for these households using this measure of housing bur"] [2.7702741622924805, 16.476579666137695, "miums that are currently paid and the \nextent to which they are financially burdensome. That analysis was predicated on the FIRM currently in place (the 2007 FIRM), the NFIP rate schedule in effect between July 1, 2015, and June 30, 2016, and the ava"] [2.7884957790374756, 16.47370147705078, "ructure t\nype (e.g., slab, basement, enclosure, crawlspace, subgrade crawlspace)\n\u2022 number of floors\n\u2022 location of M\n&E \n\u2022 flood zone\n\u2022 structure el\nevation relative to BFE\n\u2022 residency (\nwhether primary residence of property owner).\nWhen a structure i"] [2.7671546936035156, 16.474756240844727, " annual flood insurance premium increases to 18 percent per year, so large premium increases would be phased in over multiple years. For exam -\nple, if premiums triple as they do in some of the scenarios below, it would take approxi -\nmately seven ye"] [2.8647167682647705, 16.606061935424805, "d:\n\u2022\n building co\nverage: the lesser of replacement cost and $250,000 (the maximum \noffered by the NFIP)\n\u2022 contents co\nverage: $100,000 for structures with $250,000 in building coverage \nand 40 percent of the amount of building coverage for structure"] [2.829726457595825, 16.546581268310547, "s to $2,500 and is shown in Table 3.4. Including the other premium components increases the total premium to $2,762. \nThe bottom part of Table 3.4 shows the non -elevation-based premium for this \nstructure. The building and contents rates are shown i"] [2.7973930835723877, 16.533245086669922, "tructure\nLocation of M&E In basement\nBuilding coverage $250,000 with $2,000 deductible\nContents coverage $100,000 with $2,000 deductibleFlood Insurance Premium Scenarios 37\nSomewhat unexpectedly, changes in the NFIP rate schedule between 2012 and "] [2.7556402683258057, 16.47918128967285, "62\nNon-elevation-based rate\nBase premium $2,850 $1,203 $4,053\nIncreased cost of compliance premium \u2014 \u2014 $55\nDeductible adjustmentc\u2014 \u2014 0\nReserve fund assessmentb\u2014 \u2014 $616\nFederal policy fee \u2014 \u2014 $45\nHFIAA surcharge \u2014 \u2014 $25\nTotal $4,794\na \u20137.5% of base pr"] [2.7307333946228027, 16.472549438476562, "paid in the high-risk areas of the 2007 FIRM is $1,880 (see Table 2.8 in Chapter Two), just more than one-half of the $3,500 average projected in scenario B. Primary reasons for this for gap are:\n\u2022\n The coverage le\nvels observed for policies in force"] [2.758664846420288, 16.481380462646484, "PFIRM affects flood insurance premiums by increasing the number of struc -\ntures in high-risk areas and by increasing, for most properties, the property-specific BFE. As shown in Table 3.5, there are 25,900 \u201cnewly mapped\u201d properties under the PFIRM\u2014t"] [2.751023054122925, 16.479537963867188, "ifference for one- to four-family structures in the study is area is \u20135.0 feet. \nPremiums for Properties Already in High-Risk Zones\nHow premiums would change under the increasing risk depicted by the PFIRM depends importantly on whether the property "] [2.74930739402771, 16.489898681640625, "perience a premium increase and the average premium across properties increases by $500. \nEliminating grandfathering does have a considerable impact for properties that \nare already in high-risk zones according to the 2007 FIRM. As can be seen by com"] [2.740116834640503, 16.475683212280273, "igure 3.7), and at least \n75 percent of properties see increases of $1,800 or more (first column of Figure 3.8). The reason is that Congress directed FEMA to gradually increase rates from the PRP rate to the standard X-zone rate for newly mapped pro"] [2.7616689205169678, 16.4814395904541, "grandfatheringDrop \ngrandfathering, \nkeep pre-FIRM \nratesAdopt PFIRM \nwith risk-based \nratesAdd 8 inches of SLR \n06,000\n5,0004,0003,000\n2,0001,0007,000\nRAND RR1776-3.8\nPremium change ($)\n5th \npercentile$400 $0 $0 $400 $0\n25th percentile$1,800 $0 $300"] [2.785386085510254, 16.49253273010254, "he \nPITI ratio when the premiums in scenarios B and G are assumed. In both of these sce-narios, all properties are assumed to have flood coverage at the same coverage amounts assumed in this chapter. Moving to premium scenario B does not increase the"] [2.755718469619751, 16.468446731567383, "E. \nOutside the high-risk zones of the 2007 FIRM, the median premium remains at \n$500, with or without pre-FIRM rates. This assumes that property owners continue to qualify for PRP rates outside the high-risk area. Continued qualification for the PRP"] [2.9101815223693848, 16.33185577392578, "y as the Jamaica Bay subarea)\n\u2022 South Beach/\nMidland Beach/New Dorp Beach/Oakwood (referred to jointly at \nthe East Shore subarea).\nWe oversampled in these subareas to get a better representation of vulnerable \ncommunities in our study.1 This chapter"] [2.9144370555877686, 16.37246322631836, "\nJamaica Bay 2,800 2,600\nRockaway Peninsula 11,300 9,700\nEast Shore 6,300 5,800\nRest of study area 21,100 18,300\nOverall study area 48,100 42,700\nSOURCE: Property address provided by the New York City Department and Finance. Residency status \ndetermi"] [2.928609848022461, 16.352514266967773, "s full of summer bungalows by the early 20th century. Over time, these bungalows were winterized and became year-round residences. These two communities are home to approximately 11,000 people and more than 9,000 residen -\ntial units.\nFlood Risk Prof"] [2.9314205646514893, 16.361793518066406, "head Bay comprise detached (see Figure 4.8) and semidetached one- and two-family homes, and there are numerous multifamily buildings. Elevating or retrofitting \nFigure 4.5\nFirst Floor Below Street Level in Gerritsen Beach\nSOURCE: Image used with perm"] [2.9644484519958496, 16.29722023010254, " Boulevard. These communities were expanded by dredging and filling in marshland (NYC Plan -\nning, 2016). \nFlood Risk Profile\nThese communities have long experienced flooding during storm events and even regu -\nlar tidal flooding. These communities e"] [2.9191982746124268, 16.32917594909668, ",000 residents. In mid- to late 19th century, the Rockaways was primarily a waterfront resort area. The construction of the Cross Bay Bridge, the Marine Parkway Bridge, and improvements to railway services between the 1920s and 1940s made the Rockawa"] [2.9386086463928223, 16.361982345581055, "sion of the New York City Department \nof City Planning. All rights reserved.\nRAND RR1776-4.1266 The Cost and Affordability of Flood Insurance in New York City\nEast Shore Subarea\nBackground\nThe East Shore of the Staten Island study area consisted pr"] [2.9154343605041504, 16.428144454956055, "ity in Five Vulnerable Subareas 67\nTake-Up Rates and Housing Burden\nFlood insurance take-up rates vary considerably across the five study subareas. \nTable 4.2 reports estimates of the take-up rate in 2012 and 2016 for one- to four-family \npropert"] [2.883181095123291, 16.428144454956055, "\n (\u226480% AMI)Percentage Housing \nBurdened \n(PITI Ratio >0.40)Percentage Older \n(Financially Responsible \nPerson \u226565 Years Old)\nStudy SubareaEstimated \nPercentage95% \nConfidence \nIntervalEstimated \nPercentage95% \nConfidence \nIntervalEstimated \nPercent"] [2.8011462688446045, 16.4410457611084, "000 6,000 7,000 8,000 9,000 10,000 \n5th percentile $400 $400 $500 $400 $400 $400\n25th \npercentile$500 $500 $700 $700 $500 $500\nMedian $700 $500 $1,300 $1,700 $1,700 $700\n75th percentile$700 $700 $3,000 $3,100 $3,500 $3,400\n95th percentile$700 $3,600 "] [2.8509111404418945, 16.458831787109375, "wner-occupied residences in Canarsie. Reflecting the large premium increases in the Rockaway Penin-sula, the increase in the percentage of households that are housing burdened is particu -\nlarly large\u2014increasing from 16 percent under current conditio"] [2.779477834701538, 16.478559494018555, "d, flood insurance premiums are particularly burdensome \nfor households in Canarsie. A substantially higher proportion of households in Canar -\nsie are currently housing burdened than in the other subareas examined and a substan-tially higher proport"] [2.7523093223571777, 16.502717971801758, "d be affected by shifting from the effective FIRM to the PFIRM can provide insight into how households and neighborhoods will be affected by whatever change ultimately occurs.\nAnother source of uncertainty is that the magnitude of price changes will "] [2.844794750213623, 16.539546966552734, " study area is in the high-risk zones of the PFIRM). Many factors beyond floodplain location and flood insurance prices go into determin -\ning property values; for example, the 2008 subprime mortgage crisis had an enormous effect on housing prices. O"] [2.8370494842529297, 16.522178649902344, "eas\n5th percentile $235,000\n25th percentile $307,000\n50th percentile $407,000\n75th percentile $516,000\n95th percentile $850,000\nMedian home price by study subarea\nCanarsie $390,000\nSouthern Brooklyn Waterfront $361,000\nJamaica Bay $400,000\nRockaway P"] [2.839515209197998, 16.546916961669922, "ecline in value of some property \nin the current high-risk zone is so large that the property is almost worthless. This \n3 The average mortgage is prepaid in fewer than 30 years, but the value of the property is based on its resale value \nand not how"] [2.8307676315307617, 16.551652908325195, "00\nNOTES: Sample limited to one- to four-family properties in the PFIRM with complete ECs. There are no \nhomes from Canarsie in our sample with an EC that are inside the high-risk zones of the effective FIRM. Maximum decline in value is bounded at th"] [2.881981372833252, 16.572736740112305, "ome drops, the household no longer ben -\nefits from spending the same amount of money to purchase a now less-valuable home from the lender. Because the value of the home has dropped, selling the home also does not raise sufficient revenue to pay back"] [2.8868541717529297, 16.5494327545166, "4) and Gyourko and Tracy (2014).\nIn January 2016, the mortgage default rate in New York City was 1.0 per -\ncent (Barraza, 2016), or just over 300 mortgage defaults per year among owner- occupied residences in the study area. Table 5.4 shows over 150 "] [2.850680112838745, 16.56351661682129, "uch of an empirical difference.7 These inelastic \nestimates are also based on much smaller changes in price than those considered here. If the probability that a $5,000 increase in insurance costs causes a household to drop its insurance is more than"] [2.8254284858703613, 16.547868728637695, "n flood insurance prices will cause sig -\nnificant decreases in property values. Table 5.2 shows that households in the study area but outside the high-risk zones of the effective FIRM will see the value of their property decrease by roughly $10,000 "] [2.9955554008483887, 16.596248626708984, "ed by the National Academies of Sci -\nences, Engineering, and Medicine on behalf of the Federal Insurance and Mitigation Administration (FIMA).\n1 The first three programs subsidize flood insurance premiums \nin different ways. The fourth makes flood i"] [3.0304205417633057, 16.722064971923828, "is complete.\nWe do not examine the potential for incorporating CRS participation into a flood insurance affordability \nstrategy in this report. That topic warrants further study.Table 6.1\nFlood Insurance Affordability Program Designs\nDesign Name Desc"] [3.0591988563537598, 16.781211853027344, " designs are also modeled using premium scenario E (PFIRM, 2015 rate schedule without pre-FIRM rates, but with grandfathering). \n5.\n Design para\nmeters. Each design is modeled under a set of base-case design \nparameters for eligibility and benefit l"] [3.072765350341797, 16.77411460876465, "g Burdened Not Housing Burdened\nExtremely and very low \nincome (\u2264 50% of AMI)6,800 (16%)b4,500 (46%) 2,300 (7%)\nLow income (51 to 80% of AMI)8,600 (20%) 3,400 (35%) 5,200 (16%)\nModerate income (81\u2013120% of AMI)9,100 (21%) 1,200 (12%) 7,900 (24%)\nMi"] [3.057218313217163, 16.779359817504883, "2 The Cost and Affordability of Flood Insurance in New York City\ndecline in benefits avoids a sudden change in benefits from 80 percent of the premium \nto zero and the associated incentive to reduce income to just below the threshold. It also opens "] [3.1003732681274414, 16.831340789794922, "o 0.80, but remains high.6 As shown in the last column of \nTable 6.3, this design provides benefits to many households that are not housing bur -\ndened and thus could afford the flood insurance premium without the program. More than one-half of the "] [3.043398380279541, 16.76132583618164, "households that are housing burdened without the program increases when full-risk rates are used (from 9,700 to 14,200). For scenarios B and E the program causes little change in the percentage of households that are housing burdened in the study are"] [3.086916923522949, 16.79949188232422, ",000 to 15,400), while the number of beneficiaries who are housing burdened declines by 600 (from 9,700 to 9,100). Even though the cost of the more narrowly targeted program is 18-percent lower than in the base case, the outcomes for the housing-burd"] [3.0739495754241943, 16.784435272216797, "d by HUD\u2019s Section 8 housing choice vouchers for renters. That program expects renters to pay 30 percent of household income toward rent and then fills in the gap between the household contribution and a measure of market rent in the area.\n8 In the d"] [3.080146312713623, 16.800111770629883, "his design tends to reward less financially conservative households. A household that, for example, took on the maximum amount of debt when times were good would be more likely to benefit from the program than households that did not borrow up to the"] [3.0550148487091064, 16.788864135742188, "ects the number of beneficiaries \nand program cost. Higher flood insurance premiums increase a household\u2019s PITI ratio, \nand, as expected, the number of beneficiaries is higher when the program is run using premium scenarios based on the PFIRM. As is "] [3.0737063884735107, 16.790653228759766, "00)15,500 \n(13,000\u201318,000)\nAnnual premium subsidy $14 million \n(7\u201321)$19 million \n(11\u201326)$26 million \n(18\u201334)\nOutcomes for households that are housing burdened without the program\nNumber of beneficiaries 6,900 9,700 9,700\nAnnual premium subsidy $14 "] [2.9643797874450684, 16.671674728393555, "e pre-\nmium charged for the $2,000/$2,000 and $10,000/$10,000 policies. NFIP actuaries consulted during this study indicated that the deductible factors are based on actu -\narial data and that differences in the factors provide a first estimate of th"] [3.024200201034546, 16.74585723876953, "ere could be years where \nno flooding events take place or years where multiple flooding events take place.\n12 Because of this relationship between expected outlays and the difference in premiums, the annual cost of a \nprogram in which the government"] [3.022376298904419, 16.770545959472656, "vious designs have provided financial assistance for flood insurance premiums \nbut have not made any effort to modify the structure to reduce risk. This design makes flood insurance more affordable by modifying structures in ways that reduce the NFIP"] [3.029151201248169, 16.76816177368164, " approach is attractive because, rather than funding subsidy \npayments year after year, mitigation reduces risk and the need for subsidies in the first place. Mitigation also means that households experience fewer and less-severe flood losses and the"] [3.0285890102386475, 16.769943237304688, "ned, but rather the cost of the loans after repayments have been made. This cost is due to the below-market interest rates and loan default. The subsidy rate for the low-interest loans provided by the SBA provides a basis for estimating the cost of "] [2.968797206878662, 16.71756362915039, "levation is determined using the \nfloor above the crawlspace or enclosure. Retrofitting a residential structure with flood vents typically costs between $6,000 and $9,000, and we assume a cost of $8,000 in the program simulations (see Table 6.15). \nR"] [2.957995891571045, 16.7044734954834, "$70,000 in our program simulations. An obvious downside of this mitigation measure is the loss in utility and potential rental income that basements generate for homeowners. \nStructure Elevation\nThe last and most expensive mitigation measure consider"] [3.0383191108703613, 16.782817840576172, "ber of structures for which \nmitigation measure is feasible and household is eligible2,600 \n(1,500\u20133.600)7,200 \n(5,300\u20139,100)21,100 \n(18,300\u2013\n23,900)15,700 \n(13,100 \u201318,100)\nNumber of structures for which mitigation measure is cost-effective and"] [2.994851589202881, 16.72739028930664, "households in the study area that are housing burdened (given the rate schedule that underlies pre-mium scenario B). \nA final point to underscore regarding the projections in Table 6.16 is that they pre-\nsume all eligible structures participate in th"] [3.056723117828369, 16.80124282836914, "ion $94 million $330 million\nAverage premium without program $9,100 $4,600 $5,000 $26,500\nAverage premium with program$5,300 $3,900 $1,200 $4,400\nAverage PITI ratio without program 1.32 0.82 0.83 1.11\nAverage PITI ratio with program1.07 0.80 0.72 0.5"] [3.036247730255127, 16.78183364868164, " row six.\nFinally, row seven reports the difference in costs between the two designs. The \nresults show that government cost for design 5 will be lower than for design 1 under particular circumstances. Government cost is lower if the subsidy is provi"] [3.0501132011413574, 16.785778045654297, "out \nProgram\nDesignFlood Insurance \nUnaffordableFlood Insurance \nAffordableBenefit Cost \nwith Full \nParticipationaWithout \nProgramWith \nProgram Pros Cons\n1. Income-based subsidy 9,700 22,000 $33 million per \nyear$2,100 $650 Least data required on \nho"] [3.0107452869415283, 16.728559494018555, "rs the relatively small number of middle-income households that are housing burdened from the program. \nThe premium reductions and program costs for the deductible subsidy design are \nmore modest than in other programs. We have modeled a program in w"] [2.9940011501312256, 16.705018997192383, "art of the program.Table 6.20\nNumber of Beneficiaries and Program Costs Under Premium Scenario B and Premium Scenario G\nWith Premium Scenario B With Premium Scenario G\nDesignNumber of \nBeneficiaries Program CostNumber of \nBeneficiaries Program Cost\n1"] [2.761370897293091, 16.493635177612305, " be largely phased out by the time a revised FIRM is adopted for New York City, but even without pre-FIRM rates, the median premium with grandfathering is not much higher than under the 2007 FIRM. It should be remembered, however, that not all homeow"] [2.9751720428466797, 16.663347244262695, " 450 per year, or 1.5 percent of homes with mortgages per year. Most of these defaults will be in the high-risk zones of the effective FIRM. Some study areas, such as the Rockaway Penin -\nsula, could be particularly hard hit by increased default rate"] [3.0192935466766357, 16.62863540649414, "tentially lower than with the premium subsidy alone. We illustrate that this can indeed be the case with savings up to hun -\ndreds of millions of certain multiyear scenarios, but only if the low-income households that qualify for the income-based sub"] [3.045330762863159, 16.40768814086914, ". to provide a reliable and representative estimate of the affordability of flood \ninsuranc\ne for one- to four-family homes in New York City\n2. to provide acc\nurate estimates of flood insurance affordability for one- to four-\nfamily homes in each of "] [3.0831642150878906, 16.3725528717041, "me. Study subarea was not a factor in sampling in this stage, so the additional sample would be expected to be proportional to the representation of each study area among the sample frame structures. The final sample size was 2,800 structures with an"] [3.0702314376831055, 16.403358459472656, "2015 and May 2016. Waves were \norganized in part by geographic location.\nTo enable survey results to be projected to the study area as a whole, properties \neligible to participate in the study were randomly selected; consequently, we could not accept"] [3.08060359954834, 16.396398544311523, "rt staff to ensure accurate information was communicated in response to inquiries. Staff fluent in Spanish, Chinese, Russian, and other languages were available on call as needed.\nDuring the course of the study, 345 phone-based inquiries were receive"] [3.066486120223999, 16.383705139160156, "60 study participants.\nSite Visits and Elevation Certificates\nFollowing completion of the questionnaire by study participants, the project- scheduling team contacted each participant by phone and/or email to schedule the site visit for the land surve"] [3.0647006034851074, 16.378074645996094, "ic command. The outcome variable is an indicator variable for participation in the study (1 indicating yes), and the explanatory variables are also all indicator variables. As shown in Table A.4, the following variables are included in the response-r"] [3.0269663333892822, 16.42150115966797, "e Coefficient Prob > |z| Coefficient Prob > |z|\nStudy subarea\nCanarsie 1.102 0.56 1.122 0.54\nSouthern Brooklyn \nWaterfront0.679 0.04 0.908 0.63\nJamaica Bay 1.097 0.56 1.070 0.71\nRockaway Peninsula Reference \u2014 Reference \u2014\nEast Shore, Staten Island 0.7"] [3.029982328414917, 16.42486572265625, "y duration, creation of maps for use by door-to-door canvassers, the process used to match the study addresses to the NFIP policy database, and the process used to match the study addresses to the Build It Back database. \nGeodatabase Development: Dat"] [2.981994390487671, 16.42256736755371, "ch\n \u2013Canarsie\n \u2013 Rockaway Pe\nninsula including Rockaway Park and Rockaway Beach\n \u2013 Sheepshea\nd Bay, Gerritsen Beach\n \u2013 South Beach, M\nidland Beach, New Dorp Beach, Oakwood.\nSource Data Manipulation\nThe following data-manipulation steps were performed"] [2.914327383041382, 16.39409637451172, "l. \nFor riverine areas, the BFEs are stored in the FIRM database as attributes to line \nfeatures that cross the floodplain perpendicular to stream flow. Using the elevation of the BFE lines as input and the zone AE flood hazard areas as a mask, a Tri"] [3.11765456199646, 16.39925765991211, "d. PINs were assigned for the first 300 addresses in wave A. PINs were assigned for sub -\nsequent mailing waves as the mailing waves were identified (number of addresses and neighborhoods).\nPrepare Data for Mailings and Telephone Outreach\nThe study d"] [3.1085550785064697, 16.409162521362305, "e addresses were geocoded and their points were moved to locations that better represented real-world locations. \nTo improve the display of tabular information in AGOL, only selected fields were \nkept in the study geodatabase that was prepared for AG"] [3.041905403137207, 16.4276065826416, "aded into the tool. A starting and ending location for each route was chosen, and an ordered route and directions were output. Once the route was created, map sheets at a size and scale that could be printed and carried in the field were gener -\nated"] [3.1078102588653564, 16.795040130615234, "au on the relationship between household income and household net worth. These data are based on statistics for households nationwide, but they provide an initial sense of how adding an asset test to an income-based eligibility criterion could reduce"] [3.101180076599121, 16.793668746948242, "m an \n1 The ranges were $19,999 or less, $20,000 to $29,999, $30,000 to $39,999, $40,000 to $49,999, $50,000 to \n$59,999, $60,000 to $79,999, $80,000 to $99,999, $100,000 to $119,999, $120,000 to $149,999, and $150,000 \nor more.Table C.1\nAMI-Based I"] [3.051988363265991, 16.75235939025879, "3 15.6 33.8\nNOTE: Data on household net worth by income quintile from U.S. Census Bureau, Survey of Income \nand Program Participation (SIPP), 2008 Panel, Wave 10 (U.S. Census Bureau, undated[c]). Net worth is defined as total assets less total liabil"] [3.0386133193969727, 16.74186897277832, "a change in jobs has reduced household income. It could also be the case that workers in the household have retired. The extent to which remaining costs are unsustainable to a household depends on their level of accumulated assets. The role of assets"] [2.8958756923675537, 16.632951736450195, "auses a substantial movement of households to the higher-income share categories. \nRelationship Between Building Coverage, Contents Coverage, \nReplacement Cost, and Mortgage Balance\nThe top section of Table D.3 examines the relationship between build"] [2.934807777404785, 16.666532516479492, "h NFIP policies.\n1 Mortgage balance is reported by survey respondents. \nProperties with building coverage are divided into three groups:\n1. those with a mortgage and mortgage balance less than or equal to replacement cost\n2. those with a mortgage and"] [2.8813517093658447, 16.617507934570312, ".3\u201339.3%\n30% < x \u2264 45% 9,600 22.1% 8,000\u201311,400 18.4\u201326.4%\n45% < x \u2264 60% 4,600 10.7% 3,500\u20136,100 8.1\u201314.1%\n60% < x 8,300 19.1% 6,700\u201310,100 15.6\u201323.3%\nNOTE: These values are based on a sample of 569 owner-occupied residence households. Categories \nma"] [2.7812042236328125, 16.47997283935547, "or building coverage.159APPENDIX E\nFlood Insurance Premium Model\nThis appendix first describes the model that was developed to project flood insurance \npremiums under a number of assumptions about the FIRM in effect and the availabil -\nity of pre-FIR"] [2.7604739665985107, 16.463754653930664, "r\nElevation-based rates in VE zones\nNFIP rate table 2012 and 2015\nFlood zone VE\nStructure type Elevated with enclosure, elevated without enclosure, all other\nElevation difference +4 to \u201313 in feet\nPRP \nNFIP rate table 2012 and 2015\nFlood zone Xa\nStru"] [2.759507417678833, 16.485769271850586, " 2012 and $45 \n in 2015 for other policies\nHFIAA charge = $0 in 2012; $25 in 2015 for primary residences; $250 in 2015 \n for nonprimary residences.\nThis premium information is used to develop the following"] [2.761890172958374, 16.478727340698242, "truc- \n ture and PR\n3 is lower than the rate after Step 3 (allows for pre- \n FIRM rates fo\nr grandfathered structures in high-risk zones of \n 2007 FIRM and se\nts rates for newly mapped pre-FIRM prop \n erties to sta\nndard X-zone rate).3 \nStep"] [2.7146172523498535, 16.4317626953125, "schedule used in the premium model went into effect. Rates generally increase over time, and one would expect the model to overpredict premiums for policies that Table E.3\nComparison of Model Predictions with Premiums in the 2012 Policy Master File ("] [2.7491912841796875, 16.452898025512695, "se with coverage).Table E.4\nComparison of Flood Zone\nFlood Zone According to \n2016 Policy Master FileFlood Zone According to EC Completed for Study\nA or AE V or VE B, C, and X Total\nA or AE 154 0 3 157\nV or VE 0 1 0 1\nB, C, X 18 1 114 133\nTotal 172 2"] [2.763262987136841, 16.47525405883789, "e, but it is somewhat more common for structure to be declared pre-FIRM in the PMF when it is post-FIRM on New York City\u2019s PLUTO property database than the reverse. Nineteen percent of post-FIRM properties are identified as pre-FIRM in the PMF (11 of"] [2.7654402256011963, 16.47275161743164, "s and 18% per property.If there is no lender requirement, the lapse rule does not apply.\nSOURCE: FEMA, 2016a, Section 5 (Rating).170 The Cost and Affordability of Flood Insurance in New York City\nTable F.2\nRating Options Available When the Flood "] [2.759777069091797, 16.46727752685547, "r V can be canceled and rewritten to a PRP going back to the inception date of the current term (the term the map change took place in). If the building does not qualify for a PRP (based on loss- \nhistory requirements\nb), \nthe policy can be endors"] [2.955251932144165, 16.644344329833984, "e pay-ment associated with taking a loan worth 80 percent of the 2016 assessed property value at a 5-percent interest rate. For the two remaining primary residences that have mortgages but are still missing mortgage payments, we impute mortgage payme"] [2.8975915908813477, 16.604755401611328, "tional insurance expenditures.\n2\nUtilities\nIn addition to the costs associated with PITI, we collect information on utility expen -\nditure as another component of housing cost. We ask homeowners to report their prior month\u2019s electric and gas bills, a"] [2.8337879180908203, 16.56327247619629, "ms unlikely based on current take-up rates, but would be socially desir -\nable because it reduces the risk of households facing sudden unexpected loses. How -\never, such a change in practice would also mean an increase in insurance prices causes a la"] [2.8128676414489746, 16.528932571411133, "ults.Economic Effects Model 177\nTable G.1\nDecline in Property Value Because of Change in Flood Insurance Premium from Scenario B to Scenario G, Flood Insurance Purchased Indefinitely (2016 Dollars)\nProperties in \nthe High-Risk Zones \nof the Effecti"] [2.9950010776519775, 16.497434616088867, " RR1776-H.1-2182 The Cost and Affordability of Flood Insurance in New York City\nFigure H.1\u2014Continued\nRAND RR1776-H.1-3Survey Instrument 183\nFigure H.1\u2014Continued\nRAND RR1776-H.1-4184 The Cost and Affordability of Flood Insurance in New York C"] [2.9984030723571777, 16.465248107910156, "a Monica, Calif.: RAND \nCorporation, RR-328-NYC, 2013. As of March 15, 2017: http://www.rand.org/pubs/research_reports/RR328.html192 The Cost and Affordability of Flood Insurance in New York City \nDixon, Lloyd, Noreen Clancy, Seth Seabury, and Adr"] [3.076131820678711, 16.725521087646484, "S. Department of Housing and Urban Development.\n\u201cIncome Limits,\u201d Office of Policy Development and Research (PD&R), U.S. Department of Housing and Urban Development, undated. As of March 29, 2017: https://www.huduser.gov/portal/datasets/il.html#2015Re"] [2.940648078918457, 16.355154037475586, "orhoods/gerritsen-beach.page\n\u2014\u2014\u2014, \u201cResilient Neighborhoods,\u201d nyc.gov, undated(d). As of March 20, 2017: \nhttp://www1.nyc.gov/site/planning/plans/resilient-neighborhoods.page\n\u2014\u2014\u2014, \u201cRockaway Park and Rockaway Beach,\u201d nyc.gov, undated(e). As of March 22"] [3.021117925643921, 16.629600524902344, "ualifying Ratios (4155.1),\u201d hud.gov website, March 1, 2011b. As of \nMarch 20, 2017: https://portal.hud.gov/hudportal/documents/huddoc?id=4155-1_4_secF.pdf\n\u2014\u2014\u2014, FHA Single Family Housing Policy Handbook 4000.1 , Washington, D.C., December 30, \n2016. A"] [3.002222776412964, 16.507312774658203, "ns that reduce \ufb02ood \ninsurance premiums by making the home less susceptible to \ufb02ood risk. This report builds \non a previous work by the RAND Corporation on \ufb02ood insurance in New York City, Flood \nInsurance in New York City Following Hurricane Sandy "] [12.646225929260254, 13.546173095703125, "SOCIAL AND ECONOMIC WELL-BEING\nEvaluation of the Homeless \nMultidisciplinary Street Team for the City of Santa Monica\nJ. Scott Ashwood, Karishma Patel, David Kravitz, David M. Adamson, \nM. Audrey Burnam\nPrepared for the City of Santa MonicaLimited P"] [12.626192092895508, 13.513630867004395, "cerns that are influenced by the \nnatural and built environment, technology, and co mmunity organizations and institutions that \naffect well-being. For more information, email chep@rand.org. \n iv Contents \nPreface ..................................."] [16.80735206604004, 10.213956832885742, "............................................ .................... 17 \t\nLimitations ................................................................................................................... ........................... 17 \t\nRecommendations .."] [16.787696838378906, 10.234511375427246, "eral population to \nseek services to address these conditions on their own. For thes e reasons, chronically homeless \nindividuals are often repeat us ers of emergency services\u2014including medical, law-enforcement, \nand paramedic-response services. Th i"] [16.798328399658203, 10.220242500305176, ", to date only one client has formally \u201cgraduated\u201d and transitioned to step-down care and is no longer receiving services from the HMST. Transitioning clients to step-down care is currently the program\u2019s greatest challenge. \nHow do community stakeho"] [16.79299545288086, 10.224724769592285, " recommend that the HMST provide more in formation on the impact of their efforts to \nthe other stakeholders in the community. So me individuals we interviewed said they \nwould like to know the outcomes of encounters with the clients. \n\uf0b7 We recommen"] [16.744375228881836, 10.246439933776855, "asons, chronically homel ess individuals are often repeat users of \nemergency services\u2014including medical, law-enfo rcement, and paramedic-response services. \nThis pattern of service use is expensive for ci ties both in dollars and manpower. A recent "] [16.790149688720703, 10.222000122070312, "nity and \norganizations within it, and recommendations for improvement based on our interviews. \nThe goal of the HMST is to reduce the public co st of services by the highest utilizers of \nemergency services among the homeless population in the City"] [16.794902801513672, 10.219949722290039, "sion in 2016 based on input from the city attorney\u2019s office, the police \ndepartment, and the fire department, and using ad ded consideration for data from the emergency \nrooms of local hospitals. Future additions to the HMST roster are made in a simi"] [16.78262710571289, 10.192659378051758, "gs he was willing to work on kind of snowballed.\u201d1 \nIn the early stages, HMST focuses on small, da ily tasks that a client wants done. Then, as \nsmaller goals are accomplished, the case manage r focuses on bigger goals, such as access to \ngeneral rel"] [16.79349136352539, 10.210817337036133, "w, June 25, 2018. 6 someone who can diagnose mental illness and develop meaningful treatment plans.2 However, \nwhile there are advantages to the HMST\u2019s abilit ies in the field, there is only so much that \nspecialists can do \u201cwith a backpack on.\u201d3 Lik"] [16.78372573852539, 10.22171688079834, " \n2 Interview with city administrator, August 30, 2018. \n3 HMST interview, June 25, 2018. \n4 HMST interview, June 25, 2018. \n5 Interview with Santa Monica Police Depa rtment representatives, June 27, 2018. \n6 HMST interview, June 25, 2018. 7 Client g"] [16.800893783569336, 10.218931198120117, " working with or responding to calls involving \nhomeless individuals. \nClients of the HMST say that going beyond trad itional case management has contributed to \nthe team\u2019s success but has also built high expe ctations. Many clients rely on the team"] [16.825057983398438, 10.192710876464844, "12 months following. We received Santa Monica \nPolice Department (SMPD) encounter data cove ring both the pre-period and post-period for the \nclients and comparison groups. The HMST clients had a much higher average number of police \nencounters (22.1"] [16.818185806274414, 10.19717025756836, " Experienced Fewer Encounters with First Responders and Emergency \nDepartments Than Those in Comparable Ho meless Population 6 to 18 Months After \nEngagement \nTable 2 summarizes the change in outcomes between the year prior to the HMST and the \nyear "] [17.025968551635742, 10.186439514160156, "isit $1,3254 \nNOTE: The original estimates from Wu & Stevens are in 2014 dollars. We have converted their estimates to 2016 \ndollars. \n1 This is the per-arrest cost. \n2 This is the per-arrest cost plus the cost of one day of jail in a male facilit"] [16.784761428833008, 10.23758602142334, "verag e annual spending of \n$500,000. When we sum the total savings per client in the first 12 m onths and in months 6 to 18, \nwe estimate annual savings of $103,000 in the fi rst year and $259,000 between months 6 and 18. \nThis represents an offset "] [16.806175231933594, 10.226458549499512, "erve, such \nas other factors that may be changing during th e same time period or random fluctuation in \nencounter rates. We do have police department encounter data for a comparison population of chronically homeless individuals, but the comparison "] [16.800493240356445, 10.212058067321777, "ck outcomes beyond those within the na rrow focus of this evaluation. Our small \nsample size limited our ability to conduct more rigorous statistical analyses of outcomes \nas well as our ability to tell a more comple te story of client experience. E"] [16.796464920043945, 10.221819877624512, " contribute to the primary progr am goals that motivate the intervention. \nFor the HMST, the major inputs are the select ion of the cohort that ensures the highest \nutilizers are being served; the human, logistical, and financia l resources that mak"] [16.790851593017578, 10.204535484313965, "nesses \n- Ways to Improve \nDevelopment of Individual Treatment Plans How do you know HMST to enroll? (if familiar) \n- Strengths - Weaknesses \n- Ways to Improve \nEvaluation of Clients and \nProvision of Services How do you know HMST to evaluate servic"] [16.798173904418945, 10.21363639831543, "zing themes included how the HMST works, the visibility of the intervention, the \neffectiveness of the intervention, and recommen dations. In addition to key themes, we noted \nrecommendations by the category of interviewee (e.g., staff member, client"] [16.80318832397461, 10.191169738769531, "to use name, middle name, a nd date of birth to match records. The SMFD \ndata were in an electronic fo rmat but required significant mani pulation before they could be \nadded to the database. Table A3 summarizes the data we received. Data from the HM"] [16.867685317993164, 10.145833969116211, "th the pre- and post-peri ods in our evaluation. 26 The patterns in the figures reflect the patterns described in the main text above. There is a \ndecline in encounters over time fo r most of the HMST clients and little change in encounters for \nthe "] [16.771194458007812, 10.244688987731934, "t that there are few clients of the \nHMST. The small sample size prevented us from controlling for additional predictors in our \nmodels, such as individual dem ographics or individual measures of health or behavior. We did \nnot have the statistical p"] [16.68714141845703, 10.24764347076416, "ng return \non investment over time, we are able to capture this aspect of the HMST. 30 References \nCity of Santa Monica, City Council Report from Public He aring of the Annual Review of the \nCity\u2019s Plan for Homeless Services , Santa Monica, Calif.:"] [-3.384598731994629, 3.8996479511260986, "CORPORATION\nDigital Resources for \nSTEM Educators and Recommendations for Cyberlearning Initiatives\nResults from the National Science Foundation \nDigital Library/Distributed Learning Program Evaluation\nTora K. Bikson, Susan G. Straus, Grace Agnew, Ni"] [-3.4023799896240234, 3.8817861080169678, "ernally. Findings were made available to the RAND Corporation researchers who conducted the second and third phases of the evaluation. \nThe Phase 2 evaluation provided a preliminary assessment of the program, based largely on \nexisting information r"] [13.819561958312988, 4.543055534362793, "nment, a division of the \nRAND Corporation dedicated to improving policy- and decisionmaking in a wide range of policy domains, including civil and criminal justice, infrastructure protection and homeland security, transportation and energy policy, a"] [-3.3718979358673096, 3.9115049839019775, ".................................................... xxviii\tAbbreviations ............................................................................................................................. xxix\t\nGlossary ..................................."] [-3.374091386795044, 3.908963918685913, "......................................................................................... . 70 \t\n5. Digital Tools and Services ........................................................................................................ 73\t\nBroad Review o"] [-3.386138916015625, 3.897686004638672, "rship ............................................................................ 154\tAppendix B. Evaluation of the NSDL Technical Platform ........................................................ 155\tAppendix C. Key NSDL Tools and Services ........"] [-3.3993775844573975, 3.885037422180176, ".. 103\tFigure 6.4. Mean Number of URLs by Starting Point and Task ................................................ 104\tFigure 6.5. Total Number of Host URLs by Starting Point and Task ........................................ 105\tFigure 6.6. Distribut"] [-3.3821821212768555, 3.9027302265167236, ". Questions for Search Strategies ................................................................................. 60\tTable 4.16. Search Strategies Supported ...................................................................................... 60\tT"] [-3.386486053466797, 3.898343324661255, "rocesses, and Outputs Contributing to Success .............................. 141\tTable A.1. Timeline of the NSDL Leadership Projects .............................................................. 154\tTable B.1. Navica OSMM Categories ................"] [-3.3997035026550293, 3.897144317626953, "gineering, and mathematics (STEM) education at all levels\u201d (NSF, 2010). By default, when we use the term NSDL in this report, we are referring to the program. The NSDL portal refers specifically to the website NSDL.org, which is a starting point for "] [-3.3820443153381348, 3.904209613800049, "uture or similar enterprises. Lessons learned about the sustainability of digital initiatives for STEM education are relevant to a range of stakeholders, including NSF, the broader NSDL community of researchers and developers, \nxiii \n STEM educators,"] [-3.350492477416992, 3.9341812133789062, "development and application of a framework for evaluating the health and sustainability of digital initiatives, a review of tools and services funded through the NSDL program, usability studies, and case studies of three full instantiations of the NS"] [-3.3127124309539795, 3.971526622772217, "es the service, and the customer, who often funds or pays for it; small enterprises often focus their attention on the client when the customer is more critical to their success (Rothschild, 2012). Communication with the target audience can be facili"] [-3.340254306793213, 3.9446749687194824, "ent institution to document the project\u2019s contribution to advancing the parent institution\u2019s mission. Another sustainability strategy is to look for natural alignments of the initiative across departments in the institution, such as the library, depa"] [-3.3572816848754883, 3.927464485168457, "d to enable users to display, \ncopy, download, or modify resources, as well as whether this information has been conveyed clearly. Ensuring an effective rights platform involves not only acknowledging and documenting the copyright of site content, di"] [-3.359663248062134, 3.925475835800171, "e, could be viewed as sustainability strengths for NSDL. However, improvements were needed in integrated security beyond basic user identification and password protection and in support for users in terms of training and personalized services. \nThe N"] [-3.388131856918335, 3.895545482635498, "a few key tools and services for further analysis. It should be noted that our analysis of NSDL services was limited; therefore, many of the conclusions discussed here should be considered tentative. \nWe found a diverse range of themes in the techno"] [-3.3956139087677, 3.8882415294647217, "earch service in comparison with a general search engine (Google) when seeking representative STEM content. In the second, we designed a usability experiment with preservice teachers and library science students to assess the relative effectiveness a"] [-3.4342103004455566, 3.848959445953369, "ess, is likely to have a positive effect on the uptake of NSDL. Adding graphical displays to NSDL may also influence use of search results. \nLessons from Case Studies \nWe evaluated three full instantiations of the NSDL logic model using a replicated"] [-3.4739298820495605, 3.8076746463775635, "vice or preservice \nscience teachers). \nAll three cases show ed evidence of success. In all cases, teachers were enthusiastic about \nthe benefits of access to vetted, digital resources that are aligned with standards. They report ed \nthat the resourc"] [-3.38086199760437, 3.903338670730591, " and persistent user-developer communities and partners. The communities and partners promote sustainability through their demand for resources and services and through the social capital they generate as they contribute back to the digital initiativ"] [-3.378323554992676, 3.906351327896118, " resources by vetting collections; on the other hand, this strategy excluded a good deal of dynamic and interesting content on the w eb, such as YouTube channels, Twitter feeds from \nprominent scientists, and open-source online textbooks. Likewise, w"] [-3.3663673400878906, 3.918187141418457, " and innovate. In later stages, projects that have produced promising results and have designed plans for sustainability can be funded under contract or cooperative agreement to implement such plans and transition their products to other sponsors. Li"] [-3.4266319274902344, 3.857545852661133, "rs) \nand students to evaluate program goals, NSF opted not to seek approval for data collection as \nrequired by the Paperwork Reduction Act of 1995 (Public Law 104-13), which mandates approval for systematic data collection from ten or more persons u"] [-3.3795111179351807, 3.905748128890991, "ey themes and topics in these sources of secondary data. \n\u2022 Finally, another critical recommendation is that cyberlearning initiatives, particularly \nmultiyear, collaborative initiatives such as NSDL, need a much greater focus on \nsustainability from"] [-3.3859503269195557, 3.898949146270752, " the Phase 1 evaluation of National Science Digital Library/Distributed Learning at GOH in 2008. He subsequently served as a consultant to GOH for the Phase 2 evaluation and as a consultant to GOH and RAND for the Phase 3 evaluation. His principal ef"] [-3.3727684020996094, 3.911646842956543, "dvisory Board \nTD-ESC Teacher Domain Educational Standards Correlation \nTNS Technical Network Services \nUCAR University Center for Atmospheric Research \nUNESCO United Nations Educational, Scientific and Cultural Organization \nURL uniform resource "] [-3.391104221343994, 3.8966128826141357, "vices or tools, such as search \ncapabilities, website authoring, and blogging applications, to support users, collection providers, and the Core Integration project to enhance the usability, usefulness, and value of the digital library \nTargeted Rese"] [-3.386733055114746, 3.9019408226013184, "ive evaluation of NSDL, based on the assumption that the program would continue for several years. However, because the program was discontinued, NSF requested a shift in focus of \n \n1 As noted in Bikson"] [-3.4188249111175537, 3.866999387741089, "brant community of developers and users who can create innovative content and tools and improve them on an ongoing basis. \nThe results of the Phase 3 evaluation of NSDL are intended to benefit the Directorate of \nEducation and Human Resources within"] [-3.4059290885925293, 3.877861976623535, "y funded contracts; NSF opted not to seek such approval, which greatly limited the extent and nature of primary data that we could collect to address program outcomes and impacts. The evaluation team also was not provided with annual progress reports"] [-3.379258871078491, 3.913217306137085, "ions sought to develop, organize, and manage sets of digital content related to STEM learning within a coherent theme (e.g., subject area or grade level) (this track was discontinued in 2004). \n\u2022 Pathways, which replaced the Collections track in 2004"] [-3.357956886291504, 3.927912473678589, " collaboration and no common elements of look and feel across pathways. These findings suggest that NSDL.org did not appear to be substantially greater than the sum of its parts. \nEvidence of User Activities to Find and Access Resources \nThe NSDL po"] [-3.371863603591919, 3.9118192195892334, "ecause the NSDL portal and pathways are tightly associated with the collections they represent, we assess ed them jointly. NSDL.org and pathways are expected to \nhelp users find their way to appropriate collections and to locate resources of interest"] [-3.3879339694976807, 3.8960700035095215, " regarding the state of health of the collections. Therefore, in Phase 3, we focused more narrowly on dimensions of collections noted in the Phase 2 evaluation related to authoritativeness (e.g., evidence of peer review and professional oversight), c"] [-3.410677194595337, 3.875661849975586, "ter Six ), and case \nstudies (Chapter Seven). Chapter Eight summarizes our results and presents recommendations. \nThe chapters are not necessarily stand-alone\u2014i.e., understanding the content of some of the \nchapters requires a general understanding "] [-3.411012649536133, 3.875650644302368, "gital content (Griffin, 1998; Zia, 2008). DLI ran from 1994 through 1998; based on its impressive achievements\u2014which included the original development of Google\u2019s search technology\u2014DLI -2 began in the spring of 1998 \n(Griffin, 2005). DLI-2 enjoyed su"] [-3.379160165786743, 3.905463695526123, "geted Research. (Note that we use the term stage to refer to periods of development of the NSDL program, whereas we use the term phase to refer to the evaluation of the NSDL program.) \nTable 2.1. NSDL Program Tracks , Stage 1 (2000\u2013 2003) \nName Des"] [-3.376587390899658, 3.915931463241577, "s a basic metadata repository, and collections were intended to aggregate a very large number of online resources (Howe et al., 2011). \nTable 2.2. New NSDL Program Tracks , Stage 2 (2004\u2013 2008) \nName Description and Relationshi ps \nPathways Pathwa"] [-3.376491069793701, 3.908919334411621, "program (see Table 2.3 for details). \n \n 16 Table 2.3. NSDL Pathways Projects \nFYs Funded \nPathway Name URL Description Pathways I Pathways II \n2004\u2013 2007 2008\u2013 2011 NSDL Applied Math and Science: Community College \n(AMSER) amser.org All dis"] [-3.395482301712036, 3.8948655128479004, "o -cost extensions or rece ived supplementary support. \n18 As these changes were taking place within the Services and Pathways tracks, the CI project \nwas overhauling the technical infrastructure of NSDL.org in ways that would support the needs \nof"] [-3.378255605697632, 3.9065165519714355, "Similarly, the Pathways II grants were much smaller than the original awards and required the projects to implement a sustainability plan. The final award to UCAR in 2011 (see Table A.1) was intended to support the reorganization and business plannin"] [-3.377986431121826, 3.9037563800811768, "ding levels rather than \nproject counts, as shown in Figure 2.2. In comparison to Collections, far fewer Pathway projects were funded, although the level of funding for Pathways projects by the end of the program (approximately $43.4M) approached tha"] [-3.3785560131073, 3.9069883823394775, " NSDL program solicitation thus influenced the projects that \nwere supported\u23afbut the changes took many years to substantially affect the program\u2019s portfolio \nand transform the NSDL community. \n \n0 10 20 30 40 50 60 70 80 \n00 01 02 03 04 05 06 07 08 0"] [-3.3528048992156982, 3.9322292804718018, "op a framework to delineate the elements of sustainability for digital initiatives that develop collections or curate collections assembled from other sources. In this chapter, we review and synthesize the relevant literature to develop a comprehensi"] [-3.338129997253418, 3.9466896057128906, "s must be able to attract customers in a competitive marketplace where they have many options, even in the nonprofit space. \nFinally, we have included findings from the learning object repository and open educational \nresources (OER) literatures. OE"] [-3.302198886871338, 3.983455181121826, " and the organizations that manage them, we will discuss search services that\nare specific to the collections, since these affect the usability, and hence the sustainability, of the collections. \nHowever, the broader range of digital library tools an"] [-3.3506977558135986, 3.934504985809326, "lection contributors, and parent organizations, who have varied interests in the collection and its success. However, a more nuanced view of the organization\u2019s audience is critical when considering the sustainability of a digital collection initiativ"] [-3.3565282821655273, 3.928884506225586, "we et al., 2011, p. 1), and \u201cNSDL\u2019s ability innovate and achieve educational impact is depend[e]nt upon a diverse ecosystem of large and small entities whose interleaved efforts produce, consume, process, aggregate, reorganize, embellish and tinker w"] [-3.3799240589141846, 3.904536247253418, "ng success. \nAn initiative that functions in this way has come to be known in the literature as a community \nof practice. Etienne and Beverly Wenger-Trayner defined a community of practice as \u201cpeople who engage in a process of collective learning in"] [-3.3141655921936035, 3.970615863800049, "ders, and users. The idea that the \u201cuser knows best\u201d also may not work well with emerging technologies, such as digital libraries, where users may not conceive of ways that technology can dramatically improve and transform their work processes. \nAcc"] [-3.328366279602051, 3.9566328525543213, " development policy and safeguards for protecting copyright of resources (particularly for repositories that encourage user contributions) are other important policies that are relevant for accountability to the audience and are related to the usabil"] [-3.3037943840026855, 3.9795589447021484, "ntified user needs. Different expectations for technical infrastructure among developers and users can pose a significant risk to the sustainability of grant-funded projects. Grants are usually awarded for innovative, groundbreaking technologies, whe"] [-3.320535182952881, 3.9638845920562744, "ices. Webster (1992) described the focus of marketing as relationship management. Madhusudhan (2008) echoed this view and delineated a number of marketing activities, including customer relationships, branding and corporate identity, marketing commun"] [-3.3253109455108643, 3.959667682647705, "profit\torganizations.\tOngoing\treview\tof\tthe\tstrategic\tplan\tis\trequired\tto\tensure\tthat\tit\tis\tflexible\tto\tchanging\tcircumstances.\tThe\torganization \u2019s\tstakeholders\tand\t\naudience\tshould\tbe\tencouraged\tto\tprovide\tongoing\tfeedback\tabout\tthe\tstrategic\tplan\ta"] [-3.313082456588745, 3.9717464447021484, "-defined audience, strong leadership, and measurable goals, it is difficult, if \nnot impossible, to obtain funding for digital initiatives. Even if projects demonstrate these attributes of sustainability, funding to sustain digital collection initiat"] [-3.339841842651367, 3.9433538913726807, "zed. Rothschild (2012) offered a similar approach in which organizations develop innovative resources that can be sold for profit, supporting the nonprofit arm of the enterprise. Minnesota Public Radio, for example, has many successful product spin-o"] [-3.32739520072937, 3.9577226638793945, "es for cost-savings and factoring them into a business plan, however, can be complex (Bishoff and Allen, 2004). \nCollections \nWe end our sustainability literature review with a discussion of the health of collections. A \ngrowing body of literature ("] [-3.3376691341400146, 3.947697639465332, "es that do not support the mission, do not conform to collection scope, or are not intended for the primary and secondary audiences can often be eliminated. However, elimination can be interpreted broadly to mean finding a new home for the resources,"] [-3.3505477905273438, 3.934260845184326, "le for an extended time? Although all usability factors are important, impact is \nthe primary criterion for weeding resources. Resources that can demonstrate high impact will help the portal be competitive for ongoing funding and stakeholder support,"] [-3.3524365425109863, 3.9329757690429688, "building trust in the repository by its user base. However, an \nessential attribute of usability is responsiveness to a user need. In the e-learning space, usability requires resources to be appropriate for the intended learning task (Ardito et al., "] [-3.360031843185425, 3.9250617027282715, "ver, assessing quality in a federated metadata repository, such as the NSDL portal, has an added layer of complexity. In their study of metadata in federated repositories, Shreeves et al. (2005) noted that metadata may be of high quality within a loc"] [-3.34889554977417, 3.9422664642333984, "el. Creators of resources own the rights to the \nfurther exploitation and use of the works of their creation, unless they transfer those rights to another person or organization. Copyright confers the right to control use of the resource, such as cop"] [-3.352229118347168, 3.9331185817718506, "sources, and metadata but also documenting the licensing \nthat enables permitted uses of the resource by the audience. A sustainable repository will invest considerable time and effort in a rights management strategy that enables the fullest, \n43 b"] [-3.344102621078491, 3.941110134124756, "ous chapter, we reviewed the sustainability literatures on digital collections, \nlearning object repositories, and nonprofit businesses to develop a general model for assessing \nthe health and sustainability of digital initiatives (see Figure 3.1). T"] [-3.3595688343048096, 3.925734281539917, "ther ways to assess attributes of the model. \nTable 4. 1. Sustainability Model Concepts and Attributes for Digital Library Initiatives \nAudience Organization Collections \n\u2022 Identification \n\u2212 Mission, purpose, and value \nproposition \n\u2212 Clients an"] [-3.3457467555999756, 3.939894914627075, " services of the portal, since these \nshould be aligned to the needs of the audience. Prominently advertising the identified audience \nalso tells potential users that the portal has collections and services suited to their particular needs. Questions"] [-3.3447208404541016, 3.940845012664795, "an help you engage student interest, shorten lesson preparation time, provide concept updates, and develop curricula that are in line with national standards for content, use of animals and humans, and student safety.\u201d \nThe NSDL portal and all the p"] [-3.344511032104492, 3.9412598609924316, " \nResource organization Does the site provide private workspaces, where users can organize and \nsave resources in personal folders and share resources with others? \nAudience participation Does the site solicit or encourage participation through s"] [-3.351034641265869, 3.934180974960327, "igned and implemented separately from the primary portal, such as the Middle School Portal, SMART (Science and Mathematics Accessible Resource Tool), which provides resources created by students for other students that are separate from the Middle Sc"] [-3.3567581176757812, 3.928711414337158, "data consist of \u201cdynamic information about digital learning objects that is generated as they are used, reused, adapted, contextualized, favorited, tweeted, retweeted, shared, and all the other social media style ways in which educational users inter"] [-3.3417513370513916, 3.9437389373779297, "ent been conducted, as indicated by pop -up surveys \nwhen the portal or pathway site was visited, or information about staff dedicated \nto evaluation of the portal? \nExternal assessment Has an external assessment been conducted by an independent g"] [-3.3492276668548584, 3.9362335205078125, " pathways have made progress in identifying target \naudiences, although there are opportunities for improvement: \n\u2022 While NSDL.org and the pathways identify their audiences, in many cases, the audience \nis very broad, such as K\u201312 or K\u2013gray, and we f"] [-3.318208932876587, 3.96662974357605, "ithin digital initiatives. This research could demonstrate how paradata influence or reflect user workflows and could validate the usefulness of different types of paradata to support teachers\u2019 decisions about which resources to select and use. \nWit"] [-3.311131238937378, 3.973600149154663, " used several measures to assess evidence of sustainable organizations on projects\u2019 \nwebsites. In particular, we looked for the staffing roles (described in Chapter Three), as shown in Table 4.9. \nTable 4. 9. Questions for Leadership and Strategic St"] [-3.3427929878234863, 3.942200183868408, " was limited information we could obtain about other aspects of organization, such as the \nrole of the parent organization and opportunities for alignment of the initiative across departments in the parent institution. Likewise, without access to the"] [-3.315659284591675, 3.9697554111480713, "e educational outreach missions of their parent \ninstitutions. One example is SMILE, which is a portal for informal education, reflecting the key mission of its lead organization, the University of California at Berkeley\u2019s Lawrence Hall of Science an"] [-3.338172435760498, 3.9471540451049805, "keholder confidence in the sustainability of the initiative. If not, and if the projects seek to become sustainable (either as independent start-ups or in coordination with their host institutions), our literature review provides guidance about how t"] [-3.3216168880462646, 3.963850736618042, "s in the collection been selected by a peer -review process \nor other professional oversight , with selection (accessioning) according to \na documented process and removal (deaccessioning) when they are no \nlonger viable? \nAvailability (or attrition"] [-3.369105815887451, 3.9161064624786377, "g that resources were available for ten metadata records in each pathway. For this analysis, we conducted ten portal-appropriate searches and selected the first resource appearing in the results list. As Table 4.14 demonstrates, the low attrition rat"] [-3.3986785411834717, 3.8859448432922363, "ilability was similar across both assessment periods . \nTable 4.1 6. Search Strategies Supported \n Number of \nSimple Search es Number of \nAdvanced Search es Number of \nBrows ing Options \nNSDL .org Phase 2 1 1 1 \nNSDL .org Phase 3 1 1 1 \nPathways"] [-3.3450586795806885, 3.940277099609375, " educator workflows. NSDL has made these advances largely through the development of the Learning Activity Readiness (LAR) metadata schema (see box). The NSDL rubric for assessing metadata for LAR compliance includes the following elements: title, UR"] [-3.34708309173584, 3.9381752014160156, "a tional \nstandards? \n \nWe examined ten metadata records from each pathway and these same 180 records in NSDL \n(using the same records assessed for availability described earlier). We rated each of these criteria (accuracy, completeness, and consiste"] [-3.3634254932403564, 3.9219295978546143, "e value of NSDL as a one-stop shop. In particular, NSDL often provides composite records consisting of reviews and suggestions for use from annotation metadata, along with aggregated use from paradata, such as number of views and comments. This is on"] [-3.350461959838867, 3.9350767135620117, " ChemEdDL (Chemical Education Digital Library) resources that are not available at the ChemEdDL portal. \n \n67 \u2022 The NSDL portal leaders, working in conjunction with several pathways partners, have \ncompiled a growing collection of math Common Core r"] [-3.352372646331787, 3.9329655170440674, "ce for users about the rights associated with a resource (copyright metadata) and the uses they are permitted to make of a resource (permitted-use metadata). \nTable 4.2 2. Rights and Permitted -Use Policies and Metadata \n Copyright and \nUse Polic i"] [-3.3499062061309814, 3.9357049465179443, " provide accurate and complete metadata that are consistent across records. Perhaps the most-important metadata improvements, however, consist of greatly enriched descriptions of resources, such as the alignment of NSDL materials to educational stand"] [-3.342784881591797, 3.9422152042388916, "ortal, presumably merely a gateway to the collections of pathways and the third-party resources selected by the NSDL RC, has a significant investment in its science literacy maps, professional development resources, and the policy and guidelines reso"] [-3.3591206073760986, 3.930098056793213, "le NSDL and most portals have an identified \naudience, the audience identification is generally very broad. Although there is considerable improvement in metadata and metadata displays, there is no evidence that these changes are being made in collab"] [-3.3684558868408203, 3.915250301361084, "el as our organizing perspective. Tools and services are important attributes of sustainability because they support use of digital collections, and NSDL projects were expected to generate an array of diverse tools and services to discover, organize,"] [-3.372859239578247, 3.908208131790161, "ysis of the development of and user communities associated with them (selection criteria for the key tools and services are described below). We asked two sets of questions related to the logic model, the first focusing on the products and outputs of"] [-3.361086845397949, 3.911134719848633, "lection Services - - - - 0 3 0 2 1 2 4 12 \nIntegrated Services - - - - 0 0 1 3 0 0 0 4 \nUsage Development - - - - 4 4 1 1 0 7 5 22 \nOther 9 13 12 11 11 4 2 4 3 6 5 80 \nTOTAL 9 13 12 11 15 11 4 10 4 15 14 118 \nNOTE: \u201c Other \u201d refers to all Service"] [-3.398686647415161, 3.8863749504089355, " simulations. \nStandardConnection \u2014\nMapping NSDL Educational \nObjects to Content Standards (0121543) The investigators are developing a natural language processing tool \n(\u201cStandardConnection \u201d) for the automatic assignment of content standards and "] [-3.3778111934661865, 3.905083417892456, "itutional partners. \nPedagogic Services for \nDigital Libraries (0532768) Building on a successful example, the Starting Point Digital Library connects pedagogic \nmaterials to teaching materials in digital library collections. It is helping teachers"] [-3.3596460819244385, 3.8901100158691406, " courses. \nOur review of abstracts also showed that some projects proposed redundant services. \nFor example, ten distinct award abstracts from 2000 to 2010 mentioned commenting tools, while more than 20 abstracts mentioned annotating resources. \nAlt"] [-3.3722422122955322, 3.909363269805908, "evidence of whether the projects were completed, \npartially completed, not completed, or of unknown completion status. Measurement of the relationship of services to NSDL captured two features of NSDL collaborative development: We classified projects"] [-3.3941402435302734, 3.8849198818206787, "research. Finally, we found no evidence of tool or service development, or research products, for the remaining four projects. \nRelationship of Project s to NSDL Program \nThe columns in Table 5.3 show the sample of 22 services in terms of their rel"] [-3.391052484512329, 3.8918559551239014, "originally proposed to develop. \n\u2022 Other projects apparently never committed to developing NSDL-ready services, although their products may have led to new ideas, new projects, or new services, some of which stayed within the NSDL community and some"] [-3.318800449371338, 3.9581830501556396, "ecific instantiation of the latter. \n \nAlthough the services differed substantially in their purposes, user communities, and \nlongevity, we established a standard template to capture the common features of the services that \nworked relatively well. "] [-3.3866467475891113, 3.8952369689941406, "xpert Voices, for example, had many thousands of page views per month and hundreds of persistent users. IA has more than 7,500 registered users and has produced more than 17,000 projects. Nevertheless, of the services discussed here, only the Strand "] [-3.367250919342041, 3.920943260192871, "ed by groups outside the NSDL.org team (Zia, 2008). The case of IA demonstrates that this was indeed possible. \nSeveral reasons for the declines in activity of the NSDL Services projects are apparent. \nFirst, even popular services showed a quick dec"] [-3.3748042583465576, 3.9067296981811523, "egration may become increasingly important. For example, the NSDL program\u2019s plan to reposition itself for the future (Howe et al., 2011) \ndiscussed the STEM Exchange, which is a system that enables education practitioners to integrate paradata and i"] [-3.378891944885254, 3.9093403816223145, "on iTunes project also expanded the idea of integration in an innovative way, by \nsuccessfully integrating NSDL content in a broadly used platform outside the NSDL \ninfrastructure. Given the range of widespread platforms, such as Facebook and Twitter"] [-3.3906285762786865, 3.892969846725464, "to touch on several of the broad themes related \nto services that were discussed earlier. One relates to the trade-offs inherent in trying to control the digital resources and services being developed by projects, to ensure that they reuse materials "] [-3.3899452686309814, 3.8940188884735107, "scientific accuracy, bias, advertising, design and usability, and other aspects of digital libraries. In McCown, Bollen, and Nelson (2005), public school teachers evaluated 38 search terms and search results from Google and NSDL, but participants wer"] [-3.382159471511841, 3.9017250537872314, "s trust in the resource and is an increasingly important measure of information retrieval effectiveness (Abdul-Rahman and Hailes, 1999; Karlgren, 2008; Ramachandran et al., 2009). The trustworthiness of the resource is particularly important on the w"] [-3.388070821762085, 3.8958232402801514, "earch functionality in the current NSDL portal are now aligned with these \nrecommendations. However, it is not evident from the description of relevance ranking provided to searchers (NSDL , n.d.-b) that the presence of filtering-element metadata cor"] [-3.3883378505706787, 3.8959248065948486, "hool educational level = \nhigh school; \nresource type = data \nset, instructional \nmaterial \n4 Classroom activity to \ndemonstrate pattern recognition in middle school mathematics Topic pattern recognition \nmathematics classroom activity middle sc"] [-3.391575574874878, 3.8923075199127197, "., conditions 1\u20135). We applied appropriate filters to the first five results from each of these five search conditions and compared ratings of cumulative gain and discounted cumulative gain for the results from key word\u2013only searches in NSDL and Goog"] [-3.412052631378174, 3.872274875640869, " the eight searches was 124 for NSDL and 203 for Google. The total score for NSDL was 39 percent lower than the score from Google, showing that NSDL produced much less relevant results. Similarly, using a different approach for ranking relevance, McC"] [-3.395193338394165, 3.8888633251190186, "ers are considered together, the NSDL relevance \nrankings are closer to those of Google. Table 6.5 shows discounted cumulative gain scores for results from the NSDL filtered search and Google. Results show much closer relevance scores. When filters a"] [-3.39575457572937, 3.8887360095977783, " step. \n \n97 Figure 6.1. Google Result Set for Animal Camouflage Photograph \n \nSOURCE: Screenshot of Google search results for \u201canimal camouflage photograph,\u201d 2013. \n \n98 Figure 6.2. NSDL Result Set for Animal Camouflage Photograph \n \nSOURCE: "] [-3.398113250732422, 3.8860995769500732, " Different sites led participants to different resources\u2014e.g., resources reported by DLESE and MSP2 users were only sometimes in the set of resources reported by NSDL users, \nand resources found by DLESE, MSP2, and NSDL users were only sometimes in t"] [-3.4035098552703857, 3.8807332515716553, "and beyond. Second, the development of an improved middle school pathway presents an opportunity to explore whether there are usability differences as a function of grade-level orientation versus subject-matter domain, in comparison to generic starti"] [-3.3986194133758545, 3.8850581645965576, " to complete. The criteria also ensured that we could compare grade-oriented pathways (specifically, MSP2, which focuses on all STEM topics taught in middle school), subject-oriented pathways (which vary based on the subject chosen), and NSDL.org. \n"] [-3.3993172645568848, 3.8837313652038574, "tor degrees of freedom varied because of a \nsmall number of missing responses.17 Results are shown in Figures 6.3\u20136.8. \nParticipants had an easier time finding resources for some tasks than others. Results \nshow a statistically significant effect for"] [-3.3953068256378174, 3.8889694213867188, "ing points affected the diversity of host websites.23 \nGiven that there were few effects for domain, we combined results across earth sciences and \nphysical sciences for our remaining analyses. \nGoogle led to the widest range of results, followed by"] [-3.401135206222534, 3.883272409439087, " URLs, and the number of pages viewed per site was generally less than for the text-plus-image task. Findings differed slightly in that participants in the NSDL starting point had the smallest maximum page views (nine) compared with the other startin"] [-3.382011890411377, 3.9024205207824707, "al in Table 6.8 show that NSDL users were more likely to find resources also found by pathway starters than the reverse, suggesting that pathway sites are more discoverable through NSDL than the reverse. Likewise, the differences between common resou"] [-3.390397310256958, 3.89418363571167, "this is the case for some of the sites that were selected most frequently by Google users (e.g., youtube.com and quizlet.com). In addition, when users started their searches with Google, results did not include an NSDL-affiliated site until the 11th "] [-3.4087939262390137, 3.8741822242736816, "ngs of authoritativeness did, F(3,91) = 5.15, p < 0.01. \nA contrast showed substantially lower ratings of authoritativeness for resources in .com domains (M = 1.71 out of 3.0) compared with those in .edu, .org, and .gov domains (means ranged from 2.5"] [-3.394435405731201, 3.889103889465332, "nt, but relevance ratings remained lower than those from Google. In addition, NSDL does not take full advantage of the metadata to rank the relevance of search results. It is common in digital library initiatives to rank information provided in metad"] [-3.427715539932251, 3.859433889389038, "ture research should systematically review the content of the resources that users find. It also is critical to obtain feedback from users about the search experience. As noted, federal regulations on research limited our ability to investigate users"] [-3.4513635635375977, 3.8324546813964844, "t cases reflecting different models of implementation. Our intent was to find field settings where lessons could be learned about successful implementation of cyberlearning approaches to advance STEM education. \nWe evaluated these full instantiations"] [-3.4703238010406494, 3.811795711517334, "ajors to become K\u201312 math and science teachers \nand by increasing the number of strong STEM K\u201312 teachers in high-need school \ndistricts. \n\u2022 iCPALMS aims to create online tools and services to enable K\u201312 math and science teachers to integrate high-q"] [-3.4673421382904053, 3.814098596572876, " of varied academic ability levels in mastering a science field. \n\u2022 Support new standards-based curricula effectively for earth science instruction in DPS. \nRAND\u2019s prior formative evaluation study included a visit to the CCS and DPS site in a \nprelim"] [-3.465749502182007, 3.8157758712768555, "guides. Curriculum units were framed in terms of standards, key concepts, and learning goals to be achieved. What was lacking were high-quality interactive and tailorable resources\u2014the sorts of materials likely to engage diverse students with differi"] [-3.4653940200805664, 3.816200017929077, " However, some aspects of the organizational context raised concerns among the districts. \n119 First, although acquisition and use of CCS was free, which likely promoted adoption, a \nnonnegligible amount of teacher time would be expended in develop"] [-3.4373366832733154, 3.8459866046905518, "by the National Center for Atmospheric Research at UCAR and well-known to the technical team. The follow-on effort examined whether the system could readily accommodate a different science domain; the choice of physical sciences was driven in part by"] [-3.4576709270477295, 3.824172258377075, "space with their own contributions. By the start of the following academic year (2009\u20132010), the system was judged ready for rollout; all earth science teachers in DPS received four hours of training led by the CCS principal investigators and TAB mem"] [-3.4626994132995605, 3.818962574005127, "districts we visited, a key point is that the CCS interface is \nintuitive, as is navigation. A second major consideration is that the resources CCS presents are selected from trusted providers of high-quality materials and have been vetted, so teache"] [-3.4646265506744385, 3.816984176635742, "utility of the resource ratings. \nOutcomes \nEffects on Teaching and Learning \nTeacher uptake of CCS is widespread and voluntary in earth science instruction. CCS \nresearchers estimated that across the six adopting districts, about a third of them ar"] [-3.463547468185425, 3.818686008453369, "l districts in particular. \nThe Noyce program was first authorized in 2002 through the NSF Authorization Act and \nthen reauthorized through America COMPETES in 2007 and 2010. The program provides funds \nto universities for student instruction, academ"] [-3.4578897953033447, 3.8241238594055176, "enjoy a rich virtual community and to access high-quality teaching resources from their classrooms, thus improving their retention and enhancing their professional development opportunities. \nNoyce scholars also play a key role in developing and diss"] [-3.4422593116760254, 3.8403773307800293, "olars see [digital \nresources] more frequently. Some are virtual, others are in -person day or multi -\nday workshops on how to use different resources. Those were very popular. And \nwhen presenter is partnered with Noyce alum, that makes a big differ"] [-3.4598281383514404, 3.8224847316741943, "imilar search engines\u2014reflecting views about resource authoritativeness and usability. One participant noted, for example: \nI do a lot of \u201cFrankenstein \u201d stuff\u2014sometimes I take individual photos, \nsometimes labs, and piece it together. \nI \u201cFrankenst"] [-3.4872965812683105, 3.7945539951324463, "folios, to information about effective classroom-management strategies, and to Noyce Voices, which is a Noyce-tailored portal to MERLOT Voices that helps Noyce scholars remain in contact with each other. Participants in our discussions noted that the"] [-3.465646266937256, 3.8162310123443604, "ask [the] master teacher, \u201cDo you think this would work? What would be \npitfalls? How can I make it better? \u201d \nI was only in Noyce for a semester, but in that semester, I networked with in -\nservice teachers and professors, and I was involved in NS"] [-3.443671941757202, 3.8387434482574463, "bstacles \nto uptake. \nVariations in the Availability and Quality of Technology \nThe technology available in high-need classrooms varies significantly, and many teachers do \nnot have sufficient access to computers and projectors. Firewalls inhibit s"] [-3.4418489933013916, 3.8402087688446045, " exercises that would not otherwise be possible: \nWhen you find videos, you find a way of teaching something you hadn \u2019t really \nrealized. It opens up your vocabulary for things. The way you say it to some kids \nmake s sense, and you have to say it f"] [-3.4677681922912598, 3.8141865730285645, "ese [online] resources. \nThe resources are more critical once we are advanced. We can know how much \ntime the resources require, know if it is appropriate. \nInterviewees reported that digital resources also have positive effects on student \nlearni"] [-3.4898622035980225, 3.791412830352783, "ers. \n\u2022 Establish a collaborative network of users. \n\u2022 Build capacity for long-term sustainability. \nIn brief, CPALMS is a website that provides standards-based, instructional content for users, \nand iCPALMS is a portal that allows users to customize"] [-3.493112087249756, 3.786830186843872, "he development process accounts for the technical capabilities of diverse systems. For example, in many districts, computers in the schools use outdated Internet browsers because other school software is not compatible with browser updates. As a \nres"] [-3.5194501876831055, 3.7618777751922607, "training for early adopters, who would then spread the word among other potential contributors and end users. For example, the management team introduced CPALMS at conferences for district math and science curriculum specialists whose role it is to r"] [-3.4869508743286133, 3.7943902015686035, "of the server were the only complaints that case study participants reported). This problem was resolved by obtaining funding through the Teacher Standards Instructional Tool grant to add servers and update software at the Florida DOE and transfer CP"] [-3.4886772632598877, 3.7926039695739746, "n the case study provided comments that illustrate these benefits: \nIt\u2019s great to know that teachers have a one -stop shop where they can put in the \nbenchmark, find a great aligned activity that \u2019s age appropriate, that \u2019s already \nvetted and ready "] [-3.4948196411132812, 3.7864372730255127, "ther teachers. \nOther Effects \nAlthough iCPALMS was still under development at the time of this case study, and the study \ndid not identify effects on learning other than statements about improved student engagement, \nCPALMS and iCPALMS have demons"] [-3.471038341522217, 3.8107826709747314, "rocess in other districts and for other topical domains (physical science). CCS fostered technology readiness by providing all earth science teachers in DPS with hardware and Internet connectivity prior to rollout, in contrast to MERLOT and Noyce Sch"] [-3.5115480422973633, 3.7696845531463623, " In CPALMS and iCPALMS, the project \ndirector was the primary champion, but a growing community of user-developers also \nserved to stimulate demand for digital resources. \n\u2022 All three cases used participatory design of the system beyond the project\u2019s"] [-3.4098010063171387, 3.8740484714508057, "ces, and community members\u2019 contributions in the form of creating, sharing, and vetting resources, plus support from partners, furthered the development of diverse collections of high-quality STEM instructional resources\u2014thereby fueling additional de"] [-3.407283306121826, 3.879859685897827, "he NSDL portal has also helped to foster communities of developers and users who can share \nideas and resources, tools, and services. \n143 These roles reflect the components of the NSDL logic model and also mirror its dynamic \nprocesses: The NSDL p"] [-3.3884856700897217, 3.896963596343994, "e NSDL logic model. To our knowledge, however, CCS is one of the only NSDL projects that has approached this ideal. In the final chapter, we discuss some of the reasons that this goal has been so challenging for the NSDL program to achieve, and we id"] [-3.402498245239258, 3.8813445568084717, "arch from the top-level page for pathway portals. The NSDL portal may be \n145 able to improve the relevance of search results by capitalizing on existing strengths\u2014i.e., by \nmaking use of its high-quality metadata, connection to educational standard"] [-3.39631986618042, 3.889600992202759, "evelop their tools and services independently of other projects, and thus we did not see as much collaborative reuse and mixing of services as the NSDL logic model might have predicted. \n146 To What Extent Did NSDL Produce a Growing and Vibrant Com"] [-3.3670175075531006, 3.917893886566162, " program ended in FY 2011, and many of the NSDL pathways continue to \noperate. As of December 2014, management of NSDL.org was transferred to the Institute for the Study of Knowledge Management in Education and is available at https://nsdl.oercommons"] [-3.386190891265869, 3.9012911319732666, "pand \ncollections to provide access to innovative content and genres and to present resources in \ncompelling and informative ways (e.g., images rather than text), particularly to maintain relevance to digitally savvy users. This poses a potentially t"] [-3.384565591812134, 3.90520977973938, "t not implemented in NSDL sites. For well-established services, such as faceted search or browsing, it was reasonable that the program would expect funded projects to implement versions that could be integrated quickly into the NSDL platform. However"] [-3.3708651065826416, 3.9144866466522217, "just passive consumers of digital resources, but this will impose additional management and monitoring costs on the library operators\u2014assuming that they want to maintain high levels of quality. \nRecommendations to Address Trade -offs \nSome of the ten"] [-3.3640058040618896, 3.921480655670166, "ch the whole of \nNSDL is greater than the sum of its parts; indeed, many of the project s\u2019 products are highly \ninterdependent. For example, the NSDL portal and pathways are jointly generating composite metadata and paradata; in addition, resources a"] [-3.431549310684204, 3.857349395751953, "cated case studies. At the same time, as we have noted throughout this report, a wider range of research targets and methods is needed for a thorough evaluation of NSDL or other digital initiatives. \nMost important is evaluating impact on student en"] [-3.344111204147339, 3.9410500526428223, "stainability, such as development of strategic plans and funding for sustainability, and how the initiative contributes to the mission of the parent and sponsoring institutions (and vice versa). Data from parent and sponsoring institutions would addr"] [-3.338434934616089, 3.947131872177124, "collection and analysis to a relatively few key projects and results, yielding more-complete information about outcomes, such the diversity of products, gaps, and redundancies in tools and collections and perhaps unexpected new topics of research and"] [-3.363416910171509, 3.921982765197754, "it intends on STEM education for the long term. We examine the major components of the NSDL technical infrastructure and assess them according to standard and emerging rubrics for open-source software applications. The components that are evaluated a"] [-3.378136396408081, 3.9070851802825928, "Collection System) \nand the Java-based Open Access Initiative (jOAI) Protocol for Metadata Harvesting (OAI-PMH) \napplication. \nThe NCS is a reference implementation of the Digital Collection System (DCS). The NCS is \na web-based metadata creation an"] [-3.3758604526519775, 3.9091317653656006, "r) \nassociated with privileges within specific collections. Workflow control at the record level is \nprovided by statuses, with the ability to publish a metadata record in the NSDL Digital Discovery System (DDS) tied to a status indicating readiness "] [-3.382110595703125, 3.902693748474121, "s of the organization evaluating the software. A popular model is the Navica Open Software Maturity Model (OSMM) (OSS Watch, 2010). The OSMM assesses maturity across six categories, with each category weighted according to the need of the organizatio"] [-3.3645787239074707, 3.9202728271484375, "s broadly to a collection of metadata items. OAI-PMH applications may support data provision (responding to requests), harvesting (requesting metadata), or both (Open Archives Initiative, n.d.). The OAI implementation within the NCS, discussed above,"] [-3.364056348800659, 3.9210188388824463, "ty of Illinois at Urbana-Champaign Grainger Engineering Library, n.d.) and the OCLC WorldCat OAIster database (OCLC, n.d.), a union catalog of millions of metadata records harvested via OAI from OAI data providers. \nThe most important role for the jO"] [-3.387944459915161, 3.8965978622436523, "CPALMS 10 9 (90%) \nMatDL 10 10 (100%) \nMathDL 10 6 (60%) \nMathLanding 10 10 (100%) \nMiddle School Portal 10 10 (100%) \nSMILE 10 9 (90%) \nTeacher\u2019s Domain 10 10 (100%) \nTeaching with Data 9 9 (100%) \nTeach the Earth 10 10 (100%) \nTO"] [-3.3542325496673584, 3.9308032989501953, "ipt eye-readable text or JavaScript Object Notation (JSON) format, allowing developers to embed and reuse NSDL resources using a wide range of technologies, such as JavaScript, PHP (Personal Home Page), and JSP (JavaServer Pages) (John Weatherley, pe"] [-3.4164199829101562, 3.868286371231079, " the components, particularly the scheduling of jOAI harvesting and the implementation of the DDS Search API. We evaluated search more extensively in Chapter Six , where we also provide recommendations for improving search \nprecision through the sett"] [-3.42257022857666, 3.861546754837036, "omized Mediawiki. It included NSDL branding and was \nintegrated into the NSDL framework; new pages in the wiki were added to the NSDL repository , \nand plug- ins allowed the wiki editing tool to directly reference and incorporate content from the \nNS"] [-3.404895782470703, 3.8798627853393555, "oted below. The NSDL Science Literacy Map service (http://strandmaps.nsdl.org/) continues to be used, with approximately 3,000 visitors a week between October 1, 2009, and \nSeptember 30, 2012. \nSustainability The future of the Strand Map Service an"] [-3.403202533721924, 3.881375551223755, "DL \nResource Center. Subsequent grants from NSF also offered professional development to teachers and evaluated the effectiveness of those efforts. \nSubsequent \nservices/ tools or \nuses None \n \n168 Table C.5. NSDL on iTunesU \nService/Tool \nName "] [-3.493834972381592, 3.7874317169189453, "ake several modifications to CPALMS; \nadd servers to host \nCPALMS/iCPALMS ; and \nupdate software \nMath an d Science \nPartnerships/Bioscopes 2011 U.S. Department of Education (funded \nthrough the State of Florida) Teachers , along with arts and \nsc"] [-3.4063892364501953, 3.873704195022583, "e used for research purposes only. We will not link your email address \nwith your responses. We will keep all responses confidential and will not retain your email \naddress after the study. \nIf you prefer a hard copy of the survey , along wi th a "] [-3.408935785293579, 3.8747384548187256, "th \t\no Once\t or\ttwice\ta\tterm \t\no Less\toften\t\n\t \t \n174 \t\n7.\tPlease\tcheck\tall\tof\tthe\tways\tthat\tyou\thave\tused\tNSDL. \t\no Find\tinformation\tabout\ta\tSTEM\tsubject\tto\tplan\tor\tupdate\ta\tlesson \t\no Find\tother\tresources\tto\tuse\tfor\tdelivering\ta\tlesson,\tsuch\tas\tvid"] [-3.4267516136169434, 3.855745553970337, "sagree Disagree \nSomewhat Neither \nAgree nor \nDisagree Agree \nSomewhat Agree Strongly \nAgree \n1 2 3 4 5 6 7 \na. are\tcurrent. \t o o o o o o o \nb. are\tcomprehensive. \t o o o o o o o \nc. are\taccurate. \t o o o o o o o \nd. reflect\treal -world\tcontent."] [-3.4373269081115723, 3.844595193862915, "\tschool \u2019s\tnetwork\taccess\t (e.g.,\t\nspeed\tand\treliability )\tsupports\tmy\tuse\t\nof\tNSDL\tresources.\t \to o o o o o o \nj. My\tnetwork\taccess\tat\thome\tsupports\t\nmy\tuse\tof\tNSDL\tresources. \to o o o o o o \n\t \t \n179 12.\tPlease\trate\tthe\t following\tstatements\tabout\t"] [-3.41357159614563, 3.865668773651123, "ee, \u201d\tplease\trate\t\nthese\tdescriptions\tof\tyour\texperience\twith\ttechnology.\t\n \n Strongly \nDisagree Disagree Disagree \nSomewhat Neither \nAgree nor \nDisagree Agree \nSomewhat Agree Strongly \nAgree \n\t 1 2 3 4 5 6 7 \na. If\tI\theard\tabout\ta\tnew\tinformatio"] [-3.375479221343994, 3.909522533416748, "ternational Symposium on Database, Web and Cooperative Systems , \n1999. As of October 17, 2013: \nhttp://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.38.7934 \nAckerman, S. L., K. Tebb, J. C. Stein, B. W. Frazee, G. W. Hendey, L. A. Schmidt, and R"] [-3.371471643447876, 3.9134888648986816, "ce of Creative Tension \nwith Technical Developments,\u201d Bulletin of the IEEE TCDL , 2003. As of January 18, 2013: \nhttp://www.ieee-tcdl.org/Bulletin/v1n1/blandford/blandford.html \nBlue Ribbon Task Force on Sustainable Digital Preservation and Access, S"] [-3.368152379989624, 3.9168765544891357, "n Rules for Evaluating Open Source Software, Collaborative Consulting, 2004. \nDownes, S., \u201cModels for Sustainable Open Educational Resources,\u201d Interdisciplinary Journal of \nKnowledge and Learning Objects, Vol. 3, 2007, pp. 29\u201344. \nDupret, G., \u201cDisc"] [-3.3695178031921387, 3.9153952598571777, "ucation Development Center, Inc.: Waltham, Mass., 2005. \nHarley, D., J. Henke, and D. Nasatir, Use and Users of Digital Resources: A Focus on \nUndergraduate Education in the Humanities and Social Sciences , Berkeley: Center for \nStudies in Higher Ed"] [-3.3677053451538086, 3.9172186851501465, "Karlgren, J., \u201cChanging the Subject\u2014One Way of Measuring Trust in Information,\u201d Workshop \non Novel Methodologies for Evaluation in Information Retrieval, Glasgow, March 30, 2008. \nAs of May 23, 2013: http://soda.swedish-ict.se/2763/ \nKennedy, J., \u201cA "] [-3.370274782180786, 3.914635181427002, "Archives Info, \nVol. 1, No. 3, 2001\u20132002. As of December 19, 2016: http://www.archivesinfo.com/newsletter/Winter2001.pdf \nMargaritopoulos, T., M. Margaritopoulos, I. Mavridis, and A. Manitsaris, \u201cA Conceptual \nFramework for Metadata Quality Assessmen"] [-3.3807601928710938, 3.905143976211548, ". As of January 18, 2013: http://www.tccgrp.com/pdfs/per_brief_tenkeys.pdf \nMultimedia Educational Resource for Learning and Online Teaching, \u201cPartner Communities and \nInstitutional Teaching Commons,\u201d web page, 2009. As of March 6, 2017: http://info."] [-3.3696534633636475, 3.9154458045959473, "ion. \nOCLC, \u201cThe OAIster Database,\u201d web page, n.d. As of October 17, 2013: \nhttp://www.oclc.org/oaister.en.html?urlm=168646 \nOpen Archives Initiative, \u201cOpen Archives Initiative Protocol for Metadata Harvesting, \nInteroperability Through Metadata Harv"] [-3.3705520629882812, 3.914682388305664, "nuary 18, 2013: http://hdl.handle.net/2142/145 \n \n195 Smith, A., Building and Sustaining Digital Collections: Models for Libraries and Museums, \nWashington, D.C.: Council on Library and Information Resources, 2001. As of January 18, \n2013: http://ww"] [-3.3705387115478516, 3.9145190715789795, "009/11/best-practices-for-6-common-user-interface-elements/ \nWebster, F. E., \u201cThe Changing Role of Marketing in the Corporation,\u201d Journal of Marketing, \nVol. 56, 1992, pp. 1\u201317. \nWenger-Trayner, E., and B. Wenger-Trayner, Introduction to Communities"] [-4.934861183166504, 16.235252380371094, "SOCIAL AND ECONOMIC WELL-BEING\nUpdating the Costs of \nCompliance for California\u2019s Hospital Seismic Safety Standards\nAppendix D. Regional Cost Analysis\nBenjamin Lee Preston, Tom LaTourrette, James R. Broyles, R. J. Briggs, \nDavid Catt, Christopher Ne"] [-4.962783336639404, 16.2622013092041, "riteria, we defined analysis regions as individual counties with at least ten \nhospitals and groups of counties containing fewer than ten hospitals each. For county groupings, we used the California economic markets defined by the California Employme"] [-4.933189392089844, 16.232948303222656, "iring structural performance category (SPC) and nonstructural performance category (NPC) upgrades. 3 Table D.2. Regional Seismic Upgrade Costs \nAnalysis Region Hospitals Retrofit \nCost \n($B) Escalated \nCost \n4%/year Demand Surge \nEscalated Cost "] [16.182260513305664, 12.454002380371094, "CORPORATIONAppendix\nThe Welcome Baby Program\nAn Implementation and Outcomes \nEvaluation\nSarah B. Hunter, M. Rebecca Kilburn, Teryn Mattox, Jill S. Cannon, \nTerry Marsh, Melissa Felician, Maya Buenaventura, Lauren Davis, \nMatthew CefaluLimited Print"] [16.169740676879883, 12.47085952758789, "......................................... 34\t\nTable B.2. Other Reviewed Documents ........................................................................................ 43\t\nTable C.1. Fidelity Domain One: Staff Qualifications ......................"] [16.180500030517578, 12.459208488464355, "Back to Sleep ............................................................................................................... 62\t\nTable D.10. Co-Sleeping ................................................................................................"] [16.180038452148438, 12.459027290344238, "was specifically designed by the research team \nfor this project. It was developed based on both a review of the Welcome Baby program materials that outlined the key elements of the program and meetings with F5LA, LABBN, and \nthe Welcome Baby sites a"] [16.18833351135254, 12.450348854064941, " that \nidentifies you, including the audio recording of this interview, at the end of the study. Due to the \nextensive data protection procedures we have in place there is minimal risk associated with participation in this interview. There is no dire"] [16.204328536987305, 12.431968688964844, " recruitment \na. Is there anything about your site or organization that has helped your staff to recruit women postnatally? (e.g., bilingual hospital liaisons) \nb. Is there a system in place to monitor outreach and recruitment activities? If so, 11 "] [16.187829971313477, 12.452377319335938, "erience \nNext, I would like to ask you about training resources and technical assistance \n18. Can you describe your experience with PAC/LAC\u2019s [Perinatal Advisory Council: Leadership, Advocacy, and Consultation\u2019s] workshops and technical assistance? \n"] [16.186229705810547, 12.45140552520752, "Name ___________________ Date ___________________ \n \nParticipant Name: ___________________ Welcome Baby Site ____________________ \nThe purpose of this protocol is to guide the semi-structured interviews with Welcome Baby \nHome Visiting staff (includi"] [16.18759536743164, 12.452628135681152, "ts. \nIf you have any questions or concerns about the study or this interview, you can contact \nSarah Hunter, the Principal Investigator or Jim Tebow from RAND\u2019s Human Subjects Protection Committee. Their contact information is provided in the initia"] [16.185998916625977, 12.455057144165039, "ively? \n12. Provision of service delivery/home visits \na. Is there anything about your site or organization that has helped to ensure that participants received their nurse visit? 16 \n b. Is there anything about your site or organization that has he"] [16.182716369628906, 12.456400871276855, "ain communication challenges? \nStaff Support \nNow I will ask you some questions related to staff support and supervision \n19. Do you receive support from your supervisor? If so: \na. What kind of support do you receive? \na. How often do you receive "] [16.18427085876465, 12.45344066619873, " been enrolled in the Welcome Baby program. \nExperience with Program \nProgram Enrollment \n1. How did you learn about the Welcome Baby Program? (Ask where and when they were approached). \n2. How was your enrollment experience? \n3. Did you have any pr"] [16.188148498535156, 12.451888084411621, "ffsurvey@rand.org. \nPlease enter your 5 -digit survey password. ____________________ \nScreen 2 [ALL] \nFirst 5 LA, has contracted the RAND Corporation, a nonprofit, nonpartisan, research organization, to conduct an \nevaluation of the Welcome Baby p"] [16.187667846679688, 12.44432258605957, "@rand.org. If possible, \nwhen you contact the Committee, please reference Study #2015 -0645. \nPlease indicate whether or not you agr ee to participate in this study. \n______Yes, I agree to participate in this study \n______No, I do not agree to par"] [16.19273567199707, 12.44713306427002, " CDA \n\u25a1 CHES \n\u25a1 CIPSW \n\u25a1 CLC \n\u25a1 CLE \n\u25a1 IBCLC/RLC \n\u25a1 ISW \u25a1 LCSW \n\u25a1 LPN \n\u25a1 LISW \n\u25a1 LMFT \n\u25a1 PHN \n\u25a1 RN \n\u25a1 Other, please specify: _____ ____ \n9. In what language(s) are you able to provide Welcome Baby services? [select all that apply] "] [16.193574905395508, 12.447047233581543, "\nknow the exact date, please enter your best estimate . \n__________ [clickable calendar] \nIf your supervisor has never observed one of your home visits, please leave the date field blank and check \nthe box below. \no My supervisor has never observed"] [16.1951961517334, 12.444995880126953, "\n30. Please indicate your agreement with the following statements using this scale: \n[Strongly Agree; Agree; Neutral; Disagree; Strongly Disagree] \na. I believe that Welcome Baby services help the families I serve. \nb. Welcome Baby program materia"] [16.185993194580078, 12.451847076416016, "enter \no Valley Presbyterian Hospital \no White Memorial Medical Center \nScreen 27 [ALL] \n37. What is your current Welcome Baby job title at ? [select one] \nIf you do not see your exact title listed, please select the standard Welcome "] [16.189056396484375, 12.450545310974121, "is scale: \n[Strongly Agree; Agree; Neutral; Disagree; Strongly Disagree] \na. The Welcome Baby new staff training (also called \u201cCohort Training\u201d) prepared me to deliver \nWelcome Baby as required by my current position. \nb. The regional training ses"] [16.15607261657715, 12.478889465332031, "uding contact lists, protocols, forms, and \nmemoranda of understanding, were gathered from each site and abstracted for relevant information. \nAbstraction content: The research team designed the abstraction form to cover the required \nelements of th"] [16.183019638061523, 12.454974174499512, " \n \n \nTransportation \n \n \n 36 Document Type Referral Directory/Binder Referral Protocols Formal MOU \nChecklist Items \nUp-to-Date \nEnglish \nContact \nInformation \nfor Referral \nType (Y/N) Up-to-Date \nSpanish \nConta"] [16.18955421447754, 12.449668884277344, "to any of these questions. The survey should take about \n10\u201315 minutes. \nIn this next section, please answer some questions about the services you have received from Welcome \nBaby. We are interested in your honest opinions, whether they are positive"] [16.1986026763916, 12.441736221313477, " \u00a8 \u00a8 \n 40 Agree Disagree Not sure \n16. A baby with colic can cry for 20 or 30 minutes at a time, \nno matter how much you try to comfort him (her). \u00a8 \u00a8 \u00a8 \n17. Fathers are naturally clumsy when it comes to taking care \nof babies. \u00a8 \u00a8 \u00a8 \n18. Taking"] [16.181175231933594, 12.458552360534668, "aches, and Parent Coach Supervisors over the course of a client\u2019s engagement with the \nWelcome Baby program. Examples of information recorded in the SFDB are the types of content covered during home visits, measures of maternal and child health and s"] [16.170103073120117, 12.470768928527832, "This appendix provides an overview of our methods for calculating fidelity domain \nachievement thresholds described in Chapter 4 of the report. Each table provides information on \none fidelity domain\u2019s specifications for data, sample, method for crea"] [16.173328399658203, 12.464442253112793, "me of survey, as applicable. \nDates covered by data May\u2013August 2017 \nFrequency of measurement Once \nReporting process Self-reported survey answers \nAverage across sites 101 of 117 staff (86%) met minimum requirements. \nAdditional notes \u2022 Ref"] [16.160781860351562, 12.480116844177246, "ervision than other staff positions surveyed. \n\u2022 Four sites had a Staff Survey response rate less than 54%. \n\u2022 Across sites, total Staff Survey sample size ranges from 2 \u201317. \n\u2022 A site achieved domain fidelity if 100% of surveyed staff met minimum re"] [16.141895294189453, 12.498854637145996, ".7. Fidelity Domain Seven : Hospital Enrollment \nFidelity domain Hospital Liaisons approach mothers who give birth at the hospital and \nencourage them to enroll into Welcome Baby. \nData source Monthly site data reports provided by LAB BN \nSample "] [16.192644119262695, 12.449760437011719, "ring these time periods: \n\u2022 prenatal home engagement (up to 27 weeks) \n\u2022 prenatal telephone assessment (by 32 weeks of pregnancy ) \n\u2022 prenatal home engagement (by 38 weeks of pregnancy) \n\u2022 postpartum hospital engagement \n\u2022 postpartum Nurse home "] [16.162412643432617, 12.478347778320312, "iance Inventory, Bond subscale \u20134 items) \nSample 1,976 client visits (a client may have completed more than one survey) ; \nBest Start families \nMeasure/indicator All staff are mentored and trained to build positive relationships with their \nclient"] [16.17718505859375, 12.463241577148438, "tions. \n\u2022 We did not include content related to referrals for services. \n\u2022 We excluded visits designated \u201cOther.\u201d \n\u2022 We base the site -level domain status on site achieving average \npercentage or above based on Welcome Baby \u2013wide average \nacross "] [16.196842193603516, 12.433101654052734, "pecifications for individual outcome measures reported in \nChapter 4. \nTable D.1. Parenting Practices \nData source Five mother -reported HOME inventory (Caldwell and Bradley, 1984) items on \nthe Client Survey . Note that the full HOME inventory i"] [16.200233459472656, 12.436678886413574, " D.3. Family Planning \nData source SFDB \nSample Data from 21,266 visits. We excluded the following from our analyses: \n\u2022 family planning data from the post -NICU -discharge visits or visits \nlabeled \u201cOther\u201d \n\u2022 data from clients not enrolled in "] [16.201398849487305, 12.435047149658203, "ck all that apply .\u201d In a very small \nnumber of cases, staff person checked a valid type of insurance for \nthe child (in most cases Medicaid) and also checked the \u201cno insurance\u201d box. In these cases, the child was marked as having insurance. \n \nTable"] [16.202159881591797, 12.435358047485352, "me \n\u2022 visits with missing home safety data \nMeasure/indicator Percentage of visits where home safety inspection is completed with no \nhome safety issues identified \nDates covered by data January 2016 through December 2017 \nFrequency of measurement "] [16.19245719909668, 12.43474292755127, "ge of children above the ASQ- 3 cut -off on all five ASQ scales, \nat a given visit \nDates covered by data January 2016 through December 2017 \nFrequency of measurement Every postpartum visit excluding the hospital and post-NICU -discharge \nvisits "] [16.187570571899414, 12.443222045898438, "0.24 5,232 \nPercentagge of content covered \u20130.19 0.27 9,954 \nRN to Two -to-Four -Week Visit \nFamily Characteristics \nLow income \u20130.24* 0.11 7,130 \nLow-birthweight child 0.26 0.21 7,082 \nBirth complications 0.15 0.15 7,132 \nFirst birth \u2013"] [16.187944412231445, 12.40276050567627, "ications \u20130.19 0.11 5,380 \nFirst birth \u20130.09 0.07 5,366 \nEnrolled prenatally 0.30*** 0.09 5,380 \n 67 Coefficient \nEstimate Standard Error Number of \nObservations \nSome English 0.66*** 0.12 5,374 \nNo English 0.48*** 0.11 5,374 \nMother black "] [16.21025276184082, 12.420912742614746, "n #6 Technical Appendix \nTable F.1. Outcomes by Time Point, Including Benchmarks \nOutcome \nCategory Outcome \nMeasure Data \nSource Measure Rates and Number of Observations \n(bold = outcome analysis) \nBenchmarks \n (sources below table) Hospita"] [16.201696395874023, 12.43345832824707, "t \nrecommended \nintervals SFDB % with up -to-\ndate well-child \nvisits % N/A N/A 91.6 89.6 93.6 83.2 89.9 LAMB Survey (2010, 2012 \ncombined): % of infants with any well- baby \ncheckup: 98.1% in LAC, \n96.7% in BSC (2) \nN N/A N/A 5,089 4,269 4,070 3,4"] [16.19246482849121, 12.443255424499512, "eastfeeding 3-month \nvisit 33.1 34.9 40.3 31.7 31.9 33.0 35.7 43.7 33.3 36.9 35.7 32.2 \nAny \nbreastfeeding SFDB % with any \nbreastfeeding 72-hour \nRN visit 91.5 81.5 91.7 90.7 94.0 93.2 93.7 93.0 95.9 93.3 93.6 95.0 \n% with any \nbreastfeeding 3-"] [16.190000534057617, 12.446772575378418, " co -sleeping \u2022 No co -sleeping \nHome visitor \nworkloads Positive \u2022 Immunizations up \nto date \u2022 Child insurance \n\u2022 Immunizations \nup to date \n\u2022 No home safety \nissues \u2022 Back to sleep \nNegative \u2022 Family \nplanning \u2022 Family planning \u2022 Famil"] [16.190303802490234, 12.437115669250488, ", and J. Arthur Gillaspy, \u201cDevelopment and Validation of a Revised Short \nVersion of the Working Alliance Inventory,\u201d Psychotherapy Research, Vol. 16, No. 1, 2006, pp. 12\u201325. \nLarsen, Daniel L., C. Clifford Attkisson, William A. Hargreaves, and Tuan "] [13.807571411132812, 4.731918811798096, "Image credits\u2014Cover: Violetastock/GettyImages; p. iv: digitalskillet/GettyImages; p. xvi: asiseeit/GettyImages; \np.\u00a04: Debby Lewis-Harrison/GettyImages; p. 8: digitalskillet/GettyImages; p. 14: oscarhdez/GettyImages;p. 38: fstop123/GettyImages; p. 4"] [18.575647354125977, 12.597280502319336, "alth. Maltreated children fare worse than their peers on many important outcomes within these domains. The effects can persist and have long-term consequences into adulthood, including reduced labor market productivity, increased involvement with the"] [18.58363151550293, 12.58786392211914, " into young adulthood, manifested in numerous ways, including home-lessness, underemployment, criminal conviction, and substance abuse. Overall societal costs associated with child maltreatment may total $80 billion annually (Gelles and Perlman, 2012"] [18.527164459228516, 12.652097702026367, "tives. Increases in prevention lead to decreases in mal-treatment and improvements in young adult outcomes but do not affect the experiences of children who enter the system and result in small additional costs. Increases in treatment lead to improve"] [18.5606746673584, 12.618192672729492, " experiencing the different events in the model (e.g., maltreatment, referral to the system, placement in foster home). The baseline model, therefore, is intended to represent the current situation. We then used the model to assess the average effect"] [18.592782974243164, 12.58426570892334, "ilies involved with the child welfare system, whether to emphasize in-home options or out-of-home placements.\nWhat Effects Do Individual Policies Have?\nTo understand the effects of individual policies, we estimated how the quantity and quality of pre"] [18.609514236450195, 12.565741539001465, "eventive services in the model, such as the Nurse-Family Partnership, have been shown to have a number of positive benefits for children and families beyond reducing the likelihood of maltreatment (Olds, 2006). These benefits include improved infant "] [18.59549331665039, 12.582172393798828, "Specifically, family preservation efforts led to changes in the young adult outcomes, with the largest changes when both quantity and quality of the policy were increased. The effects ranged from 0.4 to \u20139.8 percent for substance abuse, from \u20133.6 to "] [18.595888137817383, 12.582314491271973, "f the individual options that we considered achieves all these objectives.\nWe estimated the effect of a policy package that combined increases in \npreventive services and treatment in the form of support for kinship care. The results are summarized a"] [18.57767105102539, 12.596338272094727, "ce of those children who are in the system and their outcomes in young adulthood. Family preservation and kinship care efforts also lead to reductions in the overall cost of the system because they promote placements that are less costly than the oth"] [18.570823669433594, 12.609135627746582, "ific jurisdictions would allow a number of important improvements, including more-specific informa-tion on pathways through the system; better data on children\u2019s experiences in the system; and information on how the child welfare system interacts wit"] [18.580089569091797, 12.5960693359375, " the \nproject. She was highly engaged and provided invaluable input throughout the entire process. We are particularly grateful for her assistance in identifying and connecting us with experts to provide input into the model.\nSusan Gates, director of"] [18.57134437561035, 12.579410552978516, "ations at 37.4 percent (Kim et al., 2017) and lifetime substantiated maltreatment at 12.5 percent (Wildeman et al., 2014). Child maltreatment has been linked with child and family characteristics, such as a child\u2019s age, race/ethnicity, gender, and sp"] [18.571067810058594, 12.602872848510742, "t to sepa-rate them when looking at outcomes (Masten and Wright, 1998). \nOver time, the effects of maltreatment and child welfare system in-\nvolvement can persist, with effects on outcomes that last into young adulthood, including reduced labor marke"] [18.574676513671875, 12.60193157196045, "er comes from a mix of state and local funding (DeVooght and Cooper, 2013). This total likely does not include funding for all child maltreat-ment preventive services. The survey that generates these estimates asks about funding for these services pr"] [18.569778442382812, 12.607965469360352, "ult is a model that estimates the average \neffect of implementing the policy in all jurisdictions across the country. \nTo simulate the effect for a particular state or locale, the model assump-tions and data would need to be changed to better reflect"] [18.57586097717285, 12.600845336914062, "maltreatment and detection component of the model until he or she leaves childhood.\nSystem Pathways\nThe child welfare system pathways component of the model represents the possible pathways through the child welfare system for a child whose suspected"] [18.564945220947266, 12.614156723022461, "plex array of risk and protective factors ultimately influence how children fare over time. The outcomes are influenced by the circumstances that led to the maltreat-ment itself and, to some extent, the involvement with the child wel-\nfare system. At"] [18.572589874267578, 12.605805397033691, "d the model to estimate the effect of implementing several\ndifferent policy, program, or practice changes.\nThese steps are briefly described below and in greater detail in \nAppendix B, available on the project website (www.rand.org/child-welfare-mode"] [18.561038970947266, 12.61918830871582, "features, such as poverty rate.\n1 \nTo simulate the experiences of these children, we had to determine \ntheir chances of experiencing each of the many child welfare events \nand/or outcomes in our model. We pooled information from admin-\nistrative data"] [18.57354164123535, 12.607027053833008, "S reports 18\u201322. We also reference the National Survey of Child and Adolescent Well-Being (NSCAW) Wave II Child Permanency report. With these data, our model simulates the childhood experiences for a cohort that is like the 2010 to 2015 cohort over t"] [18.570804595947266, 12.60898494720459, "typical goal for calibration is to get model outputs that are within the natural variance from year to year for \neach metric. The 0.3-percent difference between our model outputs and the calibration targets is generally much smaller than the natural "] [18.5687255859375, 12.610331535339355, "ot directly account for all of the complexities in how \nboth risk and protective factors interact and the uncertainties about the causal pathways. However, it allows for an understanding of how child maltreatment and system involvement affect outcome"] [18.576576232910156, 12.592217445373535, "Some children experience multiple types of maltreatment (e.g., neglect and physical abuse); the estimates have been adjusted to account for this.\nEfforts to prevent maltreatment will also occur during this period. \nCollectively, our model estimates t"] [18.58152198791504, 12.593766212463379, " 1,000 children.\nIn higher-risk cases, the child is moved from the home to an out-of-\nhome placement. Our model projects that there will be 59 out-of-home \nplacements per 1,000 children. Most children who are removed from \nthe home will experience on"] [18.581310272216797, 12.595720291137695, "ixed, regular, adequate \nnighttime residence by age 25. This includes adults living in travel accommodations, sharing the housing of \nother persons due to hardship, having a nighttime residence that is not designed for ordinary use as a regular \nslee"] [18.595958709716797, 12.579452514648438, "es in child welfare. \n8 Substance abuse includes heavy drinking, defined as typically consuming five or more drinks three times per \nweek, and drug use, defined as use within the past ye ar of cocaine, amphetamines, hallucinogens, or heroin, \nbut n"] [18.590208053588867, 12.565264701843262, "d maltreatment. \nAmong promising targeted primary prevention approaches, home vis-\niting is the most widely studied. A number of assessments have found associations between prevention approaches and reductions in the risk factors for child maltreatme"] [18.594608306884766, 12.582919120788574, "t but assumes that\neffectiveness does not change (Scenario A).9\n\u2022The s\necond scenario holds the quantity of services constant but\nassumes that preventive services are of higher quality (Scenario\u00a0B).We assume that the increase in the effectiveness is "] [18.594039916992188, 12.584572792053223, "agencies or community-based organizations may not \nbe included in this total. Over the same time period, the population of children in NCANDS-reporting states was approximately 67.7 million. Taken together, this equates to 33.9 preventive services fu"] [18.594661712646484, 12.58320426940918, "f prevention, the model estimates approximately \n0.3\u00a0percent fewer investigations and 1.1 percent fewer substantia-\ntions and out-of-home placements relative to baseline. With increases in both quantity and quality (Scenario C), we see somewhat large"] [18.59682273864746, 12.579127311706543, "1.6% \u20131.5% \u20131.6% \u20131.6%\n\u20133.6%\u20133.4% \u20133.5%\u20133.6%FIGURE 4.6\nEffects of Prevention Scenarios on Outcomes, Percentage Change \nfrom Baseline26Family Preservation Services\nFamily preservation programs are designed to prevent out-of-home \nplacements or to reun"] [18.59731101989746, 12.581741333007812, "ot find that the program increased the likelihood that children would remain in the home, program participa-tion was associated with a higher rate of reunification for chil-dren in out-of-home care (Olsen, Laprade, and Holmes, 2015).\nHow the Policy I"] [18.595224380493164, 12.583395004272461, "reatment also increased slightly, both because the number of incidents increased and because of increased opportunities for detecting maltreatment when families receive family preservation services. For the quality scenario (B), both the average numb"] [18.594926834106445, 12.583780288696289, "r Family Preservation Scenarios30RAND RR1775x1-4.9Scenario A Scenario B Scenario C\nPrevention spending\nChild welfare system spending\nNet spending\u20130.3%\n\u20139.9%\u20139.1%\u20136.7%\u20136.2%\n\u201313.7%\u201312.7%\u20130.1%+0.2%FIGURE 4.9\nEffects of Family Preservation Scenarios on "] [18.59467887878418, 12.583785057067871, "ounseling, respite care, and legal services (Lin, 2014). How and where services are offered varies significantly (for example, they can be peer to peer, provider-led, school-based, or community-based). Training and education interventions can support"] [18.596092224121094, 12.581393241882324, "anship as a permanent outcome;receipt of targeted preventive services;receipt of supports and services for transition to adulthoodTABLE 4.3\nKinship Care Scenarios33relatively little impact on detecting maltreatment in the population. \nThere is a very"] [18.596094131469727, 12.582845687866211, "first, which focuses on quantity, results in a 50-percent increase in the quantity of funded preventive services and in the number of children placed with kin (Scenario A). The second option focuses on quality by assuming that the preventive services"] [18.595420837402344, 12.583418846130371, "oodTABLE 4.4\nCombined Prevention and Kinship Care Scenarios\nRAND RR1775x1-4.13Scenario A Scenario B Scenario C\nMaltreatment episodes\nReferrals to child welfare\u20131.6%\u20130.2%\u20130.6%\n\u20134.1%\u20131.5%\u20130.2%FIGURE 4.13\nEffects of Combined Approach of Prevention and "] [18.581209182739258, 12.59570598602295, "nge from Baseline\nRAND RR1775x1-4.16Scenario A Scenario B Scenario C\nHomelessness\nUnderemployment\nSubstance abuseCriminal conviction\u20132.8%\u20131.6%\n\u20132.3%\n\u20133.3%\u20132.2%\n\u20133.0%\u20132.5%\n\u20135.8%\u20135.6%\n\u20136.4%\u20135.2%\u20132.4%38\n39CHAPTER FIVE\nDiscussion\nUnder current policy, f"] [18.617904663085938, 12.559725761413574, "vices are designed to prevent child maltreatment from occurring and thus reduce the number of children that ever enter the system. If a child has been maltreated, family preservation treatment efforts are aimed at providing services and supports that"] [18.59865379333496, 12.579483985900879, "ore children. The increase is partially offset by reductions in spending on screenings, investigations, services, and temporary placements as fewer children flow through the system. We assume that quality can be improved at no additional cost by real"] [18.596181869506836, 12.582464218139648, "ide services and supports to the kin caregivers to ultimately decrease time in care and increase the child\u2019s chances of returning to the family. The increases in temporary kinship care and permanency outcomes with kin lead to small improvements in ou"] [18.573932647705078, 12.606315612792969, "ich is extremely com-plicated. Building such a model requires many assumptions. In many cases, the available data and literature do not provide as much infor-mation as would be ideal, and there is certainly room for reasonable disagreement about the "] [18.568361282348633, 12.612859725952148, "placement. However, it is difficult to say how much of the discrepancy represents real differences in the sources and how much is simply the result of not being able to make an apples-to-apples comparison between empirical data and the internal calcu"] [18.569562911987305, 12.610270500183105, "the effects of system experience on outcomes. To address this problem, we augmented the information we found in the literature by conducting data analyses designed to address this question specifically, but additional research in this area is needed "] [18.570703506469727, 12.608262062072754, "nformation on pathways through the system; better data on children\u2019s experiences in the system; and information on how the child welfare system interacts with other related systems, such as education or criminal justice.\nFinally, while the baseline m"] [18.572858810424805, 12.60540771484375, " pathways through the system, and consequences in a comprehensive quantitative model that can be used to simulate the potential impact of policy changes. The estimates presented here provide policymakers with a sense of the relative costs and benefit"] [16.82553482055664, 8.033143043518066, "rmer Foster Youth: Outcomes at Age\u00a023 and 24,\u201d Chicago, Ill.: Chapin Hall at the University of Chicago, 2009.\nCourtney, M. E., B. Needell, and F. Wulczyn, \u201cUnintended \nConsequences of the Push for Accountability: The Case of National Child Welfare Pe"] [16.798141479492188, 8.060225486755371, "es Bell Associates, Profiles of the Active Title IV-E Child Welfare \nWaiver Demonstrations , Arlington, Va., 2016.\nJones Harden, B. J., \u201cSafety and Stability for Foster Children: A \nDevelopmental Perspective,\u201d The Future of Children , Vol. 14, No. 1,"] [16.81312370300293, 8.041659355163574, "ly Partnership: An Evidence\u2010Based \nPreventive Intervention,\u201d Infant Mental Health Journal , Vol. 27, \nNo.\u00a01, 2006, pp. 5\u201325.\nOlds, D. L., J. Eckenrode, C. R. Henderson, Jr., H. Kitzman, J. Powers, \nR. Cole, K. Sidora, P. Morris, L. M. Pettitt, and D."] [16.745363235473633, 8.056011199951172, "hildren\u2019s Bureau, Child Maltreatment 2014 , \nWashington, D.C., 2016.\nWashington State Institute for Public Policy, Intensive Family \nPreservation Programs: Program Fidelity Influences Effectiveness\u2014Revised , Olympia, Wash., 2006.\nWildeman, C., N. Ema"] [8.023049354553223, 0.9703789353370667, "Discount Justice\nState Court Belt-Tightening in \nan Era of Fiscal Austerity\nMichael D. Greenberg, Samantha Cherney\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This"] [11.376203536987305, 17.569564819335938, "participants included judges, state court administrators, prominent mem -\nbers of the bar, and legal scholars. \nThis report shares key issues and topics from the January 2015 conference sessions. This \ndocument is not a transcript. Rather, it summari"] [8.019979476928711, 0.9694624543190002, "mitted to the public interest.\nRAND Ventures is a vehicle for investing in policy solutions. Philanthropic contributions \nsupport our ability to take the long view, tackle tough and often-controversial topics, and share our findings in innovative and"] [8.036347389221191, 0.9821978807449341, "....................................... 12\nDo Courts Risk Being Delegitimized When Challenging the Constitutionality of Budget Cuts \nImposed by Other Branches of State Government? .................................................... 13\nWhat Role Can"] [8.022282600402832, 0.9707165956497192, "....... 29\nQ&A from the Audience ...................................................................................... 30\nCHAPTER SIX\nAccess to Justice and Business-to-Business Litigation .................................................. 33\nQuest"] [8.031108856201172, 0.9764547348022461, ", state court administrators, prominent members of the bar, and legal scholars. \nKeynote speeches at the conference were given by Tani G. Cantil-Sakauye, the Chief \nJustice of California, and by William T. Robinson III, co-chair of the American Bar A"] [8.028993606567383, 0.9753997325897217, "nd all those who engaged in the conference discussions. We would particularly like to \nthank the following participants for their contribution to the panels and the discussion, with -\nout which the conference would not have been feasible: Joseph Dohe"] [8.02603816986084, 0.9732713103294373, "d by chapters, which correspond to the panel discussions \nand speeches that took place during the conference. Each of the panel discussions is sum -\nmarized by the major themes that were discussed in the order that they were covered at the conference"] [7.986478805541992, 0.936330258846283, "nd somebody asked me, \u201cWhat are you working on now, and what excites you about it?\u201d And I replied, \u201cThere are two things that have been on my mind lately. One of them is the institutional administration and governance of state court systems. The othe"] [7.996747970581055, 0.946191132068634, " most elegant text, and the best Constitution. But at the end of the day, if you\u2019re not willing to put money into the institutions that actually carry out the work, the documents are capable of becoming empty. The promises are capable of being unfulf"] [7.998918056488037, 0.9482001662254333, "it comes to the money side of the picture. This is true with regard to the courts and the judiciary, as it is with regard to lots of other kinds of institutions.4 Discount Justice: State Court Belt-Tightening in an Era of Fiscal Austerity\nIt turns"] [8.004426002502441, 0.953245222568512, "dea of the Minnesota Supreme Court; Judge Carolyn Kuhl of the Los Angeles Superior Court; Mary McQueen, president of the National Center for State Courts; and Michael Greenberg, senior behavioral scientist and then director of the RAND Center for Cor"] [8.006133079528809, 0.9548816680908203, "e funding mechanism worked well during the temporary surge in foreclosure filings, but it then caused the courts to go into the red when foreclosures started to tail off several years later. McQueen and Greenberg also talked about the pros and cons o"] [8.00078296661377, 0.9499703645706177, "urt system in Minnesota. She observed that when the state transi -\ntioned from county funding to state funding in 2005, the Chief Justice decided to share her governance authority over the courts by creating the Judicial Council, which is a 25-member"] [8.003358840942383, 0.9525315165519714, "en shifted to address the court system governance models and choices of \nother states. McQueen described the governance systems in Oregon and Florida. In Oregon, she pointed out, the move to centralize funding for the courts by the state legislature "] [8.009974479675293, 0.9581838250160217, "d that that financing mech -\nanism ties back to governance, since the flow of money also reflects who has decisionmaking authority over the money. Greenberg concluded that Ohio illustrates how complex the local budgeting and governance picture actual"] [8.028929710388184, 0.9726758599281311, "he impact on the system, Kuhl described morale, security, and geographic \naccess challenges that have resulted from the resourcing cuts. She also described several func -\ntional measures suggesting impairments in the speed and volume of cases process"] [8.022592544555664, 0.9699883460998535, "bmit their budget proposals for the governor\u2019s approval prior to reaching the legislature (a practice akin to that of an execu -\ntive branch agency) or else by being subject to detailed line-item appropriations that restrict the courts in shifting th"] [8.043670654296875, 0.9901583790779114, "obert Peck then spoke to the latter question and about the response of the courts them -\nselves to funding shortfalls that putatively threatened their constitutional function. Peck observed that there has been a series of cases addressing the status "] [8.028658866882324, 0.9756401181221008, "opriation below the level at which it had been prior to 1991. This was a compromise result, but it generated lots of ill will and distrust between the branches of government in New York.\nLippman concluded that the New York experience in 1991 invites "] [8.03276538848877, 0.977423369884491, "summarized this another way by emphasizing that public recognition of the importance of the courts, and of keeping them fully functional by keeping them fully funded, is often central in these kinds of disputes\u2014and lack of public recognition is probl"] [8.039565086364746, 0.985991895198822, "o litigants. This got noticed by the newspapers and by the legislature. The courts made the decision to con -\ntinue allocating money to legal aid for the poor, based on the belief that this was constitution -\nally imperative, even while staff were be"] [8.03905200958252, 0.9845934510231018, "Equal Protection Problem?\nA member of the audience observed that the burdens of the budget shortfall in California \ncourts have fallen heavily on personal injury cases, such that delays and geographic problems in accessing the courts have become part"] [8.03381633758545, 0.9794026613235474, "o say that a shutdown response is not only not unprecedented, but that it is almost a necessity when budget cuts become draconian. In those situations, Lippman said that the courts run through all the options presented by Judge Kuhl in the earlier se"] [8.015769958496094, 0.9636057019233704, " the judiciary is a unified system, there is a lot of autonomy built into it at the local, trial court level.\nCan You Describe the Transition from Local to State Funding of the \nJudiciary?\nSungaila followed up with a question about the transition fro"] [8.035655975341797, 0.9805887937545776, " choices to make about each disposable dollar and that she must make the best case for why they should invest in the judicial branch. This takes time, education, and exposure to the courts. Now when she goes to the Capitol, Cantil-Sakauye does not as"] [8.041346549987793, 0.9845051765441895, "the broader, long-term future of the judicial branch. Cantil-Sakauye shared a term she coined to reflect her vision: \u201cAccess 3-D.\u201d The first element of three-dimensional access is remote access to the courts. Litigants should be able to file, search,"] [8.034075736999512, 0.9783840775489807, "t of their own districts: how many judicial officers are employed, how many cases there are, where budgets have been cut, and how many people have been laid off. In those snapshots, the Judicial Council also tries to include anecdotal information to "] [8.033270835876465, 0.9783431887626648, "but a significant amount of money had been spent on it, and it had been cited as wasteful. Several Keynote Address: Tani G. Cantil-Sakauye, Chief Justice of California 21\ncounties were prepared to implement it, but it would have taken millions of "] [8.048561096191406, 0.9878138899803162, "filings have declined.\nAs for criminal filing fees, Cantil-Sakauye explained that current thinking posits that law \nenforcement personnel were laid off during the recession, which led to fewer arrests and crimi -\nnal reports and, ultimately, fewer fi"] [8.038061141967773, 0.9803871512413025, "lawyers and litigants, noting the cost of such technol -\nogies as the CourtCall remote appearance system. Cantil-Sakauye acknowledged the possibil -\nity of adverse impact from such advances and affirmed that the judiciary cannot be improved on the ba"] [8.029753684997559, 0.9754993319511414, "riefly summarize the empiri -\ncal research that has been done on the economic impact of state courts and also to recreate the intellectual journey that NCSC undertook during 2009\u20132014 in attempting to help the courts with their funding crisis, by way"] [8.029582023620605, 0.9730904698371887, "een little formal evaluation work done on these to quantify and validate their impact. Clarke went on to suggest that even in theory, their chief impact may have less to do with their economic effects than with their impact on rule of law. In turn, C"] [16.181188583374023, 2.983783483505249, "rts are likely to become increasingly reliant on remote technology to adjudicate cases in the service of cost-cutting efforts.\nEagly began by describing the basic concept of remote adjudication, which (in the immi -\ngration context) involves a detain"] [16.09144401550293, 2.963677406311035, "tigants. However, she also went on to describe her qualitative work to investigate the impact of remote adjudication on immigration respondents who are being held in remote locations and to assess why those persons may become disengaged from the proc"] [8.005084991455078, 0.9541231989860535, "bserved that this theme had already come up in bits and pieces in the earlier panel discussion in the conference. The pilot qualitative study that Greenberg and McGovern did looked specifically at the court systems in Utah, California, Massachusetts,"] [8.03144645690918, 0.9755592942237854, "e states that have adopted it? What has the impact been on access to justice? What are the implications of remit -\ntances from judicial fees and fines to a state\u2019s general fund? Is funding for the courts more or less resilient for court systems in wh"] [8.03686809539795, 0.9763827323913574, " of the reasons why empirical research on courts \nand litigation is difficult to conduct and to interpret across studies. One problem that he pointed out is the difficulty in simply designating a unit of observation, like a \u201ccase\u201d or a \u201ctrial.\u201d These"] [8.041693687438965, 0.9817642569541931, "ative dispute resolution schemes. Kritzer agreed with the premise of the question and observed that the vast majority of trial-like proceedings and adjudications are happening outside the court system, as in the context of unemployment proceedings, S"] [8.03652286529541, 0.9804201126098633, "Community in California Been Affected by the Funding Crisis That the Courts Are Facing?\nHolden commended the court leadership for doing as much as they can under difficult cir -\ncumstances and noted that the funding crisis has affected businesses dif"] [8.083334922790527, 1.0181063413619995, "sinesses have, particularly in resolving complex cases in an efficient manner. In sum, Holden opined that there is a need for stronger funding by the legislature to the courts overall, including the complex litigation courts, to improve the timelines"] [8.058608055114746, 0.9908249378204346, "tigation 35\nSandefur suggested that these dynamics create two basic problems for the courts. First, \nthere are high rates of default in civil matters, simply because people do not realize that they \nare supposed to show up and do not understand th"] [8.082189559936523, 1.0195162296295166, "of lack of diversity in the field of mediation, which he explained as resulting in large part from the difficulties for young people trying to break into the field. In turn, he described those difficulties as being exacerbated by submarket rates for "] [8.077619552612305, 0.9968060255050659, " to Sandefur, \nasking her about the importance of the 92 percent of justiciable problems reported in her survey that nevertheless did not generate any court system involvement. The audience member asked whether the courts should be concerned about th"] [8.053536415100098, 0.9988899230957031, "n a manner with which they are okay. Kichaven also pointed out that similar systems are being developed in Europe to handle other categories of civil matters beyond divorce. 39CHAPTER SEVEN\nFinal Keynote Address\nThe concluding address of the conferen"] [8.038285255432129, 0.981838583946228, " we were kidding earlier, I think during the lunch break several of us [said], when\u2019s \nthe last time you went to a cocktail party and somebody came up to you and said, \u201cLet\u2019s talk 40 Discount Justice: State Court Belt-Tightening in an Era of Fisca"] [8.065266609191895, 1.006536841392517, "e should take on a cause that had historical significance and merited continuity of leadership. We wouldn\u2019t worry about who got the credit. We would be focused on the opportunity to serve and to make a difference over a period of time. And we chose t"] [8.037491798400879, 0.9818316698074341, "ge, the most experience, the most perspective; and yet, for whatever reason, it remains one of our biggest challenges to figure out how to get our judges out into the com -\nmunities. In politics we say, \u201cMake friends before you need them.\u201d And I get "] [8.03441333770752, 0.9804888367652893, "are in crisis. Courthouses must be \nopen to keep the public peace and tranquility. Courthouses must be open for the wheels of justice to turn. \nWe\u2019re committed. We need to be more missionary-like, I respectfully submit, and enlist \nmore of our sister"] [8.033337593078613, 0.9803830981254578, "3:00 p.m. Break \n \n3:15 p.m. Panel #4: Access to Justice and B2B Litigation \n \nModerator: Geoffrey McGovern \n\u2022 Rebecca Sandefur, University of Illinois College of Law \n\u2022 Craig Holden, Lewis Brisbois Bisgaard & Smith \n\u2022 Jeff Kichaven, Jeff Kicha"] [-2.068148374557495, 13.738978385925293, "Incorporating Resilience \ninto Transportation Planning and Assessment\nSARAH WEILANT, AARON STRONG, BENJAMIN M. MILLER\nSOCIAL AND ECONOMIC WELL-BEING\nPrepared for the Transportation Research BoardLimited Print and Electronic Distribution Rights\nThis d"] [-2.0822808742523193, 13.733356475830078, "ation system assets: transportation activities, transportation outputs and outcomes, and, finally, socioeconomic outcomes. This logic model, together with more-traditional views of resilience, informed the development of the absorptive capacity, rest"] [-2.09918475151062, 13.705900192260742, "...................................................................... 1\t2. Resilience in a Transportation Context ....................................................................................... 4\t\nStakeholder Interviews ....................."] [-2.0613577365875244, 13.758270263671875, ".................................................................................... 50 \t\nWhat Stakeholders Are Saying About Transportation Planning and Resilience .................................... 52 \t\nInterview Recruitment and Protocol ......."] [-2.067901849746704, 13.776128768920898, "neau et al., 2003, Framework ........................................ 79\t\n \n viii Tables \nTable 2.1. Resilience Metrics, Based on Bruneau and Colleagues\u2019 Components of Resilience .... 8\t\nTable 3.1. Potential Hazards to Resilience ................"] [-2.0898184776306152, 13.720205307006836, "te more \naspects of resilience: \n\u2022 Expand the objectives and scope of the framework to include shocks and stresses that are \nnot directly tied to climate change, including cyberattacks. \n\u2022 Broaden the asset data to include human and equipment assets"] [-2.0904340744018555, 13.724588394165039, "n Research Board \nTTTR Truck Travel Time Reliability \nVAF Vulnerability Assessment and Adaptation Framework \nVMT vehicle miles traveled \n \n xii \n 1 1. Introduction \nThe Federal Highway Administration\u2019s (FHWA\u2019s) Vulnerability Assessment and Ad"] [-2.0856637954711914, 13.731805801391602, "luable locations. Overlaying these ideas on a more traditional characterization of resilience could contradict or miss key aspects of the value of the transportation system in times of stress or shock. Therefore, our approach for better integrating r"] [-2.092931032180786, 13.718768119812012, "ting organizations, academics, and others who focus on resilience in transportation. This approach informed our conceptual framework and provided context for resilience that can be used to modify the implementation of the VAF. Our conceptual framewor"] [-2.0946426391601562, 13.713412284851074, "ach to resilience. Each of the AREA dimensions of resilience suggests a means through which to increase the resilience of the system, although by different methods. Importantly, the networked nature of the transportation system means that the aim of "] [-2.1028409004211426, 13.69655990600586, "er to glean insights from those facing different geographies and contexts, although some organizations did not respond or declined to participate. Stakeholders that were interviewed provided valuable information about how transportation planners and "] [-2.097195863723755, 13.710006713867188, "pected new challenges to arise in the future, such as autonomous vehicle adaptation, coordination among organizations for long-term planning with a resilience focus, increased wear and tear on infrastructure, climate change impacts, and sustainable f"] [-1.9976263046264648, 14.012043952941895, "em while maintaining functions in the presence of a shock, and (3) reducing the time to recovery to normal functioning, which might be different from pre-event functioning. These themes translate into three capacities at the community or regional lev"] [-2.088872194290161, 13.709736824035645, " withstand and recover from incidents\u201d (Tennessee DOT, 2015, p. 4). As \n 7 noted by Dix and colleagues, 2018, p. 5, state DOTs and MPOs differ on how they propose to \nimprove their resilience capabilities: \u201cSome emphasize the importance of system "] [-2.0880231857299805, 13.717936515808105, "lternate routes \nAvailable capacity on alternate routes \nCongestion on alternate routes \nAvailability of alternate routes, such as g raph theory connectivity score \nTransit alternatives \nAdjacent park -and-ride lots \nResourcefulness Safety ser"] [-2.0763766765594482, 13.73624324798584, "ete qualities of those segments. Preferences among different qualities of the roadway segments are determined by the preferences incorporated into the model. \nPlanners care about how \u201ccritical\u201d a roadway segment is in terms of usage, availability of "] [-2.087425708770752, 13.717594146728516, "lanning process. The FAST Act adds resilience to sections of the U.S. Code (particularly Title 23, Highways, and Title 49, Transportation). For example, 49 C.F.R. \u00a7 5303 (a)(1), Metropolitan Transportation Planning, now seeks \u201cto encourage and promot"] [-2.0974113941192627, 13.706144332885742, "n a major transportation route is closed. The Colorado DOT, for example, has been proactive in thinking about system resilience rather than solely focusing on hardening infrastructure. States also are required to develop a risk-based asset management"] [-2.0890040397644043, 13.714757919311523, "In particular, they highlight metrics focused on job access, such as cumulative opportunity and gravity metrics (discussed in Chapter 4). Jobs are not the only destination users might want to access. Nicholls, 2001, looks at access to public parks as"] [-2.0951945781707764, 13.707391738891602, " such as achieving environmental objectives or supporting emergency management capabilities. Indeed, 49 C.F.R. \u00a7 5303 (a)(1) states that resilient surface transportation systems should be encouraged \u201cwhile minimizing transportation-related fuel consu"] [-2.103651523590088, 13.69353199005127, "gions, such as \npermafrost melt, coastal erosion, and volcanic activity, can affect both transportation planning and a variety of environmental benefits ( duVair, Wickizer, and Burer, 2003). \n 14 Who Benefits from Transportation Infrastructure? \n"] [-2.09002947807312, 13.723670959472656, "h mobility options to providing citizens with access to a system, even when that system faces shocks or stresses. \n 15 3. Conceptual Framework \nIn this chapter, as well as in Chapters 4 and 5, we discuss our conceptual framework, which \nexpands"] [-2.094036102294922, 13.72104263305664, "nsportation organizations are doing, specifically focusing on hazards associated with climate change and extreme weather events. We use the VAF as a starting point for incorporating resilience into transportation planning. As illustrated in Figure 3."] [-2.089773654937744, 13.7197265625, "systems approach, the benefits of prioritized or \nincreased investments in the transportation system likely will increase the probability that the \ntransportation system stays at or near a preferred state of well-being. In this case, we would note th"] [-2.0969467163085938, 13.705622673034668, "ctivities). These outputs then lead to higher-level outcomes, which are system achievements, including desired or observed changes for the transportation system and in the context of the system of systems. As noted earlier, the left side of the figur"] [-2.0961904525756836, 13.711477279663086, "frastructure assets, roads, bridges, and tunnels that are vulnerable to risk. Information on the social system also is needed, including on education; health services; and economic systems, such as businesses, in order to understand the criticality a"] [-2.1445913314819336, 13.654512405395508, "tation system. \nTransportation System Outputs \nIn an ideal system, the inputs and activities will achieve three main outputs. The first output is \naccess to critical social and economic systems. The transportation infrastructure provides access to \nc"] [-2.1157591342926025, 13.688623428344727, "om transportation infrastructure; and those who lacked options with affordable fees for service for public transit and community-led ride sharing services, or personal vehicles. Collaboration and service provision for all populations are important el"] [-2.0902490615844727, 13.722158432006836, "ansportation \nsystems and the aspects of resilience that can be used to achieve well -being (Figure 3.3). \nSpecifically, we describe the capacities needed to improve the resilience of the system. \nWhat This System M eans for Resilience and What Is N"] [-2.043879270553589, 13.903676986694336, "of Resilience \nAs discussed in Chapter 2 and in Appendix B, Bruneau and colleagues\u2019 2003 framework defines \na resilient system as having the following characteristics: \n\u2022 reflective: continuously evolving \n\u2022 robust: anticipating potential failures \n\u2022"] [-2.082451105117798, 13.734057426452637, "unity or by providing multimodal access to vulnerable and remote populations. Adaptive capacity investments could include adding roads that provide redundancy so that the system can handle more traffic, reducing potential congestion during both disru"] [-2.1188957691192627, 13.692085266113281, "red critical according to the Colorado DOT criticality index. In essence, criticality is how important a segment is to the movement of goods and people, while providing access to vulnerable populations. This is consistent with the definition of criti"] [-2.0907340049743652, 13.7210693359375, "e system. Additionally, the criticality of different assets and how they are distributed across the community provides a means for understanding equitable access to the transportation system. Long-term transportation planning should consider the suit"] [-2.0752477645874023, 13.738985061645508, "ible outcomes listed in Chapter 3. Assessing resilience first requires defining the desired level of service the transportation system should be able to maintain when faced with specific hazards that result in stresses or shocks. For example, transpo"] [-2.0700292587280273, 13.72911548614502, "resilience for different elements of \nthe transportation system (see Figure 3.4 in Chapter 3). Metrics based on existing or desired data and information can be mapped to each element of the logic model to help planners clarify what they are measuring"] [-2.0721700191497803, 13.73405647277832, "systems to make more-informed decisions that contribute to a resilient transportation system. The metrics described in this section include some of those documented in Chapter 2 and new metrics for consideration. \nMeasuring Inputs and Activities \nIn"] [-2.0690314769744873, 13.74277114868164, " a cyber disruption interferes with their normal ability to regulate traffic flow. Planners also should consider the return periods of risks that are most relevant to their regions. \nTransportation planners frequently invest in activities to increase"] [-2.0811824798583984, 13.723917007446289, "hysical resources set aside for known disruptions, such as snow, fire, cyber system disruptions, or congestion. \nHaving response plans in place can greatly improve the speed and effectiveness of efforts to \nrestore transportation capacity. Some of th"] [-2.075904130935669, 13.731437683105469, "ined and \nsupported roles in disasters \nMeasures of \ncommunities\u2019 communication \ncapabilities Amount of time it takes to contact all community \nresidents in the immediate aftermath of an event \nPercentage of community residents that can be \nconta"] [-2.0808920860290527, 13.722970962524414, "tive Capacity Inputs and Activities \nStep of Logic \nModel Category Sample Me trics \nInputs Availability of alternate \nroutes and alternative mode choices The distance to alternative routes \nFriability , or the change in the population -weighted"] [-2.0795981884002686, 13.723602294921875, "nors\u2019 Institute on Community Design, 2017. \nDifferent groups might have different access to the transportation system during times of shock \nor stress. Such metrics as heat vulnerability ind exes, as described in Madrigano et al., 2015, can \nhighligh"] [-2.0807266235351562, 13.71236515045166, "fferent times. Discussions of such metrics can be found in Venter, 2016; Governors\u2019 Institute on Community Design, 2017; and Dix et al., 2018. These metrics are useful for assessing the absorptive capacity for traffic flow and congestion, either as a"] [-2.077606678009033, 13.723011016845703, "l highway system \nPavement and bridge condition on local roads \nCondition and availability of sidewalks, crosswalks, and bicycle \ninfrastructure \nReliability metrics Measures of resilience (Zhang et al. , 2010) \nTruck Travel Time Reliability (TTT"] [-2.07655930519104, 13.728038787841797, "es in travel costs, travel time, or travel speed before and after an event. Absorptive capacity is concerned with keeping this change as small as possible, while restorative capacity is concerned with having \nany changes return to normal operating le"] [-2.083636999130249, 13.698972702026367, "given area \nor on a given route \nNumber (or rate) of alcohol -related incidents that occur \neach year in a given area or on a given route \nNumber (or rate) of tr uck-related incidents that occur \neach year in a given area or on a given route \nSea"] [-2.0916919708251953, 13.724936485290527, "this problem, it is important to measure the cost of transportation and cost of living for system users, particularly vulnerable or low-income populations. Such metrics include measures of housing costs, single-mode or multimodal transportation costs"] [-2.0747859477996826, 13.755467414855957, "e the hazards that will be considered as part of \nthe vulnerability assessment. The VAF is designed to consider climate change vulnerability but it can be expanded to consider shocks and stresses that are not directly tied to climate change. In \n "] [-2.089359760284424, 13.72779369354248, "ncrease the resilience of the system. By having alternate routes or modes available or by expanding capacity, an individual asset would become less critical to the functioning of the system as a whole. This would increase the resilience of the system"] [-2.092881917953491, 13.719040870666504, "ties. The AREA approach to resilience highlights approaches \nthat subject-matter experts could use to incorporate resilience from a systems-level perspective. Given the subjective nature of the stakeholder input process, many of the suggested improve"] [-2.0549113750457764, 13.761961936950684, "is \ndifficult to analyze as a whole but that should be considered through the AREA approach. Thus, capacity and equity concerns can be considered jointly, and solutions can be identified that take into account the different aspects of the AREA approa"] [-2.08705735206604, 13.742304801940918, "y could be more cost-effective and increase the resilience of the entire system. The focus should be on the resilience of the network rather than of an asset. Having options across the spectrum of capacities is important, given the scarce resources t"] [-2.1077051162719727, 13.75532341003418, "ience into the transportation system requires a change in perspective from \nprotecting every asset to a systems-level view. It is not simply the direct transportation infrastructure \nthat is important in building resilience; it is also the human and "] [-2.1018877029418945, 13.695757865905762, "e costs and benefits of resilience when making long-term investments in highway and transportation infrastructure. The interviews also provided insight into how stakeholders think about and understand transportation resilience, which might influence "] [-2.112484931945801, 13.680692672729492, "el DOTs and MPOs. Invitations \nwere emailed to participants; the recruitment email is included at the end of this Appendix. \nFinal Sample and Interview Timeline \nWe conducted nine interviews at eight organizations over three months. We acknowledge "] [-2.1131784915924072, 13.676860809326172, "more than one conversation, as well as detailed examples of problems, successes, or recommendations related to planning for transportation resilience. \nWhat Stakeholders Are Saying About Transportat ion Planning and Resilience \nIn this section, we"] [-2.1182806491851807, 13.670401573181152, "or all transportation \nprojects that receive federal funding ( U.S. Department of Transportation, Federal Transit Administration, 2019). \n 53 current status of roads, their maintenance, and future construction. MPOs also might interact with \nmul"] [-2.105374336242676, 13.691515922546387, "erations for resilience. \nFinally, stakeholders noted a few additional influencers in transportation planning and \ninvestment with whom they might interact only tangentially or not at all. This includes such organizations as local or grassroots advo"] [-2.111625909805298, 13.684930801391602, "events, was mentioned. Stakeholders noted that it was important that this information be shared with MPOs in all locations affected by hurricanes to help plan for future stresses and shocks. \nIn terms of interaction and communication with other sect"] [-2.1266796588897705, 13.659544944763184, "gn, it will be important to understand the implications of those options in a broader, long-term context. \nTransportation Funding \nWith the exception of pilot projects funded by FHWA (U.S. Department of Transportation, \nFHWA, 2018c), none of the in"] [-2.1378157138824463, 13.652962684631348, "recreation, \ndaycare, [and] senior centers. You can\u2019t get anything done in the community if [the] \nsystem isn\u2019t functioning properly. \nTransportation planning and infrastructure influence the location of housing facilities, utilities, \nand other ele"] [-2.1073532104492188, 13.688977241516113, " because of changing U.S. tariffs \n\u2022 jurisdictional overlap, lack of clarity about who owns certain road infrastructure and who can\u2014or who understands the need to\u2014act to address issues that affect multiple jurisdictions \n\u2022 unclear roles and responsi"] [-2.108285665512085, 13.695079803466797, "work in \norder to understand how transportation can affect the resilience of bigger systems and entire regions. Finally, one stakeholder noted that transportation resilience is the ability to learn from experience to better respond with the assets pr"] [-2.105095624923706, 13.692723274230957, "ods. Increased communication with the public and improved warning systems would provide them with the ability to make more-informed decisions about what to do in certain events. \nData and Measur ement \nThe stakeholders we interviewed were not collec"] [-2.098917245864868, 13.705214500427246, "ent resilience strategies for the short, medium, and long term \n\u2022 the need to understand the connectivity between transportation programs and systems during events so that appropriate plans result in sustained movement of people and goods \n\u2022 the ne"] [-2.0932445526123047, 13.709663391113281, "ortation resilience and improving opportunities for MPOs to consult each other for guidance on how to meet those standards. The stakeholders suggested \nthat the standards should extend beyond transportation agencies in their applicability and \nshould"] [-2.0960581302642822, 13.689007759094238, "pant name], \nHello, my name is [name] and I am a/an [title] at the RAND Corporation (www.rand.org). I am \nconducting a study on behalf of the Transportation Research Board (TRB) to help them develop an analytic framework for the Federal Highway Admi"] [-2.1082451343536377, 13.685235023498535, "participation are minimal. \nDo you have any questions about our confidentiality procedures before we begin? [If yes, respond \nto all questions. If no, proceed with discussion.] \nGeneral Background Questions \n1. Can you describe your role at [respond"] [-2.104771137237549, 13.716578483581543, "ticipate, prepare for, and adapt to changing conditions and withstand, respond to, and rapidly \nrecover from disruptions, along with a reduction in overall vulnerability.] \nBased on that [if not already answered], \n12. What do you want to be resili"] [-1.9273267984390259, 14.125215530395508, "urces based on \nsearches using widely available online databases and keywords relevant to each of the topic areas. \nWe searched Google Scholar and Web of Science using the following keywords: \u201cresilience,\u201d \u201cresilience framework,\u201d \u201cresilience conceptu"] [-2.0450074672698975, 14.168534278869629, "red by the movement of the system from one equilibrium state to another, and the length of time it takes for the system to rebalance once the stressor has been removed. Holling, 1973, was the first to transfer these ideas from the physical sciences t"] [-2.042283058166504, 14.176587104797363, "capacity to deal with future stressors, whereas mitigation efforts are limited to minimizing and repairing damage after the event (i.e., recovery). \nComponents of Resilience \nThere is a growing convergence of the definitions of resilience used in di"] [-2.0423879623413086, 14.156786918640137, "cal \nsystem The capacity of a system to absorb disturbance and reorganize while undergoing change so as to retain essentially the \nsame function, structure , and feedbacks \u2014and therefore the same identity \nAdger, 2000 Social The ability of commun"] [-1.9642395973205566, 14.120640754699707, " Norris et al. , 2008, p. 129. \n \n 71 Resilience Frameworks in the Literature \nMany of the nuances in definitions of resilience arise when developing frameworks for \nanalyzing resilience and community risk. A system-of-systems approach disaggreg"] [-1.9659814834594727, 14.118463516235352, "conomy and society, and \ninfrastructure and environment through the seven qualities of resilient cities described earlier. \nThis framework integrates the individual systems through various channels. \nFigure B.1. The City Resilience Framework \n \nAcco"] [-1.9732547998428345, 14.122649192810059, "he system is dysfunctional at this point, it can, again, take one of two paths. The system\u2019s ability to adapt to the changed environment, together with the \nsystem\u2019s ability to recover, determines whether the system can adjust to the changed environ"] [-1.9948503971099854, 14.12981128692627, "em sends to firms and households. In other words, how individuals and \n \n 75 firms behave before, during, and after a shock (or in the presence of a stressor) are mitigating \nfactors that influence the resilience of the system. \nAlthough Rose, 2004"] [-1.9774017333984375, 14.127991676330566, "base \n4. policies \n5. implementation \n6. monitoring and evaluation \n7. internal consistency \n8. organization and presentation \n9. interorganizational coordination \n10. compliance. \nThe first six principles contribute to the seventh, internal consiste"] [-1.9656615257263184, 14.14588451385498, " incorporated into a larger, community-level analysis that considers the joint determination of the larger system. In addition to those two points of analysis, the framework explicitly incorporates decision support as a subsystem within the larger sy"] [-1.9577136039733887, 14.127593040466309, "o other interdependent systems\u2014to that subsystem. This approach is very similar to that of Rose, 2004, and others, who have used input-output and computable general equilibrium\u2013type models that can simulate the interdependencies in the supply chain. "] [-1.9504563808441162, 14.118351936340332, " actors, environments, purposes , \nand disciplines involved. Instead, the landscape of resilience indicators is just as \ndiverse as the systems, communities, or disasters that are studied . \nIt is difficult to develop a single system of metrics that"] [-1.9250186681747437, 14.095210075378418, "ional, community capital, environmental, educational, and health systems that were identified in Cutter, 2016. \nIn addition to the systems discussed in the aforementioned reviews, there are various \nresilience indexes that have been considered. For "] [-1.9686129093170166, 14.126205444335938, " of the indicator systems is that if the subsystems are resilient, then the \nsystem is resilient. This is a significant assumption and one that misses a point often made in the \nresilience literature: There are cascading consequences across the syste"] [-1.9544340372085571, 14.134415626525879, "atrix that summarizes the strength and presence of a connection between two subsystems can be used as a weighting matrix in the development of an index of resilience that comes from indicators of resilience of the subsystems. Rather than relying on s"] [-1.9992456436157227, 14.070189476013184, ", pp. 1403\u20131409. \nAdger, W. Neil, \u201cSocial and Ecological Resilience: Are They Related?\u201d Progress in Human \nGeography, Vol. 24, No. 3, 2000, pp. 347\u2013364. \nAhmed, Rashid, Mohamed Seedat, Ashley van Niekerk, and Samed Bulbulia, \u201cDiscerning \nCommunity R"] [-1.9758868217468262, 13.85577392578125, "s of Coordinating Human \nService Transportation and Transit Services, Washington, D.C.: Transportation Research Board, Report 91, 2003. As of August 5, 2019: http://onlinepubs.trb.org/onlinepubs/tcrp/tcrp_rpt_91.pdf \nButler, Lisa D., Leslie A. Morlan"] [-1.9504636526107788, 13.894515037536621, "8\u2013606. \nCutter, Susan, Bryan Boruff, and W. Lynn Shirley, \u201cSocial Vulnerability to Environmental \nHazards,\u201d Social Science Quarterly, Vol. 84, No. 2, June 2003, pp. 242\u2013261. \nda Silva, Jo, and Braulio Eduardo Morera, City Resilience Framework, Unit"] [-1.922065258026123, 13.948338508605957, "rd, NCHRP Synthesis 527, 2018. \n 89 Francis, Royce, and Behailu Bekera, \u201cA Metric and Frameworks for Resilience Analysis of \nEngineered and Infrastructure Systems,\u201d Reliability Engineering and System Safety, Vol. \n121, January 2014, pp. 90\u2013103. \nG"] [-2.0249102115631104, 14.175220489501953, "ty and Emergency Management, Vol. 6, No. 1, 2009, pp. 1\u201348. \nKimhi, Shaul, and Michal Shamai, \u201cCommunity Resilience and the Impact of Stress: Adult \nResponse to Israel\u2019s Withdrawal from Lebanon,\u201d Journal of Community Psychology, Vol. \n32, No. 4, July"] [-1.990918755531311, 13.844635963439941, "North America,\u201d Transport Policy, Vol. 37, January 2015, pp. 167\u2013176. \nMarshall, Wesley E., Alejandro Henao, and Rachel Bronson, Building a Framework for \nTransportation Resiliency and Evaluating the Resiliency Benefits of Light Rail Transit in Denve"] [-1.8860803842544556, 13.852198600769043, "gy Use and Greenhouse Gas Emissions: A Longitudinal Study from Vancouver, Canada,\u201d Transportation Research Part D: Transport and Environment, Vol. 62, 2018, pp. 715\u2013725. \nNicholls, Sarah, \u201cMeasuring the Accessibility and Equity of Public Parks: A Cas"] [-1.9630082845687866, 13.876444816589355, " Act, Washington, D.C., December \n4, 2015. \nPublic Law 115-254, Federal Aviation Administration Reauthorization Act, Division D, Disaster \nRecovery Reform, 2018. \n 94 Putnam-Walkerly, Kris, and Elizabeth Russell, \u201cWhat the Heck Does \u2018Equity\u2019 Mean?"] [-1.98292875289917, 13.848699569702148, "enter, The Wharton School, University of Pennsylvania, Working Paper No. 2018-01, March 2018. As of August 5, 2019: https://web-oup.s3-us-gov-west -1.amazonaws.com/showc/assets/File/ \nCIRI_Tonn_Improving%20US%20Transportation%20Infrastructure%20Resil"] [-1.9243403673171997, 13.893804550170898, "in/erelief.cfm \nU.S. Department of Transportation, Federal Transit Administration, \u201cTransportation \nImprovement Program (TIP),\u201d webpage, March 11, 2019. As of March 11, 2019: https://www.transit.dot.gov/regulations-and-guidance/transportation-plannin"] [16.205196380615234, 12.428565979003906, "CORPORATIONResearch Report\nThe Welcome Baby Program\nAn Implementation and Outcomes \nEvaluation\nSarah B. Hunter, M. Rebecca Kilburn, Teryn Mattox, Jill S. Cannon, \nTerry Marsh, Melissa Felician, Maya Buenaventura, Lauren Davis, \nMatthew CefaluLimite"] [12.650224685668945, 13.586584091186523, "icy concerns that are influenced by social \nand behavioral actions and systems that affect well-being. For more information, email \nsbp@rand.org. \nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to \nactively impr"] [16.182085037231445, 12.45938777923584, " Question 1: To What Extent Are Sites Implementing Welcome Baby to Fidelity? ............. 19\t\nEvaluation Question 2: Is There Variability in Site s\u2019 Ability to Reach Fidelity to Welcome Baby? ..... 23\t\nEvaluation Question 3: How Are Sites Maintain"] [16.17487907409668, 12.462118148803711, "............................................ 40\t\nFigure 4.2. Percentage of Primary and Secondary Referral Types for Which Each Site Has \nValid Contact Information ......................................................................................"] [16.174789428710938, 12.463703155517578, "............................ 70\t\nFigure 4.18. Percentage of Infants with Passing Scores on Each of the ASQ-3 Domains ............ 71\t\n \n vi Tables \nTable S.1. The Welcome Baby Fidelity Domains ......................................................"] [16.169248580932617, 12.470052719116211, "......................................................... 29\t\nTable 4.7. Hospital Enrollment (Domain 7) Percentage Approached and Enrolled, \nby Site ...................................................................................................."] [16.193462371826172, 12.442426681518555, "ty are born healthy, maintain a healthy weight, are safe from abuse and \nneglect, and enter kindergarten ready to succeed in school and life (F5LA, 2014a). Over the last \ndecade, F5LA has developed a unique approach to supporting families through a t"] [16.1876163482666, 12.44819164276123, "n was designed to help F5LA decide how to best allocate resources for \ntraining, program monitoring, and other program management activities. The evaluation findings \nare also likely to be valuable to other home visiting programs, as the fidelity com"] [16.178205490112305, 12.461729049682617, "ndated. \nF5LA developed a Welcome Baby Fidelity Framework (see Table S.1; Appendix A) to guide \nthe implementation of the program, and the framework specifies central components of the \nprogram in terms of staff training and expertise, number and ti"] [16.176616668701172, 12.463715553283691, "ent \nFocus \nGroups Staff \nSurvey Referral \nDocuments Client \nSurvey Stronger \nFamilies \nDatabasea \n1. To what extent are \nsites implementing \nWelcome Baby to \nfidelity? X X X \n2. Is there variability in \nsites\u2019 ability to reach fidelity to"] [16.17723274230957, 12.46318531036377, "aining Community Resource and Referral Networks? What, If \nAny, Gaps Exist in These Networks? \nThe completeness of referral directories varied widely across sites. Very few sites had \ndeveloped the organizational infrastructure to facilitate successf"] [16.167558670043945, 12.472506523132324, " leaving the program. \n6. To What Extent Do Participants Achieve Short- and Intermediate-Term Outcomes? \nWe examined Welcome Baby participants\u2019 outcomes across all sites and visits for 12 \noutcome measures. Where regional or national benchmarks were "] [16.17731475830078, 12.46250057220459, " is particularly important because reflective supervision was related to several positive participant outcomes, such as well-child \nvisits, immunizations, home safety, and safe sleeping practices. Reflective supervision also \nappears to negatively re"] [16.175724029541016, 12.462393760681152, "pment of \ndetailed protocols for all high-priority referral types, including public benefits, alcohol, smoking, and drug treatment (all protocols should include the provision of client confidentiality). F5LA \nshould also support sites in developing a"] [17.453969955444336, 8.29150390625, " Agniel, Mollie Rudnick, Christian Lopez, Patricia Lozano, Anamarie Auger, and Lance Tan. Rachana Seelam and Rodger Madison were the study \nprogrammers and assisted with the data safeguarding plan. We appreciate Tiffany Hruby\u2019s help \npreparing this d"] [16.203845977783203, 12.431743621826172, "the quantity of births and diversity of families, it is not surprising that child and family \noutcomes are highly variable. There have been gains in some areas over the last decade\u2014for \ninstance, the rate of third-grade students scoring at or above p"] [16.191774368286133, 12.434586524963379, "s to use a \nfamily-centered, strength-based approach to accomplish the following objectives: ensuring \nparents can provide enriching structured and nurturing environments, strengthening parental \nresilience and self-efficacy, ensuring that children a"] [16.188379287719727, 12.446224212646484, "act evaluation should be conducted. 3 Figure 1. 1. Welcome Baby Logic Model: Family & Child Level \n \nSOURCE: F5LA, \u201c First 5 LA Welcome Baby Logic Model: Family & Child Level,\u201d fact sheet, undated. \nNOTE: PHQ = Patient Health Questionnaire; ASQ = "] [16.185340881347656, 12.452066421508789, "dy of the early implementation of the Welcome Baby expansion in the \nremaining Best Start sites was conducted in March 2014. Through semistructured interviews with a variety of key stakeholders, researchers found that stakeholders were enthusiastic a"] [16.18604850769043, 12.452266693115234, " our approach to examining \nimplementation and outcomes, results from the evaluation, implications, and conclusions. \nChapter 2 provides an overview of the Welcome Baby program. Chapter 3 describes the data \nsources used for each of the evaluation qu"] [16.19318389892578, 12.438913345336914, "lp them better \nconnect with their child. \nSoon after delivery, a Hospital Liaison conducts a risk assessment with women interested in \nreceiving home visitation services. The level of risk identified through the Modified Bridges for Newborns Screen"] [16.178382873535156, 12.460403442382812, "1 \nAsian 1.92 \nMother \u2019s risk factors \nAverage Bridges Score (standard deviation) 43.27* \n(16.33) \nPercentage first time mothers 36.60 \nChild \u2019s risk factors \nPercentage gestational age < 37 weeks at birth 7.26 \nPercentage low birth weight "] [16.17729377746582, 12.462728500366211, "treach Specialists develop and maintain key community contacts, conduct client intakes, and follow up with potential clients. \nFigure 2.2 depicts an organizational chart for a typical site. \nFigure 2.2. Typical Welcome Baby Site Organizational Chart "] [16.180402755737305, 12.459248542785645, "m families, the Welcome Baby pilot study, and extensive meetings with other \nstakeholders (LABBN, 2008). \nTable 2.3. The Welcome Baby Fidelity Domains \nFidelity Domain Description \n1. Staff Qualifications Staff meet minimum requirements \n2. Staf"] [16.173355102539062, 12.46448040008545, "of Welcome Baby stakeholders to ensure that multiple perspectives are included \n\u2022 pilot test all instruments before deploying \n\u2022 design data collection, analysis, and reporting procedures to facilitate sustainability by \nWelcome Baby stakeholders for"] [16.164016723632812, 12.477228164672852, "ion on the staffing- and service delivery\u2013related domains, \nand client focus groups helped to explain variation in the participant-related domains (e.g., participant perception of the relationship). \n 14 Table 3 .2. Quant itative Data Sources That "] [16.175025939941406, 12.46567440032959, "on allowed us to collect qualitatively rich \ninformation about staff perceptions of support for Welcome Baby program implementation, \nincluding factors that staff perceived as influencing program delivery. Key domains in the \ninterview protocol inclu"] [16.181364059448242, 12.458913803100586, "variability in sites\u2019 abil ity to reach fidelity to Welcome \nBaby? If so, what factors account for this variability? \n \nTopic areas (components of \nfidelity framework) \n \u2022 staff qualifications \n\u2022 staff training \n\u2022 supervisory requirements \n\u2022 ref"] [16.178598403930664, 12.461755752563477, "m outcomes? \n7. What are the relationships between program fid elity outcomes \nand participant outcomes? \nTopic areas (components \nof fidelity framework) \u2022 parent perceptions of the relationship with the Welcome Baby \nproviders (part of fidelity "] [16.17168617248535, 12.46752643585205, "ut every site achieved fidelity in at least two domains (supervisory \nrequirements and participant perception of the relationship). Individual sites achieved fidelity in \n18 to 80 percent of measured domains, with an average of 48 percent. \nMethods \n"] [16.175119400024414, 12.466032981872559, ", Parent Coach \nSupervis ors, and RNs met minimum \nclient engagement requirements, \nbased on number of visits in last week \nworked prior to survey 78% of staff \nD7. Hospital \nEnrollment Site reports \n(12 months \nper site) January\u2013\nDecember \n201"] [16.19167137145996, 12.446328163146973, "y \nshading and \u201cN/A\u201d indicates we did not have data for that site and domain. Additionally, we \nexclude from the summary the three domains for which we did not have available data for site-\nlevel analysis (domains 6, 12, and 14). Eight of the 12 site"] [16.172630310058594, 12.468534469604492, "ts and participant perceptions of \nthe relationship), all assessed sites achieved fidelity thresholds with the Welcome Baby model; \nthree sites achieved one domain each (one site met staff qualifications, one met reflective \nsupervision, and one met "] [15.136077880859375, 13.609909057617188, "alysis. Data were coded independently by research staff using a \n 24 constant comparative process. Initial coding was done on notes from 25 of the earliest interviews \nconducted, using a conventional content analysis approach and allowing the conten"] [16.157886505126953, 12.483637809753418, " the 11 measured domains \n(domains for staff qualifications, reflective supervision, and hospital enrollment), only one site \nmet fidelity thresholds. For one domain (participant perception of the relationship), all 12 sites \nmet fidelity thresholds;"] [16.170717239379883, 12.47084903717041, "blic \nhealth certification and six months of home visiting experience. That\u2019s hard to find, especially the home visiting experience. It would be easier to get [RNs] if they could \nshadow for training and get that home visiting experience that way. \n"] [16.170745849609375, 12.47120189666748, "allenging because on \ntraining days that are back to back it really cuts into seeing clients. We have to see \n32\u201340 [clients] and if I miss two to three days in a month for training, I can only see \n32 at the most. It cuts into my numbers when we hav"] [16.16672134399414, 12.476320266723633, "is supervisory \nrequirement. \n 28 Domain 4: Reflective Supervision \nAcross the five staff positions, an average of 61 percent of all staff met minimum individual \nand group reflective supervision requirements in the past three months (Table 4.5). O"] [16.092594146728516, 12.551692008972168, "rcent \nmeeting workload requirements (Table 4.6). We note that threshold achievement rates were \ncalculated based on survey responses for the number of client visits conducted in the last week \nworked, which we multiplied by four to determine number "] [16.141456604003906, 12.498750686645508, "three to four clients a day and \nstretching themselves. \nDomain 6: Prenatal Enrollment \nAlthough we were unable to assess whether sites met the fidelity threshold on this domain \nusing quantitative data, staff were asked in the interviews whether th"] [16.17009735107422, 12.470930099487305, "cember 2017 . \nDomain 7: Qualitative Findings \nConsistent with the quantitative findings, staff reported more challenges in missing some \nclients at the hospital (the \u201capproach\u201d requirement of this domain) than in enrolling families once \napproached"] [16.168441772460938, 12.47362232208252, " losing a client. \nAlthough the largest drop-off in program participation occurs between the hospital and home \nvisits, we did not find consistent themes addressing this time point. \nDomain 9: Timing of Service Delivery \nThe fidelity threshold was b"] [16.171613693237305, 12.46877670288086, "er examples about these points). \nDomain 10: Referrals to C ommunity Services \nThe fidelity threshold was based on rates at or above the Welcome Baby\u2013wide average, \nwhich was 25 percent of referrals as reported in SFDB data. We included referrals ma"] [16.187088012695312, 12.451669692993164, "a are not subject to external validation. Additional information \non how this measure was specified can be found in Appendix C. Most recommended content \nitems from the Welcome Baby Fidelity Framework were captured in the SFDB data, but in a few \ncas"] [16.11910629272461, 12.510713577270508, "ted documents, we \n 37 identified gaps in referral networks or procedures that may be preventing the proper \nimplementation or successful completion of referrals. \nUsing this approach, we requested the following documents from each site\u2019s Program \nM"] [16.139591217041016, 12.491284370422363, "ral types. \n 39 Table 4.13. C ategories of Information Gathered for Primary and Secondary Referral Types \nDocument Type Primary Referral Types Secondary Referral Types \nReferral directory Contact information present in a centrally \nmaintained"] [16.13912010192871, 12.496195793151855, "gure 4.2). One site did not \nhave a referral directory, while two additional sites had referral directories with less than 50 \npercent of categories covered. Across the primary referral types, with respect to smoking \ncessation and SSDI/Supplemental "] [16.1617488861084, 12.474355697631836, "l types \n 42 consideration indicates the presence of a clear and present danger to an individual or to \nothers (Alliance of Information and Referral Systems, 2017). \n\u2022 Role of home visitor in making referral: Does the protocol require staff to assist"] [16.173309326171875, 12.467700958251953, "re not made because there were no resources in the \ncommunity to refer families. The most common responses were the lack of mental health care \nresources, especially for clients with Medi-Cal or with no insurance, and limited housing service supports"] [15.20097827911377, 13.513002395629883, "obtain qualitative feedback, we conducted 20 focus groups (in Spanish and English) that \nincluded 140 participants across the 12 sites. Similar to the site interviews, field notes taken \nduring the focus groups were reviewed against the digital recor"] [16.18657112121582, 12.448974609375, " to the nine-month visit). The size of the sample across some of the sites precluded us from running \nstatistical tests, but the observed average values and standard deviations showed consistently \npositive scores with low variability across the site"] [16.179279327392578, 12.460772514343262, " requires a lot of \ninformation. Here with Welcome Baby it was fast and did not take much time. \n\u2022 It was pretty fun, she explained a lot of cool things about the program. \n\u2022 It was a good experience, the lady who enrolled me was really nice, and she"] [16.174545288085938, 12.466891288757324, " a question\u2014it would be much easier. \n\u2022 I would like to get the information in a way that has more visuals. The book that we get \nhas too much information [that is difficult to digest]. \nAnother commonly expressed program improvement recommendation"] [16.198387145996094, 12.443129539489746, "g me with information. \nProgram participants also felt that Parent Coaches gave them the confidence they needed, \noften assured them that they were doing a good job, and cared not only about the baby but also \nabout them (as moms) and about their oth"] [16.1629695892334, 12.476701736450195, "ient or visit characteristics were associated with continuing to the next visit. \nMethods \nThe dependent variable in the model was the visit. The visits considered were \n\u2022 the RN visit \n\u2022 the two-to-four-week visit \n\u2022 the two-month visit \n\u2022 the thre"] [16.17766761779785, 12.463475227355957, "ferent types of families. The fidelity variable was measured at the previous visit\u2014for example, staff qualifications at the hospital visit for the \u201chospital to RN\u201d \ntransition analysis. Not accounting for these differences may bias the estimates of t"] [16.177919387817383, 12.458893775939941, "ns. \nRelationship Between Family Characteristics and Program Retention \nWe examined demographic/family, birth, and visit characteristics to better understand \nprogram retention. Across all visits, receiving prenatal services was the only characterist"] [16.180757522583008, 12.458601951599121, "\u20130.31 \u20130.17 \u20130.17 \nAge >34 \u20130.02 0.00 0.26 0.13 0.19 \nFirst birth 0.11 \u20130.10 \u20130.01 \u20130.09 \u20130.08 \nLow-birthweight \nchild 0.28 0.26 \u20130.22 \u20130.21 \u20130.26 \nBirth complications 0.26 0.15 0.19 \u20130.19 \u20130.19 \nPrevious Visit Variables \nWorked full time 0.08 N"] [16.176895141601562, 12.464017868041992, "sit Transition \nFidelity Component Hospital to \nRN Visit RN to Two -to-\nFour -Week \nVisit Two-to-Four -\nWeek to Two-\nMonth Visit Two-Month \nto Three -to-\nFour -Month \nVisit Three -to-\nFour -Month \nto Nine-\nMonth Visit \nD1. Provider met \nminimum "] [16.194177627563477, 12.439652442932129, "nsight into how Welcome Baby clients fare relative to these \nexternal benchmarks. While we do not have the data to assess the degree to which the samples in \nthese other data sets are comparable to the Welcome Baby sample, they use similar age groups"] [16.194677352905273, 12.44272232055664, " \nAbout how often does your child have \na chance to get ou t of the house? 5 = every day \n4 = 4 or more times a week \n3 = a few times a week \n2 = about once a week \n1 = a few times a month or less Child gets out of the house at least 4 \ntimes pe"] [16.193235397338867, 12.441038131713867, " measured using a modified version of the \nKIDI (MacPhee, 1981). Several items on the KIDI were modified, and many items were \nremoved entirely from the survey at the request of F5LA, such that the full KIDI scale was not \nkept intact. The full list "] [16.219335556030273, 12.422728538513184, "ternal depression, \nusing data from the SFDB, the Welcome Baby administrative database described in Chapter 3. \nFamily planning was measured using the home visitor\u2019s report of whether the client used any \nform of family planning or contraception. Th"] [16.191082000732422, 12.447991371154785, "e 5\nSite 1Site 9Site 6Site 7Site 3\nSite 8\nSite 10\nSite 4\nSite 12Site 11\nSite 2\nPRAMS (2004\u2013 2006) NSFG (2006 \u20132010) \n 63 nurse should administer the PHQ-9 (Kroenke, Spitzer, and Williams, 2001), which is a more \ndetailed evaluation for assessing mild"] [16.200895309448242, 12.43443775177002, "h visits (36 percent in \nWelcome Baby versus 38 percent in the LAMB), and slightly more likely to be incorporating \nbreastfeeding in some capacity into their infant feeding routine than the average for Los Angeles \nCounty at both the 72-hour (93 perc"] [16.201183319091797, 12.434338569641113, "e was no recent benchmark for children\u2019s insurance coverage at hospital exit, or at a specific \ntime in the first year. \nFigure 4.12. Percentage of Clients Whose Infant Is Covered by Health Insurance, by Visit , with Los \nAngeles County Benchmark "] [16.197772979736328, 12.435269355773926, "home safety inspection was completed with no issues identified. Home visitors then provide \ntailored home safety education to the client according to needs identified. \nThe vast majority of home safety issues identified fall in the category of inade"] [16.18785858154297, 12.449087142944336, "nchmarks \n \nSOURCES : SFDB for Welcome Baby ( n = 4,958, January 2016\u2013 December 2017); Los Angeles County Department \nof Public Health for LAMB, 2014 (n = 6,035) . \nChild Development \nAs part of the Welcome Baby curriculum, Parent Coaches adminis"] [16.178178787231445, 12.46308708190918, " For the five \npostpartum visits beginning with the RN visit, we estimated a set of models for 12 outcomes \nwith these fidelity components. The outcomes were positive parenting practices, parent \nknowledge of infant development, use of family plannin"] [16.179615020751953, 12.46141529083252, "nt for \nclustering. For the few continuous outcomes in our analysis, we used the mixed command in \nSTATA. Also as described in the methods for Evaluation Question 5, we used the Benjamini-\nHochberg procedure with a false discovery rate of 0.10 to adj"] [16.153850555419922, 12.48671817779541, "taff training \nand workload standards were associated with lower rates of family planning. Further, meeting \nthe home visitor workload fidelity threshold was associated with lower use of family planning \nfor the last four visits, one of the most cons"] [16.17224884033203, 12.468353271484375, "e \nrelationships across all the outcomes for the five visits. \nOverall we find little evidence to support a relationship between the fidelity components and \nclient outcomes. This finding could be because of a true null effect or to the analyses bei"] [16.139238357543945, 12.501277923583984, "idelity in at least two domains (supervisory requirements and participant \nperception of the relationship). Within each domain, between 18 and 80 percent of sites met the fidelity threshold. \n2. Is there variability in sites\u2019 ability to reach fidel"] [16.177444458007812, 12.463597297668457, "but a lower likelihood of staying in the program for later visits. For the \n2-to-4-week visit and later visits, adherence to Welcome Baby fidelity standards is related to lower rates of \nparticipant s leaving the program. \n6. To what extent do part"] [16.17632293701172, 12.465229034423828, "here the sites on average scored well, but we did not have any \nbenchmarks to compare to the Welcome Baby site performance, including \n\u2022parenting knowledge\n\u2022immunization rates\n\u2022home safety. \n 78 Recommendations for Improving the Welcome Baby Program "] [16.171571731567383, 12.469614028930664, "frequently, and staff across positions and sites \nquestioned the quality and value of reflective supervision. Since reflective supervision appeared \nto negatively relate to retention between the hospital and RN visit, an examination of the quality \no"] [16.195276260375977, 12.445534706115723, "ompleting four or more postpartum visits, there are potentially lessons \nlearned from staff at the high-performing sites that could help improve performance at other \nsites. \nReferrals to Community Services ( Domain 10) \nSite performance on this f"] [16.17345428466797, 12.46870231628418, "ition (i.e., Evaluation Question 5), we examined both \nparticipant characteristics and performance on the fidelity domains. The practical value of the \nfindings from these analyses is twofold. Knowing which family characteristics are associated \nwith"] [16.179367065429688, 12.461481094360352, "pecific policy issue. The findings do suggest some areas where \nF5LA could explore some improvements or clarity in Welcome Baby policies and procedures as \ndescribed in more detail in next section. \nOngoing Monitoring for Quality Improvement \nAs des"] [16.17821502685547, 12.462835311889648, "uation was designed to gather information on the 14 elements or domains of program fidelity within the \nWelcome Baby Fidelity Framework. However, we lacked available data to assess site fidelity in \nthree domains: prenatal recruitment and enrollment "] [16.177661895751953, 12.463501930236816, "o be a self-administered instrument and \nvalidated for pen-and-paper as well as electronic administration (Erbe et al., 2016). The \nreliability of the PHQ when administered verbally has not been well-established (Mission \nHealth, 2018). In the Welcom"] [16.204971313476562, 12.430941581726074, "amount of variability in the degree to which individual \nsites achieved fidelity to the Welcome Baby model and the rate at which thresholds were met across the different fidelity domains. Similarly, sites varied widely in the completeness of their \nr"] [16.199214935302734, 12.425674438476562, "stitute, 2013. \nBenatar, Sarah, Heather Sandstrom, Embry Howell, Timothy Triplett, Ian Hill, Margaret \nWilkinson, and Todd Franke, Best Start in LA Pilot Community Evaluation: Effects of \nWelcome Baby Home Visiting: Findings from the 24-Month Child "] [16.21053695678711, 12.40478801727295, " Replicating Home Visiting \nPrograms with Fidelity: Baseline Data and Preliminary Findings , Washington, D.C.: \nChildren\u2019s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services, 2012. \n 87 Daro, Deborah, Kar"] [16.198768615722656, 12.424089431762695, " Jennifer Ho, Effects of Welcome Baby Home Visiting on Maternal \nand Child Medi-Cal Enrollment and Utilization: Findings from a Merger of Welcome Baby \nand Medi-Cal Data, Washington, D.C.: The Urban Institute, 2017. \nIngoldsby, Erin M., Pilar Baca, "] [16.805694580078125, 8.04482650756836, "de for Communities, Santa Monica, Calif.: RAND \nCorporation, RB-9741-SNM, 2013. As of August 8, 2018: \nhttps://www.rand.org/pubs/research_briefs/RB9741.html \nMcCroskey, Jacquelyn, and William Meezan, \u201cFamily-Centered Services: Approaches and \nEffecti"] [2.8249003887176514, 4.287787437438965, "ased Examination of Risk Factors for Involvement with Child Protective Services,\u201d Child Abuse and Neglect, Vol. 37, No. 1, January 2013, pp. 33\u201346. \nO\u2019Connor, Elizabeth, Rebecca C. Rossom, Michelle Henninger, Holly C. Groom, and Brittany \nU. Burda, \u201c"] [2.8184709548950195, 4.285436630249023, "l. 52, No. 2, 2015, p. 30. \nWhite, Kari, Stephanie B. Teal, and Joseph E. Potter, \u201cContraception After Delivery and Short \nInterpregnancy Intervals Among Women in the United States,\u201d Obstetrics and Gynecology, \nVol. 125, No. 6, 2015, p. 7. \nWhiteman,"] [10.45369815826416, 18.370925903320312, "CORPORATION\nPhysician Reporting \nRequirements for Injured Workers in California\nA Review of Reporting Processes and Payment \nPolicies\nDenise D. Quigley, Madeline B. Doyle, Barbara O. WynnLimited Print and Electronic Distribution Rights\nThis document "] [11.326472282409668, 17.691566467285156, "nt of Industrial Relations under contract \n41336064. It was conducted under the umbrella of RAND\u2019s Justice Policy Program. \nRAND Justice Policy \nThe research reported here was conducted in the RAND Justice Policy Program, which spans \nboth criminal "] [10.05276870727539, 18.435401916503906, " Physician Services ............................................................... 5 \nSummary of Methods .................................................................................................................. 6 \nOrganization of This Repor"] [10.13149642944336, 18.46677017211914, ".................................................................... 35 vi Chapter Five: Allowances for Workers\u2019 Compensation\u2013Required Reports Within the \nResource-Based Relative Value System Context ................................................"] [10.084228515625, 18.44822120666504, "..............................................................................................................................3 \nTable 1.2. Summary of Physician Reporting Requirements Across California and the \n20 States in Environmental Scan ......"] [10.176767349243164, 18.470125198364258, "...90 \n ix Summary \nCalifornia\u2019s workers\u2019 compensation (WC) program provides medical care and wage-\nreplacement benefits to workers who suffer on-the-job injuries and illnesses. Injured workers are \nentitled to receive all medical care reasonably r"] [10.000019073486328, 18.42225456237793, "t. Third, we compared the x allowances for the WC-required reports under the Official Medical Fee Schedule (OMFS) with \nthe allowances for other services that require comparable physician activities and estimated the impact of any changes in the fee"] [9.992856979370117, 18.4269962310791, "patient\u2019s \nprogression toward maximal medical improvement and return to work. Within this overall framework, the reporting requirements should be designed to provide information needed for claims management and care coordination while imposing minima"] [9.973180770874023, 18.41556739807129, "smissions, it does not include transmission of a paper form via \nfacsimile (U .S. Department of Health and Human Services, 2013). xii \u2022 To facilitate care coordination: \n- Clarify that secondary treating physicians should submit RFAs for proposed \n"] [9.98473834991455, 18.429914474487305, "n to similar services paid under the \nRBRVS and substantially lower than the allowances under the medical-legal fee schedule. \n! Give the primary treating physician the option of not evaluating the impairment level and completing the P&S report. Inco"] [9.988253593444824, 18.436874389648438, "\nHCPCS Healthcare Common Procedure Coding System \nICD-9 International Classification of Diseases, Ninth Revision \nML Medical-Legal \nMMI maximal medical improvement \nOMFS Official Medical Fee Schedule \nP&S Permanent and Stationary \nPE practice expens"] [10.013827323913574, 18.425251007080078, " \n1 SB 863, which was enacted on September 18, 2012, contained a number of provisions that touch on different aspects of the \nmedical care system. The intent is to constrain the rate of increase in medical expens"] [9.973217010498047, 18.41156578063965, "the report is not separately payable but rather is included within the allowance for the underlying evaluation and management (E&M) visit. \nPrimary Treating Physician\u2019s Progress Report \nOver the course of treatment for a WC claimant, primary treating"] [9.981274604797363, 18.433988571166992, " \n2 All issues related to utilization review will be addressed in a separate RAND study examining the impact of the SB 863 \nprovisions. The report is currently being reviewed and canno"] [10.005976676940918, 18.507083892822266, "ng as his or her report contains all the information required by 8CCR \u00a710606. \n4 In contrast, DWC maintains two elect ronic record systems for other claims transactions. The Workers \u2019 Compensation \nInformation System (WCIS) uses the standards ado"] [9.660645484924316, 18.97950553894043, "nsition period beginning January 1, 2014. Relative to the pre-RBRVS fee schedule, the RBRVS fee schedule increased the overall allowances for E&M visits and for medicine and decreased the allowances for surgery, radiology, pathology, and anesthesia. "] [10.010261535644531, 18.42679786682129, "or the typical non-WC patient. The PR-2 and P&S report were viewed as atypical, WC-specific reporting requirements, and separate allowances were continued at pre-RBRVS levels but with regular updates. The separate allowances are not included in the 1"] [10.025583267211914, 18.43504524230957, "d the \n20 States in Environmental Scan \n DFR PR-2 P&S Report \nArizona Required Required Required \nCalifornia Required Required Required \nFlorida Required Required Required \nGeorgia Not required (optional) Not required Required \nIllin"] [10.034209251403809, 18.432340621948242, "C-required reports and compares them to the OMFS allowances for comparable services. \n\u2022 Chapter Six summarizes our findings and potential refinements that might be made in the reporting requirements and reporting policies to improve the quality of re"] [9.97143268585205, 18.40542984008789, "ally agree to submitting comparable information in another format and reporting mode. SB 1160 (Mendoza) amended the Labor Code in September 2016 to require that the DFR be filed electronically with DWC and the employer.\n2 \nBecause separate bills are"] [9.990729331970215, 18.418046951293945, "the selected states. Nearly all states requiring a DFR permit the form to be submitted electronically\n5 and also have a print-\nformat version of the form to be completed manually and submitted as a hard copy via mail, fax, or hand delivery. \nAmong th"] [9.985937118530273, 18.427093505859375, "at Fillable PDF, \nread-only PDF Fillable PDF, \nread-only PDF Read -only PDF Fillable PDF, read-only \nPDF, Word file \nReporting mode Mail, fax, email, or \nelectronic (if payer \nand provider agree) \n Electronic \nsubmission (online portal) , mail "] [9.987646102905273, 18.42221450805664, "e case in \nCalifornia) believe that the allowance for the E&M visit does not appropriately compensate the provider for filing a DFR. In Texas, where the DFR is paid at a flat rate, physician compliance with submitting the report is not an issue. In W"] [9.974087715148926, 18.410329818725586, "parison to the \nCalifornia DFR ). 13 When the physician sees and examines the patient, he or she performs the following steps, \nwhich are considered part of the E&M visit: \n\u2022 Review the patient\u2019s history and the patient\u2019s account of the injury and h"] [9.977784156799316, 18.410057067871094, "he life of the claim. \nReporting Issues and Potential Improvement s \nDuring the interviews with California physicians and users, several issues were raised \nconcerning the DFR. Physicians and users alike indicated that there is a lack of clarity on w"] [9.966614723205566, 18.392955780029297, "d, information on a DFR \ncompleted by an emergency physician is often not consistent with or as comprehensive as the information on subsequent DFRs. Some payer interviewees indicated that the DFR serves to alert the payer that there has been a change"] [9.96807861328125, 18.4224853515625, "d to manage the claim, other \nthan as a potential mechanism to alert the claims administrator that a change of primary treating physician has occurred. \nPhysicians believe that bundling the report into the allowance for the examination does not \nappr"] [9.96841812133789, 18.432157516479492, " In total, an estimated 1.4 million reports were filed that resulted in more than $15 million in medical expenditures in 2014. Because of WCIS underreporting, these estimates understate total volume 18 and spending. Payments for PR-2s were nearly 1 "] [9.974554061889648, 18.42909812927246, "ss Reports \nOf the 20 most populated states, 6 states require the primary treating physician and, in some \ninstances, any ancillary physician to complete and file progress reports throughout the life of a \nWC claim. These states are Arizona, Florida,"] [10.006606101989746, 18.418033599853516, " there is a change in the injured worker\u2019s work status or work restrictions or the carrier has established a reporting schedule based on the worker\u2019s scheduled appointments with the primary treating physician. 20 Table 3. 2. Features of PR -2 for C"] [9.975895881652832, 18.413908004760742, " the most populated states require prospective authorization for at least some \ntreatments or services. These states are Florida, Indiana, Minnesota, New York, North Carolina, Ohio, Texas, and Washington. Six of these states have a separate form. Flo"] [9.976987838745117, 18.400066375732422, "f the primary treating physician. \nAfter a patient visit, the primary treating physician reviews and incorporates his or her \nobservations and findings from the recent visit and any secondary or specialty treating physician reports. Then, the physici"] [9.967376708984375, 18.40376091003418, " on the authorization, it would be appropriate to see the patient more or less frequently than 45 days. 23 Request for Authorization \nAccording to our interviews held with physicians and users, the primary purpose of the RFA \nis to request authoriza"] [9.952278137207031, 18.39180564880371, "medical reasons for specific medication or procedural requests, and that only in instances in which there is a significant delay will the primary treating physician submit the RFA on behalf of the specialist. \nThe level of effort required to complete"] [9.961203575134277, 18.401498794555664, "s with the patient\u2019s progress \nUsers indicated that the progress report should provide a comprehensive and thorough \ndescription of the patient\u2019s progress and response to treatment. It should be focused on the 25 patient\u2019s status and future treatmen"] [9.969563484191895, 18.40991973876953, "nt requested \n\u2022 Indicates the page number on which the requested treatment can be found (if a medical report is attached to the form) \n\u2022 Is consistent with the treatment plan \n\u2022 Combines all treatments on the same RFA (rather than multiple forms for "] [16.876596450805664, 20.281557083129883, " \n4 Assembly Bill 1124 (Perea) requires DWC to implement a drug formulary by July 1, 2017. DWC is proposing to designate a list \nof exempt drugs that will not re"] [9.936736106872559, 18.366439819335938, "plan, and information on the requested \ntreatment or service to be located in one place. \n\u2022 Allow for modified timelines for submission of PR-2s to align with the patient\u2019s \ntreatment timeline and to correspond with what is medically necessary in the"] [9.97474193572998, 18.421749114990234, "s, which results in insufficient time to review the records before the patient is seen or delays in submitting the PR-2. Finally, the quality of progress reports needs improvement. The physicians and users noted that the reports often do not reflect "] [9.981924057006836, 18.420761108398438, "robat PDF form that can be completed and submitted electronically or can be downloaded and submitted in hard copy. The primary treating physician may substitute or append a narrative report to accompany or replace the form to report adequately on the"] [9.980854988098145, 18.43501853942871, "ery status as P&S and rating the impairment. These are Arizona, Florida, Georgia, Illinois, Minnesota, New York, Tennessee, Texas, and Wisconsin. Washington requires a report from the primary treating physician that the claimant is P&S, but the impai"] [9.945401191711426, 18.47621726989746, " evaluation \nand report ($90) No \nseparate allowance ; \nCPT 99455 used for the evaluation and report ($217.22) No separate \nallowance ; \nallowance for the evaluation and report set at Level 5 E&M consultation code (CPT 99245) Yes; allowance \nis t"] [9.971811294555664, 18.435834884643555, "ices), which includes the report. However, the evaluation often includes medical record review, which does not have an established fee schedule amount and is payable \u201cby report\u201d based on the physician\u2019s report describing the services. By default, thi"] [9.966514587402344, 18.433298110961914, "ess, many reported that completion of the P&S report often takes several hours because the physician is required to account for the research involved, provide a report of the evaluation, and calculate the impairment rating based on the AMA guides. We"] [9.954916954040527, 18.429122924804688, "shes causation, addresses apportionment, and provides a rationale for why the injured worker has been determined to have P&S status \n\u2022 Describes in detail how the physician arrived at the rating and provides supporting information \n\u2022 Indicates the pe"] [9.966062545776367, 18.438196182250977, " the initial report is increasing. \nWe also discussed several opportunities to improve the quality and efficiency of filing final \nP&S reports. The following options were suggested: \n\u2022 Implement graduated allowances to align with timely submission of"] [9.988024711608887, 18.423561096191406, "the patient is P&S. It is used to inform the employer of the work capacities and \nactivity restrictions resulting from the injury that are relevant to potential regular work, modified work, or alternative work. The RTW and Voucher report is required "] [9.723249435424805, 18.97008514404297, "ients, ranging from a Level 1 visit involving a problem-focused history and examination and straightforward medical decisionmaking (typically involving ten minutes of physician face-to-face time) to a Level 5 visit \n "] [9.78824520111084, 18.796422958374023, "The longer time estimates for new patient visits translate into higher RVUs for both the physician work and the practice expense component of new patient visits than for established patients. \nAssumptions regarding any additional reporting and docume"] [9.930559158325195, 18.49639129638672, "patient. When the RBRVS was implemented, the underlying pre-RBRVS \n \n2 The DFR also imposes a reporting burden on the office administrative staff in o"] [9.663446426391602, 18.95155906677246, "ved in preparing the report. To address this challenge, we identified other codes that might be used as indicators for the reasonableness of the allowance for progress reports. Codes that include one or more activities related to coordinating with ot"] [9.640149116516113, 18.99703025817871, "ervice. For example, CPT 99358 is defined as one hour of prolonged service related to an E&M visit without patient contact. Assuming the allowance was for 60 minutes, we calculated the equivalent RVUs at 25 percent of total RVUs. The last columns of "] [9.67974853515625, 18.927745819091797, " physicians. It would account for \nnot only the effort required to complete the report but also the effort involved in \nmanaging the patient between progress reports. \n\u2022 G0181 is billable in a given month if the physician spends at least 30 minutes i"] [9.942282676696777, 18.478294372558594, "mpairment rating, including any medical record review. Both activities are integrally related, and an assessment of the adequacy of the allowance for the report needs to be considered in concert with the allowance for the disability evaluation. In th"] [9.920890808105469, 18.508119583129883, "the combined allowance for the E&M visit (assuming a CPT 99215\u2013established patient visit is billed) and the final PR-2 is $209.42 (line 1 in the table). If the injured worker is determined to be P&S with permanent impairment, the same E&M allowance a"] [9.947022438049316, 18.467689514160156, " are bundled, so we did not find codes that describe the actual activities involved in completing the DFR and PR-2; instead, we identified codes that appear to describe comparable activities. For the P&S, we expanded our comparison to include the fee"] [9.978865623474121, 18.426393508911133, "arch 1, 2017, an additional allowance may be payable for the examination or report when prolonged services are involved. 47 Chapter Six: Summary of Findings, Discussion , and \nRecommendations \nIn this chapter, we first summarize the main findings "] [9.955046653747559, 18.45265007019043, "s from the Lewin study \nimply that the additional reporting burden is not any greater for new WC patients than for other WC patients and that, to the extent that the 20-percent add-on is intended to compensate for the additional resources required to"] [9.955883979797363, 18.399465560913086, "orts from physicians caring for Medicare patients, and most activities performed for Medicare patients that are similar to those required to complete a progress report are separately payable. When we compared what is payable for the average PR-2 with"] [9.949594497680664, 18.45905303955078, "rment and apportionment issues should be eliminated from the P&S report and addressed only in medical-legal examinations. \nThe states with similar data elements to California\u2019s include the allowance for the report in \nthe allowance for the examinatio"] [9.969324111938477, 18.409318923950195, "ount for reporting burden that is not otherwise incorporated into the allowance for the related medical care, and any separate allowances should be designed to encourage high-quality reporting in a timely manner. The remainder of this section discuss"] [9.972559928894043, 18.414531707763672, "e were requested in RFAs that underwent utilization review.\n1 Because DWC rules anticipate physicians will submit RFAs and our review \nof utilization review plans indicates that the use of prior authorization (which waives the RFA) is not widespread,"] [9.972794532775879, 18.405899047851562, "process RFAs could be reduced. Depending on how it is implemented, electronic reporting could provide a platform for communications between the primary treating physician, secondary treating physicians, and the claims administrator. If properly desig"] [9.95532512664795, 18.398571014404297, " to respond to questions that may arise during the medical necessity review process, yet the communication is between the reviewer and the primary treating physician. Second, utilization review decisions, appeal requests for independent medical revie"] [9.961170196533203, 18.405635833740234, "hysician. This way, the primary treating physician would be apprised of the secondary physician\u2019s proposed treatment and could intervene if appropriate. There would be no delays in treatment. Both the primary and secondary physicians should be advise"] [9.971985816955566, 18.415613174438477, "rements could affect a physician\u2019s administrative \nburden in filing the DFR. Completing and filing the report through a website portal is likely to be \nmore burdensome tha n scanning an d uploading a completed document. Either method involves \naddi"] [9.949462890625, 18.459197998046875, "tre atment \nfor pesticide poisoning . \n4 In the past, first- aid-only claims have been underreported to the Workers \u2019 Compensation Insurance Rating Bureau , but the \nextent of the underreporting has not been determined. The bureau\u2019 s rules effective "] [9.937997817993164, 18.471660614013672, "t the 1.2 multiplier. Because the benchmark is based on an estimate of the physician\u2019s time spent completing the PR-2, we do not believe the multiplier is appropriate. A $30 allowance would be a substantial increase (144 percent) over the current all"] [9.923076629638672, 18.45940399169922, "owance to the primary \ntreating physician for the PR-2 only if the PR-2 is complete and addresses all components of the report. In our interviews, we heard concerns from claims administrators regarding the quality of the PR-2s. The rationale for this"] [9.953888893127441, 18.456768035888672, "S report. Without further clarification, the prolonged service codes could lead to duplicate payments. Close monitoring of the use of the codes will be required to identify any abusive billing practices. \nA related issue is whether the current struct"] [9.948892593383789, 18.392440795898438, " as is done in Washington, or whether the primary treating physician can independently choose to perform the rating. \nPotential Improvements in Physician R eporting Requirements \nAs discussed previously, we identified three overarching refinement obj"] [10.006917953491211, 18.426973342895508, "ned using the medical-legal evaluation process. \n- Use the allowance for the DFR and any increases in the allowances for other \nreports to incentivize timely electronic submissions of high-quality WC-required \nreports. \nOur research was completed pri"] [10.093428611755371, 18.45933723449707, "setts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington, and Wisconsin. Refer to Table A.1 for the population numbers and Figure A.1 as a visual representation of the stat"] [10.111353874206543, 18.521976470947266, "ding each form\u2019s data elements. The web search also included systematically searching state statutes and regulations to better understand rules concerning physician reporting, and reviewing each state\u2019s physician fee schedule to determine whether the"] [10.121062278747559, 18.48838996887207, "er states in order to identify valuable \naspects of the reporting required of physicians in documenting treatment of injured workers in California. The environmental scan consisted of conducting exploratory, informal interviews with state WC staff, a"] [10.104220390319824, 18.50063133239746, "eived purpose of the reports, the attributes of a good report, what is involved in the filing process, the level of effort required to 65 complete a report, the reasonableness of the deadlines, and any improvements that could be \nmade. \nEach member "] [10.106327056884766, 18.48197364807129, " group of physicians and users. We developed a set of slides to guide the discussions and sent ahead of the webinar a set of background slides with more detail on the background of the reports and the findings from interviews and the environmental sc"] [10.022110939025879, 18.43202018737793, "views across the workers\u2019 compensation experts and reporting the \ninformation in aggregate form. \n7. Your participation is voluntary, and you can decline to discuss any topic that we raise. We will not be reporting your participation to anyone outsid"] [10.004891395568848, 18.420209884643555, " the roles or tasks of each of these people? 69 4. What is your level of personal involvement in the processing or submitting of this \ninformation? Peripheral? Central? Does this vary by type of injury? Other factors? \n5. Apart from the time you spe"] [10.008358001708984, 18.41774559020996, "ason for the PR-2 \nor if a Request for Authorization is also involved? \n13. Next, I would like to talk about the resources and time it takes your practice to fill out and submit these Progress Reports. \nProbe: Overall, how much time do you think your"] [10.000558853149414, 18.38125228881836, "l, how much time do you think your staff spends on helping prepare and \nsubmit the Permanent and Stationary Report? Clinical or administrative staff? \n22. Is the deadline of 20 days after last examination for the submission of the Permanent and \nStat"] [10.015730857849121, 18.412967681884766, " Would you please tell me the typical process for preparing, processing, and submitting a medical-legal report? \nA. Probe: Who is involved? \nYourself as the primary care physician or treating physician? (Yes/No) \nNurse practitioner? (Yes/No) \nMedical"] [9.989645004272461, 18.408260345458984, "Report of Injury or Primary Treating Physician\u2019s Progress Report \n8. There seem to be different practices regarding who can submit a progress report and be paid for it. What policy does your organization follow? \nProbe: The regulations require that a"] [10.0784330368042, 18.44302749633789, " you have told us, are there any areas that we failed to cover or important questions that we should have asked? \n5. If you were going to summarize the most important points of our discussion today that relate to the efficiency or utility of reportin"] [9.937520980834961, 18.364757537841797, "r Illness \nThe DFR is the initial documentation recorded by a treating physician on the extent of the \ninjured worker\u2019s illness or injury. The DFR is a one-page form that lists the insurer\u2019s and \nemployer\u2019s contact information, details the injured wo"] [9.97742748260498, 18.407392501831055, "opportunity to document the injured worker\u2019s work status, including whether the patient should remain off work, return to modified work, or return to work with no limitations. Last, the treating physician must log his or her credentials\u2014including med"] [10.003060340881348, 18.422584533691406, "ination s, including any specific 79 measurements of atrophy, range of motion, and strength and a full report of any diagnostic test \nresults, all related diagnoses, and their respective ICD-9 codes. The primary treating physician is \nexpected to r"] [9.997408866882324, 18.40956687927246, "k with restrictions. If the latter option is selected, the physician is asked to indicate the number of hours the worker is restricted to performing specific functions, motions, positions, or activities. The physician must also specify any lift or ca"] [9.980321884155273, 18.420122146606445, "y deadline \n\u2022 Printable PDF \n\u2022 Mail, fax reporting \nmodes \n\u2022 Not separately payable; bundled into \nE&M visit \u2022 Required \n\u2022 Progress Report \n(Narrative) \n\u2022 Separate from DFR \n\u2022 30-day frequency \n\u2022 Narrative/chart note format \n\u2022 Mail, fax reportin"] [9.976990699768066, 18.41106414794922, "Minnesota \u2022 Required \n\u2022 Health Care Provider Report \n\u2022 10-day deadline \n\u2022 Printable PDF, fillable \nPDF \n\u2022 Electronic Data Interchange (online \nportal), mail, fax reporting modes \n\u2022 Not separately \npayable; bundled into \nE&M visit \u2022 Required \n\u2022 He"] [9.969010353088379, 18.424142837524414, "rting modes \n\u2022 Separately payable (not to exceed $10 \nfor reports 20 pages in length, and 25 cents per page for \nany additional page \nafter 20) \u2022 Not required \u2022 Required \n\u2022 Final Medical Report \n\u2022 Separate from DFR \n\u2022 21-day deadline \n(after MM"] [10.792191505432129, 18.399606704711914, " Compensation, September 19, 2012. As of \nFebruary 1, 2016: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB863 \nCalifornia Senate Bill 1160 (Mendoza), Workers\u2019 Compensation, September 30, 2016. As of \nFebruary 1, 2017:"] [11.050187110900879, 18.214740753173828, "enko, WCRI Medical Price Index for Workers\u2019 Compensation, 8th ed. \n(MPI-WC), Cambridge, Mass.: Workers\u2019 Compensation Research Institute, 2016. As of February 1, 2017: http://www.wcrinet.org/studies/public/books/wcri184.pdf \nFor reference, Table R.1 "] [10.318410873413086, 18.379117965698242, "rtment of Labor and Industries, Workers \u2019 Compensation \nhttp://www.lni.wa.gov/claimsins/claims/ \nWisconsin Wisconsin Department of Workforce Development, Workers \u2019 Compensation \nhttps://dwd.wisconsin.gov/wc/ \nTable R.2. Links to States\u2019 Doctor\u2019s"] [10.14905834197998, 18.39156723022461, "//www.dir.ca.gov/dwc/PR -4.pdf \nFlorida Uniform Medical Treatment/Status Reporting Form (DFS- F5-DWC- 25) \nhttps://www.myfloridacfo.com/division/risk/WorkersCompensation/Documents/06.DW\nC-25_Uniform_Treatments.pdf \nGeorgia Final Medical Report (WC"] [22.081865310668945, 20.44487953186035, "An Evaluation of New \nMexico\u2019s Online Intake System for Civil Legal Aid\nShamena Anwar, Mauri Matsuda, Cassia Spohn, Meagan CahillJUSTICE, INFRASTRUCTURE, AND ENVIRONMENTLimited Print and Electronic Distribution Rights\nThis document and trademark(s) c"] [22.07911491394043, 20.4433536529541, "ce, infrastructure development and financing, environmental policy, transportation planning and technology, immigration and border protection, public and occupational safety, energy policy, science and innovation policy, space, telecommunications, an"] [22.081863403320312, 20.44541358947754, "...................... 14\t\r \u00a0\nDevelopment and Rollout of the Online Intake System .......................................................................... 14\t\r \u00a0\nHow New Mexico's Online Intake System Works ........................................"] [22.081867218017578, 20.445100784301758, "....... 70 v Figures \nFigure 2.1. Map of New Mexico and NMLA Offices ................................................................... 7 \t\r \u00a0\nFigure 3.1. Process Map of the Online Intake System ..............................................."] [22.082685470581055, 20.44525909423828, "seeking legal assistance who receive help is constrained by the available resources (Sandefur and Smyth, 2011). One way to enable the scarce existing resources to serve more individuals in need is to increase the overall efficiency of the process. In"] [22.08390235900879, 20.443199157714844, "intake systems seem to have many benefits, it is useful to \nunderstand the experiences of agencies that have implemented these systems to see if these benefits are realized, as well as whether there are unintended consequences that arise after implem"] [22.081302642822266, 20.445938110351562, "resolved by adjusting the online intake system so that cases could directly feed \ninto LANM and NMLA\u2019s CMS. However, this issue was present during the entire time of our eva luation (from \nMay 2016 through December 2016). ix many of these applic"] [22.08346176147461, 20.443984985351562, "this online intake system is not truly online\u2014rather, it is a hybrid system that allows individuals to initiate the intake process when it is convenient for them but requires them to complete it through a phone call during regular business hours. Bec"] [22.085067749023438, 20.443117141723633, "e of it. Out of the 100 survey respondents who answered all relevant questions, 40 percent said they would have used the online intake option had they known about it, which indicates that wider advertising of the online system should result in increa"] [22.08364486694336, 20.443782806396484, "ement in efficiency during this period, and they also did not make any staffing \nchanges due to perceived efficiency improvements. It is thus unrealistic to expect to see any real \nchange in the number of individuals who m these legal aid agencies "] [22.082876205444336, 20.444454193115234, " cannot be reached. \nThe online system should request that applicants provide \nseveral time windows during which they would be \navailable to receive a callback. Improve efficiency of the online intake process by \nreducing the number of online app"] [22.087066650390625, 20.436546325683594, "ges (both potential and already implemented) listed in Table S.1 \nmight lead to increased efficiency and usage of the online intake system, it is important to note that there is no empirical evidence to support this yet. Due to the recentness of som"] [22.082286834716797, 20.4450626373291, "legal issues are not entitled to legal assistance, there are a variety of agencies and services that exist to provide civil legal assistance, which is defined as free legal advice and representation to qualifying (low-income) individuals. These servi"] [22.083110809326172, 20.444412231445312, "online as well as through traditional call-in or walk-in methods. Data were collected from three sources: (1) staff interviews were conducted with agency directors and intake staff at the two legal aid agencies involved five months after the online i"] [22.088125228881836, 20.436687469482422, "ng their own system. We thus expect these results to be helpful to other legal aid agencies as they identify many potential issues that agencies will need to think about as they develop their online intake system. 3 The remainder of this chapter p"] [22.049869537353516, 20.469432830810547, "reduce the portion of intake hours that are spent on litigants who are over the income threshold (or who have an issue outside the range the agency handles) and that they therefore cannot help; instead these intake hours can primarily focus on workin"] [22.076969146728516, 20.44875717163086, "their online intake \nprocess. Note that this agency already had an existing online intake process that accounted for one-third of all intakes. TIG funding was used to overhaul their online intake web interface such that it was more user-friendly and "] [22.08106803894043, 20.445783615112305, "onducted too soon after implementation and often are not able to go into detail regarding the extent of process inefficiencies, whether these online systems reach new types of applicants, and what the key barriers are for applicants in using the onli"] [22.0811767578125, 20.44605255126953, "ne intake system was implemented, LANM had approximately 16 staff members, while NMLA had approximately 65 staff members. \n \n \n1 We conducted our site visit together with John Tull, who authored the eva"] [22.080684661865234, 20.44658660888672, "ies for services, LANM can refer the case back to NMLA for services, or they can provide services (i.e., legal advice) themselves.\n4 \nThus, with the exception of domestic violence and emergency cases, LANM is set up to be the centralized point of int"] [22.080116271972656, 20.448305130004883, "e individuals do not live in New Mexico. This is what we define as a prescreening stage, as applicants who are screened out at this stage do not have their information entered into the agency\u2019s CMS, and there are no records kept regarding them. All a"] [22.075864791870117, 20.440858840942383, "es for Children, Senior Citizens Law Office, Disability Rights New Mexico, and the Southwest Women\u2019s Law Center. When a case is referred, the agency that completed intake can send this information to the new agency if the applicant consents to having"] [22.081928253173828, 20.445520401000977, "have diffuse intake systems, \nimplementing an online intake system will require many agencies to adopt this technology. \nComparison of Law Access New Mexico and New Mexico Legal Aid Clients \nTable 2.2 presents summary statistics of the cases LANM "] [22.07941246032715, 20.450471878051758, "r 3, LANM did not accept family law cases through the online intake \nsystem for most of the period we will be evaluating. Family law cases fall into the categories Divorce/Sepa ration/ \nAnnulment and Custody/Visitation listed in Table 2.2. 12 Tab"] [22.082122802734375, 20.445070266723633, "he remaining case types were seen by both agencies, the composition and the nature of the case within a category will differ across the agencies. \nThe \u201cLocation\u201d panel in Table 2.2 looks at the county groupi ngs where applicants reside. The \ncount"] [22.081727981567383, 20.44535255432129, "esigned to give individuals in need of legal aid assistance another way to be initially triaged to \neither LANM or NMLA. Whereas before individuals would initially contact one of the two agencies (usually by phone) and then would be triaged to the ap"] [22.080217361450195, 20.443212509155273, "ncy of the legal aid providers (Tull, 2016). The project partners developed the online intake system during 2014 and 2015 and began by reviewing the documentation for triage systems in place in Illinois, Massachusetts, Ohio, Iowa, and New York City ("] [22.07880973815918, 20.44920539855957, "any of the cases that the online system triages to NMLA are later transferred over to LANM. Very rarely is a case transferred from LANM to NMLA. 16 Figure 3.1. Process Map of the Online Intake System \n \nThe first screen asks individuals to enter t"] [22.05152702331543, 20.48543930053711, "income threshold that individuals must meet to qualify for services. Because it is difficult to conduct exact income qualification screens with individuals self-entering information (and likely generating noisy estimates of their actual income), the "] [22.080158233642578, 20.4464111328125, "e screeners use when applicants either call or walk in (described in Chapter 2). LANM took the remaining cases and automatically entered those into their CMS and had their intake screeners call the applicants back during their normal intake hours to "] [22.082902908325195, 20.44378089904785, " all of the service providers, as well as providing links to online information that can help individuals who are over the income threshold and will need to represent themselves (pro se litigants). Currently, the system can only refer individuals to "] [22.083791732788086, 20.44367218017578, "ve civil legal aid. We discuss below how the online intake system can affect each \nof these outcomes. \nBecause the online intake system is available 24 hours a day, there is an expectation that \nindividuals who are not available during regular busine"] [22.07938575744629, 20.44854736328125, "trast, when intake screeners spend an hour handling cases that were triaged to LANM through the online system, they will directly call a set of individuals who made it through an initial screening process online and had an issue that \n "] [22.080699920654297, 20.44655990600586, " via the phone and internet availability is relatively limited in some of these rural areas. Staff working in the outlying offices noted that there is limited web and cell coverage in the southeast, southwest, and northwest quadrants of the state, as"] [22.084186553955078, 20.44321632385254, " these agencies can reach these individuals \nby phone during business hours to complete the intake process. Staff noted it was \ndifficult to reach many of these applicants; in Chapter 5 we show quantitative evidence \nthat a large percentage of these "] [22.08159828186035, 20.44597053527832, " designed to help the agencies conduct a conflict check asked applicants whether there were any adverse parties; staff noted \napplicants generally did not understand how to respond to this question. \n\u2022 When the online intake system sends the applica"] [22.08197021484375, 20.445356369018555, "ding implementation, LANM had a backlog in family law cases, \nand therefore they decided to not use the online intake system for these cases for most of the period that we evaluated the use of the online system (from May 2016 through December 2016). "] [22.082717895507812, 20.445043563842773, " \n5 This is shown in Figure 5.5. 26 4. Quantitative Data \nIn addition to the qualitative data we collected during our site visit, we also collected several \nquantitative data sets that form the crux of our analy"] [22.07933807373047, 20.449495315551758, " it. 27 The third and fourth data sets provide more detailed information on all cases that went through \nintake at NMLA and LANM, including the age, gender, race /ethnicity, disability status and zip \ncode of the applicant, the case type, the dat"] [22.08069610595703, 20.447629928588867, "riable, as any case that is identified as coming through the online system in \nthe CMS data should also be present in the online triage data. Merging these data sets also allowed us to identify \nthe length of time it takes to open a case in the CMS "] [22.080442428588867, 20.44700813293457, ". First, we \nintended to administer the survey between September 2016 and June 2017. While the survey was fielded in this way to the individuals using the online system, the survey that was administered to the applicants using the traditional intake"] [22.083410263061523, 20.444107055664062, " regarding the representativeness of these survey results. Note that all survey respondents are likely to skew toward being primarily English speakers as we did not develop a Spanish version of the survey. \nTable 4.1 presents descriptive statistics "] [22.08139991760254, 20.445907592773438, "use the period s during which the surveys were administered to online intake users and traditional intake users \nwere different, the differences between the columns in Table 4.1 may also represent a difference in case mixes due \nto seasonal trends. "] [22.08070945739746, 20.447721481323242, "t of the system. \nWith these caveats in mind, this chapter presents a variety of analyses that aim to conduct \nas much of the ideal evaluation plan that is currently possible. The chapter is organized into \nthree parts, which compose the three key "] [22.082103729248047, 20.4473934173584, "e and intake process, as well as the cases accepted, is different for LANM and NMLA, we conduct these process comparisons separately by agency. At the conclusion of this section, we discuss some of the key takeaways regarding the likely impacts on ef"] [22.08038902282715, 20.447755813598633, "telephone intake process, they were not allowed to enter through the online intake system. This indicates that if LANM had not chosen to divert these family law cases, the usage of the online intake system would have been measurably higher during thi"] [22.081592559814453, 20.446203231811523, "w of Table 5.1 lists 772 cases as com ing through the online intake system during this period, \nwhile Figure 5.1 notes that 808 cases were accepted for intake through the online system during this period. While there should be a one- to-one correspon"] [22.080615997314453, 20.447052001953125, "when median days are being compared . 36 the client withdrawing from the process, 44 percent of the online cases resulted in the client \nwithdrawing from the process. The next panel in the table (\u201cResults When Withdrawals Dropped\u201d) shows that once"] [22.079429626464844, 20.44961929321289, "duals had to call in during normal business hours to begin the intake process, one would expect them to continue to be available during this time frame.\n9 This issue of the online cases \n \n8 For the phon"] [22.0808162689209, 20.447372436523438, "g it on Monday through Friday 8:00 a.m.\u20135:00 p.m.). Each \ncoefficient presented in Table 5.2 reveals how the proportion of online applicants in that group that were unable to be reached differs from the proportion of applicants that were unable to be"] [22.078601837158203, 20.450572967529297, " system sent 179 cases to NMLA. Similar to the process at LANM, NMLA had \n \n10 Note that a priori it was not clear which group would have the higher percentage of rejected cases that are rejected \nbecaus"] [22.08212661743164, 20.446353912353516, "tem sends significantly more cases to NMLA than actually belong there. Recall from Chapter 3 that this issue was brought up to us in discussions regarding the issues with the online system\u2014these analyses provide evidence that confirms these perceptio"] [22.08335304260254, 20.445232391357422, "that have not reached a final outcome by January 26, 2017. A \ntotal of 7 online intake cases and 489 traditional intake cases were dropped due to this sample restri ction. While this \nrestriction results in disproportionately dropping cases that are "] [22.09488868713379, 20.43329429626465, " \n14 There were only eight online intake cases that were rejected. \n 42 Our results also highlighted two key inefficiencies with the online system that existed \nbetween May and December 2016. First, 35 percent of th"] [22.081607818603516, 20.446516036987305, "applicants who will never complete intake because they cannot be reached.\n16 \n \n15 Staff intake hours fluctuated quite a bit over the period examined \u2014while the intake hours tended to stay the same, \ns"] [22.083507537841797, 20.443803787231445, "ake system that might reduce the rate at which online applicants drop out include having applicants select a time window when they could most easily receive a callback. The online system should also make it clear to applicants before they even begin "] [22.081438064575195, 20.44586753845215, " The last row of the table presents the usage level over the entire evaluation period. Monthly trends are important to examine as the average usage level will underestimate the usage level going forward if usage is increasing over time. Using data on"] [22.082130432128906, 20.445581436157227, "ocess is technically a hybrid system that allows individuals to initiate the intake process online \nwhen it is convenient for them but requires them to complete it by receiving a callback from an intake worker during \nregular business hours. \n \nfami"] [22.083940505981445, 20.443714141845703, "through the \nonline system and the percentage of total NMLA intakes. The results show that the usage rate of \nthe online system was consistently low for NMLA during this entire period, and there does not seem to be any evidence of an upward usage tre"] [22.086421966552734, 20.441570281982422, " use this method. In our interviews with some of the outlying NMLA offices, staff suggested that a majority of their intakes came \nfrom the shelters. 47 able to address any of the current barriers, they may be able to increase usage of the online"] [22.0887393951416, 20.43914222717285, "lected a given reason.\n25 The first five reasons listed in the table correspond \n \n23 Three individuals were dropped from the data because they either did not answer whether they knew about the \nonline i"] [22.08273696899414, 20.445083618164062, " the LANM clients who used the online intake system with those who used the traditional intake system using a \n \n26 We coded a respondent as having an issue with internet access if they selected either o"] [22.105419158935547, 20.45441436767578, "uage version. All minority groups (i.e., blacks, Hispanics, and Native Americans) were less likely to use the online system than whites. Applicants with physical disabilities were also less likely to use the online system, while applicants with consu"] [22.084394454956055, 20.44795036315918, "hich the issue was either missing or related to family law. The reference group (i.e., left-out group) for the location groupings \nin the table is living in the Albuquerque/Santa Ana and Santa Fe county groupings. The reference group for the case ty"] [22.088741302490234, 20.435195922851562, "ects \nAccess to Justice? \nAs discussed earlier in Chapter 3 (and shown in the logic model presented in Figure 3.2), \nthere are two ways in which the online intake system might be expected to affect access to \njustice: (1) It can allow individuals t"] [22.085641860961914, 20.442468643188477, "duals who used the online system while they were at work during regular business hours may have found it difficult to use the traditional call-in service during that same time\u2014calling in generally takes longer (as it includes waiting on the line for "] [22.131059646606445, 20.399534225463867, "d with their case. 0.63\t\r \u00a0\n0.24\t\r \u00a0\n0.13\t\r \u00a0\n0%\t\r \u00a010%\t\r \u00a020%\t\r \u00a030%\t\r \u00a040%\t\r \u00a050%\t\r \u00a060%\t\r \u00a070%\t\r \u00a0\nbusiness\t\r \u00a0hours\t\r \u00a0 weekday\t\r \u00a0off\t\r \u00a0hours\t\r \u00a0 weekend\t\r \u00a0 54 Figure 5.4. Did the Online Intake System Allow New Clients Access to Legal Aid? \n"] [22.084726333618164, 20.444049835205078, "ividuals would have been able to complete the intake process \u2014\nthese would then be the sole individuals who submitted an online application who would be able \nto complete the intake process and who would not have if only traditional intake methods w"] [22.085742950439453, 20.44152069091797, "io because there was no realized efficiency gain. Thus, one would not expect the online intake system to have any real impact on the overall level of individuals who received legal aid services from NMLA and LANM during this period. \n "] [22.086158752441406, 20.44205093383789, "number of hours they work will automatically reduce the number of individuals that can receive services. LANM was also consistently understaffed in attorneys across this period. Thus, because there was a general decline in the number of intakes and i"] [22.08441162109375, 20.442975997924805, "\nwebsites used to assist individuals in filling out legal forms is Law Help Interactive, which was launched by Pro Bono Net in 2005. \n 58 Because our evaluation examines a relatively short period after implementation, it is not \nsurprising that man"] [22.09530258178711, 20.431650161743164, "period. First, New Mexico intentionally did not widely advertise the online system during this period as they wanted to ensure the system was working smoothly before encouraging widespread use. As evidence of this, our survey of individuals that used"] [22.085206985473633, 20.442285537719727, "he legal aid agencies likely did not see real \nimprovement in efficiency of the intake process, and they also did not make any staffing changes due to perceived efficiency improvements. Thus, while we do not expect to find that the online intake sys"] [22.084529876708984, 20.443349838256836, "process by \nreducing the number of online applicants that drop out of \nthe process because they cannot be reached. \nThe online system should request that applicants provide \nseveral time windows during which they would be \navailable to receive a ca"] [22.081388473510742, 20.446271896362305, "out this report, this online intake system is really a hybrid \nof an online and traditional call-in or walk-in system. The fact that so many individuals that accessed the online intake system subsequently dropped out indicates there is likely a reaso"] [22.08159065246582, 20.446727752685547, "line Triage Data \n The original data file included all cases for which the online triage tool referred the case to \nNMLA between April 25, 2016, and December 31, 2016. We deleted 3 observations that were \nduplicates (based on name, date of birth, an"] [22.087379455566406, 20.439842224121094, "\n8. How many hours do you use the internet in a typical week? \no 0 hours \no 1\u20133 hours \no 4\u20137 hours \no 8\u201314 hours \no 15 or more hours \n9. If you wanted to use the internet, how easy would it be for you to get access (either at home or \nthrough work, a"] [22.08831214904785, 20.439998626708984, " read in English? \no Very well \no Well \no Not well \no Not at all \n7. How often do you read in English? (this includes reading anything such as instructions, forms, \nnews, recipes, etc.) \no Every day \no A few times a week \no Once a week \no Less than "] [22.084394454956055, 20.419179916381836, "and Aaron Smyth, \u201cAccess Across America: First Report of the Civil Justice \nInfrastructure Mapping Project,\u201d SSRN, October 11, 2011. As of September 6, 2018: http://dx.doi.org/10.2139/ssrn.1962790 \nSandefur, Rebecca L., \u201cWhat We Know and Need to Know"] [5.921989440917969, 7.427432060241699, "SOCIAL AND ECONOMIC WELL-BEING\nThe Potential Economic \nValue of Unlicensed Spectrum in the 5.9 GHz Frequency Band \nInsights for Future Spectrum Allocation Policy\nDiana Gehlhaus Carew, Nicholas Martin, Marjory S. Blumenthal, Philip Armour, \nJesse Last"] [5.922138690948486, 7.426243782043457, "ctrum that is the current subject of debate\u2014the 75 MHz that comprises the 5.9 GHz frequency band. \nThis study had several core objectives: \n\u2022Estimate the potential economic value of an unlicensed frequency band that is currently\nunder discussion for"] [5.916604995727539, 7.431534290313721, ".................. xii\t1. Introduction ................................................................................................................................. 12. Policy Importance of Unlicensed Spectrum ...................................."] [5.914098262786865, 7.433286190032959, ".................................................... 37\t\nTrade Policy ............................................................................................................................................ 37\t\nInternet Regulation ............."] [5.929586410522461, 7.421476364135742, ".......................................... 7\t\nFigure 5.1 Correlation Among Variables of Interest ..................................................................... 15\tFigure 5.2. Variation in Speed Relative to Average Speed Across All States over "] [5.916123867034912, 7.431971549987793, " and businesses. It also enables the proliferation of technologies such \nas smart homes, sensor-based transportation networks, smart electric grids, and sustainable smart cities. Yet this emergence also creates new challenges for policymakers and rai"] [5.9072699546813965, 7.436184883117676, "e. x For Approach 1, we estimate that the annual potential contribution to GDP ranges from $59.8 \nbillion to $96.8 billion. For Approach 2, we estimate that the potential annual contribution to \nGDP ranges from $71.0 billion to $105.8 billion. Acro"] [5.908430576324463, 7.435947895050049, "formation criterion \nBIC Bayesian information criterion \nDFS dynamic frequency sharing \nDSRC dedicated short-range communications \nFCC Federal Communications Commission \nGB gigabyte \nGDP gross domestic product \nGHz gigahertz \nGbps gigabit(s) per seco"] [5.900084495544434, 7.442093849182129, "ave been raised, for example, about sufficient spectrum throughput to access the millions of apps that do everything from online banking to health monitoring, and the resulting effect on consumers if \n1 For example, see Zaber, Bohlin, and Lindmark (2"] [5.912105083465576, 7.432734966278076, "asuring economic value, along with \nthe challenges inherent in estimating the potential economic value of spectrum, and explains our methodological approach to valuation. Chapter 4 explores the potential net effect on our estimates of the inherent tr"] [5.89597749710083, 7.444272518157959, "2 (Ericsson, undated). Cisco\u2019s Visual Networking Index predicts that global mobile traffic will increase at a compound annual growth rate of 47 percent though 2021, at which time three-quarters of all mobile data traffic will be high-bandwidth video "] [5.9168195724487305, 7.430640697479248, "r WiFi-enabled communications.7 We hope \nthat this study helps advance the question of how to allocate spectrum going forward, given the pace of wireless communications innovation and the projected proliferation in wireless data demand. \n \n \n \n \n "] [5.920045375823975, 7.428321838378906, "e marginal value is constant), which adds to measurement challenges. The actual value of a given MHz of frequency will depend on the modulation scheme that runs on it and the type of device or application that is sending or receiving data. Marginal v"] [5.923815727233887, 7.426407337188721, "roadband engage in a measurement approach that uses proxies and rough approximation for demand, such as through number of internet-enabled devices and wireless data consumption. This includes studies by Katz (2018), GSMA Intelligence (Lewin, Phillipa"] [5.90635871887207, 7.437068462371826, "at makes this 75 MHz valuable. We see two ways in which this frequency could generate potential economic gains: (1) It supplies an additional 75 MHz of spectrum for unlicensed use, and (2) it enables the creation of larger-bandwidth channels\u201480 MHz a"] [5.9236273765563965, 7.426300525665283, "1 for our estimate for contribution to GDP, this time looking at the gains to consumers from having faster speeds enabled by higher-bandwidth channels. Implicit in this estimate is an assumption that the price that consumers pay for WiFi is unchanged"] [5.844645023345947, 7.475591659545898, "fits stemming from residential use of WiFi represent the \nlargest segment of current value according to Katz: about 50 percent of the total estimated value \nin 2017, and forecast to increase to 60 percent of total value by 2020. Moreover, from a prac"] [5.587889671325684, 7.643762588500977, "tively limited launch of V2V technology using the DSRC band in the United States \nmeans the current economic market value of such technology is likely small.\n9 One recent report \nfound that the U.S. DSRC market was forecast to reach a value of $12.2 "] [5.924472808837891, 7.425159931182861, " value. However, because of the wide range in forecasted value of the V2V and V2I technologies market, over long time horizons, along with uncertainty in the estimates of social value, we do not pursue that calculation here. Given the limited data on"] [5.974616527557373, 7.391830921173096, "lable observations, which could lead to bias in the estimates. The instrument used for speed is also not valid, as an analysis of U.S. data shows that the residential internet penetration rate is highly correlated with GDP. Moreover, the justificatio"] [6.007059574127197, 7.37135648727417, "ross All States over Time \n \n \nUsing this graph, we identified four states that could be potential outliers in terms of \nvariation. Three states\u2014Delaware, Ohio, and Kansas\u2014demonstrate large deviations from the mean relative to other states at variou"] [5.999993801116943, 7.381080627441406, "eed1) instead of the natural log of average speed. \n5. Same specification as Model 1, except variation outlier states (Delaware, Ohio, Kansas) \nremoved. \n6. Same specification as Model 1, except temporal trend outlier state (Washington, D.C.) removed"] [5.956507682800293, 7.420900344848633, "rimary estimate for the elasticity of speed suggests a 1 percent increase in internet \nspeed results in a 0.0197 percent increase in real GDP. However, given the log-log functional form, this is not a linear estimate and holds only for small changes "] [5.940488815307617, 7.418610572814941, "nown as the \u201cexclusion\u201d restriction) means that the lags of broadband speed affect current GDP only through current average internet speed. This isolates the true effect.\n17 \nThe second main confounder is reverse causality. It is possible that highe"] [5.924394130706787, 7.425595760345459, "in \nuse, using the allocation provided by Katz (2018), which estimates the value of unlicensed spectrum in the United States. However, given the available information on these devices, we assume that each of them has the same product specification in"] [5.926244735717773, 7.423890113830566, "rage speed, here 80 percent, and multiply that by our measure for returns to speed for a 100 percent increase, 1.37, to get 1.10 percent. We next multiply this by per capita GDP along with our share of WiFi consumption that is on the 2.4 GHz network,"] [5.9360551834106445, 7.414681911468506, " increase the weighted average speed possible in larger-bandwidth channels. Therefore, the contribution to GDP would be potentially larger. Second, as population increases over time, the potential value over time will also increase. This can be demon"] [5.965027809143066, 7.385324954986572, " estimates. Similarly, changing from one spatial stream to two spatial streams will not change the estimated contribution to GDP as long as it is consistently applied across scenarios. \nThe same also holds even if we consider a change in technologic"] [5.930592060089111, 7.419075965881348, "he potential economic value created from opening an \nadditional 75 MHz under given assumptions and conditions. This includes technical assumptions \nrelated to device specifications, modulation scheme, bit coding rate, and guard interval, which are de"] [5.927910327911377, 7.421741008758545, "haracteristics: \n\u2022 two spatial streams \n\u2022 80 MHz channel bandwidth (4 x 20-MHz channels, bonded) \n\u2022 256 quadrature amplitude modulation (QAM), 5/6 coding rate, 400 ns guard interval \n\u2022 802.11ac compliant. \nPer the MCS Index,22 this configuration prov"] [5.953942775726318, 7.40184211730957, "d for Devices by Load Share and Device Share, 2017 \nDevice Load Share, 2017 Share of Devices, 2017 \n4G smartphone 17.8% 41.7% \nTablet 14.0% 20.9% \nSmart home devices 0.1% 1.1% \nLaptop 66.5% 29.0% \nGaming console 0.3% 4.5% \nVirtual re"] [5.932549476623535, 7.416571140289307, "2,067 4,255,148,529 \nSmart home \ndevices 75 1.70 3.0 0.1% 245,810 26,579 18,435,730 \nLaptop 750 43.49 2.0 66.5% 118,219,368 326,981,498 88,664,526,168 \nGaming \nconsole 300 1.17 3.0 0.3% 681,398 50,794 204,419,259 \nVirtual reality \nsy"] [5.942425727844238, 7.409156799316406, "blished to enable quick and unambiguous reference to a particular hardware configuration. Because the MCS Index table captures diverse configurations with respect to each system characteristic, it is useful for performing technical sensitivity analys"] [5.954410552978516, 7.400920867919922, "ly more sensitive to the traffic load from laptops than any other category of device, although overall varying traffic load does not sizably impact the baseline estimates. Table 6.7 shows the GDP 32 increase comparison against the baseline derived a"] [5.927099704742432, 7.422753810882568, "rs, since they pay for WiFi access privileges (it is included as part of the standard internet package). \nThe approach presented here aligns with the physics identity presented in Chapter 6 \n(Approach 2) and takes advantage of a measure of willingnes"] [5.905888557434082, 7.446121692657471, "onal amount consumers are willing to pay for an additional Mbps (Nevo, 2016): \n$1.76. \n\u2022 U.S. households: 125.1 million. \n\u2022 U.S. residential internet penetration rate: 0.71. \n\u2022 residential WiFi share of total WiFi consumption (Katz, 2018): 0.43. \nWe "] [5.898248195648193, 7.443248748779297, "viders and come from mobile off-loading. Another potential gain to producers, especially from opening the 5.9 GHz band, is from the increased capacity for backhaul\u2014the middle-mile networks between the consumer\u2019s connection point (edge network) and in"] [5.915346622467041, 7.4318060874938965, "ion to GDP. \n \n \n 37 8. Looking Forward: Implications of Current Trends and Potential \nFuture Policies \nIn this chapter, we consider how current trends and potential future policies might affect \nconsumers\u2019 demand for online data\u2014and therefore unl"] [5.90852689743042, 7.435960292816162, "ces, people, and content come online. Some privacy and security against online threats is likely to make consumers more comfortable relying on the internet, and therefore increase demand. Alternatively, depending on the severity of restrictions, regu"] [5.824007511138916, 7.5092620849609375, "icensed use, which would not add new WiFi capacity. However, no such discussion for this type of rededication has been noted to date. \nEach of these options come with trade-offs that could affect not only the realized economic \nvalue of spectrum in t"] [5.806753635406494, 7.512074947357178, "Alternatively, another option could be co-channel-sharing without prioritization. One new research study conducted simulations of co-sharing WiFi traffic with DSRC and found little interference when both operated jointly (Pang, Padden, and Alderfer, "] [5.929264545440674, 7.419403076171875, " (Approach 1) or $71 billion and $106 billion (Approach 2) annually, depending on assumptions. We further find a total potential economic surplus that ranges between $82 billion and $190 billion. A summary of our estimates is provided in Table 10.1. "] [5.895383358001709, 7.443538188934326, "growing concerns over satellite-based communications creating additional congestion and interference in higher-frequency bands suggests that more research could help policymakers work through these issues (Canis, 2016). This research would also serve"] [5.927733421325684, 7.421059608459473, "nelization Chart \nSOURCE : IEEE, 2015. \nWhen determining the economic value of additional unlicensed bandwidth, it is essential to \nconsider the physical limitations of current technical capabilities regarding wireless \ncommunications. These attrib"] [5.904798984527588, 7.437644004821777, "missions. The guard interval is typically a very small unit of time; for example, 400 or 800 ns is the standard described for 802.11ac. As with code rate, guard intervals represent a trade-off between speed and accuracy, as longer guard intervals dec"] [5.926472187042236, 7.420733451843262, "s per second kbps\t\n\ud835\udc35\ud835\udc35!=Bandwidth per channel,in kilohertz (kHz) \nM = Signal levels in use, typically 2n for \u201cn\u201d- bit digital communication systems . \n\t\nThis equation provides the mathematical relationship between bandwidth, data rate, and the \nsign"] [5.926119327545166, 7.405352592468262, " system. However, this phenomenon is highly localized, affected even by building materials and physical layout of an area. As a result, credible analysis using the Shannon-Hartley noise constraint should not be generalized to large areas. So, in situ"] [5.936807155609131, 7.408946514129639, " \nThis category holds the most uncertainty when trying to predict demand in the next five \nyears. The promise of a \u201csmart home\u201d has endured for decades, but little technical definition exists. As currently imagined, it typically represents an Interne"] [5.934134006500244, 7.415737628936768, "he headset uses to provide an immersive experience. While these systems are still evolving, and only a handful of systems are available on the market, our research found that a representative data rate for these systems (based on pixel density and sc"] [5.9341559410095215, 7.419173717498779, "0 7,200 \n5G smartphone 3 802.11ax 1024- QAM Unavailable Unavailable 40 1,000 \nSOURCES AND NOTES: We obtained these specifications from the following websites in mid -2018: \n\u2022 4G smartphones: http://www.apple.com/iphone -x/specs \n\u2022 Tablet: http:/"] [5.939131259918213, 7.416244029998779, "l three pieces of the change in consumer surplus. \nBecause of limitations in available data, we solve for r twice using the same formula but \nunder two sets of assumptions about wireless residential monthly data consumption. We then carry through the"] [5.928619861602783, 7.423432350158691, "d estimates. \nTable C.2 . Change in Consumer Surplus per Household with Isoelastic Demand \n\t\t Moderate Heavy \nR \u20130.3 \u20130.155 \nP(Q) \t\ud835\udc52\ud835\udc52(!\"(!\"!.!) \u2013 !\"(!))/!.!\t\t\ud835\udc52\ud835\udc52(!\"(!!\".!) \u2013 !\"(!))/!.!\"\"\t\nQ1 152 294 \nQ2 172 314 \nP1 $52 $52 \nP2 $41.31 $40.65 \n\u0394C"] [5.9096808433532715, 7.433357238769531, "hmic Transformations,\u201d Methodology \nInstitute, London School of Economics, March 17, 2011. \nBerry, Steven, and Philip Haile, \u201cIdentification in Differentiated Product Markets,\u201d Annual \nReview of Economics, Vol. 8, No. 1, 2016, pp. 27\u201352. \nBeuse, Nath"] [5.948455333709717, 7.398833274841309, ", and Qingjiang Tian, A Quantification of 5 GHz \nUnlicensed Band Spectrum Needs, San Diego, Calif.: Qualcomm Technologies, 2017. As of November 7, 2018: https://www.qualcomm.com/media/documents/files/a-quantification-of-5-ghz-unlicensed-band-spectrum"] [5.921797275543213, 7.427122592926025, "omeplug Alliance, HomePlug AV2 Technology: Raising the Bar for Sustained High-\nThroughput Performance and Interoperability for Multi-Stream Networking Using Existing Powerline Wiring in the Home, 2015. As of November 6, 2018: http://www.homeplug.org/"] [5.9269819259643555, 7.423582553863525, "vember 6, 2018: https://www.usnews.com/news/business/articles/2017-11-01/ap-newsbreak-govt-wont-pursue-talking-car-mandate \nMCS Index, website, undated. As of November 7, 2018: \nhttp://www.mcsindex.com 61 Meltzer, Joshua P., and Peter Lovelock, Regu"] [5.9305524826049805, 7.419742584228516, "o-electronics.com/info/wireless/wi-fi/80211-channels-number-frequencies-bandwidth.php \nReed, William Robert, \u201cOn the Practice of Lagging Variables to Avoid Simultaneity,\u201d Oxford \nBulletin of Economics and Statistics , Vol. 77, No. 6, 2015, pp. 897\u201390"] [4.3611860275268555, 18.087080001831055, "Energy Efficiency as a \nTool for Preservation of Affordable Rental Housing\nEvaluation of the Efficiency Emphasis in the \nMacArthur Foundation\u2019s Window of Opportunity Initiative\nHeather L. Schwartz, Aimee E. Curtright, Cordaye Ogletree, \nElizabeth Tho"] [4.415741920471191, 18.056026458740234, "ss its potentially disas -\ntrous consequences for affordable rental housing. We saw that the imperative to raise energy- \nef\nficiency standards could undercut the preservation of affordable rental housing.\nMultifamily buildings are generally older a"] [4.398576736450195, 18.093040466308594, "olicy devel -\nopment based on evidence, we we\nre heartened by even the limited impact our grantmaking \nhad on the data used by building ow\nners, utilities, policymakers, and financiers when consid -\nering energy- ef\nficiency improvements, incentiv"] [4.417413234710693, 18.063356399536133, "l housing.\nIn the WOO-\n EE i\nnitiative and in this evaluation, the term energy efficiency (EE) refers to \ntechnologies and mea su\nres aimed at using less energy (at less cost) to provide the same level of \nser vi\nce, without necessarily modifying th"] [4.411241054534912, 18.072996139526367, "ther policy concerns that are influenced by the natural and built envi -\nronment, technology, and community organizations and institutions that affect well-being. For more information, email chep@rand.org.vii Table of Contents\nForeword ............."] [4.408743381500244, 18.079086303710938, " Studies of Energy Efficiency in Affordable Housing in Win dow o f Opportunity .......... 43\nThe Rise of a Nonprofit Industry Leader from an Ecosystem of Organ iz\nations: \nElevate Energy .........................................................."] [4.409877777099609, 18.08026123046875, "orth Sharing .................................................................... 78\nAPPENDIXES\nA. Interview Methods ................................................................................................. 81\nB. Experts Interviewed ......"] [4.370903491973877, 18.10673713684082, "mes of the Energy- Ef\nficiency Focus of the Win do\nw of \nOpportunity Initiative ..................................................................................................... 58\nC\n.1. WO\nO- EE G\nrants in Chronological Order .............."] [4.393886089324951, 18.102815628051758, "d numbers of homes preserved through the philanthropic initiative.\nAbsent the appropriate research design to quantify the energy- ef\nficiency innovations and \nactivities that occurred solely bec\nause of the MacArthur Foundation\u2019s philanthropic init"] [4.39848518371582, 18.098562240600586, "al housing sectorYes Somewhat\n4.\n \n I\nncreased cross- se\nctor (e.g., between affordable \nhousing and energy-efficiency sectors) awareness and collaborationYes Yes\n5.\n \n I\nncreased share of energy-efficiency incentives/ \nsubsidies/policies/regulatory"] [4.390769004821777, 18.10354232788086, "d enduring impact. Among other benefits, \nthe foundation\u2019s considerable investments in the Preservation Compact helped to grow Elevate Energy, which has gone on to be a leading organ\n iz\nation in energy efficiency and \nwhich nearly half of the interv"] [4.4033026695251465, 18.091949462890625, "e include MacArthur Foundation staff members Allison Clark and Mijo Vodopic, who pro -\nvided documentation, sat down for interviews, met monthly with RAND staff, and reviewed \nand provided feedback on the draft document. Debra Schwartz and Julia Stas"] [4.431543827056885, 18.112442016601562, "r vi\nce. Activities un\nder WOO- EE we\nre intended \nto increase the deployment of energy- ef\nficiency technologies to reduce electricity and heating \ndemand in affordable multifamily rental housing; WOO- EE d\nid not focus on wa\nter use or waste"] [4.427034854888916, 18.131040573120117, "o u\nnderstand how the foundation\u2019s focus evolved over the course of the four- ye\nar \nWOO- EE \ninitiative\n2. to e\nxplain what organ iz\nations and activities we\nre funded in WOO- EE\n3. to i\ndentify whe\nther the WOO- EE f\nunded organ iz\nations a"] [4.401183128356934, 18.093976974487305, "(using American Community Survey data from the U.S. Census Bureau). Additionally, we drew on the National Housing Trust\u2019s (NHT\u2019s) Prez-Cat database to cata\n lo\ng changes to states\u2019 Qualified Allocation Plans (QAPs) and on the \nDSIRE database to tally"] [4.403006553649902, 18.097900390625, "-\n EE c\naused the intermediate outcomes to occur. For example, we lack counterfactual \nexamples of housing markets that are comparable to the ones where WOO- EE g\nrantees pri -\nmarily worked to compare rates of local cross- sec\ntor collaboration or"] [4.413273334503174, 18.06268310546875, "s in technology and tech -\nnology policy, we refer readers to recent reviews by U.S. Department of Energy (DOE, 2015) and ACEEE (Nadel, Elliott, and Langer, 2015).\nFor this chapter we draw on published research, information found online about specifi"] [4.439366340637207, 18.006486892700195, "s due to ei\nther low rents or limited subsidies\u2014or both. The founda -\ntion hypothesized that improved financial viability afforded by mea su\nres like improving the \nenergy efficiency of a multifamily rental property can help to preserve affordable "] [4.426051616668701, 17.918739318847656, "\nficiency gap\u201d between multifamily rental housing relative to other \nhousing types, resulting in an estimated $200\u2013 $4\n00 per year more being spent by lower- in\ncome \nrenters (Raziei, Hallinan, and Brecha, 2016). U.S. Department of Housing and Urba"] [4.421333312988281, 17.94325065612793, "e EPA, 2017.\n3 This is consistent with observations of one of our study interviewees who operates multifamily buildings primarily in the \nMidwest. This interviewee\u2019s rule of thumb was to invest about $3,000 per ho\nuse ho\nld in energy upgrades and re"] [4.4251909255981445, 17.94338035583496, "zed rental programs, ow\nners can take a series of steps to lower the utility allowance due to \nenergy- ef\nficiency investments while increasing tenant contribution to the rent by an equivalent \namount as a way to pay for energy- ef\nficiency upgrad"] [4.4156413078308105, 17.9516658782959, "rowing economy (EIA, 2017b).\nSeveral interviewees for this evaluation mentioned the decline in energy prices as a con -\ntributing fac\ntor to the erosion of perceived benefits for EE, and as a reason that focus on EE \nwas not as pronounced as it migh"] [4.385009288787842, 17.890134811401367, " since 2002.\n8 The same interviewee, however, also noted that \u201c pe ople are turning more attention to wa ter; . . . th e wa ter prices are \nskyrocketing.\u201d\n9 We define a fa mily as \u201clow- in come\u201d if they indicate that they participated in the Su"] [4.424640655517578, 17.93743133544922, "\nRAND RR2293-2.1Natural gas\nElectricityFigure\u00a02.1\nAverage\u00a0U.S. Residential Natu ra\nl Gas and Electricity Prices, 2000\u20132016Energy Efficiency as a Tool for the Preservation of Affordable Multifamily Rental Housing 11\n were one of a few operating ex"] [4.430707931518555, 17.985069274902344, " th\nose goals. EISA superseded EPAct \nand included standards for energy conservation; for regionally specific efficiency of heating and \ncooling products; and for energy- ef\nficiency labeling of products such as home appliances and \nboilers (White H"] [4.44109582901001, 17.97785186767578, "ith major federal regulations such as EPAct and EISA. For example, Section\u00a0124 of EPAct of 2005 authorized DOE to supplement energy-\n ef\nficiency rebate programs in eligible states (109th\u00a0Congress, 2005, p.\u00a025), \nand many states created their own reb"] [4.437929630279541, 17.994190216064453, "2 2013 2014 2015 2016Figure\u00a02.3\nNumber of State, Local, and Utility Residential Energy- Ef\nficiency Programs, \nby Year in Which They We\nre Created, 2000\u2013201614 Energy Efficiency as a Tool for Preservation of Affordable Rental Housing\nUnited Sta"] [4.432715892791748, 17.971654891967773, "g; they can include new construction, although programs designated for new construction only are excluded.\nRAND RR2293-2.4Figure\u00a02.4\nNumber of State, Local, and Utility Multifamily Residential Energy- Ef\nficiency Programs, \nby Year in Which They W"] [4.445265769958496, 17.990219116210938, "ltifamily/green-initiative-financing; Freddie Mac: \nhttps://mf.freddiemac.com/docs/mf_securitization_investor-presentation.pdf; FHA: MIP reductions: https://www \n.hud.gov/sites/documents/MFHOUSINGNEWSISSUE7.PDF\nNOTES: ASHRAE\n = Am\nerican Society of"] [4.476422309875488, 17.967172622680664, "ut also bec\nause of \na focus on educating and incentivizing loan originators through reduced fees, marketing, and simplification. As a GSE interviewee told us, \u201cWe\u2019ve \n re\nally had to simplify energy \nefficiency, simplify the pro ce\nss, simplify th"] [4.444697380065918, 17.99683952331543, "k can obtain economies of scale on soft costs like le\ngal and loan- or\nigination fees \nas the bank connects the intermediaries\u2019 bundled proj ec\nts to capital markets.\n\u2022 Sp\nlit incentives continuing to \u201cdog every body.\n\u201d Be\ncause of the split- i"] [4.436080455780029, 17.98464012145996, "d pro ce\nssing of Energy Savings Per fo\nr ma\nnce Contract (ESPC) applications. HUD \nalso offered add- on\ns to HUD- fu\nnded management fees for PHAs for activities like creating a \ngreen operations and maintenance plan, benchmarking, and data coll"] [4.468103408813477, 17.894250869750977, " for developers to \nobtain th\nese highly competitive tax credits is one of the most significant ways to increase \nthe share of resources for energy efficiency within affordable multifamily rentals. Created in 1986, LIHTC has created or preserved app"] [4.443763732910156, 17.97783851623535, "mic and environmental benefits.\u201d\na26 states had functioning EERSs: AZ, AR, CA, CO, CT, HI, IL, IA, ME, MD, MA, MI, MN, NV, NH, NM, NY, NC, OH, OR, PA, RI, TX, VT, WA, WI\nOn-\n b\nill financing A loan offered in partnership with or by a utility com pa\n"] [4.486512184143066, 17.861534118652344, "ces in the QAP; for example, a QAP might \nset aside some portion of the tax credits for transit- or\niented development, or for housing to \nserve special populations, or for EE- rel\nated investments. The intense competition for tax cred -\nits has ma"] [4.462156772613525, 17.941329956054688, "eral \nstates, including Vermont, Mas sa ch\nu set\nts, and Rhode Island, ad\nopted policies in 2017 stipulat -\ning that the state wi\nll enforce any appliance regulations that the federal government rolls back.\nBuilding Energy Codes\nAlthough most buil"] [4.441309452056885, 17.989458084106445, "ent \nreduction in building energy- use i\nntensity three years la\nter and a 14\u00a0 per\ncent reduction four years \n la\nter. Disclosure of Energy Star scores led to a 9\u00a0 per\ncent decline in building energy- use i\nnten-\nsity three years la\nter and 13\u00a0"] [4.452171325683594, 17.960336685180664, "sources to\nward the underperformers.\u201d\nBut as the limited number of states and localities that mandate benchmarking attests, th\nere \nare numerous barriers to building energy- da\nta sharing. For example, when the utilities are split \nbetween the pro"] [4.4453558921813965, 17.982040405273438, "lding to repay the up- fr\nont costs of EE improvements over time \nthrough their existing monthly utility bill. It is one way that utilities can help meet energy- sa\nving 24 Energy Efficiency as a Tool for Preservation of Affordable Rental Housin"] [4.441070079803467, 17.97808837890625, " \nplan. Depending on the program, PACE borrowers typically pay back the loan through a lien on the property.\nAlthough C-\n PA\nCE transactions have doubled ev\nery two years since 2012, with approxi -\nmately $450\u00a0million in cumulative transactions as o"] [4.438407897949219, 18.004680633544922, "d increased spending so that utili -\nties can meet the EERS targets.\nACEEE estimated that in 2015 the number of utility- sec\ntor multifamily EE programs \nhad grown to 38 metropolitan statistical areas (MSAs), as compared to 30\u00a0in 2013. (The 2013 fig"] [4.423394203186035, 18.035112380981445, "th $30\u00a0million in funding aimed at building 5,000 more homes over five years. In 2017, a call for proposals by the Home Depot Foundation was focused on supporting veterans and their families with new construction or rehabilitation of permanent suppor"] [4.444819927215576, 18.00692367553711, "for green affordable housing. It provides a set of criteria for green pr\noj ec\nts \n11 See the Enterprise Green Communities Resource Guide (undated).Energy Efficiency as a Tool for the Preservation of Affordable Multifamily Rental Housing 27\nand "] [4.448822975158691, 18.006412506103516, "ntial EE proj ec\nts carry some of \nthe same fixed costs and time required for a retrofit as does a much larger building or a portfo -\nlio of many similar buildings. This reduces the profitability of small- sc\nale EE retrofits for ser vi\nce \nfirms."] [4.453708171844482, 18.004701614379883, "guidance and second \nopinions on technical quotes are increasing in some places. The combination of a properly \ntrained contractor, a third- pa\nrty adviser, and a willing financial partner to fund EE \ninvestments can functionally replace an ESCO.\n\u2022 "] [4.442412853240967, 17.986764907836914, "alls and owns the EE improvements, and the building owner pays a ser vi\nce fee \nto the third party for ongoing use of th\nose improvements. The benefit of an ESA is th\nere is no \nadditional lien on the property.\nAn example of an ESA is New York Cit"] [4.440194129943848, 18.023311614990234, ", arranges for contractors \nto install EE upgrades, and assem bl\nes the financing, which requires no loan to or guarantees \nfrom the owner. A third example is the nascent New Energy Model Organ iz\nation (NEMO), \nwhich intends to serve as a national"] [4.409451484680176, 18.0850772857666, "and standardize EE upgrades to lower cost and risk, which is a fu\nture \ndirection for the field that we discuss in the concluding chapter.\n16 Affordable Community Energy Services (ACE), \u201cOur Story,\u201d undated.31CHAPTER\u00a0THREE\nEnergy Efficiency in the W"] [4.436931133270264, 18.036569595336914, "r activities in the scope of this evaluation, as described in the next section of this chapter.32 Energy Efficiency as a Tool for Preservation of Affordable Rental Housing\nof directors, foundation staff identified EE as a \u201ccentral concern\u201d and a p"] [4.438736438751221, 18.036100387573242, "E for increasing rental affordability for tenants and for broader preservation of multi -\nfamily rental properties.\nFoundation staff also noted the risk of the affordable multifamily rental sector not taking \nadvantage of the momentum in EE, which c"] [4.440042495727539, 18.041215896606445, "but inherently risk- \nave\nrse.\n Th\nese actors had diverse and often disparate goals and incentives. The foundation\u2019s result -\ning theory of change was to work across th\nese stakeholders to find common ground and both \ndeepen and broaden reach and i"] [4.401488304138184, 18.098310470581055, "e development of social enterprises and for- pr\nofit \nfirms to provide energy- ef\nficiency ser vi\nces and products to the multifamily ho\nusing \nmarket.\n7. Ev\naluation and assessment : Provide funding for studies of existing and new energy- \nef\nf"] [4.430484294891357, 18.05027198791504, "s about trends and practices in energy efficiency within commer -\ncial real estate and in high- en\nd multifamily residential, where EE investments we\nre expected \nto be more common. The idea was to apply lessons from th\nose asset classes and to po"] [4.403156757354736, 18.081815719604492, "l sector\n7. \n I\nncreased pace and volume of energy-efficiency improvements in the stock of affordable multifamily \nrental housing\nSOURCE: Schwartz, Vodopic, and Lamond, 2011.36 Energy Efficiency as a Tool for Preservation of Affordable Rental Hou"] [4.3971381187438965, 18.10557746887207, " with \nother WOO- EE a\nwardees and affiliates.\n Ta\nble\u00a03.3 tallies the number of grants and PRIs the foundation made according to primary \nsector and primary activity. Also included is the total dollar amount provided to each of th\nese \nactivities,"] [4.412354469299316, 18.107458114624023, " of - \nsev\nen types of activity to which the foundation had originally assigned them. As an example, \nACEEE used a 2014 grant to both conduct research and host a conference. We classified this \ngrant as primarily a research activity, although it als"] [4.407170295715332, 18.092456817626953, "stments in EE for building technologies.\nData and Benchmarking\nThe foundation made three grants totaling $700,000 for activities related to improved data and benchmarking for energy efficiency, making this the smallest WOO-\n EE ac\ntivity area in term"] [4.423773288726807, 18.037439346313477, "$125,000 to $200,000 and \n we\nre primarily for research papers on applied topics such as net \nmetering, utility EE programs for multifamily rental housing, and financing models for retrofits.\nFor example, the Energy Foundation created a series of rep"] [4.41965389251709, 18.0645751953125, "econd Small Lenders\u2019 Energy Efficiency Community \n(SLEEC) meeting. La\nter that year, ACEEE\u2019s Buildings and Finance Teams presented \ntheir upcoming work on th\nese topics to the Multifamily Utility Working Group. ACEEE \nwas an \u201canchor grantee\u201d (accor"] [4.396097183227539, 18.109697341918945, "gy costs we re both more variable and more controllable than previously under -\nstood. But WOO- EE a\nlso diverged somewhat from WOO by working more explic it\nly outside \n(as well as inside) the affordable rental housing industry. Namely, WOO- EE "] [4.407948970794678, 18.07777976989746, "market, among other mission-\n or\niented sectors, which \nare typically not served by for- pr\nofit ESCOs, as described in Chapter\u00a0Two. The PPESCO has \nhad some accomplishments, which we note, but is still in the stage of testing the new business model"] [4.4138054847717285, 18.074981689453125, "t in 2007. Elevate Energy is a \u201cfull ser\n vi\nce\u201d organ iz\nation that guides ow\nners and man ag er\ns \nfrom energy assessment to completed retrofit. The companion Energy Savers Loan program provides low-\n in\nterest loans to cover the costs of retrof"] [4.422394752502441, 18.074390411376953, " need help with retrofit financing can \nobtain resources from CIC through the Energy Savers Loan Fund (Schwartz et\u00a0al., 2016).\n6 Additionally, un der WOO, CIC received four grants ($1.65\u00a0million in total) and a $2\u00a0million PRI for activities that sup"] [4.369378566741943, 18.09404182434082, "tes they have kept more than 35,000 apartment units affordable with efficiency improvements, implemented nearly $58 million in energy saving building improvements, and avoided more than 65,000 metric tons of carbon pollution.\n7 They have also had an "] [4.410356521606445, 18.076513290405273, "o be cost- ef\nfective (Braman, Kolberg, and Perlman, 2014).\nOverall, the program has provided EE retrofits to more than 35,000 units in 800 buildings,8 \nfinanced with more than $16 million from the Energy Savers Loan administered by CIC.9 Partic -\ni"] [4.42935037612915, 18.049699783325195, "ducated Peer Organ iza\ntions in Other Regions\nElevate Energy has expanded their work from the Cook County area to the who le state of \nIllinois and more broadly in the Midwest. Although still headquartered in Chicago, tod\nay \nElevate Energy has of"] [4.40656042098999, 18.078746795654297, "g with the Michigan State Hous-ing Finance Authority and a regional affordable multifamily lender, Cinnaire, to help design a PRI for Cinnaire to finance implementation of energy and \n wa\nter upgrades during the redevel -\nopment pro ce\nss. And with "] [4.409211158752441, 18.079574584960938, "vate Energy has received sizable investment over approximately \nt\nen years from the MacArthur Foundation. This has supported Elevate Energy\u2019s direct involve-\nment in the Preservation Compact, which appears to have been a key ingredient for TPC\u2019s \nsuc"] [4.4534173011779785, 18.03388786315918, "ly hap -\npens if they know and trust you. Once yo\nu\u2019ve worked with a building owner and they see the \n ben\nefits . . . th\ney may come back and work with Elevate Energy.\u201d\n13 As noted in the closing section below, this interviewee asserted that the E"] [4.432454586029053, 18.04498291015625, "energy assistance. And \n th\nere is no built-in source for that. I\u2019ve \nseen many finance agencies like ours around the country who do\nn\u2019t have the . . . \n ex\npertise of an \nElevate Energy . . . an\nd it\u2019s not easily supportable in a financing progr"] [4.431974411010742, 18.05335235595703, "solar and to bring job training to a broader, more diverse set of individuals. Both ele\n me\nnts directly target the goals of \nincreased equity and access to the benefits of solar deployment. In addition to executing commu -\nnity solar proj ec\nts, El"] [4.4301300048828125, 18.05458641052246, "st be tailored to the needs \nof the specific market, including local and regional regulations, utility markets, and real estate pricing.\nAn Experiment in Bringing a For-\n Pr\nofit Model to Affordable Multifamily \nEE Finance: VEIC, Commons Energy, and"] [4.4271721839904785, 18.05735969543457, "ose energy ser vi\nces com pa\nny designed to reduce energy costs for multifamily housing \nand other public- ser\nving buildings\u201d (VEIC, 2014). Commons Energy was created to be \u201cthe \nnation\u2019s first public- pu\nrpose Energy Ser vi\nces Com pa\nny,\u201d wi"] [4.415696144104004, 18.06425666809082, "ved a $600,000 grant and a $2\u00a0million PRI, respec -\ntively, to \u201cAccelerate preservation of and reinvestment in affordable rental housing through targeted outreach and technical \nassistance for private ow\nners and nonprofits, energy efficiency, prede"] [4.426209926605225, 18.06756591796875, "aller than ESCOs typically participate in (see discussion in Chapter\u00a0Two).\n\u2022\n Th\nird, by investing in more EE than its ESCO competitor. For example, not only do they \nimplement standard technology fixes like lights and fans; they also address insulat"] [4.455387115478516, 18.047138214111328, "till disproportionately burdensome for low-\n in\ncome ho\nuse ho\nlds (Figure\u00a02.2), but lower overall energy costs have hurt the business case \nfor EE in the short run and have eroded margins for EE upgrades that reduce the use of natu ra\nl \ngas (e.g."] [4.428078651428223, 18.062166213989258, "sing loans. Similarly, within the organ\n iz\nation, it has been impor ta\nnt to pair individuals with 56 Energy Efficiency as a Tool for Preservation of Affordable Rental Housing\n \u201ccomplementary . . . ex pertise and background and de ca des of b"] [4.394107341766357, 18.101606369018555, "using at the level needed to build trust and \neducate the consumer. Both have stressed the importance of pairing energy technology and engineering expertise with finance expertise. Both have found that many of their transactions do not involve financ"] [4.378170967102051, 18.119918823242188, ", \nVodopic, and Lamond, 2011). We used a stoplight chart to indicate the level of success for each: dark green indicates that the intermediate outcome was achieved, light green indicates that it was somewhat achieved, and red indicates that it was n"] [4.390287399291992, 18.101696014404297, "\nWOO- E E Investments?\n1. \n I\nncreased awareness of energy efficiency as a \ntool for preservation Yes Yes\n2. \n Ne\nw and more energy-efficiency public policies \nfocused on accommodating the needs of affordable multifamily rental housingYes Somewhat"] [4.387844562530518, 18.11147117614746, "e found that awareness of energy efficiency as a tool for preservation of \nmultifamily affordable rental housing has increased among actors working outside and within the traditional affordable housing sector. The combination of WOO-\n EE g\nrantee act"] [4.386344909667969, 18.108922958374023, ", on \ntopics related to the costs and opportunities of energy efficiency in multifamily housing via workshops, summits, and road shows. As an example of influence, several of \n th\nese grantees \nare high- pr\nofile organ iz\nations such as ACEEE that "] [4.392024517059326, 18.102746963500977, "Arthur for putting \u201cenergy efficiency in affordable multifamily housing on the Outcomes from WOO- EE 6 1\nmap\u201d with investors and nonprofits operating in the housing sector. In short, as one grantee put it, \n\u201cConvening power ma\ntters, and MacArth"] [4.400069236755371, 18.0887393951416, "ans that effecting change across the country is an especially large task.\nWOO- E E Influence\nThe two most relevant WOO- EE ac tivity areas (see Ta ble\u00a03.3) to this outcome are peer exchange \nand convenings ($2.5\u00a0million of foundation investment), "] [4.434298038482666, 18.032081604003906, "have been multibillion- do llar increases in green lending for \nenergy- ef\nficient multifamily rental buildings, which includes but is not limited to affordable \nrental housing, since 2010. In 2017, Fannie Mae and Freddie Mac alone purchased $45\u00a0bi"] [4.39634895324707, 18.10661506652832, "E Influence\nThe foundation invested $21.9\u00a0million in five grants and six PRIs for the promulgation of new or innovative financing vehicles for energy efficiency. \n Th\nese funds helped to pi lo\nt on- bi\nll financ -\ning, launch a PPESCO, create loan f"] [4.370423793792725, 18.13115119934082, "hstanding the Freddie Mac example, interviewees gen -\nerally felt that the impact of WOO- EE w\nas greater on state and local financing practices\u2014 \nan\nd specifically in the localities in which they focused their resources\u2014 th\nan at the national \nle"] [4.398192882537842, 18.101945877075195, " that grew over time:\nOne of the challenges of preserving affordability in multifamily housing is that the stake -\nholders have siloed perspectives: I\u2019m a ho\nuser; I\u2019m an energy- ef\nficiency person; and I\u2019m a \nfinance person. . . . \n Th\ney speak d"] [4.415940284729004, 18.074655532836914, "ctive impact of the work that was happening rather than just \n th\nese one- of\nf funding opportunities.\u201d\nIntermediate Outcome 5: Increased Share of Energy- Ef\nficiency \nSubsidies and Policies for Affordable Rental Housing\nWe rated this outcome as u"] [4.420802593231201, 18.063884735107422, "mple of increased share, an interviewee estimated \nthat $15\u00a0million (an increase over the previous level of $500,000) of Illinois\u2019s $250\u00a0million in funds spent on energy efficiency now went to affordable multifamily rental housing thanks to changes t"] [4.406491279602051, 18.076814651489258, "their Multifamily Energy Savings proj ec\nt and not specifically to their scorecards.) A Mac Ar\nthur \nstaff person indicated that a lesson learned from the scorecards was the importance of \u201cratch -\neting up the [EE] regulations, [and] more important"] [4.418023109436035, 18.099573135375977, "using, and LIHTC \nallocations for energy- ef\nficient affordable multifamily rentals. Second- or\nder changes that pro -\nmote EE include data- rel\nated activities like benchmarking and disclosure of building energy \nuse, as described in Chapter\u00a0Two."] [4.3975300788879395, 18.10782814025879, " hosted in 2013. We also conclude from interviews that WOO- EE \nh\nelped effect a change in attitude among siloed actors, enabling them to move beyond simply \narticulating barriers to EE investments in multifamily rental (such as split incentives) to"] [4.396032333374023, 18.177091598510742, "apter, we summarize what worked and what did not work in WOO- EE , drawing \non the outcomes presented in Chapter\u00a0Five. We then discuss what barriers remain for EE in \nmultifamily housing and potential next directions for the field. Fi na\nlly, we co"] [4.375545024871826, 18.122020721435547, "s for end users (in this case, \n ow\nners of multifamily rental housing) to \ninvest in EE\u2014 al\nign with the more general strategies recommended in an earlier RAND report \nabout innovation in housing (Hassell et\u00a0al., 2003).\nMacArthur Effectively Used I"] [4.366367816925049, 18.118602752685547, "PRIs are early- st\nage \nloans to allow businesses to incubate and prove ideas.\nAnd as with the broader WOO initiative, organ iz\nations we interviewed lamented Mac -\nAr\nthur\u2019s departure from multifamily housing energy efficiency. Some expressed conc"] [4.344721794128418, 18.126232147216797, " such as solar installations at affordable rental housing and the formation of a PPESCO. And several of the PRIs \n we\nre objectively successful, such as the series of loans described in Chapter\u00a0Four for \nthe Loan Savers Program, and NYCEEC\u2019s loan fun"] [4.406400680541992, 18.0528507232666, "ficiency in multifamily rental. Elevate Energy, in partnership with CIC, is considered \u201ca big influence\u201d on energy-\n ef\nficiency work with small and medium- \nsi\nzed ow\nners of multifamily housing, and its example has generated some of the lessons a"] [4.439626693725586, 18.040359497070312, "elatively similar markets (e.g., across the Midwest), state and local conditions and idiosyncrasies often require fine-\n tu\nning \nbefore they can be executed. Reflecting on the Preservation Compact in Chicago, a MacAr -\nthur program officer noted the"] [4.441247940063477, 18.002235412597656, "g tenant data to anonymize it and thus allow multifamily ow\nners to view \nwhole- bu\nilding energy- use d\nata is a related achievement that also holds promise to mitigate the \nsplit- in\ncentive prob le\nm. All other solutions of which we are aware "] [4.429182529449463, 18.05213165283203, "of funds. NEMO, described in Chapter\u00a0Two, is a brand-\n ne\nw, as yet untested model \nthat wi\nll target LIHTC properties, but aided initially with philanthropic funds. The Commons \nEnergy PPESCO that is the subject of a case study in Chapter\u00a0Four is a"] [4.429544448852539, 18.046598434448242, "e good news is that \nwe . . . \n ha\nve proven now that this [EE for multifamily rental] is not just a save- th\ne- ea\nrth kind \nof th\ning. . . . Yo\nu can approach this from a fiscal responsibility perspective.\u201d\nComing to consensus on the case for EE"] [4.393329620361328, 18.10416603088379, "lt that local partners we\nre needed to directly interact with ow\nners in person. \u201cYou \nneed someone who\u2019s with them. . . . \n Wh\nerever you roll out a lending program, yo\nu\u2019re goi\nng \nto need a local presence.\u201d While th\nere are some such interme"] [4.368341445922852, 18.120559692382812, "onger terms, and, as an extension \nof the larger WOO initiative that launched in 2000, it benefitted from that initiative\u2019s lon -\ngevity. WOO- EE g\nrantees noted that the financial support from MacArthur provided their \n org\nan iz\nation stability an"] [4.37062406539917, 18.129043579101562, "erviews we\nre voluntary and confidential. Thus, in the \nreport, we do not attribute comments and opinions to specific individuals.\nInterviews of MacArthur Staff\nFrom April to May 2017, we conducted four structured interviews with current MacArthur \n"] [4.349420547485352, 18.161083221435547, " had received a WOO- EE g\nrant or loan from MacArthur, their geographic \nlocation, and their industry sector (finance, housing, energy) to allow us to compare opinions across each of \n th\nese dimensions. Fi na\nlly, we coded interviewees\u2019 characteri"] [4.371081829071045, 18.12721824645996, " Corporation (CIC)Linda Metropulos, Acting Deputy Director for Sustainability and Housing Development, \nSarah Ralich, Energy and Construction Man\n ag er\n, and Larry Swanson, Executive Direc -\ntor: ACTION Housing\nCliff Majersik: Institute for Market T"] [4.386886119842529, 18.134737014770508, "er exchange, \ncommunications, convenings\n8 Citizen\u2019s Utility Board $200,000 2012 No E Policy analy\n si\ns, program \nevaluation, and research\n9 CNT Energy $75,000 2012 Yes E Financial innovations and \nnew financial vehicles\n10 Energy Foundation $125,0"] [4.410135746002197, 18.083227157592773, " 2011 Expansion of an on- bill r\nepayment program \nto finance energy- ef\nficiency improvements \nto multifamily affordable rental housing in \nOregon\nCommons Energy $4,750,000 2014 First PPESCO, subsidiary of VEIC; working capital for Commons Energy\u2019"] [4.385725498199463, 18.112512588500977, "ne \nto answer any question, or stop the interview at any time.\nWe plan to audio rec or\nd our conversation, solely for our internal note- ta\nking purposes. \nThe audio recording wi\nll only be accessible to proj ec\nt staff, and we wi\nll destroy the"] [4.39097785949707, 18.088485717773438, "ergy efficient?\n Who faces th ese challenges?\n Do challenges differ by type of property, age of property, owner type, region, or income b\nracket targeted?\n Are there regulatory or practical barriers that prevent or hinder subsidy streams from \nbe\n"] [4.360780239105225, 18.13062858581543, "e housing? Of raising the visibility of specific \nproj ec\nts, activities, and tactics? Can and should MacArthur do more to raise visibil -\nity?\nLessons Learned and Wrap- Up\n10) [For interviewees familiar with MacArthur\u2019s WOO- EE initiative] Do you "] [4.363829135894775, 18.060012817382812, "any of our reports.\nYour participation in this interview is voluntary.\u00a0You may choose not to participate, decline \nto answer any question, or stop the interview at any time.\nWe plan to audio rec or\nd our conversation, solely for our internal note- "] [4.386016368865967, 18.100135803222656, "tal housing?\n16) W\nhat pro g\nress, if any, was made in the 2010s in the United States to address the bar -\nriers and challenges, and leverage the opportunities, for integrating renewable energy sources into multifamily residential buildings and in ma"] [4.354811668395996, 18.122562408447266, "r organ -\niz\nations and activities? How we\nre th\nese other organ iz\nations influential?\n22) Pr\nior to the start of MacArthur\u2019s initiatives in this area (ca. 2005\u20132010), how well \nunderstood was the potential for renewable energy and energy efficie"] [4.3498358726501465, 18.136613845825195, "ervation of affordable rental housing over time?\nLessons Learned and Wrap- Up\n31) Do you think that your activities, or th ose of other awardees in the WOO program, \nenhanced the preservation of affordable housing, and how?\n What worked, what did n"] [4.424533367156982, 18.041433334350586, "on Compact\nVEIC Vermont Energy Investment Corporation\nWOO Win do\nw of Opportunity initiative\nWOO- EE W\nin do\nw of Opportunity: Energy Efficiency (a focus of the WOO initiative \nfrom 2012 to 2015)99References\n109th\u00a0Congress. Energy Policy Act of 2005"] [4.436941146850586, 17.97610092163086, "ncy Resource Standards (EERS) , \nWashington, D.C.: American Council for an Energy-\n Eff\nicient Economy, 2017. As of July\u00a018, 2018: \nhttps://aceee.org/policy-brief/state-energy-efficiency-resource-standard-activity100 Energy Efficiency as a Tool fo"] [4.43676233291626, 17.982370376586914, "\n Pe\nrcent- of\n- In\ncome Standard . \nWashington, D.C.: U.S. Department of Housing and Urban Development, Office of Policy Development and \nResearch, 2008.\nEIA\u2014 See U\n.S. Energy Information Administration\nEldridge, M., B. Prindle, D. York, and S. Na"] [4.413483619689941, 18.005617141723633, "commendations , Chicago, Ill.: Energy Foundation, 2013. As of July\u00a028, 2018: \nhttp://www.ef.org/wp-content/uploads/2014/01/BRIM_SingleFamily_20131.pdf\nFannie Mae, Fannie Mae Multifamily Mortgage Business Information , 2018. As of July\u00a028, 2018: \nhttp"] [4.430477619171143, 17.986865997314453, ", Santa Monica, Calif.: Global Green USA, 2016.\nHassell, S., A. Wong, A. Houser, D. Knopman, and M.\u00a0A. Bern st\nein, Building Better Homes: Government \nStrategies for Promoting Innovation in Housing , Santa Monica, Calif.: RAND Corporation, MR-1658, "] [4.430004119873047, 17.983922958374023, "ng/\nKrukowski, A., and A.\u00a0C. Burr, Energy Transparency in the Multifamily Housing Sector: Assessing Energy \nBenchmarking and Disclosure Policies . Washington, D.C.: Institute for Market Transformation, 2012. As of \nJuly\u00a028, 2018: http://www.imt.org/u"] [4.416312217712402, 17.977542877197266, "ly_Buildings.pdf\nNew York City Energy Efficiency Corporation (NYCEEC), \u201cMarcus Garvey Apartments,\u201d n.d. As of July\u00a028, \n2018: \nhttps://www.nyceec.com/work/marcus-garvey-apartments\nPazuniak, R., V. Reina, and M. Willis, Utility Allowances in Federall"] [4.426614761352539, 17.96500587463379, "tive , Chicago, Ill.: MacArthur Foundation Housing Program, 2011.\nSchwartz, H.\u00a0L., R.\u00a0W. Bostic, R.\u00a0K. Green, V.\u00a0J. Reina, L.\u00a0M. Davis, and C.\u00a0H. Augustine, Preservation of Affordable Rental Housing , Santa Monica, Calif.: RAND Corporation, RR-1444, "] [4.422109603881836, 17.95648956298828, "gy Efficiency in Multifamily Rental Housing,\u201d Evidence Matters , Summer 2011. \nAs of July 28, 2018: \nhttps://www.huduser.gov/portal/publications/EM_Newsletter_Summer_2011_FNL.pdf\nU.S. Energy Information Administration (EIA), Monthly Energy Review , "] [4.430880069732666, 17.98897361755371, "ram Design Considerations for Policymakers and Administrators, Lawrence Berkeley National Laboratory and State & Local Energy Efficiency Action Network (SEE Action), 2014. As of July\u00a018, 2018: https://www4.eere.energy.gov/seeaction/publication/financ"] [20.594385147094727, 9.10827922821045, "CORPORATION\nImpact of Proposition 47 \non Los Angeles County Operations and Budget\nSarah B. Hunter, Lois M. Davis, Rosanna Smart, Susan TurnerLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protecte"] [13.8690824508667, 4.360293865203857, "strict Attorney, Public Defender, Alternate Public Defender, Sheriff, Probation, Health, Mental Health, and Public Health. Interested stakeholders also include other offices or groups that provide supporting services to criminal justice populations i"] [20.602256774902344, 9.082100868225098, "............................................................................ 4 \t\r \u00a0\nCounty Estimates .................................................................................................................................. 5 \t\r \u00a0\nLos Angele"] [20.621912002563477, 9.141423225402832, ".................................................................................................................. 17\t\r \u00a0\nOffice of the Public Defender ................................................................................................."] [20.61397933959961, 9.13448715209961, ".............................................................................................................. 44\t\r \u00a0\nIntegrated Data Systems ..........................................................................................................."] [20.622920989990234, 9.143383026123047, "..... 19\t\r \u00a03.3. Adult Misdemeanor Cases Prosecuted by the DA, by Month .............................................. 20\t\r \u00a03.4. Juvenile DA Cases Prosecuted ........................................................................................."] [20.61395263671875, 9.132317543029785, "... 47\t\r \u00a03.11. Components of the Integrated Data Systems ....................................................................... 50\t\r \u00a04.1. Estimated Changes Affecting Workload for County Departments Since Proposition 47 ..... 57\t\r \u00a0B.1. Workflow an"] [20.608354568481445, 9.127497673034668, "operational and fiscal impacts of Proposition 47 and other legislative initiatives. \nMethods \nWe used a mixed-methods approach and data from multiple sources to undertake a new \napproach of how county departments have been affected by Proposition 47,"] [20.625293731689453, 9.142146110534668, "eting minutes, websites, and other public information regarding state and other county efforts to enhance our understanding about trends in workload and Proposition 47\u2013relevant activities. \nFindings \nSummary of the Impact on County Operations and Wor"] [20.607131958007812, 9.115290641784668, "ct.\n3 However, LASD experienced \nan increase in arrests for larceny theft offenses following Proposition 47, although the larceny theft arrest rates appear to be at about the same levels as 2010\u20132011 (the years before and after Public Safety Realignm"] [20.618654251098633, 9.137789726257324, " the effect of Proposition 47 on health services utilization suggest that further examination is merited to understand how these individuals are referred to and use services, as well as these individuals\u2019 outcomes. \nIssues Associated with Reliably Es"] [20.600017547607422, 9.120061874389648, "trics: The Board of State and Community Corrections will provide all 58 counties\u2019 information from 2011\u20132015 on population data, crimes reported, arrests, and jail populations, but it is up to each county to analyze its own data. In our review, possi"] [20.624021530151367, 9.144845962524414, "ected by Proposition 47. \nMeasuring Workload \nAlthough several county departments (e.g., the APD) have developed systems to capture data \non the level of effort associated with different types of cases, it likely is impossible to implement \nsimilar "] [20.605850219726562, 9.138409614562988, "mples of both types of metrics for each goal: \n\u2022 Goal One: Enhance public order and safety. Output metrics are especially relevant to \nlaw enforcement agencies, such as numbers of arrests by offense type and charge, number of citation and releases \u201ci"] [20.603713989257812, 9.121039390563965, "justice system of nonserious, nonviolent offenders. A central question the Los Angeles County Auditor-Controller has tried to address is the cost savings to county departments as a result of Proposition 47. However, given current \ninformation systems"] [20.594707489013672, 9.078536033630371, "riminal justice reforms passed in California over the last five years\u2014e.g., Proposition 36 (2012), Assembly Bill 109 (2011), Assembly Bill 1468 (2014), Proposition 57 (2016)\u2014designed to reduce state prison overcrowding, focus criminal justice expendi"] [20.613140106201172, 9.12198543548584, "\nIn the remainder of this chapter, we first provide a brief overview of Proposition 47 and \nhighlight some of the considerations in evaluating how the measure has affected state and county \nagencies. Next, as context for this report, we summarize pre"] [20.613149642944336, 9.128968238830566, "capacity of 10,000 to 30,000 beds, with additional potential savings from a reduction in county \nprobation caseloads (Males and Buchen, 2014; Taylor and Cohen, 2014). One preliminary estimate suggested annual savings between $100 million and $175 mil"] [20.605939865112305, 9.117718696594238, "ition 47 also limits when theft of property of $950 or less can be charged as a felony. For shoplifting, under \nProposition 47, shoplifting property worth $950 or less is always a misdemeanor and can no longer be charged as \nburglary in the second d"] [20.625226974487305, 9.138036727905273, "acts. \nState Estimates \nIn January 2016, the California Department of Finance released an estimate for fiscal year \n(FY) 2015\u20132016 state net savings from Proposition 47 of $29.3 million (California Department \nof Finance, 2016). This estimate was bas"] [20.59966278076172, 9.098104476928711, "47\u2019s total fiscal effect. \nWhile the initial Department of Finance estimate was revised upward to $39.4 million and \nsupplemented by a discretionary one-time investment of $28 million, resulting in a total allocation related to Proposition 47 of $67."] [20.610397338867188, 9.125999450683594, "s would opt for drug treatment programs if they were not compelled to with the threat of jail time. In addition, Proposition 47\u2013eligible individuals\u2019 mental health and drug treatments needs are unclear. \nFourth, county-level efforts to quantify the i"] [20.61804962158203, 9.137327194213867, "velopments in metrics and tracking methods (Naimo, 2016b). The status update noted newly developed methods implemented by several county departments (Probation, PD, APD, and DA) to improve tracking of workload and cost changes resulting from Proposit"] [20.61258888244629, 9.13113021850586, "osition 47 on county operations and workload, discussion of recommendations for measuring the impact of Proposition 47 and other legislative initiatives moving forward, and recommendations for county metrics. \nAppendix A details the statutory changes"] [20.607803344726562, 9.125900268554688, "nties and research institutions, such as the Public Policy Institute of California [PPIC] report titled \u201cHow Has Proposition 47 Affected California\u2019s Jail Population,\u201d Bird et al., 2016) to enhance our understanding of Proposition 47\u2013relevant activit"] [20.60457992553711, 9.124495506286621, "ow each entity\u2019s operations had changed as a result of Proposition 47 and the entity\u2019s effort to monitor operational and fiscal impact. We explored issues related to the ability of the departments to measure and track workload related to Proposition "] [20.61315155029297, 9.13338851928711, "mber 15, 2016. We also participated in the Los Angeles County Criminal Justice Reform Metrics meeting held on November 14, 2016. \nThe meetings that we attended allowed us to learn more about the status of different activities \nand initiatives relate"] [20.61385154724121, 9.133953094482422, "e department\u2019s efforts, as presented in \nthe following chapter, were circulated to individuals designated as our key points of contact regarding the operations, budget, and information technology (IT) to check for factual accuracy. Revisions to the d"] [20.61916732788086, 9.139010429382324, "departments, followed by law enforcement, and \nfinishing with the health service departments. For each department, we provide budget information; we do not analyze budget changes, but focus on workload changes and potential cost implications. We also"] [20.635936737060547, 9.156451225280762, "ey agency, for misdemeanor consideration; or (3) \ndecline the case for prosecution pending a request for further investigation from law enforcement.\n2 They decide what charge or charges, if any, are appropriate based on the evidence \npresented. Prose"] [20.619651794433594, 9.138321876525879, "950 limit for property offenses is not the only factor \n \n2 If the case is a straight misdemeanor in a city that has its own city attorney or city prosecutor, law enforcement can \npresent the investigati"] [20.623628616333008, 9.145244598388672, "ee months after Proposition 47 passed) for both new cases and old cases that require amendment. \nThese changes are reflected in PIMS. The PIMS database system is 25 years old and was developed to produce case statistics and produce charging documents"] [20.62380599975586, 9.14441967010498, "ion 47 went into effect. Applications currently represent the majority of the Proposition 47 legacy caseload.\n4 Since the \ndeadline was extended to 2022 for legal relief, workload on applications, as well as petitions and preconviction motions which "] [20.621814727783203, 9.144193649291992, "he process, and are less likely to go to preliminary hearing or jury \ntrial. \nFigure 3.2. Adult Felony C ases Prosecuted by the DA , by Month \n \nSOURCE : DA, 2016b. \nNOTES: Vertical red line marks Proposition 47 implementation. T hese numbers refl"] [20.622568130493164, 9.143494606018066, " processes: outreach, case intake, eligibility review, legal proceedings, related legal proceedings, and data compilation (see Table B.1 in Appendix B). \n0\t\r \u00a0500\t\r \u00a01,000\t\r \u00a01,500\t\r \u00a02,000\t\r \u00a02,500\t\r \u00a0Number\t\r \u00a0of\t\r \u00a0Prosecuted\t\r \u00a0Juvenile\t\r \u00a0Petit"] [20.626911163330078, 9.148811340332031, "additional legal action was taken following the court hearing. The PD classifies its Proposition 47 caseload into three effort levels, labeled \u201cCategory 1,\u201d \u201cCategory 2,\u201d and \u201cCategory 3.\u201d As of October 2016, the PD had handled a total of 58,512 cas"] [20.630691528320312, 9.143973350524902, "47 legacy cases. Finding more cost-effective or efficient ways to conduct outreach could thus help reduce the workload and fiscal impact of Proposition 47 going forward (see Appendix B). \nLimitations \nThe dashboard only reflects the average weighted "] [20.623010635375977, 9.142791748046875, "ics (including but not limited to \n0\t\r \u00a01000\t\r \u00a02000\t\r \u00a03000\t\r \u00a04000\t\r \u00a05000\t\r \u00a06000\t\r \u00a0New\t\r \u00a0Case\t\r \u00a0Filings\t\r \u00a0\nFelony\t\r \u00a0 Misdemeanor\t\r \u00a0 \n26 mental health issues, homelessness, substance use status, and jail status); (2) case characteristics, \ni"] [20.617887496948242, 9.136800765991211, " what kind of work is being generated for each case type. \nLegacy Case Petitions and Applications \nBased on the eWorkflow management system, APD estimates for FY 2014\u20132015 that its \ndirect costs for Proposition 47 requests for service were $451,838."] [20.613786697387695, 9.136459350585938, "\n \n0\t\r \u00a0100\t\r \u00a0200\t\r \u00a0300\t\r \u00a0400\t\r \u00a0500\t\r \u00a0600\t\r \u00a0700\t\r \u00a0Number\t\r \u00a0of\t\r \u00a0APD\t\r \u00a0Case\t\r \u00a0Filings\t\r \u00a0\nFelony\t\r \u00a0 Misdemeanor\t\r \u00a0 \n29 Table 3.4. APD\u2019s Estimate of Average Cost per Case, by Case Type and Fiscal Year \n FY 2013\u2013 2014 \n(Pre\u2013Proposition 47)"] [20.609119415283203, 9.127249717712402, "ns is further complicated by limitations of the department\u2019s existing data systems. \nDuring our discussions with LASD staff and our review of materials, it was clear that LASD data systems do not allow calculations of changes in the level of staffing"] [20.609188079833984, 9.124016761779785, "ounty before and after Proposition 47, \nbut we want to note here that designation of a case as Proposition 47 by LASD is done at a very early stage in the justice process. Designation is not updated based on plea bargaining or \n "] [20.60992431640625, 9.124074935913086, " for Los Angeles County, 2008 \u20132015\nSOURCE : LASD , 2016b . \nNOTE: Statistics broken down by Part I offense category are provided in Appendix C. \nNational crime trends suggest that Los Angeles County experienced an above-average \nincrease in Part I "] [20.60152244567871, 9.11737060546875, "sition 47 led to changes in charging behavior; for instance, the decrease in arrests for possession of a controlled substance (HS 11350) may have been displaced by an increase in arrests for possession of a controlled substance with intent to sell (H"] [20.610727310180664, 9.127392768859863, "cate the average amount of time or staffing resources needed to quantify costs associated with increased calls for service. LASD noted that there is substantial variability in the resource needs for handling a call for service, depending on the speci"] [20.608339309692383, 9.126496315002441, "ncapacitation effect prior to Proposition 47. \n70,000\t\r \u00a075,000\t\r \u00a080,000\t\r \u00a085,000\t\r \u00a090,000\t\r \u00a095,000\t\r \u00a0100,000\t\r \u00a0105,000\t\r \u00a0110,000\t\r \u00a0\nJan-\u00ad\u201013\t\r \u00a0\nMar-\u00ad\u201013\t\r \u00a0\nMay-\u00ad\u201013\t\r \u00a0\nJul-\u00ad\u201013\t\r \u00a0\nSep-\u00ad\u201013\t\r \u00a0\nNov-\u00ad\u201013\t\r \u00a0\nJan-\u00ad\u201014\t\r \u00a0\nMar-\u00ad\u201014\t\r \u00a0\nMay-"] [20.618562698364258, 9.140628814697266, "fferencing ADIP one year pre- post Proposition 47 that the Auditor -Controller initially calculated hard \ncost savings for LASD of $13.7 million in FY 2015 \u20132016. 37 Figure 3.11. Trends in Custody Population and Functional Beds , Jan uary 2010 \u2013Octo"] [20.6070499420166, 9.129420280456543, "the second quarter of 2016, with a corresponding increase in the share of inmates requiring medium or high security (levels 5\u20137 and 8\u20139, respectively) (LASD, 2015a, 2015b). Again, since statistics prior to Proposition 47 are not available, it is not "] [20.60948371887207, 9.126846313476562, "d to be pulled from past reports. \n39 Proposition 47, these percentages increased to 90 percent in early 2015 but have since dropped \nsteadily. In July 2016, male and female release criteria were 30 percent. The implementation of mandatory split se"] [20.59164047241211, 9.107467651367188, "rt dedicated to Proposition 47 cases. \nCost Analysis \nAs with other departments, based on the data available, we feel it is impossible to calculate \npotential savings or cost increases in LASD operations as a result of Proposition 47. The \n40 Audito"] [20.606943130493164, 9.126911163330078, "population of 5,107 (Table 3.5). Specifically, of the initial probationer population (as of November 4, 2014), 30 percent (or 15,329 individuals) were identified by Probation as potentially being eligible for legal relief under Proposition 47. As of "] [20.61797523498535, 9.137306213378906, "ints in time: September 2014 (before Proposition 47 was implemented), \nOctober 2015 (one year following the passage of Proposition 47), and July 2016 (2.5 years following the passage of Proposition 47). Probation uses somewhat different categories of"] [20.60403060913086, 9.119954109191895, "igible Proposition 47 probationers; to assist with outreach efforts by posting Proposition 47 signage in probation supervision offices; to train deputy probation officers to provide supervised individuals with general information; and to refer indivi"] [20.604724884033203, 9.129185676574707, "passing of Proposition 47 because of their criminal justice status are no longer receiving those services. However, they represent a very small subset of the potential population affected by Proposition 47 that may be receiving DMH services, given th"] [20.600622177124023, 9.133614540100098, "et al., 2001; Hubbard et al., 1989; Simpson et al., 1997).\n \nTable 3. 8. DPH Proposition 47 Cases, November 4, 2014 , to September 30, 2016 \nProposition 47 cases 318 \nRemained in treatment after Proposition 47 154 \nDischarge d after remaining in t"] [20.528230667114258, 9.118425369262695, "(6.4%) 127 days 55 days \nDischarges 5,978 \nFY 2013 \u20132014 Admissions 8,327 3,109 \n(51.5%) 2,433 \n(40.3%) 491 \n(8.1%) 121 days 57 days \nDischarges 6,033 \nFY 2014 \u20132015 Admissions 7,611 2,418 \n(47.6%) 2,219 \n(43.7%) 443 \n(8.7%) 112 da"] [20.54540252685547, 9.10286808013916, "ere is some controversy \nregarding court-mandated treatment due to its potential coercive nature, research suggests that court-mandated substance-use treatment may be just as effective as treatment that is not court-mandated. For example, several stu"] [15.867494583129883, 10.380032539367676, "mation (e.g., disability and insurance status). Once data are matched across departments, a unique identifier can be assigned (identifiable information can be removed before analysis). \nSet up in 2007, the ELP can track individuals longitudinally, al"] [13.95849323272705, 3.192638397216797, "ore inclusive than the ELP; it will include information from the courts, prosecution, and defense as well as from law enforcement and probation departments in Los Angeles County. JAIMS includes information from the Proactive Information Exchange syst"] [20.572023391723633, 9.114985466003418, "anagement system using the same software product as CWMDM with future plans to link its master data management to CWMDM. JAIMS will deploy the ISAB master data management with links to CWMDM once ISAB master data management is fully operational; ther"] [20.60591697692871, 9.12790584564209, "is eligible, anyone with a felony arrest or conviction prior to November 2014 was included, which likely means that the database overestimates the number of individuals who are qualified for relief. For example, prior criminal history that would prec"] [20.567197799682617, 9.093457221984863, "ilized to provide data analytics to support agency workload analysis, service integration, and program evaluation. Integration between JAIMS and CWMDM would allow for measurement of service utilization. The data analytics and statistics are still in "] [20.590261459350586, 9.097521781921387, "t had identified 196 Post-Release \nCommunity Supervision offenders and 827 mandatory supervision offenders released from supervision as a result of Proposition 47 (Riverside County Community Corrections Partnership Executive Committee, 2016). The Riv"] [20.616975784301758, 9.138347625732422, "ely following Proposition 47, but perceived changes in prosecution charging (e.g., increased filing of felony drug sales cases under HS 11366). Of the 40 courts reporting complete data in the first six months of 2015, misdemeanor filings increased by"] [20.6058349609375, 9.1244478225708, "1 (the years before and after Public Safety Realignment was enacted). Calls for \nservice increased about 5 percent from the year prior to Proposition 47, although there \ndoes not appear to be a trend break at the time of Proposition 47. LASD also has"] [20.63083839416504, 9.145341873168945, "e county \ndepartments lacked the infrastructure to readily monitor workload changes and then translate \nthose changes to fiscal impacts. Although caseload information is available, translating caseloads to workload was reported to be relatively diffi"] [20.606962203979492, 9.12424087524414, "tion 47 \nfor county departments. To do so, we provided assessments of changes in workload resulting from Proposition 47 for the individual departments, as well as estimates of costs obtained from several different departments, such as the PD and APD."] [20.585163116455078, 9.103096008300781, "eles County\u2019s efforts: arrests (including by offense type); changes in jail bookings and populations; probation caseload changes; increases in cases handled by the DA, PD, and APD; and changes in drug court participants. At the same time, there is ex"] [20.624595642089844, 9.142779350280762, "to draw a sample of cases and ultimately individuals to follow over time.\n1 With respect to identifying a cohort of new Proposition 47 \ncases, ISAB agencies have developed a Proposition 47 data strategy and logic model, as discussed in Chapter Three."] [20.70045280456543, 9.192937850952148, " the agency (e.g., training sessions, community outreach, administrative responsibilities). This approach addresses many of the limitations of other assessment methods that were based on aggregate case counts or weighted caseloads (Gramckow, 2012). W"] [20.622135162353516, 9.150315284729004, "ed by a program, policy change, or activity, as opposed to the consequences of \nthat workload. County departments are able to directly influence outputs, and they can represent measures of what is most directly salient for county agencies. Outcome me"] [20.616809844970703, 9.140204429626465, "ber or percentage of individuals with identified need or \nrisk profile referred to appropriate services, by service type or program provider; and \nnumber or percentage of inmates released from custody with supervision or service \nreferral. Possible o"] [20.63987922668457, 9.16946029663086, "r drug-related crimes\u2014including sales, \npossession for sales, transportation, and possession of narcotics while armed with a \nfirearm\u2014remain unchanged. \n\u2022 Forgery crimes: Proposition 47 amended PC 473, adding a new subdivision (b) that makes the offe"] [7.687721252441406, 4.545830726623535, "sued to another person, without consent, with the intent to \ndefraud. \nA nonexhaustive list of superseding priors is provided below. \n\u2022 PC 37: treason \n\u2022 PC 128: perjury causing the execution of an innocent person \n\u2022 PC 182: conspiracy to commit a cr"] [7.694103717803955, 4.548907279968262, "n \n\u2022 PC 311.1 (F/M): sending, bringing, or possessing obscene material depicting a person under age 18, with the intent to distribute or exhibit \n\u2022 PC 311.2(b): sending, bringing, or possessing obscene material depicting a person under age 18, with t"] [20.705669403076172, 9.227080345153809, "d Party \nCat 1 \nCases ** Cat 2 \nCases** Cat 3 \nCases** Assumed Item DPD III Paralegal ITC ITC ITC Ware -\nhouse \nWorker II IT \nTechnical \nSupport \nAnalyst I IT Super -\nvisor N/A \n14,934 37,241 5,218 Monthly Budgeted Salary FY 2016\u2013\n2017 $12,"] [20.626176834106445, 9.147109031677246, "gal services that \noriginate with Proposition 47 intake.*Category 3 Proposition 47 Case \nTime CalculationAverage time to complete \nexpungement .\n**Case totals as of September 5, 2016. \n Filing only done on Proposition 47 \u2013eligible cases . \n \nPropos"] [20.63802146911621, 9.152347564697266, " 5 minutes 2\u20135 \nminutes \n\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0 5.4 Court filing X \n\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0 5.5 Court proceeding 5\u201320 \nminutes \n\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a0\t\r \u00a06 \n Process 6 : \nProposition 47 data \ncompilation \n"] [20.5771484375, 9.11214542388916, " \n11 Category 2 Proposition 47 Case Time Calculation: High end of determined range. \n12 Category 3 Proposition 47 Case Time Calculation: Average time to complete an \nexpungement. \n13 Monthly will be updated on the first Monday of the following mo"] [20.619970321655273, 9.13895034790039, "OTES: Leftmost vertical red line represents timing of Assembly Bill 109, and rightmost vertical red line represents \ntiming of Proposition 47 . Seasonal adjustment calculated by the authors, with details on methodology provided below. \n0\t\r \u00a020\t\r \u00a04"] [23.00128746032715, 9.90322208404541, "and assess changes in workload and resource needs following policy changes moving forward. \nStep One: Identifying the Scope of the Study \nAt the outset of the study, stakeholders need to determine the scope of the study that is \nfeasible given time a"] [23.06226348876953, 9.904427528381348, "on steps performed and not solely on statutory requirements. It should also be recognized that, even when different professions participate in the same processing step, they may have different time requirements. \nThe key pieces of information needed "] [23.12733268737793, 9.924210548400879, "t in which the study will take place. Below, we outline the relevant potential data collection methods. \nSelf-Reported Time Logs \nSelf-reported time log methods require county department staff to keep a daily record of the \ntime spent on various task"] [23.01319122314453, 9.892233848571777, "rt can be estimated for each case type by \nsumming the time spent by each agency (and within each agency, each profession) in each major processing step. The total time spent is then divided by the total number of cases recorded at \neach processing s"] [20.570363998413086, 9.085508346557617, "ons/Crime_Data_Dec2015.pdf \nBuchen, Lizzie, and Michael Males, \u201cProposition 47: Estimating Potential County-Level Savings \nand Jail Population Reductions,\u201d Center on Juvenile and Criminal Justice, October 2014. As of December 19, 2016: http://www.cj"] [20.529949188232422, 9.039634704589844, "ry 3, 2017: \nhttp://www.sandiegocounty.gov/content/dam/sdc/probation/CCPdocs/CCP_Meeting_Presentation_02-16-15.pdf \nCounty of San Diego, Public Safety Group, Adopted Operational Plan Fiscal Years 2015\u201316 \nand 2016\u201317, San Diego, Calif.: County of San"] [20.529977798461914, 9.076493263244629, "erced \nTreatment for Drug-Abusing Offenders,\u201d Federal Probation, Vol. 62, 1998, pp. 3\u201310. \nFederal Bureau of Investigation, \u201cCrime in the United States, 2015,\u201d undated. As of March 8, \n2017: https://ucr.fbi.gov/crime-in-the-u.s/2015/crime-in-the-u.s"] [20.559993743896484, 9.071141242980957, "d Study \nReport, Madison, Wisc.: National Council on Crime and Delinquency, 2006. \nJudicial Council of California, \u201cEarly Impacts of Proposition 47 on the Courts ,\u201d Operations and \nPrograms Division, Criminal Justice Services, March 2016. As of Dece"] [20.579164505004883, 9.090948104858398, ". \n\u2014\u2014\u2014, ISAB\u2019s Proposition 47 Data Analytics Strategy, provided to RAND on December 7, \n2016c. \nLos Angeles County Sheriff\u2019s Department, \u201cAbout the Los Angeles County Sheriff\u2019s \nDepartment,\u201d web page, 2010. As of February 22, 2017: \nhttp://www.la-she"] [20.55971908569336, 9.069576263427734, "015),\u201d County of Los Angeles Department of Auditor-Controller, April 5, 2016a. As of December 21, 2016: http://file.lacounty.gov/bc/q2_2016/cms1_242181.pdf \n89 \u2014\u2014\u2014, \u201cProposition 47: Status of Tracking Methods and Metrics (Board Agenda April 12, \n201"] [20.542875289916992, 9.062129020690918, " Street-Level Officers,\u201d Criminal Justice Review, Vol. 26, No. 1, 2001, pp. 17\u201337. \nSmith, Brad W., Kenneth J. Novak, James Frank, and Christopher Lowenkamp, \u201cExplaining \nPolice Officer Discretionary Activity,\u201d Criminal Justice Review, Vol. 30, No."] [15.775426864624023, 10.250744819641113, "hington, D.C.: U.S. Department of Justice Office of Community Oriented Policing Services, 2012. \nWu, Fei, and Max Stevens, \u201cThe Services Homeless Single Adults Use and Their Associated \nCosts: An Examination of Utilization Patterns and Expenditures "] [7.34368371963501, -4.0650105476379395, "SOCIAL AND ECONOMIC WELL-BEING\nForensic Familial and \nModerate Stringency DNA Searches\nPolicies and Practices in the United States, \nEngland, and Wales\nTepring Piquado, Carl F. Matthies, Lucy Strang, James M. Anderson\nPrepared for the National Insti"] [13.900894165039062, 4.28641414642334, "s research was conducte d in the Justice Policy Program within RAND \nSocial and Economic Well-Being. The program fo cuses on such topics as access to justice, \npolicing, corrections, drug policy, and court system reform, as well as other policy conce"] [7.333108425140381, -4.053225040435791, "......................................................................... ....... 6\t\nQualitative U.S. State Laboratory Interviews .................................................................................. ..... 7\t\nQualitative England and Wale"] [7.343488693237305, -4.064456939697266, "....................................................................................................... ........................ 27 \t\nModerate Stringency Matches ........................................................................................"] [7.338150978088379, -4.056695461273193, "... 45 \t\nFuture Research ............................................................................................................... ....................... 46 \t\nCost Estimates ....................................................................."] [7.3451361656188965, -4.066208839416504, "s for Local and State DNA Database Matches Among \nResponding LDIS Laboratories, 2010 and 2018 (Prorated) ................................................. 26 \t\nTable 3.3. Familial Database Search (FDS) of the California and Texas Arrestee Databases "] [7.337631702423096, -4.060396671295166, "ith familial \nDNA testing policies to develop a more in-depth understanding of the effect of familial and \nmoderate stringency DNA testing. One case study ex amined a state where familiar searching and \nmoderate stringency match reporting is explic i"] [7.339640140533447, -4.0577802658081055, " Federal Bureau of Investigation, \u201cFrequently Asked Questions on CODIS and NDIS, Questions 25 and 28,\u201d \nundated. x Of responding LDIS laboratories, 42 percent ar e using probabilistic genotyping software to \ninterpret DNA profiles derived from crime"] [7.341681480407715, -4.060904026031494, "ty estimate thresholds \nif specific loci are searched at moderate stri ngency. SDIS laboratories were focused on hiring \nadditional personnel because curren t staff struggle to keep pace with DNA testing and database \nmanagement responsibilities. \n "] [7.348690032958984, -4.068599700927734, "source forensic profile that has already been uploaded \nto NDIS without producing any exact matches through rou tine searches. \n \n3 Federal Bureau of Investigation, \u201cCODIS-NDIS Statistics,\u201d September 2"] [7.346791744232178, -4.068699836730957, "tremel y partial profile would be disregarded unless it \nrelated to a serious offense such as murder or sexual assault, for which every DNA result is \nscrutinized for its value and potential contribution to th e investigation. \nConclusion and Impli"] [7.345820426940918, -4.066939353942871, " e fficacy, we know little about familial searching or \nmoderate stringency search policies or practices. \nA number of regulatory and res ource constraints may limit its application and/or adversely \nimpact other avenues of investigation. Where pol"] [7.347634792327881, -4.067690849304199, "ble offense and all \nconvicted offenders.2 \nFollowing practices originally used in Engla nd, U.S. forensic DNA databases have steadily \nincreased in size and scope through revision of stat e statutes to expand the class of individuals \nfor whom a DN"] [7.34569787979126, -4.0657148361206055, "tations, \nY-STR profiles are the same for all male first- degree relatives of the same paternal lineage \n(i.e., a father and his sons will all have the same Y-STR profiles, as will their sons). Y-STR \nprofiles are the preferred method of confirming k"] [7.353165626525879, -4.07449197769165, " close matches . 4 one allele at each locus. Some state policies also stipul ate that these partial matches suggestive of \nkinship must be discovered by happenstance, or routine moderate stringency searches, rather \nthan through a deliberate familial"] [7.361091613769531, -4.082553863525391, "ing Post-Conviction \nLitigants\u2019 Access to DNA Database Searches to Prove Innocence,\u201d Boston College Law Review , Vol. 60, No. 2, \n2019, p. 709\u2013751. \n9 Daniel Schorn, \u201cA Not So Perfect Match: How Near DNA Match Can Incriminate Relatives of Criminals,\u201d"] [7.315424919128418, -4.036823749542236, " of this report, we provide an overview of forensic DNA laws, regulations, policies, \nand practices that govern the use of fam ilial DNA or moderate stringency searches. \nSDIS and LDIS Laboratory Survey \nWe invited all SDIS and LDIS administrators "] [7.330783843994141, -4.0626959800720215, "d the \nimplications of this policy option. \nThe topics discussed during the interviews were \n\uf0b7 processes on the use of familial moderate stringency searches and the resulting partial \nmatches \n\uf0b7 stakeholders involved in authorizing, conducting, and "] [7.297159671783447, -4.01721715927124, "ve tool. Familial searches \nwere first used in England in 2002 and led police to the perpetrator of th ree cold-case homicides \nthrough the DNA of his son, who committed auto theft and whose DNA was already in the database.\n1 \nModerate stringency sea"] [7.335773468017578, -4.05710506439209, " as models, the director of the Texas \nDepartment of Public Safety asked the SDIS administrators to devise a procedure for familial \nsearch in response to a series of unsolved sexual assaults of elderly women. With the assistance \nof attorneys from t"] [7.35306978225708, -4.071893692016602, "019. \n9 Utilizing DNA Technology to Solve Cold Cases Act of 2011, H.R. 3361, 112th Congress (2011). \n10 Federal Bureau of Investigation, \u201cLabor atory Services: Famili al Searching,\u201d 2011. 11 several states have explicitly prohibited its us e. The c"] [7.353107452392578, -4.066363334655762, " U.S. Department of Justice, NCJ 230183, 2010. \n13 Nelson, 2010. \n14 The White House, Office of the Pre ss Secretary, \u201cFact Sheet: Investments to Reduce the Rape Kit Backlog and \nCombat Violence Against Women,\u201d press release, March 16, 2015. \n15 J."] [7.362932205200195, -4.083003997802734, "y exogenous timing of state da tabase expansions, she finds \nthat the combined deterrent and probative effects of adding fel ony convicts decreased violent and \nvolume property crime rates. A 12-percent increase in database size (i.e., the approximat"] [7.358263969421387, -4.078353404998779, " \n21 Stephen P. Myers et al., \u201cSearching for First-Degree Familial Relationships in California\u2019s Offender DNA \nDatabase: Validation of a Like lihood Ratio-Based Approach,\u201d Forensic Science International: Genetic"] [7.354263782501221, -4.074700832366943, "ch is believed to be the first conviction using familial search techniques \nin Australia.31 \nGranja and Machado review the use of familial searching in the United Kingdom and \nPoland.32 They argue that the use of familial searching depends in part on"] [7.337733268737793, -4.056794166564941, " \n34 Aaron Opoku Amankwaa and Carole McCartney, \u201c The Effectiveness of the U .K. National DNA Database,\u201d \nForensic Science International: Synergy, Vol. 1, 2019, pp. 45\u2013 55. \n16 assault kits, \u201ctouch DNA\u201d). None of the SDIS laboratories report ed"] [7.339330673217773, -4.058122158050537, "ate matches 909 956 \u201322% \nModerate and partial SDIS/NDIS \nmatches confirmed 330 140 \u201369% \nTotal matches 1,753 2,371 35%b \na The third column is a percent change in a percentage, derived by taking, for example, exact matches 2010/total \nmatches 2010"] [7.341511249542236, -4.054051399230957, "ns.36 \nFigure 3.5 shows 25 of 26 LDIS laboratories that responded to the survey currently use \nCODIS 20 STRs. Eighteen of the responding LDIS laboratories conduct Y-STR testing as well, \nwith another four relying on cont ract laboratories for th e "] [7.344706058502197, -4.056849479675293, "laboratories reported that they \nshared some suspect profiles with SDIS in accordance with the law. \nAs a means of ensuring that our understanding of CODIS terminology was consistent with \nLDIS laboratories, our survey asked LDIS labor atories wheth"] [7.337337017059326, -4.0570197105407715, " trace DNA samples in property crimes had \nincreased the fraction of forensic partials and forensic mixtures in LDIS and SDIS databases. \nLDIS laboratories were asked to report the number of forensic partials, forensic mixtures, and forensic profiles"] [7.354735374450684, -4.044353485107422, "of LDIS Laboratories Using Fortuitous Partial Matches or \nFamilial Searches to Aid Investigations \n \nLDIS laboratories that use fortuitous partia l matches were asked whether they conducted \nY-STR or mtDNA testing to confir m the likelihood of kinshi"] [7.335183143615723, -4.053191184997559, "s portion of the surv ey. Seven of eight res ponding LDIS laboratories \nreplied that it was either \u201ctoo time-consuming\u201d or \u201crequired data they do not collect.\u201d One \nresponding LDIS laboratory commented on the defi nition of \u201cconfirmed,\u201d stating that"] [7.3398823738098145, -4.0572733879089355, " in the \ncase of California), some portion of which are not exact matches. Thus, these SDIS laboratory \nadministrators have dealt exte nsively with moderate stringency matches. Both Texas and \nCalifornia were early adopters of familial searching as w"] [7.341088771820068, -4.060775279998779, "s from the investigating and prosecuti ng agencies. The request forms describe the \nconditions under which the familial search will be conducted and require applicants\u2019 signatures \nto attest that they unders tand and agree to the terms.43 \nThe famili"] [7.31476354598999, -4.033168315887451, "S administrator, the laboratory information management \nspecialist, the DNA technical lea d, and three other SDIS laboratory personnel. In California, \nthere are seven people on the FDS committee, including the state CODIS administrator, DNA \ntechnic"] [7.300985813140869, -4.014598846435547, "tative from the office of the district attorney. The offender name is revealed at the conclusion of an informational session, afte r making sure investigators and prosecutors \nunderstand the significance of the prospective FD S match and the proper w"] [7.353405475616455, -4.073537826538086, "o cover it, and Interviewee 1 noted th at it was only after the technique had been \nemployed on a number of occasions that discus sions around legislation emerged. The Protection \nof Freedom Act 2012 sets out the legal framework re lating to the coll"] [7.352448463439941, -4.083103179931641, "dited and have authorization to take genetic material and \ngenerate a profile that is loaded and stored in the National DNA Database. \nWhen a law enforcement agency wishes to c onduct a familial DNA search with a crime-stain \nprofile that is suitabl"] [7.352632522583008, -4.074201583862305, "onsiderations. For exampl e, if you have an offender in his 30s [with a \nprofile in the National DNA Database], and th e offense happened 15 years ago, what are the \nchances that a child of that offender would be 20 or 25 now? Those sorts of calcula"] [7.351185321807861, -4.072859764099121, "he lowest one we\u2019ve found is 1,100th on the list.\u201d In some cases, if the \nDNA profile has distinction\u2014for example, some unusual components\u2014a relevant hit may move \ncloser to the top of the list. Adding age and ge ographical parameters was also report"] [7.353386402130127, -4.075441360473633, " is a probabilistic thing.\u201d Furthermore, the interviewee stated that the efficacy of a \nfamilial inquiry will be significantly lower when looking at sibling relationships rather than \nparent-child relationships, noting the similarity in the DNA of "] [7.324002265930176, -4.045802116394043, ". Several interviewees hi ghlighted the relative \nexpense of running a familial inquiry (Interviewees 1 and 6). In terms of contributing costs, \nInterviewee 1 noted that cold cas es may be investigated by retired detectives who have been \nhired as c"] [7.350241661071777, -4.071494102478027, "rom a \npolicing perspective, then, the argument could be made that conducting an investigation with the \nuse of a familial DNA search is an extensi on of normal police operations. However, the \ninterviewee raised two matters of concern. First, for th"] [7.3582634925842285, -4.0789690017700195, "e are a number of estimates available on the \nproportion of young Black men from urban areas in the National DNA database, which suggests \nthat they constitute between one-quarter and one-third of profiles in the database. The 38 interviewee also de"] [7.347902774810791, -4.067743301391602, "hnology has advanced and become more \nsensitive, increasingly mixed and partial samples are being gathered and used in investigations. \nInitially, these searches were predominantly us ed in sexual offense cases, but they are now \nincreasingly common "] [7.352921009063721, -4.073406219482422, "butor. \nIn this area, Interviewee 2 described the National DNA Database St rategy Board as taking \nthe lead role in minimizing ri sk associated with using mixe d samples by establishing strong \nelimination procedures. The inte rviewee noted that th "] [7.343595504760742, -4.06552791595459, ", criminal justice policymakers are hampered from adopting evidence-based familial \nDNA practices by our lack of knowledge about the us e and effect of this evidence. Our project\u2019s \nrelated studies sought to incr ease that knowledge base. \nOur findi"] [7.323861598968506, -4.044562816619873, "sins), and even sixth-de gree relatives (second cousins, \nonce removed).3 The genetic genealogy databases can also provide matches with more distant \ncousins.4 These trends raise issues of privacy, bias, and efficacy.5 Additionally, while familial \ns"] [7.4120402336120605, -4.132358551025391, "h at exist within the crim inal justice systems will \nresult in racially biased genetic population surveillance. In California, for example, Black people \naccount for about 20 percent of felony arrestees, but only 6 percent of the state\u2019s populatio"] [7.35670804977417, -4.076922416687012, "d Marper v. the United Kingdom (European Court of Human Rights, 2008). \n15 National DNA Database Strategy Board Annual Report 2012\u201313 , Gov.UK, Home Office, 2013. 44 may also be the case that the exoneration of Black and Latinx people could be poss"] [7.356330871582031, -4.077256202697754, "ther than identifying a few \nsuspects based on an investigation of a crime, it can subject large numbers of people to \n \n \n16 Schorn, April 1, 2007. \n17 Carpenter v. United States, 138 S. Ct. 2206 (2018"] [7.357740879058838, -4.078457832336426, "Matches, 2009.\n21 Ram, 2011.\n22 L. Gusmao et al., \u201cDNA Commission of the International Society of Forensic Genetics (ISFG): An Update of the\nRecommendations on the Use of Y-STRs in Forensic Analysis,\u201d International Journal of Legal Medicine , Vol. 12"] [7.3409037590026855, -4.062514781951904, "\nother investigative leads have been exhausted,\u201d convenes a committee to review familial search \nrequests and results,27 and uses supplemental test ing of Y-chromosome DNA.28 Depending on \n \n25James Ra"] [7.345314025878906, -4.065855503082275, "orcement the inexact nature of the investigative lead in searches that \nyielded candidates and counseled caution. Thus , concerns about pr ivacy and government \noverreach implied by the policies seem genuine. \nAdditionally, given the p ace of techn"] [7.342838764190674, -4.0643768310546875, "rate stringency searching \nand reporting of partial match results. Additionally, it is our recommendation for the future \nimprovement of policies that this informati on should be made publicly available online. \nOverall, this report sought to provid"] [7.414862632751465, -4.132264614105225, ", p. 36. As of June 12, 2019: \nhttps://cbssacramento.files. wordpress.com/2018/07/crime- in-california-2017c2a0.pdf \n\u2014\u2014\u2014, \u201cCrime in California 2017,\u201d Table 37, Di spositions of Adult Felony Arrests, \n1982\u20132017, p. 49. As of June 12, 2019: https://cbs"] [7.359817981719971, -4.078447341918945, "m Sleeper\u2019 Is \nWinning over Skeptics,\u201d Los Angeles Times , October 25, 2016. \nGierlack, Keith, Shara Williams, Tom LaTourette , James M. Anderson, Lauren A. Mayer, and \nJohanna Zmud, License Plate Readers for Law Enforcement: Opportunities and \nObsta"] [7.358152866363525, -4.079100608825684, " of Arrestee DNA Expungement,\u201d University of Pennsylvania Law \nReview Online, Vol. 164, No. 51, 2015, pp. 51\u201360. \nKennett, Debbie, \u201cUsing Genetic Genealogy Databa ses in Missing Persons Cases and to Develop \nSuspect Leads in Violent Crimes,\u201d Forensic"] [7.3943281173706055, -4.113832473754883, "loads/system/uploads/attachment_data/file/252885/NDNAD_Annual_Report_2012-13.pdf \nNational Police Chiefs\u2019 C ouncil and Home Office, National DNA Database Annual Report, 2017 \nto 2018, London: Home Office, 2019. As of June 11, 2019: https://assets.pub"] [7.353306770324707, -4.065715789794922, "res, CODIS Master Document \nList, DRN: CO-MDL,\u201d 2012. As of June 11, 2019: https://txdpslabs.qualtraxcloud.com/ShowDocument.aspx?ID=43050 \nThomas, Laura, \u201cNothing to Hide, Something to Fear: The Use of Partial DNA Matching in \nCriminal Investigations"] [20.65550994873047, 0.0786440372467041, "CORPORATION\nThe Energy Implications \nof Drones for Package Delivery\nA Geographic Information System Comparison\nTimothy R. GuldenLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. Thi"] [20.65964126586914, 0.07687332481145859, "following areas: energy consumption, infrastructure requirements, aerial congestion, privacy, and noise. The other forthcoming RAND publications include the following: \n\u2022 \u00a0What\u2019s the Buzz on Delivery Drones? (Welser and Xu, 2016) \n\u2022 \u00a0What\u2019s the Buzz"] [20.63522720336914, 0.08986779302358627, " that division. Collectively, their contributions reflect pooled grants from a range of sources, including corporations, trade and professional associations, individuals, government agencies, and private foundations. \u00a0\n v Contents \u00a0\nPreface ....."] [20.640615463256836, 0.08226373791694641, "as from the Geo-Registered Map ........................................... 4\t\r \u00a0Figure 2.3. Delivery Areas Overlaid with 2010 U.S. Census Block-Level Data ........................... 5\t\r \u00a0Figure 2.4. Synthetic Delivery Districts Derived from Block-Le"] [20.63956642150879, 0.08409617841243744, "bined the estimated energy used by trucks and drones to produce an estimate of total energy consumption under the drone scenario. \nWe found that the 20-percent drone scenario would require 13 fewer truck routes, 468 fewer \ntruck miles, and 46.8 fewe"] [20.64045524597168, 0.08152513206005096, "focus on larger items and difficult delivery situations. Drones and trucks are quite different with respect to their weight, energy needs, and optimal routing strategies. This raises the question of how such a shift might be expected to change the ov"] [20.636274337768555, 0.08534647524356842, "ning 20-percent more people) and repeated the mileage and diesel consumption estimate for these areas. Finally, we compared the energy content of the diesel saved with the electricity used by the drones to find the energy consumption of the two deli"] [20.638032913208008, 0.08392563462257385, "day. We therefore assume that district boundaries are drawn primarily based on the population that they contain. This assumption is used in subsequent steps to define a set of hypothetical delivery areas covering the metropolitan region. \nFigure \u00a02.3"] [20.640748977661133, 0.08174014091491699, "s might require deviations from the great circle distance (GCD) shortest path. For the sake of simplicity, we will use GCDs, assuming that such deviations would not be required for most flight paths. \nFigure \u00a02.6. \u00a0Estimating \u00a0Drone \u00a0Stops \u00a0as \u00a0a \u00a0Ra"] [20.635568618774414, 0.08651749044656754, "\u00a0miles \u00a0\nTruck \u00a0 fuel \u00a0use \u00a0(10 \u00a0 MPG ) \u00a0 459.6 \u00a0 gallons \u00a0 412.8 \u00a0 gallons \u00a0 46.8 \u00a0 fewer \u00a0gallons \u00a0\nDrone \u00a0 stops \u00a0 0 \u00a0stops \u00a0 1,550 \u00a0stops \u00a0 1,550 \u00a0more \u00a0drone \u00a0stops \u00a0\nDrone \u00a0 miles \u00a0 0 \u00a0miles \u00a0 9,406 \u00a0miles \u00a0 9,406 \u00a0more \u00a0drone \u00a0miles \u00a0\nD"] [20.646636962890625, 0.08011288940906525, "nt of \ndelivery stops could be serviced by drones instead of trucks. We conducted the analysis by \nconstructing a simple simulation model using real data for an actual city: Minneapolis, Minnesota. While the numbers and calculations in this prelimina"] [20.669044494628906, 0.06905192881822586, "\u201d data set, 2010. As of September 17, \n2017: https://www.census.gov/geo/maps-data/maps/block/2010/ \nWelser, William, IV, and Jia Xu, What\u2019s the Buzz on Delivery Drones? Santa Monica, Calif.: \nRAND Corporation, PE-230-RC, 2016. As of September 12, 201"] [7.167145252227783, -0.9232864379882812, "SOCIAL AND ECONOMIC WELL-BEING\nWhat America\u2019s Users \nSpend on Illegal Drugs, 2006\u20132016\nAppendixes\nGregory Midgette, Steven Davenport, \nJonathan P. Caulkins, Beau Kilmer\nPrepared for the Office of National Drug Control PolicyLimited Print and Electro"] [7.190525531768799, -0.9031000137329102, "g the number of cocaine, heroin, and methamphetamine users, and Appendix D presents survey-based data about the size of marijuana purchases. Appendix E extends the consumption estimates based on the limited set of drug use indicators available for 20"] [7.220806121826172, -0.8759864568710327, "........ 3 Figure A.6. Heroin Consumption Estimates ................................................................................... 4 Figure A.7. Marijuana Users by Use Category ...................................................................."] [7.226683139801025, -0.8705914616584778, "....................................... 33 Table E.4. Methamphetamine Consumption and Use Indicators, 2006\u20132017 ............................. 35 \n \n vii Abbreviations \nADAM Arrestee Drug Abuse Monitoring \nASI Addiction Severity Index \nCBSA core-ba"] [7.237687110900879, -0.8590514063835144, "278 278 324 327 322 282 200 161 1450100200300400500600Cocaine (PMT)3Figure A.4. Estimates of Chronic Heroin Users \n \nFigure A.5. Heroin Expenditure Estimates \n 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016\nBest "] [7.262282371520996, -0.8354954123497009, "6 $37 $42 $37 $31 $27 $28 $28 $27 $31 $36 $39 $46 $44\nLower $6 $7 $8 $10 $10 $12 $10 $8 $6 $7 $7 $7 $7 $9 $9 $11 $11\nONDCP (2014a) $9 $13 $17 $20 $23 $26 $25 $23 $18 $17 $150102030405060708090Methamphetamine \nexpenditure\n(billions, 2018 dollars)\n2000"] [7.263720512390137, -0.8340390920639038, "co; Denver ; Las Vegas; Phoenix; Salt Lake City; Tucson, Arizona; Rio Arriba \nCounty, New Mexico \nNortheast: Albany, N ew York; Boston; Manhattan , New York City; Philadelphia \nPacific: Anchorage, Alaska; Honolulu; Los Ang eles; Portland, Oregon;"] [7.255304336547852, -0.8422211408615112, "r because of admissions rules or availability constraints, the former \u2019s reported \ntreatment rate in TEDS will be twice as large as the latter. However, we expect that such a situation is unlikely. 9 substance or substances leading to admissions "] [7.229184627532959, -0.869713544845581, "verall prevalence over several years of data (e.g., 0.10 percent between 2008 and 2010), even small changes in the number of positive tests observed in any area result in relatively large changes in prevalence rates entering our models. At this point"] [7.255908966064453, -0.8423808813095093, "oisoning rate per 10,000 people (cocaine, heroin), and NSDUH reported \npast-year use rates for drug d in county a in time t. \n\u2022 I represents six region indicator variables, where each county a belongs to exactly one \nregion A and A contains at least"] [7.255734920501709, -0.8422794938087463, "ariables, and drug use by region interaction terms, we chose a final specification for each drug model empirically. We selected models based on whether any coefficients in the group were significant in the saturated model and refined each specificati"] [7.254453659057617, -0.8433248996734619, "il later \nin this appendix. \nUpdates to the Logistic Regression Model \nOne may expect that the demographic profile of cocaine, heroin, and methamphetamine users \nhas changed in the time since the original model described in Kilmer et al. (2014b) wa"] [7.2794952392578125, -0.8197082281112671, "st two reasons. First, the fact that data in ADAM counties are different from the rest of the United States suggests the two groups may not be equivalent, and that the estimated coefficient based on ADAM data does not accurately represent national da"] [7.265031337738037, -0.8326674103736877, "f low-reporting agencies from the county-level aggregate data (National Archive of Criminal Justice Data, 2019). However, the coverage indicator provided in the UCR county file cannot be used reliably to scale to a nationally representative count of "] [7.238206386566162, -0.8600621223449707, " \nOpiates Methamphetamine \nCDC overdose cocaine \u00d7 region 6 1.458 \n \n0.829 \nCDC overdose cocaine \u00d7 region 7 1.766 \n 1.178 \nCDC overdose psychostimulant \u00d7 region 2 \u221256.487a \n \n 19.573 \nCDC overdose psychostimulant \u00d7 region 3 "] [7.2559051513671875, -0.8421101570129395, "y and transform upper and lower bound 95-percent confidence intervals for each using the same basic formula: \n\ud835\udc45\ud835\udc45A\nJK%=expMlogisticG\ud835\udc45\ud835\udc45AH\u00b1seElogisticG\ud835\udc45\ud835\udc45AH\u00d71.96IR\n1+expMlogisticG\ud835\udc45\ud835\udc45AH\u00b1seElogisticG\ud835\udc45\ud835\udc45 AH\u00d71.96IR. \nAt this point, we have a predicted value fo"] [7.073251724243164, -0.9984255433082581, "an four past-month use days), misreporting due to responses clustering along these intervals could influence our consumption estimates, though the direction of the potential bias is difficult to guess. \nAlthough there is a decent-sized literature abo"] [7.257895469665527, -0.8393869996070862, "as reported a false negative. Although the third reason can be an issue, there is also the possibility of a false positive or that the user misreported use days. The bias because of the specificity and sensitivity of the urinalysis test can work in b"] [7.234777927398682, -0.8622143268585205, " activity that occurred further in the past and may not be tied to current drug use. However, \nthis exclusion had very little effect on our estimates. 23 Table C.3. Arrests per Arrestee \nDrug 1\u201310 Use Days \nin Past Month 11 or More Use Days \n"] [7.231352806091309, -0.8645134568214417, " past month 42,672 8,513 17,489 \n4\u201310 use days in past month 121,116 13,325 24,657 \nFewer than 4 use days in past month 204,734 12,811 21,930 \n Although these individuals are not otherwise criminally involved, they are CDUs. Similar to \nwhat was d"] [7.21597957611084, -0.8813745975494385, " 21.1% 7.0% 30.2% 1.4% \n2007 42.7% 20.5% 6.1% 29.0% 1.7% \n2008 41.6% 21.6% 6.3% 28.8% 1.6% \n2009 46.2% 19.4% 6.0% 27.0% 1.4% \n2010 47.6% 19.2% 5.5% 26.7% 1.0% \n2011 50.2% 18.4% 6.2% 23.6% 1.6% \n2012 50.1% 20.9% 5.4"] [7.257776737213135, -0.8456636667251587, "t. Examining overdose deaths without accounting for the impact of fentanyl likely grossly overstates use, as many of the recorded deaths likely also involve fentanyl. The relationship between overdose deaths and consumption lies somewhere between all"] [7.230571746826172, -0.8685213327407837, "hetamine. \nThe consumption model used in this report draws on the relationships among the various \ndrug use indicators available as the foundation for our estimates. We also assume by necessity that these relationships are stable over time, as we ext"] [7.237074375152588, -0.8624286651611328, "rcise to avoid the suggestion of confidence that may be associated with a more complicated method. The upper and lower points in the ranges defined in the following figures do not incorporate statistical uncertainty. \n 31 Cocaine \nTable E.2. Cocain"] [7.271729469299316, -0.8276500701904297, " 93,327 \n2008 30 281,715 0.39% 232,392 3,041 3,013 103,326 \n2009 31 286,671 0.46% 191,792 3,278 3,249 118,136 \n2010 27 266,023 0.40% 236,936 3,036 2,991 110,393 \n2011 30 281,936 0.40% 260,408 4,397 4,353 119,765 \n2012 33 293,622 0.50% 309,232 5,"] [6.92259407043457, -1.127492904663086, "pters Five and Six, an \nincrease in the potency of marijuana available and the proliferation of THC consumption methods other than smoking suggest measures of consumption by weight are potentially spurious. Implicit in these estimates is the assumpti"] [7.1361470222473145, -0.9512528777122498, "y 17, 2019: https://www.icpsr.umich.edu/icpsrweb/content/NACJD/guides/ucr.html 39 Reuter, Peter H., \u201cSeizure of Drugs,\u201d in Rosalyn Carson-DeWitt, ed., Encyclopedia of Drugs and \nAlcohol, Vol. III, revised ed., New York, Macmillan, 2001, pp. 1022\u20131"] [7.150420188903809, -0.9384031891822815, "What America\u2019s Users \nSpend on Illegal Drugs, 2006\u20132016\nGregory Midgette, Steven Davenport, \nJonathan P. Caulkins, Beau Kilmer\nCORPORATION\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected "] [7.180233478546143, -0.9098442196846008, "economic well-being of populations and communities throughout the world. This research was conducted in the Social and Behavioral Policy Program within RAND Social and Economic Well-Being. The program focuses on such topics as risk factors and preven"] [7.197182655334473, -0.8974382281303406, "of the Modern Marijuana and Opioid Markets .............................. 57\nChanges in Marijuana Markets ..................................................................... 57\nChanges in Opioid Markets and Associated Challenges ................"] [7.248126983642578, -0.8495070338249207, "............................................... xiii\n S.\n2. Re\ntail Expenditures on Illicit Drugs, 2006\u20132016 .................................. xiv\n S.\n3. Co\ncaine, Heroin, and Methamphetamine Consumption, 2006\u20132016 .......... xiv\n 2.\n1. Es\ntimatin"] [7.212808132171631, -0.885341465473175, "hat drug overdose deaths in 2018 exceeded 68,000, of which more than 47,000 involved opioids\u2014close to the number of AIDS deaths at their peak in 1995 (CDC, 2011). Although heroin, prescription opioids, and synthetic opioids (such as fentanyl) receive"] [7.218146800994873, -0.8797617554664612, "t consumption grew in 2016 among a stable number of users as price per pure gram declined.\n\u2022\n He\nroin consumption increased 10 percent per year between 2010 and 2016. \nWhereas most heroin consumed in the United States comes from poppies grown in Mexi"] [7.23318338394165, -0.864437460899353, " but they have a very specific and nuanced meaning that is vulnerable to misinterpretation. They reflect only one source of uncertainty: a 95-percent confidence interval surrounding the share of adult male arrests involving a positive drug test.\n4 Th"] [7.213056564331055, -0.8847243785858154, "124 121 123 129 143 145 146\nNOTES: The lower and higher ends of the ranges for cocaine, heroin, and methamphetamine reflect \nonly one source of uncertainty: a 95-percent confidence interval surrounding the share of adult male arrest events involving "] [7.188609600067139, -0.9113853573799133, "7). Figuring out how data from these new sources can be mined to develop insights about the markets should be a priority.\nWith respect to the other drugs, bringing back the ADAM program or some ver -\nsion of it would be enormously useful, particularl"] [7.164741039276123, -0.9288714528083801, "ths at their peak in 1995 (CDC, 2011). Although heroin, prescription opioids, and synthetic opioids (such as fentanyl) receive most of the attention, deaths involving methamphetamine and cocaine are both on the rise. Marijuana continues to receive at"] [7.215628147125244, -0.8808706998825073, "can be done. Numbers of chronic users can be estimated more accurately than spending, which in turn is subject to less uncertainty than estimates of quantities (weights) consumed. Likewise, there is a stronger foundation of evidence for marijuana tha"] [7.232439041137695, -0.8645822405815125, "d C provide additional information about our approach to estimating the number of cocaine, heroin, and metham-phetamine users, and Appendix D presents survey-based data about the size of marijuana purchases. Appendix E extends the consumption estimat"] [7.256484031677246, -0.8413511514663696, "untry for 2000\u20132016.\n3 We extrapolate estimates for 2014\u20132016 \nby imposing the associations estimated for 2000\u20132013 on observed covariate values for 2014\u20132016.\n2.\n Pr\noject the share of positive drug tests among adult male arrest events in all \ncount"] [7.257674217224121, -0.8402639031410217, "s two criteria. For \neach drug, we estimated models that optimize the amount of variation in county-level prevalence that is associated with variation in the included covariates. Among candidate models, several may produce similar predicted prevalenc"] [7.258502006530762, -0.8391745090484619, "(based on urinalysis and self-report information)Average across annual estimates, 2000\u20132003, 2007\u20132013Calculate for three groups: 4\u201310, 11\u201320, and 21 or more use days in past month\nMultiplying by F1 yields the number of adult male CDU arrest events w"] [7.239392280578613, -0.8575717806816101, "tanding warrants has \nrelatively little effect.\nc Based on ONDCP\u2019s (Rhodes et al., 2012; Kilmer et al., 2014b) assumption that occasional users of cocaine, heroin, and methamphetamine in NSDUH \nshould be multiplied by four because of underreporting.1"] [7.23593807220459, -0.8618645071983337, " to the CDU total generates an estimate of the number of adult male CDUs in the country. \nFigures in Chapters Two, Three, and Four include error bands to visualize the \nscale of uncertainty underlying our best estimates. These uncertainty ranges refl"] [7.227962493896484, -0.8712872266769409, "urvey both indicate an increase in use among those sample frames. TEDS data show that cocaine admissions dropped linearly between 2006 and 2015. TEDS is strongly related to prevalence in ADAM historically and is likely to \n6 The impact of fentanyl i"] [7.209157943725586, -0.891237735748291, "has changed since ADAM was terminated in 2013, we may understate the true number of chronic users. Given that the composition of treatment admissions and overdose decedents is now more female and less concentrated in a few big cities than was the his"] [7.240622520446777, -0.8625931739807129, " data series that underlie the CDU estimates. Past-\nmonth heroin users in NSDUH, heroin treatment admissions, and heroin overdose deaths all show increases starting in 2006 or 2007. The figure is dominated by over -\ndose deaths with evidence of heroi"] [7.244772911071777, -0.8548669815063477, "gest that about two-thirds of chronic heroin users are in the group that uses 21 or more days per month (Table 2.5), a considerably larger propor -\ntion than for cocaine.\nMethamphetamine\nFigure 2.5 and Table 2.6 present estimates of the number of chr"] [7.228104114532471, -0.8703358769416809, "sts to the FBI, meth -\namphetamine gets combined with \u201cother dangerous drugs.\u201d \nThese issues dramatically increase the uncertainty concerning the model results, which is captured in the very large error bands (Kilmer et al., 2014a, p. 26). \nFigure 2."] [7.238482475280762, -0.8583807349205017, " those who traded them for some other good or service, or those who produced their own). \nThe estimates presented in this chapter come with an important caveat. Cocaine, \nheroin, and methamphetamine expenditure data are extremely limited in the Unite"] [7.236105442047119, -0.8595113754272461, "ated for the 2000\u20132003 period and the 2007\u20132013 period. \n3.\n Use t\nhe change between the periods 2000\u20132003 and 2007\u20132013 for ADAM-II \ncounties to extrapolate the linear growth in expenditures between these periods in the larger set of ADAM-I counties"] [7.222659587860107, -0.8743845224380493, "end and 130 percent more than what methamphetamine users spend because of the concentration of expenditures among daily/near-daily users. Average spending on \nTable 3.1\nAverage Monthly Cocaine Expenditures (nominal dollars)\nYear21 or More Days in \nPa"] [7.263204097747803, -0.8330176472663879, "3. \nWe adjust the annual expenditure estimate for inflation using the Bureau of \nLabor Statistics\u2019 CPI-U, which increased by 24 percent from 2006 to 2018 (Bureau of Labor Statistics, 2019). Note that trends in expenditure estimates for all three drug"] [7.236021041870117, -0.8604499697685242, "OTE: Figure does not include expenditures by non-CDUs.0102030405060Cocaine expenditure (billions, 2018 dollars)\n2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Light\nWeeklyMore than weeklyDaily/near-daily\nTable 3.5\nCocaine Expenditures by User "] [7.230597972869873, -0.8660397529602051, "/near-daily\nTable 3.9\nMethamphetamine Expenditures by User Type (billions, 2018 dollars)\nUser Type 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016\nLight 1.1 1.0 0.8 0.8 0.8 0.8 0.9 1.1 1.2 1.5 1.4\nWeekly 2.4 2.0 1.6 1.7 1.8 1.7 1.9 2.3 2.5 3.0"] [7.22649621963501, -0.8706678748130798, "arter-based acquisitions were more or less common than the 1.125 figure would sug -\ngest, it is a simple exercise to modify this assumption. For example, if one-fifth of product consumed was acquired via in-kind transfers, then the factor would be 1."] [7.193062782287598, -0.9051371812820435, "(percent)Heroin\nMethCocaine36 What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\nto have fallen 30 percent since 2010. Although fentanyl-laced heroin, methamphet -\namine, and cocaine have been reported, we cannot assess the impact of fentanyl "] [7.221594333648682, -0.8763498067855835, "As was discussed in Chapter Two, the range depicted by the \u201chigher\u201d and \u201clower\u201d estimates reflects only a portion of the uncertainty in these estimates.Figure 4.3\nCocaine Consumption Estimates\n0100200300400500600\n2006 2007 2008 2009 2010 2011 2012 20"] [6.910346031188965, -1.136967658996582, "18; Orens et al., 2018; and Oregon Liquor Control Commission, 2019). \nAs will be discussed in greater detail in the next chapter, these changes might well \nhave influenced the average quantity consumed per day of use and even threatened how meaningfu"] [6.872975826263428, -1.1698644161224365, "available (through 2013), and (3) the remaining adult non\u2013criminal justice\u2013involved population, using an adjustment factor discussed later in this chapter. We also present estimates for infrequent marijuana users who report consuming in the past year"] [6.878116607666016, -1.1645100116729736, "report 11\u201320 days of use per month), and (5) daily/near-daily users (those who report 21 or more days of use in the past month).\nTable 5.1 provides estimates of the number of marijuana users by user group \n(both unadjusted and adjusted). The unadjust"] [6.925233364105225, -1.1232632398605347, "ily (21 \nor more days of use). For users who report using blunts but not marijuana, unless they later clarified that their blunt use did not include marijuana, the maximum number of their blunt-use days was taken as their number of marijuana-use days"] [6.879817485809326, -1.1629314422607422, "and Related Conditions \n(NESARC) data provided parameters for average numbers of joints consumed per day, estimated separately for each past-month user group: occasional (1.68), weekly (1.92), more than weekly (1.92), and daily/near-daily users (3.87"] [6.9280805587768555, -1.1212594509124756, "stantially beyond the traditional smoked products, such as joints and blunts. In Washington state\u2019s legal market, extract-based products, such as edibles, vaping oils, and waxes, accounted for more than 20 percent of sales by the latter part of 2016 "] [6.908212661743164, -1.142659068107605, "er groups (i.e., one to three, four to ten, 11\u201320, and 21 or more past-month use days). Each group-specific RASTUD is multiplied by the number of use days reported by that group\u2019s past-month buyers who did not report reselling . Multiplying by \n12 c"] [6.939643859863281, -1.111708164215088, "res may be underreported to a larger extent than use. For example, respondents may feel comfortable admitting to use but not to purchasing, or they may misremember or underreport the number of days they pur -\nchased in the past month or how much they"] [6.941374778747559, -1.1100784540176392, ".5 percent higher than the RASTUD-based series.Figure 5.3\nTwo NSDUH-Based Series Related to Marijuana Expenditures\n2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 201604080Expenditure (billions, 2018 dollars)20Legacy replication\nRASTUD-based estima"] [6.916600227355957, -1.131531000137329, "t-month use days) increased from 9.7 million to 11.1 million (a 14-percent increase). That group\u2019s RASTUD increased from $8.39 to $8.92 (or 6 percent), and the proportion who recently purchased marijuana for personal consumption increased from 68.7 p"] [6.930301189422607, -1.1201667785644531, "tment generates an estimate of $49.2 billion of spending for 2014, which is close to what is reported in Table 5.3 ($53.7 billion).\nExtrapolating from Washington State\nCaulkins et al. (2019) estimates that Washington state\u2019s 755,000 NSDUH-identified "] [6.923985481262207, -1.1273945569992065, "ative approaches to estimat -\ning market size that may transcend these challenges\u2014though, in some cases, only if the right additional data collection is undertaken. \nChanges in Marijuana Markets \nMarijuana markets have been changing rapidly due to in"] [6.891040802001953, -1.1598988771438599, "was consumed in the United States by combust -\ning dried plant material in joints, pipes, or bongs. Often, only the parts of the plant that contained higher concentrations of THC (notably the flowers or buds) were used, and other material (leaves, tr"] [6.909609317779541, -1.1387443542480469, "l \nmarket, where extract-based products, such as edibles, vaping oils, and dabs, accounted for roughly one-third of sales in mid-2017 (see Chapter Five). It is no longer reasonable to treat nonflower consumption as unimportant. \nThe next few sections"] [6.8878703117370605, -1.1559433937072754, "AUSID reports (e.g., Rhodes et al., 2001, and Kilmer et al., 2014a) by estimating the number of days of use broken down by type of user, and then multiplying those figures by an estimate of the average number of grams consumed per day of use. Those r"] [6.887584686279297, -1.1557444334030151, " users in Washington state in 2013 sug -\ngest that daily/near-daily users consumed between 1.3 and 1.9 grams per use day, with \na best estimate close to 1.6 grams (Kilmer et al., 2013). A similar survey conducted for the Colorado Department of Revenu"] [6.896572589874268, -1.1524931192398071, "that weight consumed per \nday of use has changed, and data are insufficient to settle the matter empirically. Hence, we do not think it is safe to make any particular assumption about stability or change in consumption per day of use and do not view "] [7.076845645904541, -1.0069808959960938, "f THC purchased is better defined, but focusing on it would fail to \nrecord material that is grown by the user, given to or shared with others by the grow -\ners, or obtained by barter (such as when workers in the illegal marijuana industry are paid i"] [7.200289249420166, -0.9006810188293457, "ariation can be seen in Figure 6.1 by plotting data series for two other fentanyl-related measures for the entire country and by geographic region: (1) total mortality attributed to synthetic opioids, derived from the CDC\u2019s Multiple Cause of Death re"] [7.197799205780029, -0.9035702347755432, " Atlantic\n906030\n0120\n2013 2014 2015 2016 2013 2014 2015 2016West North CentralPacific\n1,000\n500\n0New England\n2013 2014 2015 2016West South Central\n1,000\n500\n066 What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\ndeaths to fentanyl consumption"] [7.185778617858887, -0.91073077917099, "ude 100-kilogram seizures of cocaine. Measurement of the Modern Marijuana and Opioid Markets 67\nLet Wd equal the weight of drug d consumed in the United States and Wdi equal \nthe weight of drug d consumed in region i . Because heavy users dominate"] [7.115666389465332, -0.9701061844825745, "ty card programs, and other sources (Caulkins, 2016, and Kilmer and Pacula, 2017). Figuring out how data from these new sources can be aggregated and manipulated to develop scientifi -\ncally based insights should be a priority for those who want bett"] [7.037681579589844, -1.033629059791565, "endence , Vol. 117, No. 1, \nAugust 2011, pp. 59\u201361. \nCaulkins, Jonathan P., \u201cCannabis Policy Research Agenda,\u201d comments presented at the Cannabis \nScience and Policy Summit 2016, New York, April 2016. As of May 17, 2019: https://www.youtube.com/watch"] [7.034670352935791, -1.0374280214309692, "t Drugs: 1981\u20132007 , Alexandria, Va.: Institute for Defense Analyses, October \n2008. \nGallet, Craig A., \u201cCan Price Get the Monkey Off Our Back? A Meta-Analysis of Illicit Drug \nDemand,\u201d Health Economics , Vol. 23, No. 1, January 2014, pp. 55\u221268.\nGmel"] [7.051680564880371, -1.0217151641845703, "LCB, 2013. As of May 17, 2019: https://www.rand.org/pubs/research_reports/RR466.html\nKilmer, Beau, Steven Davenport, Rosanna Smart, Jonathan P. Caulkins, and Gregory Midgette, \nAfter the Grand Opening: Assessing Cannabis Supply and Demand in Washingt"] [7.0117316246032715, -1.0522987842559814, "2005 , Santa Monica, Calif.: RAND \nCorporation, MG-829-MPF/NIDA, 2009. As of May 17, 2019: https://www.rand.org/pubs/monographs/MG829.html\nOffice of National Drug Control Policy, National Drug Control Strategy: Data Supplement 2016 , \nWashington D.C."] [7.037593364715576, -1.0333919525146484, "anna, Jonathan P. Caulkins, Beau Kilmer, Steven Davenport, and Greg Midgette, \n\u201cVariation in Cannabis Potency and Prices in a Newly Legal Market: Evidence from 30 Million Cannabis Sales in Washington State,\u201d Addiction , Vol. 112, No. 12, December 201"] [20.670238494873047, 0.06797120720148087, "CORPORATION\nInternational Commercial \nDrone Regulation and Drone Delivery Services\nTherese JonesLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation of RAND \nintell"] [20.655710220336914, 0.07821373641490936, "ergy Implications of Drones for Package Delivery: A Geographic Information \nSystem Comparison (Gulden, 2017) \n\u2022 \u00a0Design Perspectives of Delivery Drones (Xu, 2017) \n\u2022 \u00a0Small Unmanned Aerial System Certification and Traffic Management Systems (Kuhn,"] [20.85515785217285, -0.06766105443239212, "s \u00a0\nPreface ............................................................................................................................................ iii\t\r \u00a0\nTables ................................................................................."] [20.869522094726562, -0.07778126001358032, "ry \u00a0\nDue to a sharp increase in drone use internationally, countries are struggling to incorporate \ndrones into their aviation regulatory frameworks. This report draws on a literature review and \ndiscussions with subject-matter experts to summarize "] [20.87685775756836, -0.08402859419584274, " \u00a0guidelines \u00a0or \u00a0require \u00a0licensing, \u00a0registration, \u00a0and \u00a0insurance, \u00a0\nbut \u00a0upon \u00a0following \u00a0\nproper \u00a0procedures \u00a0it \u00a0is \u00a0straightforward \u00a0to \u00a0operate \u00a0\na \u00a0commercial \u00a0delivery \u00a0drone. \u00a0\u2022 \u00a0Costa \u00a0Rica \n\u2022 \u00a0Iceland \n\u2022 \u00a0Italy \u2022 \u00a0Norway \n\u2022 \u00a0Sweden \n"] [20.869930267333984, -0.07859984785318375, "s are struggling to adapt current laws to new technology. To address this issue, this report summarizes national-level commercial drone regulations across the world, discusses the regulatory approaches taken by different countries, and examines how s"] [20.868995666503906, -0.07810802757740021, "allow drones at all for commercial use. \n2. \u00a0Effective ban: Countries have a formal process for commercial drone licensing, \nbut requirements are either impossible to meet or licenses do not appear to have \nbeen approved. \n3. \u00a0Requirement for constan"] [20.86439323425293, -0.07577681541442871, "s, but legal obstacles\u2014such as the inability to procure proper certification or insurance\u2014make these rules into an effective ban. 4 Table \u00a02. 1. \u00a0Drone \u00a0Legislation \u00a0Approaches, \u00a0 by \u00a0Country \u00a0\nApproach Definition Countries \nOutright \u00a0b an Count"] [20.880178451538086, -0.08615570515394211, "art 107, which governs drones under 55 lb. As of August 24, 2017, almost exactly one year after its enactment, seven companies have been given Part 107.31 exemptions, allowing them to operate BVLOS.\n2 In October 2017, President \nDonald Trump advocate"] [20.85838508605957, -0.07107916474342346, " of \nexperimental BVLOS technology. The United Arab Emirates regulations explicitly list parcel delivery as a possible use. \nWhile other countries have drafted or enacted drone legislation, it is largely vague \nbecause of a lack of need, capacity, or"] [20.902353286743164, -0.10427382588386536, "g/ \u00a0\nTraining \u00a0\nRequirements \u00a0\nfor \u00a0Pilots \u00a0Regulations \u00a0Regarding \u00a0\nRegistration, \u00a0\nOperational \u00a0\nRequirements \u00a0Insurance \u00a0\nRequired \u00a0Distribution \u00a0\nof \u00a0Goods \u00a0\nAllowed \u00a0Obstacles \u00a0to \u00a0\nDelivery \u00a0Drone \u00a0Use \u00a0\n(if \u00a0any) \nCosta \u00a0Rica No Authorizati"] [20.8914737701416, -0.09585011005401611, "ation, \u00a0\nOperational \u00a0\nRequirement s Insurance \u00a0\nRequired Distribution \u00a0\nof \u00a0Goods \u00a0\nAllowed Obstacles \u00a0to \u00a0Delivery \u00a0\nDrone \u00a0Use \u00a0(if \u00a0any) \nArgentina Commercial \u00a0use \u00a0\nbanned \nBrazil Possible \u00a0under \u00a0\n25 \u00a0kg \u00a0if \u00a0\nauthorized;\u037e \u00a0\nmust \u00a0a"] [20.892030715942383, -0.09652046859264374, "name \u00a0and \u00a0address ;\u037e \u00a0\nlimited \u00a0to \u00a0100 \u00a0 m \u00a0in \u00a0\naltitude \nBelgium Yes Drone \u00a0pilot \u00a0\nlicense \u00a0required Manufacturer\u2019s \u00a0\ncertificate, \u00a0regist ration \u00a0\nrequired;\u037e \u00a0maximum \u00a0\nheight \u00a090 \u00a0m \u00a0for \u00a0\ncommercial \u00a0use Yes Transport \u00a0of \u00a0\nmail \u00a0or \u00a0"] [20.887563705444336, -0.09586919844150543, "e;\u037e \u00a0\ncertificate \u00a0if \u00a0<\n \u00a025 \u00a0kg \u00a0Required \u00a0to \u00a0d isplay \u00a0ID \u00a0\nthat \u00a0transmits/ \u00a0\nrecords \u00a0data \u00a0in \u00a0real \u00a0\ntime;\u037e \u00a0license \u00a0plate \u00a0and \u00a0\ndeclaration \u00a0of \u00a0vehicle \u00a0\ncompetence \u00a0required \u00a0 LOS \u00a0operations \nLatvia Yes \u00a0 \u00a0 \u00a0 Requires \u00a0a \u00a0flight \u00a0"] [20.888351440429688, -0.09390202164649963, "ion \u00a0\nof \u00a0Goods \u00a0\nAllowed Obstacles \u00a0to \u00a0 Delivery \u00a0\nDrone \u00a0Use \u00a0(if \u00a0any) \u00a0\nSwitzerland May \u00a0grant \u00a0\nexemptions \u00a0May \u00a0grant \u00a0\nexemptions \u00a0None \u00a0required \u00a0\n< \u00a030 \u00a0kg \u00a0None \u00a0required \u00a0< \u00a030 \u00a0kg \u00a0Yes LOS \u00a0operations \nUkraine \u00a0 \u00a0 \u00a0 \u00a0 > \u00a020 \u00a0kg"] [20.92149543762207, -0.11879200488328934, "required \u00a0 for \u00a0\ncommercial \u00a0use;\u037e \u00a0\ncostly \u00a0(up \u00a0to \u00a0$4,000) Registration \u00a0 required \u00a0 for \u00a0\ncommercial \u00a0use, \u00a0manual \u00a0\nand \u00a0log \u00a0book \u00a0needed LOS \u00a0operations 17 Country LOS \u00a0\nOperations \u00a0\nRequired Flight \u00a0Permitted \u00a0\nOver \u00a0Populated \u00a0\nAreas "] [20.89097785949707, -0.09575116634368896, "ing \u00a0course ;\u037e \u00a0\nair \u00a0traffic \u00a0control \u00a0\nlicense \u00a0or \u00a0flight \u00a0\ncrew \u00a0license \u00a0\nrequired Registration, \u00a0operations \u00a0\nmanual, \u00a0airworthiness \u00a0\ncertificate \u00a0required Yes \nQatar Permission \u00a0required \nSaudi \u00a0Arabia Ban 19 Country L"] [20.87185287475586, -0.08081503957509995, "for countries with existing drone legislation, laws are constantly being \nreevaluated: Almost all of the laws listed were written or amended within the past two \nyears. While drone laws almost always move toward a more permissive approach to regulati"] [20.8759765625, -0.08328080922365189, "ugust 13, 2017. As of August 28, 2017: \nhttps://www.casa.gov.au/aircraft/landing-page/flying-drones-australia \nSzal, Andy, \u201cAmazon Could Test More Drone Deliveries with Australia Expansion,\u201d \nManufacturing.net, May 24, 2017. As of August 28, 2017: h"] [20.87579917907715, -0.08330760151147842, "ugust 29, 2017: \nhttp://www.mincom.gov.bn/dca/_layouts/15/start.aspx#//dca/Theme/Home.aspx \nCambodia \nMarkert, Francis, \u201cDrone Regulations in Cambodia,\u201d Drone Traveller blog, April 18, 2017. As \nof August 29, 2017: \nhttps://drone-traveller.com/drone-"] [20.867713928222656, -0.07765041291713715, "dla Bez \nPilota,\u201d CAA/S-SLS-010-0/2012, March 1, 2012. As of August 28, 2017: http://webdav.agents.fel.cvut.cz/data/teaching/bep/smernice_caa-s-sls-010-0-2012.pdf \nDenmark \nNjord Law, \u201cNjord Insight: New Danish Drone Rules in 2016 and 2017,\u201d January "] [20.866933822631836, -0.07707113772630692, "atory-response-pub-68218 \nIndonesia \nHanafiah Ponggawa & Partners, \u201cUpdated Drone Regulations in Indonesia: Now, a Specific Rule \nfor a Specific Drone,\u201d July 12, 2016. August 29, 2017: \nhttp://hprplawyers.com/updated-drone-regulations-in-indonesia-no"] [20.866500854492188, -0.07677316665649414, "ar,\u201d 2017. As of August 29, 2017: \nhttps://www.airport-uav.com/drone-rules/legislation-africa/regulations-madagascar/ \nMalawi \u201cMalawi and Unicef Launch Drone Air Corridor,\u201d BBC News, June 29, 2017. As of August 29, \n2017: \nhttp://www.bbc.com/news/wor"] [20.867712020874023, -0.07765650749206543, "ry-of-pizza-in-New-Zealand/4271479363638/ \nCivil Aviation Authority of New Zealand, \u201cPart 101 CAA Consolidation,\u201d March 10, 2017. As \nof August 29, 2017: https://www.caa.govt.nz/rules/Rule_Consolidations/Part_101_Consolidation.pdf \nNorway \nLuftfa rts"] [20.904069900512695, -0.10326001048088074, "drone-control-network-paving-way-for-commercial-boom/ \n\u201cRussia Introduces Obligatory Drone Registration,\u201d RT, December 31, 2015. As of August 28, \n2017: https://www.rt.com/politics/327536-russian-introduces-obligatory-registration-of/ \nSaudi Arabia \n"] [20.849273681640625, -0.06485239416360855, "uary 1, 2017. As of August 29, 2017: \nhttp://www.tcaa.go.tz/files/Air%20Navigation%20Services/Aeronatical%20Information%20Circulars/AIC%2005%20-%202017%20Unmanned%20Aircraft%20Systems.pdf \nThailand \nBarrow, Richard, \u201cQuick Look at the New Drone Law i"] [20.664487838745117, 0.0679342970252037, "-RC, 2017. As of October 5, 2017: https://www.rand.org/pubs/research_reports/RR1718z1.html \nKuhn, Kenneth, Small Unmanned Aerial System Certification and Traffic Management Systems , \nSanta Monica, Calif.: RAND Corporation, PE-269-RC, 2017. As of Nov"] [-1.884043574333191, 15.557876586914062, "www.rand.org\nRR-2129-RF9780833 098962ISBN-13 978-0-8330-9896-2ISBN-10 0-8330-9896-9\n54550$45.50Policymakers, program practitioners, and investors who want to achieve the greatest possible benefits from the \nresilience projects that they support lack "] [-1.9132899045944214, 15.573801040649414, "d.orgFor more information on this publication, visit www.rand.org/t/RR2129\nLibrary of Congress Cataloging-in-Publication Data is available for this publication.\nISBN: 978-0-8330-9896-2\nPublished by the RAND Corporation, Santa Monica, Calif.\n\u00a9 Copyri"] [-0.42989474534988403, 13.570396423339844, "s conducted in the RAND Infrastructure Resilience and \nEnvironmental Policy program, which performs analyses on urbanization and other stresses. \nThis includes research on infrastructure de velopment; infrastructure financing; energy policy; \nurban p"] [-1.9228076934814453, 15.604901313781738, "................................................................................... .........4\nCHAPTER 2\nA Review of Resilience Frameworks ................................................................................................5\nFoundations "] [-1.936960220336914, 15.598869323730469, ".......................... .......... 35\nA Graphical Representation of the Framework .............................................................................. 36\nPrimary Challenges in Estimating the Resilience Di vidend ........................."] [-1.9305952787399292, 15.613081932067871, "...................................................................7 5\nDiamond Valley ................................................................................................................ ............76\nExecuti ve Summary ................."] [-1.9157973527908325, 15.625358581542969, "........................................................................... .... 117\nApplying the RDVM to Estimate the Potential Di vidend for Da Nang ................................... 118\nData ......................................................"] [-1.9339544773101807, 14.162275314331055, " Key Definitions Used in this Report ..................................................................... 151\nReferences .............................................................................................................................."] [-1.8731480836868286, 15.39236068725586, "..........................98\nFigure 4.12. Mapping a Forest Ecosystem ......................................................................................1 00\nFigure 4.1 3. Mapping of the Resilience System ..........................................."] [-1.837753176689148, 15.472299575805664, "Table 4.18. Runoff by Restoration and Fire in Conklin et al. (2015) .............................................106\nTable 4.19. Other Studies That Estimate the Relationship Between Restoration and Runoff ........107\nTable 4.20. Value of Water Runoff"] [-1.921531319618225, 15.605063438415527, "ro vide a systematic, \u201cstructural\u201d frame-\nwork for assessing resilience inter ventions that ultimately create benefits and costs within a \nsystem such as a community or city. The model is a means to systemically account for the returns to resilience "] [-1.925799012184143, 15.610793113708496, "to the future. \nThe RDVM is a flexible approach that helps users think about inter ventions in a structured, \nsystems-focused way, and it guides users in how to use data to pro vide evidence of the di vi-\ndend. In real-world settings with limited da"] [-1.9220129251480103, 15.616447448730469, " vidend, and the limitations of the model. While we belie ve that the \ninclusi ve wealth conceptualization of systems for e valuating resilience projects is a promising \nway forward, the need to generate and use extensi ve quantities of data in compl"] [-1.9523569345474243, 15.635629653930664, "ill allow for the construction of portfolios that can, potentially, make all stakeholders winners with the appropriate choices of projects with portfolios. The budget constraints that arise in portfolio analysis pro vide additional limitations that t"] [-1.9203940629959106, 15.60828685760498, "S i e r r a N e vada \nAdapti ve Management Project, and Blue Forest Conser vation. In particular, Phong Tran at \nISET; Simone Lombardini and Rob Fuller at Oxfam; N ick W obbrock at Blue Forest Con-\nservation; Sasank Vemuri and Elma Morsheda at the A"] [-1.9259612560272217, 15.612529754638672, "e the case. \nDeveloped to help o vercome these issues, the Resilience Di vidend Valuation Model (RDVM) \ndocumented in this report is a modeling framework designed to help analysts and practitioners estimate the realized or potential resilience di vi"] [-1.9452491998672485, 15.639702796936035, "isk of loss from an outside shock or stressor and any co-benefits the project or in vest-\nment produces.\nHowe ver, as noted by Anderies, et al.:\nThe resilience lens is useful for making suggestions about broad categories of in vestment \nsuch as in th"] [-1.937120795249939, 15.642266273498535, " of an ad verse e vent. As such, the resil-\nience di vidend is not equi valent to the value of increased resilience of the system, though it \ntheoretically includes these potential net benefits.\nValuing the resilience di vidend requires that we under"] [-1.9401155710220337, 15.628076553344727, " estimates of the resilience di vidend can be calculated either before (ex ante) or after (ex post) \nthey are implemented.4This report is not designed to be a users\u2019 guide for the RDVM. We ha ve produced a separate \nguidethat focuses on when and how "] [-2.0151031017303467, 14.158935546875, " length of time it takes for the system to rebalance once the stressor has been remo ved. C.S. Holling\n3 was the first to transfer these ideas from the physical sciences to the bio-\nlogical sciences. Holling\u2019s distinction from the physical sciences i"] [-2.035207509994507, 14.147564888000488, "ow quickly can the system get back to \u201cnormal\u201d functioning\u2014understanding that \u201cnormal\u201d may look different after the e vent than before it\u2014labeled \nrestorati ve capacity. These ideas are laid out implicitly in Francis and Bekera\n7 and explicitly \nin R"] [-2.037435531616211, 14.178665161132812, "e, may remo ve some responses to risk that may be \nbeneficial. In particular, if the focus is solely on what happens after a disaster occurs, there is a risk that strategies or actions to reduce vulnerabilities will be under valued or ignored entirel"] [-2.0407984256744385, 14.176222801208496, "n, 1998 Community The process through which mediating structures (schools, peer \ngroups, family) and activity settings moderate the impact of oppressive systems\nPaton, 2001 Community The capability to bounce back and to use physical and economic \nres"] [-1.967878818511963, 14.1204195022583, "Arup International De velopment.\n14 NIST (2015). Disaster resilie nce framework .9and the long-standing notion of cities as \u2018systems of systems.\u2019\u201d15 Howe ver, Arup re views stud-\nies on subsystems rather than on the system as a whole. This lea ves th"] [-1.9734960794448853, 14.128653526306152, "approach disasters \nas problems of risk management within a systems-of-systems framework combined with some form of either risk management or resilience. The major differences are the detail and connec-tions among the different systems and subsystems"] [-2.0144035816192627, 14.153508186340332, "es into account the three major elements of resilience: adaptation, absorption, and reco very. Additionally, Norris et al. do not \nrecognize that post-e vent functioning from one e vent is the pre-e vent functioning for the next \nevent. This circular"] [-2.0085408687591553, 14.165511131286621, "they use to produce goods and ser vices and, ultimately, community well-being. How flexible \nthe system is, inherently, and how it is enhanced through the mitigating acti vities of firms \nand indi vidual households determines the system\u2019s inherent l"] [-1.9808446168899536, 14.11130142211914, "licitly discusses the objecti ves of increasing resilience. It is paramount when \nbeginning an exercise aimed at increasing resilience to know what the goals are. These goals tie into the metrics that will measure progress toward increasing resilienc"] [-1.9910186529159546, 14.141975402832031, "ng of a community. By making this distinction between vulner-\nability and resilience, these potential complementarities may be lost. One key point the Cutter work recognizes is the link between resilience and sustainability. Sustainability is a large"] [-1.9516798257827759, 14.137444496154785, "tion &\n infrastructure in placeCommunity\nOther\nsystems\nHospital\nsystemElectric power\nservice\nWater\nserviceLocal emergency\nMgmt.system\nSOURCE: Bruneau et al. (2003). Used with permission.\nFigure 2.6. Bruneau et al. (2003) Framework\nRESILENT\nCOMMUN"] [-1.9855402708053589, 14.122737884521484, " vide a le vel playing field for all participants to the decisionmaking process. \nTo obtain accurate tradeoffs, the spillo ver of resilience in one subsystem to the other subsys-\ntems needs to be incorporated with the direct effect on the subsystem. "] [-1.9185210466384888, 15.593295097351074, "d to the role of adapti ve beha viors and substitutability when discussing the resiliency of systems. Furthermore, \nwhen taking a system-of-systems approach, the interdependencies across subsystems play an important role in how the entire system resp"] [-1.9306671619415283, 15.603649139404297, " relationships between \ncapital stocks, goods and ser vices, and the value of goods and ser vices to stakeholders in an \neconomic system o ver time. Capital stocks are durable resources that can be used together to \nproduce a stream of goods and ser "] [-1.959804654121399, 15.617969512939453, " the capital stocks is gi ven by state transition \nequations Kn = fn (K1, K2,..., KN )An. This portfolio of stocks is broadly defined and can \ninclude man-made, natural, human, and social stock le vels.3 Changes in the quantity and qual-\nity of ca"] [-1.947445273399353, 15.60045051574707, "ion mechanism. \nOur experience to date has suggested that many resilience projects view changes in this alloca-\ntion mechanism as key sub-objecti ves in the inter vention. The pro vision of information has the \nability to change how people respond an"] [-1.9462461471557617, 15.613658905029297, "silience is defined as one minus the probability of a switch into \nthe bad state, and valued as the change in the net present value of future flows associated with \na change in a related resilience \u201cstock.\u201d9 The approach was used by Walker, et al. in"] [-1.9373246431350708, 15.628291130065918, "end \nThis framework can be adapted to our definition of the resilience di vidend. Let social pref-\nerences be represented by a utility function U\n(C(t)), where C(t) is a vector of valued flows \nthat accrue o ver time t, and assume that this vector of"] [-1.9293924570083618, 15.603281021118164, "oods and ser vices produced from these stocks, \nand the well-being that these flows create. Each of these elements is assumed to be functionally related, mimicking a system-of-systems approach, and can be affected either directly or indi-rectly by re"] [-1.955725073814392, 15.627058982849121, "nd ser vices that cannot be valued quantitati vely can be discussed qualitati vely.\nGoods a nd services are the tangible and intangible items that are produced within a system. \nThe capital stocks are the durable inputs used in the production relat"] [-1.9455639123916626, 15.620157241821289, "o pri vate or public insurance. Then the willingness to pay for the in vestment \nwould be equal to the damage to the home, as the household would be indifferent between paying for the in vestment \nand the home being damaged, irrespecti ve of what act"] [-1.994946002960205, 15.645791053771973, " of a \ndeveloping country with a large agricultural economy. For simplicity, we assume households in \nthis economy only produce one crop. Due to a lack of fertilizer, households face a stressor in the form of declining land fertility. In this example"] [-1.9290974140167236, 15.615804672241211, "duals in volved. \nSuch changes, relati ve to BAU, would ha ve to be estimated or simulated in order to quantify \nthe resilience di vidend associated with these acti vities.\nSocial Welfare Function\nThe social welfare fu nction reflects the full social"] [-1.9457207918167114, 15.643821716308594, "puts, howe ver, would require \nempirical data. Furthermore, we note that in the ex post case, the resultant (partial) resilience dividend is conditional on what actually happened and thus does not include the expected \nvalue associated with all poten"] [-1.9217113256454468, 15.595316886901855, "and organizations \nor go vernments.\nBecause of their properties, the proper valuation of a change in the pro vision of a public \ngood is to sum the benefits that accrue to e very stakeholder affected. Many public goods \nare not traded in a market, ma"] [-1.9684449434280396, 15.588946342468262, ", an inter vention may slow or re verse depreciation of a stock, such \nas increased maintenance of a man-made stock, or augment its quality, such as an in vest-\nment in education affecting human capital and augmenting o verall labor producti vity.\n\u2022 "] [-1.946518063545227, 15.621423721313477, "that is producti ve since it helps achie ve certain outcomes once it is put to use. Social \ncapital arises from social networks, and these networks themsel ves produce social capital. \nTrust and reciprocity in volved in the relationships within these"] [-1.9401435852050781, 15.629495620727539, ".\nFor consumers, goods and ser vices pro vide welfare through the generation of a gap between \nwillingness to pay and what is actually paid, which is termed consumer surplus. Direct benefits from a resilience project should thus be calculated as the "] [-1.9445422887802124, 15.640352249145508, " generate income and produce more sa vings. \nBene\ufb01ts Related to the Allocation Mechanism \nAlthough the direct benefits and co-benefits are more or less comprehensi ve categories, the \nimportance of the link between beha viors and benefits is importan"] [-1.945738673210144, 15.643685340881348, "ws a graphical example of how one might approach the ex post e valuation of a \nresilience project that creates co-benefits and has experienced a shock prior to the e valuation. \nThe well-being, or measure of social welfare, for the (obser vable) worl"] [-1.9454803466796875, 15.640302658081055, "he project and BAU cases gi ven \nshocks that actually happened. This approach, while practical, may ignore rele vant \nshocks in the future, which may be different from shocks experienced in the past.\nIn the case of forward-looking ex ante cases, we c"] [-1.9459182024002075, 15.639535903930664, " a poten-\ntially complex e valuation. For ex ante settings, simulation modeling can often pro vide \nestimates of the project and BAU paths. \nFor additional details about data collection and estimation, readers are referred to the \npractitioner\u2019s guid"] [-1.9747940301895142, 15.664693832397461, "e \nchange, PovertyHousehold/ \nCommunityNo estimate Data limitations mean only a partial RD \ncan be estimated, but there is evidence that the project changed behaviors and certain capital stocks with bene\ufb01ts to the communities. Obtaining a full RD wou"] [-1.9454929828643799, 15.640386581420898, "RD of a project before \nit is complete, it is advisable to use a pre-project estimate approach on disaster risk reduction, broad-based development for community resilience, and economic development investments, and it is important to de\ufb01ne a counterf"] [-1.9684815406799316, 15.659289360046387, "o a treatment-and-control framework.\nThe resilience di vidend is defined as the difference in outcomes between inter ventions that \ntake a resilience view and those that do not. Outcomes are typically related to the ability of \n\u201cpeople to better with"] [-1.99576735496521, 15.666629791259766, " others, help their neighbors, and engage in search-and-rescue efforts. Furthermore, we ha ve evidence that indi viduals trust their community lead-\ners more after the inter vention, leading to increases in social capital. While we do not ha ve the \n"] [-1.9907437562942505, 15.670001029968262, " a The effects on social capital can affect absorptive capacity, co-bene\ufb01ts, and recovery/transformative \ncapacities. As such, we treat it as its own category in the exposition.\nSOURCE: Authors\u2019 calculation based on multivariate regression analysis.4"] [-1.9977279901504517, 15.677411079406738, " Project\nThe systems being analyzed are certain Nepalese communities that primarily grow crops \nand li vestock for income and face flood risk. The objecti ve of the analysis is to compare the \ndifferences in well-being outcomes for households in comm"] [-1.9968897104263306, 15.664796829223633, "ssets that a household values in terms of information or \nentertainment, such as tele visions, radios, or DVD players. Additionally, households ha ve \ndurable capital stocks of housing, livestock co ntainment, and storage . Essentially, increased own"] [-1.9949907064437866, 15.65047550201416, "ld well-being.\nWell-Being\nMeasures of well-being in the model are closely related to the good and ser vices discussed \nabove. Damage (including loss of crops, other property, and life) is a direct measure of well-\nbeing after a flood, though the dat"] [-1.9851791858673096, 15.66716194152832, "heoretic framework is the dynamic feed-\nbacks that occur between outputs and capital stocks and among capital stocks themsel ves. As \nhouseholds generate income, they may in vest in capital stocks. As households produce goods, \nthey may be deteriorat"] [-1.9952781200408936, 15.675869941711426, "n the \u201cparallel trends\u201d assumption that \nthe groups would ha ve otherwise turned out the same. Howe ver, when there is only one period \nof data before the treatment period (as in this case), it is impossible to verify this assumption \nother than thro"] [-2.0125555992126465, 15.695018768310547, "ccess to credit and sa vings in 201 3;\n\u2022 other forms of income beyond agriculture in 201 3;\n\u2022 whether they recei ved an early warning about the 2012 storm;\n\u2022 what actions they took following the early warning in 2012;\u2022 opinion data on community leade"] [-2.0059030055999756, 15.684517860412598, "ousehold engaged in casual employment in 2010; whether the \nhousehold engaged in formal employment in 2010; whether the household owned a business in 2010; whether the household engaged in crop production in 2010; whether the household owned li vesto"] [-2.004909038543701, 15.684793472290039, "ouseholds and not exploiting \nthe treatment/control group structure). \nAs shown in the second column of Table 4.4, results demonstrated the counterintuiti ve result \nthat only pri vate flood protection has a significant impact on crop losses7\u2014but hou"] [-2.000051498413086, 15.677433013916016, "pri vate and \npublic protection measures are substitutes for other actions (like changing crop patterns, moving li vestock, etc.) and that public and pri vate protections are complements to each other. \nThat is, if the community takes public protecti"] [-2.013500690460205, 15.690855979919434, "teraction on social capital. In particular, Oxfam asked \nhouseholds if, mo ving forward, they had trust in their community leaders in the face of the \nnext e vent. As was found in Oxfam\u2019s effecti veness re view, inter vention households trust their \n"] [-2.0100247859954834, 15.690513610839844, " from the flood of \n2012. Thus, some differences in income may be dri ven by the flood and carried o ver to 201 3. \nAdditionally, we ha ve information on changes in soil fertility. One of the main dri vers of soil \nfertility is erosion, which is asso"] [-2.0461106300354004, 15.736495018005371, "sets Between Intervention and BAU Households\nAssetsDifference Between \nIntervention and BAU 2010Difference Between \nIntervention and BAU 2013Change in \nOwnership 2010\u20132013\nOxen 0.16* -0.02 -0.18*\nCows 0.36*** 0.38*** 0.01Buffalo -0.19** -0.22*** -0."] [-1.947770357131958, 15.640058517456055, "kely not feasible for many projects. Indeed, for any large-scale project with implications that stretch into the future, such data cannot be compiled ex post. Future research (and data collection) might be better ser ved to identify those parts of th"] [-1.9547970294952393, 15.646697998046875, "lar threshold, making ex ante analysis valuable mo ving forward. 60Ideal ex post data structures should include data for at least four points in time: prior \nto the intervention, after the intervention and before a shock, after a shock, and at some p"] [-1.9733082056045532, 15.653265953063965, "ther case studies presented in Chapter 4 and the lessons learned \nfrom all the cases in Chapter 5. This case study is intended primarily to help readers under-\nstand how to apply the RDVM framework gi ven a set of data or information about a gi ven "] [-2.0090243816375732, 15.691445350646973, "ock from the storm compared to similar households (in the control group) that did not participate in the inter vention nor were exposed to the storm.\n10 These benefits were \ngenerated because the project changed farmers\u2019 crop choices (or, in terms of"] [-2.0059590339660645, 15.68415641784668, "s\u2019 analysis.\nOxfam Pakistan Intervention Background11\nOxfam conducted an inter vention in three districts in Pakistan in 2010\u20132011 through part-\nnerships with the Sindh Agricultural and Forestry Workers Coordinating Organisation (SAFWCO) and the Balo"] [-2.0035481452941895, 15.689645767211914, "ion increases, build social \ntrust, and pro vide a means for resol ving disputes. This may change the allocation mechanism \nor capital stocks within the system.\nThe inter vention acti vities took place in 2010\u20132011. There was a shock\u2014se vere flooding"] [-2.006415843963623, 15.693559646606445, "ocation mechanism or production process that is go verned by the \nstock of a vailable resources. Oxfam\u2019s inter vention aims to change both how and which crops \nare grown. 65Figure 4.4. Mapping of the Pakistan System\nLand\nAssets\nHumanCrops\nLivestockAg"] [-1.9983152151107788, 15.682311058044434, "These \u201ccontrol\u201d communities were chosen based on their proximity \nto the treatment communities.\nThis sur vey design allows us to estimate the partial net resilience di vidend of the inter ven-\ntion by comparing treatment and control households. Impor"] [-2.014437198638916, 15.69642162322998, "ot affect all households. This allows us to esti-\nmate the annual partial resilience di vidend for households not affected by the flood and those \nthat were, since treatment and control households are similar prior to the inter vention.\nOur approach,"] [-2.006150722503662, 15.687429428100586, "and in particular dairy production\u2014was an important focus of Oxfam\u2019s \nintervention. Additionally, we know that households obtain income that is not related to farm-\ning but not the amount.\n17 This is why we belie ve we are only estimating a portion o"] [-1.9754995107650757, 15.66981029510498, " may be significant compared to crop income.69Results\nWe di vide our presentation of the results into two broad sections. First, using a partial measure \nof well-being (agricultural income), we estimate the net annual value in 2012 of the resilience "] [-1.9971067905426025, 15.680636405944824, "zed the de velopment path between treatment and control \nhouseholds without a shock. Alternati vely, the inter vention may be a le vel shift up rather than \na growth cur ve. \n18 Because Oxfam only collected flood damage data, we ha ve no physical mea"] [-1.9906407594680786, 15.684245109558105, "as measured by a positi ve self-reported crop loss. Figure 4.6 presents \nour conceptualization for this analysis. With only one year of data (2012), the estimate of the resilience di vidend for those households affected by the shock includes the tota"] [-2.002798318862915, 15.686368942260742, "find no significant difference between treatment and control.72control group, but the reco very benefit was likely negati ve compared to households that did \nnot experience the shock. Note that this conclusion rests on the assumption that we ha ve ac"] [-2.036849021911621, 15.720358848571777, "ds. Additionally, while the pre vious analysis takes the inter vention as an \u201call or noth-\ning\u201d construct that estimates a verage effects, this analysis will allow us to better understand \nwhich aspects of the inter vention pro vided value to the hou"] [-2.0441982746124268, 15.727416038513184, "crease income. \nThe last two practices require a little more explanation. Kitchen gardens do not necessarily \nincrease production but are used to grow higher- value crops for personal consumption. Thus, \nit isn\u2019t the quantity of production that appea"] [-2.000720262527466, 15.686544418334961, "e di vidend. We are able to identify which \naspects of the inter vention increased income as well as which aspects were successfully incor-\nporated into beha vior. \nConclusions and Lessons Learned\nThe Oxfam\u2013Pakistan case shows that it is feasible to "] [-1.9749269485473633, 15.657452583312988, "one. 76Another challenge with estimating the resilience di vidend for those that experience the shock is \nthat we must condition on the obser ved event. Estimating the resilience dividend associated \nwith a particular shock is difficult , since the"] [-1.922675609588623, 15.64371395111084, "the resilience di v\nidend elements of interest.\nDiamond Valley\nThis case study is based on the RDVM. It pro vides a demonstration of how RDVM can be \napplied in real-world situations. The case can be read on its own, but it is part of the broader pac"] [-1.927950382232666, 15.673074722290039, "e resilience di vidend that may result from \nimposing a share-based rights system. As such, the proposed inter vention is an institutional \nchange (water rights structure and enforcement), which in turn changes beha vior of agricul-\ntural producers ("] [-1.9120889902114868, 15.695037841796875, "ue of non-production-\nbased public goods related to community viability and stability. As such, the resilience di vi-\ndend is really a measure of the total (pri vate and public) net benefits pro vided via the inter ven-\ntion and achie ved by exercisi"] [-1.8768454790115356, 15.706765174865723, " allows us to estimate the change in profitability to water \nusers, the Duke Uni versity analytical report did not calculate the secondary and tertiary values \nassociated with community viability and cohesion. These include the value of a voiding the"] [-1.833348274230957, 15.751442909240723, "propriated by a factor of about 4 \u00bd when \nconsidering all water rights in the basin (see Figure 4.7). Perennial yield, defined as the maxi-mum amount of groundwater that can be consumed in the long run without depleting the reservoir, is estimated at"] [-1.8952300548553467, 15.699128150939941, "withdrawal of groundwater.\nApplying the Resilience Dividend Model to Estimate the Potential Dividend \nfor the Diamond Valley\nThe system under consideration is the quantity-based agricultural-hydrological system. The \nGMP is the hypothetical inter ven"] [-1.8855321407318115, 15.699712753295898, "ate to withdraw water \nfor purposes other than domestic use.83Figure 4.8). Historically, irrigators in the basin ha ve grown Timothy hay and alfalfa on an \n11-year rotation. While there may be some potential for a producer whose water rights are curt"] [-1.887542486190796, 15.708041191101074, "ral equilibrium \n28 Zeff, H., et al. (2016). Benefits, costs, a nd distributio nal impacts of a grou ndwater tradi ng program i n the Diamo nd Valley, \nNevada . New York: Rockefeller Foundation.\n29 Possibilities for future analysis include a sur vey"] [-1.9021706581115723, 15.631921768188477, " di vidend. \nThere are se veral elements that are not included in the model due to a lack of data. First, we do \nnot include bankruptcies, monitoring costs, legal costs, or other financial costs that might be associated with a change of the system.\n3"] [-1.8921178579330444, 15.702709197998047, "igators (i.e., o verdrawing water relati ve to their allotment) would \nlead to increased pri vate profitability at the expense of others.\nEmpirical Methods\nAs mentioned earlier, a quantitati ve assessment of the expected benefits of a share-based, \nr"] [-1.892916202545166, 15.696213722229004, "oduction (lack of system di versity or a vailable substitutes). Readers \ninterested in additional technical details are referred to the original analysis.\n38\nFor the purposes of this case study, we assume that modeling scenario (B), \u201csudden curtailme"] [-1.9041365385055542, 15.675215721130371, "me full curtailment to 35,000 acre-feet either during or \nimmediately after the planning horizon. Drawdown rates for project scenarios are either 3% or 6% per year, for a total of four project scenarios. BAU curtailment is in accordance with current "] [-1.9049619436264038, 15.687775611877441, "llion in scenario (E) and $8.2 million under scenario (F). 88Figure 4.9. Estimated Resilience Dividend from Agricultural Production, Net Present Value, \n30-Year Time Horizon\n$ -$10$20$30$40$50$60$70\nScenario E, 3% Scenario F, 3% Scenario E, 6% Scen"] [-1.8966954946517944, 15.69799518585205, "eping more water. 3% and 6% refer to assumed rate of decline of assignable water due to curtailment. Basinwide, there are 9 owners of senior rights only, 17 owners with mixed rights, and 40 with junior rights only. Baseline pro\ufb01tability for senior ri"] [-1.9008818864822388, 15.691274642944336, "undwater management plan is \ndeveloped in the region, there would be e vidence of a community stability resilience di vidend \nif any particular producer is willing to accept less profitability in exchange for keeping junior rightholders in production"] [-1.897839069366455, 15.684200286865234, " also likely to impair community stability and vitality. \nConsideration of this alternati ve baseline highlights the short-run/long-run trade-offs between \nprofitability and the long-term sustainability of the community as it exists today. It also pr"] [-1.919820785522461, 15.6620512008667, "he discount rate is used in net present value calculations to enable comparison of monetary flows at different points in \ntime. A positi ve discount rate suggests less weight on future flows. So, for example, the net present value of $100 next \nyear "] [-1.956505298614502, 15.654740333557129, "e appropriate methods to detail the expected beha vioral changes associated with any \nproject inter vention.\nCalculation of the resilience dividend may be highly dependent on assumptions made \nabout adaptive and transformative capacities of the agent"] [-1.9395198822021484, 15.651677131652832, "ti ve resilience di vidend for each of the four \nscenarios examined, there were both \u201cwinners\u201d and \u201closers\u201d in terms of profitability. Thus, an overall social net benefit, when aggregated, does not necessarily imply that e veryone wins. We \nrecommend"] [-1.9275059700012207, 15.646148681640625, "ity element to the resilience di vidend. Although we currently lack such \ninformation, any realized management plan that results in decreased net profitability for senior rightholders relati ve to the baseline, but for which there is support from thi"] [-1.896720290184021, 15.677166938781738, "entify \neach and e very element of the resilience di vidend at a detailed le vel, limited information and \ndata may preclude doing so. In these cases, aggregating a set of (perhaps ill-defined) benefits into a broader category (like the benefits from"] [-1.8320832252502441, 15.53941535949707, "d not the type of rights system in place (e.g., prior appropriation versus a shares-based system). Howe ver, the distribution of the di vidend varied significantly, \nwith mixed rightholders accounting for nearly 60 percent of the o verall gain for sc"] [-1.7907594442367554, 15.402848243713379, ". In addition to estimating a resilience di vi-\ndend of forest restoration, we discuss some of the estimation and policy challenges that may arise in the de velopment of a forest resilience bond. \nFor this case study, the resilience di vidend would b"] [-1.7598923444747925, 15.358769416809082, "Unknown (Site Speci\ufb01c)Fire Suppression Cost $18-21Fire Structural Damage Unknown (Site Speci\ufb01c)Fire Water Quality/ \nSedimentation$8.70\nSocial Bene\ufb01t Unknown (Site Speci\ufb01c)\nSOURCE: Authors\u2019 calculations.\nThis approach pro vides bounds for a partial qu"] [-1.756059169769287, 15.308476448059082, "anagement. Throug h ecosystem restoratio n.\n45 Vilsack, T. (2015). \u201cThe cost of fighting wildfires is sapping forest ser vice budget.\u201d U.S. Forest Ser vice 2017.99Restoring forests to a more natural state may ha ve other benefits as well: there is po"] [-1.7719687223434448, 15.317438125610352, "lliot, W. J., Miller, M. E., and Enstice, N. (2016). \u201c Targeting forest management through fire and erosion modelling.\u201d \nInternational Jour nal of Wildla nd Fire , 25(8), 876-887.\n49 We assume that the BAU case is the present situation of an unrestor"] [-1.7629181146621704, 15.355690002441406, "ecosystem restoration that selecti vely har vests different ages of trees depending on the \nrestoration\u2019s goals. \nSecond, fires are a result of the fuel pro vided by trees and forest debris. We treat fire severity \nas \u201cbad\u201d because, while fires pre "] [-1.8576964139938354, 15.497675895690918, "pproach, we \nwould know what stakeholders are willing to pay for each of the goods and ser vices pro vided \nby a forest, and could then estimate the value of the indi vidual capital stocks and, in aggregate, \nthe forest as a whole. Because we do not "] [-1.7866190671920776, 15.382060050964355, "ystem. 103There are two important outside forces\u2014forest fires and precipitation\u2014that we ha ve not \nexplicitly described in Figure 4.12. First, from the data presented in Figure 4.11, it appears that forest fires are determined outside the system, and"] [-1.7617746591567993, 15.355935096740723, "cult \nto estimate and may be geographically dependent.\nThe impacts of fire suppressio n: The main focus of the restoration is not necessarily ecosystem \nservices but fire suppression costs. There are two sets of impacts to consider: First, what is th"] [-1.7516276836395264, 15.325705528259277, "S. Department of Agriculture, Forest Ser vice, Rocky Mountain Research Station. \npp. 141\u2013148.\n53 Lynch, D. L., and Mackes, K. (200 3). Costs for reduci ng fuels i n Colorado forest restoratio n projects . U. F. Ser vice, USDA \nForest Ser vice Proceed"] [-1.7499929666519165, 15.346826553344727, "t within the forest and is equal to a board that is one foot long by one \nfoot wide by one inch thick.\nSOURCE: Wilm and Dunford (1948).\n56 Wilm, H., and Dunford, E. (1948). \u201cEffect of timber cutting on water a vailable for stream flow from a lodgepol"] [-1.7527786493301392, 15.350723266601562, "ra-tion to 0.5 cm 10 years out (2 cm of increased runoff translates into 0.06 acre-feet of water per acre of restoration and 0.5 cm translates into 0.01 acre-feet). \nOther studies ha ve also estimated the impact of changes in forest structure on run"] [-1.74636971950531, 15.350127220153809, "efficiency of 80% and a dam height of 300 feet, an acre-foot of water produces \napproximately 244.8 kWh of energy or 0.245 MWh. Using data from the EIA, we estimate that the a verage day ahead price for wholesale electricity in 2016 was $ 30.31 per M"] [-1.7524014711380005, 15.35131549835205, "urn in California, this implies that the annual probability of an acre of forest burning in California is approximately 0.5 percent. If these forests were restored, the expected savings in fire suppression costs are $2.10\u2013$2.50 per acre of fire in an"] [-1.755887746810913, 15.35328483581543, " differences \nin runoff between restored and unrestored forest that would gi ve rise to changes in value for \nwater and electric utilities. These changes will be small in comparison to the sedimentation and potentially increased treatment costs. As s"] [-1.758246660232544, 15.365059852600098, "al Damage Unknown (Site Speci\ufb01c)Fire Water Quality/Sedimentation $8.70Social Bene\ufb01t Unknown (Site Speci\ufb01c)\nSOURCE: Authors\u2019 Analysis.\nIn addition to the resilience di vidend estimates of a forest restoration project, there exist a \nnumber of aspects "] [-2.0283701419830322, 15.680582046508789, "essed. Additionally, some work suggests that to realize these estimated ben-efits, 20%- 30% of the landscape would need to be restored.\nISET Da Nang, Vietnam\nThis case study is based on the RDVM. It pro vides a demonstration of\u00a0how the RDVM can \nbe a"] [-2.03499436378479, 15.708248138427734, "nam.\u201d \nUrba n Climate , 12, 85.\n69 Throughout this analysis we use the term typhoon-resilient housing, as ISE T-Vietnam did in its cost-benefit analysis. \nISET also used the term storm-resistant housing in its housing inter vention. We chose to use t"] [-2.0180718898773193, 15.686297416687012, "t rate as of June 2015, and each inter vention household also had some sa vings. In \naddition, ISE T\u2019s pre-inter vention feasibility study found that households are willing to take \nloans to in vest in resilient housing,71 suggesting that poor and ne"] [-2.012497663497925, 15.688055038452148, "e outcomes of intervention and non-intervention population and their perceptions on trust in community to rely on each other in case of storm events; early warning reception; capacity to prepare and respond to events based on training; understanding "] [-2.02777361869812, 15.673433303833008, "ntial to grow e ven \nstronger due to climate change. Weather, combined with an increasing population and rapid economic de velopment, make Da Nang prone to flooding and disasters. The area has increas-\ningly experienced typhoon and flood e vents that"] [-2.0208041667938232, 15.682798385620117, "ented technical training for local builders and financial sa vings training for households, hosted community \nrisk management workshops, and created sa vings groups aimed at building good sa vings habits \nand trust among participants. The objecti ve "] [-2.018841028213501, 15.676820755004883, "lable for analysis. Howe ver, a number of potentially broader \nsocial impacts ha ve been assessed. For example, 702 Women\u2019s Union staff trained in commu-\nnity-based disaster risk management and climate change, and at least 644 people in the target be"] [-1.9865281581878662, 15.66127872467041, " very and transformational capacities in the broader \ncommunity. We cannot directly measure these aspects but understand there are changes in behavior that may affect social capital, which is discussed in the following sections. \nApplying the RDVM to"] [-2.0181684494018555, 15.682683944702148, " Financial capital plays a critical role both in the \nprovision of housing capital and in the reco very process after a typhoon occurs. As ISE T has \nshown, in vesting in typhoon-resistant housing is cost-effecti ve, but households may lack the \nfin"] [-2.013772487640381, 15.684832572937012, "k associated with the absorpti ve capacities is \ntyphoon protectio n. Resilient houses protect household members but can also shelter members \nof the public (e.g., neighbors, tra velers, fishermen) who lack resilient housing, which may build \ncommun"] [-2.0316765308380127, 15.659455299377441, "nducted a random selection household assessment87 \nfr o m Ma y t o J un e 20 1 2 tha t in cl uded dem ograp hi c an d eco n o mi c co n di ti o ns info rma ti o n , construction conditions of homes, household assets, and historical information regard"] [-2.016073703765869, 15.692625045776367, "sehold le vels. These estimates would include things \nlike increased economic wealth due to increased income associated with the well-being of resilient households. They would include other human and social capital estimates at the com-munity le vel "] [-2.0241613388061523, 15.668769836425781, "ed? Housing, & Human Capital (No electricity \nor internet reduces access to information)\nDisaster Response & \nPreparednessMethod alerted of storm/s (TV, \nNewspaper, Radio, neighbors etc.)Human & Social Capital \nDid you move due to past storms (2009 "] [-2.0207839012145996, 15.64183235168457, "atisfaction on as scale of \n1-5 (very satis\ufb01ed) with things like the following: success in your life, safety during storms and \ufb02oods, feeling that you are part of the community, future securityHuman & Social Capital, well-being as it \nrelates to the "] [-2.033137083053589, 15.710174560546875, ". ** Responses for this question were not included in the dataset from ISET.\nSOURCE: Authors\u2019 analysis.\nFor each of the questions outlined in this table, we ha ve identified where each fits within the \nconceptual model elements. This process indicate"] [-2.017345666885376, 15.693246841430664, "on the community for support in an e vent like Typhoon Nari; a follow-up \nquestion could ask how much and what types of support they would anticipate recei ving. \nFinally, se veral questions could be asked about the household perception of their well"] [-2.045844078063965, 15.718977928161621, "ecti ve \ncan contribute to household well-being in a typhoon resilience system. The steps identified in this analysis can be used to consider similar analysis in future projects. \nSocioeconomic data should be collected. More detailed information on t"] [-1.9600884914398193, 15.655473709106445, "both pre-project and post-project approaches for estimating the resilience di vi-\ndend. It is a good example of a large-scale, broad-based resilience project, but the project design also makes calculating the resilience di vidend challenging. \nExecut"] [-1.9648996591567993, 15.663174629211426, "t two strategies for estimating the resilience di vidend, \none based on a pre-project perspecti ve and one that looks forward to a post-project period when \nit may be feasible to measure the realized benefits if data are collected to support measurem"] [-1.9493906497955322, 15.643141746520996, "\nbaria project includes planning, preparation, and procurement in 201 3\u20132015 and infrastruc-\nture construction in 2016\u20132017. Data collection for the Mathbaria project\u2014especially the output assessment at the household and community le vel\u2014has not been"] [-1.9664040803909302, 15.650798797607422, "sical capital includes changes to piped water, bridges, drainage, roads, and cyclone shel-\nters. This suite of infrastructure impro vements pro vides both pri vate and public benefits. Pri-\nvate benefits come through in vestments in water and sewage"] [-2.0154497623443604, 15.683839797973633, "income, employment, and health quality. Income \nis a measurable proxy for household utility, capturing changes in earnings that dri ve other \naspects of welfare. At the household le vel, employme nt will be correlated with income, but at a \ncommunit"] [-1.950589656829834, 15.648128509521484, "silience di vidend. The components can be di vided into three broad catego-\nries. The first set is in vestments that target disaster risk reduction and are unlikely to produce \nco-benefits, such as community cyclone shelters. The second set is in ves"] [-1.960044264793396, 15.66426944732666, ", which limits our ability to calculate numerical estimates of the resilience \ndividend. \nOur approach using ADB-generated rate of return estimates is straightforward: we would \ncategorize estimated net benefits according to the resilience di vidend "] [-1.9751262664794922, 15.670822143554688, "ta. In addition, where feasible \nthe project should measure changes in outputs, since those will be realized on a shorter time horizon than outcomes. Household data, collected through sur veys, would support estimates \nof the changes in well-being, i"] [-1.992730736732483, 15.69262409210205, "81.1 TBD TBD TBDBridges 41.2 TBD TBD TBDCyclone shelters 69.9 TBD TBD TBDTotal 1,057.5\nNOTES: Bene\ufb01ts estimates from ADB 2014(a) and component summaries from ADB 2014(b). TBD indicates that \nthese estimates are to be determined given existing data th"] [-1.9594180583953857, 15.666692733764648, "ost-Project Resilience Dividend\nType of capital or good/service Outputs to measure Outcomes to measure\nPhysical capital Infrastructure built Avoided damage\nAvoided mortality/morbidity\nHuman capital Residents trained \nMunicipal workers trained Worker "] [-1.9450643062591553, 15.637689590454102, "only for the resilience project but also for the \nrelevant BAU cases, whether they are for alternati ve investment or no in vestment. \nNon-physical capital is difficult to incorporate. Economic analysis of infrastructure projects \nis unlikely to addr"] [-1.9532384872436523, 15.659405708312988, "enarios that can be used. For instance, with the forest bond project, the BAU case could ha ve been either \u201cdo nothing\u201d or the opposite extreme of clear cutting the entire forest. \nIn fact, any alternati ve forest management strategy could be used as"] [-1.9790838956832886, 15.673810005187988, "he lack of a benefit may be because the shock was larger than what had been planned for and the investment in protection was too small compared to the shock that was obser ved. Protection \nmeasures are typically designed for either an entire distribu"] [-1.9584472179412842, 15.637639045715332, " beha vior \nto shift to something new\u2014perhaps relaxing a constraint or introducing new opportunities\u2014can be an indicator of changes in resilience capacities, and is also directly linked to the pro-duction or consumption of goods and ser vices. In Nep"] [-1.9984301328659058, 15.6755952835083, "e actions to reduce damage. This informa-\ntion likely changed people\u2019s beha vior by encouraging them to take pri vate mitigation actions, \nbut not all households in the inter ventions will take action. In the case of these households, \nthe resilience"] [-1.9548224210739136, 15.628604888916016, "ger term could help shed light on this process, but the ability \nto determine a casual effect from the inter vention versus other inter ventions or circumstances \nis complicated the further remo ved one is from project completion.\nRegardless of data "] [-1.9695215225219727, 15.669424057006836, "ltural producers had choices of 1) buying or sell-\ning water rights; 2) extending the depth of their wells based on the state of the groundwater capital stock; and 3) ceasing production entirely. The hydro-economic model captured this \nbehavior using"] [-1.9415684938430786, 15.636245727539062, "ected for both project and BAU stakeholders if a casual \ninference approach was to be used, or simulated in the case of a forward-looking project that has not yet been implemented.\nThese four time periods are important because they allow us to isolat"] [-1.9405807256698608, 15.626949310302734, "e cases, aggregation of various components of the resilience dividend into broad \ncategories of goods and services may be an effective empirical strategy. As noted through-\nout this document, changes in the flows of valuable goods and ser vices are t"] [-1.930444598197937, 15.623711585998535, "ssary to create a consistent model of a system. Howe ver, the relationships between these model elements are \ncomplex and, in some cases, not well understood. Examples include how changes in institu-tions will ultimately change human beha vior, and t"] [-1.9240596294403076, 15.604565620422363, "alth founda-\ntion of the RDVM relies hea vily on theories of value that predominate modern economics. In \nparticular, we assume that something (i.e., a good, ser vice, policy, or action) is valuable if and \nonly if an indi vidual would be willing to "] [-1.9307490587234497, 15.621003150939941, "ata structures that can best suit quantification of \nthe di vidend, the importance of beha vior in generating a resilience di vidend, and the limita-\ntions of the model. While we belie ve that the inclusi ve wealth conceptualization of systems for \ne"] [-1.958884358406067, 14.184954643249512, "he RAND research team, the Rockefeller Foundation has defined \nfive characteristics of resilient systems.1 The following reproduces those characteristics and \ntheir definitions:\n\u2022 Aware: knowing your strengths, assets, liabilities and vulnerabilities"] [-1.9927507638931274, 14.30237865447998, "h which these changes might be \nmade is informational (as with awareness), as exposure to differing ideas or strategies may result in pri vate or public actions that are different than that which would ha ve been taken other-\nwise. Another channel mi"] [-1.9470700025558472, 15.640329360961914, "d that has the potential to produce other bene\ufb01ts not directly related to the shock or stressor\nResilience Lens An approach to project and portfolio development that \nbetter accounts for system interdependencies and potential co-bene\ufb01ts, with the ult"] [-2.109717845916748, 14.241241455078125, "t h System Scie nce, 13(11), 2707-2716. \nAnderies, J., Folke, C., Walker, B., and Ostrom, E. (201 3). \u201cAligning key concepts for global \nchange policy: Robustness, resilience, and sustainability.\u201d Ecology a nd Society , 18(2), 8.\nArrow, K. J., Dasgup"] [-2.0830917358398438, 14.261150360107422, "i ve and acti ve learning in the adapti ve management of nutrients in shallow \nlakes.\u201d Canadian Jour nal of Agricultural Eco nomics/Revue ca nadienne d\u2019agroeco nomie, \n57(4), 555-57 3.\nBrown, D., & Kulig, J. (1996/97). The concept of resiliency: The"] [-1.962786316871643, 14.535621643066406, "and \nPsychopathology, 5, 517\u2013528.\nElliot, W. J., Miller, M. E., and Enstice, N. (2016). \u201c Targeting forest management through fire \nand erosion modelling.\u201d International Jour nal of Wildla nd Fire , 25(8), 876-887.\nEureka County (2016, September). Eu"] [-2.06005597114563, 14.277835845947266, " adaptation from a disaster risk perspecti ve.\u201d Natural Hazards , 70(1), 609-627.\nLongstaff, P. H., Security, Resilie nce, and Commu nicatio n in Unpredictable E nvironments Suc h \nas T errorism, N atural Dis as ters, a nd Complex Tec hnology, Cambri"] [-2.145164728164673, 14.307534217834473, "Commu nity Psyc hology, 41(1-2), 127-150.\nPaton, D., and Johnston, D. (2001). Disasters and communities: Vulnerability, resilience, and \npreparedness. Disaster Pre vention and Management, 10, 270-277.\nPawson, R. (200 3). \u201cNothing as practical as a go"] [-2.0204362869262695, 15.583067893981934, "alysis for typhoon resilient housing in Danang city, Vietnam.\u201d Urba n Climate , \n12, 85-10 3.\nTurner, B. L., Kasperson, R. R., Matson, P. A., McCarthy, J. J., Corell, R. W., Christensen, L., \net al. (200 3). \u201cA framework for vulnerability analysis i"] [-1.9188432693481445, 15.610095977783203, "the net benefits of a resilience project. We call the framework the Resilience Dividend Valuation Model (RDVM). We use the term resilience dividend to describe the net benefits associated with the absorption of shocks and stressors, the recovery path"] [15.684511184692383, 16.493017196655273, "Nicholas M. Pace, Lloyd DixonAssigning Responsibility \nFollowing a Catastrophe\nAlternatives to Relying Solely on Traditional \nCivil LitigationCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein "] [15.649577140808105, 16.566587448120117, "e that traditional civil \nlitigation might not be the best way to assign responsibility . We do not, however, address the \nunderlying question of whether an alternative to ordinary litigation is actually needed for any \nparticular type of adverse eve"] [15.684904098510742, 16.461694717407227, "................................................................................................... iii!\nTables ........................................................................................................................................"] [15.702445030212402, 16.36788558959961, "\nAgency Investigations .............................................................................................................................. 14 !\nAgency Determinations ......................................................................"] [15.749273300170898, 16.286869049072266, "......... 31 !\nNational Childhood Vaccine Injury Act of 1986 ............................................................................ 31 !\nNational Swine Flu Immunization Program of 1976 ........................................................"] [15.781545639038086, 16.34217071533203, ".................................................................................. 44 !\nChapter Five: Oil Spills in Navigable Waters ........................................................................................... 47 !\nBackground ......"] [15.689179420471191, 16.44699478149414, "................................................................................ 113 !\nOverview of Framework Examples ...................................................................................................... 113 !\nPrimary Goals of the "] [15.679230690002441, 16.454044342041016, "le S.2. Primary Goals of Example Frameworks .................................................................................. xx !\nTable S.3. Liability Protections Embedded in Frameworks .........................................................."] [15.690502166748047, 16.446813583374023, "e have argued that an approach better suited to handle \nthe flood of claims that arises fo llowing a major disaster is needed, one that minimizes the \ngeneration of substantial legal and other transaction costs while extending liability protections \n"] [15.689785957336426, 16.459230422973633, "ility for an adverse event might be affixed upon or accepted by \nindividuals or entities through formal procedures (such as agency hearings), informal actions \n(such as when a company voluntarily sets up a claim fac ility to pay requests for compensa"] [15.723016738891602, 16.419458389282227, " Determinations \nAgency determinations are nonadversarial proceedings in which agency staff affix \nresponsibility on a party based on its internal review of relevant facts and controlling \nregulations, statutes, and departmental guidelines and proce"] [15.694530487060547, 16.431560516357422, "t might arise in the future, regardless of the party \u2019s \nactions. \nFrameworks \nThese processes must be viewed in the context of overarching frameworks that reflect \nlegislatures \u2019 intentions as to how legal relationships between actors ought to be"] [15.70129108428955, 16.31483268737793, "s) with pneumoconiosis ( \u201cblack lung\u201d), as well as to their surviving \ndependents; it typically requires the operator of the last coal mine in which the \ninjured or diseased worker was employed for a year or more to cover the cost of \nthose benefits"] [15.706106185913086, 16.361499786376953, "S. Senate issued its resolution of advice and consent to ratify the \ntreaty on July 31, 2003. \n10 Pub. L. No. 101-380. \n11 Pub. L. No. 85-256. xvi Personnel Protection Act of 2003 and the National Smallpox Vaccination Program made \npossible b"] [15.720352172851562, 16.306081771850586, "hose limitations. Punitive damages continued to be prohibited, but carriers would now \nbe strictly liable (sometimes referred to as presumed liable ) for proven injury claims up to \nabout $153 ,000 (as of April 2017 ). Claims beyond that point would"] [15.875311851501465, 16.25377082824707, "overed persons) \nNOTE : OSLTF = Oil Spill Liability Trust Fund, created by OPA. \na A demise charter is a vessel lease in which all of the vessel\u2019s operating expenses pass to the lessee . xviii OPA was expressly enacted to address responsibility i"] [15.740150451660156, 16.310155868530273, "er o f licensees across the \ncountry, this equates to a potential fund of about $13 billion to address claims arising out of a \nsingle incident, although the owner or operator of the power plant where the incident actually \noccurred would be directl"] [15.739264488220215, 16.289064407348633, "itional tort lawsuit. \nThe NCVIA took a different approach, conferring no blanket immunity on manufacturers of \nspecified types of vaccines, but instead markedly narrowing the theories of liability that could \nbe used against them. Claims for compe"] [15.736413955688477, 16.34071922302246, "be vital to the nation \u2019s public health \nwere at risk or currently inadequate. The story behind OPA is not as straightforward : \nDeveloping a comprehensive and rapid response to immediate needs following a spill was \narguably a motivation of at leas"] [15.81232738494873, 16.346982955932617, " Although the favored parties under OPA and Price \u2013Anderson \ncontinue to bear responsibility for the costs of compensation, remediation, and recovery (as well as a ssociated transactional expenses), such parties have the benefit of potentially \nsi"] [15.763406753540039, 16.367883682250977, "hly structured system \nfor considering a very s pecific type of claim and rules crafted for a singular purpose (such as \nthe NCVIA program), but it would also cover instances in which traditional tort litigation is the \nsole option available to claim"] [15.795778274536133, 16.312850952148438, "st \na PRP for claims \npreviously paid \u2022!Not relevant; claimant does \nnot participate because its \nclaims have already been \nresolved Responsible party \n(\u201cclaimant \u201d is the OSLTF) \nOPA: Claim \nresolution through \nlitigation Civil lawsuit of c laim"] [15.78656005859375, 16.285945892333984, "allpox vaccine \nacts: Agency claim \nresolutions Semiformal internal \nagency determination \nof claims against the \nUnited States \u2022!There are limits on \nattorneys\u2019 fees (assuming \nno impact on the availability \nof counsel) . \n\u2022!If the claim meets th"] [15.788140296936035, 16.300281524658203, "s to one year . \nFor PRPs: Results of agency claim decisions are \nnot relevant until trust fund reimbursement \naction is initiated . \nOPA: Agency -initiated \ncivil reimbursement \nactions Civil lawsuit brought by an \nagency against a PRP for \nclai"] [15.783183097839355, 16.283349990844727, "mination of a claim pres ented to it, such as when OPA \nclaimants proceed against the OSLTF to recover damages or recovery costs or when Swine Flu \nAct and smallpox vaccine act claimants seek compensation from the Secretary of Health and \nHuman Serv"] [15.783641815185547, 16.33978271484375, "are considered. In contrast are semiformal agency determinations in which the \ndecisionmaker has some sort of preexisting relationship with what might be thought of as an \ninterested party. For example, claims submitted against the OSLTF under OPA"] [15.787005424499512, 16.312942504882812, "e PRP in district \ncourt \nFor PRPs: Not as part of this \nprocess, although defenses \ncould be put forth if an agency \nseeks reimbursement through court action \nOPA: Agency -\ninitiated civil \nreimbursement \nactions Civil lawsuit \nbrought by an \nag"] [15.782480239868164, 16.26559066772461, "specifically address claim \nprocedures . \nFor PRPs: Not directly relevant \nfollowing substitution of the \nUnited States as defendant -payor For claimants : The claimant \ncould request reconsideration \nof the decision, although \nappellate review wo "] [15.707432746887207, 16.397579193115234, " in this regard because aviation litigation is a target- rich \nenvironment, especially in the period following the disaster , when so much about the \ncircumstances leading up to the incident is still unknown. There are few downsides to filing \nsuit"] [15.69671630859375, 16.431800842285156, "catastrop he-level losses. Given that reality, policymakers \ndesiring to create a functional alternative model for determining responsibility should be less \nconcerned with building an impregnable wall against ancillary litigation and instead focus "] [15.69580078125, 16.429134368896484, "ntained the following features in varying forms: \n\u2022!a set of underlying goals for making the effort to change traditional tort \n\u2022!various protections for individuals and entities that would otherwise find \nthemselves embroiled as defendants in liti"] [15.690088272094727, 16.445899963378906, "the political consensus that supported its creation. Framework designers \nmust incorporate realistic means for claimants to seek redress of losses that are no longer \navailable through traditional tort remedie s. This does not imply that claimants m"] [15.690717697143555, 16.42829132080078, "king sure that some sort of credible governmental \nbackstop is in place seems like a necessary component of any framework that purports to deal \nwith the liability consequences aris ing from a potential catastrophe. \nProgram designers must also anti"] [15.683829307556152, 16.406633377075195, "lpful. Such an ex post, ad hoc \napproach maximizes the amount of political will that would be needed to move a radical \nproposal through an otherwise -sluggish and suspic ious legislature. An argument could be made \nthat, even with foreknowledg"] [15.7197847366333, 16.338729858398438, "ted external defibrillator \nALJ administrative law judge \nAPA Administrative Procedure Act \nATSA Aviation and Transportation Security Act \nATSSSA Air Transportation Safety and System Stabilization Act of 2001 \nCAA Clean Air Act \nCDC Centers f"] [15.694608688354492, 16.455463409423828, "There was an implicit assumption that the resolution of a dispute would affect the interests \nand behaviors of the parties alleging and defending such claims almost exclusively because the \nconcerns and actions of those not directly involved in the "] [15.692974090576172, 16.438133239746094, "t reimburse an injured party . It reviews \nexamples of circumstances in which s tatutory substitutes for the traditional tort system have \nbeen adopted for dealing with at least some of the consequences of widespread harm, \ndescribing the approaches"] [15.64907455444336, 16.488399505615234, " elements of negligence, the losses that a plaintiff alleges must be proven t o exist or there \ncannot be a finding of legal responsibility on the part of the defendant (in other words, no injury means \nno tort). 3 Terminology \nCatastrophes and Di"] [15.679601669311523, 16.46613121032715, "rom providing assistance , with near -total \ndisruption of everyday life); and Sugarman, 2007 (major disasters are harms that are catastrophic to many \npeople and often sufficiently grave to overtax the capacity of moderate and larger communities to "] [15.673312187194824, 16.459339141845703, "erest in responsibility is not solely in identifying the root or proximal cause of \na catastrophe. Actions that are asserted to contribute , to any degree , in the sequence of events \nleading to onset are in play, as are postonset actions that als"] [15.690253257751465, 16.433372497558594, "ther process that might be utilized for assigning \nresponsibility . In Chapter Two, we describe different types of processes in greater detail. \nThese processes generally have a well -defined structure . The NTSB does not examine the causes \nof tra"] [15.677427291870117, 16.438823699951172, "ons, if the number of lawsuits filed in courts throughout the country \nis any indication.25 And although NTSB investigations target the nation \u2019s most serious aviation, \nrail, maritime, highway, and pipeline incidents each year in order to make the"] [15.692277908325195, 16.4344425201416, "iver was intoxicated . This mosaic of rules and regulations are \nthe background against which an individual or entity is determined to be responsible for an \naccident and the extent of a responsible party \u2019s financial liability for th e resulting \n"] [15.707526206970215, 16.4168643951416, "rative determination, and \nthe outcome of the civil lawsuit in the example presented above as individual processes within \nthe sam e larger framework. Although the EPA might rely on the outcome of the NTSB \ninvestigation before deciding who should"] [15.697729110717773, 16.443708419799805, "ance of fairness \n\u2022!\u201cleakage \u201d to the traditional civil litigation system \n\u2022!rationalizations offered for changing traditional legal relationships between parties. \nFinally, in Chapter Nine , we provide some concluding comments on the application"] [15.794465065002441, 16.617557525634766, "n addressing catastrophe -related claims on behalf of themselves and those similarly \nsituated. If a judge approves the representative plaintiffs \u2019 motion for class certification, one or \n \n27 We refer to this"] [15.714624404907227, 16.492101669311523, "ence would be presented to the trier of fact . The role of judges in the litigation process has \ntraditionally been limited to ruling on pretrial motions and overseeing the conduct of trials . \nJuries are typically used to decide questions of fact "] [15.705862045288086, 16.448894500732422, "d other subjective \ncomplaints) . In most jurisdictions, the trier of fact also has the option of awarding punitive \ndamages to the plaintiffs, primarily for the purpose of punishing the defendants. \nUnder certain circumstances, multiple defendants"] [15.684303283691406, 16.46552085876465, "licy, the insurer might pay the defendant\u2019s attorneys\u2019 fees \nand litigation expenses. \nModified Tort Litigation \nAn argument can be made that seemingly minor modifications to traditional tort liability can \nessentially create what amounts to a ve"] [15.71327018737793, 16.404354095458984, "rtain types of parties might not be held \nliable for damages arising out of specified acts or omissions. Intentional acts are \noften excepted. \n\u2022!limitations on total financial liability : Liability can attach to certain parties, but they \nwoul "] [15.71546459197998, 16.41094970703125, " similar rule change but only with regard to noneconomic \nawards . \n\u2022!imposition of a w aiting period : A potential plaintiff would be prohibited from filing \na new lawsuit until a specific period of time has elapsed from the event , presumably \nto"] [15.694412231445312, 16.40737533569336, " inspect chemical facilities ; obtain samples or equipment ; and examine company records, \ninventories, and operating procedures .31 An investigation might take 12 months before a report \ncontaining key findings and root causes of the accident "] [15.750411987304688, 16.37423324584961, "ite \n \n31 42 U.S.C. \u00a7 7412(6)(L); EPA, 2013b, p. 1. \n32 CSB, undated . \n33 CSB, 2013 , p. 10. \n34 42 U.S.C. \u00a7 7412(6)(G). \n35 MSHA, 2011 , p. 7. 16 physical examination s of the accident site, inspect compan"] [15.810381889343262, 16.33762550354004, " reimbursing the costs \nof cleanup. That determination is not a rigidly formal process and might , for example, simply \ncome from a quick search of property records to find out who owned an abandoned oil-storage \nfacility. \nThese determinations a"] [15.767005920410156, 16.394868850708008, "ncy determinations can involve a more extensive and focused investigation, one that might have a \nrole for stakeholders. For example, an EPA designation of a PRP can, should the agency so choose, include \nreviewing documents, conducting site invest"] [15.745487213134766, 16.39789581298828, "cisions , or to the courts ), \nhave the decision based solely on the record, and receive a statement of reasons for the \ndecision.45 That said, ordinary criminal and civil proceedings offer par ties far more -liberal \nopportunities to defend allegati"] [15.751214981079102, 16.437009811401367, "ning argument, presentation of witnesses and exhibits, and opportunities for cross -\nexamination and evident iary challenges. Closing arguments can take the form of a posthearing \nbrief submitted by each party , filed at least a month after the con"] [15.741186141967773, 16.422578811645508, "gulations. Moving out of the \nrealm of administrative law and int o the civil and criminal courts is done to seek the judgment \nof a decisionmaker in a neutral forum that the agency\u2019 s conclusion about a party\u2019 s \nresponsibility was, in fact, a co"] [15.748252868652344, 16.504262924194336, "ion, DOJ \nwill file the recovery action in court. As was true for the civil penalty actions described above, \nat trial , the defendant can challenge its responsibility for the underlying incident giving rise to \nthe cleanup operations . \n "] [15.69914722442627, 16.441497802734375, " \u2019s \nperspective) in these proceedings might be far more of a co ncern to a corporate defendant than \nthe size of any civil or criminal fine. Convictions can lead to debarment or the loss of an \noperating license , events that could push a once "] [15.698150634765625, 16.406890869140625, "cceptance of responsibility can also come much later in the process, when it can be a tactical \ndecision. In the 200 0 crash of Alaska Ai rlines Flight 261, the airline and the successor to the \nmanufacturer conceded liability on the eve of trials "] [15.740654945373535, 16.316875457763672, " which law, rather than \ncontract, requires a party to bear some responsibility for an adverse event that might arise in \nthe future, regardless of the party \u2019s actions. Under the Price \u2013Anderson Nuclear Industries \nIndemnity Act, for example,"] [15.692631721496582, 16.388381958007812, "this chapter is illustrative rather than \ncomprehensive and focus es on those that were intended to replace or modify some aspect of \ntraditional tort litigation (for example, we do not include the legislation that granted the NTSB \nthe power to co"] [15.701476097106934, 16.341651916503906, "ment of Transportation that an air carrier was a victim of an act \nof terrorism limits the carrier \u2019s responsibility to third parties to a maximum of $10 0 million in \nthe aggregate, with the federal government responsible for any liability above th"] [15.707405090332031, 16.294038772583008, "HSA) of 2002, major legislation enacted in \nreaction to the events of September 11, 2001.65 HSA contain s several provisions related to \nvaccine injury liability that we discuss at length in Chapter Seven, as well as the Support Anti -\nTerrorism b"] [15.70854377746582, 16.32670021057129, "ment of the 1984 Warner \namendment (Pub. L. No. 98-525, \u00a7 1631) , which provided essentially the same protections to government \ncontractors. \n69 Pub. L. No. 105-170 (1998). 28 negligence or intentional misconduct.70 Legislative history suggest"] [15.708414077758789, 16.325408935546875, "can submit \nevidence opposing a determination of eligibility or later challenge an award by arguing that it \nwas made based on a mistake of fact or that there has been a change in the claimant \u2019s medical \ncondition . The Benefits Review Board can rev"] [15.727865219116211, 16.348594665527344, "f the amount calculated by \nthe federal government as the \u201cmaximum probab le loss \u201d for such claims, $50 0 million , or the \nmaximum liability insurance then available on the world market at a \u201creasonable cost. \u201d The \nfederal government provides a "] [15.6943941116333, 16.300552368164062, "the \nproviders were complying with national security requirements will trigger a dismissal of any \ncivil action , unless the court finds that the certification was not supported by substantial \nevidence. \nGeneral Aviation Revitalization Act of 1994"] [15.832026481628418, 16.290599822998047, "ecovering losses related to oil pollution and limitations on the \nliability of those deemed responsible for the discharges.83 In Chapter Five, we describe OPA in \ndetail . \nPaul D. Coverdell Teacher Protection Act of 2001 \nIn states that receive fede"] [15.7426118850708, 16.32756233215332, "duct defect claims (other than when the firearm was used in the commission of a \ncrime) , and in certain actions brought by the U.S. Attorney General.85 The act also include s the \nChild Safety Lock Act of 2005 as one of its provisions, which exten"] [15.726318359375, 16.259098052978516, "ed for \nscanning seaborne cargo for the presence of nuclear material might be one such technology).90 \nThe protections apply to all claims against the seller that are related to an act of terrorism \nwhen its DHS -certified technology was deployed in "] [19.025724411010742, 15.390925407409668, "n, we describe the smallpox vaccine acts in detail. \nTerrorism Risk Insurance Act of 2002 \nThe Terrorism Risk Insurance Act (TRIA) provide s a federal government reinsurance \u201cbackstop\u201d \nfor losses associated with acts of terrorism in exchange for req"] [15.700932502746582, 16.35174560546875, " of a computer system to appropriately handle date- related data for \nthe year 2000 and beyond.94 \nThe act includes imposition of a uniform punitive -damage standard of \u201cclear and convincing \nevidence \u201d and, in instances in which the defendant is a s"] [15.727069854736328, 16.360904693603516, "6-37 (1999). 36 power plant accidents in Chapter Six), we look at the development of a regime under the Price \u2013\nAnderson Act for addressing liability in the face of accidents at commercial nuclear power \nplants. Finally ( mass vaccine injuries i"] [15.7018404006958, 16.365140914916992, " to adopt (via the r atification of a \ntreaty) a framework for assessing responsibility to serve as an alternative to traditional tort. \nLegal proceedings involving international aviation accidents offer a particularly interesting case \nstudy be"] [15.715241432189941, 16.35782241821289, "r. 1991); and El Al Isr. Airlines v. Tsui Yuan Tseng, 525 U.S. 155 (1999). 38 In the 1960s, a de facto carve- out was created for the liability cap as it pertained to passengers \ndeparting from or arriving in the United States , made possible by"] [15.703958511352539, 16.367584228515625, " \n99 Order of Civil Aeronautics Board Approving Increases in Liability Limitations of Warsaw Convention and \nHague Protocol, reprinted in a note following 49 U.S.C. \u00a7 40105 (1994). \n100 Lloyd v. Am. Airlines (In re Air Crash at Little Rock Ar"] [15.71178913116455, 16.354204177856445, "without physical injuries Depends on the state \nwhere the case is \nfiled; might include \ninstances in which the claimant \nsustained no physical \ninjuries Depends on the \nstate where the \ncase is filed; might \ninclude instances in which the claimant"] [15.710878372192383, 16.369091033935547, "urisdiction al \nrules \nImmediate \npayments by \ncarrier Required within \n15 days Required within \n15 days No requirement No requirement \n 41 For some aspects of the litigation that ensued from the Flight 214 incident, where the claim is \nbrought"] [15.707072257995605, 16.352867126464844, "gine manufacturers , parts suppliers, \nairports, air traffic controllers, hijackers, or other passengers , fall outside of the legal \nframework established by the convention for modified tort litigation . The fourth column of \n "] [15.693172454833984, 16.33460235595703, "plier) , Honeywell International, and the San Francisco Fire Department were formal parties. \nThe investigation was extensive, as evidenced by a docket containing more than 90,000 \nseparate entries logging evidence submissions, investigatory event"] [15.737360954284668, 16.367347717285156, "ries.118 The MDL cases \nwould not include a lawsuit filed in California state court by the family of a Chinese student \nwho was killed during the incident ; the suits claim that errors by local first responders (and not \nthe Montreal -protected carri"] [15.689163208007812, 16.380998611450195, "hold. This can be helpful in the context of relatively minor injuries, in \nwhich the complex proof required to show negligence on the part of the carrier might require \nsignificant legal resources that can overwhelm the potential recovery . The exp"] [15.742579460144043, 16.335453033447266, "in which the airline was essentially \nblameless , at least insofar as monetary claims exceeding the threshold are involved. The many \nnon-Montreal claims being brought on behalf of passengers on Asiana Flight 214, a flight \ncertainly international "] [15.854419708251953, 16.300535202026367, "unate possibilities. None of these incidents, however, compares with \nthe national attention and legislative concern triggered by the 1989 grounding of the Exxon \nValdez and its implications for the environmental health of Prince William Sound, Alas"] [15.84165096282959, 16.30094337463379, "enses would have no limitation \n(recovery costs in CWA, federal and state cleanup costs for OCSLA). Recoverable damages \nwould , in every instance , include cleanup costs incurred by the government, but the laws \ndiffered markedly as to wh ether oth"] [15.862675666809082, 16.295852661132812, "tive and immediate removal of a discharge, and [provide] mitigation or prevention \nof a substantial threat of a discharge, of oil or a h azardous substance\u201d131 involving the nation\u2019s \nnavigable waters, the adjoining shorelines, an exclusive economic "] [15.862525939941406, 16.30080223083496, " depend for food, economic security, or other products. The \ncrew of a commercial fishing boat might fall under this definition. \n\u2022!profits and earning capacity: Any claimant could recover for lost profits or \ndiminished earning capacity arising o"] [15.851930618286133, 16.30093002319336, "ircumstances in which liability can be shifted or eliminated completely can be narrow.141 A \n2004 revision to OPA added an \u201cinnocent landowner\u201d defense, in which a responsible party \ncould argue that , when the real property where the discharge ema"] [15.880278587341309, 16.289806365966797, "pe Line Co. v. Conewago \nContractors, Inc. , 1994 WL 539326 [M.D. Pa. Aug. 22, 1994] ). \n142 33 U.S.C. \u00a7 2703(d). The 2004 revision mentioned is Coast Guard and Maritime Transportation Act of \n2004, Pub. L. No. 108-293. \n143 OPA, \u00a7 1003(c). \n14"] [15.86495304107666, 16.288616180419922, "nsible parties to operate within U.S. territory.152 The requirements extend, however, only \nto vessels, offshore facilities, and deepwater ports, and , in some instances , the minimum \ninsurance level might be lower than the cap. \nThe liability ca"] [15.845711708068848, 16.29438018798828, " tax on crude oil used in or exported fro m the United States.155 With OPA, \nexisting environmental cleanup funds (such as the CWA\u2019s \u00a7 311 revolving fund; the DWPA\u2019s \nliability fund ; and TAPAA\u2019s Trans -Alaska Pipeline Liability Fund) were subsumed "] [15.826976776123047, 16.30743408203125, "the OSLTF) for a determination and would be successful only to the \nextent that their losses were not caused by their own gross negligen ce or willful m isconduct.165 \nThere would be a time limit of six years following the end of recovery efforts to"] [15.854758262634277, 16.298017501831055, "over remova l costs or damages takes place, the action could be brought in state \ncourt (depending on applicable jurisdictional rules) or federal court.172 A set of time limits \ndifferent from those for bringing claims against the fund exists for f"] [15.844587326049805, 16.303361892700195, "00.135(c); see also 40 C.F.R. \u00a7 300.305(b)(2). \n176 U.S. Coast Guard, 2013b. \n177 33 C.F.R. \u00a7 136.305(a). \n178 33 C.F.R. \u00a7 136.307. 56 unlike the civil litigation process, in which blanket denials of each allegation and statement of \nfact in t"] [15.857658386230469, 16.298595428466797, "dentified them as responsible and stating that , if the identification was \ndisputed, evidence would need to be provided.\n183 There was no response to the letter. A \nsubsequent complaint that DOJ filed on behalf of the Coast Guard sought to recover "] [15.870059967041016, 16.279977798461914, "e \nnotice of design ation might get the agency to reconsider, but there does not appear to be any \nduty on the agency to do so , at least not one set forth in OPA. Although the federal APA rules \nregardi ng informal agency decisions could be utilize"] [15.81982135772705, 16.305957794189453, "ent of the total costs of \ndamages and re medi ation (none of these incidents fell into the \u201cmystery spill \u201d category because \nthe source of the discharge was always identifiable ).192 In such instances, the OSLTF was able to \ncover the remaining 3"] [15.8616304397583, 16.296768188476562, " contemplates a situation in which \nresponsible parties could pay claims for \u201c interim short- term damages \u201d without precluding any \nfuture recoveries for losses outside the scope of those interim payments,\n194 a situation that \nwould not be common i"] [15.874710083007812, 16.2897891998291, "e outside of OPA, but \nthey might be subject to restrictions, such as the Limitation of Liability Ac t, which limits all shipowner \nliability for damages to the postincident value of the vessel and its cargo. 60 Taken together, these points sugge"] [15.904699325561523, 16.257333755493164, " \n198 \u201cComplaint, \u201d filed April 21, 2010, in Shane Roshto & Natalie Roshto v. Transocean, Ltd. & BP, plc. , Civil \nAction No. 2:10- cv-01156, E.D. La . \n199 Some of these consolidated cases had been terminated or transferred by this time"] [15.917696952819824, 16.266315460205078, "igher than the applicable limits of liability.204 Although Deepwater Horizon \nis obviously the most prominent example o f those 64 events, the 2010 Enbridge pipeline \nrupture in Michigan and subsequent release of more than 843,000 gallons of tar "] [15.877588272094727, 16.291412353515625, " And often , more than one agency \nconducts its own inquiry. In Deepwater Horizon , government investigation reports were issued, \nfor example, by the U.S. Chemical Safety and Hazard Investigation Board, a national commission \nformed by the preside"] [15.860648155212402, 16.320539474487305, "es \u201d \n(46 U.S. Code \u00a7 6308[a] ). As a result , a Coast Guard accident report could not be used in a trial for \ndamages , nor could it be used in an admin istrative proceeding brought by th e designated responsible \nparty. \n208 CSB, 2014; National C"] [15.737725257873535, 16.314069747924805, "ikely health and public welfare consequences of a severe nuclear \npower plant incident in the United States at the pre sent time range from the modest to the \nhorrific, photographic images of the destruction at the Chernobyl power station and the "] [15.747284889221191, 16.32610511779785, "er \nplant near Pleasanton , California , became the first commercially licensed reactor to supply significant \npower to the electric grid. \n211 Duke Pow er Co. v. Carolina Envtl. Study Group , 438 U.S. 59, 89 (1978). 66 companions in tort . Altho"] [15.745503425598145, 16.33661651611328, "mnibus coverage \nto deal with future claims due to injury latency.215 \n \n212 Pub. L. No. 85-256 (1957). The Price\u2013 Anderson Act has been characterized as a congressional response \nto a \u201c lack of adequate avai"] [15.761151313781738, 16.334903717041016, "o be promulgated by the AEC.219 Such \nstandards were subsequently defined as a release related to a \u201csubstantial discharge or \ndispersal of radioactive material offsite \u201d that \u201chas resulted or will probably result in substantial \ndamages to persons o"] [15.748178482055664, 16.338354110717773, "tion was substantially changed by congressional \namendment .225 The mi nimum limits of private insurance had risen to $14 0 million , but, instead \nof a fixed amount of government financial assurance beyond that point, the basic core of protection i"] [15.754408836364746, 16.3319034576416, " process that sets strict limits on available damages.229 Or it could decide that \nmassive funding of radiation cleanup operations completely satisfied its statutory requirement \nto protect the public, even if some individuals a nd entities with p"] [15.751311302185059, 16.327869415283203, "ed until a later date\u201d) , and provide \nrecommendations of additional sources of funds, such as new revenue measures, to a ddress \npotential above -cap losses.231 It would be up to Congress, of course, to enact legislation to \nactually create the com"] [15.735566139221191, 16.34151268005371, "ntended a \ncomplete bar against punitives; others assert that the prohibition is effective only when the layers of \nprivate insurance and postincident assessments have been exhauste d, requiring the federal government to \nfill in any gap in coverage"] [15.742127418518066, 16.35129165649414, "the work, such as reporting \npotential issues to NRC staff when discovered during the course of an investigation, and the \nOffice of Investigations can assist staff in reviewing matters of regulatory concern, but its \nprimary interest is in law enfo"] [15.754945755004883, 16.31000518798828, "ensed facility that poses an \nactual or a potential hazard to public health and safety, property, or the environment. \u201d242 \nAn example of an IIT causal investigation involved the June 2011 fire and associated power loss \nto certain systems at the For"] [15.744795799255371, 16.32928466796875, "e being one of the oldest congressionally created frameworks for \nassessing responsibility following a disaster , actual experience with Price \u2013Anderson is limited \nin this regard. It has been reported that the insurance pool facilitated by the a"] [15.748991966247559, 16.351634979248047, " as \u201ca little judicial jiu -jitsu,\u201d the plaintiffs then seemed to embrace the \ndefendants \u2019 theory by disclaim ing any effort to prove that a Price\u2013Anderson nuclear incident \nhad occurred and instead argued that the verdict should stand because i"] [15.731758117675781, 16.37818145751953, " program or \nwho will pay for it. Second, there is no requi rement that the president submit a proposed plan \nin advance of a nuclear crisis that might involve tens of billions of dollars \u2019 worth of losses and \nwidespread calamity . The 1988 amend"] [15.710988998413086, 16.391456604003906, "ntangible losses (such as for pain, suffering, \ndisfigurement, or emotional distress ) should be allowed only under narrowly defined \ncircumstances and, when available, the amounts strictly controlled . A more traditional tort- like \napproach woul"] [15.726068496704102, 16.2576847076416, "in response to these threats unexpectedly triggers severe illnesses in a substantial \nproportion of recipients , causing both significant injuries and widespread economic disruption, \nwith a latency period that is long enough to allow large numbers "] [15.723416328430176, 16.253816604614258, " resulted in a major federal effort, as \nPresident Gerald Ford put it in March of that year when making a request to Congress for \nfunding, to \u201cinoculate every man, woman and child in the United States. \u201d258 The proposed \nstrategy w as for the federa"] [15.745621681213379, 16.271846771240234, "ndant in any action against a participant. Because the federal courts would have \nexclusive jurisdiction over swine flu vaccine \u2013related claims, cases originally filed in a state \ncourt would be removed to federal court. \nSwine flu vaccine \u2013related"] [15.7461576461792, 16.272005081176758, "ries, is arguably one such exercise in judgment. \n265 28 U.S.C. \u00a7 2675(a). \n266 28 U.S.C. \u00a7 2401(b); DuBose v. Kansas City S. R. Co. , 729 F.2d 1026, 1030 (5th Cir. 1984) . 80 months to settle the claim or deny it .267 And, if denied, the claimant "] [15.749902725219727, 16.2662296295166, " \n267 28 U.S.C. \u00a7 2675(a). \n268 28 U.S.C. \u00a7 2401(b). \n269 Pascale v. United States , 998 F.2d 186, 188 (3d Cir. 1993). \n270 28 U.S.C. \u00a7 2402. \n271 28 U.S.C. \u00a7 2678. \n272 Pub. L. No. 94-380. \n273 Pub. L. No. 94-380. \n274 Pub."] [15.740097999572754, 16.255451202392578, ", Civil Division, developed \nprocedures as claims began to be filed . The procedures were revised as \nthe claims workload increased . At the time of our review, the \nadministrative procedures for processing swine flu claims had not been \ndocumented "] [15.735459327697754, 16.17123794555664, " and soreness during the first day or two after vaccination \u201d \nwould be \u201chighly unlikely. \u201d285 The consent form itself simply noted that \u201cmost people will have \nno side effects from the vaccine, \u201d although some people (presumably everyone outside of "] [15.729747772216797, 16.255659103393555, "imately \nsurvived appellate scrutiny.294 \nAs the litigants were engaging in extensive discovery in the MDL proceeding, in June 1978 , HEW \nSecretary Joseph A. Califano Jr. described a new policy under which GBS claimants need not \nprove negligen c"] [15.732876777648926, 16.249746322631836, "toid arthritis , all common complaints in claims received \nby HEW ) had resulted would still need to prove that the facts of the case supported a liability \nstandard available to the plaintiff under the appropriate state law where the incident occur"] [15.698041915893555, 16.2330322265625, "ng Office, 1981 . \n301 U.S. General Accounting Office, 1981 , Enclosure I, p. 5. \n302 By late March 1979, there were 1,045 GBS claims among the total of 3,694 and 276 GBS lawsuits out of \n464 ( Office of Technology Assessment, 1979, p. 100). \n303"] [15.746795654296875, 16.26810073852539, "l Research Council, 1985 , Table 6.1, p. 91. As of December 15, \n1983, 4,152 claims had been filed, with 34 then pending. Given that 4,179 claims would ultimately be \nfiled, the 61 claims that , by the end of 1983, were either still pending or "] [15.73998737335205, 16.27083969116211, "port: \nManufacturers have become concerned not only with the problems of time and expense \n[in dealing with the civil tort system], but with the issue of the availability of affordable \nproduct liability insurance that is used to cover losses relat"] [15.740803718566895, 16.26710319519043, "ort system. \u201d\n317 Tort \nlawsuits were still possible, but the NCVIA required every claimant (which could include the \nrecipients of the vaccine or their families) to first seek compensation through an administrative \nprogram (described in the act as "] [15.732584953308105, 16.256187438964844, "ong as certain specific conditions were present, the claimant would have no \nneed to prove causation during the administrative process. The VICP table described, for each \nvaccin e covered by the program, known adverse side effects and the time per"] [15.735634803771973, 16.26534080505371, " have been cause d by other, defined \nillnesses or factors and the injury is demonstrated to have met the other requirements of Section 2111 \nand the Table, the injury is to be deemed to be vaccine -related \u201d); Bunting v. Sec\u2019y of Dep\u2019t of Health & "] [15.735123634338379, 16.256805419921875, "ensated claims would have to show that the action was brought in \u201cgood \nfaith \u201d and with a \u201creasonable basis \u201d for the claim in order to recover attorneys \u2019 fees. \nIt is important to keep in mind that most of the special rules regarding the types of "] [15.741536140441895, 16.264183044433594, "ld be outside of the act\u2019s limitations on \nliability. But even though the health care provider would not receive the liability protections, \nclaims agains t the provider would still have to be submitted to the mandatory administrative \nclaim process "] [15.721585273742676, 16.26729965209961, " or administrator, but instead would be \nthe trust fund , which is already financed by the per -dose excise tax. \nPart of the rationale behind creating the administrative compensation program was to address \na large number of claims that would othe"] [15.744427680969238, 16.25274658203125, " m \ndisorders in children led to the establishment of an Omnibus Autism Proceeding within the Court of Federal Claims to consolidate the processing of more than 5,400 autism -related cases. \nUltimately , six test cases presenting two different the"] [15.771984100341797, 16.23200798034668, "njuries Resulting in Autism \nSpectrum Disorder or a Similar Neurodevelopmental Disorder , Autism Master File, Office of Special \nMasters, U.S. Court of Fede ral Claims. \n347 HHS, 2014 . Dismissals include adverse determinations by specia l masters ("] [15.73947525024414, 16.261695861816406, "ess . Many \nhad their roots in claims involving the relationship between vaccines and autism, usually turning on the question of whether adulterants or contaminants in the injected materials were \nresponsible for the alleged injuries. The argument w"] [15.7144775390625, 16.233909606933594, "n $20 0 million defending such claims.358 \nSuch expenditures were likely to be prime motivators behind a few extra sentences added at the last minute to HSA, sweeping legislation en acted in the shadow of 9/11.\n359 Applying to both \npending and fut"] [15.680889129638672, 16.198932647705078, "as achieved for the more common and somewhat milder form two \ndecades later.363 \nSimilar efforts were being conducted in other countries, and, by 1980, the World Health \nOrganization (WHO) formally declared that the disease had been eradicated from t"] [15.685754776000977, 16.199853897094727, "ior -level \nexercise ( \u201cDark Winter \u201d) at Andrews Air Force Base that simulated a bioterrorism at tack \ninvolving simultaneous releases of smallpox at shopping malls in three U.S. cities. The \nparticipants concluded that such an attack could signifi"] [15.663714408874512, 16.16747283935547, " event of a terrorist attack.374 That policy shifted \nmarked ly over the following year, the result of considerable debate within President Bush \u2019s \nadministration about whether the risk of a terrorist attack involving smallpox had increased to \nthe "] [15.692626953125, 16.20162010192871, "ing the location of newly discovered infected people . \n375 Weisberg, 2008; Stevenson and Stolberg, 2002. \n376 Broad, 2002; \u201cThe Expanding Smallpox Plan,\u201d 2002 ; Weisberg, 2008. \n377 Stevenson and Stolberg, 2002. \n378 During a House session on No"] [15.702366828918457, 16.225727081298828, "inancial exposure of vaccine manufacturers, it could have simply indemnified \nthe producers from potential liability and reimbursed them for any trial awards or \nsettlements.385 Instead, it was claimed, making the federal government the sole target o"] [15.709705352783203, 16.226985931396484, "program !to increase the nation \u2019s bioterrorism preparedness. \u201d388 Under \nHSA, the IOM suggested, claimants alleging adverse reactions would be limited to lawsuits \nbased on theories of negligence in manufacturing or administration, and, as a result "] [15.710156440734863, 16.22735023498535, "ment \nand are licensed and are doing everything properly, negligence would not \napply.391 \nThe fallback position for such a result would be a mix of health insurance and workers \u2019 \ncompensation: \nSo then the next step is how do these individuals get"] [15.712665557861328, 16.223133087158203, "ith striking speed, and , on the same day (April 11), the Senate passed the bill by unanimous \nconsent and the House voted passage without objection.394 When President Bush signed t he act \ninto law two weeks later, a type of no -fault compensation "] [15.749457359313965, 16.254676818847656, "er existing 42 U.S.C. \u00a7 233(a) , describing USPHS liability for damages related to \npersonal injury, including death, resulting from the performance of \nmedi cal, surgical, dental, or related functions, including the conduct of \nclinical studies o"] [15.72143840789795, 16.239057540893555, "t of 1992, Pub. L. No. 102-501. \n402 HSA \u00a7 304(c), amending PHSA, \u00a7 224(p)(3). \n403 HSA \u00a7 304(c), amending PHSA, \u00a7 224(p)(2)(B). The protections would also apply if the administrator had \nreasonable grounds to believe that the recipient was in "] [15.69094467163086, 16.196821212768555, "n January 24 not only set in motion the liability protections contained in HSA; it \narguably expanded their scope beyond what the legislation described.409 As part of the \u201cPolicy \nDeterminations \u201d in the declaration, the Secretary stated that determ"] [15.703373908996582, 16.2187442779541, "spect of program design involves the \ndevelopment of a smallpox vaccine injury table that, like the one used for the VICP, would \nidentify the types of injuries, illnesses, and other conditions that would be presumed to have \nresulted from primary ad"] [15.710803985595703, 16.223133087158203, " total ceiling that matched the amount that SEPPA authorize s for death cases.423 In \ninstances in which the claimant was actually the survivor of an eligible person , that dea th \nbenefit would be calculated in a manner modeled after the approach u"] [15.70368766784668, 16.205020904541016, "ing in the vaccination \ncampaign, if one of its employees had been inoculated elsewhere and inadvertently was the \nsource of a secondary transmission.432 The issue of liability protection for th ose falling outside \nof a strict official , agent , or "] [15.71642017364502, 16.23008155822754, "oth Section 304 and SEPPA remain on the books and can be triggered as \ncircumstances require . However, although the liability protections of Section 304 could be \navailable in advance of an actua l attack (any declaration of a potential public he"] [15.698564529418945, 16.215953826904297, "d. Reg. 61869\u2013 61871 \n(Oct. 17, 2008). 108 in December 2015 and remains in effect until the end of 2022.440 Given the more -expansive \ndefinitions of what constitutes covered countermeasures in PREPA and the far greater powers \nafforded to HHS to s"] [15.720928192138672, 16.250999450683594, "p the benefits of a fully featured compensation program (operated at \ngovernment expense) that would siphon off the vast majority of claims that would otherwise \nmanifest themselves as costly lawsuits (regardless of whether compensated) spread acros"] [15.698493003845215, 16.260438919067383, "ry litigation . Presumably, the autism spike was totally unexpected by those drafting the \nlegislation and those overseeing the day -to-day operation of the claiming process. \nEpidemiologists arguably have a fairly precise view of the most likely in"] [15.710323333740234, 16.265146255493164, "h risks associated with receiving a particular \ntype of vaccination . It is unlikely, for example, that parents weighing the risks and benefits of \nchildhood vaccines take into account the compensation rules, inner workings , and annual \nstatistics o"] [15.699380874633789, 16.4205379486084, " types of mass \nadverse events. A wide range of policy choices are represented in the case studies, some \naffecting the behavior of actors only before the event unfolds (such as with mandatory \ninsurance coverage), and some coming into play only "] [15.790385246276855, 16.313417434692383, "ees \nAgency adjudication OSLTF, although potentially also \nparties that the agency later \ndeem s responsible \nAgency -initiated \nrecovery litigation Parties deemed responsible by \nagency determination \nModified tort litigation Parties deemed r"] [15.76767349243164, 16.266721725463867, "as well as its caps on \nfinancial exposure and modifications to ordinary tort litigation , apply to any party that might \nconceivably be liable for the event. The funds for compensation would come from Price \u2013\nAnderson \u2019s mandated mix of private i"] [15.74288272857666, 16.26593017578125, "mmunity on manufacturers of \nspecified types of vaccine s, but instead markedly narrow ing the theories of liability that could \nbe used against them . Claims for compensation advanced against those manufacturers (as well \nas vaccine administra"] [15.767170906066895, 16.30931282043457, "ntly inadequate .443 The story behind OPA is not as \nstraightforward ; developing a comprehensive and rapid response to immediate needs following \na spill was arguably a motivation of at least equal importance to industry protection, but the \n "] [15.740440368652344, 16.296804428100586, "s as \nDefendant Caps on \nAggregate \nLiability Funding for \nLosses \nSpread \nAcross Other \nSources Eliminate or \nLimit the Use \nof Strict \nLiability Punitive \nDamages \nProhibited Other Limits on \nBases for \nRecovery, \nAvailabl e \nDamages , or \nAttor"] [15.754561424255371, 16.312541961669922, "e trier of fact, the availability of the \noften extremely powerful discretionary- act defense , and a requirement that the claim be \npresented to a federal agency for consideration prior to filing suit (a prohibition on strict -\nliability theories"] [15.735616683959961, 16.289913177490234, "ld pay claims under the NCVIA\u2019 s administrative compensation scheme . \nAt this point , the focus of the protections in Table 8.3 shifts from limiting the exposure of a \nfavored party to restrictions on individual claims . One approach involves alte"] [15.756123542785645, 16.28551483154297, "s are clearly off the table for \nMontreal, Price \u2013Anderson , the Swine Flu Act , and the smallpox vaccine acts, although there is \nnot yet universal agreement on the question of whether OPA permits punitive damages if they \nwere available under gen"] [15.750382423400879, 16.243572235107422, "ard or EPA) . \n \n447 On the former assertion, see, e.g., Eisenberg et al., 1997 . On the latte r, see, e.g., Exxon Shipping Co. v. \nBaker , 554 U.S. 471 (2008). \n448 Punitive damages are unavailable to claim"] [15.694817543029785, 16.420124053955078, "king the payment at the time might seek to \nrecover the sums advanced down the line . In addition, a requirement that a claimant must first \nturn toward an administrative compensation scheme can go far toward siphoning off lesser-\nvalue cases that"] [15.802689552307129, 16.319015502929688, "l PRP \ndetermination of \nclaims \u2022!The responsible party is \nalready identified as a \nresult of agency \ndetermination . \n\u2022!The responsible party is \nstrictly liable . \n\u2022!A wide range of damages \nis available, including pure economic loss . \n\u2022!The cla"] [15.734053611755371, 16.261327743530273, "sible \ndespite a federal \ndefendant . \n\u2022!Strict liability would be \npresumed for claims \ninvolving GBS. United States (general fund) \nNCVIA: Agency \nclaim resolutions Formal adjudication of \nclaims against the \nUnited States \u2022!There is no need to"] [15.743882179260254, 16.29668426513672, "lematic, the value of such a presumption cannot be \noverstated.450 But many claims advanced with the benefit of a presumption nevertheless fail \nbecause the claimant cannot or will not (or does n ot understand the need to) provide needed \ndocumentati"] [15.801278114318848, 16.30282974243164, "iffs in civil litigation instead . \nSpeed of Determination \nDespite the fact that comprehensive data on time needed to reach a decision regarding \nresponsibility in these frameworks were not always available, it is probably safe to say that the \nfas"] [15.802096366882324, 16.310850143432617, "\nOPA: Agency -initiated \ncivil reimbursement \nactions Civil lawsuit brought by an \nagency against a PRP for \nclaims previously paid For claimants : Not relevant because individual \nclaims would already have been reso lved \nadministratively \nFor "] [15.811388969421387, 16.296478271484375, "ancial liability for \ndamages and (in most instances) recover y costs might provide considerable incentive to accept \nthe result except in instances of clear error. \nOPA envisions a relatively simple but somewhat more adversarial process for clai"] [15.797032356262207, 16.228435516357422, "al significance for the party \nbecause a future ac tion to recover the administrative award is certainly possible). \nOnce third -party neutrals do get involved , time to reach a decision increases markedly. A claim \npresented as part of the NCVI"] [15.750825881958008, 16.37501335144043, " of control or opportunity to participate in the \ndecisionmakin g.453 The illustrative frameworks we have reviewed differ markedly in the \nprocedures in place to provide parties with this sense of fairness. Measured by the appearance \nof impartial"] [15.781118392944336, 16.332626342773438, " \n453 See, generally, Longan, 1995, pp. 298\u2013 300. 133 Table 8.7. Fairness-Related Features of the Responsibility Determination Process\nFramework and \nActivity Process for \nAssigning \nResponsibility Rights and Limitations of \nParties Oppo"] [15.811344146728516, 16.3558349609375, "es without \nspecific regulatory authority . \nFor PRPs: Not directly relevant \nfollowing substitution of the \nUnited States as defendant -payor For claimants : Can request \nreconsideration ; if a claimant \nremains unsatisfied , that \nclaimant can pr"] [15.770641326904297, 16.26076889038086, "view \nFor PRPs: Not directly relevant \nfollowing substitution of the \nUnited States as defendant -\npayor \n \nLawsuits filed by those alleging personal injuries initiated after the completion of the \nadministrative claim resolution processes under t"] [15.7687349319458, 16.259944915771484, "al industry . . . . Lawmakers designed vaccine court to favor \npayouts, but the government fights legitimate claims and fails its obligation to publici ze \nthe court, worried that if they concede a vaccine caused harm, the public will react by \nskipp"] [15.828258514404297, 16.227399826049805, "nd the NCVIA because any compensation to be paid actually comes out of the \nexisting trust fund , not the pockets of any private party. That said, the situation for responsible \nparties under OPA and the NCVIA (defined here as the source of the di"] [15.830707550048828, 16.30565071105957, "n erroneous decision on a claim . Providing at least the opportunity for a responsible party to \nintervene in an earlier administrative process in which a claimant is seeking compensation from \nthe fund !a proceeding in which the responsible part"] [15.698307991027832, 16.408191680908203, "ay in accepting that \nresponsibility could have adverse consequences.457 \nLeakage to Civil Liti gation \nAnother area we wish to explore in this chapter involves the degree to which the frameworks \nfully address the responsibility -assignment need"] [15.75047779083252, 16.300369262695312, "cine claims , but there have been many attempts to \nadvance autism and thimerosal lawsuits . \nSmallpox \nvaccine acts Low There is little reason to go outside the act. \nPrice \u2013Anderson has also had low leakage historically because the definition of w"] [15.690747261047363, 16.44252586364746, "tages compared to having their legal relationships determined \nby traditional tort liability.458 In the discussion that follows , we describe some of the rationales \nthat have been offered in support of these outcomes . \nTable 8.9. Potential Consequ"] [15.73617172241211, 16.299606323242188, "ater Montreal , facilitate maritime activities involving oil propulsion or \nproduction or trade by protecting shipowners and certain other parties from unlimited liability \nthrough OPA, encourage commercial nuclear power by facilitating insurance pro"] [15.70200252532959, 16.391780853271484, " \n459 Arguably , the Black Lung Benefits Act of 1972 could also be considered a type of framewo rk with \nretrospective application. One of its provisions is that the last coal mine in which the worker was 142 r"] [15.751054763793945, 16.32679557800293, "ments of national policy to assist in a n \nentirely governmental task \u201d in which the \u201cgovernment sets policy, makes decisions, and controls activities \nand circumstances \u201d (H.Rept 98-124, Part 1 [1983] ). \n461 See, e.g., Popper, 1998, p. 134: The "] [15.74301815032959, 16.33965301513672, " U.S. companies would be at a competitive disadvantage in the global marketplace in \nthe conduct of these risky but important activities without the benefit of similar limitations.467 \nPrice increases would be one negative result of the reduced level"] [15.744711875915527, 16.339393615722656, "situation, although they could provide bene ficial \ncompetition in a stronger U.S. market. 144 caps argue that , although smaller companies (or U.S. companies generally , if the competition \nthreat is global) might be forced to engage in other ac"] [15.734895706176758, 16.359516143798828, " \n471 See, e.g., Thompson, 2010: \nIf we make companies responsible for 10 0 percent of damages, they might pay more on \nboth safety measures and insurance . . . . That could discourage smaller start -ups and raise \nthe cost of exploration and drilli"] [15.91699504852295, 16.243881225585938, "le for injury claims below the current threshold of about $153,000, thus \neliminating the difficult task of proving negligence. Absent narrowly drawn circumstances, \nvessel and oil production facility owners and operators are deemed responsible unde"] [15.732776641845703, 16.293296813964844, "e smallpox vaccine acts), and, although the third (the NCVIA) offered a \nform of strict liability in an administrative setting, it applied to only a narrow set of \ncircumstances , and the money to pay claims came not from the manufac turer or distrib"] [15.758562088012695, 16.386871337890625, "n the injuries and times of onset are listed in the programs \u2019 respective vaccine tables. \nFrom a claimant \u2019s perspective, the flip side of these potentially positive features is, of course, \nthe same liability limitations that work to the benefit "] [15.708953857421875, 16.281091690063477, " \n481 See, e.g., La Fetra, 2003 (arguing that the NCVIA , Biomaterials Access Assurance Act of 1998, a nd \nGeneral Aviation Revitalization Act of 1994 constitute the \u201cthree narrow areas in which Congress has \n"] [15.706578254699707, 16.43905258178711, "t produced \nthe catastrophe is repeated daily. In addition, existing procedures for resolving disputes might \nnot be well suited to handling the flood of claims that could arise following a major disaster, \npossibly generating substantial legal an"] [15.697504043579102, 16.407421112060547, "ular industry , product, or activity. At least within the confines of this \nparticular report, we are not in a position to opine about whether such concerns are valid ones \nor whether the underlying issues in play (such as the promotion of childho"] [15.723346710205078, 16.38921546936035, "p. 524 ( \u201chighly individualized and very generous tort system in the United \nStates . . . remains the most prominent system for awarding financial compensation to victims \u201d of human-\ncaused disasters); and Rabin and Bratis, 2006, p. 353 ( \u201cVirtua"] [15.6995210647583, 16.387351989746094, "l either look elsewhere to adjudicat e their disputes or refrain from conducting \nthe types of activities the alternative framework was designed to support . \nCreating a Viable Alternative to Traditional Tort \nWhat does it take to put a comprehens"] [15.70904541015625, 16.388084411621094, "n the aftermath of the 9/11 disaster has been told \nmany times, but it too reflects a period in U.S. history when the nation was essentially on a war \nfooting.491 Had the requisite political will to move the act from a blank sheet of paper to fully \n"] [15.73572063446045, 16.37089729309082, "on Fund), and 153 of liability shield without creating any sort of offsetting opportunities for those who would find \nthe courthouse door at least partially shut when looking for full redress of their grievances. But, \nfor the most part, the poten"] [15.727757453918457, 16.346445083618164, "ct of 2002 do not prohibit or \ncap tort claims , although the former substitutes the United States as the defendant while the latter created \nan exclusive federal cause of action for terrorism -related claims (it should be noted that the Atomic \nTest"] [15.693646430969238, 16.22478675842285, "lm of the possible . Similar problems with planning \nahead can be found in the Swine Flu Act saga, when an unexpected surge in GBS claims \noverwhelmed an already- stressed administrative claim handling program that had been largely \ndeveloped on the"] [15.70439338684082, 16.421794891357422, "e \nof a f avored party without including some sort of corresponding compensation program . In the \nshadow of a looming national emergency or when it is likely that the restrictions would \nadversely affect few individuals or businesses , widespread "] [15.711380958557129, 16.386741638183594, "s often because their designers did \nnot fully flesh out necessary details in their haste to change the status quo or because they did \nnot consider how the program \u2019s features would play out under real-world conditions and when \ninvolving actual, r"] [15.789058685302734, 16.30342674255371, "ext of a dramatic and unforeseen spike in demand, with perhaps \ntwo exceptions. \nFirst was Price \u2013Anderson \u2019s experience with TMI . The act was designed from day 1 to act as the \nprimary foundation for addressing legal questions arising from a major"] [15.680130004882812, 16.446374893188477, " when subjected to stresses arising not from the \nmost likely worst -case scenario (the one imagined during program design) but instead from the \nworst -possible -case scenario . A type of red-team analysis might be required, one that forces \ndesi"] [15.746607780456543, 16.378875732421875, "on \nbenefits would be a sufficient and no-cost (at least to PRPs ) avenue for satisfying claimants \nturned away from courthouse doors, underscores the dangers of ignoring the problem. \nIt is also important to make sure that the program can oper"] [15.671228408813477, 16.455738067626953, " purposes . \nAdministrators need this sort of general road map to help guide their design decisions, judges \nrequire it as well to more accurately interpret how the law should be app lied, and the public at \nlarge is no less deserving of legislative"] [15.654961585998535, 16.472747802734375, " justice, on the other hand, would seek to make the victim \nwhole via a \u201cmore fulsome process to ensure that the claimant really is a victim and that the person \nagainst whom a claim is made really is a responsible party \u201d (p. 586). \n505 Price\u2013 And"] [15.699820518493652, 16.429718017578125, "ations? Parties will not hesitate to bypass the framework in \nfavor of alternative approaches that they perceive to be fairer, quicker, more certain, capable of \ngreater finality, or less expe nsive . What is to stop the local courts from being clog"] [15.647194862365723, 16.434043884277344, " correction s to fix ill -considered language is not a process \nthe public welfare can afford. \nLooking Forward \nIt is worth reflecting how fortunate this country was to have some of the best legal minds in \nplay when drafting ATSSSA legislation f"] [15.700871467590332, 16.40899658203125, "ank page .511 \nIn that light , essentially three options are available to policymakers in the context of planning \nfor legal determinations following a disaster. First, they could cross their fingers and hope that \nwhat is already in place will work "] [15.682400703430176, 16.382110595703125, "r 11th Victim \nCompensation Fund of 2 001 would never have made it out of committee before the tragic \nevents of that day unfolded . The problem is that the window of opportunity will be short, and \nlittle time would be available for any sort of tho"] [15.62264347076416, 16.204269409179688, ",\u201d October 7, 1987. As of March 31, 2016: \nhttps ://www.asme.org/getmedia/3663519d -0882- 4b7e -ab6c -f036b080cfdd/ \n128-Vallecitos -Boiling -Water -Reactor -1957.aspx \n\u201cAmtrak Bill Clears in Final Hours,\u201d CQ Almanac 1997, 53rd ed., March 22\u201328, "] [15.656049728393555, 16.176319122314453, "p://www.nytimes.com/2002/07/07/us/ \nus-to-vaccinate -500000- workers -against -smallpox.html \nBroad, William J., and Judith Miller, \u201cGovernment Report Says 3 Nations Hide Stocks of \nSmallpox,\u201d New York Times , June 13, 1999. As of September 12,"] [15.630430221557617, 16.144508361816406, ": \nhttps://www.citizen.org/article/ \nletter -transportation -secretary -rodney -slater -opposing- corporate- welfare -and-liability \nCohen, Henry, Making Private Entities and Individuals Immune from Tort Liability by Declaring \nThem Federal E"] [15.834339141845703, 16.2354679107666, ". As of July 22, 2017: \nhttps://www.uscg.mil/foia/docs/DWH/2886.pdf \nDirector, NPFC \u2014See Director, National Pollution Funds Center. \nDupree, James H., president, BP Exploration and Production, \u201cDeepwater Horizon,\u201d letter to \nThomas Morrison, chi"] [15.636636734008789, 16.21159553527832, " Journal of Empirical Legal Studies , Vol. 6, No. 4, December 2009, \npp. 637\u2013 686. \nGarvin Law Firm, \u201cFlorida Supreme Court to Rule on Medical Malpractice Damage Caps ,\u201d \nNovember 21, 2011. As of Apr il 25, 2016: \nhttp://www.garvinlegal.com/blog/c"] [15.630688667297363, 16.199199676513672, "//www.washingtonpost.com/local/trafficandcommuting/ \namtrak -faces-95-million -hit-as-congress- celebrates -new-highway- bill/2015/12/10/ \n1a33379c -9a8f-11e5- 8917- 653b65c809eb_story.html \nHarvey, Steve, \u201cCalifornia\u2019s Legendary Oil Spill,\u201d Los A"] [15.639883995056152, 16.22765350341797, "rticles/ \nlaw-clouds -compensation -for-amtrak -crash -victims -1431636543 \nKlein, Jerome O., and Charles M. Helms, \u201cStrengthening the Supply of Routinely Administered \nVaccines in the United States: Progress and Problems \u20142005,\u201d Clinical Infectiou"] [15.629870414733887, 16.20293617248535, "e Safety and Health, Coal Mine \nSafety an d Health, Accident/Illness Investigations Procedures , Handbook PH11 -I-1, June 2011. \nAs of July 22, 2017: \nhttps://arlweb.msha.gov/READROOM/HANDBOOK/PH11-I- 1.pdf \nMinority staff , Committee on Governm"] [15.6255464553833, 16.204225540161133, ", \nNTSB/AAR -14/01, June 24, 2014a. As of Jul y 22, 2017: \nhttps://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1401.pdf \n\u2014\u2014\u2014, \u201c NTSB Finds Mismanagement of Approach and Inadequate Monitoring of Airspeed Led \nto Crash of Asiana Flight 21"] [15.646930694580078, 16.18580436706543, "org/futures/globalprospects/37944611.pdf \nOrin, Deborah, \u201cBush: All Americans Are Troops vs. Terror,\u201d New York Post , Nov ember 9, 2001. \nAs of Dec ember 8, 2014: \nhttp://nypost.com/2001/11/09/bush -all-americans- are-troops -vs-terror/ \nOrnste"] [15.610547065734863, 16.16193962097168, ", New \nYork: Springer, 2006 , pp. 303\u2013 360. \nRamseur, Jonathan L., Oil Spills in U.S. Coastal Waters: Background, Governance, and Issues for \nCongress , Washington, D.C.: Congressional Research Service, Report 7-5700, Apr il 30, 2010. \nAs of July "] [15.625997543334961, 16.199626922607422, "m/2014/01/20/asiana -flight- 214-passengers -sue-boeing/ \nSchleifstein, Mark, \u201cFederal Judge Dismisses Most of Remaining Katrina Damage Lawsuits,\u201d \nTimes -Picayune, Dec ember 27, 2013 (updated March 2, 2017) . As of July 28, 2014: \nhttp://www.n"] [15.629615783691406, 16.17757225036621, "ays Out Plan on Smallpox Shots; Military Is First,\u201d New York Times , Dec ember 14, 2002. As \nof November 1, 2014: \nhttp://www.nytimes.com/2002/12/14/us/ \nthreats -responses -vaccinations -bush- lays-plan- smallpox -shots- military -first.html \nS"] [15.821688652038574, 16.280651092529297, "Pollution Funds Center, \u201cRE: J05003 -0021,\u201d letter to IMC Shipping , October 15, \n2013a (copy on file with the authors) . \n\u2014\u2014\u2014, National Pollution Funds Center, \u201c Oil Pollution Act (OPA) Frequently Asked Questions ,\u201d \nOctober 22, 2013b (last modifie"] [15.614189147949219, 16.182764053344727, "chair, U.S. House of Representatives Committee on Interstate and Foreign \nCommerce Su bcommittee on Energy and Power, and Bob Eckhardt, chair, U.S. House of \nRepresentatives Committee on Interstate and Foreign Commerce Subcommittee on \nOversight and "] [15.626811981201172, 16.203248977661133, "r Accident Consequences , NUREG/BR -0359, Rev. 1, Dec ember \n2012b. As of May 2, 2017: \nhttps://www.nrc.gov/docs/ML1234/ML12347A049.pdf \n\u2014\u2014\u2014, \u201c Backgrounder on the Three Mile Island Accident ,\u201d February 2013 (last reviewed and \nupdated December "] [15.692468643188477, 16.457082748413086, ".S. civil litigation system might not always be the most effective and ef\ufb01cient means for assigning \nresponsibility following a catastrophic event and providing just compensation to large numbers of affected individuals and entities. Some have argued"] [11.40090274810791, 17.876449584960938, "CORPORATION\nModeling the Economic \nImpact of a California Workers\u2019 Compensation Formulary\nAndrew W. Mulcahy, Simon Hollands, Erin L. Duffy, Aaron Strong, \nBarbara O. WynnLimited Print and Electronic Distribution Rights\nThis document and tradem"] [11.341113090515137, 17.67721939086914, "g in a wide range of policy domains, including civil and criminal justice, infrastructure protection and homeland security, transportation and energy policy, and environmental and natural resource policy. \nThis report also drew on the expertise in RA"] [16.857566833496094, 20.263208389282227, "......... 8 \t\r \u00a0\nData Source ............................................................................................................................................... 8 \t\r \u00a0\nData Source Limitations and Discussion ............................."] [16.841733932495117, 20.245031356811523, "cian Dispensing Module ............................................................................................................. 32 \t\r \u00a0\nGeneric Substitution Module ................................................................................"] [16.852420806884766, 20.25687599182129, " S.1. Modeling Steps ............................................................................................................ xi \t\r \u00a0\nFigure S.2. Model Output by Step, 12-Month Utilization in Terms of Systemwide \nPrescription Bill Lines ........"] [16.87297248840332, 20.281518936157227, ". 22 \t\r \u00a0\nTable 3.5. Share of Volume and Spending Meeting Special Fill Criteria and Listed as \nSpecial Fill Drugs, 2014 WCIS Data .................................................................................... 23 \t\r \u00a0\nTable 3.6. Share of Volume"] [16.90501594543457, 20.30841636657715, " (IMR) appeals. \nAssembly Bill (AB) 1124 requires the Division of Workers\u2019 Compensation (DWC) in \nCalifornia\u2019s Department of Industrial Relations to implement a drug formulary no later than July 1, 2017. The legislation intended that the formulary f"] [16.89689826965332, 20.298246383666992, "escriber decisionmaking and, ultimately, prescription fills and spending. The magnitude and direction of the adjustments are informed by a review of the literature on the effects of formularies and utilization management tools on prescription drug vo"] [16.859882354736328, 20.263822555541992, " third module reduces prescription fill volume for drugs subject to PR after shielding prescription fills subject to special and perioperative fill rules (as in the first module). Some of the reduction in volume is shifted to preferred drugs in the s"] [16.852426528930664, 20.25938606262207, "p two therapeutic classes by total 2014 spending were opioid analgesics and \nnonsteroidal anti-inflammatory drugs (NSAIDs). These two classes accounted for 39 percent of California WC payments and 48 percent of both California WC prescription bill li"] [16.83403778076172, 20.248384475708008, "alculating the maximum amounts that Medicaid programs pay for certain multisource drugs. In most cases, these changes reduce the maximum amount paid for drugs based on the previous formula. Because the WC fee schedule is based on MediCal prices, and "] [16.853857040405273, 20.258569717407227, "ical prescription bill data subject to modeling steps and \nassumptions described above. \nThe change in WC employer costs in the 12 months immediately following the full \nimplementation of the formulary is by assumption half of the reduction in medic"] [16.881027221679688, 20.28421974182129, "S guidelines, and the formulary listing is publicly available at no cost. In terms of changes in per-prescription frictional costs, it is not clear how insurers/pharmacy benefit managers (PBMs) will implement PR, although this process is similar to \u201c"] [16.9058895111084, 20.30848503112793, "report. \nRosalie Malsberger provided invaluable programming assistance. We would also like to thank our peer reviewers, Frank Neuhauser (UC Berkeley) and Christine Buttorff (RAND). \n \n xvii Abbreviations \nAB Assembly Bill \nACOEM American College "] [16.90485191345215, 20.30733299255371, "ical treatment for work-related injuries and illnesses that \nincludes both physicians and other ancillary providers. \nThere must be a written agreement between the employer \nand the provider, and the provider must agree to provide \ncare consistent wi"] [16.909746170043945, 20.311756134033203, "al properties and clinical use. Drugs assigned \nto the same therapeutic class are often therapeutic \nalternatives. \ntherapeutic equivalent This term refers to FDA-designated \u201cAB\u201d substitutable versions of the same active ingredient (that is, drugs t"] [16.89369773864746, 20.296714782714844, "r therapies, an injured worker is entitled to pharmaceuticals that are \nindicated for his or her injuries and prescribed and dispensed consistent with the MTUS guidelines. However, there have been concerns over both the rising cost per claim for phar"] [16.920289993286133, 20.321043014526367, "(PR)3 and other utilization management \ntools to confirm medical necessity and encourage appropriate use. Insurers often conduct drug utilization review to monitor prescription activity relative to the formulary. When implemented in conjunction with "] [16.9066162109375, 20.30791473388672, "ith an independent six-member Pharmacy & Therapeutics (P&T) committee. These updates are exempt from rulemaking and may be implemented through orders posted on the DWC website. \nIn addition to the Labor Code revisions, AB 1124 expresses legislative "] [16.863479614257812, 20.266162872314453, "ent and update the formulary, and made recommendations for the formulary implementation policies and updating process (Wynn et al., 2016). This report estimates the impacts of the formulary on the volume of and spending on prescription drugs, as well"] [16.82636260986328, 20.23038673400879, " developed five separate modeling steps (or \u201cmodules\u201d) that we apply sequentially to the \nbaseline data (Figure 1.1). These modeling steps incorporate the various provisions of the formulary, such as requiring PR for physician-dispensed prescriptions"] [16.838062286376953, 20.24898910522461, "stem assigns identifiers to specific drug products and is maintained by the U.S. Food and Drug\nAdministration (FDA). Physician\t\r \u00a0Dispensing\t\r \u00a0Module\t\r \u00a0\nGeneric\t\r \u00a0Subs titution\t\r \u00a0Module\t\r \u00a0\nProspective\t\r \u00a0Review\t\r \u00a0Module\t\r \u00a0\nBulk\t\r \u00a0Drug\t\r \u00a0Mod"] [16.872831344604492, 20.27893829345703, " and pharmacy-dispensed fills recorded as prescription bill lines. Each medical bill includes information on the injured worker and provider, diagnosis and procedure codes, the provider\u2019s charges, actual payments to providers, and codes explaining th"] [16.94802474975586, 20.343589782714844, " the drug ingredient or drug ingredient route \nof administration level into our NDC-level WCIS data. This step required several adjustments so that drug ingredients matched between the California WC drug listing and Truven\u2019s RED BOOK data, due to dif"] [16.829570770263672, 20.2384033203125, "for example, 5-mL \nincrements of volume for liquid and topical formulations)\u2014was almost always reported for pharmacy-dispensed fills but was often missing for physician-dispensed fills. We imputed quantity for physician-dispensed fills using a combin"] [16.856334686279297, 20.265594482421875, "iber would have written two prescriptions\u2014one for the initial four-day supply and another for the remaining 26 days. In reality some prescribers will not write the second prescription at all, while others may write a full 30-day prescription as the s"] [16.878631591796875, 20.2723445892334, "rescribed in conjunction with opioid and \nNSAID analgesics to control side effects from these drugs. \n\u2022 \u201cPsychotherapeutic agents\u201d includes primarily selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs"] [16.854019165039062, 20.25338363647461, "\t\r \u00a0\nSkin/Mucous\t\r \u00a0 Membrane\t\r \u00a0 Ag.,\t\r \u00a0Misc.\t\r \u00a0 4.79\t\r \u00a0 37,696\t\r \u00a0 4.33\t\r \u00a0\nAntihyperlipidemic\t\r \u00a0 Drugs\t\r \u00a0 4.34\t\r \u00a0 23,198\t\r \u00a0 3.88\t\r \u00a0\nCardiac\t\r \u00a0Drugs\t\r \u00a0 4.16\t\r \u00a0 56,919\t\r \u00a0 7.95\t\r \u00a0\nAntiemetics\t\r \u00a0 3.50\t\r \u00a0 12,059\t\r \u00a0 0.41\t\r \u00a0\nAntivirals\t\r"] [16.851123809814453, 20.25583839416504, "nsdermal. \n 15 \n Table 3 .3. Spending and Volume for the T op 20 Drugs by Volume, 2014 WCIS Data \nDrug Ingredient Form Route Drug Class Spending \n($millions) Bill \nLines Imputed \nStandard Units \n(millions) \nAcetaminophen/Hydrocodone Bitartrate "] [16.903818130493164, 20.305742263793945, "y equivalent to reference drugs and often less expensive, payers often encourage the use of generics to control costs. CA Labor Code Section 4600.1 requires dispensing of FDA-approved substitutable generics unless a generic is not available or the pr"] [16.8792724609375, 20.29100799560547, " implicitly recognizes physician in-office dispensing in Section \n4600.1 (dealing with generic drugs) and Section 5307.1 (dealing with the Official Medical Fee Schedule or OMFS). \nPhysician dispensing is facilitated by FDA-approved \u201crepackagers,\u201d wh"] [16.844139099121094, 20.25135040283203, "hysician-dispensed drugs account for more than half of total spending for most of these classes plus skeletal muscle relaxants. 0%\t\r \u00a010%\t\r \u00a020%\t\r \u00a030%\t\r \u00a040%\t\r \u00a050%\t\r \u00a060%\t\r \u00a070%\t\r \u00a080%\t\r \u00a090%\t\r \u00a0100%\t\r \u00a0Share\t\r \u00a0of\t\r \u00a0Generic\t\r \u00a0and\t\r \u00a0Brand\t\r \u00a0Sp"] [16.859764099121094, 20.26607894897461, "ecial and Perioperative Fills Before for All Drugs \nA small share of prescription volume (in standard units) and spending meets the special or \nperioperative fill criteria (regardless of whether they are listed as being eligible for either \nprovision"] [16.843965530395508, 20.252620697021484, "lume and Spending Meeting Special and Perioperative Fill Criteria for \nSelected Therapeutic Classes, 2014 WCIS Data (%) \n\t\r \u00a0Share of V olume (standard units) Share of S pending \n\t\r \u00a0Perioperative Special Perioperative Special \nTotal 0.7 2.5 1."] [16.836763381958008, 20.244831085205078, "Meeting Perioperative Criteria a nd Listed as P erioperative Drugs, 2014 WCIS Data \n\t\r \u00a0Spending\t\r \u00a0($mils) \t\r \u00a0Periop.\t\r \u00a0Share\t\r \u00a0of\t\r \u00a0\nSpending\t\r \u00a0(%)\t\r \u00a0Volume\t\r \u00a0(000\u2019s\t\r \u00a0of\t\r \u00a0\nstandard\t\r \u00a0units) \t\r \u00a0Periop.\t\r \u00a0Share\t\r \u00a0of\t\r \u00a0\nVolume\t\r \u00a0(%)\t\r"] [16.843341827392578, 20.259675979614258, "12 106.20 1.66 \n2013 103.4 3 1.61 \n2014 101.9 5 1.59 \nNOTES : RAND analysis of 2012 through 2014 WCIS pharmacy and medical prescription bill \ndata for outpatient drugs. Reported prices are calculated as the sum of total payments divided \nby the sum o"] [16.816192626953125, 20.225614547729492, "ily a single brand-name drug [pregabalin]). 27 \n Table 3 .8. Spending and Volume by Therapeutic Class, Selected Classes, \n2014 WCIS D ata With and W ithout 2017 FUL P rices Applied \n Observed \nSpending W ithout \n2017 FUL P rices \n($millions) Spen"] [16.828989028930664, 20.23298454284668, "inator. In cases where we found tentative approvals in the 2015 through 2017 range, we conducted a broader Internet search to find news articles, court decisions, and industry reports to identify a likely date for first marketing. \nThrough this proce"] [16.869035720825195, 20.327932357788086, "were informed by our review of the \nliterature and our expert opinion. The literature review focused on peer-reviewed studies \nevaluating the impacts of prior authorization (that is, PR in the California WC context) on utilization and spending for dr"] [16.891063690185547, 20.294689178466797, "ird of prescriptions was not written. \nFinally, we reviewed a recent report from the Texas Department of Insurance Workers\u2019 \nCompensation Research and Evaluation Group documenting the impacts of a recently implemented (in 2011) formulary for its WC p"] [16.846755981445312, 20.250438690185547, "riptions to avoid the time costs of PR. In addition, the formulary will help prescribers more easily identify preferred drugs that are consistent with MTUS guidelines. For these reasons, we expect prescribers will shift to preferred drugs and will wr"] [16.87773895263672, 20.279756546020508, "rcent) to other drugs in the same class. We report results assuming (a) a 10 percent discontinuation rate and a 25 percent switch rate to other drugs in the same class; and (b) a 30 percent discontinuation rate and a 75 percent switch rate to other d"] [16.8563289642334, 20.261165618896484, "ding first fill and perioperative prescriptions where appropriate. Next, we aggregated these reallocated prescriptions at the therapeutic class level. We then allocated these prescriptions to preferred drugs in the same class based on volume shares. "] [16.833070755004883, 20.243389129638672, "ate analysis of all calendar year 2014 WCIS medical data (to be included in a forthcoming report), RAND estimated total 2014 WCIS medical spending to be $4.2 billion. Before implementing spending changes to reflect new FUL prices and generic entry, w"] [16.84825897216797, 20.254610061645508, "California. Macroeconomic impacts are modeled within an input-output model, IMPLAN. IMPLAN assumes a linear relationship between production and consumption and bridges these two via local production and consumption as well as sector-specific imports "] [16.810632705688477, 20.215110778808594, " \u00a03\t\r \u00a04\t\r \u00a05\t\r \u00a06\t\r \u00a0\nBaseline\t\r \u00a0(2014\t\r \u00a0\nutilization\t\r \u00a0at\t\r \u00a0\n2017\t\r \u00a0fee\t\r \u00a0\nschedule\t\r \u00a0prices)\t\r \u00a0After\t\r \u00a0Physician\t\r \u00a0\nDispensing\t\r \u00a0\nModule\t\r \u00a0After\t\r \u00a0Generic\t\r \u00a0\nSubstitution\t\r \u00a0\nModule\t\r \u00a0After\t\r \u00a0\nProspective\t\r \u00a0\nReview\t\r \u00a0Module\t\r \u00a0Af"] [16.83138084411621, 20.23736000061035, "ptions tend to have modest effects on estimating changes in utilization and costs. The combination of all lower- and upper-bound estimates, however, results in a significant range in estimates. For example, the lower- and upper-bound reductions in"] [16.849014282226562, 20.254920959472656, "ng the full \nimplementation of the formulary is half of the reduction in medical spending, or $22.7 million. \nOver the longer term, a larger share of the prescription drug spending reduction may accrue to California businesses and insurers, although "] [16.851720809936523, 20.263608932495117, "algesic spending and utilization in particular is reduced in each module, especially when we allow for substitution to NSAIDs. The estimated changes in California WC prescription drug spending and net revenue for California providers dispensing presc"] [16.86554527282715, 20.270917892456055, "l liens. Liens can include payments for prescription drugs. If the formulary reduces prescription utilization contributing to medical liens\u2014particularly for compounded drugs or drugs with particularly high per-unit prices\u2014our results will underestima"] [16.915979385375977, 20.316123962402344, "ated to prescribing or specific formulary provisions. For example, because the special fill policy could have the unintended effect of increasing the number of office visits (particularly in the cases of physician dispensing) for practitioners to wri"] [16.945388793945312, 20.341697692871094, "eferred \n Ciclesonide Non-Preferred \n Cimetidine Preferred \n Ciprofloxacin Preferred \n Ciprofloxacin Hydrochloride Preferred \n Citalopram Hydrobromide Non-Preferred \n Clarithromycin Non-Preferred \n Clindamycin Hydrochloride Prefe"] [16.94003677368164, 20.337678909301758, "red \n Hydrocortisone Non-Preferred Yes \n Hydromorphone Hydrochloride Non-Preferred \n Hypromellose Preferred \n Ibandronate Sodium Non-Preferred \n Ibuprofen Preferred \n Imipramine Hydrochloride Non-Preferred \n Indomethacin Preferred "] [16.986366271972656, 20.38334846496582, " Non-Preferred \n Rabeprazole Sodium Preferred \n Ranitidine Hydrochloride Preferred \n Rimexolone Non-Preferred \n Risedronate Sodium Non-Preferred \n Rivaroxaban Non-Preferred \n Yes \nSalmeterol Xinafoate Non-Preferred \n Salsalate Pref"] [16.876794815063477, 20.279001235961914, "(Lu et al., 2010) \n(McCombs et al., 2002) \n(Louder et al., 2011) \n(Workers\u2019 Compensation Research Institute, 2014) \n(Texas Department of Insurance, 2013) 51 \n References \nAdams, Alyce S., Fang Zhang, Robert F. LeCates, Amy Johnson Graves, Dennis Ro"] [16.876218795776367, 20.278301239013672, ". R. Cline, J. C. Schommer, R. S. Hadsall, and J. A. Nyman, \u201cRetrospective \nAssessment of Medicaid Step-Therapy Prior Authorization Policy for Atypical Antipsychotic \nMedications,\u201d Clinical Therapeutics, Vol. 30, No. 8, August 2008, pp. 1524\u20131539; di"] [16.87700653076172, 20.27867317199707, "e: Results of a Longitudinal, Population-Based Study,\u201d Clinical Therapeutics, Vol. 32, No. 4, April 2010, pp. 729\u2013741; discussion 716. \nLaw, M. R., D. Ross-Degnan, and S. B. Soumerai, \u201cEffect of Prior Authorization of Second-\nGeneration Antipsychoti"] [16.87810516357422, 20.27973747253418, "lary Change with Therapeutic Interchange for Statin Drugs in a Multistate Managed Medicaid Organization,\u201d Journal of Managed Care Pharmacy, Vol. 12, No. 4, 2006, pp. 331\u2013340. \nMomani, Aiman A., S. Suresh Madhavan, and David P. Nau, \u201cImpact of NSAIDs"] [16.890317916870117, 20.29292106628418, " Dongchun Wang, and Te-Chun Liu, Interstate Variations in Use of \nNarcotics, 2nd ed., Cambridge, Mass.: Workers Compensation Research Institute, 2014. \nVon Korff, Michael R., \u201cLong-Term Use of Opioids for Complex Chronic Pain,\u201d Best Practice \n& Rese"] [14.343490600585938, 2.934190034866333, "Fostering Innovation to Respond to \nTop Challenges in Law Enforcement\nProceedings of the National Institute of Justice\u2019s \n2018 Chiefs\u2019 Panel on Priority Law Enforcement Issues and Needs\nJohn S. Hollywood, Sean E. Goodison, Dulani Woods, Michael J. D."] [14.25770378112793, 2.7815122604370117, " skills, abilities, andexperiences that are most useful to have in today\u2019s policingenvironment\n\u2022develop a continually updated inventory of law enforcementinformation analysis tools. This process should also highlightgaps in the available tools.Key Fi"] [14.213111877441406, 3.189235210418701, "ciated interventions to improve trust, as well as improved, more-realistic interaction skills training.\n \u2212The need for longer-term reform. To get at the underly -\ning causes of distrust, panelists called for a systematic review of the criminal justi"] [14.3035888671875, 2.954718828201294, "ntire community of practice. PCJNI reports on prior sector-wide panels for law enforcement include the following:\n\u2022 High-Priority Information Technology Needs for Law Enforcement , which identified needs for innovation broadly \nrelated to IT and data"] [14.382976531982422, 2.861755847930908, "did not attempt to recruit a representative sample of executives, nor should the results be considered representative of law enforcement practitioners\u2019 general opinions on technologies. Instead, the results reflect the expertise and experience of the"] [14.539156913757324, 2.324556350708008, "riority needs and issues identified in the previous law enforcement Workshop Participants\nRichard Biehl\nDayton, Ohio, Police Department\nJean-Michel Blais\nHalifax Regional Police\nJimmy Chapman\nRoanoke County, Virginia, Police Department\nJohn Donohue\nN"] [14.752606391906738, 1.8696929216384888, "s, the panelists rerated the need based on what they heard. Following the second round of voting, we used a clustering algorithm to group the needs into three tiers (Tier\u00a01, high EV; Tier\u00a02, medium EV; and Tier\u00a03, lower EV). In the third and final ro"] [14.270187377929688, 2.797191858291626, "he development of use cases and meshing new tools with \nexisting practices\n\u2022 difficulties in acquisition processes\n\u2022 cybersecurity and interoperability issues\n\u2022 unintended consequences (e.g., floods of body-worn cam -\nera data challenging data manage"] [14.271254539489746, 2.7713472843170166, " discussed the fact that technology providers have such an advantage in technical expertise and resources that it is often the vendors who set the requirements and directions of law enforcement technology. \nMarket power. Panelists noted that law enf"] [14.292013168334961, 2.799078941345215, "dards and certifi -\ncation schemes for various technologies in partnership with associations and industry because NIJ did this effectively with body armor. That said, panelists mentioned the downside that standards development, maintenance, and compl"] [14.360113143920898, 2.8491475582122803, " the value and appropriateness of capturing and showing video evidence from body-worn cameras. One panelist noted that he or she quickly realized that the videos shown on cameras often did not reflect the real situation experienced by officers (becau"] [14.322912216186523, 2.721644163131714, "ithholding those data. However, a key challenge to such national guidelines is the wide variation in state and local laws dictating retention and release that are currently in place. One point of concern was the growing call for officers filming or o"] [14.229168891906738, 2.814328670501709, "internet-enabled devices in cars and clothing\u2014is growing. There also are increasing numbers of programs and apps being run on these devices, such as officer-installed apps with unknown data reten -\ntion and cybersecurity protections. These, in turn, "] [14.231318473815918, 2.9427759647369385, "igative resources. \nIt was noted that the current state of affairs often leads to \nvictims of cybercrime being frustrated when their local agency has no means or resources to investigate incidents in which they were harmed. It was further noted that "] [14.234339714050293, 2.6217873096466064, "eed for this topic: research to \ndevelop a general strategy on which organizations should take the lead regarding various cybercrimes and how that would be determined. It was of middling priority to the panel (Tier 2), possibly trading off the growi"] [14.28637981414795, 2.724374771118164, "o be able to return DNA profiles of arrestees, as well as matches to crime-scene DNA stored in an FBI database, within two hours (FBI Laboratory Services, undated). \nIn this area, panelists specifically focused on issues sur -\nrounding rapid DNA iden"] [14.684813499450684, 3.110353708267212, " reported feeling that agencies and, hence, officers themselves did not have sufficient resources to respond to this environment. \nThese pressures, combined with a lack of resources, were \nseen as likely to have negative effects on officers\u2019 physical"] [14.36075496673584, 2.9955077171325684, "omen in law enforcement. \nPanelists noted that the recommended assessments should reflect and support the growing presence of women in policing. \nFamily involvement. Panelists suggested that involv -\ning officers\u2019 families in new health strategies i"] [14.379108428955078, 2.94313645362854, "etail in the following sec -\ntions.\nTheme 6: A Systematic Review of the \nCriminal Justice System and the Roles of All Stakeholders in It Is Needed\nDiscussion on this topic began with comments that those \nconcerned with trust commonly focus on bias in"] [14.341848373413086, 2.9015040397644043, "lved shootings. For an outside perspective, they also sug -\ngested looking at community-led ways to improve public safety without having to resort to traditional policing tactics. \nAgencies Need Assistance in Improving \nCommunication with Communities"] [14.343674659729004, 3.011746883392334, "rch and Training on Reducing \nBias and Use of Force\nPanelists emphasized the importance of methods to reduce \nofficer-involved shootings and officer bias resulting in dispa -\nrate outcomes. They emphasized that such methods need to be realistic and r"] [14.297855377197266, 2.8340272903442383, "practices, and techniques.\nGiven the breadth of this challenge, discussions have been \nsimilarly broad. These discussions included such topics as \n\u2022 difficulty developing solutions relevant to departments of \ntwo to 2,000 officers\n\u2022 models including "] [14.279921531677246, 2.8281376361846924, "urces and improve effectiveness for core missions.16Theme 9: There Is a Need to Specify How \nto Select and Train Officers of the Future Selecting Officers of the Future\nGiven the discussion about officers needing problem-solving \nand soft skills (eit"] [14.281940460205078, 2.8104629516601562, "cal or hard skills; soft skills, e.g., empathy and communication; life experience; and technology skills.Need: Conduct research to identify the sets of \nskills, abilities, and experiences that are most useful to have in today\u2019s policing environment."] [14.101585388183594, 2.838620185852051, " of dissemi -\nnating evidence-based business cases to share specified types of information in specific ways. The second motivation was the concern that those receiving law enforcement\u2013sensitive infor -\nmation would not protect it appropriately or tha"] [14.32153034210205, 2.830500602722168, "ders. On the issue of analytic quality, including building capabilities for independent review of privately provided tools, panelists proposed law enforcement application to ensure that quality and accuracy were sufficient. Other proposals focused on"] [14.180203437805176, 2.730623722076416, "ated to Addressing the Flood \nof Information\n\u00f3\u00f3\u00f3\u00f3 (Tier 1) Issue: Officers and agencies are often \nunaware of the tools, systems, and processes \navailable to them.Need: Develop a continually updated \ninventory of law enforcement information analysi"] [14.317102432250977, 2.794590473175049, ". That said, according to one panelist, \u201cthere is more information out there that is still hard to get,\u201d and readers needed help not only with finding research but also in deter -\nmining which results are \u201cmeaningful to me as a police chief [or other"] [14.31218147277832, 2.8276443481445312, "at emerged from the workshop lacked \npriority needs for innovation. These top issues can be priori -\ntized for further consideration in terms of the types of innova -\ntions that might help: \n\u2022 training on digital evidence\n\u2022 determining state and law "] [14.226057052612305, 2.794478178024292, "sure that high-demand closed publications are converted to open access (e.g., by paying for them).21Table 1. Themes and Priority Needs for Innovation\nTopic Themes High-Priority Needs\nUsing new \ntechnologies while responding to technological changes i"] [14.352458953857422, 2.90030574798584, "ps should be repeated. \n\u2022 6A. (\u00f3\u00f3\u00f3 ) Call for a National Commission on \nCriminal Justice to evaluate the current state of criminal justice practices and the equity, efficacy, and legitimacy across the entire criminal justice system.\n7 . Better strate"] [14.23746109008789, 2.8032689094543457, "em (typically from crash scenes).\na\n13. Agencies need assistance in order to interact more effectively with social media companies. \u2022 13A. (\u00f3\u00f3\u00f3 ) Conduct research to identify the \nlegislative gaps in order to standardize when and how emergency or inv"] [14.357074737548828, 2.9148192405700684, "e top-three needs from the panel was in this area: calling for research and evaluation of public-sentiment moni -toring tools. This panel also called for research on improved training to reduce bias and uses of force. \nPanel members then expanded wha"] [14.342333793640137, 2.8002748489379883, "tainty about how to ensure that vendors provide data in the event of a lethal crash and, if they do provide such data, that the data are in a form that could be understood by investigators. They also called for creating liaisons between law enforceme"] [14.350380897521973, 2.9063799381256104, "ould accept that regulation. \nA Lack of Easy Solutions to Top Challenges\nSecond, despite the range of innovation needs, the panel discus -\nsion reflected the reality that some of the most pressing chal -\nlenges were not found to have easy, short-term"] [14.470481872558594, 2.751110076904297, "om presentations at other national conferences, with an emphasis on the annual International Association of Chiefs of Police Technology meet -\nings. Given the scope of this workshop, searches were restricted to law enforcement invitees without inclus"] [14.780708312988281, 1.8036471605300903, "ext sec -\ntion. \nAt the end of the meeting, panelists were asked to react to \nthe prior two days of discussion and findings and provide top takeaways for readers. These takeaways were captured in the conclusions section of this report. \nPrioritizatio"] [14.765423774719238, 1.7560776472091675, "ium, and low EV groupings. The use of three EV tiers is manageable and provides a clear focus for decision -\nmakers (e.g., the needs in the high-EV tier); it is also consistent with prior PCJNI studies. Figure A.2 shows a histogram of the needs\u2019 over"] [14.217463493347168, 3.2084386348724365, " (NIJ), the Priority Criminal Justice Needs Initiative has carried out research to assess \nand prioritize technology needs across the criminal justice community. The fundamental goal is to enable innovation in the U.S. \ncriminal justice community\u2014fro"] [14.164029121398926, 2.6195056438446045, "\u201d to optimize forensic analyst labor across state and local demandsNeed to develop best practices and best practice business rules for body-worn camera videoInvite researchers and organizations (e.g., International Association of Chiefs of Police, PE"] [14.163247108459473, 2.6333696842193604, " alerts) \ndynamically tailored to individual officers both in the field and at headquarters. Should automatically generate alerts when people of interest (such as parolees) have made contact with police\nNeed educational materials for key web technolo"] [14.121533393859863, 2.6409764289855957, "wledge across the systemUtilize existing software tools for analysis of data sets like cell tower data. Examples exist that are web-based and can be bought on a \ncase-by-case basis, but knowledge of what is available is limited\nDepartments must acqui"] [13.61839485168457, 1.8516266345977783, " being developed (who needs what information with what \nattributes) by different groups (National Public Safety Telecoms Council, FirstNet, Global, etc.). Need to include concepts, policy, and procedures for mutual aid networks. Must explicitly consi"] [13.758638381958008, 2.7090015411376953, "ility movement\u201d\u2014get to consensus on tools being used, quality assurance, protections against bias, \nand civil liberties protections.\nConduct a gap analysis on existing automated social monitoring tools to determine the shortcomings for criminal justi"] [14.291350364685059, 2.7586328983306885, "ards for \nhandling and securing public data held by law enforcement.\n3. Law enforcement is challenged by the rise of cybercrimes.\n\u2022 Law enforcement is not prepared for cyber threats, especially threats from the IoT.\n\u2022 Law enforcement\u2019s role in fighti"] [14.381304740905762, 2.9203286170959473, "ate of criminal jus -\ntice practices and the equity, efficacy, and legitimacy across the entire criminal justice system.\n7 . Better strategies, tactics, and tools to improve community relations and public trust. \n\u2022 Agencies need assistance in improvi"] [13.854593276977539, 2.930340528488159, "p a federal law enforcement infor -\nmation protection law, because it might facilitate the sharing of information that is protected by other laws (e.g., HIPAA, FERPA).\n\u2022 10B. (\u00f3) Collect and publicize \u201csuccess stories\u201d \nthat occurred as a result of p"] [14.47559928894043, 2.70209002494812, "n the detection of basic activities like walking, running, throwing, entering and exiting a car, carrying an object, handing off an object, and assembling and dispersing (Intelligent Systems Laboratory, undated). \n3 For a general characterization "] [13.939223289489746, 3.7116854190826416, "t C. Davis, and Brian A. Jackson, Digital \nEvidence and the U.S. Criminal Justice System: Identifying Technology and Other Needs to More Effectively Acquire and Utilize Digital Evidence , Santa Monica, Calif.: RAND Corporation, RR-890-NIJ, \n2015. As "] [13.485236167907715, 3.787304401397705, "5. As of November 5, 2018: https://www.rand.org/pubs/research_reports/RR928.html\nIJIS Institute, homepage, undated. As of May\u00a022, 2019: \nhttps://www.ijis.org/\nInternational Association of Chiefs of Police, \u201cIACP Introduces \nNational Criminal Justice "] [13.582847595214844, 3.717353582382202, "html \nViolanti, J. M., \u201cCoping Strategies Among Police Recruits in a High-\nStress Training Environment,\u201d Journal of Social Psychology , Vol. 132, \nNo. 6, 1992, pp. 717\u2013729. \nVincent, James, \u201cU.S. Lawmakers Say AI Deepfakes \u2018Have the \nPotential to Dis"] [13.920589447021484, 4.177037239074707, " Criminology and Criminal Justice.\nDulani Woods is a data science practitioner adept at data acquisition, transformation, visualization, and analysis. His primary areas of \nresearch have included homeland security and justice policy. He has a master"] [13.862380027770996, 4.600431442260742, "ersonal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint \nand linking permissions, please visit ww"] [-0.8252068161964417, 14.536553382873535, "SOCIAL AND ECONOMIC WELL-BEING\nDecision Support Tool for \nthe San Francisco Bay-Delta Levees Investment Strategy\nDocumentation and Use\nDavid G. Groves, Nidhi Kalra, James Syme, Hollie Ellis, Charles L. Gardiner, \nLawrence H. Roth\nSponsored by the Del"] [12.637805938720703, 13.57614803314209, "he world. This research was conducted in the Community Health and \nEnvironmental Policy Program within RAND Social and Economic Well -Being. The program \nfocuses on such topics as infrastructure, science and technology, community design, community he"] [-0.849841833114624, 14.598938941955566, "................................................................. 8\t\nRisk to Habitat ........................................................................................................................ 9\tRisk to DAP .............................."] [-0.8220622539520264, 14.6312837600708, "............................................. 14\t\nFigure 3.1. DST Overview (Panel 1.1) ......................................................................................... 17\t\nFigure 3.2. Islands and Tracts (Panel 2.1) .........................."] [-0.8225120902061462, 14.635324478149414, "anking of Islands (Panel 5.3) ...................................................................... 35\t\nFigure 3.24. Impact on DAP (Panel 5.4) ...................................................................................... 36\t\nFigure 3.25. Is"] [-0.8537396788597107, 14.588703155517578, "tate\u2019s water supply, flooding important habitat, or compromising the Delta\u2019s historic towns, prime agricultural land, or public roadways. \nThe possible investments to mitigate these risks are numerous, and they will affect Delta risks differently. Th"] [-0.838883638381958, 14.610732078552246, " Expected Annual Fatalities \nSLR sea level rise \n 1 1. Introduction \nSacramento \u2013San Joaquin Delta Levees \nThe Sacramento\u2013San Joaquin Delta comprises over 100 islands and tracts northeast of the \nSan Francisco Bay (Figure 1.1). Most are below sea l"] [-0.8622789978981018, 14.592085838317871, "ty vs. risk \nto water supply vs. risk to habitat) and assumptions about future risks to enable a transparent \ncomparison of results across different metrics. Such an exploratory modeling approach is suited \nfor long-term policy questions in which the"] [-0.8517765998840332, 14.602815628051758, "e metric or time \nperiod), set metric weights for island rank and investment rankings, define portfolios of levee investments, and explore different trade -offs across the portfolios. Figure 1 .2 summarizes the \ninputs, discussion and analysis, an"] [-0.8406204581260681, 14.597017288208008, "itation timing and patterns, including extended periods of \ndrought; earthquake hazards; ecosystem factors; or project costs could be assimilated into the \nDST to inform revised priorities. \n1 See the Project Documents section of the Delta S tewardsh"] [-0.8451418876647949, 14.588232040405273, "physical processes. Many of these characteristics\u2014such as biodiversity, water \nquality, habitat structure and connectivity, food web dynamics, nutrient cycling, and species \npopulation dynamics\u2014could be used to measure ecosystem function and flood ri"] [-0.8048000335693359, 14.583806991577148, "e depends only on river stage), a population proportion at risk given \nthe warning time, proportions of the population considered willing and able to evacuate \ngiven warnings, and a mortality function, which is used to estimate the mortality rate giv"] [-0.8279767036437988, 14.609561920166016, "s south of the Delta and within the Delta. Levee breaches and resulting floods threaten \nto disrupt water supply. \nIdeally, one would measure the risk to water supply as a product of the probability of levee \nfailure and the consequence of that fai"] [-0.8439681529998779, 14.601259231567383, " and biologically appropriate habitats, functional corridors, and \necosystem processes (Delta Stewardship Council , 2013). The elements that create ecosystem \nvalue are complex. For decisionmakers and stakeholders to understand and trade off the imp"] [-0.8265202045440674, 14.621381759643555, "ial tidal habitat. \nRisk to DAP \nThe State Legislature recognizes \u201cthe unique cultural, historical, recreational, agricultural, \nand economic values of the Delta as an evolving place\u201d (California Water Code Section 29702). \nAs such, the Council provi"] [-0.5875616073608398, 14.34339714050293, "ddresses two questions. First, what are the risks now, and \nwhat will they be in 2030 and 2050 if the State does not make levee investments? This is the risk \nin a future without action. Second, what would the risks be now and what would they be in 2"] [-0.4398021996021271, 14.163299560546875, " however, is uncertain. \nThere is much uncertainty about how future risks will evolve over time. For instance, while \nsea levels will increase, the magnitude and timing of these increases are uncertain. As another \nexample, the likelihood of the magn"] [-0.8384777307510376, 14.589019775390625, "ethodology Report \n(Arcadis, 2017b). Specifically, the report describes six uncertain factors that could affect the \ncalculations of probability of flooding: \n\u2022 Discharge-Recurrence: frequency of peak river flows \n\u2022 Stage-Discharge: relationship betw"] [-0.834835946559906, 14.618867874145508, "pecified \nweights to develop an aggregate risk metric. The aggregate risk ranking is then used to classify \nthe islands into three priority categories, per Council request: \n\u2022 Very High Priority \n\u2022 High Priority \n\u2022 Other Priority. \nTo aggregate risk "] [-0.8520895838737488, 14.602006912231445, "year Reduction in flooded acres/ million \ndollars invested \n \nThe DST ranks investments first by their effect with respect to risk reduction. Then the DST \nallows the user to construct portfolios by including projects that are cost-effective above"] [-0.82673180103302, 14.63280963897705, "map of the Delta study area and allows the user to highlight islands and tracts by \nname and to filter the islands shown by levee status (e.g., unleveed, leveed, or flooded) and area \n(Figure 3.2). There are 170 islands and tracts included in the stu"] [-0.828368067741394, 14.6115083694458, "hat about $30 billion of assets is vulnerable \nto flooding across the entire Delta. As with population, most of the assets are on the eastern \nedges of the Delta\u2014namely North and Central Stockton and West Sacramento and Maintenance \nArea 9 North. \n "] [-0.8274248838424683, 14.627154350280762, "roup. This was determined in consultation with the Council, DWR, user groups, and \nother stakeholders. The version below shows the many islands important to the State Water \nProject/Central Valley Project (SWP/CVP), colored by the various functions e"] [-0.8203278183937073, 14.635065078735352, "H\nEGBERT TRACT\nEMPIRE TRACT\nHASTINGS TRACT\nHOLLAND TRACT\nHOLT STATION\nHONKER LAKE TRACT\nPerforms Function?\nYes\nNo\nIslands Important for Water Supply for Different User Groups\nFilters and Options\nWater Supply Users\nAntioch\nCCWD\nEBMUD\nNorth Delta\nSacra"] [-0.8286092281341553, 14.633819580078125, "results indicate the number of legacy \nFigure 3.8 . Legacy Towns ( DAP) (Panel 2.9a) \n \nDelta as Place\nLegacy Towns (#) Island/Tract\n0 1 2\nDelta As Place Asset\n[number; acres; 1/0]GRAND ISLAND\nBETHEL ISLAND\nBRANNAN-ANDRUS\nDLIS-07 (KNIGHTSEN A..\nDL"] [-0.8218107223510742, 14.632888793945312, "-27DLIS-28\nDLIS-31 (GARABALDI ..\nDLIS-32DLIS-33\nDLIS-43 (POTRERO HIL..\nDREXLER TRACT\nEHRHEARDT CLUB\nFABIAN TRACT\nGLANVILLE\nGLIDE DISTRICT\nGRAND ISLAND1\n111\n1\n11\n1\n1111111111111111Delta As Place Assets\nLegacy Towns (#)\nPrime Agricultural Land (acres)\n"] [-0.8086700439453125, 14.62629508972168, ". Islands shaded darker red are estimated to \nhave higher expected annual fatalities. In general, these risks increase under later years and \nthe high SLR scenario, as selected on the left. Three islands under baseline conditions have \nEAF greater th"] [-0.8164471387863159, 14.633451461791992, " S..\nSHIN KEE TRACT\nDLIS-41 (JOICE ISLAND A..\nDLIS-34\nGLANVILLE\nSTATEN ISLAND\nEMPIRE TRACT\nWINTER ISLAND\nDLIS-44 (HILL SLOUGH U..\nMCCORMACK-WILLIAMS..\nDLIS-33\nDEAD HORSE ISLAND\nRIO BLANCO TRACT\nDLIS-40\nDREXLER TRACT\nPROSPECT ISLAND\nKASSON DISTRICT10."] [-0.8131835460662842, 14.631808280944824, "aseline\n2030, nominal\n2030, high\n2050, nominal\n2050, high\n0.0 4.0Expected Annual Fatalities\n \nRisk to Property\nIsland or Tract\n$0.0M $20.0M $40.0M $60.0M\nExpected Annual Damage [$]MAINTENANCE AREA 9 N..\nNORTH STOCKTON\nBISHOP TRACT/DLIS-14\nRECLAMAT"] [-0.816719114780426, 14.639165878295898, "AND\nWEBB TRACT\nCLIFTON COURT F..\nTWITCHELL ISLAND\nMCDONALD ISLAND\nBACON ISLAND\nBYRON TRACT\nHOLLAND TRACT\nBETHEL ISLAND\nMANDEVILLE ISLAN..\nSHERMAN ISLAND\nHASTINGS TRACT\nWOODWARD ISLAND\nJERSEY ISLAND\nJONES TRACT\nUNION ISLAND WES..\nVICTORIA ISLAND\nMAINT"] [-0.8211889863014221, 14.635180473327637, "eton, Rio Vista, Knightsen,\nand Bethel Island).\nClick on the next \"Risk to\nDelta as Place\" panel aboveto advance.Year & SLR Scenario\n2012, baseline\n2030, nominal\n2030, high\n2050, nominal\n2050, high\n2.0% 10.0%Probability of Flooding 30 This panel show"] [-0.8091948628425598, 14.632637023925781, "e threshold value are deemed high risk \nfor the specific metric. The DST allows the user to adjust the thresholds and explore how the \nsettings affect the analysis. Table 3.1 shows results for the default thresholds. These thresholds \nare set so that"] [-0.8157385587692261, 14.626919746398926, "The visualization shows the amount of risk for each \nisland and metric (length of horizontal bars) and defined threshold (vertical red bars). Bars shaded in dark red represent risks that are greater than the threshold. The user can sort the islands b"] [-0.8244040608406067, 14.632030487060547, "ore of 4.0, followed by Byron Tract and Maintenance Area 9 North. \nFigure 3. 20. Identify Islands Have the Most Risk Across All Risk Metrics to \nCreate a Composite Risk Score (Panel 4.2) \n \nSection 5. Ranking Islands by Risk \nThe DST next maps and"] [-0.8208245038986206, 14.63611888885498, "ight\n1\nProperty Weight\n1\nWater Supply Weight\n1\nNon-Tidal\nHabitat Weight\n1\n0.0 2.0 4.0\nComposite Risk\nScoreMAINTENANCE AREA 9 SOUTH\nBYRON TRACT\nMAINTENANCE AREA 9 NORTH\nBRANNAN-ANDRUS\nGRAND ISLAND\nSHERMAN ISLAND\nBETHEL ISLAND\nBISHOP TRACT/DLIS-14\nNORT"] [-0.8162721991539001, 14.638815879821777, "tial\nOther PriorityShow High Tidal\nHabitat Potential\nDon't Show\nShowYear & SLR Scenario\n2012, baseline\n2030, nominal\n2030, high\n2050, nominal\n2050, high\n5.3) Tiered Ranking of Islands\n JERSEY ISLAND (2.0)CENTRAL STOCKTON "] [-0.826129138469696, 14.632318496704102, "c events. See Chapter One for \nadditional information on the PL84 -99 guidelines. Panel 6.1) Islands and Tracts with Investments , 76Legacy Towns\n198,433139,97872,298Prime Agricultural LandThis panel reports out the\nimpact of the ranking on\nDelta as"] [-0.8281505107879639, 14.63094711303711, "r which islands a\nPL84-99 (or other) investment is\ndefined. The bar chart and map shading\nindicates the cost of the investment.\nPL84-99 guidance is a minimum\nrequirement established by the U.S.\nArmy Corps of Engineers (USACE) for\nlevees in its Rehabi"] [-0.8207488059997559, 14.637737274169922, " Scenario\n2012, baseline\n2030, nominal\n2030, high\n2050, nominal\n2050, highOptions and Filters Island/Tract\n0.000 0.020 0.040 0.060\nEAF Reduction [lives/year]BRANNAN-ANDRUS\nGRAND ISLAND\nTERMINOUS TRACT\nBETHEL ISLAND\nHOLT STATION\nNEW HOPE TRACT\nWALNUT "] [-0.8220310807228088, 14.639045715332031, "Flooding of Non -Tidal Habitat with \nInvestments (Panel 6 .6) \n \nChange in Flooding for Islands Posing Greatest Water Supply Risk with Investments\nFilters and Options\nYear & SLR Scenario\n2012, baseline\n2030, nominal\n2030, high\n2050, nominal\n205"] [-0.8292418718338013, 14.628005981445312, "nt Priorities (Panel 7) \n \nSection 8. Developing a Portfolio of Levee Investment s \nSection 8 of the DST\u2014Developing a Portfolio of Levee Investments\u2014allows the user to \ndevelop portfolios that cost-effectively reduce risk to lives, property, water "] [-0.8207112550735474, 14.636979103088379, "Very High SHERMAN ISLAND $1.3M 0.1%\nMCCORMACK-WILLIAMSON.. $3.6M 1.8%\nTWITCHELL ISLAND $4.2M 0.3%\nJERSEY ISLAND $2.4M 0.1%\nHigh TERMINOUS TRACT $18.1M 1.5%\nGLANVILLE $6.4M 3.4%\nTYLER ISLAND $6.2M 0.8%\nLITTLE EGBERT TRACT $2.3M 4.4%\nDREXLER TRACT $5.3"] [-0.8247068524360657, 14.634061813354492, "ST $11.6M 0.2%\nBOULDIN ISLAND $11.1M 0.6%\nBRADFORD ISLAND $3.8M 0.5%\nHOLLAND TRACT $1.9M 0.2%\nBACON ISLAND $8.1M 0.2%\nMANDEVILLE ISLAND $6.3M 0.2%\nVICTORIA ISLAND $2 1M 0 0%9.89 $0.10 0.12% 0.4\n4.95 $0.07 0.1\n4.42 $0.11 0.2\n1.00 $0.02 0.10% 9.0\n0.380"] [-0.8285889625549316, 14.611987113952637, " \nand other factors, before approving projects at high priority or other priority tracts. If available funds are sufficient to fully fund levee improvements at the very high priority tracts, then funds for improvements or major rehabilitation of lev"] [-0.7828441262245178, 14.502016067504883, "alog.data.gov/dataset/public-and-conservation-trust-lands \n\u2014\u2014\u2014, California EcoRestore Fact Sheet, 2015. \nhttp://resources.ca.gov/docs/ecorestore/ECO_FS_Overview.pdf \nCouncil\u2014See Delta Stewardship Council. \nCRA\u2014See California Resources Agency. \nDelt"] [-0.647235631942749, 13.403477668762207, "s and Applications,\u201d Environment International, Vol. 32, \n2006, pp. 1072\u20131093. \nNAS\u2014See National Academy of Sciences. \nNational Academy of Sciences, Sea-Level Rise for the Coasts of California, Oregon, and \nWashington, 2012. 49 National Research Co"] [11.408205032348633, 17.63443946838379, "Lloyd Dixon, Kathryn Kuznitsky Emerging Trends \nin Compensation for Widespread LossesCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation of RAND \ninte"] [11.377937316894531, 17.576099395751953, "AND Institute for Civil Justice \nICJ was founded in 1979, and it has been dedicated to making the civil justice system more \nefficient and more equitable by supplying government and private decisionmakers with the results of empirical analyses and a"] [16.13867950439453, 17.332265853881836, ".................................................................................4 \t\nFactors That Prompted Coordination of Regulators and Indi vidual Claimants in the \nVolkswagen Case ................................................................"] [16.09000015258789, 17.278900146484375, ".................................................... 25\tAppendix. Conference Agenda ..................................................................................................... 27\t\n \n 1 Introduction \nEvents that cause widespread losses a"] [16.129934310913086, 17.317604064941406, "and obvious mass tort \nsituation. Everybody started simultaneously off to the races: the federal government, the \nstate government, and private plaintiffs. It ended up being a missed opportunity for \ncoordination. The government was able to extract s"] [16.1590576171875, 17.3503360748291, "e, comprehensive settlement. \nIs Coordination Becoming More Common? \nParticipants agreed that coordination between public and private litigants is becoming more \ncommon, but that it is not new (particularly in environmental cases) and it does not"] [16.17974853515625, 17.371458053588867, " \nFactors That Prompted Coordination of Regulators and Individual \nClaimants in the Volkswagen Case \nAlthough the panelists covered a wide range of recent examples of how regulators and \nlitigants have interacted in mass litigation, the Volkswagen \u201c"] [16.17108154296875, 17.36369514465332, " judge for the Northern District of California, presided over the case. One participant observed that some judges would have been more passive and allowed parties to \u201crun wild,\u201d but Judge Breyer saw the importance of a global resolution. The court no"] [16.16039276123047, 17.351749420166016, "fs, and to the regulators. But there was another interesting problem: a continuing problem with respect to damages. In the Volkswagen case, there were vehicles on the road that were continuing to pollute, and that was a problem that had to be address"] [16.1984920501709, 17.3911190032959, " the key to the whole case was that EPA and CARB needed to approve the method for fixing the cars. \nA different participant pointed out that one size does not fit all. There are cases in which one \nwould absolutely want to stage compensation. One wou"] [16.152849197387695, 17.34400749206543, "nmental harm, they knew that they had an opportunity to work together with government prosecutors to ameliorate that harm, and they knew they had an opportunity to work with the Federal Trade Commission to compensate consumers. Everyone knew that all"] [16.17323875427246, 17.366100311279297, "ccording to one participant, is for the federal courts to move \nquickly. But they can only move quickly if they have the cooperation of the litigants, and cooperation is not a given; it can be urged, but it is not necessarily achieved. The way it was"] [16.170103073120117, 17.362125396728516, "olkswagen diesel emissions case. \nLack of Transparency \nWhen regulators and public agencies are involved in the settlement process, transparency is \nimportant. The need for transparency is somewhat unusual in the settlement process because \nsettle"] [11.319859504699707, 16.618173599243164, "at contracts with the government. While the government will sometimes administer a claims process (either directly or through a contract), it is not something the government prefers to do, particularly for claims programs that can go on for years. "] [11.32130241394043, 16.598976135253906, " worked on the defense side for many years observed that liens were not part of the conversation with pharmaceutical and medical device claims that were settled years ago\u2014they were the plaintiffs\u2019 and plaintiffs\u2019 lawyers\u2019 problems. Then Medicare and "] [11.314512252807617, 16.618066787719727, "osited that there will be more and more attempts by Medicare to \narticulate how it can assert rights to reimbursement for future medical costs. \nOne participant observed that Medicaid increasingly has the same status as Medicare \nregarding liens. Me"] [11.318536758422852, 16.601404190063477, "utting out bids for contractors to do liability set asides. This will be an issue moving forward. \nOne participant foresaw problems with future medical costs on the private side. For example, \ncould a private health care insurer file a lien for fut"] [11.32114315032959, 16.599042892456055, "y plan has the responsibility to make payment. Yet Medicare seems to ignore that and instead demands payment regardless of the limits of the defendant\u2019s liability (e.g., when the defendant is only 45 percent liable). \nAnother participant agreed, sta"] [11.322821617126465, 16.603527069091797, "column one and held back column two. If plaintiffs\u2019 lawyers did not want to work with a claim resolution company, they needed to work with the lawyers for the lienholders to resolve the lien. Once the liens were resolved, any amount remaining in colu"] [16.09083366394043, 17.27358055114746, "l rules and other procedures were originally tailored to a civil \nlitigation paradigm of one plaintiff, one defendant, and two lawyers. However, the paradigm is changing, and it has become increasingly common to see litigation with large numbers of c"] [16.090734481811523, 17.275575637817383, "ers and judges involved in MDLs is small, \nand this \u201crepeat player effect\u201d has resulted in outcomes that are in the interest of lawyers and judges but not the injured parties. Many academics criticize judges for using too many \u201cinnovative\u201d procedures"] [16.06437873840332, 17.247886657714844, "e the elements of their claims).\n3 \nInventory Settlement: Paxil Birth Defects Litigation \nThe Paxil birth defect litigation did not use an MDL, class action, or quasi\u2013class action; \nrather, it used an inventory approach. The defense\u2019s strategy w"] [16.053491592407227, 17.236804962158203, " always result in payments. Many cases are vigorously defended and result in no payment or very limited payments to a limited set of people. \nA potential advantage of class actions is something approaching global peace. One \nparticipant pointed out"] [16.046337127685547, 17.215734481811523, " result can be claims for injuries that are not caused by the product in question. In Vioxx, for example, about one-third of the claimants could not produce medical records that they had taken Vioxx. For many products, there are no signature symptoms"] [16.050586700439453, 17.2304630279541, "ers wanting a return on their up-front investments. \nFurther work is also warranted on alternative systems around the world for processing mass \nclaims\u2014specifically, on the New Zealand system. American scholarship has not looked at New Zealand\u2019s sy"] [16.046178817749023, 17.242944717407227, "rss iinn SSeettttlleemmeennttss \n\u2022 Moderator: Nicholas Pace, Social Scientist, RAND Corporation\n\u2022 The Honorable Charles R. Breyer, Senior Judge, United States District Court for the\nNorthern District of California\n\u2022 Elizabeth J. Cabraser, Partn"] [11.324771881103516, 16.601036071777344, " explored the role o f liens in \nthe settlem ent process and how different aggregation processes (class action, multidist rict litigation, and inventory \nsettlement) affec t compensation. Multiple participants argued that collec ting more data on th"] [13.920083999633789, 4.025036334991455, "Fostering \nInnovation in U.S. Law Enforcement\nIdentifying High-Priority \nTechnology and Other Needs for Improving Law Enforcement Operations and Outcomes\nJohn S. Hollywood, Dulani Woods, Sean E. Goodison, Andrew Lauland, \nLisa Wagner, Thomas J. W"] [13.988243103027344, 3.837155342102051, "t a research effort to assess and prioritize technology and related needs across the criminal justice community. This initiative is a component of NIJ\u2019s National Law Enforcement and Corrections Technology Center (NLECTC) system and is intended to sup"] [13.827418327331543, 3.9919068813323975, "2016.\n\u2022 Schwartz, Heather L., Rajeev Ramchand, Dionne Barnes-Proby, Sean Grant, Brian A. Jackson, Kristin Leuschner, Mauri Matsuda, and Jessica Saunders, The Role of Technol -\nogy in Improving K\u201312 School Safety , Santa Monica, Calif.: RAND Corporati"] [14.172419548034668, 2.745483875274658, "nd Policing .................................................................................. 8\nThe Challenge of Race and Perceptions of Police ........................................................... 9\nIncreased Scrutiny from the Community and"] [14.22070026397705, 2.62607479095459, "................................................. 62\nPriority Needs for Improving Defenses Against Active Shooters .......................................... 62\nFostering Innovation in U.S. Law Enforcement: A Short-Term Roadmap ...................."] [14.184379577636719, 2.610569477081299, ".................... 82\n D.3. Identifying Special Priority Needs\u2014Operational ............................................. 83\n D.4. Identifying Special Priority Needs\u2014Strategic and Administrative ......................... 84\n D.5. Low-Hanging"] [14.185820579528809, 2.677957534790039, "or service to help solve an operational problem facing law \nenforcement or take advantage of an opportunity (such as new technologies coming on line). Products and services can include materiel items, such as improved equipment or software, and nonm"] [14.218111991882324, 2.7723751068115234, " driven \nlargely by the social and political tensions raised in recent years, in the wake of officer-involved shootings and civic unrest in Ferguson, Missouri, and Baltimore, Maryland. Under this theme, panelists had Tier 1 needs on improving how age"] [14.20263385772705, 2.685041666030884, "ociation of Chiefs of Police (IACP).\nThere is a need to improve dispatch center operations. Tier 1 needs include calls to \nassess costs and benefits of consolidating dispatch operations, as well as improve the question trees used by 911 call operato"] [14.091379165649414, 2.905553102493286, "ry) that include sustainment costsWork with other government agencies and associations to prepare the model language and identify examples.\nKnowledge of effective practices and technologies: improving management practicesBrief explanation of evidence"] [14.110751152038574, 2.887213945388794, "d staff who provided guidance and suggestions during all parts of the project. We specifically recognize Steven Schuetz and William Ford, who were most involved in this effort.\nWe would like to acknowledge the reviewers, Elizabeth Groff at Temple Uni"] [14.19408130645752, 2.6236538887023926, " in comparison, covered a full range of law enforcement problems, opportunities, and responses, including needs related to vehicles, facilities, personal equipment, personnel development, and training, as well as IT. \nLEAP 2 took place over the cours"] [13.067063331604004, 4.3616132736206055, "ders, and themselves during enforcement activity. More broadly, they are charged with maintaining positive relations and trust with the communities they serve, giving life to the widely cited \u201cPrinciples\u201d statement that \u201cthe police are the public and"] [14.144760131835938, 2.9488415718078613, "ncounter and then share that recording with the world through social media. Cam -\neras of all types, including police body-worn and dashboard-mounted cameras, have given the public a never-before-seen view into police work and have raised the expecta"] [14.109273910522461, 2.9218649864196777, " leaders of other organizations) over the past few years, backed with evidence captured in a range of scholarly articles. \nChapter Three describes the current state of law enforcement technology and practice, as \nwell as previously generated needs fo"] [13.769232749938965, 3.3908138275146484, "been motivated by anti-police hatred tied to use-of-force incidents (Fernandez, P\u00e9rez-Pe\u00f1a, and Bromwich, 2016). This environment may have contributed to increas -\ning fear among officers for their own safety , as measured in a recent Pew poll (Morin"] [13.13915729522705, 4.145145416259766, " even more critical, and more challenging, in the future. \nThe purpose of this chapter is to provide a contemporary narrative review of modern \nAmerican policing. This modern history and associated challenges have been directly influ -\nenced by polic"] [12.960797309875488, 4.349376678466797, "he country. \nIn the process, the term \u201cFerguson\u201d would become shorthand not just for the Michael \nBrown shooting and its immediate aftermath. It would come to represent the beginning of an intensive public examination of police use-of-force policies,"] [12.96764850616455, 4.333242416381836, "Vaughn, and Lim, 2014) or limited pool of incidents (Nix et al., 2017; Hine et al., 2016). But, for the profession as a whole, the new national system should help answer fundamental questions about police use-of-force trends. \nAnother federal respons"] [13.035035133361816, 4.28251314163208, "te video, agencies must expect that the video will be viewed almost instanta -\nneously by thousands of people across the country and around the world. They must also know that, in today\u2019s environment, a single controversial incident captured on video"] [13.122676849365234, 4.211802959442139, " both criminal and internal probes of the incident (Miller, Toliver, and Police Executive Research Forum, 2014). \nA growing number of jurisdictions are enacting laws or regulations governing when and \nhow videos will be released (National Conference "] [13.037096977233887, 4.350678443908691, "ce and found vast differences of opinion between African-Americans and whites. Seventy-five percent of whites said the police treat different racial and ethnic groups fairly; three-quarters of whites also said police use the right amount of force for"] [12.975351333618164, 4.296011924743652, " formal consent decrees (i.e., legal agreements in which an agency agrees to make specified changes, with the implementation of those changes overseen by a court) (U.S. Department of Justice, 2016). In the first five fiscal years of the Obama adminis"] [13.16067123413086, 4.070342540740967, "er year in the 1920s, which was the 12 Identifying High-Priority Technology and Other Needs for Improving Law Enforcement Operations and Outcomes\ndeadliest decade in U.S. law enforcement history (National Law Enforcement Officers Memo -\nrial Fund,"] [13.115274429321289, 4.153901100158691, "inhabitants, 1996\u20132015.\u201d \n5 Federal Bureau of Investigation, Crime in the United States , 2015, Table 12, \u201cCrime Trends, by Population Group, \n2014\u20132015.\u201d \n6 Of the 1,532 additional homicides recorded in 2015 as compared to 2014, these four cities "] [13.196431159973145, 4.089739799499512, "dent in Ferguson. While the evi -\ndence for a national Ferguson effect is lacking, some cities may be seeing increases consistent with the Ferguson effect hypothesis, particularly cities with large African-American popula -\ntions.\n8 Further research "] [14.284400939941406, 3.045835494995117, "daunting in the current environment, in which negative perceptions of the police, more opportunities in the private sector, and sometimes archaic police hiring policies and standards are making it difficult to attract new recruits (Wilson et al., 201"] [14.5567045211792, 2.647749423980713, "is of digital evidence not only possible but also crucial for solving crime (Goodison, Davis, and Jackson, 2015). And in today\u2019s \u201cCSI\u201d world, digital evidence is becoming increas -\ningly important\u2014indeed, expected\u2014by juries in many criminal cases. Ho"] [14.207234382629395, 2.6921510696411133, "elopment and training\nFacilitiesVehicles\n\u2022 Personal clothing, protection, \nor augmentation\n\u2022 Weapons and force\u2022 Ground\n\u2022 Aircraft\u2022 Watercraft\u2022 Associated technologies\n\u2022 Internal access control\u2022 Internal environmental control\u2022 Internal physical infras"] [14.175175666809082, 2.694167375564575, "s of training at all levels. \n3. Facility Operations and Population Services , which includes all aspects of maintain -\ning the buildings and structures, as well as the related security. This topic also includes management of infrastructure and logis"] [13.449394226074219, 3.2066473960876465, "5, p. 3) \nIt is not clear whether these changes have made police more effective. Evaluation research \non police technology has tended to focus more on operation and outputs\u2014for example, \nwhether a technology works and makes a process faster\u2014than on i"] [14.301578521728516, 2.644120216369629, "resented in each subcategory. \nInformation Collection \nThe collection of information is vital to performing day-to-day law enforcement operations, and currently many information collection tools are available to law enforcement. Basic data collection"] [13.974871635437012, 2.857231855392456, "g, 2015). Farrar and Ariel (2103) found that body-worn cameras were associated with a 50 percent decrease in use-of-force incidents. Similarly, a University of Cambridge study found a 93 percent decrease in complaints against the police after officer"] [13.6155366897583, 1.9181724786758423, "G), and wireless Internet from both public and private hosts. \nFrom an information delivery perspective, we have seen an upsurge in the number of \nvendors offering systems with common operational picture-type displays, which show anno -\ntated maps, t"] [13.843771934509277, 3.0005075931549072, "ork has been done to improve the sharing and use of information. Feder -\nally supported examples alone include, but are not limited to, the following:\n\u2022 The National Information Exchange Model (NIEM) is a common technical framework for sharing struct"] [13.69619083404541, 3.087908983230591, "vely involved in information sharing, to include sponsoring several IEPD standards packages; it maintains a center on social media, as well. \nAt a lower level, we have seen an upsurge in vendors offering information integration \nservices.\nHowever, th"] [14.052237510681152, 3.0494682788848877, "ledge Development and Training \nDOJ and other organizations have put a great deal of resources into creating online resources for disseminating law enforcement\u2013related knowledge. As the first of just a few examples, NIJ maintains the CrimeSolutions.g"] [14.060836791992188, 2.8382105827331543, "nsic backlogs, although most, except for the general Paul Coverdell Forensic Science Improvement Law Enforcement Technology and Practice Today 25Table 3.1\nSample Technology and Practice Resources for Law Enforcement Agencies\nNeed Resource Descript"] [14.01950454711914, 2.880908489227295, "Center for Problem-Oriented Policing (University at Albany/Office of Community Oriented Policing Services)Repository of over 100 guides with ideas to address different types of crime-generating problemshttp://www.popcenter.org/26 Identifying High-"] [14.159954071044922, 2.673929452896118, "The National Institute for Occupational Safety and Health (2016) maintains a portal on motor vehicle risks and potential solutions. \nThis domain does cover unmanned or remotely piloted vehicles\u2014aerial, ground, and on \nthe water. Unmanned aerial vehic"] [14.159494400024414, 2.6523125171661377, "nducted energy weapons to its offi -\ncers, for example (D\u2019Onofrio, 2016). \nPrior Law Enforcement Needs: The First Law Enforcement Advisory Panel \n(LEAP 1) and Related Studies\nThere have been a number of studies on law enforcement agencies\u2019 needs for "] [14.17876148223877, 2.7377331256866455, "rds, common operational pictures, health monitoring systems, and law enforcement process initiatives than there was \u201csupply.\u201d Finally, top themes in keynote addresses in IACP conferences from 2011 to 2014 were also reflected as top-ranking needs, of "] [14.126506805419922, 2.7432568073272705, "stions have included: How can sponsors make practitioners better \naware of technology information and training? How can sponsors make it easier for practi -\ntioners to find the information they need? How can the presentation of information be better "] [14.12624454498291, 2.7416090965270996, "s for policies, procedures, and guidance related \nto video surveillance, sensor systems, and cybersecurity. This continues to be an area where RAND sees high demand from both practitioners and external organizations for additional guidance and knowle"] [13.944804191589355, 2.240858316421509, "eployable biometric devices with a range of biometric sensors and connectivity needed to positively identify some -\none within a minute; a device that can extract photos, texts, and other electronic evidence from \n5 Recent articles starting to exami"] [14.200093269348145, 2.6675093173980713, "a new technology into their organizations and operations?\n\u2022 Are there any people in your organization who publish articles to inform other agencies on how to integrate new technologies into their organizations and operations?\n\u2022 Who comes to mind when"] [14.255294799804688, 2.601407051086426, "lists also discussed how the operational context of policing has changed since the original LEAP in 2013. Panelists then identified issues facing law enforcement, focusing on issues that go beyond what LEAP 1 covered in 2013, and brainstormed and dev"] [14.317072868347168, 2.4982709884643555, "ds that rose to the top of the highest tier likely merit par -\nticular attention and focus. Needs in the middle-rated group are in Tier 2, and needs in the bottom-rated group are in Tier 3. \nThese steps are explained in more detail below. Appendix C "] [14.243922233581543, 2.715129852294922, "ower, with lowering costs being weighted, on average, far lower than the others.\nThe 2013\u20132014 LEAP 1 showed a somewhat different pattern of weights on the objec -\ntives. That panel rated reducing crime as the most important, followed by improving co"] [14.245007514953613, 2.643291473388672, "unity rela -\ntions and uses of force. At the same time, budgetary pressures have been reduced since the height of the 2008 recession. We find it likely that these changes in priorities reflect changes in the social, political, and budgetary environme"] [14.458354949951172, 2.371842384338379, "AP 2. At the end of both sessions of LEAP 2, we had 82 needs from the Operational session and 72 needs from the Strategic and Administrative session.\nPrioritizing Needs\nThe first step in prioritization was to capture the objectives that each need sup"] [14.696608543395996, 1.9290107488632202, "areas as\n\u2022 cost to the fielding agencies\n\u2022 policy and politics, notably including security, privacy, and civil rights concerns\n\u2022 culture\n\u2022 human factors (solution not too hard to use).\nHigh-rated solutions were seen as likely to succeed in the field,"] [14.28003215789795, 2.5163700580596924, ".5\nStrategic and Administrative Needs, by Overall Score and Tier\n0 200 400 600 800 1,000 1,200 1,400 \n0 10 20 30 40 50 60 70 80 Median objective-weighted expected value \nNeed rank \nRAND RR1814-4.5Top\nTier 1Tier 2Tier 3 \nFigure 4.6\nLEAP 2 Needs, by Pr"] [14.28466510772705, 2.5367870330810547, "rove\ntrustLower\ncostsImprove \nresponsesImprove \ncompetencies\nRAND RR1814-4.7Number of needs\nWeight\nLaw enforcement objective\nTier 1 Tier 2 Tier 3 WeightIdentifying and Prioritizing Innovation Needs in T"] [14.202564239501953, 2.6144015789031982, "ment, and dispatch center (i.e., PSAP) operations. Consistent with this panel\u2019s emphasis on improving community trust, there also was a dramatic increase in needs related to communicating with the public. There were also slight increases in needs for"] [14.273223876953125, 2.550297737121582, "ment but that support only one or two objectives. If improvement on those objectives was viewed as particularly important by the panelists, then neglecting to identify those needs would potentially miss an opportunity to do so.\nAnother way to look at"] [14.260655403137207, 2.773118257522583, " assessments of community policing implementations to determine which ones are more successful.\nS\nEvidence-based management practices are often not generalizable across different agency sizes and environments.Examine ways to better present to decisio"] [14.191800117492676, 2.7304437160491943, "g that can be read and understood quickly.\nO\nTraining best (and worst) practices and instructional design are either not well known or not implemented widely.Develop a taxonomy or set of categories and supporting information that can be used to desig"] [14.149040222167969, 2.7103826999664307, " and disseminate partnerships with universities, community colleges, and federal training programs (enrollment limited) that already provide training and support on Internet investigations, to make it a routine part of training and operations. Traini"] [14.171783447265625, 2.6094722747802734, "ansparency may give the public the incorrect impression of what is actually going on (e.g., \u201cshots fired\u201d ended up being firecrackers, \u201ddangerous area\u201d is a busy shopping mall).Develop best practices surrounding ensuring that the appropriate levels o"] [14.174860000610352, 2.6727616786956787, "imes it is optimized for fire and emergency medical services [EMS]).Research the locally optimal sets of questions (with branching) to gather the critical information and be able to dispatch law enforcement, firefighters, and EMS.\nS\nAgencies unwillin"] [14.43036937713623, 2.588836669921875, "Opportunity) Associated Need\nSolve more casesS Insufficient data exist to adequately measure the impact of forensic backlogs and other bottlenecks on criminal justice system efficiency and throughput.Do a study to measure the impact of forensic backl"] [14.701260566711426, 2.448871374130249, " needs that can be considered \u201clow-hanging fruit,\u201d which are needs \nthat had top-rated median risk scores (defined as technical feasibility score \u00d7 operational feasi -\nbility score). All low-hanging fruit needs were already captured either as Tier 1 "] [14.173050880432129, 2.6616809368133545, "nforcement\u2019s sharing and use of \ninformation.\n\u2022 About 15 percent were needs to improve law enforcement\u2019s forensic capabilities.\n1 Figure 5.1 reflects both Tier 1 needs and special priority needs, as discussed in Chapter Four.Figure 5.1\nBuilding the "] [14.282618522644043, 2.7540111541748047, "arting with the repository and working outward.\nNeed for a Research Repository\nPanelists noted that important research and technology results are not widely known by the practitioner community. In this top-ranked need, they called for a repository th"] [14.27784252166748, 2.7475485801696777, "ivacy, \ncivil rights, and cybersecurity protections for new technologies. LEAP 2 had few top-rated needs on these topics; instead, the discussion focused on privacy, civil rights, and security as attributes that needed to be embedded by default. One "] [14.22814655303955, 2.8109219074249268, "ctices, and may be more realistic. One potential example cited was public commentary by law enforcement officials; while a need for more and better training was cited, it was also acknowledged that it can be difficult to foster the instincts needed f"] [14.361128807067871, 2.805020332336426, "). Change management strategies will need to be able to respond to such objections directly.\nDesires for change management specifically included calls for help in evolving agency \nstructure, hiring, retention, and human resources. For example, paneli"] [14.370903015136719, 2.9232375621795654, "nelists noted, the problems are clearer than the \nsolutions. Technology would seem to be an obvious means to help support improved relations; however, while the potential for new technology to create new problems is clear (for example, the failure to"] [14.412847518920898, 2.880974531173706, "sion was that agencies need to actually listen to the feedback, \u201ctruly listening\u201d to concerns from the community, and to create a feedback loop so that the community would have evidence that law enforcement had heard their concerns, even if law enfor"] [14.316250801086426, 2.776013135910034, "d that since agencies already do not feel they are able to train offi -\ncers sufficiently on topics such as technology, even on the basics, new tools and systems can leave officers worn out and overloaded. \nTo address this, panelists called for metho"] [14.618352890014648, 2.683227777481079, "l evidence indefinitely may result in both higher facility costs and higher labor costs to find, access, and manage all of the evidence when needed. They even noted that problems in finding and maintaining evidence in large stores could result in pro"] [14.162187576293945, 2.6820855140686035, "es for selecting gear, carrying gear, and informing the public of why different types of personal gear are needed.\nTechnologies to Reduce Casualties: Incapacitation Devices\nPanelists noted that current less-lethal weapons, including conducted energy "] [14.209636688232422, 2.6447577476501465, "ticipants citing problematic consolidations of fire and police dispatch. Participants wanted operational and financial efficiencies but also wanted to retain ownership, direction, and control of important assets. Participants also called for research"] [14.186448097229004, 2.64837384223938, " need to be coordinated with the development and education efforts of DHS, such as with DHS\u2019s First Responders Group (U.S. Department of Homeland Security, First Responders Group, 2016). Needs to reduce crime were well-covered in LEAP 1, and a number"] [14.156414985656738, 2.873032569885254, "rials to produce an initial taxonomy.\nPolice-community relations: strategiesR&E on sectoral/community policing practicesReview prior references to produce a quick guide on what seems to work best.\nMeasures for evaluating community-relations activitie"] [14.182574272155762, 2.7145919799804688, "e law enforcement discipline as a whole. \nLaw enforcement today is facing a number of challenges, including erosion in public trust \nand confidence, a rise in homicides and other violent crime that includes a spike in attacks on officers, and continu"] [14.270456314086914, 2.626708745956421, "ty (California)\nGary Woodruff Depu ty Chief, Lawrence (Indiana) Police Department\nHarlan Yu Princip al, Upturn (D.C.)\nMike Yu Dete ctive, Montgomery County (Maryland) Police Department69APPENDIX B\nPre-Meeting Questionnaire\nThank you for agreeing "] [14.224333763122559, 2.691444158554077, "s include tracking the numbers of sick days, long-term leave days, and health-related departures from agencies over time.\nReduce Casualties in the Line of DutyReduce the numbers of serious or fatal injuries to law enforcement, bystanders, and suspect"] [14.215014457702637, 2.6338589191436768, "uding lethal, less-lethal, restraints, and related technologies\n\u2022Management, Personnel Development, and Training \u2014including departmental poli -\ncies, strategy and tactics, training, education, management and business process, andother concerns.\nQuest"] [14.30539321899414, 2.629253625869751, "as you would like)\n1. \n2. \n3. \nQ7. What problems or shortfalls exist in the area of management, personnel, develop -\nment, and training that hurt LE agencies\u2019 ability to achieve their missions effectively and \nefficiently? (List as many or as few as"] [14.784833908081055, 1.8992923498153687, ", and Re-Rating the Needs\nThe ratings process is a variant of RAND\u2019s Delphi method, which was first introduced in the \n1950s (for example, Dalkey and Helmer, 1963). As RAND\u2019s portal on the Delphi method notes,\nThe method entails a group of experts wh"] [14.766180992126465, 1.8192087411880493, "list j , E(V\nij), is:\nE(Vij)= CkIk\nk=18\n\u2211\u239b\n\u239d\u239c\u239e\n\u23a0\u239f(MijXTijXOij).\nHere,\n\u2022 The first summation in the formula reflects the weighted number of objectives that the \nneed supports. Ck represents the weight for each objective (recall this was generated by \n"] [14.75674057006836, 1.8422582149505615, "ntial outcomes of an effort to meet a need with a real-world benefits perspec -\ntive. The approach provides for much more rigor than simply asking panelists how important each need is.\nCategorizing the Needs into Priority Tiers\nWe used a hierarchical"] [14.670620918273926, 1.9110685586929321, ", \u201c1\u201d represents the need that had the \nhighest score, and \u201c82\u201d represents the need that had the lowest score. The pattern of branches \nshows when each \nneed or group of needs was combined into a larger group, with the length of \neach branch \nreflect"] [14.61637020111084, 1.9871059656143188, "alue score for each need. Dendrogram \ngenerated using Wessa (2016).\nRAND RR1814-D.1Tier 3\n(55\u201382)\nCut: 470\nTier 2\n(30\u201354)\nTier 1\n(1\u201329)\nCut: 665\nTier 1+\n(1\u20137)\nCut: 1,03082 Identifying High-Priority Technology and Other Needs for Improving Law Enfo"] [14.194778442382812, 2.6613106727600098, "ng\n2. Social media strategies and tools for interacting with the public\n ii. Fiel d analytic tools or test technologies\n1. Drug and alcohol screens and tests\n iii. Labo ratory tools and techniques for evidence analysis (forensics technologies)\n1. Chr"] [14.172098159790039, 2.6961660385131836, "ecision dashboards (e.g., COMPSTAT)\n2. Tablet or mobile applications for presentation of data to officers\n2. Vehicles\na. Ground\ni. Automobiles\n1. Patrol cars\n2. Patrol SUVs\n ii. Moto rcycles\n1. Patrol motorcycles\n2. Patrol tricycles\niii. Bicycles\niv."] [14.271862983703613, 2.7770416736602783, " center design\n6. Real-time crime centersFull Law Enforcement Technology Taxonomy 91\n7. For jail design and related technologies, see \u201cFostering innovation in \ncommunity and institutional corrections\u201d\n ii. Fur nishings and contents\n1. Visitor inte"] [14.146578788757324, 2.647043228149414, "ing\n iii. Pol icies and knowledge for carrying out roles\n1. Standard operating procedures and department specific policies\n2. Special operations plan templates and tools\ne. Specialist/technologist knowledge development and trainingFull Law Enforcemen"] [14.253535270690918, 2.7296152114868164, "current situation.***\nO75 1 *Doctrine and Strategy for Carrying Out Agency MissionsBest practices on sectoral policing with community engagement elementsIssue: Overcoming \u201cus versus them\u201d mentalities between departments and communities. \nNeed: Develo"] [14.254913330078125, 2.7437708377838135, "entions are effectiveIssue: Evidence-based management practices are often not generalizable across different agency sizes and environments.\nNeed: Evaluation reports need to show information about \nwhen and where interventions/technologies are more ar"] [14.18149471282959, 2.6627745628356934, "2 Acquisition and Technology DecisionmakingUse cases for portable fingerprint scannersIssue: It is difficult to verify identities when individuals lie about who they are.\nNeed: Collect and disseminate agency use cases and \nexperience with portable fi"] [14.234481811523438, 2.704633951187134, "enforcement personnelIssue: Law enforcement agencies are often \u201ctraining grounds\u201d for individuals who leave for larger agencies/salaries (especially in highly technical fields). As a result, law enforcement agencies have difficulty retaining experien"] [14.215654373168945, 2.7107646465301514, "gy for Carrying Out Agency MissionsIdentify sources of assistance for agencies to measure their effectivenessIssue: There is not a common understanding of the definition of what it means for agencies to be effective.\nNeed: Identify sources of assista"] [14.181242942810059, 2.687790632247925, "yIssue: Reduce information overload and lack of accessibility of academic/technical papers. \nNeed: Academics need to work with practitioners to create \ndocuments and training that can be read and understood quickly.* * *\nO91 1 Practices and Tactics T"] [14.157639503479004, 2.651881456375122, "t between standards for recording and standards for public disclosure, which is having a de facto affect on cases. \nNeed: Set up a collaborative effort to identify promising \nlegal provisions and policies around video footage and other law enforcemen"] [14.189789772033691, 2.677431344985962, "ble F.1\u2014continuedFull List of Needs from LEAP 2 105ID Tier Top Category Title Description\nReduce Crime\nSolve Cases\nImprove HealthReduce CasualtiesImprove TrustLower CostsReduce CompetenciesImprove Responses\nS127 3 Firearm Range Technologies Study "] [14.27871036529541, 2.690225839614868, "ers, etc.) that are most likely to get support. **\nS129 2 Staff Equipment Storage and MaintenanceStudy costs of storing excess evidenceIssue: Significant amounts of excess evidence are being retained well beyond retention standards.\nNeed: Study the c"] [14.202313423156738, 2.694469690322876, " linking, forensic evidence, and tracking tools to solve more crimes. \nNeed: Research and dissemination on integration and \nfiltering of crime analysis and forensic analysis data to collectively solve crimes.* *\nO17 2 Computational Tools R&D on impro"] [14.171767234802246, 2.6390483379364014, "esulting in delayed justice and wasting other law enforcement resources. \nNeed: Examine the potential effects of \u201csharing \narrangements\u201d to optimize forensic analyst labor across state and local demands. * **Table F.1\u2014continuedFull List of Needs from"] [14.225846290588379, 2.6599349975585938, "Monitoring R&D on \u201cgoing dark\u201d and \nworkaroundsIssue: End-to-end encryption supports both improved protection of law enforcement and the public and concealment of criminal activity. \nNeed: Research and dissemination on data on the nature \nand extent "] [14.101749420166016, 2.6055185794830322, "ratory Tools and Techniques for Evidence Analysis (Forensics Technologies)Partner with universities on studying forensic backlogsIssue: Forensics backlogs at labs (especially state and federal) are resulting in delayed justice and wasting other law e"] [14.124674797058105, 2.655280828475952, "e vendors with identifying information needed by officers at different points on a callIssue: Many information displays result in information overload for responding officers.\nNeed: Assist software vendors with identifying the pieces \nof information "] [14.180682182312012, 2.647362470626831, "cement dataIssue: Open data/transparency may give the public the incorrect impression of what is actually going on (\u201cshots fired\u201d ended up being firecrackers, \u201ddangerous area\u201d is a busy shopping mall).\nNeed: Develop best practices for ensuring that t"] [14.193683624267578, 2.6503021717071533, "om LEAP 2 115ID Tier Top Category Title Description\nReduce Crime\nSolve Cases\nImprove HealthReduce CasualtiesImprove TrustLower CostsReduce CompetenciesImprove Responses\nO29 2 Information Presentation \nTools and DashboardsR&D on interfaces for prep"] [13.882685661315918, 2.958914041519165, "esistant to facilitating data interchange). \nNeed: Have DOJ publish model interoperability language \nthat can be readily dropped into requests for proposals for new RMSs. Language will need to support being configured for different sizes and types of"] [13.931797981262207, 2.9311559200286865, "interchange standards.* *\nS55 2 System Integration and Information SharingModel records and evidence lawsIssue: Records and evidence laws are out of date\u2014many were written in the paper records era. \nNeed: Develop model laws that can be easily adapted"] [14.000057220458984, 2.9117748737335205, " Develop data interchange standards (including \nbusiness rules) to facilitate making the connection between law enforcement records and court records.* *\nS99 3 IT Systems for Managing Mission-Related DataStandards for RMS/CAD systems to include built"] [14.150777816772461, 2.675257444381714, "esImprove Responses\nS63 3 Information Security Case studies on how agencies \nhave implemented cyber protectionsIssue: Law enforcement agencies are still susceptible to cyber attacks. \nNeed: Disseminate case study vignettes that describe the \nsuccesse"] [14.090339660644531, 2.6407699584960938, " more consistent incapacitation effectsIssue: Need more-reliable and safer incapacitation weapons than the status quo (conducted energy weapons, beanbags, pepperballs). \nNeed: Research to develop weapons and practices that \nhave consistent effects in"] [14.142972946166992, 2.673910617828369, "cene lighting.* *\nO151 3 Pursuit Management Research on remote vehicle immobilization technologiesIssue: Insufficient pursuit mitigation/vehicle immobilization technologies to address changes in pursuit policies. \nNeed: Research on remote immobilizat"] [13.361719131469727, 3.8344781398773193, "BC News, July 9, 2016. As of June 7, 2017: http://www.nbcnews.com/tech/tech-news/police-shootings-test-new-era-violent-social-media-video-n605366\nBerg, Mark T., Eric A. Stewart, Jonathan Intravia, Patricia Y. Warren, and Ronald L. Simons, \u201cCynical \nS"] [13.380459785461426, 3.85942006111145, " Profiling,\u201d Journal of Contemporary Criminal Justice , \nVol. 28, No. 2, 2012, pp. 206\u2013227.\nComey, Jim, \u201cMessage from the Director,\u201d in Federal Bureau of Investigation, Crime in the United States, \n2014. As of June 7, 2017: https://ucr.fbi.gov/crime-"] [13.430691719055176, 3.792112112045288, "rts References 127\nDurham Constabulary, \u201cSir Robert Peel\u2019s Principles of Law Enforcement,\u201d 1829. As of June 12, 2017: \nhttps://www.durham.police.uk/About-Us/Documents/Peels_Principles_Of_Law_Enforcement.pdf\nThe Economist, \u201cPolice Departments Strug"] [13.514147758483887, 3.634314775466919, " (RMSs) as They Pertain to FBI Programs and Systems , Washington, D.C.: U.S. Department of Justice, \nno date. As of December 5, 2016: https://www.fbi.gov/file-repository/law-enforcement-records-management-system.pdf/view \nFederal Bureau of Investigat"] [13.510574340820312, 3.3115077018737793, "ation/attachments/MPD%20Annual%20Report%202015_lowres_0.pdf \nGroff, Elizabeth R., and Tom McEwen, Identifying and Measuring the Effects of Information Technologies on \nLaw Enforcement Agencies , Washington, D.C.: Office of Community Oriented Policing"] [13.892929077148438, 3.158198833465576, "nvironment_Playbook.pdf \nInternational Association of Chiefs of Police, Law Enforcement Priorities for Public Safety: Identifying Critical \nTechnology Needs , Alexandria, Va., 2005.\n\u2014\u2014\u2014, \u201cRecommended Guidelines for the Use of Unmanned Aircraft,\u201d Alex"] [13.591126441955566, 3.567922353744507, "oads/2016/09/ \n21-Sep-16-Supt-Johnson-Announced-Major-Hiring-Plan.pdf\nJones, Jeffrey M., \u201cIn U.S., Confidence in Police Lowest in 22 Years,\u201d Gallup, Inc., June 19, 2015. As of June 7, \n2017: \nhttp://www.gallup.com/poll/183704/confidence-police-lowe"] [12.933883666992188, 4.452864646911621, "ice \nUse of Force: An Examination at Micro and Meso Levels,\u201d Journal of Criminal Justice , Vol. 42, No. 6, 2014, \npp. 491\u2013499. \nLEITSC\u2014 See Law Enforcement Information Technology Standards Council.\nLevenson, Laurie L., \u201cPolice Corruption and New Mode"] [13.327455520629883, 3.918637990951538, "ril 13, 2017: \nhttp://www.policeforum.org/assets/docs/Free_Online_Documents/Police_Evaluation/ \nthe%20bottom%20line%20of%20policing%202003.pdf Morin, Rich, Kim Parker, Renee Stepler, and Andrew Mercer, Behind the Badge: Amid Protests and Calls for \n"] [13.376189231872559, 3.848616123199463, "cademies Press, 2004. Newport, Frank, \u201cU.S. Confidence in Police Recovers from Last Year\u2019s Low,\u201d Gallup, Inc., June 14, 2016. \nAs of April 26, 2017: http://www.gallup.com/poll/192701/confidence-police-recovers-last-year-low.aspx \nNIJ\u2014 See National I"] [13.320295333862305, 3.884052038192749, "d Administration of Justice, The Challenge of Crime in a Free \nSociety , Washington, D.C.: U.S. Government Printing Office, 1967.\n\u201cProtests Against Police Violence Continue Across U.S.,\u201d CBS News, July 11, 2016.\nPublic Law 106-297, Death in Custody R"] [13.711468696594238, 3.826826333999634, "afety , \nSanta Monica, Calif.: RAND Corporation, RR-1488-NIJ, 2016. As of June 8, 2017: https://www.rand.org/pubs/research_reports/RR1488.html\nShaw, Clifford, and Henry McKay, Juvenile Delinquency and Urban Areas , Chicago: University of Chicago \nPre"] [13.320123672485352, 3.9143009185791016, "an.org/features/body-camera-update/index.html \nU.S. Department of Homeland Security, First Responders Group, \u201cFirst Responders,\u201d DHS.gov, 2016. As of \nNovember 3, 2016: \nhttps://www.dhs.gov/science-and-technology/first-responders# \nU.S. Department o"] [13.955415725708008, 3.2988641262054443, "e\u2013Community Relations in a Majority-Black \nCity,\u201d\u00a0 Journal of Research in Crime and Delinquency , Vol. 45, No. 4, 2008, pp. 398\u2013428. \nWessa, P., \u201cHierarchical Clustering (v1.0.3),\u201d Free Statistics Software (v1.1.23-r7), Office for Research Developmen"] [14.613579750061035, 3.045166492462158, "ponding to an active shooter. There is also a need for a review of technologies that might improve of\ufb01cers\u2019 \nhealth.\nCORPORATION"] [4.731743335723877, 7.8545613288879395, "Measuring Automated \nVehicle Safety\nForging a Framework\nLaura Fraade-Blanar, Marjory S. Blumenthal, James M. Anderson, Nidhi Kalra\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protect"] [13.809769630432129, 4.489577770233154, "y held nature of AV data limits the details of what is made public or shared between companies and with the government. The report focuses on identifying key concepts and illuminating the kinds of measurements that might be made and communicated. \nT"] [4.767182350158691, 7.747050762176514, "................................................................ 1\t\nContext for Contrasting AV and Conventional Automotive Safety ......................................................... 1 \t\nMeasurement Framework Focuses on System and Ecosystem Lev"] [4.740803241729736, 7.713088512420654, "....................................... 29 \t\nMeasure Category 2: Leadin g Measures ............................................................................................. 29 \t\nMeasure Category 3: Lagging Measure .............................."] [4.754316329956055, 7.72159481048584, "..................................................... 55 \t\nRecommendations ................................................................................................................................... 58 \t\nThe Bigger Picture ................."] [4.7782416343688965, 7.757449626922607, "sure (Denominators), and Comparisons \nfor AV Safety Metrics and Potential Rating of Characteristics (outlined in Table 3.3) ........ 41\t\n \n viii Summary \nThe race to introduce automated vehicles (AVs) to consumers and communities is premised \nin p"] [4.741187572479248, 7.673398494720459, " (simulation, closed courses, and public roads) and deployment (on public roads). \nThe practice that we are calling demonstration \n(while acknowledging that there are other uses \nof that term) is common in product development. For AVs, it involves en"] [4.763908863067627, 7.707433700561523, " and long terms). A third type of measurement, around standards, processes, procedures, and design, is not included because it can be applied at lower levels of vehicle composition (i.e., not for complete vehicles) that evolve constantly, and because"] [4.817955493927002, 7.737929821014404, "their concerns on the \nsafety of the public, not on how development is progressing per se (which is the \ndeveloper\u2019s concern). \n\u2022 The opportunity to leverage a demonstration stage as a time for communication outside a company about safety (e.g., to p"] [4.776748180389404, 7.946988582611084, "so benefited from discussions with research organizations, including California PATH at the University of California, Berkeley; Exponent; kVA; the Insurance Institute for Highway Safety; and the PEGASUS Project. Conversations with Advocates for Highw"] [4.786584854125977, 7.752126693725586, "n computer-\nbased technologies, how to think about, measure, and discuss AV safety is not obvious. That is no small irony; proponents of AVs have emphasized their potential to be safer than the conventional vehicles they are expected to displace. In "] [4.828429698944092, 7.822414398193359, "ufacturing and mechanical engineering roots. Companies focusing on mobility as a service (e.g., ride-share services) have also entered the fray because of the potential synergy of AVs with new service models. Cross-fertilization of different communit"] [4.817405700683594, 7.80682373046875, "h as those responsible for perception processes \nand for planning how the AV will move through the environment it perceives. \nThe macro-level systems of AV composition consist of the vehicle itself, its occupants \n(themselves representing the comple"] [4.779475688934326, 7.746391773223877, "teady stream of feedback, new inputs, and discussion. \nA principal constraint on the articulation of very specific metrics is the absence of publicly \navailable data.\n13 AVs\u2019 computer-based technologies collect and analyze vast amounts of data that "] [4.770682334899902, 7.768022537231445, "h vehicle technology and the \nlarger roadway ecosystem are evolving\u2014what is judged a safe car today might not represent safety tomorrow. As reflected in media coverage and congressional hearings, the average consumer would like to compare the safety "] [4.695925712585449, 7.745886325836182, "and measures aimed at reducing the risk of accidents. . . . Traffic safety is an indicator of [the] road transport system, as a consequence of the \ninteraction of factors that determine i ts operation.\u201d\nd \n\u2022 \u201cIn most technical contexts, safety is de"] [4.699557781219482, 7.978085994720459, "rred relative to the number of people exposed to the \npotential for harm? For motor vehicles, exposure-based rates of risk have been measured based on population (e.g., per licensed driver or registered vehicle), amount of driving (e.g., vehicle mile"] [4.787359714508057, 7.772934913635254, "otective roadside \nobjects \nPost-crash \u2022 First-aid skills \n\u2022 Access to medics \u2022 Ease of access \n\u2022 Fire risk \u2022 Rescue facilities \n\u2022 Congestion \nSOURCE: Peden et al., 2004. \n \nThere are a variety of views on how safe AVs should be before commer"] [4.818395614624023, 7.79331636428833, "hardware and software) in the face of a malfunction (a kind of functional safety).\n29 It also \nprovides a framework for evaluating associated tools, such as simulators. ISO 26262 starts at the \nvehicle level, and addresses testing of separate compone"] [4.844466209411621, 7.802156925201416, "p safety and security requirements for the system design. Probability \nRisk Assessments and Fault Tree Analysis focus on hardware -specific failures within a system and can \nassist subcomponent designers in understanding how their electronics affect "] [4.89608097076416, 7.9403204917907715, "ndustry can agree to as \nbroadly beneficial.39 Deep consideration of policy mechanisms for motor vehicle safety is \nbeyond the scope of this report. \nSpecial Aspects of Level 4 AVs \nAs with other levels of automated driving systems, the development "] [4.775722503662109, 7.778436660766602, "hip than consumer ownership). \n \n41 NHTSA (2017b) outlines the role of ODDs. The industry is guided in more detail by SAE J3016 (SAE Mobilus, \n2018). \n42 SAE Mobilus, 2018. \n43 One pair of researchers"] [4.750242710113525, 7.715538501739502, "ety Considerations Extent to Which \nPublic Is Exposed How Risk Is Controlled \nArtificial settings: \nsimulationa There is no risk because automated \ndriving is not occurring in a real environment Not at risk \u2022 No risk exists. The \nenvironment is "] [4.771015167236328, 7.72623872756958, "nd best practices)? \n2. External validity:47 Is simulated AV performance consistent with real-world \nperformance under the same and other parameters (e.g., if the simulation assumes full sun \nat a 90-degree angle, does the AV system perform similarl"] [4.818244457244873, 7.763195991516113, "hysical environment, although environments could be limited and/or highly controlled.53 \nMany closed courses exist around the world\u2014some for exclusive use by a given developer or \nOEM, others available on a membership basis or other paid use. In 2017"] [4.767879962921143, 7.701778411865234, "er situations that fall within the ODD but in which the AV cannot function, and evaluate \nAV system performance after upgrades can be explored on public roads. Driving in closed courses and simulation provide additional settings to explore and circle"] [4.764060020446777, 7.678049564361572, "\n \nHowever, these loops risk myopia without the following: \n\u2022 procedures that introduce faults (a process referred to as fault injection59) into the AV \nsystem hardware, software subsystems, or communication between subsystems to test \nrobustness \n\u2022 "] [4.762186527252197, 7.671318531036377, " deployment stage, where the product is released to the public (Figure 3.3). Sometimes, particularly for software-based technology, refinement and revisions (some characterized as upgrades) continue during deployment. For AVs, safety in development a"] [4.758340835571289, 7.675613880157471, "res can be generated from scenarios in artificial or public \nroad settings. Many developmental pathways exist, from extensive testing in a private campus \n \n66 SAE Mobilus (20 18) outlines such fallback "] [4.779454231262207, 7.701577663421631, "me able to show that the AV does not \npresent a danger to the general public\u2014especially people, but also animals and \nproperty outside the vehicle. \n\u00be During demonstration, the goal is to show publicly that the AV is safe for commercial deployment o"] [4.782623767852783, 7.701502799987793, "velop \u201ca generally accepted and \nstandardized procedure, for the testing and approval of automated driving functions.\u201d PEGASUS Research Proje ct, \nhomepage, undated -a; PEGASUS Research Project, undated- b. \n77 Koopman and Wagner, 2018. \n \n 25 cou"] [4.8274922370910645, 7.774623870849609, " and Measuring Systems \nto \u201censure an independent further development and long -lasting maintenance of the standard.\u201d Association for \nStandardization of Automation and Measuring Systems, undated. \n79 California Code of Regulatio ns, undated; Nowako"] [4.768479347229004, 7.700094699859619, "ubcomponents are focusing safety requirements around significant mishaps that \nmust be avoided while the lower -level functions can perform as intended beyond the safety constraints. \n \nBy appropriately defining requirements and performing specifi"] [4.768073558807373, 7.701981067657471, "col by developers, \nwho can be expected to design for satisfying the protocol\u2014which is different from addressing \nreal-world requirements. Demonstration does not prove the vehicle is safe; at best, it shows the vehicle is not unsafe.\n87 \nDeployment "] [4.7322187423706055, 7.6954665184021, "elopment and demonstration take place in artificial \nsettings and on public roads, deployment only on public roads. Safety in development, \ndemonstration, and deployment can be assessed by multiple measures, with different interpretations and differe"] [4.729645252227783, 7.679929733276367, "outcome, but in \n \n90 The Abbreviated Injury Scale is maintained by the Associati on for the Advancement of Automotive Medicine \n(undated). \n91 Government of Alberta, 2015; Occupational Safety and Healt"] [4.723249912261963, 7.679220199584961, "dated. \n94 California Department of Motor Vehicles, undated. \n95 California Department of Motor Vehicles, 2017. \n96 Felton, 2018. \n97 Prescott, 2017. \n98 That reality, echoing situations observed with aviation automation, has motivated the rise "] [4.712010383605957, 7.661599159240723, "tment of Motor \nVehicles. Waymo, 2016. \n100 Infractions could also include violations or misdemeanors. Exact terminology differs between states. Within this \nreport, infractions refers to noncriminal violations of state and local traffic law. \n101 "] [4.705158710479736, 7.661798477172852, "nite number of driving \nbehavior rules is almost always violated. Somehow, safety envelopes were violated\u2014one of the \nRSS rules was not met by the AV or another road user. There could be other attractive ways to define the safety envelopes and \nother"] [4.714465141296387, 7.712166786193848, "bjective; physics -based; a vailable using current technology; currently in use in simulation and public road \nsettings \nWeaknesses Fails to distinguish initiators from responders; incomplete; might not serve as a proxy for all crash types; \nrelati"] [4.712904453277588, 7.6707987785339355, "crashes resulting in property damage over a certain cost, crashes resulting in injury, in severe injury (Abbreviated Injury Scale 3+), in death, etc. As an additional layer, outcomes can be classified by crash types or configurations. Measures that i"] [4.719748497009277, 7.662564754486084, " driving on public roads with a safety driver, meaning the simulated rate had low validity. However, if the simulation were run 5,000 times, always with the same result, the simulated rate could have high reliability. Similarly, safety in the develop"] [4.720881462097168, 7.66088342666626, "use of an excellent AV system performance or disengagement\u2014is the developer\u2019s purview. In the demonstration stage on closed courses and public roads, disengagement becomes informative if a human safety driver is involved (compared with an unmanned ve"] [4.6931867599487305, 7.632417678833008, "engagements are not informative) from \ndemonstration (when disengagements are highly informative and central to a comprehensive view of safety). The demonstration stage as outlined in the report doe s not currently exist. Until the demonstration stag"] [4.7155280113220215, 7.674019813537598, "h a measure might have high validity, medium reliability, high feasibility, and high non -\nmanipula tability. \n\u2022 In demonstration using simulation s, the measure reflects the count or rate per given simulation (or per \nscenario) of simula ted crashe"] [4.74094295501709, 7.706627368927002, "ne metric that has high non-manipulatability but medium validity and feasibility with another metric that has high validity and feasibility but medium non-manipulatability might present a coherent safety argument. \nAt every stage in each setting, th"] [4.744431972503662, 7.738433361053467, "xtent of penetration) Per hour driving \n(on public roads) All roadway types, in all weather, at all \nspeeds, with clear lane markings and no pedestrians, bicyclists, or scooters detected Same model \u2013year conventional \nvehicles with ADAS, excluding"] [4.740970134735107, 7.71735143661499, "erwise, the comparison is \nbiased. This concern gives weight to the question of which conventional vehicles should be \nincluded. Contrasting an HAV to a 12-year-old car (the current average vehicle age on the road in 2016\n116) is biased because of th"] [4.807707786560059, 7.813166618347168, "Level 4 vehicles because the system is expected to be able to operate (monitor the driving \nenvironment; steer; accelerate or decelerate; and respond effectively where it cannot do those \nthings\u2014 i.e., fall back) without the aid of a human driver wit"] [4.752758026123047, 7.715123653411865, "ng on what consumers need to understand, what regulators need to know, and what information companies need to communicate internally\u2014or, possibly, externally within the industry. Although taxonomic guidelines found in SAE J3016 map levels of automati"] [4.74806022644043, 7.70894718170166, "ow for differing lengths of time to be analyzed, but still require time to be bucketed. Bucketing exposure requires developers to decide when the system has changed sufficiently to start measuring safety afresh (i.e., to start a new bucket). \nOne po"] [4.754352569580078, 7.714013576507568, "there will be larger delays and larger variations in when the upgrade is downloaded. \nFigure 3.6. Decay of Influence of Time Period n over Time \n \nThe Ecosystem \nThus far, safety has been considered at the system level. As Figure 1.2 shows, the eco"] [4.733602046966553, 7.692323207855225, "e in immediate proximity to or contact with, elevating the safety of the entire fleet.\n127 \nAn ecological study could be implemented in many ways. The simplest option is to compare \na safety metric for location X to location Y, where X has AVs and Y"] [4.951903343200684, 7.980686187744141, "mendations aimed at furthering broad public dialogue about the safety of vehicles that are highly (and eventually fully) automated. \nAVs in the Broad Motor Vehicle Context \nBeyond passenger vehicles, automation is of interest for trucks and buses. A"] [4.976259708404541, 7.843351364135742, "t (e.g., the closed course of the American Center for Mobility\n134); so do \nefforts to promote development and use of common scenarios (e.g., the PEGASUS project), \ncommon testing code and procedures (e.g., Voyage\u2019s Open Autonomous Safety Initiative1"] [4.969327926635742, 7.833844184875488, "sultant information \n3. how the system interacted with the external environment \n4. safety lagging or leading events \n5. cybersecurity incidents (which will be discussed in next section).143 \n \nTheoretically, all data could be shared between compani"] [4.957355976104736, 7.874439716339111, " have a history of buying, evaluating, and rating automobiles. A new \ndata set containing detailed crash reconstructions for all lagging-measure events at or above a \ngiven severity would enhance understanding of how AVs fail and what happens when th"] [5.06047248840332, 7.9188971519470215, "on rely at least in part on some kind of connectivity with \nother vehicles, infrastructure, or the internet. This connectivity is probably necessary, but it also increases cybersecurity risks. Even for conventional vehicles, over-the-air communicatio"] [4.928720474243164, 7.868220329284668, "apers on \nvulnerabilities, threats, and attacks on automotive systems. \n151 Consumer Reports has weighed in on this issue. Barry, 2018. \n152 For a discussion of how AV cybers ecurity lapses might implicate liability, see Winkelman et al., forthcomi"] [4.814117431640625, 7.76009464263916, " \n154 Winkelman et al., forthcoming. \n155 Evtimov et al., 2017. \n156 The process of learning by doing, combining different modes of development and testing to capture unanticipated \ncircumstances and challenges, was documente"] [4.9033708572387695, 7.7358903884887695, "stem\u2019s website (undated) underscores that associated reporting is \u201cConfidential. \nVoluntary. Non -punitive.\u201d Other reporting channels for safety incidents in aviation include the Federal Aviation \nAdministration Hotline (2018) and the National Trans"] [4.846323490142822, 7.7688422203063965, "mportantly, effective risk communications can lead to the safer use of the vehicles. If there are particular circumstances that lead to even small amounts of increased risk, warning users of these risks could lead to increased vigilance and reduced c"] [4.770241737365723, 7.709716320037842, "Vs, as Chao noted. When elevators \nwere initially developed, there was considerable public fear. Being supported by unseen machinery while riding in a box that had the potential of dropping one to one\u2019s doom likely elicited considerable fear. To addr"] [4.766114234924316, 7.698953151702881, " more miles driven) . Demonstration is undertaken \nby testing through simulation and on closed courses and public roads with safety drivers\u2014the \nsettings discussed in this report. In closed courses and on public roads, demonstration protocols must co"] [4.809800148010254, 7.757248401641846, "ote a safety culture. The great race to develop safe and practical AVs should contribute to the overall goal of safe motor vehicle environments. This report\u2019s framework is intended to assist in that process. At the same time, it is important to ackno"] [4.760105609893799, 7.794129371643066, " these early results requires care and \ncaution because of differences in severity threshold and a lack of generalizability beyond the \ngeographies, time periods, and manufacturers included. Additionally, results associated with the AVs reflect the c"] [4.700319290161133, 7.959303855895996, "206e1bb49731bf3.pdf \nAssociation for the Advancement of Automotive Medicine, \u201cOverview,\u201d webpage, undated. As \nof September 4, 2018: https://www.aaam.org/abbreviated-injury-scale -ais \nAssociation for Standardization of Automation and Measuring Syst"] [4.674503326416016, 7.998178482055664, "al Report of Autonomous Vehicle Disengagements, \nundated. \n\u2014\u2014\u2014, \u201cAutonomous Vehicle Disengagement Reports 2017,\u201d webpage, 2017. As of September \n4, 2018: https://www.dmv.ca.gov/portal/dmv/detail/vr/autonomous/disengagement_report_2017 \nCenters for D"] [4.651307106018066, 8.00057315826416, "7. \n\u2014\u2014\u2014, \u201cFAA Hotline Reporting Form,\u201d August 13, 2018. As of September 5, 2018: \nhttps://hotline.faa.gov \nFederal Highway Administration, Surrogate Safety Assessment Model and Validation: Final \nReport, McLean, Va.: U.S. Department of Transportation"] [4.679819107055664, 7.963429927825928, "of September 4, 2018: https://www.theverge.com/2018/1/10/16874410/ voyage-self -driving-cars-villages-florida-retirement-communities \nHayward, John C., \u201cNear Miss Determination Through Use of a Scale of Danger,\u201d in \nProceedings of the 51st Annual Mee"] [4.694936752319336, 7.949057579040527, "n. \n 67 Jha, Saurabh, Subho Sankar Banerjee, James Cyriac, Zbigniew Kalbarczyk, and Ravishankar K. \nIyer, AVFI, Fault Injection for Autonomous Vehicles, Luxembourg, IEEE/IFIP International \nConference on Dependable Systems and Networks, June 2018. A"] [4.638901710510254, 7.998405456542969, "th authors, June 11\u2013August 24, 2018. \nLaris, Michael, \u201cFederal Researchers Are Using Data from Waze and Maryland to Try to Predict \nRoad Dangers,\u201d Washington Post, 2018. \nLe Coze, Jean-Chrisophe, Kenneth Pettersen, and Teemu Reiman, \u201cThe Foundations "] [4.6529860496521, 7.949644088745117, "rporation, PE-241-RC, 2017. As of September 2, 2018: https://www.rand.org/pubs/perspectives/PE241.html \nM\u00f6ller, Niklas, Sven Ove Hansson, and Martin Peterson, \u201cSafety Is More Than the Antonym of \nRisk,\u201d Journal of Applied Philosophy, Vol. 23, No. 4, "] [4.604732990264893, 8.016890525817871, "files/pre-crash_scenario_typology-final_pdf_version_5-2-07.pdf \n\u2014\u2014\u2014, Safety-Related Defects and Automated Safety Technologies , Washington, D.C.: U.S. \nDepartment of Transportation, NHTSA Enforcement Guidance Bulletin 2016-02, Docket No. NHTSA-2016-0"] [4.677567958831787, 7.998358249664307, "ournal of the Transportation Research Board, Vol. 2559, 2016, pp. 65\u201372. \n 72 Nowakowski, Christopher, Steven E. Shladover, Ching-Yao Chan, and Han-Shue Tan, \n\u201cDevelopment of California Regulations to Govern Testing and Operation of Automated \nDriv"] [4.668067455291748, 8.039493560791016, ": \nKluwer, 1991, pp. 175\u2013217. \nRoose, Kevin, \u201cCan Ford Turn Itself into a Tech Company?\u201d New York Times Magazine, \nNovember 9, 2017. As of August 31, 2018: https://www.nytimes.com/interactive/2017/11/09/magazine/tech-design-autonomous-future-cars-det"] [4.655612468719482, 8.005517959594727, "of-passenger-cars-in-the-united-states/ \nStern, Paul C., and Harvey V. Fineberg, eds., Understanding Risk: Informing Decisions in a \nDemocratic Society, Washington, D.C.: Committee on Risk Characterization, National Research Council, 1996. \nStilgoe"] [4.688061714172363, 7.966351509094238, "d Prevention, Vol. 71, October 2014, pp. 82\u201392. As of September 11, 2018: https://www.sciencedirect.com/science/article/pii/S0001457514001365 \n 76 Waymo, Report on Autonomous Mode Disengagements for Waymo Self-Driving Vehicles in \nCalifornia, Mounta"] [4.796934604644775, 7.744085311889648, "a new kind of measurement. While acknowledging that the closely held nature of AV data limits the amount of data that are made public or shared between companies and with the government, the report highlights the kinds of information that could be p"] [6.2580790519714355, 20.31241798400879, "Zero Days, \nThousands of Nights\nThe Life and Times of Zero-Day \nVulnerabilities and Their Exploits\nLillian Ablon, Andy Bogart\nCORPORATION\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected b"] [6.272727012634277, 20.324434280395508, "ap might justify retention. But without information on the over -\nlap, or concrete metrics based on actual data, it is challenging to make a well-informed decision about stockpiling.\nTo address this question, RAND obtained rare access to a dataset of"] [11.37741756439209, 17.570003509521484, "widely to policymakers, practitioners in law and business, other researchers, and the public.\nThe ICJ is part of RAND Justice, Infrastructure, and Environment, a division of \nthe RAND Corporation dedicated to improving policy- and decisionmaking in a"] [6.281286716461182, 20.3317813873291, ".................................... 22\nCHAPTER THREE\nAnalysis of the Data ................................................................................ 27\n1. Life Status: Is the Vulnerability Really a Zero-Day? Is It Alive (Publicly Unknown) \no"] [6.2591938972473145, 20.323001861572266, "earchers: Who Looks for Vulnerabilities? ........................ 73\nC. How Mitigations Have Affected Exploitability: Heap Versus Stack \nExploitation Case Study ....................................................................... 79\nD. Close Co"] [6.30520486831665, 20.34547233581543, "Smoothed Hazard Function ............................................................ 91\n F.3. 365-\nDay Time Interval, with Percentages per Group and Interval ............... 96\nTables\n 3.1. Description of Various Life Statuses ................."] [6.270764350891113, 20.323883056640625, "en the zero-day vulnerabilities or exploits the U.S. government keeps and those its adversaries are stockpiling. If both sides have the same stockpiles, then some argue that there is little point to keeping them private\u2014whereas a smaller overlap migh"] [6.280013084411621, 20.331418991088867, " as alive (publicly unknown) or dead (publicly \nknown) may be misleading and too simplistic \nCommon practice is to classify a vulnerability simply as alive (publicly unknown) or \ndead (publicly known); however, our analysis revealed that there are s"] [6.286172866821289, 20.335615158081055, "ties\u2014in particular the ones that exploits are created for gray, or government, market use\u2014are likely old. \nWhile our data showed that a short life is 1.5 years, this might be long enough for \nmost vulnerability researchers. \nFinding #3: No characteri"] [6.244919776916504, 20.30167579650879, "interval (i.e., all of our data in one time interval) yielded a 40 per -\ncent overlap. With the exception of the 14-year interval, our data show a relatively low collision rate. This may be because those in the private exploitation space are looking "] [6.260403156280518, 20.315263748168945, "lities and develop -\ning exploits in-house if a long life is desired. \nExploit development time does not appear to have an influence on the lifespan or \nsurvival time of an exploit.\nAt the most basic level, any serious attacker can likely get an affo"] [6.26499605178833, 20.318920135498047, "it does not come from labor, but rather the value inherent in them and the lack of supply. Other tangible costs (acquiring products to find the vulnerabilities in, setting up test infrastructure, main -\ntaining and porting the exploit to work on mult"] [6.25892972946167, 20.314420700073242, "chwarz, Caolionn O\u2019Connell, Igor Mikolic-Torreira, and Sasha Romanosky provided invaluable insights and feedback. We also thank Ernesto Amaral for his exper -\ntise and input on methodologies for evaluating demographic data, Andrea Golay for her thoug"] [6.264923095703125, 20.319169998168945, "reate an exploit for a zero-day vulnerability. \nLittle Is Known About the Extent, Use, Benefit, or Harm of Zero-Day \nExploits \nSoftware vendors aim to create flawless software, but this is aspirational. Devices, net -\nworks, systems, and processes in"] [6.2686591148376465, 20.321996688842773, " the file system) does not mean the implementation is available (perhaps there is a fixed/static file that is not part of any other directory, thus, nothing an attacker enters will ever get to that desired file location) (Libicki, Ablon, and Webb, 20"] [6.272437572479248, 20.325807571411133, " used in some operations while still a zero-day.\nBeyond these high-profile examples, little is known about the true extent, use, \nbenefit, and harm of zero-day exploits. Discussions are often speculative or based on what is discovered after the vulne"] [6.282103538513184, 20.332874298095703, "atch against anyone using it, but it may also leave a critical population vulnerable. Furthermore, who finds the zero-day makes a difference\u2014for example, an affected vendor or a bug hunter working on the vendor\u2019s behalf, or cybercriminals or other ne"] [6.2817206382751465, 20.337678909301758, "and version of code, how often it gets patched, how long a vulnerability should be held before it is made public, and who the target is. \nThere has been much discussion on this topic: Following the discovery and disclo -\nsure of the Heartbleed vulner"] [6.267331600189209, 20.32111358642578, "vendor)?12\nIt may be additionally helpful to know:\n4. Cost: W\nhat is the cost to develop an exploit for the vulnerability (e.g., in order \nto help set purchase price)?\nAnswering these questions can be useful in determining which vulnerabilities to \n"] [6.227390289306641, 20.287778854370117, "ng zero-day exploits.\nOther groups that may be interested in the research results include:\n\u2022\n Those who a\nre actively looking for vulnerabilities and developing exploits for \noffensive purposes. The results could help them be more efficient in develo"] [6.268960475921631, 20.322473526000977, "t is no longer considered a potential harm to the public. \nBut this view is largely oversimplified. Vulnerabilities can remain privately known \nbut get quietly patched (so thus are no longer considered zero-day); conversely, vul -\nnerabilities can be"] [6.266698837280273, 20.320585250854492, "represent those that might use zero-days against the interests of Blue. Furthermore, there is an assumption \nis that, if a vulnerability is private, it is (1) in use and (2) in use by a nation-state or criminal. But vulnerability researchers we spoke"] [6.307117462158203, 20.354555130004883, "ad been cre-ated, and if and when the vulnerability was found externally by a third party. It also contains information on the analyst who wrote the exploit and the relevant security bulletin (where applicable). \nThe dataset contained numerous catego"] [6.268890857696533, 20.323148727416992, "erabilities \nand public knowledge vulnerabilities (i.e., the teal overlap between the blue and green in Figure 1.4).\nOur research focuses on the characteristics of vulnerabilities that are in the over -\nlap between Blue (or a reasonable proxy for Blu"] [6.270891189575195, 20.32380485534668, "find vulnerabilities, they \nmust determine whether or not they are able to develop an exploit. Many factors can come into play when decid -\ning whether an exploit will be developed to take advantage of the vulnerability. For example, there may be oth"] [6.287720203399658, 20.3360595703125, "t reliable for multiple \nversions, but this timeline was not captured. \n25 These dates are fairly accurate, as exploit developers tend to be quite excited, proud, and eager to share with \ntheir colleagues when one of their exploits is fully function"] [6.289208889007568, 20.336416244506836, " size for \nanalysis, as it meant that we could use only those with complete information for per -\nforming survival analysis and calculation of expected lifespan. In the cases where we had only the month and year timestamp for the birth date, we defau"] [6.258382797241211, 20.313861846923828, "ty researchers (Appendix B), a case study on how mitigations have affected exploitability (Appendix C), an investigation of close collisions (Appendix D), a first order look at cost and pricing considerations for zero-day exploits (Appendix E), and a"] [6.268787384033203, 20.322608947753906, " core develop -\nment team), the \u201cblocker bug\u201d submitted for patch allows the introduction.\n3 For example, the introduction of call flow graphing in Windows 10.18 Zero Days, Thousands of Nights: The Life and Times of Zero-Day Vulnerabilities and T"] [6.263128757476807, 20.317523956298828, " emerged that would assist in exploitation. \n5 For the cases in our data where no exploit was created (although exploitable vulnerabilities were found), \napproximately half were not exploited because certain capabilities were required or conditions "] [6.233292579650879, 20.293106079101562, " Here we are talking about reliability for exploits, not implants or \u201cpayloads.\u201d Reliability is desired for exploits, \nbut it is not always guaranteed. Reliability for an implant, however, is critical. While an exploit provides initial access, an im"] [6.254453659057617, 20.31021499633789, "ind and what needs to be cleaned up). For more details about the exploit development cycle and some factors that go into exploit development, see Appendix A, \u201cThe Exploit Development Cycle.\u201d\nPeople in the Zero-Day Vulnerability Space\nSome vulnerabili"] [6.234701633453369, 20.294811248779297, "country), \u201cblack hat\u201d cybercriminals, or hob -\nbyists with various motives.\n18 The most sophisticated aim to not only find zero-day \nvulnerabilities but also to create fully functional exploits for them. \nWhile exact numbers are unknown, many estimat"] [6.202269554138184, 20.26603889465332, "s in the lowest tier is at least an order of magnitude larger than in the highest tier. For example, there are more than 26,000 researchers on the BugCrowd platform (though it is unclear how many are active bug hunters, as only ten have collectively "] [6.191664218902588, 20.259065628051758, "e government market. More Discussion of Zero-Day Vulnerabilities 23\ncases, able to avoid detection. As such, PoC exploits are generally an end goal for white \nhat researchers, whereas the gray and black markets deal in fully functioning exploits.2"] [6.238016128540039, 20.295629501342773, "as a \u201cmaster of the dark arts\u201d to get custom-\ners. Once a vulnerability researcher gained traction, she or he could shift to the white market. \n25 One vulnerability research group shared that they had three to four entities to which they sell; anoth"] [6.2390055656433105, 20.297746658325195, "-in-the-middle\u201d refers to an attacker who is in the middle of the legitimate \nsender and receiver, relaying and possibly altering the communications between the two parties.More Discussion of Zero-Day Vulnerabilities 25\nExploit Developers (and Exp"] [6.236915111541748, 20.291860580444336, "ion-based model, whereby subscribers get regular information about zero-\nday vulnerabilities that have not yet been disclosed. Often, subscribers use the feed to test their own products against zero-day vulnerabilities to further secure them, or use "] [6.260829448699951, 20.314361572265625, "rability or vulnerabilities that the exploit is taking advantage of. An exploit dying means that one of the previously unknown vulnerabilities (if multiple exist) gets discovered.\n1\n1 It could also have a patch available, but at the most basic level"] [6.263160705566406, 20.318038940429688, "sing terms such as \u201cdead\u201d may be misleading, because the vast majority of cyber actions \nuse these \u201cdead\u201d N-Day vulnerabilities. One expert we spoke with suggested we use the terminology \u201ca vulner -\nability previously undescribed in literature,\u201d espe"] [6.277280330657959, 20.329925537109375, " the BUSBY vulnerability researchers found that it could provide privilege escalation\u2014something much more severe.\n4 For example, one of BUSBY\u2019s exploits had a vulnerability that had been found in a 32-bit version of a system \nbut was not exploitable"] [6.261836051940918, 20.3171329498291, "so a security patch will never be issued).\nSecurity Patch A vulnerability found by a third party and recognized as a security vulnerability; an advisory, patch, and/or CVE has been issued.\nKilled by BUSBY A vulnerability publicly disclosed by the pri"] [6.279857635498047, 20.331336975097656, "abilities). Figure 3.4\nVulnerabilities Found by BUSBY Each Year, by Current Life Status (n = 207)\nRAND RR1751-3.40 5 10 15 20 25 30 \n2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number of vulnerabilitiesUncertain\nCode refacto"] [6.326043128967285, 20.353267669677734, "at had a date of birth (n = 127).\n8 \n8 Seven of our exploits that died had no birthdate recorded, as their vulnerabilities were purchased by a third \nparty. We do have date of maturity for those exploits (i.e., the date when a fully functional explo"] [6.340547561645508, 20.3602352142334, " plots, we obtained the median survival time\u2014\nexploits that had a life status of Immortal; however, because survival analysis and life expectancy analysis are \ntypically done on humans or things that are all expected to die or fail at some point, we "] [6.364743709564209, 20.395795822143555, "ause there were more data points to draw from, providing greater precision in the estimate of sur -\nvival probability.\n11\nAfter initial detection, any given exploit (and thus its vulnerabilities) has a median \nsurvival time of 5.07 years (95 percent "] [6.326363563537598, 20.359695434570312, "t developer) to detection by outside partyAnalysis of the Data 37\n1. Vulnerability type: Mem ory Corruption, Memory Mismanagement, Logic, \nMixed or Other\n2. Platfo\nrm affected: Linux, OSX, Open Source, PHP, Unix-based (excluding \nLinux), Windows"] [6.336216449737549, 20.364246368408203, "is analysis on their own, so they were combined. \n15 Curves that end in a horizontal line indicate that the last observed value was alive; curves that end in a verti-\ncal line indicate that the last observed value was death (i.e., public disclosure)"] [6.350501537322998, 20.374197006225586, "r data, based on its assumption of a constant hazard function, which our data appear to exhibit. Further details about the hazard function and plots of our unadjusted hazard estimates and parametric model comparisons can be found in Appendix F, \u201cAddi"] [6.339938640594482, 20.366729736328125, "ies) is expected to live 6.90 years (with 95 \npercent confidence interval: 5.39 to 8.84 years).18\nProportional Hazards Regression Modeling \nTo assess whether any particular characteristic of an exploit contributes to a lower or higher probability of "] [6.282675743103027, 20.333768844604492, "or without adjustment for the other characteristics. Without more data, we \ncannot statistically determine whether any characteristic of an exploit indicates a long or short life. The high p-values may be a result of a true absence of effect, or a re"] [6.347392559051514, 20.397716522216797, " rich debate that many have spoken and written about. Schneier (2014) believes that vulnerabilities are plentiful (which one might interpret as dense), and as such the overlap is relatively small; Geer (2014) states that vulnerabilities are sparse en"] [6.305304050445557, 20.35415267944336, " In particular, those who rely on zero-day exploits for offensive or defensive purposes, such as penetration testing or trying out a new detection tool, may want to know how long they can expect to go undetected by their target during a campaign. Vul"] [6.268556594848633, 20.323078155517578, "efore, the fewer number of points in the higher diagonal bands is \nartificially lower than what the complete plot would display, if we had had additional follow-up time available.\nBecause this analysis does not take into account censoring, we cannot "] [6.26129674911499, 20.315885543823242, "unable to determine the dates that those exploits were found.\n26 Certainly, there are many times when the use or usefulness of an exploit does not rely on its vulnerabilities \nbeing zero-day. But for the sake of argument, we consider the cases where"] [6.271378040313721, 20.323490142822266, "o outstanding trends for those exploits (n = 16) that had an exploit development time of more \nthan 90 days: Over 56 percent are still unknown (with one Immortal, and one Code Refactor), and roughly 31 percent are known and have had security patches."] [6.278039932250977, 20.330448150634766, " of exploits\nTime to develop an exploit (days)55 \n21 31 \n13 \n5 7 5 5 \n1 4 \n0 0 12 \n0\u201310 10\u201320 20\u201330 30\u201340 40\u201350 50\u201360 60\u201370 70\u201380 80\u201390 90\u2013\n100 100\u2013\n110 110\u2013120 >120 Analysis of the Data 49\nWe also evaluated exploit development time compared with "] [6.282529830932617, 20.333724975585938, "ghts: The Life and Times of Zero-Day Vulnerabilities and Their Exploits\nImplications for Defense\nOversimplifying vulnerabilities as either alive (publicly unknown) or dead (publicly \nknown) may be creating a barrier for vulnerability-detection effort"] [6.279736518859863, 20.331392288208008, " help continuously bring new researchers to looking at code already deemed clean. \nFinding and patching vulnerabilities in code becomes harder with software reuse \nbetween platforms and, in particular, with the Internet of Things, as more code is reu"] [6.277702331542969, 20.32906723022461, "osed, it often leads to the \ndiscovery and disclosure of other similar vulnerabilities; this could be a factor in increasing collisions. 54 Zero Days, Thousands of Nights: The Life and Times of Zero-Day Vulnerabilities and Their Exploits\nOn the ot"] [6.300280570983887, 20.352005004882812, "icator of a long life was a vulnerability \nbeing found in a class that had already been thoroughly examined by other vulnerability researchers (e.g., font bugs). Other vulnerability researchers we spoke to agreed with this supposition. \n3 Of course,"] [6.2943267822265625, 20.34552764892578, "rate may be \n4 This is a prime example of how data can be used to support a variety of viewpoints, in particular a high versus \nlow collision rate. Those that have argued that the overlap is small (or large) do not typically specify the time \ninterv"] [6.224422931671143, 20.284238815307617, "ing a product to the public, or study the techniques of how offense finds vulnerabilities. Additionally, defenders could consider tackling software security by treating all code as insecure, and investing \n5 There are many analogies for this swarm m"] [6.24559211730957, 20.30244255065918, "al (with a median of 22 days, minimum of 1 day, and maximum of 955 days).\nThe cost to develop (and, relatedly, the value or price of) an exploit can rely on \nmany factors: the time to find a viable zero-day vulnerability (research time), the time to "] [6.275500297546387, 20.327783584594727, "ly.\nIn our data, vulnerabilities purchased from external third parties had a shorter \nlifespan (average life of 1.4 years). This may be an argument for finding vulnerabilities and developing exploits in-house if a long life is desired. \nGovernments c"] [6.283248424530029, 20.33374786376953, " code bases and previous versions\u2014exploitable vulnerabilities may still exist, and older products may still be in use around in the world.\nTo beat the software testing programs (\u201cfuzzers\u201d) and bug hunters searching for \nvulnerabilities in the public "] [6.2642974853515625, 20.318923950195312, "aracteristics not necessarily mutually exclusive). If another vulnerability usu -\nally exists, then the level of protection consumers gain from a researcher disclosing a vulnerability may be seen as modest, and some may conclude that stockpiling zero"] [6.268773078918457, 20.322769165039062, " the affected vendor finds a vulnerability, it may not say as much. Fur -\nthermore, some researchers choose to not to disclose vulnerabilities they have found. \nThere are several reasons why an exploit developer or bug hunter may have found \na vulner"] [6.276365280151367, 20.328855514526367, "nd another might focus on web-based applications and server-side software. Others are not as discriminating.\n14 Because \nour data came from one source, not all vulnerability or product types are represented in the data (e.g., indigenous versus commer"] [6.275404930114746, 20.328048706054688, "nvolved in discus -\nsions. We only scratched the surface of what is possible to investigate with data. More \nresearch threads exist. For example: \n\u2022\n What (\nif any) characteristics of zero-day vulnerabilities indicate a long or short \nlife, and what "] [6.268956184387207, 20.322195053100586, "ro-day?65APPENDIX A\nThe Exploit Development Cycle\nThe exploit development process consists of many steps, each of which can go through \nmultiple iterations.\nPhase 1: Discovery and Verification\nIn the first phase, vulnerability researchers search for "] [6.268392562866211, 20.321901321411133, " are created equal. Some have the ability to go deeper than others, and some find different bugs \ndepending on their method. For example, AFL (American Fuzzy Lop) finds bugs quickly by tracking down every \n\u201cif statement\u201d in a code base. \n2 Taint ana"] [6.26358699798584, 20.318565368652344, "concept). Once narrowed down, the researcher determines exactly what can be done with the crash (e.g., remote code execution, information leak, crash a different process), the potential impact caused by the crash, and other requirements needed to red"] [6.260837554931641, 20.316051483154297, "not exist in an operational environment. In an operational setting, the target system may be under heavy load, and different language packs and dynamic link libraries (dll\u2019s) may be loaded differ -\nently. Thus, any lab-based assumptions about process"] [6.238799571990967, 20.29693031311035, "y of estimates for the percentage of crashes or triggered bugs that would turn into useful, exploitable vulnerabilities: 0.5\u20131 per -\ncent, 15\u201320 percent, 25\u201330 percent. One vulnerability researcher shared that that as high as 50 percent of vulnerabil"] [6.253139495849609, 20.3093204498291, "anyone can write fully func -\ntional exploits. Conference talks, reports, and books can outline how an exploit was created. But taking that information and writing an exploit for a new vulnerability still requires skill. Some liken it to the culinary"] [6.258666038513184, 20.314836502075195, "publicly \nunknown\u2014and alive\u2014for a long time) may depend on the ability of the exploit devel -\noper to go several layers deeper into code spaces than normal fuzzing (which is typi -\ncally on the surface). \nSome vulnerability researchers are better tha"] [6.236850261688232, 20.296510696411133, "g a vulnerability. Figure B.2 shows that the rate of devel -\nopment is not steady: In some years, a researcher may not find or develop an exploit. \nFrom these data, it appears that there is a high frequency of early developers (e.g., \nresearchers U, "] [6.1847381591796875, 20.247425079345703, " career of vulnerability researchers in the gray, or government, markets with the life-time of bug hunters in the white markets (i.e., bug bounties, vendors, and groups such as Google\u2019s Project Zero). \n4 Interestingly, white hat bug hunters who inve"] [6.248147487640381, 20.30370330810547, "nted, since some exploits developed and vulnerabilities found were not reported or recorded in our data due to sensitivities or ongoing operational use at the time of collection. \n6 The low count for August is statistically significant, while the hi"] [6.269491672515869, 20.323284149169922, "d manipulate than the heap).\n1 Because of this, exploits based \non stack overflows were more common, and, as such, security vendors focused on cre-ating mitigations for the stack (e.g., stack cookies, stack canaries, stack address space layout random"] [6.2594146728515625, 20.314407348632812, "an exploit devel -\noper examining the details of a newly released vulnerability advisory, and finding other similar\u2014and still publicly unknown (i.e., alive)\u2014vulnerabilities. \nTwenty-four of BUSBY\u2019s exploits are close collisions. As of our information"] [6.254179000854492, 20.30971908569336, "e are correct, or getting the right configurations and infrastructure set up. For those who fuzz, once the fuzzing tool is set up, it can be very fast to find vulnerabilities\u2014one person gave an estimate of \n1 This included two teams of exploit devel"] [6.2525177001953125, 20.308664321899414, "e developers to keep \nlooking. Even then, the research is not continuous. If the exploit developers have not found anything after a few \nmonths of looking (and cycling through a handful of exploit developers), they may wait until a new version of the"] [6.149780750274658, 20.2186222076416, "sts (premium of a high-demand, low-supply product, etc.) can cause the price to rise dramatically. And, to be clear, our analysis does not take into account the cost or time of failing to find vulnerabilities or to develop a fully function -\ning expl"] [6.175700664520264, 20.246673583984375, "rabilities claimed that gray market prices of exploits for the Tor Browser Bundle were two orders of magnitude higher than prices paid on the white market for Firefox vulnerabilities. Others we spoke to noted that it is often common practice for expl"] [6.1852264404296875, 20.254192352294922, "pe a sandbox, or remotely jailbreak [for mobile devices], then the payout is greater). \nIn the end, for those who sell their exploits, the entity that purchases the vul -\nnerability can often be the ultimate decider of what to purchase and for how mu"] [6.391338348388672, 20.406280517578125, "Kaplan-Meier curve, though they tend to overestimate the Kaplan-Meier curve in the first two years. Subsequently, each approximates the Kaplan-Meier curve\u2019s general shape, with differing rates of decay starting in year five. We chose the exponential "] [6.340304374694824, 20.359758377075195, "the exponential model-based estimates of expected lifetime.\nWe used Cox proportional hazards regression modeling to determine the hazard \nratio for each characteristic. \nThe hazard function itself can be interpreted as the instantaneous probability o"] [6.350690841674805, 20.37799835205078, "a common model. In the partially adjusted model, we removed the \u201cplatform affected\u201d category, because source type is heavily correlated to the platform affected (e.g., all Windows is closed source) and just performed regression adjusting for vulnerab"] [6.297508716583252, 20.34419822692871, "0.969 0.93 \n(0.40, 2.20)0.872 1.04 \n(0.46, 2.37)0.925\nLocal 0.72 \n(0.41, 1.27)0.255 0.62 \n(0.30, 1.32)0.214 0.60 \n(0.31, 1.17)0.134\nMixed 0.64 \n(0.25, 1.69)0.373 0.65 \n(0.24, 1.78)0.406 0.61 \n(0.23, 1.62)0.318\nOther 0.26 \n(0.06, 1.12)0.071 0.15 \n(0.0"] [6.277520656585693, 20.32965660095215, "AOL, Ethereal, Adobe, Alt-N Tech -\nnologies, CryptoCat, and RealPlayer/RealServer, as well as some lesser-known vendors.\nTable G.1\nData Frequency Counts\nRow Labels Count\nLife Status\nLiving 66\nCode Refactor 21\nImmortal 13\nKilled by BUSBY 8\nOther\u2014featu"] [6.263530254364014, 20.318523406982422, "ies and Their Exploits\nRow Labels Count\nRemote code injection 1\nSQLi 1\nStack overflow 40\nStack overflow (x2); memory 1\nStack overflow; heap overflow 1\nType confusion/object mismanagement 1\nUnsecure environment variables (so can eventually take \nadvan"] [6.264720916748047, 20.3181209564209, "am attempts to put data in a memory area past a buffer (Open Web Application Security Project [OWASP], undated-a).\nbug Software flaw.104 Zero Days, Thousands of Nights: The Life and Times of Zero-Day Vulnerabilities and Their Exploits\nbug bounty A"] [6.263904094696045, 20.317968368530273, "n vulnerability for the version of the product it was created for; that product is no longer main-tained (so a security patch will never be issued).\nimplant A program that solidifies and maintains access initially pro-vided by an exploit (i.e., achie"] [6.178306579589844, 20.250850677490234, "htly controlled environment that restricts permissions \non what can be run (to prevent malicious code from execut-ing or accessing something it should not, for example).\nsandbox escape Code that can escape a sandbox.\nstack A data area or buffer used "] [6.089951515197754, 20.180009841918945, "toc9 \nBugCrowd, \u201cWhat\u2019s a Bug Worth?\u201d 2015. As of January 30, 2017: \nhttps://pages.bugcrowd.com/whats-a-bug-worth-2015 \n\u2014\u2014\u2014, \u201cThe State of Bug Bounty,\u201d June 2016. As of January 30, 2017: \nhttps://pages.bugcrowd.com/hubfs/PDFs/state-of-bug-bounty-20"] [5.954366207122803, 20.071664810180664, ", 2017: http://www.reuters.com/article/us-cyber-blackhat-apple-idUSKCN10F2TX\nGeer, Dan, \u201cCybersecurity as Realpolitik,\u201d BlackHat, August 6, 2014. As of January 30, 2017: \nhttp://geer.tinho.net/geer.blackhat.6viii14.txt \nGellman, Barton, and Ellen Nak"] [6.06121826171875, 20.159069061279297, "de: Platinum Edition , \nNew York: John Wiley & Sons, 2006. Kuehn, Andreas, and Milton Mueller, \u201cAnalyzing Bug Bounty Programs: An Institutional \nPerspective on the Economics of Software Vulnerabilities,\u201d paper presented at 2014 TPRC: The 42nd Researc"] [5.993658065795898, 20.10588836669922, "Market , presentation given at RSA Conference 2015, San Francisco, April 20\u201324, 2015. As \nof January 30, 2017: https://www.rsaconference.com/writable/presentations/file_upload/ht-t08-the-wolves-of-vuln-street-the-1st-dynamic-systems-model-of-the-0da"] [6.064834117889404, 20.15142822265625, "d-hackers-fix-cybersecurity-holes-or-exploit-them/371197/ \nSchryen, Guido, and Eliot Rich, \u201cIncreasing Software Security Through Open Source or Closed \nSource Development? Empirics Suggest That We Have Asked the Wrong Question,\u201d paper presented at th"] [6.200204372406006, 20.26743507385254, "tems,\u201d in Proceedings of the 22nd ACM SIGSAC Conference on Computer and Communications Security , New York: ACM, 2015. \nZorabedian, John, \u201cHow a Hacking Team Got Hacked,\u201d Naked Security , April 2016. As of \nJanuary 30, 2017: https://nakedsecurity.so"] [13.396283149719238, 2.876415491104126, "CORPORATIONKnowing More, but \nAccomplishing What?\nDeveloping Approaches to Measure \nthe Effects of Information-Sharing on Criminal Justice Outcomes\nBrian A. Jackson, Lane F. Burgette, Caroline Stevens, Claude Messan \nSetodji, Erinn Herberman, Steph"] [13.340588569641113, 2.8120696544647217, "ial for governmental boundaries to inhibit those efforts, because criminals frequently do not limit their activities to the jurisdiction of a single law enforcement agency.\nAlthough there are high-profile success stories in which data-sharing assiste"] [13.30986213684082, 2.7914915084838867, "r at \njustice@rand.org.vContents\nPreface ................................................................................................. iii\nFigures and Table .................................................................................... v"] [13.29808521270752, 2.7653212547302246, "orts to measure its effects on performance have been \nfew and far between. Anecdotal success stories of cases in which data from sharing systems were critical to cracking a case or quickly stopping a crime in progress are easy to identify. But even t"] [13.29537582397461, 2.774209976196289, " over -\nall crime rates\u2014is a starting point to gauge whether more data-sharing helps improve those measures. Other possible measures include the speed or probability of arrests or of officers locating and interviewing a suspect. As in some previous e"] [13.277844429016113, 2.7459094524383545, "\nThree Sets of Measures Linking Sharing to Criminal Justice Outcomes\nIn collaboration with ARJIS and informed by insights from its users, we tested three \napproaches for measuring the effects of information-sharing on criminal justice out -\ncomes. Th"] [13.278706550598145, 2.7490267753601074, "re than one agency. And the time to the next contact with a different agency was shorter as well: 1.3 years for the group with ONS records versus 1.7 years for the control group without such records. Furthermore, individuals with ONS records were mor"] [13.258794784545898, 2.753129720687866, "o iden -\ntify crime series across jurisdictions. Although our analysis was suggestive that BOLO notifications increased arrests for cases in which a BOLO was used, those effects did not meet the requirements for statistical significance. \nInformation"] [13.29371166229248, 2.7587530612945557, "verage monthly number of cross-\n jur\nisdictional xiv Knowing More, but Accomplishing What? Measuring the Effects of Information-Sharing\narrests increasing from 0.044 to 0.048, while the estimate for the probability of making \na cross-jurisdictiona"] [13.356590270996094, 2.770338773727417, "lp practitioners across the justice system do their jobs better. Thinking now about which data should be recorded and kept to make that sort of high-resolution analysis of the effects of criminal justice data on outcomes possible would make a down pa"] [13.564566612243652, 2.866086959838867, "nd the threat of terrorism were frequently the focus of \ndebate about information-sharing, such sharing is just as important for other functions in the criminal justice system\u2014specifically, data moving across jurisdictional bound -\naries so that a po"] [13.640640258789062, 2.970884084701538, "organization of criminal justice in the United \nStates (as well as the broader U.S. homeland security enterprise, which includes mul -\ntiple federal, state, local, and tribal agencies with many distinct missions), individual organizations are often n"] [13.617293357849121, 2.932069778442383, "ocalities).\n2\nOther efforts exist across the country at the state and local levels or designed \naround the specific information-sharing needs of particular areas (e.g., the National Capital Region surrounding and including Washington, D.C.). These sh"] [13.341424942016602, 2.7979040145874023, "f Police, undated).\n3 \nWhile it would be difficult to estimate the resources that have been spent put -\nting information-sharing systems and initiatives in place and supporting their oper -\nation, national expenditures on information-sharing have bee"] [13.345393180847168, 2.7711102962493896, "tigating crimes; detecting threats; and making decisions about charging, sentencing, or taking other criminal justice actions involve myriad decisions, the quality of which are related to the completeness, relevance, and currency of the data availabl"] [13.315555572509766, 2.7743144035339355, "the citizens who are its subjects, and depending on how the sharing systems are designed, the information might lose its context\u2014and its meaning and implications might therefore shift\u2014as a result of being shared (Jackson et al., 2017). The accuracy o"] [13.330737113952637, 2.7763707637786865, "ormation-Sharing? 7\nsaging system and sought to connect its use to arrests, case characteristics, and other \nmeasures (which showed mixed results).3 Koper et al. (2015)\u2019s study on technology \napplications in law enforcement evaluated an internal l"] [13.298110961914062, 2.7632546424865723, "eading in the criminal justice system, such user perception studies sought \nto link the extent of system use to outcome effects. For example, looking at detectives, Danziger and Kraemer (1985, p. 200) linked use of computing to users\u2019 reports of \u201ccas"] [13.308809280395508, 2.7875735759735107, " on outcomes of interest limited the ability of both critics and pro -\nponents to support their arguments and to have a productive debate on these systems and capabilities.\nLogically Linking Information-Sharing to Outcomes for Developing \nMeasures\nFo"] [13.306923866271973, 2.7882490158081055, "olving more crimes), and the efficiency of such activity (e.g., solving them more quickly) may therefore contribute to improvement in broader (and potentially more societally impor -\ntant) measures. Reflecting the complexity of the environment in whi"] [13.302765846252441, 2.7721893787384033, " his behavior might have justified doing so (e.g., the officer may learn that the subject has a mental illness that causes him to react aggressively, so rather than arrest the sub -\nject, the officer refers him to treatment). Such actions might be re"] [13.298493385314941, 2.761687994003296, "d the former measure would capture the fact that rapid contact with suspects could have benefits for containing escalating situations and more rapidly clearing cases by arrest, as well as more rapidly resolving suspicion of individuals who turned out"] [13.302668571472168, 2.7681424617767334, "stem will not be valuable. \n10 In practice, these two effects will be mixed\u2014because getting data to an investigator or officer faster (efficiency) \nmay also help him or her identify and successfully apprehend the perpetrator (effectiveness).12 Kno"] [13.302270889282227, 2.766413688659668, "nformation-\n sha\nring\u2014whose effects would be expected to be observable at the indi -\nvidual case level\u2014would also be straightforward to assess even for systems that have already been implemented, assuming comparable groups of cases in which the shari"] [13.301070213317871, 2.762326240539551, "st \ncrime, there may be one critical dot (or a small number of dots) that makes the picture make sense. 14 Knowing More, but Accomplishing What? Measuring the Effects of Information-Sharing\nsible people to contact who were unproductive in solving "] [13.300800323486328, 2.767301082611084, "tunities for policing to prevent it.\nUnlike the simple and intermediate cases, where the question was how to appro -\npriately distinguish the different mechanisms for how information-sharing affects deci -\nsions and outcomes, in this broader case, di"] [13.28797721862793, 2.75518798828125, "d into the system in different ways (or different information-sharing features may be relevant to different people), making it possible to distinguish different outcomes. For cases, investigating officers might use the system more or less, or differe"] [13.264665603637695, 2.73644757270813, "ata in the field, mapping, crime analysis tools, and an enter -\nprise system of applications that help users solve crimes and identify offenders. In this capacity, ARJIS has developed replicable open source technical solutions, policies, and governan"] [13.270051956176758, 2.742487907409668, " and officers in managerial roles. (Detectives made up slightly more than a quarter, and managerial officers made up less than a quarter.) \nTable 3.1\nSummary of ARJIS Tools\nClass Tool or Feature Description\nUser pull User query of linked databases \n("] [13.274171829223633, 2.747403383255005, " particularly help -\nful would have been resolved without the availability of cross-jurisdictional information-\n shari\nng.1\nThe ARJIS users we interviewed varied considerably in the circumstances in \nwhich they worked, with variation even among pract"] [13.284378051757812, 2.755108118057251, "f the cross-jurisdictional systems is prominent for many users, it also demonstrates the evaluation challenge presented when an information-sharing system is not the sole system available to criminal justice practitioners in an area. One driver of th"] [13.27676773071289, 2.7500596046447754, "h not all interviewees used ARJIS tools the same amount or for the same \nthings, nearly every respondent credited the tools with increases in their productivity. \nSome estimated that the tools provided by ARJIS at least doubled their productivity, sa"] [13.31787395477295, 2.7786214351654053, " like information-sharing\u2014\nwhether within single agencies or across agency boundaries\u2014requires differences in the level of the intervention (ideally with all other factors constant) to make it pos -\nsible to look for differences in outcomes. Thinking"] [13.290165901184082, 2.757033348083496, "outinely record created opportunities for this type of evaluation in some cases and, \nin others, seriously complicated the effort. We return to those lessons at the end of the report, because they can inform thinking about system design for areas tha"] [13.299297332763672, 2.766184091567993, "th respect \nto different suspects or offenders could be used to identify effects for a subset of criminal justice outcomes. This analysis option is most relevant for case clear -\nance (e.g., where more searches regarding suspects in a case might lead"] [13.29780101776123, 2.7588253021240234, "ls operating across jurisdictional lines could also provide evidence for the effect of information-sharing efforts. \nBecause this research effort was based in a geographic area that has had cross-\njurisdictional information-sharing in place for decad"] [13.277669906616211, 2.7424256801605225, "fic loca-tions of officer deployment over time) that were necessary to do some analyses. In other cases, limitations in the way data are captured and integrated into the cross-\n \njur\nisdictional information-sharing systems made it difficult or imposs"] [13.287732124328613, 2.7437829971313477, "ring of information (for notifications related to investigations), the type of record examined in our evaluation experiment pushed information to the user doing the searching, making specific information more prominent and thus reducing the chance it"] [13.275221824645996, 2.7468783855438232, " bends down in Figure 2.\n1. \n13 The complete analysis is documented in Kovalchik et al., 2017.Developing and Testing Measures with the Automated Regional Justice Information System 27\nOne set of measures we tested focused on the role of this ARJI"] [13.281935691833496, 2.751779317855835, "that ONS records caused the differences. The observed effects may be driven by systematic differences between the two groups that we could not observe; for example, if the offenders with ONS records were higher risk than those without, such a differe"] [13.270633697509766, 2.7521860599517822, "LO notifications\u2019 effects on crime cases, \nseveral effects might be observable.\n14 Effects at the case level (e.g., a BOLO issued about \na crime case might increase the chance it was cleared) and at the suspect level (e.g., a BOLO citing a person as "] [13.302034378051758, 2.772026777267456, "tive underestimates of their actual effects. \nIn an effort to further control for any differences that the matching process did \nnot address between suspects in BOLO cases and suspects in the comparison cases, we compared the pre-post differences in "] [13.296552658081055, 2.7795846462249756, " improved information-sharing is addressing the fact that criminal activity crosses jurisdictional boundaries; for example, a single person or group may commit crimes in many suburbs of a metropolitan area.\n16 ARJIS users \nemployed BOLO notifications"] [13.298874855041504, 2.7673609256744385, " perc\nent offended in adjoining jurisdictions, and 7 perc\nent offended in jurisdictions of \nnonadjoining police forces (Wiles and Costello, 2000, p. 26). As cited previously, simi -\nlar work in the Net\nherlands indicated that offenders who moved ac"] [13.27491283416748, 2.748441696166992, "tomated Regional Justice Information System 33\nsubmitted to ARJIS that the arrest was related to a warrant originating in another \njurisdiction. If a suspect\u2019s cross-jurisdictional arrest occurring after a crime case was not \nassociated with a wa"] [13.284692764282227, 2.7545294761657715, "s, narrowing the matching criteria), the effects were in the same directions but got weaker. At the most restrictive\u2014looking at cases that involved warrants\u2014an increase from zero to ten queries was associated with the average number of cross-jurisdic"] [13.295164108276367, 2.7570748329162598, "tered during the project also produced a different set of results: lessons on how systems could be designed to make this sort of effort more straightforward by building in fea -\ntures or addressing key problems. These lessons would make it easier to "] [13.229578971862793, 2.7737038135528564, "ta about individuals, addresses, or vehicles to be more prominently displayed when a system user runs a search. Nothing in available data sets \n21 This issue was raised by Scott (2006, p. 130) in his examination of an information-sharing system in Fl"] [13.297646522521973, 2.7540194988250732, "rovide very useful data; for example, in Scott (2016, p. 123), this sort of success tagging was used to try to measure the \u201corganizational distance\u201d between the agency that was the source of data and the agency reporting a success based on its use. S"] [13.304308891296387, 2.7566027641296387, "rview report that contributed to an investigation or the fact that an arrest or booking record is tied to a crime case that already existed in a local agency system. Differences in the way that agencies\u2019 individual systems are designed can significan"] [13.27871322631836, 2.75327205657959, "useful enough for evaluation to merit saving even if there is not a strong operational reason to maintain the data. In this effort, this situation arose in our attempt to measure the effects of ONASAS 38 Knowing More, but Accomplishing What? Measu"] [13.486944198608398, 2.786848545074463, "\u2019 data. Even differences in simpler procedures (e.g., departmental conventions for assigning case numbers and whether approaches were the same across participants in the system) could make matching cases, suspects, or arrests across different jurisdi"] [13.290024757385254, 2.7547569274902344, "evel \n ana\nlyses like this one but would also make it possible to explore more-detailed ques -\ntions. For example, measuring which types of data contribute most to solving cases could make it possible to target investments to provide the highest crim"] [13.30010986328125, 2.767888307571411, "effect of jurisdictional boundaries on agency activities and effectiveness. Data-sharing via BOLO notifications was associ -\nated with increases in the number of crime cases connected to suspects\u2014an important outcome given the role of serial offender"] [13.271581649780273, 2.7435760498046875, "and how they might affect evaluation design. Initial interviewees were nominated by organizations that use ARJIS systems and included individuals from different criminal justice roles. Interviewees were asked for suggestions of others whose perspecti"] [13.267041206359863, 2.742973804473877, " important these systems are to what you do, we want to \nget an estimate of how much you use information from criminal justice IT sys -\ntems (whether your agencies\u2019 or interagency information-sharing via ARJIS) in the course of doing your work. \nTher"] [13.270106315612793, 2.7444052696228027, "tant/ \nuseful for your Top 3 tasks? How was it used? Is data from ARJIS more fre-quently a source of new leads/information or a way to confirm information from other sources\u2014or a mix of both?\n \u2013 Ind\nividual criminal history\n \u2013 Inc\nident descriptive i"] [13.319759368896484, 2.781485080718994, "s didn\u2019t exist?\n \u25e6In th\nat \u201cworld without ARJIS,\u201d how do you think the outcome of the situa -\ntion would have differed? \ni. Wou\nld the chance of resolving it been different? \nii. Wou\nld the speed of resolving it been different?49Bibliography\nAgrawal,"] [13.37186050415039, 2.86946439743042, "the Effects of Information-Sharing\nDanziger, James N., and Kenneth L. Kraemer, \u201cComputerized Data-Based Systems and Productivity \nAmong Professional Workers: The Case of Detectives,\u201d Public Administration Review , Vol. 45\n, No. 1, \nJ\nanuary\u2013Februar"] [13.6498384475708, 3.051521062850952, " Center for Best Practices, July 2009. As of \nAugust 11, 2017: https://www.nga.org/files/live/sites/NGA/files/pdf/0907JUSTICEINFOSHARING.PDF\nInformation Sharing Environment, \u201cThe Role of PM-ISE,\u201d web page, undated. As of August 11, \n2017: https://w"] [13.324352264404297, 2.8001492023468018, "ion of Serial Offenders\u2019 Crime Locations on Their Probability of Arrest,\u201d European Journal of Criminology , Vol.\n 10\n, No. 2, 2\n013, pp. 16\n8\u2013186.\nLammers, Marre, Wim Bernasco, and Henk Elffers, \u201cHow Long Do Offenders Escape Arrest? Using DNA Trace"] [13.384493827819824, 2.866018056869507, "al Mobility in Criminal Histories , presentation slides, U.S. \nDepartment of State, Bureau of Justice Statistics, October 30, 2012. As of August 11, 2017: \nhttp://www.crj.org/page/-/cjifiles/ICRN2_Cross-JurisdictionalMobilityinCriminalHistories.pdf\n"] [13.304096221923828, 2.8324995040893555, "ut Needs to More Accurately Account for Federal Funding Provided to Centers , Washington, D.C., GAO-15-155, \nNovember 2014.\nWellford, Charles, and James Cronin, An Analysis of Variables Affecting the Clearance of Homicides: A \nMultistate Study , Wash"] [-0.363965779542923, 14.47806453704834, "CORPORATION\nReducing Coastal \nFlood Risk with a Lake Pontchartrain Barrier\nJordan R. Fischbach, David R. Johnson, Edmundo Molina-PerezLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by la"] [-0.37460508942604065, 14.452505111694336, "ding Lake Pontchartrain. It is also intended for similar audiences in Mississippi whom a proposed barrier might affect.\nThe research described in this report directly applies an updated version of the CLARA \nmodel developed as part of CPRA\u2019s 2017 Mod"] [-0.34089672565460205, 14.51590633392334, "............................................................. 1\nGoals of This Study .............................................................................................. 2\nCHAPTER TWO\nMethods and Data Sources .............................."] [-0.2827637493610382, 14.564793586730957, "e \nHeights for Highway\u00a090 with Its Existing Crown and Low Gates, 100-Year Flood \nInterval ............................................................................................. 23\n 3.6. Expec\nted Annual Damage, by Alignment and Louisiana Regi"] [-0.32390880584716797, 14.537060737609863, "3.6. Incre\nase in Damage, by Annual Exceedance Probability Interval for Coastal \nMississippi .......................................................................................... 33ixSummary\nLouisiana\u2019s coastal communities face a range of chal"] [-0.2935493588447571, 14.586126327514648, "th median expected annual damage reduc -\ntion benefits ranging from $1.2\u00a0billion to $1.4\u00a0billion per year (Table\u00a0S.2). A barrier could also \nlower future design height requirements for the Greater New Orleans hurricane protection system along the sou"] [-0.3894990086555481, 14.434369087219238, " implementation as part of the final 2017 Coastal Master Plan.xiiiAcknowledgments\nThis document describes a preliminary investigation that was designed to guide analysis in \nthe 2017 Coastal Master Plan. We gratefully acknowledge the support and feed"] [-0.3535264730453491, 14.461773872375488, "from \nextreme coastal storms. Tropical storms and hurricanes making landfall nearby can push storm surge and high waves into populated areas, damaging or destroying assets, disrupting economic activity and basic services, and threatening the health a"] [-0.35023415088653564, 14.507261276245117, "Barrier\npopulated areas. In particular, given the proximity to the border with Mississippi, a primary \nconcern was that a new barrier could induce additional flooding and flood damage to Mis -\nsissippi coastal communities, such as Bay St. Louis, Gulf"] [-0.34663814306259155, 14.500313758850098, ", 2017 [hereafter FJK, 2017]). We developed results to guide CPRA\u2019s selection of one or more barrier alignments to consider in the 2017 Coastal Master Plan analysis. As a result, we describe only damage reduction benefits and potential induced damage"] [-0.3327430784702301, 14.520298957824707, " the Louisiana and Mississippi coastlines. Along the coast, CLARA labels different areas as unenclosed (those with no levees, floodwalls, or other barriers or with structures that do not fully enclose the population at risk) or enclosed (those with "] [-0.33231455087661743, 14.525764465332031, "nd \nvalue of the assets at risk from flooding and calculates damage in dollars as a function of \n3 AEPs are statistical estimates of the flooding and damage expected to recur with a certain probability in each year. For \nexample, the 1-percent or \u201c10"] [-0.3369176983833313, 14.51248550415039, "n, and Jackson counties in Mississippi. During the model improvement process, we added grid points for these counties, and Figure\u00a01.1 in Chapter One shows the combined Louisiana and Mississippi domain considered. We identified no enclosed areas for c"] [-0.35098156332969666, 14.515742301940918, " with the full 232-storm set as a baseline. We conducted two iterations of the analy -\nsis and shared and discussed results with CPRA and Arcadis through in-person and phone meetings. Conclusions from the analysis can be summarized as follows:\n5\n\u2022 Th"] [-0.3360503613948822, 14.508227348327637, " of assets at risk to include coastal Mississippi, drawing on the \nmost-recent data sources available.\n\u2022 The CLAR\nA\u00a02.0 geospatial grid requires a higher level of geospatial fidelity than the pre-\nvious analysis, motivating a move away from data sour"] [-0.32013654708862305, 14.525501251220703, "y includes the length of road (in road-miles) that falls within the vicinity of each grid point.\nAgriculture\nFor this study, we did not include crops grown in the coastal region in the updated asset inven -\ntory for Mississippi. The CLARA team analyz"] [-0.3030214011669159, 14.567038536071777, "tion Type Occupation Type Code Damage Category Code Equivalent GBS Code\nOne story 1STY Residential RES1\nTwo story 2STY Residential RES1\nMobile home MOBHOME Mobile home RES4\nMultiunit MULTI-UNIT Multiunit RES2\nCommercial COM Commercial COM\nIndustrial "] [-0.31798815727233887, 14.545890808105469, "illion in value and appear as 0.0 in the table because of rounding.Methods and Data Sources 13\nintervening time span. In addition, this simplifying assumption allows for easier interpretation \nof analysis results when looking at a single scenario "] [-0.341913640499115, 14.515362739562988, "certainty developed for 2017 and documented in Attachment\u00a0C3-25 to the 2017 Coastal Master Plan (FJK, 2017). In this instance, parametric uncertainty refers to uncertainty \nor noise associated with flood depth and damage assessment that emerges from"] [-0.29692235589027405, 14.571325302124023, "xisting road grade to a large 24.5-ft. barrier with gates. The lower alignments would be designed to reduce the volume of storm surge entering the lake but not necessarily to prevent surge and wave overtopping (i.e., they would deliberately allow som"] [-0.2970088720321655, 14.567227363586426, "ps Showing Two Proposed Alignment Configurations\nSOURCE: Arcadis.\nNOTE: Locations are approximate, and the scales of the maps are not equal.\nRAND RR1988-2.2Hwy90/10/10 CSX/10/10\nRoad crest set to a constant elevationof 10 ft.Tie into the existingSlid"] [-0.290769100189209, 14.556357383728027, "utside HSDRRS East, including Slidell and Plaquemines, also show extensive 100-year flood depths in the FWOA.18 Reducing Coastal Flood Risk with a Lake Pontchartrain Barrier\nFigure\u00a03.1\nFuture Without Action Flood Depths for the Study Region, 100-Y"] [-0.30251607298851013, 14.569327354431152, "ge, by Region and Asset Class, in Billions of Constant 2015 Dollars\n2.1\n0.5\n0.10.5\n1.6\nNOTE: The stacked bars show the 50th percentiles (medians), and the lines show the 10th- to \n90th-percentile ranges.\nRAND RR1988-3.3RegionSt. Tammany\nOrleans and J"] [-0.2788253128528595, 14.58642864227295, "erms of both EAD and damage by AEP interval. The subsequent section then details potential negative effects on Mississippi coastal parishes.\nNote that this section summarizes results for four of the five barrier alignments consid -\nered. We do not de"] [-0.29611971974372864, 14.57699203491211, "are mixed in parishes that are partially inside and partially outside of the barrier, however. For example, average 100-year depth reduction in portions of St. Tammany Parish without an enclosed protection system (i.e., nearly the whole parish except"] [-0.30786746740341187, 14.546428680419922, "t because of the assumption about future levee lifts and \nmaintenance previously described. Similarly, we observe no increases for enclosed areas of Plaquemines Parish (East Bank). This is because enclosed areas of Plaquemines already overtop and flo"] [-0.29559409618377686, 14.579143524169922, "t different geographic locations in each region (polder).Average change in surge and wave elevation (ft)\n\u20135 3Results from Proposed Barrier Alignments 25\nicant wave height (right pane) for points surrounding the protection system with Hwy90/0/2 \nin"] [-0.3025369644165039, 14.590067863464355, "elds $1.8\u00a0billion in remaining damage ($1.2\u00a0billion to $2.5\u00a0billion). Despite a much taller barrier, Hwy90/24.5/24.5 shows remaining EAD similar to that of Hwy90/0/2. This is caused by induced damage in some areas, particu -\nlarly outlying portions o"] [-0.27812138199806213, 14.6057767868042, "ent to finalizing the analysis in this report, but we did not apply it here.Figure\u00a03.6Expected Annual Damage, by Alignment and Louisiana Region, in Billions of Constant 2015 Dollars\n0.1\n0.1\n0.1 0.10.10.5\n0.2\n0.1 0.10.10.5\n0.20.2 0.20.2\n2.1\n1.5 1.4 1."] [-0.27827370166778564, 14.60528564453125, "uisiana study region, we see that EAD reduction \nat the median across the Louisiana study area ranges from $1.2\u00a0billion to $1.4\u00a0billion from the different alignments, with Hwy90/10/10 ranking highest in terms of net EAD reduction. Interestingly, Hwy9"] [-0.28937840461730957, 14.593733787536621, "); red shading indicates induced \ndamage (disbene\nfit). Fragility scenario = MTTG.\nRAND RR1988-T3.3Change in EAD (millions of constant 2015 $)\n\u201350 700Results from Proposed Barrier Alignments 29\nTable\u00a03.4\nDamage Reduction or Inducement, by Annual E"] [-0.29614147543907166, 14.585732460021973, "ven at the 500-year interval.\nPotential Induced Flood Damage in Coastal Mississippi\nOne of the primary concerns about a new Lake Pontchartrain barrier is the potential that \na new alignment, by preventing storm surge from entering the lake, would ins"] [-0.29668736457824707, 14.587059020996094, "t results as Figure\u00a0 3.8 but also includes percentage increase and is broken out further \nby type of asset. According to Table\u00a03.5, the percentage increase in EAD from a barrier in Hancock County ranges from 3.2\u00a0percent (Hwy90/0/2) to 9.5\u00a0percent (Hw"] [-0.2976357936859131, 14.59527587890625, "Table\u00a03.6\nIncrease in Damage, by Annual Exceedance Probability Interval for Coastal Mississippi\nReturn \nInterval, in Years CountyAlignment\nHwy90/0/2 Hwy90/10/10 CSX/10/10 Hwy90/24.5/24.5\nTotal Delta Percentage Total Delta Percentage Total Delta Perce"] [-0.29429998993873596, 14.588469505310059, "inducement with a particular barrier configuration in place. Figure\u00a03.9, for instance, shows a map of median 100-year damage in the FWOA (top pane) and change in median 100-year damage with Hwy90/0/2 in place (bottom pane). The color scales are logar"] [-0.30206188559532166, 14.601530075073242, "ences in performance between Hwy90/10/10 and CSX/10/10, however, and these differences occur largely in the immediate vicinity of the barrier. The dis -\ntinction among the project benefits is reduced further when taking parametric uncertainty into ac"] [-0.29580986499786377, 14.588835716247559, "ertain future scenario reflecting plausible sea level rise, land subsidence conditions, and asset growth 50\u00a0years from today. It also does not formally consider other decision metrics, such as project cost and environmental impact. However, the analy"] [-0.40063878893852234, 14.41259479522705, "chbach, \nKevin Hanegan, Kristy Lewis, David Lindquist, J.\u00a0Alex McCorquodale, Michael Poff, Hugh Roberts, Jenni Schindler, Jenneke\u00a0M. Visser, Zhanxian Wang, Yushi Wang, and Eric White, 2017 Coastal Master Plan , \nAppendix\u00a0C, Chapter 4: Model Outcomes "] [-0.4526544213294983, 14.351661682128906, "Information System, \u201cCounty Data Download,\u201d updated April 2016. \nReferenced August\u00a015, 2014. As of August\u00a015, 2014: http://www.maris.state.ms.us/HTM/DownloadData/County.html\nPeyronnin, Natalie, Mandy Green, Carol Parsons Richards, Alaina Owens, Denis"] [14.673869132995605, 0.09767915308475494, " CORPORATION\nHelping Law Enforcement \nUse Data from Mobile Applications\nA Guide to the Prototype Mobile Information \nand Knowledge Ecosystem (MIKE) Tool\nEdward Balkovich, Don Prosnitz, Steven C. Isley, Anne Boustead, Bonnie TriezenbergLimited Print"] [14.705599784851074, 0.0639742761850357, "rototype \nthat we developed. It is intended to serve as users\u2019 manual for MIKE, by explaining its prin -\nciples, illustrating its potential uses, and describing how to add content. Although this tool is not widely available, our goal in writing this "] [14.679471015930176, 0.0874980166554451, "......................................................................... 27\nCommercial Use Case ......................................................................................... 40\nCHAPTER THREE\nCurator\u2019s Guide to MIKE ...................."] [14.67978286743164, 0.08571889996528625, "...................................................................... 18\n2.15. The Instag\nram App ................................................................................ 19\n2.16. The Instag\nram Corporation ..............................."] [14.685054779052734, 0.07507814466953278, "............................................................ 43\n 2.41. Cost Inf\normation for Facebook ................................................................. 44\n 2.42. Cost Inf\normation for Yahoo ........................................"] [14.667130470275879, 0.10879139602184296, "....... 4\n 3.1. Level 1 In\nformation Sources ...................................................................... 74\n 3.2. Level 2 In\nformation Sources ...................................................................... 74\n 3.3. Level 3 In\nforma"] [14.695371627807617, 0.07363460958003998, "the Mobile Information and Knowledge Ecosystem (MIKE). This prototype is not widely distributed. The companion volume, Electronic Surveillance of Mobile Devices: Understanding the Mobile Ecosys -\ntem and Applicable Surveillance Law (Balkovich et al.,"] [14.67248821258545, 0.09909655153751373, "nt, operation, and/or use. Chapter Two describes how MIKE can be used and is intended for those who adopt and utilize MIKE. Chapter Three describes how MIKE can be edited and maintained and is intended for those who are responsible for curat -\ning MI"] [14.646098136901855, 0.1416945904493332, "ights and civil liberties. Neither is good. Law enforcement needs to be as well informed as possible when making decisions about the use of electronic surveillance.\n2 While some argue \nthat the mobile ecosystem has created a \u201cgolden age\u201d of surveilla"] [14.677590370178223, 0.09360834956169128, "the mobile ecosystem, we \ndeveloped a tool\u2014the Mobile Information and Knowledge Ecosystem (MIKE)\u2014that system -\natically relates the commercial entities that collect data about mobile device users to the types of data they collect, the rules governing"] [14.681760787963867, 0.08588209003210068, "entation and use. We explored MIKE\u2019s utility by demonstrating its use to stake-holders and asking for their feedback (see Appendix A). Preliminary assessments from repre-sentatives of these three stakeholder communities\u2014law enforcement, commercial fi"] [14.686732292175293, 0.078305684030056, " law. While this volume was not written to provide an introduction to any of the above, the glossary provides specific definitions for terminology used in this volume and may be useful for those less familiar with these topics. Note, however, \n6 Thes"] [14.729090690612793, 0.036396171897649765, "nd the utility of MIKE. Chap -\nter Four is a reference guide for MIKE and provides an architectural overview.\nThis chapter describes MIKE and illustrates ways to use it. MIKE is intended to be an \ninteractive tool, and it is therefore difficult to fu"] [14.683145523071289, 0.08610297739505768, "arch for particular types of information. MIKE\u2019s homepage also provides access to help functions.\nFigure\u00a02.1\nMIKE\u2019s Homepage\nRAND RR1482-2.1\nSearch Bar\nHelp\nQuick Links\nQuery \nFunctionUser\u2019s Guide to MIKE 7\nMIKE contains pages pertaining to corpor"] [14.697755813598633, 0.06875303387641907, "n on the phone is diff erent from that used on a server. It would probably \nbe useful for an implementation of MIKE to incorporate such details.Figure\u00a02.3\nMIKE\u2019s Description of a Mobile App\nRAND RR1482-2.3\nTechnical \nRequirements\nFunding \nModelEstim"] [14.683917999267578, 0.08037199825048447, "legal issues she must address to access the \ndata. Th e example is highly stylized to illustrate many of MIKE\u2019s features and does not pre-sume that this is the only way the investigation might proceed or that the indicated pathways are the only (or "] [14.682849884033203, 0.08195313811302185, "hat Gmail does in fact maintain MAC addresses and device IDs, along with log information about Gmail accounts (the \u201cData Contexts\u201d table in the lower center of Figure\u00a02.7).\n6\nWe entered the types of information apps gather ( data contexts ) into MIKE"] [14.70258903503418, 0.061857834458351135, "ed. Th is is typically done to manage licenses and enable the rein-\nstallation of a deleted app. Th ese app-tracking apps are only aware of the apps downloaded from the store associated with the app, e.g., Google or Apple. Figure\u00a02.6\nInitial Query "] [14.684402465820312, 0.0812084972858429, "m\u2019s device from Google.\nClicking on 2703(d) reminds the investigator about what is needed to obtain such an \norder (Figure\u00a02.13). In case of a 2703(d) order, \u201cspecifi c and articulable facts .\u00a0.\u00a0. reasonable grounds .\u00a0 .\u00a0 . are relevant and material"] [14.702136039733887, 0.06418220698833466, "elping Law Enforcement Use Data from Mobile Applications\n\u2022 Google Calendar\n\u2022 Foursquare\n\u2022 SquareCash.\n Th e investigator now has an email account associated with \u201ca\u201d phone, but needs to \nconfi rm that it is in fact the victim\u2019s phone. Matching a pi"] [14.68680477142334, 0.07950549572706223, "then off ers a drop-down listing several choices. She choses the Global Positioning System (GPS), which is likely to be more precise and accurate than Cell Site Location, and runs the query. Th is produces the list in Figure\u00a02.17.\nTh e GPS locatio"] [14.687948226928711, 0.07541131973266602, " court order provides a Yahoo \nemail address for an individual who was to meet the victim at a casino shortly before he was murdered. Given the tenuous tie to this email address, the investigator wonders what legal authorities might be utilized to re"] [14.683880805969238, 0.08226154744625092, ", she does not know what apps may have been on the POI\u2019s phone. To pursue this line of attack, she returns to MIKE\u2019s homepage and again uses MIKE\u2019s query wizard to query for all mobile apps that collect GPS location.\n13 Th is query (Figure\u00a02.23) tur"] [14.673897743225098, 0.09951916337013245, "ed\u2014the courts, law enforcement, and the commercial enterprises.\nAll the data MIKE used in this illustration, and the illustrations that follow, were derived \nfrom previous analyses (independent of any particular investigation) of the commercial enti-"] [14.684114456176758, 0.08385202288627625, "esponses to requests from those who lack a good grasp of this mate-rial may be delayed because the commercial entity or the courts find them to be overly broad or improperly specified. Here, MIKE could be used in two ways for training purposes. First"] [14.677725791931152, 0.0912490040063858, " the public and the press become increasingly concerned about geolocation, a state \nlegislator asks one of his staffers to learn more about geolocation and privacy, to figure out how \nto best address the issue. This staffer is unfamiliar with the pri"] [14.667089462280273, 0.09886179119348526, "er to a page describing how ECPA regulates law enforcement access to basic subscriber information (Figure\u00a02.28). She notes the type of information protected by ECPA in this instance (e.g., a street address) and realizes that this is different from th"] [14.676586151123047, 0.0902077928185463, "To determine what kinds of protection this law provides, the analyst then clicks on the \nlink in Figure\u00a02.30 for the required legal document. Th is brings her to Figure\u00a02.31, which explains the requirements for obtaining an order for installation of"] [14.673908233642578, 0.09955801069736481, "w private corpo-rations, not just law enforcement, use information. For each app, she also investigates the types of encryption used, the retention length, and resolution.\nTh e analyst recalls the article she read that described the criminal investi"] [14.677614212036133, 0.08956333994865417, "cts her to the page in Figure\u00a02.38.\nFrom this description, she notices that cell site location data not only seem less specifi c \nin general but that the level of specifi city of the data varies. However, Geoloqi is capable of providing fairly deta"] [14.686189651489258, 0.08058883994817734, "o \nexplore uncertainty and diff ering opinions in the law. For example, if a privacy advocate adds case law suggesting a broader interpretation of the Fourth Amendment, an assistant district attorney could be motivated to add information about the c"] [14.68649673461914, 0.07838934659957886, " hired principally to manage the company\u2019s patent portfolio, although she did craft the Protected Gardens privacy policy. WaldGardn Figure\u00a02.37\nGeoloqi\nRAND RR1482-2.37\nGeoloqi\u2019s \nWebsite\nTypes of Location \nInformationExplanation of Geoloqi\nFigure\u00a02."] [14.689817428588867, 0.07321663945913315, "e request and be reimbursed for the work required. He also wants to know what he can tell his customers.\nThe Analysis\nLG assumes that the guidance from her CEO means that staff members are to help if they can (i.e., do not fight the order) but not to"] [14.6856050491333, 0.07869305461645126, "s information than it gives to advertisers, so no notifi cation of custom-\ners should be necessary.\nTh e state investigator swallows hard, agrees to pay WaldGardn the $15,000, and two \nweeks later is rewarded with the names of two Gardns whose (as "] [14.712449073791504, 0.06037783622741699, " rewarded with several corporate guide-\nlines for law enforcement (Figure\u00a02.44).\nIn her own legal research, LG uses policies gleaned from guidelines other corporations \nhave issued. After using both MIKE and traditional legal resources to analyze the"] [14.685113906860352, 0.0784047544002533, "ages \ndata context for WaldGardnUser\u2019s Guide to MIKE 47\nSummary\nTh is example has illustrated how MIKE can support the commercial sector of the mobile \necosystem by providing guidance for how to respond to court orders and reducing the time devot"] [14.681966781616211, 0.08119936287403107, "th \nwhat MIKE is and how to use it. For more information these topics, see Chapter Two.\nCurating and Updating MIKE\nEntering Data and Maintaining the Map\nMIKE is flexible in how data can be entered. A user can focus on entering legal statutes, cases, "] [14.678511619567871, 0.08040736615657806, "typing, a list of previously used inputs will appear in a drop-down \nFigure\u00a03.1\nObtaining Information About Entries on Forms\nRAND RR1482-3.1\nHovering \nMouse Over \nBlue Question \nMark Opens \nPop-Up with \nExplanationCurator\u2019s Guide to MIKE 51\nbox.2 "] [14.666587829589844, 0.09949082881212234, "n about how to inter -\npret ambiguous situations. The law is particularly problematic in this regard. Law enforce-ment professions and privacy advocates often disagree about policies and can cite different court decisions to support their points of v"] [14.680939674377441, 0.08447767049074173, "\ndata contexts54 Helping Law Enforcement Use Data from Mobile Applications\nStructured information is added via a series of labeled boxes just below the \u201cGeneral \nInformation\u201d box. Many of these are self-explanatory, with places to enter the name o"] [14.689620971679688, 0.06893741339445114, "text is accessed in different ways, depending on whether the user is adding a new data context or updating an existing one. A user wanting to add a new data context must do so on the associated mobile app\u2019s page (as described earlier). Once added, th"] [14.687248229980469, 0.07446866482496262, "\n Encryp\ntion is for describing how the data are encrypted. If no information is available on \nwhether the data are encrypted, this row should be left blank. A user who knows what kind of encryption is used but is unsure how to describe it can press "] [14.68311882019043, 0.07620488852262497, "ead, MIKE populates appropriate legal information automatically based on the parameters entered in the data context. Figure\u00a03.6 shows a completed data context page. Th e legal information is in a box on the right. Th is legal information is not man"] [14.683859825134277, 0.07434241473674774, "specifi c details about the fi rm itself. \u201cActivities\u201d will generate a drop-down list of suggested inputs if the user presses the down arrow on the keyboard.\n5 Real name refers to how an app characterizes the data type. Of course, that name may be"] [14.653170585632324, 0.048859868198633194, "nformation about the fi rm based on other entries already in \nMIKE. For example, even though the user did not specify the mobile apps Facebook operates \nin the form in Figure\u00a03.9, a table describing these apps automatically appeared on the page in F"] [14.677534103393555, 0.08234170824289322, "itions in it, and each defi nition links to a separate page pertaining to that defi nition. Th e user can then add a description of how the term is defi ned to the defi nition page.\nFinally, the user can enter the diff erent legal contexts. Eac"] [14.68064022064209, 0.08334656804800034, "ular type of entity they can obtain it from. Correctly defining legal contexts is crucial for ensuring that MIKE connects the appropriate legal information with the appropriate technical information. Figure\u00a03.14 shows the form used to update the lega"] [14.678879737854004, 0.08118799328804016, "ry and case law.\n\u2022 Policy issue discussed allows specifi cation of any policy issues that the user thinks are impli-\ncated by this particular legal context. Th is enables MIKE to create pages capturing all statutes and cases related to a particula"] [14.681425094604492, 0.07575994729995728, "ded as \nUnstructured \nInformationCurator\u2019s Guide to MIKE 67\nstatute and the name of the document being described (separated by a slash mark). Figure\u00a03.15 \nis the form for updating the entry for \u201cCourt Order Authorizing Intercept.\u201d\nEach form provid"] [14.683187484741211, 0.0766109824180603, "s to webpages outside MIKE that pertain to that situation. However, once the user saves any changes, the completed page referring to each law enforcement situation also includes tables summarizing the relevant statutory and case law (Figure\u00a03.17). Th"] [14.685876846313477, 0.07089880108833313, " to the court that issued the ruling on the particular case being added to \nMIKE. A drop-down menu is available to assist in adding the relevant court.\n\u2022 Constitutional provisions interpreted refers to the constitutional articles and amendments \ndis"] [14.686209678649902, 0.08536002784967422, "E if changes to the structure of MIKE negatively affect MIKE\u2019s functionality.\nInstructional Videos\nThe MIKE prototype includes a number of instructional videos to help new users understand the system. These include a broad overview of what MIKE is, a"] [14.667712211608887, 0.11792664229869843, "el 4 data are sent from the app server to some other server. Users are unlikely to be \naware o\nf this data transfer, and there is no way for them to know that it occurs (aside \nfrom a possible mention in the firm\u2019s privacy policy). The transfer is on"] [14.677160263061523, 0.11054503917694092, "lt it is to extract the information about an app using the particular source. The \u201cTechnical Difficulty\u201d column is for the programming skill necessary to use the data source.\nThe \u201cScope\u201d and \u201cCoverage\u201d columns describe the total number of apps that c"] [14.677458763122559, 0.09213390946388245, "re to capture all external data transmissions. TaintDroid (Enck et al., 2010) is an example.High High Full Complete\nInvestigative reportsReports have shown which data are transmitted by particular apps (see, for example, \u201cWhat They Know\u2014Mobile,\u201d 2013"] [14.675914764404297, 0.09328851848840714, "file. This will not say what data are being sent. However, APIs usually care about only a few things (device ID, ZIP code, GPS location, etc.)Low Medium to \nhighFull Possible\nApp to API data setSome companies have lists of which apps use which APIs. "] [14.674418449401855, 0.09097959101200104, "ctions against government searches\u2014although this is probably too ambitious and may overwhelm every user of MIKE except for policy analysts.\nBroadening the scope of legal information has two advantages. First, MIKE will become \nmore useful to its inte"] [14.678288459777832, 0.08718574792146683, "esearcher to develop \ncoding procedures prior to analyzing the documents. These coding procedures are rules for assessing the meaning of the laws: Rather than reading cases individually to determine their substance and importance, the researcher eval"] [14.682611465454102, 0.08501087129116058, "ny different laws, to allow the user to research and com -\npare laws across jurisdictions.\nAddressing Conflicting Interpretation of the Law\nAlthough electronic surveillance law is evolving rapidly, there will always be areas of ambiguity where applic"] [14.68198013305664, 0.08529192954301834, "mobile app ecosystem can be difficult to obtain. Fully populating MIKE will require researchers with expertise in technology, commerce, and law to identify and exploit potential sources of information. Particularly as MIKE is being initially develope"] [14.678156852722168, 0.08902467787265778, "s\u2014could be extended to use Wikipedia\u2019s moderation tools (e.g., blogs to dispute the accuracy or completeness of content). The moderator or editor needs to be neutral so that valid alternative interpretations of ambiguous data by stakeholder groups ar"] [14.675262451171875, 0.09150718152523041, "ormation is stored within the devices or by the commercial entities and how law enforcement can use that information. MIKE also needed to convey the equally com -\nplex arrangement of federal, state and local laws, and the jurisprudence that governs a"] [14.6738920211792, 0.09685030579566956, "epiction is likely to be brittle. While static maps may be directionally correct, they are not easily extended in response to changes in the technical, commercial, and legal concepts they describe and are ill-suited to the aims of this project. Howev"] [14.672492980957031, 0.09834061563014984, "rket segments and representative firms to further investigate.Architect\u2019s Guide to MIKE 83\nFrom the academic world, one deserves special note (Basole, 2009a; Basole, 2009b). Basole \naggregated two main data sets of relationships between firms and "] [14.67857837677002, 0.10142456740140915, "ide to legal issues directly related to law enforce-\nment searches of the mobile devices, apps, and services across a selection of state and fed -\n1 The four approaches Kerr, 2007, describes are as follows: (1) the probabilistic model, (2) the privat"] [14.683782577514648, 0.08477115631103516, "set of these views.\nThe prototype\u2019s purely text and hyperlink approach forgoes graphic representations of \ninformation and relationships. Graphics provide powerful ways to understand information and relationships, and it should be feasible to extract"] [14.673962593078613, 0.11572085320949554, "rs to define additional relation-\nships between data objects \n(e.g., documents and/or webpages) to create a knowledge structure \nthat allows computers to \nextract useful information automatically. Fundamentally, semantic \nweb technologies work by \nli"] [14.685271263122559, 0.08020579069852829, "at is required for it to be displayed on the new owner\u2019s product list and deleted from the prior owner\u2019s product list.\nMuch more complex queries based on the relationships stored in MIKE are possible. For \ninstance, one can generate a display of all "] [14.68407154083252, 0.0815177783370018, "ls about sharing emerge, e.g., through a subpoena, it would be useful to capture this informa -\ntion to inform others that the data are, in fact, not shared. MIKE is a proof of concept, and this refinement is something that should be consider by an i"] [14.676446914672852, 0.08979760855436325, "elationship Diagram\n7\n3615 16\n186\n1413\n1917\n5\n31\n211\n128\n109\n95\n4\nRAND RR1482-4.2Data type\nResolution\nLegal context StatuteLegal\nde/f_initions\nRetentionThird-party\nlibraryFirmEncryptionRequired legal\ndocumentLaw enforcement\nsituation\nStorage modeMobi"] [14.706603050231934, 0.056728530675172806, "ther the statute applies to data stored locally or remotely.\n15 Has required legal documentIndicates what legal document is required to lawfully gain access to the data protected by the statute.\n16 Has applicable situation Specifies what legal situat"] [14.669047355651855, 0.107342429459095, " hierarchy includes the types of services firms perform in the mobile ecosys -\ntem.\n\u2022 The product\ns hierarchy includes physical or digital things traded in the ecosystem.\n\u2022 The organi\nzation hierarchy includes social groups.\n\u2022 The context\n and con"] [14.666765213012695, 0.1068323627114296, "his hierarchy organizes the activities that firms engage in. The purpose of the activity catego -\nrization is to link firms engaged in specific activities to legal statutes containing rules applicable to that activity. Sometimes, that linkage is dire"] [14.675544738769531, 0.09120648354291916, " interfaces, and the mobile apps.\n\u2022 Legal goo\nds organizes federal and state-specific statutes and legal process documents.\n\u2022 Physic\nal goods organizes the physical platforms, such as the cell towers and the makes and \nmodels of phones.\nOrganizationa"] [14.675649642944336, 0.09305030852556229, "pts in the future.\nAll collected data items are assumed to have both a data context and a legal context, with \nsome conditions overlapping the two contexts.\nMiscellaneous\nSince MIKE is implemented using open-source software supporting web apps, it al"] [14.673095703125, 0.09612137079238892, "n and various rules governing access to this infor -\nmation may lead to inefficient requests for information, thus requiring them to expend unnec -\nessary time and money searching for information. Policy advocates were interested in a way to demonstr"] [14.620687484741211, 0.1488661915063858, "ll represented. In contrast, policy advocates wanted a broad range of apps represented, rather than many examples of apps that fundamen -\ntally perform the same functions. Their perspective was that a range of apps would better allow them to use MIKE"] [14.644713401794434, 0.15515144169330597, "tion was not whether society should value privacy or public safety more highly but rather how to simultaneously provide meaningful privacy protections and facilitate law enforcement investigations. While stakeholder groups may disagree about the opti"] [14.661126136779785, 0.11536979675292969, "customers from hackers, i.e., protecting personally iden-tifiable information.\u2022\n Policy gr\noups discussed their interest \nin having clear standards for obtaining information, to protect privacy rights.Stakeholder Reactions to the Wiki 97Table A.2\n"] [14.675187110900879, 0.0923272892832756, " law en\nforcement officer stated \nthat \u201cthere are times when it could be extremely valuable.\u201d\n\u2022\n Law enfo\nrcement officers described \nthemselves as very likely to use MIKE, provided that it contained useful information.\n\u2022\n One law\n enforcement office"] [14.643227577209473, 0.1597987860441208, "ntrol\nMIKE Mobile Information Knowledge Ecosystem\nPOI person of interest\nPOP Post Office Protocol\nSMS Short Message Service\nURL Uniform Resource Locator101Glossary\nad exchange service Firm that allows websites to \u201csell\u201d advertising space to the \nhigh"] [14.631109237670898, 0.17345722019672394, "r Vehicles, real property records, buying habits, etc. The brokerage then sells that information to other brokerages or businesses.\ndeep packet inspection Extension of packet inspection to include examination of both \nidentifying information and cont"] [14.655064582824707, 0.12785938382148743, " transmission of packets of information \non the internet. These rules are implemented via messaging protocols acting at the different layers of communication: application, transport, and network. A fourth layer\u2014the link layer\u2014is outside the internet "] [14.618996620178223, 0.18528926372528076, "d services themselves to be part of the mobile ecosystem,)\nonion routing (e.g., The Onion Router)A technique to make communication over the internet resistant to traffic analysis and eavesdropping, using successive layers of encryption to hide not on"] [14.63161849975586, 0.1765405237674713, "provides a service to a mobile application, e.g., the ability to make a payment, archive data, display information on a geographic map, or determine restaurants in proximity to the phone. 106 Helping Law Enforcement Use Data from Mobile Applicatio"] [14.63280200958252, 0.17717920243740082, "rred to as a web address.\nweb traffic analytics The measurement, collection, analysis, and reporting of a website\u2019s use, usually to judge the popularity of a specific website or webpage. The data can also be used to assess and improve the effectivene"] [14.657476425170898, 0.1659122258424759, "y Monitoring on Smartphones,\u201d Proceedings of the 9th USENIX Conference on Operating Systems Design and Implementation , \n2010.\nGershowitz, Adam M., \u201cThe iPhone Meets the Fourth Amendment,\u201d UCLA Law Review , Vol. 56, No. 1, \n2008, pp. 27\u201358.Hall, Mark"] [14.615302085876465, 0.2359863519668579, "ps 2012 Roadmap,\u201d January 30, 2012. As of February 5, 2013: \nhttps://wiki.mozilla.org/Apps/Roadmap\nStewart, Jim, \u201cCrow\u2019s Feet Are Best,\u201d The Data Administration Newsletter , June 1, 2008. As of May 23, 2014: \nhttp://www.tdan.com/view-articles/7474Sve"] [12.046858787536621, 3.4081966876983643, "Real-Time Crime Centers in \nChicago\nEvaluation of the Chicago Police Department\u2019s \nStrategic Decision Support Centers\nJOHN S. HOLLYWOOD, KENNETH N. MCKAY, DULANI WOODS, \nDENIS AGNIEL\nSOCIAL AND ECONOMIC WELL-BEING\nPrepared for the Bureau of Justice "] [13.914030075073242, 4.31960916519165, "g crime. \nRAND Social and Economic Well-Being is a division of the RAND Corporation that \nseeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was conducted in the "] [11.979545593261719, 3.3826231956481934, ".................. 50\nCHAPTER FOUR\nSummary and Conclusions .................................................................................. 59\nSummary of Findings ...................................................................................."] [12.00570297241211, 3.387604236602783, ".............................................................. 54\n 3.\n5. Es\ntimated Intervention Effects, by Crime Type (Robbery, Shooting, Theft) .............. 55\n 3.\n6. Es\ntimated Intervention Effects, by District (2, 3, 4, 5, and 6) ..........."] [12.004461288452148, 3.3716394901275635, "Shot detection, which includes fielded sen -\nsors, costs $65,000 per square mile covered. From a labor perspective, the civilian crime ana -\nlysts in each SDSC are new hires; other staffing reflects reassignments of existing personnel. \nRTCCs typical"] [11.96912956237793, 3.366959810256958, "knowledge: what is or has happened, what it means, and what it might imply in the future. The briefings then include an initial discussion during which participants identify and agree on priorities for watches, areas, and specific missions. \n3.\n Ma\nk"] [11.971240043640137, 3.3675026893615723, "cruiting and retention of SDSC staff at all levels needs to be bolstered to increase expertise. SDSCs also need to adopt continuous improvement and change management measures to support the improvement of operations over time. Governing policies and "] [11.994097709655762, 3.3702800273895264, "rate systems. For the SDSC\u2019s app for officers in the field, we recommend cre-ating a \u201cwhat\u2019s important now\u201d screen displaying the most pressing information, rather than having different types of information on separate screens only. \nBesides technolo"] [12.127376556396484, 3.416468858718872, "ustice Assistance\nCCTV closed-circuit television\nCPD Chicago Police Department\nCVRM Crime and Victimization Risk Model\nFBI Federal Bureau of Investigation\nIIT Illinois Institute of Technology\nOODA Observe, Orient, Decide, Act\nPOD Police Observation D"] [12.12384033203125, 3.3723816871643066, "software (Vlahos, 2012; Jouvenal, 2016). There have also been evaluations of specific technologies that were present in RTCCs, 2 Real-Time Crime Centers in Chicago\nTable 1.1 \nExamples of Real-Time Crime Centers\nAgency RTCC Emphasis\nAlbuquerque, \nN"] [12.101509094238281, 3.379403591156006, "her cameras, license plate readers, automated police vehicle locator data, a gunshot detection system, call-for-service data, predictive analysis tools, a \u201cdashboard\u201d displaying key crime statistics, and operators in a central center as well as tools"] [12.142664909362793, 3.3057258129119873, " providing situational awareness during emergencies and major public events, as well as providing real-time and investigative information to officers responding to crimes. Technologies include more than 340 cameras and an ability to integrate with pr"] [12.376362800598145, 3.540909767150879, "ication is increasing the number of vehicle theft arrests. It also includes a large data warehouse of police data, corrections and probation data, open-source records data, license plate readers, and tracking and facial recognition software. It is st"] [13.0838041305542, 4.166449546813965, "erguson, Mo., and subsequent civil unrest began a new period in which law enforcement agencies have come under heavy scrutiny for the lethal use of force and broader problems with community trust and legitimacy. The 2015 death of Freddie Gray while i"] [13.013202667236328, 4.048005104064941, " to the police. As researchers looking at the nationwide increase in homicides in 2015 noted, \u201cLack of trust and confidence in the police militates against crime preven -\ntion as a co\u2010production of police and community and may promote violence as a f"] [12.006402969360352, 3.375382423400879, "ns: Laquan McDonald shooting video released; heavy protests follow through February 2016.Introduction 7\nthe CPD to the BJA National Public Safety Partnership to assist with developing a new crime \nreduction strategy to address the crime surge. The"] [11.977886199951172, 3.3691723346710205, "e receiving SDSCs first. The initial schedule of SDSC deployments was as follows:\n\u2022\n Ja\nnuary 7, 2017: District 7\n\u2022 Fe\nbruary 17, 2017: District 11\n\u2022 Ma\nrch 15, 2017: Districts 6, 9, 10, and 15.\nAs shown in Figure 1.1, these districts had the highest"] [12.009986877441406, 3.372628688812256, "orting responses to violent crimes, crime prevention efforts, and actions to reduce response times.\n\u2022\n Su\npport the development of crime reduction strategies and day-to-day missions (assigning \nresources to carry out specific policing tasks).\n\u2022 Su\npp"] [12.409849166870117, 3.463679075241089, "1.7 shows a sample predictive policing display. \nThe predictive algorithm identifies locations to focus on using a combination of inputs, \nincluding historical crime data, broken out by time of day and day of week; weather; the pres -\nence of feature"] [11.99648666381836, 3.3814823627471924, "ar to each other, with more co-arrest links resulting in greater similarities (Illinois Institute of Tech -\nnology [IIT], 2019). We observed that the CVRM was primarily employed as a static model, with updated risk scores made available to the CPD by"] [11.970231056213379, 3.3635377883911133, "icago\nWhen assessing the SDSCs\u2019 processes, we compared their processes to known best prac -\ntices and assessment frameworks related to (1) examining whether and how information tech -\nnology improvements lead (or fail to lead) to better situational a"] [11.978955268859863, 3.3679285049438477, " studies in which we worked with expert panels to determine needs for law enforcement to use emerging technologies. A signifi -\ncant part of the panel discussions concerned identifying needed protections to use the tech -\nnologies safely, legally, an"] [11.98387622833252, 3.3808977603912354, " reviews (COMPSTAT is a performance management system for police departments), and (3) trigger follow-on analyses.\nc.\n Ca\npture decisions made in the briefings and create action items to implement them, \nboth for those in the room and not in the room"] [11.964570045471191, 3.363104820251465, "e briefing to share within their area of authority (e.g., priorities, missions).\nc. Id\nentify operational directives and supporting information for SDSC personnel to \nshare using the room\u2019s communication channels.Process Evaluation 19\nSDSC Operati"] [11.951492309570312, 3.3578860759735107, "tion should acquire to become proficient in an area of expertise; Rosenstock, Johnston, and Anderson, 2000, provides a survey of management-related maturity models. The six levels in Table 2.1 align with incremental increases in added value, accompli"] [11.956717491149902, 3.3562633991241455, " of any automated or imbedded tools that turn the data into information (basic analyses, aggregate reports). The room personnel request certain statistical processing of data, grouping of associated data, or specific formatting of the data.\nLevel 4 ("] [11.955452919006348, 3.3591458797454834, "lly automated way. Human judgment and critical thinking are needed, especially in rapidly changing situations in which disjointed information and situational knowledge are dynamically pulled together to arrive at a decision or insight.\nThe levels in "] [11.958534240722656, 3.3620059490203857, " staff are able to do their tasks.\n\u2022 Po\nlice officer (Part B)\n \u2013 Th\nere are nine tasks or duties listed and all align with Level 1 .\n\u2022 Cr\nime analyst (Part C)\n \u2013Pe\nrform data analytics, formulate strategies, recommend missions ( Level 4 and Level 5 "] [11.973798751831055, 3.360161304473877, " is done and what the room personnel do. For rooms \nto evolve and get better, the rooms\u2019 personnel need to use some of their time and resources to identify shortfalls in the tools and processes used by the team.\n\u2022\n Ef\nfectiveness focuses on the quali"] [11.96354866027832, 3.362265110015869, " support regular reviews of best \npractices by internal and external experts.\nIn our observations and discussions, we found evidence of such inward-looking problem-\nsolving, with much of it being ad hoc and independently driven rather than through re"] [11.954517364501953, 3.3615946769714355, "ensure that each topic is learned at the appropriate, desired level. This process might include a one-to-two-day visit in a room before receiving the official training. By seeing the tools and processes in context, the individuals can ask relevant qu"] [11.96117877960205, 3.3620965480804443, " aspects. For example, this would include some, but not the majority, of the relevant and potential personnel flows. This would include some support for other units but perhaps more of a hands-off role, rather than in-person, everyday support. This w"] [11.96477222442627, 3.3632442951202393, "he outputs from any hub must be trusted and valued and must have credibility. Although there are many factors that can affect the trust, value, and credibility\u2014the ultimate factors that affect the performance of a room\u2014there are some common elements."] [11.978137016296387, 3.3628756999969482, "potter, and camera display, with effective over -\nwatch support limited to those places with cameras and acoustic sensors. Post-event analysis tools were also present, with results delivered to the field via the app, briefings, and roll calls. Figure"] [11.970647811889648, 3.3666346073150635, "t is needed to make the best use of the \ntechnology\n\u2022 Pe\nrsonnel who understand field operations and activities\n\u2022 Pe\nrsonnel who understand the specific nuances of the situation (e.g., the specifics of their \ndistrict)\n\u2022 Pe\nrsonnel who are available "] [11.960968017578125, 3.3616559505462646, "m\u2019s objectives\n \u2013Pa\nrtially present; some staff (crime analysts) received training from the University of \nChicago\u2019s Crime Lab, and as noted, there was some ongoing collaboration, dissemina -\ntion (newsletter), and training (all-hands meetings). We a"] [11.926531791687012, 3.4141883850097656, "ngle formula to ensure that innovations are sustained or will reach their \nlong-term potential. However, using our prior research, we can identify common reasons why innovations such as the SDSC rooms do not sustain results, and we can identify simil"] [11.938879013061523, 3.3750648498535156, "w superior does not understand the intent, history, and value of the innovation, it is likely that the inno -\nvation will not receive the care and nourishment it requires.\n5.\n Th\ne innovation and its sustainment and evolution are not integrated into "] [11.963708877563477, 3.3639862537384033, "s static. This is a major risk and con -\ncern. There are some activities that currently exist (e.g., the SDSC newsletter, the docu -\nment repository in the SDSC network area, the biweekly meetings of the analysts and Process Evaluation 33\nsupervis"] [12.08297061920166, 3.3798635005950928, "empt. Because Genetec Citigraf recently announced that they will integrate ShotSpot-ter displays, this shortcoming will likely be addressed directly by the vendor (Genetec, 2017). \nSDSC staff indicated that they also use Caboodle (a locally developed"] [12.053450584411621, 3.3774538040161133, "ctly monitoring ShotSpotter alerts at the SDSC (rather than at the citywide Office of Emergency Management Center),\n they are able to quickly get \ncameras trained on the area to begin gathering video evidence. They are also able to get patrol officer"] [12.264975547790527, 3.460679769515991, " not clear how much the social-networking tool was being used in prac -\ntice in SDSC operations. This tool was not commonly referenced during SDSC daily briefings, which tended to reflect the fact that the official focus of SDSC operations was on pat"] [12.389680862426758, 3.5067508220672607, "gs in 2018. Thus, the CVRM was reasonably effec -\ntive at identifying a subset of those at a highly elevated risk for being a PTV, and interventions with the roughly 10,000 people in the highest risk categories could potentially preempt about one-qua"] [12.42203426361084, 3.499918222427368, "terven -\ntions for those at high risk. To start with, given Chicago\u2019s low clearance rates for shootings, the CVRM is de facto a victim prediction system . As noted in a RAND study of the initial ver -\nsion of the CVRM (then called the SSL; Saunders, "] [12.364906311035156, 3.4767842292785645, "e Minority Report , and/or that the \nmodel constituted computer-assisted discrimination. An article from technology news website The Verge, titled \u201cThe Minority Report: Chicago\u2019s New Police Computer Predicts Crimes, but Is It Racist?\u201d is just one esp"] [12.063011169433594, 3.3450610637664795, "otections covering the full range of data collection and man -\n2 The Priority Criminal Justice Needs Initiative, a project for the National Institute of Justice, has worked with several \nexpert panels on law enforcement\u2019s needs for emerging informat"] [13.670328140258789, 2.7021007537841797, "y rights protections. These included a panel on social media and social network analysis \n(Hollywood, Vermeer, et al., 2018a) and a panel on video analytics and sensor fusion (Hollywood, Vermeer, et al., 2018b).Figure 2.3\nInformation Protections Fram"] [12.442099571228027, 3.4933688640594482, "e\nospatial predictive policing software. HunchLab\u2019s (now ShotSpotter Missions) \ndevelopers assert that they are transparent about how the algorithm works and that the tool uses only place-based data (no data about individuals) and only forecasts plac"] [11.997844696044922, 3.3687376976013184, "n National Institute of Justice panel on social media and social network analysis, one comment was \u201cjust because you have 500 Facebook friends doesn\u2019t mean you have a real relationship with more than a few of them\u201d (Hollywood, Vermeer, et al., 2018a,"] [11.976983070373535, 3.3621435165405273, "tics systems\u2014there is a need for more formal community engagement to develop norms for how cameras will be placed, how data and analyses will be used in making those decisions, and how the cameras should be used. \n\u2022\n CV\nRM. Descriptions of the most "] [11.966989517211914, 3.365504264831543, "ilar models) to the SDSC evaluation, we first note that the inputs needed to get to improved understanding, decisionmaking, and performance are not limited to technology in these frameworks. A more complete set of inputs is shown in Figure 2.4. \nThe "] [11.985590934753418, 3.368668794631958, " in Figure 2.5.\nPolicing also has decision cycle models. The best known of these are the SARA model for \nimplementing problem-oriented policing (Scanning, Analysis, Response, and Assessment; Eck and Spelman, 1987) and the predictive policing cycle (P"] [12.014469146728516, 3.383103370666504, " and promising crime-reduction strategies. Examples included the following:\n\u2022 Mu\nch of the daily briefings process was about identifying areas with crime problems, \nincreasing resources in those areas, and then following up on the deployments. Hot sp"] [11.988258361816406, 3.368070363998413, "ctor \nunits on scene faster than waiting for citywide dispatch.\nThe SDSCs directly contribute to the second factor in the following way:\n\u2022 Te\nchnology such as HunchLab, as well as straightforward eyeballing of crime locations, \nhot spot mapping, and "] [11.988127708435059, 3.5205318927764893, "g in-depth information about locations and persons over the radio as officers were en route or staging. \nAgain, we did not assess officer safety outcomes directly. Note that assessing officer safety \noutcomes statistically is difficult, because assau"] [12.000539779663086, 3.6110212802886963, "intervals (bars) \nin crimes, by type and period. \nOf the 40 models (ten crime types by four periods), 15 showed significant reductions in \naverage monthly crime counts after districts added SDSCs. Robberies, burglaries, and aggra -\nvated batteries sh"] [12.029857635498047, 3.608853578567505, "ges in crimes for each district, for both the 2016\u20132018 \nperiod and the 2013\u20132018 period. Figures 3.4, 3.5, and 3.6 show estimated crime changes by crime type. \nAs shown in Figures 3.3\u20133.5, the estimated crime changes include increases and also \nmore"] [12.0167818069458, 3.6719820499420166, "5\n15121110\n98765432DistrictMotor vehicle theft (2016\u20132018)\n0.5 1.5 1.02515121110\n98765432\n0.6 0.7 0.8 0.9 1.1 1.2 1.3 1.4Homicide (2013\u20132018)\n0.4 2.02515121110\n98765432\nMotor vehicle theft (2013\u20132018)\n0.5 1.5 1.02515121110\n98765432\n0.6 0.7 0.8 0.9 1."] [12.054133415222168, 3.6522011756896973, "2.0 1.0Theft\nShooting\nRobbery\nMotor vehicle\ntheft\nHomicide\nCriminal sexual\nassault\nBurglary\nBattery\nAssault\n1.5\nEstimated intervention effectCrime Rate Outcomes Evaluation 57\nFigure 3.7\nEstimated Intervention Effects, by District (7, 8, 9, and 10)"] [11.958687782287598, 3.3597776889801025, "ly planning cycles, and supporting longer-term opera -\ntions to address chronic crime problems and hold specified offenders accountable. In general, we found evidence that SDSCs were supporting much higher levels of awareness and decision -\nmaking th"] [11.9790620803833, 3.3656249046325684, "tions. Although the team did not perform detailed technical secu -\nrity, privacy, and civil rights protections evaluations, we did assess alignment of SDSC prac -\ntices and operations with key protections. In general, we did not identify major warni"] [11.964930534362793, 3.368718385696411, "Findings\nWe statistically assessed the impacts of adding SDSCs for their principal objective: reducing \ncrime. SDSCs were found in this experiment to be effective, overall, at reducing crime. In 40 models, districts\u2019 average monthly crime counts decl"] [11.963067054748535, 3.3644330501556396, ", there are three needed organi -\nzational knowledge components, as follows: \n1.\n th\ne institutional foundation to provide a basic level of knowledge (including policies \nand SOPs, covered below, along with infrastructure and formal training)\n2. per\n"] [11.982133865356445, 3.3575592041015625, "ns as well as the frequency of these situations, all of which can be summarized in training sessions. (Here, database is a bit of a misnomer: \nA searchable document will serve initially, with a database created as knowledge docu -\nmentation accrues."] [11.957343101501465, 3.3666083812713623, "raining sessions involving hands-on experience in controlled situations. \nThese sessions would lead to doing the actual task in a \u201creal\u201d situation with the \u201creal\u201d pressures and context, either supervised or in a parallel virtual exercise.\n\u2022\n As p\nart"] [11.956786155700684, 3.3620526790618896, "n the field, \norganizational knowledge, and crime analyses\n\u2022 da\nily briefings, covering reviews of what has been learned, how that knowledge will be \nused, and what is likely coming up and how to respond, especially how upcoming risks will be address"] [11.932952880859375, 3.3576278686523438, "xt target might be for its evolution (Figure 4.1). The direction of planned, conscious evolution should be toward the lower right, meaning more integration and more functional capability.\nIt is important to progress from Level 1 to 6 and from Stage 1"] [11.929569244384766, 3.385951280593872, " \nand address those issues throughout the project, using both formal and informal means. \n\u2022 Th\ne core sequence of implementing change is: (1) why do it, what is the problem, (2) what \nneeds to be done, (3) figuring out how it needs to be done, (4) ac"] [12.51212215423584, 3.803050994873047, "er range of problem-oriented policing solutions. The Better Policing Toolkit\u2019s guide on problem-oriented policing introduces core \nstrategies and methods that are the most promising in making major-crime reductions (Holly -\nwood, Lauland, et al., 201"] [11.999680519104004, 3.348875045776367, "f use was officers providing cards with personal email and phone numbers as another way to get tips. The commander during the observation period described sometimes being woken up by calls but said that the tips received were worth immediately forwar"] [12.108476638793945, 3.3576748371124268, "ese tools (especially \nHunchLab) sometimes were left off to the side. If technically feasible, we recommend integrat -\ning ShotSpotter\u2019s shot location hits and HunchLab\u2019s predictive squares (along with any infor -\nmation HunchLab can provide on what "] [11.949243545532227, 3.3316760063171387, " eye toward tools and supporting methods that (1) are based on recommend -\ning specific services and interventions, and (2) are integrated with service providers, includ -\ning treatment providers, outside of the CPD. Transparency and community partic"] [11.959755897521973, 3.335036516189575, " as a promising model for improving law enforcement agen -\ncies\u2019 awareness of their communities, improving their decisionmaking, and carrying out more effective and more efficient operations that lead to crime reductions and other policing ben -\nefit"] [12.00383186340332, 3.364147901535034, "t measures to support improving operations over time.\n5. Recruiting and retention measures are needed.\u2022\n Bo\nlster the recruiting and retention of SDSC staff at all levels, furthering \nexpertise. \n\u2022 SD\nSC supervisors should be as senior as possible, i"] [13.242103576660156, 3.8073079586029053, "m/pdfs/hunchlab/HunchLab-Under-the-Hood.pdfBauer, Kelly, \u201cBizarre \u2018Stay Fetal\u2019 T-Shirt Shows Baby Police Officer, Mocks Rahm,\u201d DNAInfo , April 7, 2016. \nAs of June 19, 2019: \nhttps://www.dnainfo.com/chicago/20160407/downtown/bizarre-stay-fetal-t-shi"] [13.277303695678711, 3.6998748779296875, "t.ojp.gov/CAT/Resource/125\nCheetham, Robert, \u201cWhy We Sold HunchLab,\u201d Azavea Blog , January 23, 2019. As of June 20, 2019: \nhttps://www.azavea.com/blog/2019/01/23/why-we-sold-hunchlab/Chicago Police Department, \u201cPolice Observation Devices (PODs),\u201d we"] [13.432692527770996, 3.6294891834259033, " , Washington, D.C.: Office of Force Transformation, April 1, \n2005.\nGenetec, \u201cGenetec Inc. Integrates ShotSpotter Gunshot Detection Technology in Security Center,\u201d press \nrelease, Montreal, Canada, March 30, 201 7. As of June 2 7, 2019: \nhttps://ww"] [13.664708137512207, 3.7834386825561523, "earch Agenda That Includes \nBusiness Cases, Privacy and Civil Rights Protections, and Needs for Innovation , Santa Monica, Calif.: RAND \nCorporation, RR-2619-NIJ, 2018b. As of September 18, 2019: \nhttps://www.rand.org/pubs/research_reports/RR2619.htm"] [13.425616264343262, 3.7320258617401123, "Appointment Necessary,\u2019\u201d in Brian T Denton, ed., Handbook of Healthcare Operations Management: Methods and Applications , New York: Springer, 2013, \npp. 349\u2013386.\nMcKay, Kenneth N., Fatih Safa Erenay, and B. Wang, Innovation Maturity Study , Toronto: "] [13.028580665588379, 3.7187862396240234, "licing Cause the Increase in Homicide Rates?\u201d Criminology \n& Public Policy , Vol. 18, No. 1, February 2019, pp. 51\u201375.\nRosenstock, Christian, Robert S. Johnston, and Larry M. Anderson, Maturity Model Implementation and Use: A Case Study , paper prese"] [13.2327241897583, 3.7114360332489014, "n \nWe Maximize Both Fairness and Effectiveness in the New Proactive Policing?\u201d University of Chicago Legal Forum , Vol. 2016, Article 16, 2016. As of June 20, 2019: \nhttp://chicagounbound.uchicago.edu/uclf/vol2016/iss1/16\nWilliams, Timothy, \u201cCan 30,"] [16.291780471801758, 9.700900077819824, "Research Report \nLocal Evaluation Report for Los Angeles \nCounty \u2019s Mentally Ill Offender Crime \nReduction (MIOCR) Program \nSarah B. Hunter, Maya Buenaventura, Matthew Cefalu \nRAND Justice Policy \nC O R P O R A T I O NLimited Print and Electronic Dis"] [13.836446762084961, 4.391978740692139, " which spans both criminal and civil justice system issues with such topics as public safety, effective policing, police\u2013community relations, drug policy and enforcement, corrections policy, use of technology in law enforcement, tort reform, catastro"] [16.284170150756836, 10.130739212036133, ".................................................................................. 4\t\nProject Goals ............................................................................................................................................. 7 \t\nPr"] [16.307907104492188, 10.16679573059082, "...................................................................................... 27\t\nProject Cost of Evaluation and Cost per Participant ........................................................................... 40\t\nConclusions and Next Steps"] [16.395896911621094, 9.705646514892578, "County MIOCR \nParticipants and Other Populations ....................................................................................... 31\t\nTable 4.9. Alcohol Use Disorders Identification Test\u2013Consumption (AUDIT-C) Results for \nLos Angeles County M"] [16.30861473083496, 9.741368293762207, "itions. To reduce the risk of recidivism and improve outcomes for individuals suffering from mental health disorders who are returning to the community after incarceration, California\u2019s Board of State and Community Corrections issued awards (called M"] [16.387266159057617, 9.700394630432129, "ear program maintained or improved their \nreported mental health and substance use status. Program graduates also demonstrated \nimprovements in health care insurance status, benefit establishment, and housing stability. Data on criminal justice invol"] [16.146089553833008, 9.662691116333008, "ion Test\u2013Consumption \nBSCC California\u2019s Board of State and Community Corrections \nCDC HQROL-4 Centers for Disease Control and Prevention Health-Related Quality of \nLife Survey \nCI confidence interval \nCOMPAS Correctional Offender Management Profilin"] [15.622779846191406, 4.754930019378662, "ifornia Department of Corrections and Rehabilitation, 2015). Silver, \nCohen, and Spodak (1989) analyzed five-year re-arrest rates among a Maryland state prison cohort and found that 73.3 percent of individuals experiencing mental illness were re-arr"] [16.3037109375, 9.721386909484863, "llargeon, Hoge, and Penn, 2010; Messina et al., 2004; Osher and Steadman, 2007; Peters and Bekman, 2007). Lack of access to treatment and other support results in higher rates of recidivism, \nhomelessness, and poor health outcomes (Baillargeon, Hoge,"] [16.322433471679688, 9.751583099365234, "ions and next steps from this work. Each of following chapters has been organized to include the topics specified in the local evaluation reporting requirements by the BSCC in its communication to local MIOCR grantees. \n \n 4 2. Project Descripti"] [16.29439353942871, 9.76026439666748, "rograms. An average GR case consists of one person, living alone, with no income or resources . 5 Table 2.1. This program logic model was initially drafted by the evaluation team. Program \nstakeholders, including staff from the Department of Healt"] [16.277414321899414, 9.769308090209961, "housing/ICMS, \nsubstance use disorder treatment, and/or other community services (as applicable to individual client) \n \u2022 Improved health, \nmental health and \nsubstance use \nstatus \n\u2022 Decreased hospitalizations \nand emergency \ndepartment visits \n\u2022"] [16.282426834106445, 9.77725887298584, "s were prepared while in custody. Jail-in reach services were provided, and 8 individuals received a coordinated release to a community-based service provider to ensure \nlinkages to community services upon reentry. In sum, the MIOCR team services i"] [16.27520179748535, 9.758147239685059, " LAC\u2019s DHS. DHS established a MIOCR Project Workgroup, \ncomposed of members from the District Attorney\u2019s office, Sheriff\u2019s Department, DMH, Department of Public Health (which includes the SAPC unit), Probation Department, Public Defender, and Alterna"] [16.445894241333008, 9.670913696289062, "der treatment through referral by the SAPC. The program also \nincluded follow-up by a community worker. \nThese project components were tracked in an Excel-based project tracking worksheet, as further \ndetailed below. We also collected information on"] [16.564231872558594, 9.631311416625977, "t completion, reentry plan establishment, benefit application activities, and linkage to FSP, permanent supportive housing/ICMS, and/or substance use disorder treatment. Staff also tracked dates of referral, assessment, service referrals, and release"] [16.487756729125977, 9.640320777893066, "llment using validated tools. As further detailed below, the Centers for Disease Control and Prevention\u2019s standard four-item set of \u201cHealthy Days\u201d core questions was used to collect data on self-perceived physical and mental health; the Mental Health"] [16.552249908447266, 9.58530044555664, "ems from the 36-Item Short-Form Health Survey (SF-36), which measures mental distress and mental well-being. The MHI-5 is a tool used to screen for overall psychological well-being and symptoms of anxiety and depression. The five questions on the MHI"] [16.455049514770508, 9.666451454162598, "a high level of security during the time of initial recruitment. \nThibodeau et al. (2009) administered the AUDIT-C to a convenience sample of 49 men \nincarcerated in a minimum-security Wisconsin state prison. The AUDIT-C was administered at \none-mont"] [16.436813354492188, 9.68630313873291, ", 2013; Bolano et al., 2016; Evren et al., 2014; Humphreys et al., 2017; Izenberg et al., 2014; Mukherjee et al., 2016; Myers et al., 2018; Owens, Rogers, and Whitesell, \n2011; Shiu-Yee et al., 2018; Thibodeau et al., 2009; Walker, 2011). For example"] [16.550172805786133, 9.602115631103516, ". Standard linear regression models assume that observations are independent. However, the surveys were administered to the same individuals at baseline, 6 months, and 12 months. Thus, observations are not independent. Because multiple observations w"] [16.316852569580078, 9.807943344116211, "tcomes and program costs. Finally, we provide conclusions and next steps regarding our study findings. \nResults \nRecruitment and Enrollment \nDuring the grant period, 152 individuals were referred to the MIOCR program. Of those, 64 \npercent were enr"] [16.14251136779785, 9.916376113891602, " Center 5.6% 0.0% \nHomeless Initiative D2 1.9% 1.0% \nCentury Regional Detention Facility 1.9% 0.0% \nWhole Person Care 1.9% 0.0% \nClient request 1.9% 0.0% \nForensic Inpatient Unit 1.9% 0.0% \nOffice of Diversion and Reentry 0.0% 3.1"] [16.37415313720703, 9.738600730895996, "ipants (7 percent) reported visiting the emergency room in the 12 months prior to enrollment in the MIOCR program. Most participants (74 percent) reported not being employed in the 12 months prior to enrollment in the MIOCR program. A little less tha"] [16.412914276123047, 9.727210998535156, "r more than one \ncategory. 24 Process Evaluation Results \nAs noted previously, the primary project components were (1) generate referrals to the program, \n(2) provide jail-based reentry services, and (3) provide linkage to and follow-up with commu"] [16.260095596313477, 9.837332725524902, "ntial participant. If the individual was accepted to the program, then a coordinated release was set up so that the contracted program staff would be present at the time of the participant\u2019s release for transport and/or acceptance into their program."] [16.400606155395508, 9.75202751159668, " \n 26 Table 4.5. Reasons for Program Termination and Days in the Program for All Program Dropouts \n(N=45) \n\tAll\tDropouts \t\nN % \nTermination reason \nClient declined 10 22.2% \nMoved out of LAC 2 4.4% \nNeeded higher level of care 2 4.4% \nPatton"] [16.258256912231445, 9.834868431091309, "rom jail to receipt of publicly funded substance use treatment in the future. \nOther program barriers experienced relate to the provision of in-jail services and \ncharacteristics of program participants. More specifically, there were some delays in t"] [16.489534378051758, 9.643603324890137, " for \nhow many days during the past 30 days was your mental \nhealth not good? \u20136.69 0.008 \u20139.1 0.017 \nCDCHRQOL 4: During the past 30 days, for about how many \ndays did poor physical or mental health keep you from doing \nyour usual activities, such"] [16.5145320892334, 9.65286922454834, "des evidence that if bias exists in the full analysis, it appears to be attenuating the estimated effect toward zero. This means that the full analysis may be conservative in its estimation (not biasing the results to favor larger impacts\u2014if anything"] [16.435760498046875, 9.685456275939941, " Other Populations \n General U.S. \nPopulation \n(BRFSS) Brent and \nMaschi \n(2015) Gjelsvik \net al. (2014) LAC \nMIOCR \nBaseline \n(N=97) LAC \nMIOCR \n6 Months \n(N=43) LAC \nMIOCR \n12 Months \n(N=22) \nGeneral health is (Centers for Disease Control a"] [16.446016311645508, 9.667753219604492, "al., 2015). These statistics are included in Table 4.8. For comparison, summary statistics from the MHI-5 data from Karus et al. (2007) (male inmates seriously ill with HIV/AIDS at two large jails in New \nOrleans and Los Angeles) and Wilkinson et al."] [16.48182487487793, 9.657245635986328, "ulations at baseline, with about one-third scoring in the positive range for a probable alcohol use disorder. As noted earlier, scores substantially declined at the follow-up time points, with about 21 percent in the positive range for a probable dis"] [16.445602416992188, 9.74615478515625, "um - \nphreys \net al. \n(2017) Walker \n(2011) \n LAC \nMIOCR \nBaseline \n(N=97) LAC \nMIOCR \n6 Months \n(N=43) LAC \nMIOCR \n12 \nMonths \n(N=22) \nMean \n(SD) \n[range] 5.99 \n(3.37) \n[0\u201310] 4.57 5.47 \n[0\u201310] 5.84 \n(2.71) \n[0\u201310] 3.30 \n(2.76) \n[0\u20139] 3.03 "] [16.536222457885742, 9.745318412780762, "9 0\u20138 0\u20134 0\u20139 \nJail days \nMean 13.3 6.1 8.1 20.5 \nStandard deviation 31.7 16.5 22.7 40.6 \nRange 0\u2013153 0\u201374 0\u201399 0\u2013153 \n12-month post -period (only includes the 52 individuals who have 12 full months of post -\nenrollment data) \n All at \n12 M"] [16.367965698242188, 9.889371871948242, ".9; SD = 1.8; 95-percent CI = 0.2\u20131.6; post-period mean = 0.4; SD = 1.2; 95-percent CI = \u20130.07\u20130.9; t = 1.2; df = 27; p-\nvalue = 0.2286). \n\u2022 There was a decrease in the mean number of jail days, but this decrease was not statistically significant (p "] [16.32493782043457, 9.873180389404297, "eipt of Medi- Cal or Other Health Care Insurance Among L os Angeles County \nMIOCR Participants by Program Status \n \nThe increase in the proportion of graduates who had some form of health care insurance from \n12 months pre-enrollment to 6 months po"] [16.25415802001953, 9.915423393249512, "till \nEnrolled All \nDropouts \nN 98 30 23 45 \n12-month pre -period (includes all 98 enrollees) \nEmployed/stipend (N) 26 6 9 11 \nEmployed/stipend (%) 26.53% 20.0% 39.1% 24.4% \nProgram completion (includes 30 individuals who graduated) \nEmployed/s"] [16.26668930053711, 9.94729995727539, "t may receive 3, 30, 60, or 90 days of residential substance use treatment or receive one to three visits a week from an FSP provider. Taking into account the enrollment of 98 individuals, and subtracting out the evaluation costs ($150,000), the prog"] [16.350868225097656, 9.804201126098633, "herefore these results should be interpreted with caution in terms of the causal link between program participation and outcomes. In addition, the current program attrition rate of 60 percent suggests there may be some room for improving the connecti"] [16.441253662109375, 9.79919147491455, "5 45.5 1 33.3 1 20.0 \nUnknown 1 2.2 0 0.0 1 7.1 0 0.0 0 0.0 0 0.0 \nTotal 45 \n 12 \n 14 \n 11 \n 3 \n 5 \n Days in program * \n Mean 211.6 \n 257.9 \n 196.4 \n 191.5 \n 237.7 \n 161.5 \n SD 93.6 \n 92.0 \n 88.5 \n 93.7 \n 31.8 \n 124.5 \n Range 37"] [16.507612228393555, 9.784615516662598, "8 1.1 \n 0.8 \nRange 0\u20132 0\u20132 0\u20131 0\u20131 0\u20130 0\u20131 0\u20130 0\u20131 0\u20131 0\u20131 0\u20134 0\u20134 0\u20132 0\u20133 0\u20130 0\u20132 \nMisdemeanor \nconvictions \n Mean 1.1 0.4 0.3 2.3 0.0 0.3 0.0 0.5 0.0 0.3 0.7 0.5 0.6 1.4 0.3 0.2 \nSD 2.0 0.8 0.5 2.9 \n 1.0 0.0 1.3 \n 0.6 1.5 0.9 0.9 "] [16.30437469482422, 9.91550064086914, " GR 12 4 2 5 1 \n% with GR 40.0 28.6 50.0 45.5 100.0 \nNOTE: ODR SHP = Office of Diversion and Reentry Supportive Housing Program; SAPC = Substance Abuse Prevention and Control residential substance abuse \nt"] [16.17009735107422, 9.904614448547363, "0 \nDomiciled (N) 24 9 4 10 1 18 1 9 5 3 27 8 9 7 1 2 \nDomiciled (%) 80.0 64.3 100.0 90.9 100.0 78.3 33.3 81.8 100.0 75.0 60.0 66.7 64.3 63.6 33.3 40.0 \nUnknown (N) 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 \nUnknown (%) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0"] [16.235401153564453, 9.635503768920898, "dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/FinalDraftMediCal2020WaiverRenewal.pdf \nCalifornia Healthline, \u201cHealth Care Revamp at the L.A. County Jails,\u201d March 1, 2018. As of July \n24, 2018: https://californiahealthline.org/news/health-care-re"] [15.76343059539795, 10.280342102050781, "th, 2017. \nHunter, Sarah B., Melody Harvey, Brian Briscombe, and Matt Cefalu, Evaluation of Housing for \nHealth Permanent Supportive Housing Program, Santa Monica, Calif.: RAND Corporation, RR-1694-BRC, 2017. As of August 13, 2018: https://www.rand.o"] [15.578853607177734, 4.6413893699646, "ctors Associated with Interest in Receiving Prison-Based Methadone Maintenance Therapy in Malaysia,\u201d Drug and Alcohol Dependence, Vol. 164, 2016, pp. 120\u2013127. \nMyers, Janet J., Mi-Suk Kang Dufour, Kimberly A. Koester, Mark Morewitz, Rebecca Packard, "] [15.60362434387207, 4.683930397033691, "8: https://www.americashealthrankings.org/explore/annual/measure/MentalHealth/state/ALL \n\u2014\u2014\u2014, \u201cPoor Physical Health Days in United States in 2017,\u201d 2018b. As of July 24, 2018: \nhttps://www.americashealthrankings.org/explore/annual/measure/PhysicalHea"] [14.706631660461426, 4.008941650390625, "CORPORATION\nFeasibility of a Survey \nPanel of Criminal Justice Agencies in Small, Rural, Tribal, and Border Areas\nJessica Saunders, Meagan Cahill, Jirka TaylorLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained h"] [13.86136531829834, 4.359930515289307, "cy \u00a0\nThe research reported here was conducted in the RAND Justice Policy Program, which spans \nboth criminal and civil justice system issues with such topics as public safety, effective policing, \npolice\u2013community relations, drug policy and enforceme"] [14.805036544799805, 4.116318225860596, "................6 \t\r \u00a0\nCommunity Corrections ........................................................................................................................6 \t\r \u00a0\nRural Agencies ............................................................."] [14.81078815460205, 4.1335601806640625, "..........................................................................................................22 \t\r \u00a0\nResults ................................................................................................................................"] [14.867177963256836, 4.113470554351807, "nfidence Intervals with 5-Percent Margin of Error .......................... 26\t\r \u00a0\nTable A.1. Strategies Used to Improve Response Rates in National Panel Surveys .................... 35\t\r \u00a0Table B.1. How Old Is Your Record Management System, in Year"] [14.82938289642334, 4.089500427246094, "ible for \nOther Types of Special Programs? ....................................................................................... 45\t\r \u00a0\nTable B.21. Other Questions Asked to the Courts Sample (March Survey) ................................ 45\t\r \u00a0\nT"] [14.78688907623291, 4.0659027099609375, "ystems, jails, and community corrections \nagencies for other projects, thus increasing SRTB representation in research. \nTo determine whether this idea is feasible, the JIC conducted several tasks across multiple \nphases. First, we used a convenience"] [14.70855712890625, 3.9990437030792236, " \nUniversity\u2019s Center for Violence Prevention and Community Safety. We are grateful to all of the \nstaff who participated in the development and implementation of this project, including our \nRAND colleagues Andrew Morral, Liisa Ecola, Josh Mallet, a"] [14.77379322052002, 4.023229598999023, "iorities specific to SRTB agencies. The purpose of the JIC is to gather information on the challenges facing SRTB agencies, identify relevant technology solutions that can address those challenges, and assess the solutions as they are implemented in "] [12.840644836425781, 13.972281455993652, "ipation, \u00a0\nvoting \u00a0behavior, \u00a0and \u00a0public \u00a0opinion \u00a0Online \u00a0and \u00a0\nface-\u00adto-\u00adface \u00a0\ninterviews \u00a0\nPSIDb \u00a0 More \u00a0than \u00a024,000 \u00a0\nresidents \u00a0(10,000 \u00a0\nfamilies) \u00a0Repeated \u00a0interviews \u00a0\nevery \u00a0two \u00a0years \u00a0Family \u00a0economics, \u00a0\ndemography , \u00a0and \u00a0\nhealth \u00a0"] [14.782570838928223, 4.121671676635742, "udinal use of survey panels also enables an analysis \nof change in variables of interest over time (Berrington, Smith, and Sturgis, 2006). The same is true for repeated cross-sectional surveys not utilizing a panel (i.e., surveys that ask a new indep"] [14.785689353942871, 4.09034538269043, "pondents via a panel on short notice is especially useful, given the rapid pace of technology development, and would therefore enable the JIC to collect information as current as possible. \nThis report describes the JIC\u2019s efforts to create a survey "] [14.799800872802734, 4.028990745544434, "sworn law enforcement officers. This definition is similar to previously published definitions, which have defined agency size based on either the number of personnel employed or the residential population served. For example, a previous study define"] [14.793282508850098, 4.014527797698975, "rature: The Rural Policy Research \nInstitute identified over 15 definitions of rural in use by federal programs. In general, this term \nrefers to areas with low-density populations at a specified distance from large cities and metropolitan areas. We "] [14.790498733520508, 4.127084732055664, "nderstanding how they are similar to or different from non-SRTB agencies. While we did not do so for the feasibility surveys, an option going forward is to provide open enrollment to other types of agencies to use as comparison groups, which we discu"] [14.801265716552734, 4.134957313537598, "t, and data were analyzed using Microsoft Excel. The results were depicted using different types of graphs and emailed to everyone who received the survey (i.e., all potential respondents in the sample, n = 148). \nDuring this time period, we worked o"] [14.813735961914062, 4.148619651794434, "was sent out in March 2016, along with the results from the previous round. \nWe selected the topic of mental health needs across the different types of criminal justice systems agencies. This month, a few individuals (3.5 percent) asked to be removed"] [14.78987979888916, 4.10145378112793, "vitations with individualized links, allowing the JIC to match\nresponses to individual respondents without requiring additional logins from respondents\n\u2022create personalized surveys based on either agency type (small, rural, tribal, border) orsector ("] [14.78166675567627, 4.0808281898498535, " each participant to classify them \ninto the correct categories\u2014small, rural, tribal, border (or other) AND law enforcement, \ncourts, institutional corrections, or community corrections? The categories are not always \nmutually exclusive, as some indi"] [14.789825439453125, 4.107075214385986, "uit agencies into the panel study. We decided to focus on a subset of the target population\u2014small law enforcement departments\u2014because it has a known sampling frame (e.g., a list of all eligible agencies) that allows us to randomly assign different po"] [14.78150749206543, 4.09045934677124, "ents operate \nto inform better policymaking \n6.This is sponsored by the National Institute of Justice \nENROLL NOW! \nSurvey questions will concern agency policies, operations, staffing, use of technology, and \nrelated topics. Each month, you"] [14.769262313842773, 4.130107402801514, "ny questions about the \nJIC survey panel, please contact Jessica Saunders (jsaunder@rand.org) \nPlease visit tinyurl.com/JICEnrollByMail to enroll in the panel.\n \nThank you, \nJessica Saunders and Meagan Cahill \n \n \n 20 Condition \u00a0Thr"] [14.80263900756836, 4.161276817321777, "___________________________ \n Please answer the following questions about your primary law enforcement agency\u2019s \ncharacteristics: \n\ufffd \u00a0Agency jurisdiction: \no \u00a0drop down menu state/county/city \no \u00a0other: fill in the blank \n\ufffd \u00a0number of sworn full-tim"] [14.769412994384766, 4.116386413574219, " populations: SRTB law enforcement, SRTB courts, SRTB institutional corrections, \nand SRTB community corrections \n3. \u00a0four populations: small criminal justice agencies, rural criminal justice agencies, tribal criminal justice agencies, and border cr"] [5.8754096031188965, 3.9566335678100586, "es except for the tribal populations. Thus, there is a sampling frame available for a probability sample for only ten of the 16 agency types; the others would require the development of a sampling frame. \nIn addition, it is also more expensive and d"] [5.8678879737854, 3.9475479125976562, " to construct. \nHow to construct a stratified sample: \n1. \u00a0specify the population \n2. \u00a0specify the feature/characteristic to stratify on \n3. \u00a0list the population according to the stratification \n4. \u00a0calculate the desired sample size per stratum \n5. "] [5.853540420532227, 3.940944194793701, "r analytic reasons to require equal numbers across different strata, such as having an equal sample size across populations to use in different analyses. \nHow to construct quota sample: \n1. \u00a0specify the population \n2. \u00a0specify the feature/characteris"] [12.846795082092285, 13.979117393493652, "bias (Groves and Peytcheva, 2008). Correspondingly, some researchers have suggested focusing efforts on increases in the effective sample size and nonresponse bias analyses, rather than response-rate maximization (e.g. Davern, 2013; Halbesleben and W"] [14.827524185180664, 4.130544185638428, "t have incentives (like the panel we tried to create), so it is hard to anticipate whether a panel study with this population would continue to get such high response rates. Still, the question of incentives for JIC panel participants merits further "] [14.788084030151367, 4.120436668395996, "ondents receive an honorarium based on the length of the survey.\n6 \nThe proposed panel survey of SRTB criminal justice agencies is a short survey of only two \nminutes per month, so a large monetary incentive would not be appropriate, but research has"] [14.816301345825195, 4.091386318206787, "ating a narrowly focused and useful survey can set the groundwork for expanding by demonstrating the survey\u2019s utility. \nWe would recommend starting with law enforcement or institutional corrections for two \nreasons: \n1. \u00a0There are already sampling fr"] [12.805981636047363, 13.929659843444824, "e \u00a0payments \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\nMonetary \u00a0compensation \u00a0for \u00a0completion \u00a0of \u00a0interview \u00a0 \u00a310 \u00a0per \u00a0adult \u00a0\nrespondent \u00a0\u20ac5 \u00a0per \u00a0adult \u00a0\nrespondent \u00a0$60\u2013 100 \u00a0per \u00a0\nrespondent \u00a0$Australian \u00a0\n30\u201360 \u00a0$50\u2013 $110 \u00a0per \u00a0\nrespondent \u00a0$65 \u00a0per \u00a0\nrespond"] [12.780508995056152, 13.909443855285645, "x \u00a0 \u00a0 \u00a0\nPromise \u00a0respondents \u00a0confidentiality \u00a0of \u00a0responses \u00a0 x \u00a0 x \u00a0 x \u00a0 x \u00a0 x \u00a0 x \u00a0\nBonuses \u00a0to \u00a0interviewers/teams \u00a0for \u00a0achieving \u00a0response -\u00ad\nrate \u00a0goals \u00a0or \u00a0working \u00a0additional \u00a0hours \u00a0x \u00a0 x \u00a0 x \u00a0 x \u00a0 x \u00a0 x \u00a0\nOngoing \u00a0monitoring \u00a0of \u00a0resp"] [14.961371421813965, 4.0765299797058105, "68\u2013 2013) . \u00a0N/A \u00a0= \u00a0not \u00a0applicable. \u00a0\n \n \n \n \n 39 Appendix \u00a0B: \u00a0Results \u00a0from \u00a0 the \u00a0Email \u00a0and \u00a0Web -\u00adBased \u00a0Surveys \u00a0\nJanuary \u00a02016 \u00a0Survey \u00a0\nThe first law enforcement survey found that departments held mixed opinions of their current \nrecords"] [14.987241744995117, 4.045368671417236, "y, almost 75 percent use some sort of remote alcohol monitoring devices with their clients. \nTable \u00a0B.7. \u00a0How \u00a0Many \u00a0Hours \u00a0Do \u00a0Your \u00a0Officers \u00a0Spend \u00a0Commuting \u00a0Per \u00a0Week? \u00a0\nResponse \u00a0Frequency \u00a0\n(%) \u00a0\n0\u20133 \u00a0hours \u00a0 45.5 \u00a0\n4\u201310 \u00a0hours \u00a0 36.4 \u00a0\n11\u201320 "] [15.144547462463379, 4.126965522766113, ".15. \u00a0To \u00a0Whom \u00a0D o \u00a0You \u00a0Allow \u00a0Access \u00a0to \u00a0Video \u00a0Visitation? \u00a0(Q uestion \u00a0Applicable \u00a0to \u00a056 \u00a0\nPercent \u00a0of \u00a0Agencies) \u00a0\nResponse \u00a0Frequency \u00a0\n(%) \u00a0\nFamily \u00a0members \u00a0and \u00a0legal \u00a0professionals \u00a0 56 \u00a0\nFamily \u00a0members \u00a0only \u00a0 44 \u00a0\n None of the comm"] [15.18146800994873, 4.101779937744141, "court \u00a0require \u00a0a \u00a0mental \u00a0health \u00a0assessment/screening \u00a0for \u00a0defendants ? \u00a040 \u00a060 \u00a0\nIs \u00a0the \u00a0training \u00a0on \u00a0mental \u00a0health \u00a0issues \u00a0adequate \u00a0for \u00a0judges? \u00a0 37 \u00a063 \u00a0\nIs \u00a0the \u00a0training \u00a0on \u00a0mental \u00a0health \u00a0issues \u00a0adequate \u00a0for \u00a0other \u00a0staff? \u00a0 14 \u00a08"] [14.366483688354492, 7.132128715515137, "at, in comparison with 2007, their budgets, workload and staff numbers had all increased. On average, reporting agencies applied for 2.8 grants, with one reporting applying for 35. They received an average of 2.6 grants, with one agency receiving 34."] [12.858172416687012, 13.974101066589355, " Piekarski, Kumar Rao, Douglas Rivers, Randall K. Thomas, and Dan Zahs, \u201cAAPOR Report on Online Panels,\u201d Public Opinion Quarterly, Vol. 74, No. 4, 2010, pp. 711\u2013781. \nBaker, Reg, J. Michael Brick, Nancy A. Bates, Mike Battaglia, Mick P. Couper, Jill "] [12.84040641784668, 13.961738586425781, "015, pp. 43\u201359. \nCochran, William G., Sampling Techniques, 3rd ed., New York: John Wiley & Sons, 1977. \nCollins, Pamela, Research for Practice: Law Enforcement Technology\u2014Are Small and Rural \nAgencies Equipped and Trained? Washington, D.C.: National "] [12.8109712600708, 13.929201126098633, "p. 103\u2013124. \nHillygus, D. Sunshine, and Steven A. Snell, Longitudinal Surveys: Issues and Opportunities, \nDurham, N.C.: Duke University Initiative on Survey Methodology, August 8, 2015. As of March 6, 2017: https://sites.duke.edu/ssnell/files/2015/07"] [12.850312232971191, 13.96462631225586, "ility \nBetween Probability Sample Estimates and Nonprobability Web Samples Estimates,\u201d Proceedings of the 2013 Federal Committee on Statistical Methodology (FCSM) Research Conference, 2014. As of March 24, 2017: https://s3.amazonaws.com/sitesusa/wp-c"] [12.865927696228027, 13.977762222290039, "Methods in Social and Behavioral Research, Thousand Oaks, Calif.: Sage Publications, 2003, pp. 671\u2013702. \nTeddlie, Charles, and Fen Yu, \u201cMixed Methods Sampling: A Typology with Examples,\u201d Journal \nof Mixed Methods Research, Vol. 1, No. 1, 2007, pp. 77"] [-2.2567150592803955, 14.319134712219238, "An Agenda to Advance Integrative \nResilience Research and Practice\nKey Themes From a Resilience Roundtable\nJoie Acosta, Anita Chandra, Jaime Madrigano\nFebruary 2017An Agenda to Advance Integrative Resilience Research and Practice ii Preface\nResilien"] [-2.2554984092712402, 14.317582130432129, "es 1\n Definitions and Drivers of Resilience 3\n Challenges to Advancing the Field of Resilience 5\n A Need for a Shared Agenda Going Forward 8\n2. Resilience Roundtable to Generate Agenda Priorities 10\n Purpose of This Agenda 14\n3. Stresses: A Res"] [-2.245758533477783, 14.31578540802002, "683.An Agenda to Advance Integrative Resilience Research and Practice v Acknowledgments\nThe authors are greatly appreciative for the time and insights of the many \ncontributors to this report. In particular, we highlight the contribution of Tracy\u00a0Co"] [-2.242110252380371, 14.309141159057617, " Integrative Resilience Research and Practice vii of the various types of impacts into a useful metric lag behind. What is needed is a \nshared agenda, going forward, that will promote research in resilience in a way that builds across\n disciplines. "] [-2.2318544387817383, 14.300274848937988, "cipants met in breakout \nsessions to discuss each topic \nand offer recommendations \nin four areas: facilitation of \nongoing multisectoral and \ninterdisciplinary dialogue \non resilience; expansion or \nenhancement of policies, \nprograms and services; \n"] [-2.2502286434173584, 14.313126564025879, "ithin communities and from one community to another). This model challenges the normative thinking that every observed effect has an observable cause and that the whole can be understood by studying the pieces.The Roundtable participants \nnoted the c"] [-2.2609498500823975, 14.320684432983398, "le discussions, \nparticipants underscored many of the challenges confronting the development of a robust workforce that can address the need for more transdisciplinary and integrated action. Resilience leadership development was a leading priority ac"] [-2.352631092071533, 14.359329223632812, "to help its residents achieve \ngood health and prosperity, while struggling with the challenges of limited opportunity, chronic violence, a history of inequity, and other stresses. Now imagine Anytown is hit with a hurricane that devastates its coast"] [-2.228196859359741, 14.30099105834961, "h year (1990 to 1999), to an average of 56 per year (2000 to 2009) (Linds\nay & McCarth, 2015). Income inequality is at the highest \nlevel for the past 50 years, with the richest 10 percent of the population now making over nine times more than the po"] [-2.1639459133148193, 14.262091636657715, "practitioners have begun to identify the key factors that promote community resilience, such as the application of long-term recovery plans, the active engagement of nongovernmental or civil society organizations, and adherence to principles of socia"] [-2.1674134731292725, 14.26636028289795, " is recognized as being culturally and contextually dependent \n(ASPR , 2015), a number of factors that drive individual resilience are common across \npopulations, including those operating on individual, family, school, and community levels. \nOn the "] [-2.243604898452759, 14.310018539428711, "levels (Zolkoski & Bullock, 2012). \nThe evolving fields of emergency management and disaster risk reduction, in particular, \nhave supported the development of the community resilience field. Emergency management started with a focus on hazard and vul"] [-2.2315592765808105, 14.305682182312012, "as much attention in resilience discussions. \nWhile this \ngrowing inquiry \ninto the factors \nthat influence \nresilience and \nshape resilient \ncommunities \nrepresents a \nstep forward \nin building the \nevidence base \nin resilience \nresearch and \npo"] [-2.264359712600708, 14.321412086486816, "s as resilience action and how those actions address long-standing social challenges are central to the resilience dialogue (e.g., how to create policies that adapt to climate change in ways that are fair across neighborhoods). Y et, too often, resil"] [-2.248764753341675, 14.3126802444458, " more coherent and robust picture on the factors and mechanisms that propel resilience development. FIGURE 1\nMoving to Transdisciplinary Science\nPsychologyResilience Science\nAnthropologySocial ScienceResilience\nScience\nAnthro-\npologyPsychology Sociol"] [-2.236731767654419, 14.306474685668945, "g \nresilience in developmental and ecological processes with attention to cultural influences on resilience; 3) intervening in resilience; and 4) resilience research on multiple systems levels\n \u2014 the broader field of resilience research and practice "] [-2.257558584213257, 14.318961143493652, " have had two challenges. They either have been highly specialized to specific sectors only or have offered important but numerous insights and recommendations, making it difficult to prioritize which directions to pursue across disciplines and secto"] [-2.2643985748291016, 14.327714920043945, "factors in resilience. The RWJF-RAND team purposefully selected experts who often meet in specialized resilience discussions but do not convene together. \n* Available online at: www.rwjf.org/en/library/features/resilience-convening-2016.html2. Resili"] [-2.2491602897644043, 14.31340503692627, "eting themes using real-time illustration (example in Figure 2).The topics were selected \nbecause they offered key \npoints of intersection or \nsynergy between the fields \nof individual and community \nresilience. Actions across \nthese topic areas woul"] [-2.246638536453247, 14.310797691345215, "aturally \noccurring innovations and programs that \nhave been evaluated57% Systems\nDevelop a minimalist set of measures Ensure measures capture response to \nacute stress and presence of capabilities \nand capacities to deal with chronic stresses of all"] [-2.2520618438720703, 14.321887969970703, "es. If\n the workforce does not understand resilience principles and frameworks, we cannot \nmove research, policy, and practice effectively. \nAs referenced earlier, some disciplines, like psyc\nhology, have already outlined waves of \nresilience resear"] [-2.2415430545806885, 14.31216049194336, "ody. While beneficial in responding to acute stress, repeated activation of this adaptive response over time can lead to negative consequences (Karatsoreos & McEwen, 2011; Selye, 1936). Recently, stress has been viewed within the context of allostasi"] [-2.259976863861084, 14.323607444763184, " required for communities, families, and individuals based on their stress background. Accumulating evidence suggests that health disparities can be partially attributed to allostatic overload resulting from exposure to multiple physical, social, and"] [-2.224463939666748, 14.302107810974121, "s on issues of enduring stress and how that relates to persistent inequity, a\n criticism in the resilience backlash mentioned earlier (chapter 1) (Allmark et al., 2014). \nTheme Recommendations\nThe insights and discussion from the Resilience Roundtabl"] [-2.1749839782714844, 14.260527610778809, "nes and sectors together (National Research Council, 2009). \nWhile there has been greater movement toward developing comprehensive resilience \nindices, these measurement tools are still limited in their ability to capture stress across a community\u2019s "] [-2.3006577491760254, 14.326302528381348, "of resilience that may be unique to a particular community. Community involvement is also crucial to the collection of new and emerging data types (e.g., social media or community experiential data) as well as the dissemination of any data collection"] [-2.2659761905670166, 14.313835144042969, "nterventions for multiple stresses, and these interventions can then be pilot tested in communities where they can have the largest\n impact. \nRecommendation 3: Focus on narratives, storytelling, and digital media to increase \nunderstanding within and"] [-2.2067103385925293, 14.294878005981445, "y is needed. Further, it has been argued While some have argued that the decline \nin American informal and formal civic \norganizations is, at least, partially due to a \nrise in media consumption, others have made \nthe case that popular culture is a "] [-2.149108409881592, 14.246609687805176, "ding to environmental shocks or stress); and connectivity across a range of scales (i.e., between individuals within communities and from one community to another) (Andries, Folke, Walker, & Ostrom,\n 2013). \nIn complex systems theory, the relationshi"] [-2.2204430103302, 14.294584274291992, "lience outcomes. \nThey also engaged in dialogue about what policies can support resilience in a systems \nframework, and what policies historically served as impediments across systems to advancing resilience (e.g., residential segregation and related"] [-2.160250186920166, 14.26892375946045, "can be highly unpredictable (since relationships between parts of the system are not linear), an important first step is mapping out the key actors and intersection points that comprise the boundaries of a community and then beginning to identify the"] [-2.2390992641448975, 14.310321807861328, "d \nadministrative partnerships and return on investment for investing in partnership\u00a0activities.\nWith this model in mind, one framework to achieve resilience and well-being is \nthrough an \u201centerprise\u201d approach, which harnesses a full range of governm"] [-2.2201035022735596, 14.296441078186035, "though the nature of resilience \u2018interventions\u2019 (i.e., policies, \npractices, plans) may look different than traditional programs (e.g., cascading shifts in policy changes from state to local, organizational partnership development), some processes ma"] [-2.0670993328094482, 14.22178840637207, "improvement of essential community services such as education or health care (Committee on Increasing National Resilience to Hazards and Disasters & Committee on Science Engineering and Public Policy, 2012a). While federal policies that promote resil"] [-2.104095458984375, 14.260513305664062, "es should reflect the \u2018business case\u2019 for resilience and be useful to practitioners, \npolicymakers, and investors so that they are able to understand the risk and ROI in resilience An Agenda to Advance Integrative Resilience Research and Practice 28"] [-2.25195050239563, 14.315709114074707, "arrative insights and pertinent facts about changing patterns in the system and inform decisions about changes to system structure or coordination (Altintas et al., 2015). Alignment of data systems across organizations requires changes to governance "] [-2.2556207180023193, 14.319085121154785, "pronged approach to planning, design, and management of public spaces to promote health and \nwell-being by leveraging community assets and inspiration (McCann, 2002).5. WorkforceResilience Can \nBe Built by \nStrengthening \nCommunity \nLeadership, the B"] [-2.2267372608184814, 14.29331111907959, "nowing how to \u201cset the table.\u201d In other words, new leaders need to bring together diverse stakeholders in effective ways. Further, leaders and the broader workforce must know how to acknowledge the depth of some of the equity and cultural values that"] [-2.2463064193725586, 14.310983657836914, "nd methodology. In team science analysis, translational strategies that can help with progressing a field include developing integrative conceptualizations of team science processes and outcomes, exploring the impact of interpersonal processes and le"] [-2.258373260498047, 14.316354751586914, "behavioral sciences must have some understanding of how the built or physical environmental affects adaptive capacity. This focus does not negate the benefit of a new, transdisciplinary field of resilience that can stand alone, but does ensure that r"] [-2.2539546489715576, 14.314760208129883, "and difficulty in working at multiple ecological levels (e.g., federal/local) (Fawcett, Schultz, Watson-Thompson, Fox, &\n Bremby, 2010). \nThis analysis adapted the IO\nM \nframework for collaborative action to outline \nrecommendations for that field g"] [-2.286766529083252, 14.339971542358398, "ived in disaster response and recovery or have been effective at addressing compounding stress (Boin & Hart, 2003). The extent to whic\nh \nthis systems or multisectoral thinking can be operationalized will not only inform the earlier recommendation ab"] [-2.28350567817688, 14.346396446228027, " any remaining residents with unmet needs so that they can get assistance \nthrough Rebuild. One year after the disaster, Anytown hosts a community celebration of \ntheir resilience. The Anytown Assets festival becomes an annual tradition where residen"] [-2.1842050552368164, 14.271800994873047, "o a full assessment of acute and chronic or enduring stresses facing some populations and some communities. Equity was also noted as critical to understanding the functioning, outcomes, and returns to developing resilience-oriented systems. \nAs summa"] [-2.238576889038086, 14.304635047912598, "s frameworks\n for action. An Agenda to Advance Integrative Resilience Research and Practice 38 TABLE 2\nRecommendations to Advance the Field of Resilience by Theme\n THEME RECOMMENDATIONS\nStresses: \nResilience should \nbe applied across a wide \nvari"] [-2.277083158493042, 14.335389137268066, " given. The meeting sparked discussion, but by no means completed the analysis and dialogue. \nAs such, more work is needed to further unpack points of intersection where \nresilience-oriented leaders can synchronize and align efforts. Further, given t"] [-2.0755462646484375, 14.254396438598633, "Ecology and Society, 18(2), 8\u201318. \nAranda, K., & Hart, A. (2015). Resilient moves: Tinkering with practice theory to generate new ways of \nthinking about using resilience. Health:, 19(4), 355\u2013371. \nArmistead, C., Pettigrew, P., & Aves, S. (2007). Exp"] [-2.132298231124878, 14.260266304016113, "mmunity. American Journal of Community Psychology, 47(3\u20134), 217-235. doi:10.1007/\ns10464-010-9399-5\nBuizer, M., Arts, B., & Kok, K. (2011). Governance, scale and the environment: The importance of \nrecognizing knowledge claims in transdisciplinary ar"] [-1.9184376001358032, 14.224544525146484, "nd \nresilience as indirect measures of reliability in the framework of water distribution network design. Procedia Engineering, 70, 379\u2013388. \nCutter, S. L., Ahearn, J. A., Amadei, B., Crawford, P., Eide, E. A., Galloway, G. E., \u2026 Schoch-Spana, M. \n(2"] [-2.1067469120025635, 14.265653610229492, " E. T., McDonald-Madden, E. V. E., Puotinen, M. L., & Possingham, H. P. (2008). Should we \nprotect the strong or the weak? Risk, resilience, and the selection of marine protected areas. Conservation Biology, 22(6), 1619\u20131629. \nGlass, T. A., Goodman, "] [-2.116788864135742, 14.272017478942871, "s in Cognitive Sciences, 15(12), 576\u2013584. \nKarlin, S. (August 22, 2016). Louisiana residents without flood insurance face uncertainty. Retrieved \nfrom www.reuters.com/article/us-usa-weather-idUSKCN10W0UG\nKeeley, B. (2015). Income inequality: The gap "] [-2.238528251647949, 14.310490608215332, "tic load. Metabolism, 55, S20\u2013S23. \nMcEwen, B. S., & Tucker, P. (2011). Critical biological pathways for chronic psychosocial stress and \nresearch opportunities to advance the consideration of stress in chemical risk assessment. American Journal of P"] [-2.132169246673584, 14.267303466796875, "conomic Co-operation and Development. (2016). Measuring well-being and \nprogress: Well-being research. Retrieved from www.oecd.org/statistics/measuring-well-being-and-progress.htm\nOrtiz de Mandojana, N., & Bansal, P. (2015). The long term benefits of"] [-2.130213975906372, 14.271224021911621, ". \nSocial and Personality Psychology Compass, 5(9), 634\u2013652. \nSelye, H. (1936). A syndrome produced by diverse nocuous agents. Nature, 138(3476), 32. Sempier, T. T., Swann, D. L., Emmer, R., Sempier, S. H., & Schneider, M. (2010 [online]). Coastal \nc"] [-2.152711868286133, 14.271880149841309, "n and Youth Services Review, 33(9), 1742\u20131748. \nUnited Nations. (2016). Sustainable development goals. Retrieved from www.un.org/\nsustainabledevelopment/sustainable-development-goals/\nUnited Nations Office for Disaster Risk Reduction. (2005). Hyogo f"] [-2.200780153274536, 14.285744667053223, "n and families. \nIt teaches children and families to understand their emotional \nreactions, communicate more clearly, solve problems more \neffectively, and set and achieve their goals. With this training, children and families learn not just to meet "] [-2.206315517425537, 14.287281036376953, "son (e.g., the Chief \nResilience Officer) or entity (e.g., Office of Resilience) to braid \nefforts to build resilience capabilities in a cross-department or \nagency manner.\nConvening: The Annual Global Forum on Urban Resilience and \nAdaptation, hoste"] [-2.015359878540039, 14.252806663513184, "iciency\u2022 Programs to support \nneighbor-to-neighbor \nnetworks\n\u2022 Community block planningCitizen engagement: In New York City, the Department of \nEmer\ngency Management coordinates the NYC Citizen Corps, \nan\u00a0initiative that seeks to make communities saf"] [-2.2777652740478516, 14.345937728881836, "to offer both insurance and resilience benefits for disaster-prone cities. For \nexample, as part of Oxfam\u2019s R4 Rural Resilience Initiative, SwissRe \nis allowing farmers along the horn of Africa to pay for crop insurance using their own labor.An Agend"] [-2.249361753463745, 14.316776275634766, " Integrative Resilience Research and Practice 52 \u2022 Finding a powerful story and underscoring the urgency or need for joint action were \nsuggested as ways to address challenges related to competing priorities. In particular, \nattendees noted that dev"] [-2.2339298725128174, 14.30186939239502, "lience \nlanguage relevant to researchers, practitioners, and policymakers? \n \u00bbHow do we take groups that focus on climate and neighborhood vulnerability \nand combine them with organizations focused on adverse childhood experiences,\n \nwhich work mainl"] [-2.2467164993286133, 14.312112808227539, "ategies to inform this thinking from the inside out \n(e.g., starting at the grassroots level)?\n\u2022 How do we build will and demand among communities of all cultures to call for \nresources and norms that make them more resilient?\nTheme 4: Resilience can"] [-2.2449967861175537, 14.304776191711426, "re \ncomponents of effective resilience strategy29%\nCreate a unified picture Demonstrate individual, family, and community/\nsystems connections across the stress continuum29%\nLink with cultural norms Link with organizational and cultural norms and \nso"] [-2.217653512954712, 14.304336547851562, "r for the Study of Social Policy Amy Fine\nCenter for the Study of Social Policy Lisbeth Schorr\nChangeLab Solutions Marcie Ashe\nChangeLab Solutions Heather Wooten\nCity of Pittsburgh Grant Ervin\nColumbia University Jeff Schlegelmilch\nColumbia Universit"] [-2.2554335594177246, 14.31658935546875, "hoch-Spana\nUPMC Center for Health Security Tom Inglesby\nUPROSE Elizabeth Yeampierre\nU.S. Chamber of Commerce Foundation Gerald McSwiggan\nU.S. Department of Health and Human Services Natalie Grant\nU.S. Department of Homeland Security Jeffrey Stiefel\nW"] [-2.2562386989593506, 14.318262100219727, "resilience research or practice take into account the \ninterconnections between organizations, families, and individuals in your community? \n\u2022 T o what extent does your work on resilience rely on or leverage collaborations with \ncolleagues and organ"] [11.334856033325195, 17.71922492980957, "Access to Medical \nTreatment for Injured Workers in California\nYear 1 Annual Report\nAndrew W. Mulcahy, Madeline B. Doyle, Rosalie Malsberger, \nKandice A. KapinosJUSTICE, INFRASTRUCTURE, AND ENVIRONMENTLimited Print and Electronic Distribution Rights\n"] [11.3873929977417, 17.56698226928711, "ions. All its reports are subject to peer review and disseminated widely to policymakers, practitioners in law and business, other researchers, and the public. \nICJ is part of RAND Justice Policy within RAND Justice, Infrastructure , and Environment"] [10.346752166748047, 19.00436782836914, ".... 6\t\n3. Data and Methodology ............................................................................................................ 9\t\nOverview of Approach ..................................................................................."] [10.32878589630127, 18.97951889038086, "................................................................................ 46 \t\nDiscussion and Recommendations ..................................................................................................... 46 \t\n \n v Appendix A. Additi"] [10.302838325500488, 19.209501266479492, "....................... 23\t\nTable 5.1. Number of Observations for Timeliness of Care Analysis, by Injury Year and \nBody Part or Condition ...................................................................................................... 24\t\nTab"] [10.289737701416016, 19.22835922241211, " Timeliness to Care \u2014First Non -ED E&M Visit, by \nInjury Year and Body Part or Condition ............................................................................ 48\t\nTable A.2. Number of Observations for Timeliness to Care \u2014First E&M Visit with"] [10.360014915466309, 18.84568214416504, "etermination process ; and monitoring of medical provider networks (MPNs ). \nMany of these recent policy changes might have affected access to care for injured workers, \nincluding changes in the availability of appropriate providers and services ; t"] [10.367012023925781, 18.819189071655273, "hose populations. \nBecause access to health care is one of the key dimensions of health care quality, there has \nbeen significant interest in refining measurements to improve construct validity (Donabedian, 1966; Berenson, Pronovost, and Krumholz, "] [10.38839054107666, 18.88921356201172, "orting tool used by the DIR to collect comprehensive information from \nWC claims administrators about initial reports of injuries and all medical billing related to WC \ncare. \nIn examining trends over time, we aim to highlight potential access -to"] [10.312073707580566, 19.024093627929688, "ng WC patients . \nUtilization and Payments per Provider \nMeasures of the number of claims (i.e., injuries) per provider , the number of bill lines (i.e., \ndiscrete medical services) per provider , and payments per provider are important complemen"] [10.310626029968262, 19.122285842895508, " likely driven by changes in very large practices or health systems treating many injured workers. Changes in the m edian claims per provider were \nmuch lower for all three measures. For example, the median number of claims per provider was 2 in 20"] [10.290984153747559, 19.196592330932617, "crease in the median wait time between injury and any E&M \nvisit, from 2 days in 2010 to 3 days in 2014. \n\u2022 The pattern is similar between Northern and Southern California , but there were \ndifferences in timeliness of care between types of injury ."] [10.390138626098633, 18.94654655456543, "umber \nof claims, bill lines, and payments per TIN. Furthermore, we expect the number of TINs treating \ninjured workers to decrease over time because of consolidation in the broader health care system , \nrather t han because of decisions to stop trea"] [10.608154296875, 18.573040008544922, "nt of Industrial Relations, Division \nof Workers\u2019 Compensation, under contract number 41336064, for which Irina Nemirovsky and \nGenet Daba served as the project coordinators . This report was reviewed according to RAND\u2019s \nStandard for High- Quality R"] [10.420442581176758, 18.795486450195312, "h as the \navailability of appropriate practitioners and services and timeliness of care. For example, \npractitioners might have changed the way that they provide services to injured workers (or \nstarted or stopped seeing injured workers at all) as a"] [10.372675895690918, 18.867000579833984, "lthough we discuss potential explanations for the trends observed here, our analyses should be considered descriptive , as we are not conducting causal analysis. \nMedical bill and administrative data offer an important but limited window into access"] [10.372818946838379, 18.821868896484375, "lations, \nbecause patients with better access to care systems are more likely to receive comprehensive, \nhigher- quality care and are therefore more likely to experience better outcomes ( Kominski et al. , \n2006). \nThe term access, as it applies to "] [10.37630844116211, 18.827640533447266, "oxy measures \u2014such as utilization of services, specialist \nreferral patterns, provider type, care setting, purpose of encounter, and the frequency or continuity of care \u2014can be used to assess access to adequate or appropriate care. However, 5 focus"] [10.337263107299805, 18.999032974243164, "e access to medical treatment from 2011 to 2013. This more recent study found \nthat the number of injured workers who received medical services in the WC system decreased \n30 percent from 2007 to 2012, followed by a slight increase in 2013, and fou"] [10.278512954711914, 19.170345306396484, " \n5 A PCP is a provider whose billing specialty is multispecialty group practice, family medicine/general practice, \ninternal m edicine, occupational medicine, or chiropractor. 7 5. visit elsewhere. \nInjured workers flow from an ini"] [10.401922225952148, 18.97791290283203, "l injuries in WCIS for tha t calendar year, respectively . In the second approach \u2014the \ninjury- year approach \u2014we first identif ied all injuries in a calendar year and then analyzed WCIS \nbill line records with service dates within 12 months of the i"] [10.334392547607422, 19.040924072265625, "articipating providers as those who submitted \nWC medical bills to WCIS for that year and for whom we have a provider identification (TIN). \nTo examine the supply of appropriate providers, we analyzed trends in participating providers \nover time "] [10.417238235473633, 18.941333770751953, "r of injury. We primarily report means (or medians , when the distributions were skewed) . \nWe tested for significant differences in means over time and across i njury types using two-sided \nstatistical tests and a significance level of 0.01 , "] [10.3685941696167, 19.003421783447266, " WC \nsystem or to all of providers\u2019 care to injured workers. Finally, some WCIS records are not linked \nto a claim identifier (JCN) ; therefore, we cannot observe injury type and other fields from the \nadministrative data. F or these records and fo"] [10.309563636779785, 19.01038932800293, "pation, Utiliza tion, and Payments \nIn this chapter, we present trends in provider participation, utilization , and payments . All else \nequal, a greater number of providers treating injured workers likely represents better access to \ncare. Measures"] [10.257414817810059, 19.052637100219727, "(increased by 670). \n \n8 Some specialties \u2014such as family medicine/general practice \u2014might have been more likely to have fewer \npractitioners per billing entity or might have been more likely to consolidate over time compared with others. The"] [10.260787010192871, 19.062850952148438, "king \nBonferroni adjustments for multiple hypothes is testing, these means would not be considered \nstatistically significantly different at conventional levels .10 Only among occupational m edicine \nproviders did we find an increase in the number "] [10.258008003234863, 19.059131622314453, "cupational medicine physicians and therapists into occupational medicine because there were typically \nfewer than 200 therapists per year. We combined physical medicine and rehabilitation providers and physical \ntherapists into physical therapy bec"] [10.264378547668457, 19.06031608581543, ".18 1,075.61 965.53 82.46 \nOther surgery 104.11 99.70 87.66 101.57 114.12 10.01 \nPathology 979.97 535.91 437.81 443.77 114.55 \u2013865.42 \nPharmacy 650.97 710.87 981.53 558.83 797.78 146.81 \nPhysical t herapy 1,280.38 13,85.19 "] [10.270270347595215, 19.06360626220703, "vider , by Specialty and Year \nSpecialt y 2010 2011 2012 2013 2014 Change \n(2014 Minus 2010) \n$ % \nAcupuncture $7,735 $8,108 $8,331 $7,750 $8,382 $647 8% \nAnesthesiology $22,592* $23,418 $27,009 $29,450 $29,485 $6,893 31% \nBeh"] [10.306487083435059, 19.103437423706055, "tion drug utilization , is 4.32 , versus 6.97 \namong those who were using prescription drugs. Therefore , the average use of services among \ninjured workers actually getting care is much higher. However, an examination of changes in \nconditional mea"] [10.285022735595703, 19.181903839111328, " prosthetics/orthotics) (all p < 0.01 ). Some \nof these changes are consistent with higher payment rates implemented through the transition to \nRBRVS in 2014. Again, it is not clear from these analyses whether SB 863 provisions or other \nfactors are "] [10.292981147766113, 19.205936431884766, "s following the injury date. \nSample Sizes \nIn Table 5.1, we present sample sizes , using the broadest definition of first visit (e.g., in any \nsetting with any provider) , of the number of injured workers per year for each injury category. \nWe exa"] [10.300996780395508, 19.20079231262207, "able A.2 for sample sizes. \n* Statistically different from the 2014 median in the same injury (row) at p < 0.001. \n 26 Table 5.4. Days from Injury to First E&M Visit with a P CP, by Injury Year and Body Part or \nCondition \n \n2010 2011 2012 "] [10.279972076416016, 19.242870330810547, "was significantly greater than in the southern region ( p < 0.001) , and the wait time for out -of-\nstate receipt of care was significantly greater than care received in the state ( p < 0.001) ( see \nFigure 5.1 ). \nFigure 5.1. Median Days from Inju"] [10.29136848449707, 19.215272903442383, "7. Mean PCPs Seen in First 12 Months of Injury, by Injury Year and Body Part or Condition \n 2010 2011 2012 2013 2014 \nAll injuries 1.25* 1.25* 1.28* 1.24* 1.21 \nLow-back pain 1.32* 1.32* 1.35* 1.30* 1.28 \nShoulder injuries 1.34* 1.33* 1.36* "] [10.295849800109863, 19.200759887695312, "s in providers (see Chapter Three) . \nThere was variation across the site of injury, but the time trends were relatively similar across \nthe three different measures of first visit. Injured workers with low -back injuries were typically \nseen withi"] [10.283172607421875, 19.22589111328125, "and by the study conditions. In \nTable 6.1 , we present the distribution of injured workers in each pathway in each injury year, \nfrom 2010 to 2013. The shaded bars signify the relative percent age of workers within each year 10% 11% 11% 11%61%65% 6"] [10.270169258117676, 19.227046966552734, "010 2011 2012 2013 \n1\u20133 ED \u00e0 Admit 0 0 0 0 \n7\u20139 PCP E&M \u00e0 Specialist 11 12 12 13 \n10\u201312 PCP E&M \u00e0 Nonspecialist 4 5 5 5 \n15\u201317 Non-PCP E&M \u00e0 Specialist 7 8 8 9 \n18\u201320 Non-PCP E&M \u00e0 Nonspecialist 5 5 6 6 \n23 Other office/HOPD \u00e0 PCP 3 3 3 "] [10.242819786071777, 19.2667236328125, "o ha d the same path but start ed at \na specialist\u2019s or non- PCP\u2019s office (pathway 15). This suggests that , for injured workers who \nstarted in one of the two main entry points (physician or outpatient), there does not appear to be a \nsignificant d"] [10.270051002502441, 19.23421859741211, "80 \n22 Non-PCP None \n1.57 1.65 1.64 1.71 \n23 Other \noffice/HOPD PCP \n7.09 6.54 6.78 7.12 \n24 Other \noffice/HOPD Other service \n5.69 5.51 6.10 6.08 \n25 Other \noffice/HOPD None \n1.54 1.66 1.91 2.27 \n26 PT PCP \n12.11 12.81 14.09 14.52 "] [10.23221206665039, 19.22936248779297, ".08 72.31 \n3 ED Admit None 12.70 1.59 1.59 3.17 80.95 \n4 ED No admit PCP 20.20 7.66 5.13 2.91 64.10 \n5 ED No admit Other service 14.20 6.23 4.62 2.36 72.59 \n6 ED No admit None 10.01 3.18 1.65 2.09 83.06 \n7 PCP Specialist PCP 22.43 12.8"] [10.289379119873047, 19.230470657348633, "3% 2.14 0.88 19,257 12.36% \n13 PCP Unknown \n78% 41% 4.49 4.28 7,494 4.81% \n14 PCP None \n8% 27% 1.24 1.18 19,347 12.42% \n15 Non-PCP Specialist PCP 77% 42% 4.04 3.48 5,981 3.84% \n16 Non-PCP Specialist Other service 47% 50% 2.27 2."] [10.28159236907959, 19.218475341796875, "er year to almost 20 for \ninjured workers with at least three visits , depending on the pathway. \nWe also examined pathways by main type of injury. The most common pathway\u2014start ing \nwith an E&M visit with a PCP, followed by a specialist visit and"] [10.387972831726074, 18.96970558166504, "ishes between different groups of \npractitioners that separately bill for services. A TIN may represent a single practitioner (e.g., a solo physician \npractice) or many individual practitioners (e.g., a large physician practice or delivery system). I"] [10.288750648498535, 19.184814453125, " and any E&M visit , from 2 days in 2010 to 3 days in 2014. \nThe pattern is similar between Northern and Southern California , but there were differences \nin timeliness of care between types of injury. \nMonitoring Provider Churn \nInjured workers m"] [10.360209465026855, 18.968673706054688, "\u2014the TIN \u2014distinguishes between different groups of practitioners \nthat separately bill for se rvices. A TIN may represent a single practitioner (e.g., in the case of a \nsolo physician practice) or many individual practitioners (e.g., in the case of "] [10.32781982421875, 19.084461212158203, " to \nmonitor access in the C alifornia WC system over time , given the numerous recent and potential \nfuture changes in California and U.S. health care systems , such as health insurance coverage \nexpansions; changes to the Patient Protection and A"] [10.276569366455078, 19.231792449951172, "tions for Timeliness to Care \u2014First Non -ED E&M Visit, by Injury Year \nand Region \n \n2010 2011 2012 2013 2014 \nNorthern region 81,792 78,462 84,704 79,743 93,487 \nSouthern region 161,456 155,763 164,933 156,445 183,852 \nOut of state"] [10.240252494812012, 19.216285705566406, "n-PCP \nE&M \nOffice/HOPD Specialist None 2,198 2,072 2,027 2,545 \n18 Non-PCP \nE&M office/ \nHOPD Nonspecialist PCP \noffice/HOPD 1,303 1,387 1,437 1,646 \n19 Non-PCP \nE&M office/ \nHOPD Nonspecialist Other service 42 57 86 76 \n20 Non-PCP \n"] [10.558609962463379, 18.633731842041016, "2018: \nhttps://www.aamc.org/download/447152/data/californiaprofile.pdf \nBenjamin , D. J., J. O. Berger, M. Johannesson, B. A. Nosek, E. -J. Wagenmakers, R. Berk, K. A. \nBollen, B. Brembs, L. Brown, C. Camerer, et al. , \u201cRedefine Statistical Signif"] [10.53274917602539, 18.631671905517578, "are,\u201d The Milbank Memorial Fund \nQuarterly , Vol. 44, No. 3, 1966, pp. 166\u2013206. \nHaddad, S., and K. Mohindra, \u201cAccess, Opportunities and Communities: Ingredients for Health \nEquity in the South,\u201d paper presented at the Public Health and Internationa"] [11.082229614257812, 18.179981231689453, "my of Social Insurance, Workers\u2019 Compensation: Benefits, Coverage, and Costs , \nWashington, D.C., October 2017. As of August 17, 2018: \nhttps://www.nasi.org/sites/default/files/research/NASI_Workers%20Comp%20Report%202017_web.pdf \nPeters, D. H., A. "] [0.2051270306110382, 12.294739723205566, "Evaluation of the Jinan \nCity Water Ecological Development Implementation Plan and Recommendations for Improvement\nDavid G. Groves, Debra Knopman, James Syme, Nidhi Kalra, Zhimin Mao\nCORPORATIONLimited Print and Electronic Distribution Rights\nThis"] [-0.4241766631603241, 13.585132598876953, " development; infrastructure financing; energy policy; urban planning and the role of public\u2013private partnerships; transportation policy; climate response, mitigation, and adaptation; environmental sustainability; and water resource management and co"] [0.1912376433610916, 12.290936470031738, "trics ............................................................................................ 13\nUncertainties ..................................................................................................... 14\nManagement Options and Stra"] [0.1647782027721405, 12.249724388122559, "rojections .................................... 67\nUnmet Demand Under a Wide Range of Futures .......................................................... 67\nSummary of Findings ........................................................................."] [0.19549812376499176, 12.280244827270508, "Plan ........................................................................ 123\nC. Adjustment of Demand Projections ................................................................. 125\nD. Regression Models Used in Climate Projections .........."] [0.21838228404521942, 12.277774810791016, "............. 28\n 3.4. Grou\nndwater Flows Used to Guide Model Calibration ...................................... 31\n 3.5. Grou\nndwater Storage in the Calibration Process .............................................. 32\n 3.6. Comp\narison of Observe"] [0.18755729496479034, 12.242148399353027, "..................................................... 56\n 5.11\n. Sour\nces of Supply for Zhangqiu Agricultural Demand Node for Historical Climate \nProjection .......................................................................................... 5"] [0.21035200357437134, 12.253839492797852, "ter Assumptions ....................................................................... 72\n 6.8. Unme\nt Agricultural Demand by Demand Projection Across Climates (left) and \nSummary of Unmet Demand from 2031 to 2050 (right) ........................"] [0.23202815651893616, 12.358532905578613, " (in years) Predicted by IPCC SREX Report ....................... 99\n 8.9. Rive\nr Stage Predicted for Various 24-Precipitation Return Periods ....................... 100\n A.1. Proj\nections of Agricultural Demand Provided by Jinan Water Resources Bu"] [0.2604525089263916, 12.361871719360352, "ime Series of Precipitation and Stage Data ........................................ 95\n 8.2. 24-H\nour Precipitation Return Period, Intensity, and Predicted River Stage .............. 98\n 8.3. Futu\nre 24-Hour Precipitation Return Period, Intensity, "] [0.15699145197868347, 12.309430122375488, "r in this kind of thinking. This has served the region well, but as the city\u2019s water needs approach\u2014and in some cases exceed\u2014the available supplies, large uncertainties about future conditions become increasingly important. Specifically, the possibil"] [-0.37368935346603394, 12.725951194763184, "confidence in results based on a limited number of scenarios, manage surprise, and use quantitative analysis in situations when key data are missing or imprecise.\nRAND\u2019s technical road map therefore includes the following elements:\n\u2022\n Intr\noduce RDM "] [-0.3272401988506317, 12.575642585754395, "ple helps to explain the difference between RDM and more-traditional engi -\nneering analysis. Suppose a new reservoir is to be built to increase storage in the Jinan system. How large should the reservoir be, how should it be operated, and what is th"] [-0.18567578494548798, 12.46469783782959, " to increase in the future. \nIn contrast, the green line shows the performance of the system with a reservoir with the \nsame capacity as before but, in this case, additional investments in interconnections or changes in operations throughout the syst"] [0.1886047124862671, 12.325933456420898, "esentation of the full span of precipitation and temperature effects generated from the climate models. Over the period from 2000 to 2050, changes in precipita -\ntion are estimated to range from \u2013100 millimeters (mm) to almost 300 mm annually; change"] [0.21011093258857727, 12.253609657287598, "n\nStrategy Name Description\n1 Current Projects Current state of Jinan system\n2 Completion of IP Includes Current Projects and completion of IP projects\n3 IP and Increased Water Reuse \n(IPR)In addition to IP, includes increase of reuse rates in distri"] [0.18723805248737335, 12.283758163452148, "sidential and industrial sectors) or climate effects on demand (agricultural sector) by 2035. For each sector, efficiency standards were evaluated at a 100-per -\ncent implementation level (full implementation) and a 50-percent implementation level. F"] [0.1968812346458435, 12.281317710876465, " strategies across a wide range of possible future climate and demand projections that could reduce future vulnerabilities. Our focus was on longer-term trends, spanning the period between the present and 2050, and the implications of these trends fo"] [0.20984847843647003, 12.252090454101562, "tions and assumptions of a continuation of current infrastructure and management. Note that demand and supply prefer -\nences were set within the Jinan WEAP model following multiple discussions with the JWRB technical team. Demand priorities have the "] [0.19897951185703278, 12.24341869354248, "ulnerable if average unmet residential demand from \nFigure\u00a0S.5\nSummary of Unmet Residential Demand and Vulnerability Across All Futures and Groundwater Assumptions\nCurrent 50% Current 50% Current 50%Low Demand High Demand Medium DemandYellow River\nAl"] [0.17558060586452484, 12.25190258026123, "sensitive to the climate projections when the initial storage is assumed to be very large. In effect, the groundwater basins absorb most of the climate sensitivity, a reason why we do see climate effects (in the form of unmet demand) in the residenti"] [0.18551626801490784, 12.238624572753906, " residential unmet demand for the same strategies as in \nFigure\u00a0S.6 across all futures. Each symbol represents a particular combination of climate pro -\njection, demand projection, Yellow River allotment, and groundwater storage. Many symbols fall on"] [0.22512532770633698, 12.258831977844238, "in data collection will have a beneficial effect on analysis and the integ -\nrity of the Jinan WEAP model. As JWRB further refines the data behind the demand and supply nodes and other model components, results could shift. \nAt the same time, the Jin"] [0.21190598607063293, 12.278554916381836, "tion of IP\nIPR\nIPR + WQIPR + SAGMIPR + WQ + SAGM\nIPR + Residential Efficiency\nIPR + Residential Efficiency + SAGMIPR + Res/Ind Efficiency\nIPR + EffAll\nIPR + EffAll + SAGM\nIPR + EffAll + WQIPR + EffAll + WQ + SAGM\nIPR + 50Eff\nIPR + 50Eff + WQIPR + 50E"] [0.1997697800397873, 12.261125564575195, "processes.\nHow Will Future Demand and Climate Conditions Challenge Jinan\u2019s System? \nWhen uncertainties are considered about future climate conditions, demand, future Yellow River allocations, and initial storage levels in groundwater basins, model re"] [0.20036455988883972, 12.262106895446777, "e outcomes if conditions in \nthe future were to take a different course then the one on which project designs were based.\nHow Will JWRB\u2019s Implementation Plan Address Future Climate and Other Uncertainties? \nAt the present time and for the next severa"] [0.21274636685848236, 12.26259994506836, "et demand almost entirely. Vulnerabilities to the industrial sector can be completely eliminated if all efficiency improvements are implemented, water reuse is implemented, and the WQ strategy for the Xiaoqing River is available as a backstop. \n\u2022\n Th"] [0.1857851892709732, 12.371508598327637, "y uncertainties that drive the analysis. Having the appro -\npriate modeling tools for the decision at hand is essential.\n\u2022 RDM pr\novides a structured approach to analysis of future conditions and strategies for \nreducing future vulnerabilities and sh"] [0.20282624661922455, 12.285887718200684, "\n(\u59dc\u7231\u534e\uff0c \u6d4e\u5357\u5e02\u6c34\u5229\u5c40\u79d1\u6280\u529e\u516c\u5ba4\uff0c \u4e3b\u4efb ), who led the JWRB technical team supporting \nthe project. Other team members included:\n\u2022 Zhan\ng Baoxiang, professor of the Shandong Water Resources Research Institute \n(\u5f20\u4fdd\u7965\uff0c \u5c71\u4e1c\u7701\u6c34\u5229\u79d1\u5b66\u7814\u7a76\u9662\uff0c \u7814\u7a76\u5458\uff0c \u6559\u6388 )\n\u2022 Mao Qia\no, vice director o"] [0.18046028912067413, 12.32949161529541, "lly, we would not have been able to conduct this project without the wisdom and \nguidance of Mu Dan Ping, RAND\u2019s business adviser for our work in China.xxxvAbbreviations\n50Eff 50-Percent Efficiency\nCCAFS Climate Change, Agriculture, and Food Security"] [0.22113026678562164, 12.265941619873047, "ter quality, improving aquatic ecosystem health, reducing damage from flooding, and increasing water use efficiency. As of this writing, most of the construction under the Pilot Scheme has been completed. Understanding how Jinan\u2019s complex hydrologic "] [0.22958330810070038, 12.258745193481445, "fined subsurface chambers, eventually discharging to the surface in a system of 733 natural springs (Kang, Jin, and Qin, 2011; Zhao, 2015; Wu, Xing, and Zhou, 2009).\nRecharge occurs primarily in the southern mountains and is largely attributed to dir"] [0.21211351454257965, 12.271421432495117, "d water system and continuous flow of spring waters.\n\u2022 Devel\nop healthy and aesthetically appealing water ecology and environmental systems.\n\u2022 Achi\neve high water quality, maintain ecological flow of rivers, and a \u201cbeautiful scenic \nview.\u201d\n\u2022 Devel\nop"] [0.21700100600719452, 12.25953197479248, "ential demand is unacceptable. \nGroundwater is the preferred source of water for residential use. Hence, continuous discharge of water from the city\u2019s springs is one of the more visible signs of success in maintaining a sustainable yield of groundwat"] [0.20481793582439423, 12.28463363647461, " critical to ensuring that Jinan\u2019s water management goals are achieved.\nTo focus our analysis, RAND sought guidance from JWRB\u2019s experts and refined the ini -\ntial set of research questions during a November\u00a02015 workshop in Jinan and follow-up discus"] [0.062496647238731384, 12.34986686706543, " with historical and current data \n\u007f Develop future projections of factors driving change \n\u007f Calibrate model \n\u007f Evaluate current system for different baseline futures \n\u007f Evaluate system with additional Implementation Plan projects \n\u007f Consider flood i"] [-0.3230934739112854, 12.6530179977417, "cientifically sound approach to analysis that is particularly \nwell-suited for considering long-term challenges to the performance of a regional water manage-ment system with large uncertainties about future climate changes, changes in demand across "] [-0.3378573954105377, 12.69173812866211, "B to apply these methods in future work.\nWith respect to capacity building, RAND built and ran a simulation model, then trans -\nferred it to JWRB for future use, built and demonstrated use of a decision support tool and then transferred it to JWRB fo"] [-0.3174886107444763, 12.546459197998047, " and oper -\national strategies, simulate operations, and determine the extent to which shortages would be reduced under the different potential sizes and strategies. Finally, decision makers would choose a design storage capacity that does best under"] [-0.3123874366283417, 12.532584190368652, "enario and limited \nstrategies were considered In RDM analysis,\nthis option would\nbe more desirable Current system con/f_iguration \nAddition of reservoir with X capacityAddition of reservoir with X capacity + other changes in system 12 Evaluation "] [0.20216721296310425, 12.262206077575684, "e the term strategy to refer to potential future projects, policies, or combi -\nnations of projects and policies that could affect water management in the Jinan system.\nPerformance Metrics\nTable\u00a02.2 lists the key performance metrics that RAND identi"] [0.21819521486759186, 12.307907104492188, " would have liked to analyze Jinan\u2019s vulnerability to flooding under a wide range of \nclimate scenarios (as represented by differences between precipitation and temperature histori -\ncal averages generated by global climate models). However, we were "] [0.21700017154216766, 12.278186798095703, "dard Data displayed for 2013 to 2015 \nin Chapter Three\nReduce flood damage Change in recurrence intervals of extreme flood eventsDescription of method in Chapter EightApproach to Analysis and Visualization of Long-Term Performance 15\ncultural\u2014are"] [0.22819030284881592, 12.278275489807129, "ls\n\u2022 incr\neased supply by drawing from the Xiaoqing River if water quality standards are met.16 Evaluation of the Jinan City Water Ecological Development Implementation Plan\nRelationships\nThe focus of this study was the development of a WEAP model"] [0.17933742702007294, 12.330111503601074, "t and for more-detailed exploration of the results. The use of a Planning Tool is part of RAND\u2019s approach of using analysis to support deliberation over choices, as recommended by the National Research Council (2009), and used to support high profile"] [0.19631651043891907, 12.284594535827637, "via the tabs at the top of the screen or via a dropdown menu in the upper left.\nFigure\u00a02.6\nScreenshot of the Jinan Water Resources Bureau Planning Tool\nRAND RR1682-2.6\nFigure\u00a02.5Planning Tool and Approach to Deliberation over Trade-Offs\nRAND RR1682-2"] [0.21835701167583466, 12.269904136657715, " estimates demands and supplies over time on a monthly basis using historical data derived from reference documents provided to the study team by the JWRB (see Appendix A) and mathematical relationships described in this chap -\nter and Appendixes C a"] [0.24000297486782074, 12.252593994140625, "r 698.73\nShanghe Shanghe County Groundwater and the Tuhai River 758.47\nLicheng Licheng District Yellow River, Xiaoqing River, and Jinxiuchuan, Wohushan, and Langmaoshan reservoirs281.00\nChangqing Changqing District Groundwater and the Yellow River 22"] [0.21802011132240295, 12.266027450561523, "ion 2004\u20132014 Significant source of surface water for Jinan Urban Center\nNandasha 1 Luzhuang Drainage \nStation2011\u20132014 Significant source of groundwater recharge and seasonal flow into the Yellow River\nXinghua 1 Xinglin inflow 1972\u20132014 Significant "] [0.23777291178703308, 12.249455451965332, "ussions with JWRB, this supply was included in the model as an annual allocation of 100\u00a0million cubic meters (MCM) per year, with 83\u00a0MCM per year for Jinan Urban Center and 17\u00a0MCM per year for Zhangqiu. An expected, doubling of this allocation to 200"] [0.22617872059345245, 12.261861801147461, "ential demands\nJiangshuiquan 1,050,000 191.80 Near \ncompletionXinglong \nReservoirQuanfu River, Longquan Reservoir\nJinxiuchuan 35,920,000 251.00 Complete Yufu River Jinan and Licheng residential demand, Xinglong Reservoir\nLangmaoshan 10,940,000 187.00"] [0.23612724244594574, 12.27475643157959, "n Reservoir \n4 Spring discharge at these nodes were calibrated assuming cyclical flow under cycled Historical Climate conditions with \nno trends in increasing discharge. Calibration of these springs is discussed later in this chapter. Table\u00a03.6\nPrim"] [0.21105168759822845, 12.283665657043457, "riables in the Jinan WEAP model to be consistent with the climate projec -\ntions (see Chapter Six). Thus, the multivariate regression models translate climate change into changes in supply availability. A detailed explanation of the development of th"] [0.21449247002601624, 12.266475677490234, "hat the water quality of Xiaoqing River (fourth through seventh row in Figure\u00a03.3) failed to meet water quality standards in virtually all months from 2013 to 2015 for all sampling loca -\ntions, rendering the River an unusable supply. If the Xiaoqing"] [0.2137422412633896, 12.279010772705078, " to have validity, historical data used throughout the model need to have the same record lengths; otherwise, the WEAP calculations that match supply to demand in each month and year would not be using internally consistent data.\n5 For \nthe Jinan WEA"] [0.1884002387523651, 12.301912307739258, "e estimated certain quantities required in the model based on observa -\ntional records, consumption statistics, and simulated reservoir operations in an effort to best reflect observed supply delivery records. For example, we applied this approach to"] [0.23371554911136627, 12.261502265930176, "Water in this catchment, which lies directly below part of Changqing, continues across the Mashan fault\u2014which is a low permeability fault close to the Yellow River\u2014to arrive in the Jinan Spring Water Catch -\nment. The Jinan Spring Water Catchment inc"] [0.24349437654018402, 12.267876625061035, "d for which we lacked historical data. For the period in which observational discharge records are available, Figure\u00a03.6 shows that simulated aggre-gate discharge is similar in amplitude and phase to observed discharge. Additionally, outside of the p"] [0.2213612049818039, 12.258045196533203, " Bai Springs.\nDistrict-Level Splits in Supply Between Surface and Groundwater\nEnsuring that quantities of surface and groundwater deliveries by district were representative of observed quantities was an important element of the calibration process fo"] [0.2240627408027649, 12.267660140991211, "20 2010 2050\nYearBai Springs Baimai Springs Baotu SpringsDevelopment and Calibration of the Jinan WEAP Model 35\nFigure\u00a03.9\nCalibration for Jinxiuchuan Reservoir Operations\nRAND RR1682-3.90.4\n0.30.20.1\n0Storage volume, 108 m3\n2014 2012 2010 2016\nYe"] [0.22106046974658966, 12.27100944519043, " and 2030. Since these projections implicitly included historically observed years, they were adjusted to match the most recently available observed data year, which was 2014. To perform the adjustment, we first estimated the projected demand for the"] [0.2271513193845749, 12.252567291259766, "elivered) as Population Scenario 2, we did not include it in subsequent analysis described in later chapters.\nInstead, we developed population scenarios using population data from the United \nNations Department of Economic and Social Affairs (UNESA, "] [0.23004184663295746, 12.24544906616211, "lic supply water use rates of 75 gallons (283.9\u00a0liters) per person per day.\n1 Note that the projection is driven primarily by water use rates rising to \nparity with New York City, not due to an assumption of population growth. Note, however that even"] [0.21045354008674622, 12.28325366973877, "wth rate of 7\u00a0percent from 2015 to 2020 and 5\u00a0percent from 2020 to 2030. These growth rates were used to estimate demand through 2020. However, to eliminate extreme growth from industrial value projections going forward, projections after 2020 were r"] [0.22689072787761688, 12.267130851745605, "fective irrigation area in 10,000 monetary units, Qg is the water demand (m3 per monetary unit), and \u03b3 is the irriga -\ntion water usage ratio. A description of estimates of change in agricultural demand under different climate projections is \nprovide"] [0.21247252821922302, 12.273735046386719, ", and residential demand projections used to develop these three projections are shown in Table\u00a04.4.\nClimate Projections\nThis study uses a range of estimates of future climate based on simulations from a set of global \nclimate models (GCMs) developed"] [0.22096659243106842, 12.370384216308594, " 2 6\nHigh 5 1 244 Evaluation of the Jinan City Water Ecological Development Implementation Plan\n\u2022 RCP\u00a08.5: It is characterized by increasing greenhouse gas emissions over time repre-\nsentative for scenarios in the literature leading to high greenh"] [0.23434779047966003, 12.330641746520996, "ent the effects of climatic variation on water supply in the Jinan WEAP model, we estimated relationships between historical precipitation, temperature, and inflows. Using regression analysis, we estimated relationships between climatic variables and"] [0.17974835634231567, 12.396455764770508, "\nRCP 8.5\n1 \n0 2 3 4 \n\u2013100 \u201350 0 50 100 150 200 250\nChange in annual precipitation (mm)Change in average annual temperature\n(degrees Celsius)Climate scenarios: change from 2000 to 205046 Evaluation of the Jinan City Water Ecological Development Imp"] [0.09258180111646652, 12.34095287322998, "tal, we thus developed 324 futures, which we then used to evaluate 16 diff erent man-\nagement strategies, including the system as currently confi gured. To facilitate the evaluation of the WEAP model almost 5,000 times, we distributed the runs over"] [0.20196089148521423, 12.248366355895996, "ectors more than offset these declines.\nUnder the High Demand projection, steep total increases in demand are seen from 2015 \nto 2030. The increases then lessen through 2050 (Figure\u00a05.3). In this projection, total demand exceeds 2,800\u00a0MCM by 2050. Ta"] [0.22569917142391205, 12.259943962097168, "n and a range between no change and 30\u00a0percent lower than Current Demand for the Low Demand projection.\nSources of Supply at Selected Demand Nodes\nThe WEAP model simulates how demand at each node is met by supply over time. To briefly \nsummarize how "] [0.22258950769901276, 12.244001388549805, "ir. In 2030, additional supply is available from the Yuqing WTP, which increases because of greater available alloca-tion from the South-North Yangtze River Transfer. Th e declining supply of industrial water, particularly in the High Demand project"] [0.20053589344024658, 12.243003845214844, "020 2030 2040 2050Low Demand High DemandSources\nJiyang Groundwater\nSouth-North TransferTuhaiYellow River\nFigure\u00a05.11\nSources of Supply for Zhangqiu Agricultural Demand Node for Historical Climate Projection\nRAND RR1682-5.110 100 200 300 400 Supply (m"] [0.11048617213964462, 12.21999740600586, "Agricultural Sector\nUnder the Historical Climate projection, there is a small amount of projected unmet demand \nin the agricultural sector for all three demand projections beginning in 2024 (Figure\u00a05.16). The pattern of unmet demand mirrors the histo"] [0.20940394699573517, 12.236710548400879, "f months in which flow is below \nthe threshold of 4.35\u00a0MCM per month. The figure shows that there is an immediate divergence \nin results among the three future demand projections and the Current Demand projections, with the future demand projections "] [0.21894708275794983, 12.227067947387695, " time under the assumption \nof Large Initial Groundwater Storage for the three future demand scenarios and Current Demand. Under the Current Demand projection, groundwater is in steady state and only devi -\nates small amounts each year until 2030, wh"] [0.21331988275051117, 12.231837272644043, " GW Storage: Groundwater storage change \n(billion m3)\n\u20135\u20134\u20133\u20132\u201310\n\u2013400\u2013300\u2013200\u20131000100200Demand \nprojection\nCurrent\nLowMediumHigh64 Evaluation of the Jinan City Water Ecological Development Implementation Plan\ning unlimited groundwater. However, a"] [0.2044544368982315, 12.233830451965332, "Initial Groundwater Storage and Low Initial Groundwater Storage\nRAND RR1682-5.21Year2010 2020 2030 2040 2050 2015 2025 2035 2045Low Initial GW Storage: Groundwater storage change \n(million m3)Large Initial GW Storage: Groundwater storage change \n(mil"] [0.19744138419628143, 12.231575012207031, " provides insight into the ability of Jinan\u2019s current water management infrastructure to meet potential future demands under a changing climate. We also defined those futures in which performance would not be acceptable with respect to key metrics, s"] [0.1775878667831421, 12.225502967834473, "demands increase more than the Medium Demand projection.\nFigure\u00a06.2 again shows unmet residential demand for all three demand projections across \nclimates for the Full Yellow River Allocation from 2015 to 2050, with the average unmet demand for the 2"] [0.15874922275543213, 12.253739356994629, "l Development Implementation Plan\nWe now classify outcomes based on unmet demand. For purposes of example, we define \nfutures to be vulnerable if average unmet residential demand from 2031 to 2050 is higher than \n5\u00a0percent of demand. 1 Any other thre"] [0.20021463930606842, 12.235321044921875, " 2045 2050 2031\u20132050Demand \nprojection\nLow\nMediumHigh\nNOTE: X symbols indicate results for the historical climate projection and the /f_illed circles indicate results for the \nclimate change projections.\nRAND RR1682-6.5\nFigure\u00a06.6\nAverage Unmet Indus"] [0.14363521337509155, 12.266650199890137, "ocation: Average annual unmet demand (2031\u20132050)\n (million m3)\n0100200300400\nNOTE: The red X symbols indicate futures in which the system is vulnerable and the /f_illed green circles indicate \nfutures in which the system is not vulnerable, depending "] [0.19311784207820892, 12.23943042755127, "undwater Storage\nCurrent 50% Current 50% Current 50%Low Demand High Demand Medium DemandYellow River\nAllocation:\n0100200300\nDistrict\nChangqing\nJinan Urban Center\nJiyangLicheng\nPingyinShanghe\nZhangqiuLow Initial GW Storage: Groundwater\nstorage change "] [0.20504967868328094, 12.23554515838623, "ections 77\nFor the predominantly urban basins in Figure\u00a06.12, the range of climate projections has \na significant effect on the ending groundwater level. The 2050 change in groundwater stor -\nage, for example, ranges from \u20131.4\u00a0billion to 0.3\u00a0billi"] [0.2061055302619934, 12.25676155090332, "seen in all demand and Yellow River allotment futures except the Low Demand, Full Yellow River Allocation futures. The climate effect is very strong as well, with no shortages in the wettest climate but significant shortages in drier climates (see Fi"] [0.2296849936246872, 12.26128101348877, "included in the IP and discussion with JWRB, two projects were identified as having the greatest potential effect on the system: a pipeline connecting the Duzhang Reservoir to the Langmaoshan Reservoir, 80 Evaluation of the Jinan City Water Ecolog"] [0.20059877634048462, 12.246566772460938, "er Management (SAGM) policy represents an aggressive response to declining spring levels at the four largest springs in central Jinan: Baotu (Baotu Quan), Black Tiger (Heihuquan), Pearl (Zhenzhuquan), and Five Dragon (Wulongquan). The decision rule c"] [0.1934524029493332, 12.260845184326172, " (residential and industrial sectors) or climate effects on demand (agricultural sector) by 2035. For each sector, efficiency standards were evaluated at a 100-percent implementation level (full implementation) and a 50-percent implementation level. "] [0.21097886562347412, 12.237184524536133, "of IP projects\n3 IPR In addition to IP, includes increase of reuse rates in districts with \nWTPs specified to 40\u00a0percent of total district WTP capacity by 2020 and 60\u00a0percent of total district WTP capacity by 2030\n4 IPR + SAGM In addition to IPR, inc"] [0.17143087089061737, 12.210338592529297, "e effective in reducing unmet demand across all climates and allocations of the Yellow River. In some future scenarios that include the wastewater reuse strategy, residential reuse rates (as a\u00a0percentage of total residential demand) actually decline."] [0.16065657138824463, 12.236202239990234, "s unmet demand by about 75\u00a0percent in the High Demand projection. \nAs with Figure\u00a0 7.2, Figure\u00a0 7.4 summarizes unmet demand in the industrial sector \nfor select strategies across all futures. Th e red symbols are those results that exceed the 30-per"] [0.1703966110944748, 12.233226776123047, "t Strategies for Historical Climate\nRAND RR1682-7.50 15 \n10 \n5 20 25 30 Unmet demand (million m3)\nYear Year2010 2020 2030 2040 2050 2010 2020 2030 2040 2050Medium Demand High Demand\nStrategy\nIPR + EffAll\nIPR + 50Eff + WQIPR\nCompletion of IPIPR + 50Ef"] [0.17393572628498077, 12.247559547424316, "ntation Plan\nHigh Demand projection as well. The strategies with only half of the efficiency improvements \n(for example, IPR + 50Eff) have a positive but smaller effect on groundwater levels over time (not shown). Groundwater levels are stabilized un"] [0.21061718463897705, 12.26672077178955, "%0%0%19%0%19%100%100%\n0%0%0%0%0%0%0%0%0%0%0%0%0%0%52%74%\n0%0%100%0%0%0%0%0%0%0%0%100%0%100%100%100%\n0%0%0%0%0%0%0%0%0%0%0%100%0%100%100%100%\n0%0%100%0%0%0%0%0%30%22%100%100%100%100%100%100%\n0%0%0%0%0%0%0%0%0%0%0%100%0%100%100%100%\n0%0%0%0%0%\n0%0%0%0%"] [0.19842183589935303, 12.253304481506348, "re for the residential sector except under High Demand or \nLow Initial Groundwater Storage conditions. In these cases, the strategies that include reuse and also the residential efficiency strategy reduce vulnerabilities significantly. Improving indu"] [0.24234655499458313, 12.390091896057129, "te change include ground saturation, vegetation and ground cover, upstream water withdrawals and diversions, and evaporation rates. In addition, future flooding will be shaped by other factors besides climate change, such as changes in popula -\ntion "] [0.3958870470523834, 12.681947708129883, "nt (whether it is a flood, a rainstorm, or an earthquake) is an estimate of the likelihood of the event. A flood with a 50-year return period is one that has a 2-percent chance of occurring each year. We will use a 50-year river stage as a benchmark,"] [0.38660162687301636, 12.626728057861328, " statistical model, s=f(p) , that can be used to predict river stage s in meters \ngiven a particular precipitation intensity p , where intensity is defined as the amount of precipi -\ntation that falls in a given time period (in this case, 24 hours). "] [0.41009414196014404, 12.695028305053711, "and stage:\n si=\u20133.6 x 10\u20135pi2+ 0.023 pi+ 23.3. Eq. 8.1\nThis \nprecipitation-stage model predicts, for example, that a precipitation of 230 mm \nwould lead to a 1-in-50-year water level of 26.7m. The model\u2019s R-squared value is 0.43 and its P-value is "] [0.39509883522987366, 12.676009178161621, "ating river stage return periods, but we use the annual maximum 24-hour precipitation data shown in Figure\u00a08.5. Here, the lognormal model provides the best fit to the data.\n5\nFigure\u00a08.6 shows the intensity of 24-hour precipitation return periods from"] [0.38260677456855774, 12.650708198547363, "ion.\n7 Th e future return periods for the 1-in-20- \nyear, 24-hour precipitation event in the East Asia region is shown on the left panel of Figure\u00a08.8. Each box plot summarizes the return periods predicted by 14 global climate models, in two diff e"] [0.2460869699716568, 12.372313499450684, "rs)\n2046\u20132065\nYears2081\u20132100Scenarios\nB1\nA1BA2\nFull model rangeCentral 50%\nintermodel range\nMedian\nB1 A1B A2\nMaximum Return Period 17 17 15\nMean Return Period 11 9 9\nMinimum Return Period 8 6 8\nRAND RR1682-8.8100 Evaluation of the Jinan City Wate"] [0.21339993178844452, 12.278663635253906, "ssible future conditions. Finally, we set out to demonstrate the value to JWRB of the Jinan WEAP model as a management and decision support tool and train JWRB\u2019s technical staff on the refinement and use of the model for future work. In this chapter,"] [0.20386776328086853, 12.257762908935547, "imulation model of the Jinan water system is only an approximation of the real physical system. The degree to which the model is a \u201cgood\u201d representation of reality depends on the quality and quantity of data available to calibrate it, and an understa"] [0.2088078111410141, 12.255358695983887, "s but very significant shortages in drier climates.\n\u2022\n Jina\nn\u2019s springs are vulnerable across all futures. In wet climates, low spring flows each year \noccur for around three months on average; in dry climates, low flows appear about eight months eac"] [0.19778241217136383, 12.261171340942383, "sectors and active management of groundwater withdrawals. Efficiency mea -\nsures will counterbalance increases in population and industrial activities. Strategies to increase water reuse and improve the water quality in the Xiaoqing River could help "] [0.2224319577217102, 12.275012016296387, "t stream flow data at the same location. This would enable the estima -\ntion of pollutant loadings to the system that then could serve as a measure of effectiveness of water pollution control strategies implemented in the future.\nModels\n\u2022 The Jinan W"] [0.19252459704875946, 12.302437782287598, "ta-gathering process, RAND created a master data inventory table to track the availability of data relative to various components of the Jinan WEAP model. This spreadsheet has been shared with JWRB, and JWRB has contributed directly to the spreadshee"] [0.28794339299201965, 12.212024688720703, "physical infrastructure used to store \nand distribute water across the model area\n5. obser\nvational data related to management of water releases from reservoirs, treatment \nplants, and other water-related infrastructure.\nTo assess the potential outco"] [0.2399061918258667, 12.259727478027344, ". The PCA, which RAND digitized, provide numerous tables and historical data that are directly applicable to the WEAP model. Additionally, Zhao (2015) provides tables and other data along with high-level information on Jinan\u2019s groundwater hydrology t"] [0.24418190121650696, 12.250244140625, " Jina\nn river flood prevention monitoring station information\n7. a summ\nary description of the Xiaoqing River after the 2006 treatment project.\nWater Demand \nWe obtained detailed data for historical water demand sectors for various geographical regi"] [0.22896285355091095, 12.253495216369629, " in the PCA (Jinan Water Resources Bureau, 2009\u20132014). Information regarding the volume and propor -\ntion of these demands that are met through groundwater withdrawals is also available in these appendix tables. \nSome historical data for correlates o"] [0.24616149067878723, 12.253532409667969, "mand] & 11 [Consumption]), Monthly\u00a0 \u2014\nJiyang 2008\u20132013 PCA \n(Tables 10 [Demand] & 11 [Consumption]), Monthly; 2011\u20132014 Jiyang Township Water Resources Communiqu\u00e9\u00a0 JWRB projections included in the third tranche\nShanghe 2008\u20132013 PCA (Tables 10 [D"] [0.24409794807434082, 12.263553619384766, "/\nPressure Head Requirements \u00a0NotesProjected Growth or Change in\nDemand Correlates or Usage\nSprings/Spring Zones1998\u20132004: Jinan Spring Water Geography, Annual; Additional journal articlesSome spring flow and level data received in third data tranche"] [0.250545859336853, 12.251503944396973, ", Hui, Linshang, Luo, Jinshui, Nandasha, Qiji, Sha, Shangdong, Shangzhong, Tuhai, Tuma, \nXiaoqing, Yudai, and Yufu rivers are contained in this file. All stations include an inflow and outflow district to aid in their placement in the schematic. The"] [0.2587375044822693, 12.244466781616211, "chuan inflowMonthly total discharge 2011\u20132014\nXiujiang 3 Beifeng, Dazhan and Duozhuang inflowAnnual mean flow, monthly and annual reservoir inflow 1977\u20132014 \n(total coverage)\nHui 2 Chentun, Zhanxiaozhuang Monthly total discharge 2011\u20132014\nAnluan 1 "] [0.2573432922363281, 12.248658180236816, "16, for Dazhan, Duozhuang, Duzhang, Jianshuiquan, Xinglin, and Xinglong reservoirs. To complete the catalog of available information for the five reservoir transfer projects, reservoir operational data for Longquan reservoir, including volume elevati"] [0.24802914261817932, 12.249838829040527, "ective WEAP schematic counterparts. The table containing data on these links has not been fully reviewed to identify gaps, but most data needed appear to be available. \nCapacities and locations of water treatment and purification plants are only avai"] [0.2183907926082611, 12.267699241638184, "on Plan\nBased on our in-person discussions with JWRB staff during the November\u00a02015 and Janu -\nary\u00a02016 workshops, we understand that construction of most of the major elements of the IP \nare either complete or under way. However, our understanding o"] [0.2748374938964844, 12.273445129394531, "ollows:\ndsy=y\u22122009\n2015\u22122009*ds2015( )+y\u22122014\n2015\u22122009*ds2009( )\nfor each year from 2009 to 2015. Therefore, projected demand ds(2014) for 2014 in sector s is \ngiven by:\nds2014( )= 5 / 6( ) ds(2015)+ 1/ 6( ) ds(2009).126 Evaluation of the Jinan C"] [0.2593836784362793, 12.264357566833496, "et (green bars in Figure\u00a0D.1) was either similar or much better than the model fit using the Shanghe precipitation data set (blue bars). Therefore, the Jinxiuch -\nuan data were used to generate regression fits for all river headflows to maintain simp"] [0.2659378945827484, 12.40119457244873, "3 + 10883.9p + 16497.5t 115 0.70\nYudai 1401650 + 117519p \u2013 68225.2t 16 0.89\nYufu 499044 + 59438.2p \u2013 58419.2t 66 0.69Regression Models Used in Climate Projections 129\nregression model in Table\u00a0D.1. The regression model does a good job of capturing"] [0.14229564368724823, 12.510836601257324, "CM Downscaled Data Portal (CCAFS, 2014a; Ramirez, 2008). As described by the data providers, the Delta Method follows the following steps:\n1. Gathering of baseline data (current climates corresponding to WorldClim).\n2. Gath\nering of full GCM timeseri"] [0.20102502405643463, 12.319011688232422, "(2013) estimated potential effects of climate change on water and agricultural production in the Yellow River basin. Changes in agricul -\ntural demand were assessed in the Yellow River basin for three climate change scenarios drawn from the IPCC Four"] [0.17564177513122559, 12.361753463745117, " Changes in Annual Mean Temperature, Precipitation, and Agricultural Water Demand from 2010 to 2030 \nIPCC Climate \nScenarioAverage Change in Temperature by \n2030 (degrees Celsius)Average Change in \nPrecipitation by 2030 (%)Change in Agricultural \nWat"] [0.2428959161043167, 12.247098922729492, ", 2013.\na For the Low Demand projection, simulations were only run for management strategies 1 to 6 in Table\u00a07.1.136 Evaluation of the Jinan City Water Ecological Development Implementation Plan\nTable F.2\nIdentification and Ownership of Global Cli"] [0.16530580818653107, 12.460556983947754, "E: Blue shading indicates representative climate scenarios.\nRAND RR1682-G.1Global emissions\nscenario\nhistorical\nrcp2_6\nrcp4_5\nrcp6_0\nrcp8_51 \n0 2 3 4 \n\u2013100 \u201350 0 50 100 150 200 250\nChange in annual precipitation (mm)Change in average annual temperatu"] [-0.5351668000221252, 13.349266052246094, "\nCollins, Matthew, Reto Knutti, Julie M. Arblaster, Jean-Louis Dufresne, Thierry Fichefet, Pierre \nFriedlingstein, Xuejie Gao, William J. Gutowski, Tim Johns, Gerhard Krinner, Mxolisi Shongwe, Claudia Tebaldi, Andrew J. Weaver, and Michael Wehner, \u201cL"] [-0.47973471879959106, 13.337810516357422, "Vishal K. Mehta, Ben Wright, and Grantley Pyke, Developing Robust Strategies for Climate Change and Other Risks: A Water Utility Framework , Santa Monica, Calif.: RAND Corporation, RR-977-\nWRF, 2014. As of December\u00a014, 2016: http://www.rand.org/pubs/"] [0.23765869438648224, 12.26986312866211, "ator Summary , 2015.\nJinan Statistics Bureau, Jinan City Statistical Yearbook 2012 , China Statistics Press, 2013.\n\u2014\u2014\u2014, Jinan City Statistical Yearbook 2013 , China Statistics Press, 2014.\nJinan Water Resources Bureau, \u201cJinan City Water Resources Pub"] [0.248388409614563, 12.291078567504883, "y A., Joan F. Kenny, Susan S. Hutson, John K. Lovelace, Nancy L. Barber, and Kristin S. Linsey, Estimated Use of Water in the United States in 2010 , Reston, Va.: U.S. Geological Survey, Circular \n1405, 2014. As of November\u00a02015: http://dx.doi.org/10"] [0.2471846044063568, 12.374978065490723, "gement , CRC Press,\u00a0November\u00a015, 2004.\nTaylor, Karl E., Ronald J. Stouffer, and Gerald A. Meehl, \u201cAn Overview of CMIP5 and the Experiment Design,\u201d Bulletin of the American Meteorological Society , Vol.\u00a093, No.\u00a04, April\u00a02012, pp.\u00a0485\u2013498.\nUNESA\u2014 See U"] [0.21348942816257477, 12.294367790222168, "egies to help Jinan meet its long-term water resources goals. RAND\u2019s approach uses well-tested methods of decision support, starting with building a shared understanding of the nature of the decision, metrics to evaluate progress toward goals, key un"] [11.66775131225586, 18.143882751464844, "STEPHANIE RENNANE, SAMANTHA CHERNEY\nWho Settles in Workers\u2019 \nCompensation?\nAn Analysis of How Trends in Claim \nSettlements Relate to Workers\u2019 Compensation Benefit Changes in Oregon\nWorkplace injury is costly to workers and firms (Leigh, 2011). Worker"] [11.67858600616455, 18.114673614501953, "to avoid the uncertainty about the judge or jury\u2019s decision on the case. In the case of workers\u2019 compensation, parties may opt for settlement to avoid the uncertainty of how long disability payments may continue when the path to recovery is uncertain"] [11.691478729248047, 18.14640235900879, "holder conversations, the increase in the frequency of settlements could, instead, indicate that claims administrators and attorneys sought to gain more information about the policy change by \u201ctesting out the system\u201d and to reduce their uncertainty a"] [11.70780086517334, 18.150819778442383, "s \nabout the anticipated duration of disability and the workers\u2019 rate of discount (or time preference). However, this ignores the very real dimensions of uncertainty for the worker. (Hunt and Barth, 2010, p.\u00a04)\nThese dimensions include whether the wo"] [11.70530891418457, 18.145429611206055, "g the claim process. For accepted claims, workers may opt for a claim disposition agreement (CDA). Under a CDA, workers release all rights to present and future benefits in return for a payment up front, typically provided in a lump sum. The CDA sett"] [11.67524242401123, 18.126949310302734, "hen a worker is injured or experi -\nences illness due to work, a workers\u2019 compensation claim is initiated, using either the Worker\u2019s and Physician\u2019s Report of Worker\u2019s Compensation (com-pleted by a doctor) or the Report of Job Related Illness or Inju"] [11.749495506286621, 18.136592864990234, "ht shows the trends as a percentage of all indemnity claims in the injury year.\nThere are several patterns of note. First, in \nall injury-year cohorts, there is a higher overall frequency of settlements among claims with a \nFIGURE 1\nTrends in CDA Set"] [11.70375919342041, 18.133747100830078, " \u201cThe majority of workers in our sample did not work before a settlement and did not return to work within one year after a settlement.\u201d Savych also examined various worker and claim characteristics, and found benefit payments were suspended, were mo"] [11.816306114196777, 18.292865753173828, "Scheduled and unscheduled injuries had differ-ent rating procedures prior to 2005: For scheduled injuries, the extent of impairment was determined relative to the injured body part; for unscheduled injuries, the extent of impairment was determined re"] [11.726030349731445, 18.135284423828125, "y type of settlement was the disputed claim settlement. By comparing claims before and after the policy change (in 1989 and 1991), the authors found that the\nintroduction of CDAs sped resolution and \nreduced TTD duration in a small group of claims: a"] [11.833267211914062, 18.26487159729004, "h efforts resulted in only two interviews. While response to such requests is typically low, the fact that we were analyzing a policy change from nearly 15 years ago limited our ability to reach out to actors who were actively working in the Oregon w"] [11.860583305358887, 18.205411911010742, "r; preinjury weekly wage; occupation and industry at the time of injury; injury characteristics, including body part, nature of the injury, and the injury event; claim characteristics, including date of injury, date of claim closure, and total values"] [11.747387886047363, 18.140792846679688, "as viewed as a significant change in policy. In particular, both noted that the work disability provisions in the new law were significant and drew a lot of attention soon after the law was passed. Both respondents indicated that this change meant th"] [11.808320045471191, 18.1461181640625, "l claimants, regardless of whether the claim ended in settlement or closure.\nFurthermore, because the data set includes infor-\nmation only on claims with indemnity payments, it is outside the scope of our research to examine the effects of settlement"] [11.879135131835938, 18.089998245239258, "ervable charac-teristics of claims that settled or claimed PPD before or after the policy change. Statistically significant changes in other claim characteristics would suggest that there were other shifts in the case mix of claims that settled or re"] [11.920422554016113, 18.11430549621582, "* 0.10* 0.25* 0.21*\n(0.33) (0.30) (0.43) (0.41)\nUpper extremities 0.31 0.29 0.16 0.15\n(0.46) (0.45) (0.37) (0.36)\nLower extremities 0.26 0.27 0.15 0.16\n(0.44) (0.44) (0.36) (0.36)\nMultiple/unknown 0.11* 0.14* 0.20* 0.25*\n(0.31) (0.34) (0.40) (0.43)\nO"] [11.848984718322754, 18.148088455200195, "istribution well, it tends to underestimate higher-value PPD awards. Figure 4 compares the predicted propensity score for the sample of claims after 2005 when we were able Empirical Approach\nNext, we used a logistic regression analysis to analyze whe"] [11.856985092163086, 18.143333435058594, "that may be likely to affect the value of the PPD award: preinjury weekly wage, body part of injury, and probability of receiving work disability. To test whether the relationship between these factors and settlements changed after 2005, we also incl"] [11.810897827148438, 18.10378646850586, " sig-nificantly affected the likelihood of settlement after SB\u00a0757. There are several potential explanations for the lack of an effect. First, workers may not have been aware of the policy change. Other actors in the system, such as attorneys and cla"] [11.76918888092041, 18.12427520751953, " the marked increase in initial settlements after 2005 resulted from actors testing out the system to under-stand how the changes may work may well be correct and is worth exploring with further research.\nLimitations\nThese findings present a prelimin"] [11.718920707702637, 18.11592674255371, "ide the scope of this analysis, \nwe also speculated on several potential explana-tions for the lack of changes in settlement behavior. First, workers and attorneys may face uncertainty about the expected value of the permanent disabil-ity award, and "] [11.46056842803955, 18.10905647277832, ", and dispute processes. \n5 Oregon Workers' Compensation Board, undated.\n6 See DCBS, 2011, and DCBS, 2016, for more details on SB\u00a0757. \n7 This restriction excludes only approximately 1\u00a0percent of \nclaims in the data set.18\nBibliography \nBarton, Sa"] [11.487518310546875, 18.09090232849121, "ted States,\u201d Millbank Quarterly , Vol.\u00a089, No.\u00a04, \nDecember 2011, pp. 728\u2013772.\nMorgan, James N., Marvin Snider, and Marion G. Sobol, Lump \nSum Redemption Settlements and Rehabilitation: A Study of Workmen\u2019s Compensation in Michigan , Ann Arbor, Mich."] [11.530362129211426, 17.961496353149414, "ttlement\nState of Oregon, \u201cClaimant Attorney Fees,\u201d webpage, undated. As \nof November 19, 2019: https://www.oregon.gov/dcbs/reports/compensation/disputes/Pages/attorney-fees.aspx19\nStuart, Elizabeth A., \u201cMatching Methods for Causal Inference: \nA Revi"] [11.408736228942871, 17.728294372558594, "ited. \nPermission is given to duplicate this \ndocument for personal use only, as \nlong as it is unaltered and complete. \nPermission is required from RAND \nto reproduce, or reuse in another \nform, any of our research documents \nfor commercial use. For"] [13.840348243713379, 4.657209873199463, "er \nand more prosperous.\nRAND is nonprofit, nonpartisan, and committed to the public interest. RAND Ventures is \na vehicle for investing in policy solutions. Philanthropic contributions support our ability to \ntake the long view, tackle tough and oft"] [13.799629211425781, 9.01416301727295, "Evaluation of North \nCarolina\u2019s Pathways from Prison to Postsecondary Education Program\nLois M. Davis, Michelle C. Tolbert\nCORPORATION\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by l"] [13.773204803466797, 9.034833908081055, " RAND Cor -\nporation, in partnership with RTI International, was chosen to evaluate the Pathways demonstration project. This report focuses specifically on the evaluation of the North Carolina Pathways Program.\nThese findings should be of interest to"] [13.785422325134277, 9.029064178466797, "................ 19\nStudent Selection Criteria, Recruitment, and Enrollment ....................................... 21\nIn-Prison Educational Activities, Supports, and Prerelease Statistics .......................... 23\nPrerelease from the In-Prison"] [13.797103881835938, 9.018617630004883, "1. Inputs for the Pathways Demonstration Project ..................................... 65Figures\n 1.1. North Carolina Pathways Program Logic Model ..................................... 9\n A.1. Cross-Site Logic Model ..............................."] [13.775389671325684, 9.033021926879883, "implementation of the in-prison component of the three pilot Pathways Programs in Michigan, New Jersey, and North Carolina. The second phase of the eval -\nuation focused on the community component. The Laughing Gull Foundation and Vera provided fundi"] [13.796403884887695, 9.019469261169434, " strengthen the PSE and reentry services available to individuals incarcerated in North Carolina\u2019s correctional system.\nThe Pathways Program was led by the NCDPS Office of Reentry Programs and \nServices in collaboration with the NCDPS Community Corre"] [13.807256698608398, 9.011007308959961, "\u2019s Pathways from Prison to Postsecondary Education Program\ncates, diplomas, and degrees; gainful employment, either part-time or full-time, and \nincreased earnings; and reductions in recidivism, including fewer community supervi -\nsion violations and"] [13.813199996948242, 9.008373260498047, "ered in prison were for only three majors (business administration, computer information technology [IT], Summary xiii\nand entrepreneurship), which did not always align with students\u2019 career interests. Sev -\neral students changed their majors once"] [13.807132720947266, 9.012213706970215, "elp support the family.\nHaving a Pathways navigator and trusted persons of authority was impor -\ntant. Most interviewees reported feeling that the Pathways navigator role was essential \nand was an important source of support for many of the students"] [13.8041410446167, 9.013557434082031, "nsitional housing managers, and other community service providers. State admin -\nistrations had to provide 25-percent match funding and staff time to plan, imple -\nment, and manage the program; agree to such policy changes as inmate transfers to \nPat"] [13.802345275878906, 9.014347076416016, " impact on how NCDPS approaches higher education in prison and reentry planning. Pathways laid the groundwork for and showed what reentry planning should look like. It also has led to more coordi -\nnation among prisons and PPOs and community resource"] [13.812154769897461, 9.00361156463623, "ed in developing the logic model and in assessing the in-prison component of the Pathways Program in North Carolina. We also appreciate the thoughtful insights provided by our technical reviewers, including Matthew Mizel of RAND, Susan Turner of the "] [15.540308952331543, 6.536085605621338, "individuals who participated in PSE programs. Davis et al. (2013) estimated that participation in college or PSE programs \nreduced an individual\u2019s risk of recidivating by 16 per centage points compared with \nthose who did not participate in correcti"] [15.526387214660645, 6.538862228393555, "-year public; two-year and less than two-year private nonprofit; and four-year, two-year, and less than two-year private for-profit colleges). \nA more recent survey of all 50 state correctional education directors by Davis \net al. (2014) found that o"] [13.826628684997559, 8.982078552246094, "nical education (CTE) programs \nand apprenticeships that lead to industry-recognized credentials to credit- bea ring \nprograms that lead to postsecondary degrees (e.g., associate and bachelor\u2019s degrees or higher) (Davis et al., 2014; Erisman and Con"] [13.802441596984863, 9.015281677246094, "tructured to enable incarcerated stu -\ndents to earn credentials and, ultimately, college degrees?\n\u2022 Who are the key stakeholders and what are their roles in supporting these types of programs?\n\u2022 What other types of supports do incarcerated students "] [13.803668022155762, 9.013245582580566, "tering college and complet -\ning their PSE through the two years following their release.6 To increase educational \npersistence and completion rates among participants, the three pilot states also pro -\nvided extensive case planning both in prison an"] [13.78846263885498, 9.02413558959961, "m in the pilot state, specifically (1) certifying the cre -\ndentials of corrections educators and the curricula used in corrections education programs for the purposes of granting credits to students for those courses after release; (2) signing artic"] [13.814156532287598, 8.997458457946777, "s. \nPSE programs funded by the state were primarily CTE. The NCDPS Division of \nAdult Correction (DAC) (now known as the Division of Adult Corrections and Juve -\nnile Justice) provided CTE and other education services to incarcerated individuals thro"] [13.799039840698242, 9.017752647399902, "litate the reentry process. Instead, it was up to the individual being released from prison to develop his or her own plan and determine his or her next steps, meaning that if an inmate was organized, he or she would have developed a reentry plan; ot"] [13.79436206817627, 9.022564888000488, "s*Academic and Instructional Supports\n\u2022 participants living in shared quarters*\u2022 computer training, access to computer lab and \nmonitored/limited internet* \n\u2022 trust-fund incentives for meeting performance goals*\u2022 flexible visitation schedule and fina"] [13.801288604736328, 9.01615047454834, "roved quality of life in neighborhoods \nimpacted by crime and incarceration\n\u2022 skilled workforce\u2022 taxpaying citizensSocietal Impacts10 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecondary Education Program\nreentry councils (LRCs). N"] [13.802807807922363, 9.015486717224121, "ate sources) and 10 pe rcent in-kind resources to be distributed over the four years of the demonstration \nproject.\n10 Some of these eligibility requirements (e.g., scores on assessments) were later relaxed during the selection pro -\ncess to ensure "] [13.809016227722168, 9.007341384887695, "elony \ndrug convictions. The time required to clear up these challenges led to the decision to supplement with Pathways \nfunds in order to get these students enrolled in college.12 Evaluation of North Carolina\u2019s Pathways from Prison to Postseconda"] [13.7985200881958, 9.018524169921875, "hed LRCs in the three designated release communities. It was also planned for the LRCs to use the funds to customize services based on the students\u2019 needs and available community resources, including employment opportu -\nnities, transportation, housi"] [13.745220184326172, 9.04896354675293, "his section, we briefly summa -\nrize the methods for each phase of the evaluation.14 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecondary Education Program\nIn-Prison Component Evaluation\nAs noted earlier, the evaluation of the in-p"] [13.754602432250977, 9.04222297668457, "eptions about the program\u2019s strength and weaknesses; (5) plans for continuing their PSE upon release from prison; (6) views about support needs; and (7) their advice for improving the program. All focus group discussions were conducted in a private c"] [13.75908374786377, 9.039871215820312, "esigning, imple -\nmenting, and overseeing the Pathways Program. This allowed us to get a higher-level perspective of the overall approach North Carolina took to the Pathways Program, stakeholders\u2019 assessments of critical factors and challenges, adjus"] [13.755875587463379, 9.04189682006836, "opped out of the program to get their perspectives on factors that influenced their decisions, their assessments of the program, their educational plans, and recommendations for improving the program.\nAnalysis\nWe qualitatively analyzed the interview "] [13.795703887939453, 9.019521713256836, " Pathways Program \nunfolded, it is important to examine how the in-prison component was designed and implemented, including student selection, recruitment and enrollment, courses and other services provided, adjustments made, and lessons learned. The"] [13.79692268371582, 9.019502639770508, "y Community College served Albemarle; AB-Tech served Craggy; and Pamlico Community College served Pamlico. Male inmate students needing developmental courses were to be housed at either Avery-Mitchell or Mountain View facilities to complete these cou"] [13.7981595993042, 9.017167091369629, " in heating, ventilation, and air con -\nditioning (HVAC); electrical wiring; commercial cleaning; welding; furni -\nture upholstery; horticulture; food services and culinary arts; carpentry; and \nmasonry.\n4\nStudent Selection Criteria, Recruitment, an"] [13.79670238494873, 9.017725944519043, "d to abide by any postrelease and/or probation conditions after exiting from prison (NCDPS, 2014).\n7 The Pathways Performance Incentive process was based on weekly progress reports from the community col -\nlege instructors who completed an incentive "] [13.799164772033691, 9.0174560546875, "er the course of the in-prison component of the Pathways Program, a total of \n3,750 credits and 259 certificates were earned by Pathways students. \nIn-Prison Educational Activities, Supports, and Prerelease Statistics\nNorth Carolina\u2019s Pathways Progra"] [13.796220779418945, 9.016386032104492, " 2. 2 indicates that a total of 3,750 credits \nwere earned during the in-prison component of the program. Certificates earned by North Carolina Pathways students while in prison were in entrepreneurship, business administration, computer IT, and dev"] [13.791914939880371, 9.02273941040039, "rollment Processes\nIn the first year, North Carolina experienced some challenges with its selection, recruit -\nment, and enrollment processes and made adjustments as needed. North Carolina had less than six months from the time of the award of the gr"] [13.79931640625, 9.01652717590332, " -\nferred to another correctional facility or promoted to minimum custody)\n13 during the \napplication process or risk losing some individuals who wanted to be in the program but were in the process of being moved to another correctional facility.\nDes"] [13.823314666748047, 8.994728088378906, "internet access created some security issues. For example, when access was first provided, email communication with college instructors not affiliated with the program was inadver -\ntently made available to incarcerated students. As soon as the probl"] [13.806171417236328, 9.011329650878906, "e students should just be grateful to be in the program. These differing views created some tension between the two groups. Program administrators at times found it challenging to accommodate students\u2019 education and study needs without making them fe"] [13.805154800415039, 9.010347366333008, "gram was embraced by the state\u2019s central leadership. This support helped set the tone that rehabilitation, and the Pathways Program in particular, was a priority. For example, a senior state administrator in North Carolina noted that Path -\nways need"] [13.801009178161621, 9.01576042175293, "the Pathways student population viewed doing so as rewarding, the students did present challenges. For example, according to one col -\nlege administrator, instructors suspected that some students struggled with attention-deficit/hyperactivity disorde"] [13.80171012878418, 9.016324043273926, "cult for some family members to The North Carolina Pathways Program\u2019s In-Prison Component 31\nvisit the student while he or she was incarcerated and, as discussed in Chapter\u00a0Three, \npresented a difficult decision for some students as to whether to r"] [13.796975135803223, 9.021696090698242, "o the general services provided to all of their reentry clients (e.g., job referrals, housing assis-34 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecondary Education Program\ntance, bus cards, counseling, program referrals), the LRC"] [13.804323196411133, 9.013079643249512, " their families while managing and seeking treatment for any substance abuse, depression, anxiety, or other mental health issues. As one community college administrator noted, Pathways students were a microcosm of the range of issues that affect most"] [13.796981811523438, 9.021997451782227, "fund services (e.g., reentry assistance and tuition assis -\ntance) and for a Pathways navigator in each of the release communities. The majority of the Pathways students said that they would not have been able to stay committed to the program if it w"] [13.805601119995117, 9.009764671325684, "y the Pathways students as having as many services and supports, the other LRCs were able to maintain the same level of financial support to the students in their communities through the end of the initiative. \nEven within the same community, student"] [13.800928115844727, 9.01573657989502, "ng.\nIn one of the release communities, the housing manager was well respected by the \nstudents. He would help them with transportation issues and encourage them to stay in the program. However, that was not the case in all the release communities. Ma"] [13.80820369720459, 9.012524604797363, "lancing work and school. Many of the students, therefore, worked additional hours so that they could purchase their own cars. \nLessons Learned\nThe implementation of the community and reentry component of the Pathways Pro -\ngram, including the challen"] [13.804817199707031, 9.015012741088867, "at same PPO, though, noted that it was not appropriate for him to interact with the students at the college, because it could inadvertently stigmatize the students. He believed that that role was better suited for the Pathways navigator. \nIn another "] [13.80665397644043, 9.012765884399414, " and Reentry Component 41\nThe Pathways navigators, PPOs, and instructors also pointed out that many of \nthe students were reluctant to ask for help. As one navigator described,\nSome of the participants wait until the last minute to come and talk ab"] [13.7946195602417, 9.011877059936523, "ed that she felt like she was failing as a mother. Another student commented that \u201c[b]alancing all my responsibili -\nties is hard. Something has to give. I feel very overwhelmed.\u201d42 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecond"] [13.80705451965332, 9.01053524017334, "ed to pay full-time bills with part-time jobs.\nMany students agreed that the incentives initially promised were more of a \ndistraction\u2014particularly when they did not come to fruition\u2014than a help. Rather, \nthe students recommended focusing on the uni"] [13.793374061584473, 9.012264251708984, "make sure that the Pathways Pro -\ngram, or something similar, would be made available to other incarcerated students. If that happened, they had the following advice for other incarcerated individuals consid -\nering enrolling in such a program:\n\u2022 \u201cYo"] [13.804171562194824, 9.011418342590332, "in-prison education component to eliminate duplication among participating colleges and provide more transfer options for students after their release. He and other staff agreed that many of the Pathways students struggled with being far away from ho"] [13.826703071594238, 9.001993179321289, "he position could be strengthened. One college administrator recommended embedding the Pathways navigator role at the college or having the navigator be a shared position between the LRC and college. Similarly, a navigator noted the importance of hav"] [13.80584716796875, 9.012667655944824, "and Snyder, 2014). Research has shown that returning citizens are particularly vulner -\nable in the first few weeks of release from prison, with peak rates for recidivism occur -\nring in the days and weeks immediately following release (National Rese"] [13.805524826049805, 9.01073932647705, " research has long recognized the important role of family in successful \nreentry. Like the Pathways students, many individuals depend on family members or other relatives or friends for financial, housing, and emotional support upon release from pri"] [13.809751510620117, 9.01002311706543, "on career paths that would lead to postsecondary certifications, diplomas, and/or AAS degrees (versus simply taking courses to bide time while in prison)\n\u2022 enabled many individuals to stay focused on education and made having infrac -\ntions while inc"] [13.829102516174316, 8.984394073486328, "e asked them about their education experience prior to Pathways, many reported that they had earned several Conclusions and Recommendations 51\nother occupational credentials while incarcerated. However, Pathways was different in \nthat it allowed th"] [13.800670623779297, 9.01391887664795, "me growing\u201d effect desired as part of the demonstration project. That is, one intended outcome of the in-prison component was that the Pathways Program would motivate other individu -\nals in prison who were not selected for Pathways to earn their GED"] [13.807823181152344, 9.00752067565918, " opportunity.\nCommunication Takes Time and Is Critical to Program Success\nAnother critical lesson learned from both the in-prison and community components was the need for regular communication among staff and students. At various points, there were "] [13.80006217956543, 9.013773918151855, "ition than those students who had to change to a different college upon release.\nThe Pathways students also expressed appreciation for meeting with success teams \nprior to release. These meetings gave them the opportunity to get to know the reentry s"] [13.799673080444336, 9.016261100769043, "d over time. This proved to be problematic for the implementers of the community compo -\nnent of the Pathways Program (e.g., program staff, reentry staff, headquarters staff). For Pathways students, this eroded their trust and introduced uncertainty "] [13.804696083068848, 9.011818885803223, "nal \nPrograms\nThere are numerous reentry stressors that can affect students\u2019 decisions about whether \nto complete their education program out in the community, work full-time, or return home or move closer to family. Housing, employment, and transpor"] [13.806900024414062, 9.010449409484863, " was more likely to understand where flexibility was needed to accommodate the chal -\nlenges the students faced in going to school full-time, working, and trying to reunite with family.\nFamily Plays a Key Role in Students\u2019 Decisions and Success\nFrom "] [13.807737350463867, 9.007610321044922, "changed majors upon release from prison. In addition, there was recognition that it would have been helpful to allow students to earn certificates while incarcerated so that they would have those certificates when released.\nNot all the credits transf"] [13.80449104309082, 9.012109756469727, "would relieve the stress of trying to go to college full-time while needing to work full-time.\n\u2022 Include enough release communities in the program so students can live near their families and other supports.\n\u2022 Invest in reentry infrastructure to ensu"] [13.804539680480957, 9.00930118560791, " three pillars.\nIn addition, NCDPS has set up a PSE advisory committee as a result of Pathways \nthat continues to discuss what they want prison education to entail in North Carolina. This has led to several colleges receiving grants (from a regional "] [13.821989059448242, 8.995038986206055, "f material support as needed.\n\u2022 Provide mentoring, tutoring, and comprehensive supports and services to stu -\ndents once enrolled.\n\u2022 Evaluate the progress of students academically, in employment and earnings, and in crime desistance.62 Evaluation "] [13.799896240234375, 9.01762866973877, "se actions to ensure that educational programming could proceed as planned\n\u2022 commitment from the director of the state parole or postrelease community supervision agency and a detailed plan from the head of the supervision agency for how the agency w"] [13.7972412109375, 9.019200325012207, "prison resources included department of corrections programming staff, cor -\nrectional staff, educational staff, case management staff, and supervisory staff to facili -64 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecondary Educat"] [13.805425643920898, 9.01175308227539, "ustice costs\u2022 reduced crime and increased public safety\u2022 improved quality of life in neighborhoods \nimpacted by crime\n\u2022 skilled workforce\u2022 taxpaying citizensSocietal Impacts\nNOTE: The dashed line indicates that the services and components are supplem"] [13.801892280578613, 9.017333030700684, "le assessment opportunities\u2022 academic and occupational training\n\u2022 remedial education\n\u2022 assessment-driven placement\n\u2022 noninstructional supports\n\u2022 classroom instruction enhanced by com -\nputer technology\n\u2022 behavior management by students sign -\ning beh"] [13.748212814331055, 9.048346519470215, "ministrators/Program Staff/Instructors\nProject Leaders: Lois Davis (PI) and Robert Bozick (co-PI)\nTel. 310-393-0411\nEmail: lmdavis@rand.org; rbozick@rand.org \n1. PURPOSE OF THE STUDY\nThe RAND Corporation, a non-profit research institution in Santa Mo"] [13.733569145202637, 9.05752944946289, "bservation checklist to guide our data collection. \nOur interest is in understanding what instructional methods are being used, the variety of instructional activities that occur, whether individualized learning is occurring, the degree to which stud"] [13.700783729553223, 9.077610969543457, "premises\u2014electronic records will be protected by password and/or encryption\u2014and will not be shared with anyone outside of this project. After completion of the study, all written materials will be destroyed 12 months after the report has been complet"] [13.715811729431152, 9.067699432373047, "ptions about program quality, usefulness, and effectiveness \nFocus Group Questions\nOverview of Focus Group [5 minutes]\nThank you for coming today. I want to introduce myself and the others working \non this project. My name is _____ and this is ______"] [13.758559226989746, 9.034711837768555, "our plans for enrolling and continuing your education upon release?\no How do you think the program will help you meet those goals?\n\u2022\tWhat do you think will be your biggest challenges when released and how might the program help you address those chal"] [13.726794242858887, 9.059748649597168, "e Depart -\nment may receive a copy of the overall results at the end of the study but will not be able to identify you personally from the copy they receive. You should know that if you indicate plans to harm yourself, to harm someone else, or to esc"] [13.739542007446289, 9.052302360534668, "in the focus group discussion today , we \nhave arranged for you to participate in an alternative activity (e.g., study hall or computer lab time). You are free to go to that activity now.78 Evaluation of North Carolina\u2019s Pathways from Prison to Po"] [13.728705406188965, 9.059124946594238, "is is a research project being conducted by the RAND Corporation; it is \nnot being conducted by the North Carolina Department of Public Safety (DPS). RAND will keep confidential your comments. DPS staff will not get a copy of your answers. The Depart"] [13.787668228149414, 9.010156631469727, "oration, 1776 Main Street, Santa Monica, CA, 90407-2138, or by phone at (866) 697-5620, or by emailing hspcinfo@rand.org.82 Evaluation of North Carolina\u2019s Pathways from Prison to Postsecondary Education Program\nRAND Corporation\nEV ALUATION OF THE "] [13.737255096435547, 9.054250717163086, "s) key to supporting this program. The interview will take between 60-90 minutes.\nThe information provided from your comments will be used by the evaluation \nteam to evaluate the outcomes of the NC Pathways Program. The findings will be summarized in"] [13.686609268188477, 9.072247505187988, "udy. De-identified data may be kept after the study indefinitely. \n8. VOLUNTARY PARTICIPATIONYour participation in the study and interviews is completely voluntary. You \nmay refuse to participate, refuse to answer any question in the interview , or s"] [13.789640426635742, 9.025164604187012, "on-instructional supports that complement classroom activities (e.g., Pathways Navigator, computers, transporta-tion, childcare, housing)\n\u00a7\tOther reentry services\n\u00a7\tViews regarding program\u2019s strengths/weaknesses and addi-tional support needed\n\u00a7\tFor t"] [15.58849048614502, 6.4410719871521, "lities, and other resources supporting program\n\u2022\tChanges in partners and stakeholders to support students in the community \n\u00a7\tPerceptions of the program\u2019s strengths and weaknesses\n\u00a7\tUpdate on data collection\no Program outcomes and impact\n\u00a7\tTransition"] [13.876562118530273, 8.941858291625977, "er 2005.\nGorgol, Laura E., and Brian A. Sponsler, Unlocking Potential: Results of a National Survey of \nPostsecondary Education in State Prisons , Washington, D.C.: Institute for Higher Education Policy, \nMay 2011.90 Evaluation of North Carolina\u2019s"] [13.811400413513184, 9.00528335571289, "nt provided to RAND.\n\u2014\u2014\u2014, \u201cUnlocking Potential: Pathways from Prison to Postsecondary Education, Request for \nProposals,\u201d 2012b, unpublished document provided to RAND.\n\u2014\u2014\u2014, Pathways from Prison to Postsecondary Education Project , New York, 2014.\nVis"] [11.58653736114502, 18.087804794311523, "Michael Dworsky, Stephanie Rennane, Nicholas BrotenWage Loss Monitoring for \nInjured Workers inCalifornia\u2019s Workers\u2019 Compensation System\n2013 Injury Year Findings (First Interim Report)CORPORATIONLimited Print and Electronic Distribution Rights\nThis "] [11.375658988952637, 17.580808639526367, "e loss for all injured workers in the state. \nRAND Institute for Civil Justice \nThe RAND Institute for Civil Justice (ICJ) is dedicated to improving the civil justice system \nby supplying policymakers and the public with rigorous and nonpartisan rese"] [11.938045501708984, 18.063175201416016, "hapter 1. Introduction and Background ..................................................................................... 1\t\nWage Loss Monitoring for Injured Workers in California ...................................................................."] [12.310134887695312, 18.04094886779785, "............................ 47 \t\nDiscussion ........................................................................................................................................ 49 \t\nChapter 5. Conclusion ........................................"] [12.305291175842285, 18.025136947631836, "......................... 44\t\nFigure 4.6. Earnings Loss by Body Part of Injury for Workers with Indemnity Benefits, \n2005\u20132013 Injuries ........................................................................................................... 45\t\nF"] [12.332921028137207, 18.006696701049805, "..................................................................................... 61\t\nTable A.7a. Demographic Characteristics of Injured Workers with Indemnity Claims .............. 62\t\nTable A.7b. Firm and Employment Characteristics of Injured W"] [12.322358131408691, 18.05252456665039, "........................................................ 83\t\nTable A.10f. Changes in Relative Earnings Compared with Overall Average, by Quartile of \nPre-Injury Earnings and Benefit Type .............................................................."] [11.929727554321289, 18.128883361816406, "ating worker counterfactual outcomes, and alignment of economic incentives and resources to support the research. \nThe California Department of Industrial Relations (DIR) has established a project that will \nprovide regular monitoring of earnings los"] [12.45443344116211, 18.267301559448242, " into account when estimating \nwage loss. The concept of wage loss relies on comparison of a worker\u2019s realized earnings after \ninjury with the worker\u2019s potential earnings in the (hypothetical) absence of the injury. \nResearchers have taken numerous a"] [12.346871376037598, 18.053115844726562, "n \u201d period for reporting in tables. xii Figure S.1 . Trends in Relative Earnings in Second Year After Injury, 2005 \u20132013 Injuries \n \nSOURCE : 2005 \u20132013 Workers\u2019 Compensation Information System ( WCIS ) and Employment Development \nDepartment (EDD)"] [12.264098167419434, 17.9194278717041, " WCIS -EDD data. \nNOTE: Relative earnings are defined as the ratio of injured worker earnings to potential earnings over the second full \nyear following the quarter of injury. \n xiv Labor Market Outcomes Vary by Industry and N ature of Injury \nAfte"] [12.24887466430664, 17.938270568847656, "ed here \nto include Los Angeles County, Orange County, Riverside County, San Bernardino County, and Imperial County) (see Figure S.3). xv Figure S.3 . Trends in Relative Earni ngs by Region and Cumulative Injury Status, 2005 \u20132013 \nInjuries with Ind"] [11.962618827819824, 18.31649398803711, " claims that have not yet fully resolved. Given the slow pace of medical recovery and claim resolution for severe injuries, data on earnings losses several years after injury are necessary to directly assess the \nlong-term impact of permanently disa"] [12.139260292053223, 17.976560592651367, "ups, Especially \nCumulative Injury Cases in Southern California \nWhile we were unable to disentangle particular policy impacts in our analyses of overall \ntrends, our analysis of key subgroups revealed some notable differences in wage loss and labor"] [11.60999584197998, 18.318601608276367, "tions \nAB Assembly Bill \nAMA American Medical Association \nCHSWC Commission on Health and Safety and Workers\u2019 Compensation \nDEU Disability Evaluation Unit \nDIR California Department of Industrial Relations \nDWC Division of Workers\u2019 Compensation \n"] [12.02273941040039, 18.214616775512695, "y disabled workers were found to be highly sensitive to economic conditions at the time of injury: Permanently disabled workers\u2019 labor market outcomes deteriorated sharply during the Great Recession of 2008\u20132009 and showed little sign of recovery thr"] [11.889917373657227, 18.334970474243164, "ement rates, a major reform \npackage known as Senate Bill (SB) 863 was enacted late in 2012 (DIR, 2017b). SB 863 included changes to the methods used for calculating final disability ratings that increased disability ratings for the majority of perma"] [11.851166725158691, 18.223495483398438, "e overall objective of this project is to provide workers\u2019 compensation policymakers in \nCalifornia with a basis for regular and ongoing monitoring of earnings loss and injured worker economic outcomes. DIR has contracted with RAND to carry out a thr"] [11.679388999938965, 18.172393798828125, "te. In addition to monitoring trends in earnings losses, a key component of this project is the development of a data set that can be used for more evaluation of specific policy changes in the workers\u2019 compensation system when it is possible to defin"] [11.772589683532715, 18.316831588745117, "eriod, and, thus, they receive only medical care. However, three in ten injured \nworkers will receive some form of indemnity benefits as compensation for a longer spell of work \nabsence or for permanent disability.\n10 Ultimately, around 15 percent of"] [11.817675590515137, 18.318342208862305, "ornia workers\u2019 compensation benefits in calendar year 2015 (National Academy of Social \nInsurance, 2017). \n 6 Recent Developments in California Workers\u2019 Compensation \nThe data used in this study include injuries occurring on or after January 1, 2005"] [11.87748908996582, 18.32030487060547, "27 and SB 228. AB 749, enacted in 2002, \nalso provided for increases in TTD and PPD benefits that were phased in between 2004 and 2006. A summary of the \nprovisions of these laws is available on the DIR website at http://www.dir.ca.gov/dwc/reform03.h"] [11.995865821838379, 18.13909339904785, "s such as these are unique to injured workers, other trends associated \nwith an economic expansion\u2014such as increased rates of job turnover, transition, and wage growth\u2014will affect all workers in the economy. In the following chapters, we describe how"] [11.850322723388672, 18.164134979248047, "itional modeling effort far beyond the scope of this monitoring report is necessary to say how the magnitude of earnings loss would evolve over time in the absence of policy changes. \nEarnings loss estimates provide a single summary measure of the e"] [11.845586776733398, 18.184587478637695, "t \nthat neither the insurance industry nor state workers\u2019 compensation agencies have mechanisms in place to collect individual-level data on outcomes for injured workers after their involvement with the workers\u2019 compensation system ends. This informa"] [11.894387245178223, 18.165430068969727, "oss for earlier injury years \n\u2022 comparison of differences in earnings loss levels and changes across subgroups of \ninjuries. \nUpdates to this monitoring report will be produced in the summer of 2018 (covering 2014\u2013\n2015 injuries) and in the summer of"] [11.798622131347656, 19.043216705322266, "onic Data Interchange versions of the First Report of Injury (FROI) and Subsequent Report of Injury (SROI). In 2007, DIR began collecting transaction-level medical treatment data at the claim level, including procedures, diagnoses, and payments. In a"] [11.871548652648926, 18.990358352661133, "ase. \nUnfortunately, compliance with reporting standards remains imperfect, and the data reported \non the SROI are less complete than what are reported by the FROI; the most recent assessment \npublished by the Division of Workers\u2019 Compensation (DWC) "] [12.339656829833984, 18.448579788208008, "be captured in the Base Wage File. The Base Wage File represents the most accurate and comprehensive possible source of data on quarterly wage and salary earnings in California. The industries covered by UI are virtually identical to the industries c"] [12.477218627929688, 18.31722640991211, "s and employment because it is impossible to observe what an injured worker\u2019s labor market outcomes would have been if he or she had not been injured. To illustrate this problem, \nimagine that we had data only on an injured worker\u2019s earnings before a"] [12.486764907836914, 18.32729148864746, "ve continued to resemble the earnings of control workers who had the same employer, same job tenure, and very similar trends in prior earnings. In effect, this method uses data to tell us how each injured worker\u2019s earnings would have evolved over tim"] [12.488201141357422, 18.34562110900879, "timate true earnings losses. On the other hand, assuming that earnings would continue to grow at some constant rate requires the fairly strong assumption that the worker would not have experienced any other voluntary or involuntary disruptions in \nem"] [12.476099014282227, 18.2977352142334, "lance \nbetween the observable characteristics of the injured workers and their control group, comparing 17 post-injury outcomes between injured and control workers should deliver valid estimates of the \ncausal effects of injury\u2014i.e., earnings loss. "] [12.519871711730957, 18.354217529296875, "group of key covariates relevant for our study \nthat can be observed for both injured and control workers: the quarterly earnings trajectory prior to the injury, job tenure, and employment status. We required that the control workers fall into \nthe s"] [12.497601509094238, 18.313955307006836, "bove, it is easier to find matched control workers at large employers with a larger donor pool. We construct ed sampling weights to produce weighted \nestimates that were representative of the sample of workers with complete records (step 3) on the \n "] [12.496113777160645, 18.317665100097656, " injury, injured worker \nearnings started to converge toward control worker earnings, with injured workers earning \napproximately $500 less than control workers by the eighth quarter after injury. \n \n20 "] [12.5073881149292, 18.276256561279297, "Injury\nTotal quarterly earnings for injured workersTotal quarterly earnings for control workersQuarterly Earnings \n(Real 2014 Dollars) 21 analysis of the closeness of earnings between injured and control workers during the pre-injury \nperiod. \nEar"] [12.335482597351074, 18.114530563354492, "injured and control workers in order to interpret the relative measures that we focus on in our presentation of results. We do note, however, that total employment or at-injury employment outcomes may be of greater interest for analyzing certain poli"] [12.412442207336426, 18.1685733795166, "ing that our data suggest long-term earnings losses for workers whose injuries did not result in permanent disability, other studies have documented comparable long- term earnings losses for workers deemed not to be permanently disabled by the worker"] [12.456665992736816, 18.24605941772461, "s, we focus on relative measures that present injured worker earnings and employment as percentages of the same measure for the comparison control workers. All our measures are constructed so that higher values represent better outcomes for injured w"] [12.474337577819824, 18.2296142578125, " terms, \nbut it has the limitation that it does not provide any context for how the loss in earnings compares with a worker\u2019s earnings potential: A $10,000 loss may represent a moderate work \ninterruption for a worker earning $100,000 per year but a "] [12.342194557189941, 18.0533390045166, ",NO K\nMQJ\nJ\nK\u2211 ]M,NS K\nMQJ.\t\t\t\t\t\t\t\t(4) \t\nAbsolute and relative measures of return to work can be defined analogously by replacing the \nindicator for employment anywhere with indicators for employment at the at-injury employer. \nAssessing Statistical "] [12.277337074279785, 17.966838836669922, "2013 for all injured workers. We then \ndescribe the composition or case mix of injured workers in California between 2005 and 2013, including demographics, job characteristics, receipt of indemnity benefits, and selected injury \ncharacteristics. Chan"] [12.335711479187012, 18.031009674072266, "le and local economic factors, change the composition of the labor \nforce over time, leading to changes in the size of the covered workforce and affecting the pool of \nworkers at risk of experiencing an injury. In particular, 2013 coincided with a ti"] [12.324492454528809, 18.01625633239746, "able \ndisability rating data are subject to significant data lags, and we do not examine disability ratings in this report. \nAnalyses that incorporate disability rating data are planned for the final policy report under this project, by which time th"] [12.322745323181152, 17.999292373657227, "n 2005\u20132007 to 78 percent in 2010\u20132012. The trend toward higher \njob tenure at injury began to reverse in 2013: The share of injured workers with one year or more 32 of job tenure fell slightly to 76 percent among 2013 injuries. A shift toward injur"] [12.313889503479004, 18.011308670043945, "ely 97 to 98 percent of what they would have earned \nwithout an injury. \nThe second line on the chart shows trends for workers who received indemnity payments but \ndid not have a permanent disability. Relative earnings for this group range between 8"] [12.381690979003906, 17.949485778808594, "reasing shares of female injured workers, increasing age, and declining pre-injury wage persist among workers with indemnity \nbenefits as in the overall analysis sample. In all years, however, workers with indemnity benefits tend to be older, are sli"] [12.00900936126709, 18.227930068969727, "er \noutcomes began to improve in 2013. However, we caution that these improvements could be due \nin part to changes in the composition of workers in 2013 or to more workers entering the system with lower-severity claims. In particular, we note that f"] [12.303744316101074, 18.027881622314453, "s associated with wage loss among permanently \ndisabled workers in previous studies, these analyses have generally been guided by specific \nresearch questions centered on benefit adequacy and have not encompassed the broader population of workers wit"] [12.356969833374023, 18.016420364379883, "10a\u2013A.10g in the appendix. As described in Chapter 2, we also tested for \nstatistically significant differences between group-specific trends and overall average trends. However, the majority of these tests for trend breaks by industry and time perio"] [12.35158634185791, 18.048053741455078, "jured at very large firms (those with \nmore than 5,000 workers) and 8.3 percentage points lower than average for workers injured at \nvery small firms (those with ten or fewer workers). While the concentration of public-sector employers in the largest"] [12.325566291809082, 18.011112213134766, "ase in 2010, approaching the trend for the first and third wage quartiles by 2013. The first \nand third wage quartiles trended between approximately 85 percent and 75 percent between 2005 \nand 2013.24 \nFigure 4.3 . Earnings Loss by Pre -Injury Earni"] [12.346229553222656, 17.99607276916504, "c injuries, cumulative injuries, multiple injuries, and other injuries. Specific injuries account for about four in five claims, and so the trend for specific injuries tracks with the overall average closely. Workers with cumulative injuries experien"] [12.312368392944336, 17.971240997314453, "Injuries \n \nSOURCE: 2005\u2013 2013 WCIS -EDD data. \nNOTES: Relative earnings are defined as the ratio of injured worker earnings to counterfactual earnings in the \nsecond full year after injury (5\u20138 quarters after quarter of injury). The gray line ind"] [12.266122817993164, 17.930278778076172, " reflect relative earnings for the indicated \nsubgroup. \nCumulative Injuries in Southern California \nAcross all of these subgroup analyses, one of the most striking patterns is the low relative \nearnings for workers with cumulative injuries. This fac"] [12.237933158874512, 17.987512588500977, "up analyses here demonstrate that these gains were not shared equally \namong all workers. Workers in industries that were especially hard-hit by the recession \ncontinued to experience larger earnings losses than workers in other industries. Workers w"] [11.988361358642578, 18.074323654174805, "verage worker who is involved in the workers\u2019 compensation system . The fact that post-\ntermination claims may contribute to the cumulative trauma trends provides another reason why \nthe wage loss trends in this report should not be interpreted as a "] [12.28127670288086, 17.900348663330078, " W e found lower relative earnings and \nemployment rates for workers who received indemnity payments, and we did not observe any improvement in labor market outcomes for workers with permanent injuries in 2013, compared with workers with permanent in"] [12.092484474182129, 18.135435104370117, "th cumulative injuries in particular as a group that \nwarrants further attention in this region. \nBased on these findings, we conclude with two main policy conclusions. \nFirst, this initial monitoring report provides a benchmark against which to me"] [12.559718132019043, 18.319622039794922, " workers in the quarter of injury. \n3. Screen out control candidates whose job tenure at the at-injury firm did not match the injured worker\u2019s tenure. We defined tenure as the number of consecutive quarters prior to \ninjury with positive earnings at "] [12.56956672668457, 18.331153869628906, "ing on consecutive tenure at the at-injury firm mitigates this concern. \nMatch quality can be evaluated using statistics that summarize the distance between the \ninjured and control workers. In order to evaluate the quality of our match, we produce t"] [12.53990364074707, 18.36639404296875, "by Injury Cohort \nImbalance 2005\u2013 2007 \nInjuries 2008\u2013 2009 \nInjuries 2010\u2013 2012 \nInjuries 2013 \nInjuries \nAverage 0.95% 1.16% 0.57% 0.35% \nAverage absolute 5.22% 5.21% 3.88% 3.59% \nAverage elementwise absolute 11.96% 10.91% 9.53% "] [12.522093772888184, 18.403244018554688, "we defined categories of workers by age, gender, region, self-insured status, injury year, and quartiles of WCIS weekly wages. Weights are defined as the inverse proportion of workers in our sample with complete records on each of these variables and"] [12.44497013092041, 18.072765350341797, "s across the four time \nperiods using the following specification: \nRelative \tEarnings ^=\ud835\udefc+\u2211 \ud835\udefd^E\nb=\ud835\udc4412008 }+\n\ud835\udefd5k\ud835\udfcf{Calendar \tyear\tof\t\ud835\udc5e>=\ud835\udc4412010 }+\n\ud835\udefd5r\ud835\udfcf{Calendar \tyear\tof\t\ud835\udc5e>=\ud835\udc4412013 }+\ud835\udf00^ ("] [12.552908897399902, 17.83928680419922, "esis tests, and thus uncorrected \ninference would run a high risk of identifying false positives (i.e., Type I errors) in terms of group differences. Coefficients for these interaction terms are shown in Tables A.10a\u2013A10e. \nSupplementary Results \nT"] [12.444758415222168, 17.858322143554688, "e 6% 6% 6% 6% \n Sprain/ strain 40% 41% 42% 43% \n Cumulative 8% 7% 8% 8% \n \n Back 18% 18% 18% 18% \n Lower extremity 22% 22% 21% 22% \n Upper extremity 32% 33% 33% 34% \n Multiple 13% 13% 13% 12% \n \nBenefit receipt PPD 49% 52% "] [12.718997955322266, 17.735132217407227, " \u20130.006 0 \u20130.032 0 0.0136 \n (0.0032) (0.0039) (0.0042) \n [0.0694] [0.0000]** [0.0027]** \n \n1,001\u2013 5,000 employees 0.0099 0.0102 0.0222 \n (0.0013) (0.0028) (0.0030) \n [0.0000]** [0.0010]** [0.0000]** \n \nMore than 5,000 employee"] [12.713594436645508, 17.73016929626465, " Permanent Differences in Relative Earnings by Region and Benefit Type \n Region Indemnity PPD Indemnity, Not PPD \nBay Area 0.0263 0.0078 0.0115 \n (0.0031) (0.0049) (0.0028) \n [0.0000]** [0.1219] [0.0002]** \n \nCentral Coast 0.0004 \u2013"] [12.724363327026367, 17.71183204650879, "demnity, Not PPD \n \nEars/h earing \u20130.0239 0.0259 0.0376 \n (0.0110) (0.0127) (0.0300) \n [0.0368]** [0.0495]** [0.2177] \n \nEyes 0.1398 0.2119 0.048 0 \n (0.0084) (0.0094) (0.0136) \n [0.0000]** [0.0000]** [0.0012]** \n \nFace 0."] [12.710806846618652, 17.731578826904297, " \n \nFull tenure 0.0082 0.0169 0.0022 \n (0.0008) (0.0007) (0.0011) \n [0.0000]** [0.0000]** [0.0514] \n \n NOTE S: Table shows linear regression coefficients from Equation 7 , standard errors in parentheses, and unadjusted \np-values i"] [12.720129013061523, 17.717178344726562, "\n \n2013 \u00b4 (101\u2013500 employees) 0.0105 0.0205 \u20130.0061 \n (0.0036) (0.0048) (0.0083) \n [0.0066] [0.0001]** [0.4692] \n \n2013 \u00b4 (501\u20131,000 employees) 0.0036 0.0025 0.0093 \n (0.0115) (0.0122) (0.0108) \n [0.7566] [0.8397] [0.3913] "] [12.718291282653809, 17.7311954498291, "9 0.0148 \u20130.0014 \n (0.0067) (0.0142) (0.0055) \n [0.7738] [0.3032] [0.8016] \n \n2010 \u00b4 Health care \u20130.014 0 \u20130.0139 \u20130.0103 \n (0.0072) (0.0120) (0.0052) \n [0.0596] [0.2535] [0.0541] \n \n2010 \u00b4 Manufacturing \u20130.0034 \u20130.0093 \u2013"] [12.717913627624512, 17.73314094543457, " Central Coast \u20130.0109 \u20130.0111 \u20130.0161 \n (0.0091) (0.0126) (0.0106) \n [0.2356] [0.3826] [0.1395] \n \n2008 \u00b4 Central Valley \u20130.0092 0.0051 \u20130.0169 \n (0.0073) (0.0120) (0.0083) \n [0.2112] [0.6732] [0.0509] \n \n2008 \u00b4 Eastern Sie"] [12.717177391052246, 17.730670928955078, "ngeles \u20130.0038 \u20130.0022 \u20130.0058 \n (0.0027) (0.0070) (0.0044) \n [0.1617] [0.7560] [0.1928] \n \n2013 \u00b4 N. Sac ramento Valley \u20130.0321 \u20130.0033 \u20130.0598 \n (0.0167) (0.0225) (0.0185) \n [0.0630] [0.8847] [0.0027] \n \n2013 \u00b4 North State"] [12.72073745727539, 17.718563079833984, ".0485 \n (0.0211) (0.0218) (0.0392) \n [0.0841] [0.4052] [0.2238] \n \n2008 \u00b4 Face \u20130.0012 \u20130.0294 0.0316 \n (0.0213) (0.0223) (0.0431) \n [0.9570] [0.1970] [0.4692] \n \n2008 \u00b4 Head \u20130.0185 \u20130.0552 0.0091 \n (0.0200) (0.0276) ("] [12.71519947052002, 17.727149963378906, "Upper extremities \u20130.0096 \u20130.0137 \u20130.0034 \n (0.0033) (0.0033) (0.0048) \n [0.0066] [0.0002]** [0.4891] \n \n \nNOTE: Table shows linear regression coefficients, standard errors in parentheses, and unadjusted p-values in \nbrackets. ** ind"] [12.4771728515625, 17.917503356933594, "0) (0.0127) (0.0131) \n [0.2243] [0.2596] [0.4336] \n \n2013 \u00b4 Full tenure \u20130.0009 0.0013 \u20130.0018 \n (0.0018) (0.0021) (0.0024) \n [0.6218] [0.5508] [0.4615] \n \n \nNOTE: Table shows linear regression coefficients, standard errors"] [11.182806015014648, 18.16952133178711, "ptember 2007a. As of June 29, 2018: http://www.dir.ca.gov/dwc/reform03.htm \nCalifornia Department of Industrial Relations, \u201cAssembly Bill 749,\u201d September 2007b. As of \nJune 29, 2018: http://www.dir.ca.gov/dwc/AB749.htm \nCalifornia Department of Indus"] [11.290400505065918, 18.145431518554688, " UC DATA/Survey Research Center, 2007. \nPace, Nicholas M., and Julia Pollak, Provider Fraud in California Workers\u2019 Compensation: \nSelected Issues , Santa Moni ca, Calif .: RAND Corporation, RR-1703-DIR, 2017. As of June \n5, 2018: \nhttps://www.rand.or"] [12.175275802612305, 17.921567916870117, "ions, \"Injury Description Table\u2014\nPart/Nature/Cause,\" undated. As of August 13, 2018: \nwww.wcio.org/Document%20Library/InjuryDescriptionTablePage.aspx \nWorkers\u2019 Compensation Insurance Rating Bureau of California, Analysis of Changes in \nIndemnity Cla"] [4.656986713409424, 8.013862609863281, "CORPORATION\nRAND Model of \nAutomated Vehicle Safety (MAVS)\nModel Documentation\nNidhi Kalra and David G. GrovesLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation o"] [4.638126373291016, 8.048888206481934, "ies might shape these factors to improve safety now and over time. In particular, this model was used in the 2017 report The Enemy of Good: Estimating the Cost of Waiting for Nearly Perfect Automated Vehicles to assess how safe highly automated vehic"] [4.696627616882324, 8.037638664245605, "hese issues. Each year, RAND\u2019s president draws on this generous gift to help RAND research and outreach teams extend the impact of completed research. \nSupport for this project is also provided, in part, by the income earned on client -funded \nresear"] [4.70603609085083, 8.357690811157227, "r Time ........................................................................21 \t\nHighly Automated Vehicle Safety Rate over Time ................................................................................. 21 \t\nChange in the State of the Art"] [4.731335639953613, 8.30046272277832, "ure with HAVs ...................................................................... 27\tFigure 5.1. Highly Automated VMT in Three Scenarios ............................................................. 31\tFigure 5.2. State-of-the-Art Fatality Rate of"] [4.7216691970825195, 8.306114196777344, "redict the pace of \nfuture diffusion or the rate of learning of HAVs. Nor does it predict how safety will evolve among non-HAVs. Predicting technological diffusion, human behavior, and future interactions of new technology in real-world transportatio"] [4.735083103179932, 8.241207122802734, "are enormously grateful to \nKenneth Kuhn at RAND and Kara Kockelman at the University of Texas for their reviews. We thank Charles Zwick for his generous support of RAND through the Zwick Impact Awards, without which this report and related materials"] [4.740492343902588, 8.276471138000488, "-diverse) miles that HAVs drive, the more potential there is for improving the state of the art in HAV safety performance. This means that near-term choices about when HAVs are introduced will also \n \n1 "] [4.69180154800415, 8.340608596801758, "ese factors may interact and result in different road safety outcomes over time. \nImportantly, the Model of Automated Vehicle Safety (MAVS) does not predict the pace of \nfuture diffusion, the rate of learning of HAVs, or how safety will evolve among "] [4.883956432342529, 8.114938735961914, "t? \n\u2022 How do we define a future with HAVs and a future without HAVs? \n\u2022 How do we measure road safety? \n\u2022 How has future road safety been assessed in the literature? \nWhat Is a Highly Automated Vehicle and What Is Not ? \nThe 2016 SAE International ta"] [4.8009033203125, 7.937329292297363, "enhanced by active \nsafety systems. \n \nThe human driver is entirely responsible for driving, even if such features as active \nelectronic stability cont rol are available and engaged. \n1 Driver assistance The sustained and operational design domain"] [4.857161521911621, 8.122892379760742, "n driving automation system \nor feature thereof is designed to function.\u201d \n \nIn contrast, common to Level 3 (conditional driving automation), Level 4 (high driving \nautomation), and Level 5 (full driving automation) is that the vehicle is responsibl"] [4.719343185424805, 8.301076889038086, "ehicle crashes. \nMAVS can be used to explore safety in any of these terms: The model equations we describe \nrefer only to a generic performance rate, which can reflect any of these metrics, and the model equations remain the same regardless. Similarl"] [4.725630760192871, 8.311132431030273, " is, incidents per VMT) of both non-HAVs and HAVs to change in this time frame based on users\u2019 inputs. The model does assume that VMT and safety rates will change smoothly over time, but, in reality, there will likely be punctuated periods during whi"] [4.832372188568115, 8.240287780761719, " adoption of those technologies. Going a step further than prior work, Li and Kockelman (2016) estimates both the types and severity of crashes that could be avoided by each type of technology, as well as the economic benefit of those savings. In rec"] [4.789254665374756, 8.277066230773926, "the full effect of many new technologies deeply uncertain. \nSecond, these existing estimates also compare the marginal benefits of a technology with the \nsafety performance of current vehicles and drivers. However, the benefit of a vehicle with a pa"] [4.711005210876465, 8.358229637145996, "s \nsuggest, for example, that from 2014 to 2044, total VMT could grow between 0.53 percent and 0.65 percent annually (Federal Highway Administration, 2016). While these bounds are themselves uncertain and include potential changes from HAV use,\n8 the"] [4.698118686676025, 8.375870704650879, "s2069 = 0.7 x 10\u20138. \nFigure 3.2. Historical Fatality Rates and Two Scenarios of Future Fatality Rates \n \nHighly Autom ated Vehicle Safety Rate over Time \nCalculating the number of safety events f is straightforward once annual VMT and safety \nrates"] [4.692575931549072, 8.379051208496094, "unction reasonably approximates more-detailed scenarios of HAV diffusion that have been developed by others, such as Bansal and Kockelman (2017) and Litman (2017). A standard logistic function is described by Equation 4.2: \n \n \ud835\udc53(\ud835\udc65) =\n,\n,IJKL . (4.2) "] [4.719466209411621, 8.341219902038574, "centage of baseline miles that will be \ndriven by HAVs, we consider how VMT may change as a result of the diffusion of HAVs. \nHAVs are widely expected to increase miles traveled because they lower the cost of travel, can provide travel opportunities "] [4.700329780578613, 8.295663833618164, "re with HAVs as they \nwould in a future without HAVs.11 In other words, s n,x = s x as defined in Equation 3.2 in \nChapter Three. However, the number of safety incidents from non-HAVs will be lower than in \nthe baseline future because non\u2013highly auto"] [4.724570274353027, 8.37894344329834, "ents as a metric for safety because it is unclear what standards of risk are \nused and whether they are homogenous across all test drivers or developers. 22 existing vehicles (Tesla, undated). Tesla calls this \u201cfleet learning\u201d\u2014that is, when an enti"] [4.701817035675049, 8.385879516601562, "15 (NHTSA, 2017 ). The figures \nin this report are based on the earlier 2015 estimat e. 23 Figure 4.3. Scenario of the Relative Fatality Rate of HAV s as a Function of Cumulative Miles Driven \nby HAVs \n \nNOTE: This figure assumes that the initial"] [4.703534126281738, 8.38205623626709, "settings, so the opportunity for and impact of software -only safety improvements may be less. \n(2051, 0.26)(2051, 9.66E+12)\n1.00E+001.00E+011.00E+021.00E+031.00E+041.00E+051.00E+061.00E+071.00E+081.00E+091.00E+101.00E+111.00E+121.00E+131.00E+14\n0.00"] [4.703554153442383, 8.402740478515625, "ded during their time on the road. Therefore, this case is best \nthought of as a useful computational bookend rather than a bookend of the actual future of fleet improvement. 26 Figure 4.5. HAV Fatalities with Perfect and with No Fleet Improvement\n"] [4.704287052154541, 8.359488487243652, "uction in the rate? t0.99 1 trillion 1 trillion 1 trillion \nHow upgradeable is the existing HAV fleet? w 0.5 0.5 0.5 \n \nThe baseline future without HAVs reflects a compounding annual growth rate of 0.6 percent \nwith a 30-percent decline in fatali"] [4.720017910003662, 8.32717227935791, "ance sooner than in the other scenarios.\n18 \nThis illustration is not to suggest that early diffusion of lower-performing technology will \nunfold as it has in this scenario, or that any of these scenarios will indeed occur. As just one example, pub"] [4.699643135070801, 8.362531661987305, "f roads ; and, most of all, behavior changes, such as changes in seat belt \nuse, distracted driving, or driving while intoxicated. \n\u2022 The timing and extent of HAV diffusion. This input will be shaped by regulatory \nchoices, such as whether to have s"] [4.660671710968018, 8.422286987304688, "\n \ud835\udc4f = \ud835\udc65 H'\u2212 \ud835\udc5a\ud835\udc65 H . (A.4) \n We can further solve for x\u2019\na and x\u2019 1\u2013a by taking the inverse of the logistic function: \n \n \ud835\udc65 =\t\u2212ln,2x($)\nx$ . (A.5) \n \nBecause of the symmetry of the standard logistic function, this simplifies to \n \n \ud835\udc5a =-\tRS\t(= 2008} + 2(&3{5$#\"+6$* <\"$* 9: 7 >= 2010} + 2()3{5$#\"+6$* "] [12.484984397888184, 18.22582244873047, ", and environmental factors remained constant, only allowing time fixed effects to vary. Specifically, we run the following models:\nand\nI0 = / + / + J2& K L*\"M$,\"N + J 2 O + D / 1!$%! /+++/\nI3 = / + / + J2& K L*\"M$,\"N + J 2 O + D / 1!$%! /+++/\nIn the"] [12.452362060546875, 18.194496154785156, "on we had to make in this analysis was whether to control for labor market conditions in the quarter of injury or two years after injury (i.e., at the time we observe post- injury earnings and employment). On the one hand, labor market conditions in "] [12.377556800842285, 18.167287826538086, "ngs losses at period 7 as the inverse of the difference between counterfactual and injured worker earnings in that period:\n)V = (I3\u2212I0) !!!\nNext, we consider the observed difference in earnings losses between period 0 (defined in our case as 2005\u2013200"] [12.251158714294434, 18.25274085998535, "ay terminal diseases 76 0.2 AIDS 75 0.1 Hepatitis C 79 0.1\nWe apply the same methods that we described for case-mix adjustment to examine the role of compositional changes in trends and regional differences in earnings losses of workers with CT injur"] [12.311427116394043, 18.29097557067871, "tions performed at the DEU (Dworsky et al., 2016). We use the ratio of average earnings losses in years three, four, and five to second-year losses in this study. Specifically, we measure first- and second-year losses directly and estimate third- thr"] [12.038854598999023, 18.262304306030273, "he second post-injury (5\u20138 quarters post-injury) by 4.95, following estimates of long-term earnings losses for workers with 2005\u20132008 injury dates reported in RAND\u2019s 2016 wage loss study (Dworsky et al., 2016). Benefit payments reflect all benefit an"] [11.98331069946289, 18.152650833129883, "ttling Within Five Years of Injury, by Year of Injury\n Indemnity Injuries\n% of Settled Claims with Settlement by . . . Years After Injury\nPD Injuries\n% of Settled Claims with Settlement by . . . Years After Injury\n Injury\nYear 1234512345\n "] [11.192338943481445, 18.178085327148438, "orkers\u2019 Compensation Claim Costs, Oakland, Calif.: Workers\u2019 Compensation Insurance Rating Bureau of California, 2015.\nCalifornia Assembly Bill 1124, Workers\u2019 Compensation, 2015.\nCalifornia Assembly Bill 1244, Workers\u2019 Compensation, 2016.\nCalifornia C"] [11.25526237487793, 18.15234375, "ds Through the Great Recession and Impacts of Recent Reforms, Santa Monica, Calif.: RAND Corporation, RR-1299-CHSWC, 2016. As of June 5, 2018: https://www.rand.org/pubs/research_reports/RR1299.html\nFlood, Sarah, Miriam King, Renae Rodgers, Steven Rug"] [11.290611267089844, 18.14858627319336, "S. Barth, Compensating Permanent Workplace Injuries: A Study of the California System, Santa Monica, Calif.: RAND Corporation, MR-920-ICJ, 1998. As of May 19, 2018: https://www.rand.org/pubs/monograph_reports/MR920.html\nRennane, Stephanie, Nicholas B"] [11.179622650146484, 18.216487884521484, "//www.wcirb.com/document/15001\nWorkers\u2019 Compensation Insurance Rating Bureau of California, The World of Cumulative Trauma Claims, Oakland, Calif., 2018. As of September 28, 2021: https://www.wcirb.com/sites/default/files/documents/the_world_of_cumul"] [2.1029651165008545, 19.769264221191406, " CORPORATION\nTOM LATOURRETTE\nDefining Recognized and Generally Accepted Good Engineering Practices for Process Safety Management\nIn response to several high-profile hazardous material releases in the 1980s, including the Union Carbide disaster in Bh"] [2.103769540786743, 19.7686710357666, "matter experts and resources.\n\u25a0 Approaches to documentation of process equipment compliance were mixed, and interview participants noted such challenges as unclear connections among manufacturers\u2019 specifications, installation docu- mentation, or both"] [2.1029231548309326, 19.768085479736328, "tion, not all of which applies to the California PSM regulation. We also reviewed the materials documenting the development of the federal and California PSM regu- lations, consisting of draft regulation text and public comments and responses. These "] [2.103071928024292, 19.76944923400879, "gulation directly. Only California and Washington have promulgated their own PSM regulations, and those are both generally very similar and nearly identical to the federal OSHA PSM regulation with regard to RAGAGEP. Califor- nia\u2019s special PSM regulat"] [2.10239577293396, 19.767667770385742, "described in the preamble to the PSM regulation (OSHA, 1992). One section of the original text required that \u201cthe employer document that the process equipment being used complies with appli- cable consensus codes and standards, where they exist; or b"] [2.103179931640625, 19.76903533935547, " to appli- cable VCSs, engineering society technical reports, manufacturers\u2019 recommendations, and employers\u2019 internal standards. The final PSM regulation was issued in 1992 (29 CFR 1910.119).\nThe concept of RAGAGEP has seen limited adoption beyond th"] [2.1035304069519043, 19.770238876342773, "hanges to agency rules, including interpretive changes, must go through\nthe Administrative Procedure Act public notice\nand comment process (Conn, 2016). Because of this ruling, OSHA was able to issue its new interpretation\n 5\nwithout soliciting publi"] [2.101820707321167, 19.76797103881836, "ndards Board, 2016). The American Petroleum Institute (API), for example, argued that RAGAGEP are broader than \u201cestablished codes, standards, published techni-\ncal reports or recommended practices\u201d (California Occupational Safety and Health Standards"] [2.1022307872772217, 19.768964767456055, "ndustries.\nDistribution of RAGAGEP Knowledge\nDo you keep a comprehensive list of all the RAGAGEP that you use to comply with the PSM standard? Responses to this question were con- sistently that they do not. Refinery representatives stated that there"] [2.102071523666382, 19.768491744995117, "at\nthey weren\u2019t sure that they did it very well. Others pointed to equipment manufacturers\u2019 specifications and installation documentation. However, as one par- ticipant pointed out, the link between manufacturers\u2019 specifications, installation documen"] [2.100599527359009, 19.766761779785156, "ng to demonstrate that an alternative approach is more protective than RAGAGEP.\n 8\nInterpretation of Should in RAGAGEP\nHow do you interpret portions of RAGAGEP that are preceded by the terms should or should not? The protest and rapid rescindment of "] [2.1206376552581787, 19.788217544555664, "st contentious aspect associated with RAGAGEP. Four of the six refinery representatives felt strongly that excluding internal standards was ill-advised and problematic. Participants emphasized that industry is innovative and that there are instances "] [2.102797508239746, 19.76905059814453, "AGEP and provided several suggestions for changes. We have summarized these concerns and suggestions here.\nThe internal standards issue emerged as the one of most concern. Four different refinery industry representatives emphasized that excluding int"] [2.1099154949188232, 19.771516799926758, "s. In both cases, participants claimed that standards development committees are unbalanced, though in different ways. Two participants claimed that API committees are dominated by production industry representatives (technology users), while the oth"] [2.1033661365509033, 19.77000617980957, " researchers, labor representatives, and other stakeholders). To facilitate community-wide consistency and quality and to ensure the safety of workers and neighboring popula- tions, these communities work together to develop standards, codes, and oth"] [2.1016173362731934, 19.767736434936523, "of RAGAGEP directly by including a definition in the proposed regulation that explicitly excluded internal standards, although it allowed facilities to use more-protective internal standards instead of RAGAGEP. Industry once again protested, but Cal/"] [2.0987355709075928, 19.763425827026367, "inate the Word Should from RAGAGEP\nOur analysis shows that the fact that some RAGAGEP indicate that certain actions should or should not be followed has created controversy about what is required for compliance. Although should nominally indicates th"] [2.1123275756835938, 19.781023025512695, " dard is more protective than RAGAGEP might be challenging. This challenge is compounded by the fact that many refineries in California have changed ownership multiple times. Internal standards thus reflect multiple owners\u2019 requirements at different "] [2.1040303707122803, 19.77086067199707, " have about the defini- tion or interpretation of RAGAGEP and its application in California\u2019s process safety man- agement standards and what would you sug- gest to resolve these concerns?\n 14\nNotes\n1\n2 For example, RAGAGEP violations were central to "] [2.1019933223724365, 19.76955795288086, "he Supreme Court,\u201d OSHA Defense Report blog, June 9, 2016. As of January 27, 2022: https://oshadefensereport.com/2016/06/09/ osha-engages-in-backdoor-rulemaking-courtesy-of-the- supreme-court/\nContra Costa Health Services, \u201cIndustrial Safety Ordinanc"] [13.846415519714355, 4.604046821594238, " of the term recognized and generally accepted good engineering prac- tices (RAGAGEP), a key element in PSM regulations. The findings are intended to help better align industry and government interpretations and expectations associated with RAGAGEP. "] [13.867063522338867, 4.596156120300293, "inciples.\nRAND\u2019s publications do not necessarily reflect the opinions of its research clients and sponsors. is a registered trademark.\nLimited Print and Electronic Distribution Rights\nThis publication and trademark(s) contained herein are protected b"] [6.578214168548584, 15.992238998413086, " CORPORATION\nJASON M. WARD, RICK GARVEY, SARAH B. HUNTER\nRecent Trends Among the Unsheltered in Three Los Angeles Neighborhoods\nAn Interim Report on the Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) Project\nThe overwhelming "] [6.57943058013916, 15.985971450805664, "and one-third indicated that they were currently on a housing waitlist.\n\u25a0 Around 80 percent of respondents said that they would accept a private room in a shelter or hotel, a per- manent stay in a motel- or hotel-like setting, or permanent supportive"] [6.591869354248047, 15.979215621948242, " and is accompanied by a demographic\n 2\nsurvey, conducted between December and February each year, that is designed to help estimate specific characteristics of the population experiencing home- lessness, including age, gender, race, ethnicity, sexua"] [6.593596458435059, 15.97330093383789, "ilable from the 2020 LAHSA PIT count and demographic survey. After selecting these primary study sites, we settled on a specific geography for each area through a combination of input from ser- vice providers and site assessments by our field work- e"] [6.587375164031982, 15.973428726196289, " the total tabulations in this report but left site-specific enumeration results and survey tabulations to the appendixes.\nEnumeration Study Methodology\nWe conducted counts roughly every two weeks in Skid Row and monthly in Hollywood and Venice.4 We "] [6.590549468994141, 15.966226577758789, "enumeration shift. We do not use any weighting to convert structures and vehicles into larger numbers of individuals, as is done in the LAHSA estimates (Henwood et al., 2020). A quick approximation of\nour count data using the 2020 LAHSA weighting for"] [6.593206882476807, 15.972328186035156, "s of periods of past and current homeless-\nness and residential status among survey partici- pants. We found that the vast majority of respon- dents, 78 percent, have been continuously homeless for a year or more, and 52 percent have been continu- ou"] [6.59113073348999, 15.960307121276855, "ousing since they became home-\n62 12 23\n61 15 22\n2\n66 9 18 2\n59 12 28\n0\n 7\nTABLE 3\nHousing Needs and Preferences of Survey Participants (percentages)\n Need or Preference\nInterested in housing\nCurrently on a waitlist\nOffered housing since homeless in"] [6.583596706390381, 15.981677055358887, "ets. We find corroboration for this general preference in the relatively low levels of respondent interest in group shelters and Bridge housing (i.e., congregate shelters with onsite case management and other services run by the City of Los Angeles)."] [6.591521739959717, 15.95857048034668, "se\nto be surveyed or are passed over by the surveyors because of, for example, concern about safety, have multiple interviewer-perceived observable charac- teristics recorded. These data are then used to con- struct nonresponse weights that are appli"] [6.58720064163208, 15.978423118591309, "re provisional and subject to change as the number of enumerations and the number of survey respon- dents increase. We are continuing both of these efforts and plan to publish an update later in 2022. As noted previously, our enumeration and survey a"] [6.597555160522461, 15.968647956848145, " suggesting that increasing funding for congregate shelters, as has been espoused by some policymakers, might have a limited ability to effectively address street homeless- ness (Galperin, 2020; \u201cLA Councilman Buscaino Seeks Ballot Measure to Prohibi"] [6.594083309173584, 15.972956657409668, "ographic area assessed in the PIT count (see Figure A.1).\nHollywood Geography\nFor Hollywood, we began by assessing the geography used in the recent count conducted by Hollywood 4WRD. We then conducted a site assessment of this area in late September "] [6.591188907623291, 15.974599838256836, "aightforward to identify because of its highly compact geography\u2014a short stretch of San Vicente Boulevard (which runs into Bringham Avenue heading northwest) that bounds the West Los Angeles VA campus to the southwest. Specifically, we enumerated and"] [6.56658411026001, 15.997950553894043, "ugh the more eastern portion of the neighborhood.\nAs mentioned earlier, we alternated our enumer- ation shifts between early morning (approximately\n6 to 9 a.m.) and nighttime (approximately 9 p.m. to 12 a.m.). These both tend to be periods during whi"] [6.581689834594727, 15.975899696350098, "survey shift began at approximately 8 a.m. and comprised two teams of three people who approached individuals on foot. During each visit, staff systematically approached individuals who appeared to be unsheltered and offered them an opportunity to pa"] [6.5779852867126465, 15.964006423950195, " (AM) 11/15/21 (PM) 12/03/21 (AM) 12/15/21 (PM) 12/27/21 (AM) 01/13/22 (PM) 01/26/22 (AM)\nVenice\n10/05/21 (AM)\n11/10/21 (PM) 12/09/21 (AM) 01/03/22 (PM) 01/28/22 (AM)\nVeterans Row 10/06/21 (4 PM)\n10/26/21 (9 AM) 11/18/21\u20132/4/22a\nCars and People Vans\n"] [6.603116512298584, 15.964045524597168, "cific differences. We intend to revisit these differences through a statisti- cal lens in a later report that will have a substantially larger sample of survey respondents.\nTABLE E.1\nFull Demographic Characteristics of Survey Participants (percentage"] [6.59472131729126, 15.967041969299316, "r longer\nDuration at current locationa Less than 3 months\n14\n25\n33\n of the response options. For clarity here, we group categories into broader periods and assume zero \u201cedge cases\u201d (e.g., 12 months exactly).\nTABLE E.3\nHousing Needs and Preferences of"] [6.597080707550049, 15.970549583435059, " 33\n 33\nNOTES: LGBTQ+ = lesbian, gay, bisexual, transgender, queer, or questioning; n = number (sample "] [6.600468635559082, 15.977521896362305, "undant \u201cother\u201d issuea Lifestyle (including drug use)\nLack of income or employment\nLack of support or assistance\n9 23\n(n = 23) 33\n8)\n6)\n29 21 8 4 Discrimination 4 Incarceration history 0\nNeed for special housing (e.g., LGBTQ+) Lack of housing or ineli"] [6.576569080352783, 15.995149612426758, " of HIV/AIDS-related illness, a physi- cal disability, a traumatic brain injury, a developmental disabil- ity, or a physical illness. The tabulated results do not provide data on answers to questions also included in the survey instrument about physi"] [6.499536991119385, 16.134923934936523, "eles, Calif.: Los Angeles Controller\u2019s Office, City of Los Angeles, September 9, 2020.\nHart Research Associates, \u201cLA County Homelessness Survey,\u201d Study 14123a, Washington, D.C., October/November 2021.\nHenwood, Benjamin F., Layan Kaileh, Nicole Wilson"] [6.525016784667969, 16.067270278930664, "meless Shelter,\u201d Los Angeles Times, December 13, 2019.\n\u2014\u2014\u2014, \u201cL.A. Officials Want Answers About Police Rollout at Echo Park Lake,\u201d Los Angeles Times, March 31, 2021.\nSheeley, Kirsten Moore, Alisa Belinkoff Katz, Andrew Klein, Jessica Richards, Fernand"] [6.582051753997803, 16.010536193847656, "resh program, the People Concern, and the St. Joseph Center, also assisted in our efforts. Clementina Verjan at LAHSA allowed us to borrow flashlights for our night enumerations and connected us with helpful individuals at LAHSA and a number of Skid "] [13.85527229309082, 4.621163845062256, " about veterans was funded by the RAND Epstein Family Veterans Policy Research Institute, which was established from a gift by the Daniel J. Epstein Family Foundation to RAND.\nThe RAND Corporation is a research organization that develops solutions to"] [-1.716996669769287, 14.345885276794434, " CORPORATION\nLIAM REGAN, MICHAEL T. WILSON\nDeveloping a Community- Led Certification Process for Facility Power Outage Resilience\nFindings from a Massachusetts Pilot\nStudy\nOn October 27, 2021, a pow- erful extratropical bomb cyclone struck the Mas- "] [-1.7116807699203491, 14.352654457092285, "erim Clean Energy and Climate Plan for 2030 (State of Massachusetts, 2016) to outline actions for achieving its greenhouse gas (GHG) emission reduction targets and develop a state road map for adapting to climate change risks (Executive Office of Env"] [-1.7100423574447632, 14.359777450561523, "ers to some of the findings from Scope 1, which are published under separate cover on MassCEC\u2019s website.1\nWith an influx of funding and greater atten- tion from U.S. federal, state, and local govern-\nments to increase community-scale power outage res"] [-1.7101173400878906, 14.36926555633545, "icy goals for resiliency certifications?\n\u2022 Who are power outage resilience decision- makers and stakeholders? How do they inter- act and share information?\n\u2022 Which qualitative and quantitative resilience metrics best reflect the needs of community, u"] [-1.7134968042373657, 14.359491348266602, "based cli- mate resilience policies and practices, the review was not intended to be systemic or exhaustive but rather targeted academic literature to identify the structural components of high-quality methods and key metrics at the narrow intersecti"] [-1.714309573173523, 14.36981201171875, " rules and guidelines for safeguarding utility workers and the public during the installation, operation, and maintenance of electric supply, communication lines, and associated equipment.\nNFPA 1660 is the standard on community risk assessment, prein"] [-1.7040181159973145, 14.37375259399414, "interviews conducted via Microsoft Teams. We conducted a total of 12 focus groups represent- ing 13 organizations between August 20, 2020, and March 12, 2021 (see Table 2).\nTABLE 2\nFocus Group Participants\nOrganization Type\nCLEAR community CLEAR comm"] [-1.707960844039917, 14.3805513381958, "pass the entirety of the disas- ter life cycle events. We then used a full life cycle model of a value chain to design the certification to maximize inclusivity of projects in different stages of development (Linkov et al., 2020) and measure facility"] [-1.7123010158538818, 14.381623268127441, "2022 and initiated the process with a group kickoff meeting in which we presented an overview of the certification forms and a summary\nof the results from the literature review and focus groups. MassCEC actively encouraged participation but offered n"] [-1.7190998792648315, 14.361610412597656, "goals for com- munity power outage resilience, in part a function\nof wide variation in definitions of power outage resilience. In addition, determining the conceptual models behind these goals was challenging due to the mixture of qualitative and qua"] [-1.7566944360733032, 14.22078800201416, "t of Power Outage Resilience\nOur literature and existing certification review found no singular metric for determining a facility\u2019s power outage resilience. These metrics, traditionally quanti- tative, allow for the performance of weak and strong are"] [-1.7131164073944092, 14.380589485168457, "etter warn- ings, reduced vulnerability, and greater prevention of disaster for subsequent disasters (FEMA, undated).\nCommunity Power Outage Resilience Goals Should Address Multiple Dimensions\nLiterature review and stakeholder focus groups identified"] [-1.7187440395355225, 14.3715238571167, "thout the requisite back- ground and might not be necessary depending on the goals of the facility owner or operator. In con- trast, if a user does not have an asset they are trying to assess and are rather examining a facility holisti- cally, they c"] [-1.7074843645095825, 14.378079414367676, " al., 2019). Focus group participants and MassCEC confirmed our analysis that the greatest proponent equities would lie in the facility owner or operator\u2019s ability to define critical loads and specify islanding capability. In addition, because of the"] [-1.7220673561096191, 14.366898536682129, "erein the \u201cquality of local leadership is . . . often as important as understanding community-wide adaptation processes\u201d\u2014in this case, that of power outage resilience (Wilson, 2013).\n 12\nUtilities and Customers Have Low Tactical Visibility into Each "] [-1.722777247428894, 14.328377723693848, "d another par- ticipant said that it is \u201cup to [the] customer to take [on] strategies that will not lose power.\u201d\nThere Are Novel Resilience Considerations for Emergency Response Planning to Address Inequities Arising from Generation-to-Outage Path Op"] [-1.701587200164795, 14.403446197509766, "response framework (see Figure 4). For\nexample, within the mitigation stage, the facility\u2019s deterministic (Panteli and Mancarella, 2015) or expected (Ji, Wei, and Poor, 2017) recovery dura- tion via the Critical Load Summary is a requested input to t"] [-1.6841130256652832, 14.40417766571045, " life and not only during a power outage event. The other interviewee discussed how the certification had triggered a network of additional conversations among the facility\u2019s staff and the stakeholders to encourage broader opera- tional preparedness "] [-1.7049400806427002, 14.378708839416504, "rag-\ning the data created through the process, but one\nof the interviewees mentioned that the certification would have been less burdensome if the pilot had been issued and executed in parallel with the Scope 1 assessments to gain the efficiencies fr"] [-1.7119615077972412, 14.37420654296875, "o fund this study to assess, develop, and pilot a power outage resilience certification. As our findings illus- trate, at present, there are substantial limitations to this approach, many of which stem from governance considerations raised by the foc"] [-1.703978419303894, 14.390006065368652, "to identify climate hazards, assess vulnerabilities, and develop action plans to improve resilience to climate change. Although MVP has demonstrated the statewide planning latitude necessary to administer and govern a power outage resilience certific"] [-1.707853078842163, 14.367817878723145, "ry regulatory policy can produce greater program participation and improve- ment than a voluntary program (Lyon and Maxwell, 2007). In this pilot phase, the CLEAR program issued the power outage resilience certification as\na voluntary program with in"] [-1.6848996877670288, 14.39042854309082, "ow much resilience the project\u2019s certifica- tion process would have given the community. How- ever, the \u201cn-of-one plus some\u201d method allowed us to explore significant gaps and incongruencies in the resourcing, planning, and understanding of power outa"] [-1.7085645198822021, 14.390729904174805, "ch could incentive underresourced communities to participate in the planning process. The administrative organization would need an equitable mechanism to decide which communities, outside of an application-based pro- cess, might a priori benefit fro"] [-1.710483193397522, 14.349166870117188, "d communities, represented by an effective, efficient, and equitable power outage resilience initiative.\n 19\nFIGURE 5\nJustice40 Initiative Census Tracts for Disadvantaged Clean Energy, Energy Efficiency, and Climate Change Communities\nSOURCE: Climate"] [-1.7045249938964844, 14.39598560333252, "nfrastructure Systems Model, OAT = Opportunity Assessment Tool, PCVA = Participatory Capacity and Vulnerability Analysis, PREP = Partnership for Resilience and Preparedness, QRE = Quick Risk Estimation, RAPTA = Resilience, Adaptation Pathways and Tra"] [-1.7069448232650757, 14.392010688781738, "cation?\n3. Have there been efforts prior to the CLEAR program to develop a resilience certification (or other certifications)?\n4. Were you aware of any public or private offerings for resilience certifications prior to issuing the RFP?\n5. Are there a"] [-1.686632513999939, 14.437360763549805, "iliency and reliability?\n 24\nAppendix C. Massachusetts Clean Energy Center Power Outage Resilience Certification Pilot Program\nThis appendix contains reproductions of the pilot power outage resilience certification forms, beginning on the following p"] [-1.6874936819076538, 14.453614234924316, "rk Phase Documentation\nX1 X2\nA1\nA2\nA3\nA4\nA5\nA6\nA7 A8 A9\nB1\nB2 B3\nC1 C2\nD1 D2\n Mitigation\nRecovery Response Preparation\nPower Asset Identification and Description\nUtility Interconnection Agreement Critical Load Summary\nCri"] [-1.6951144933700562, 14.438904762268066, "ration asset supporting the critical load? \u2610 Yes \u2610 No\ni. Is the generation asset interconnected with the power grid? \u2610 Yes \u2610 No\nii. If Yes, name the interconnected utility:\n b) Has a critical load evaluation been performed on this facility? \u2610 Yes \u2610"] [-1.6941848993301392, 14.441166877746582, "me (First, Last):\nForm Completion Date (MM/DD/YYYY):\n Applicant Official Title: CRITICAL LOAD EVALUATOR\n 2.\nDate of Critical Load Evaluation Completion (MM/DD/YYYY):\n Critical Load Evaluator Name: Organization Name: Critical Load Address - Str"] [-1.685074806213379, 14.449776649475098, "e any special power outage needs to maintain operations? \u2610 Yes \u2610 No i. If Yes, describe:\n Applicant Notes:\n You have completed Form A4. Continue to Form A5.\n 32\n SYSTEM ONE LINE DIAGRAM\nFORM A5\nInstructions: Applicants must complete this form "] [-1.6863070726394653, 14.446438789367676, "\n City:\n State:\n Zip Code:\n Operations and Maintenance Agreement Execution Date (MM/DD/YYYY):\n 4. OPERATIONS AND MAINTENANCE POINT OF CONTACT Instructions: Designate a facility point of contact responsible for the power asset\u2019s operations and\nm"] [-1.686851143836975, 14.445047378540039, "there are multiple\nmethods of fuel procurement, duplicate this form to provide information on the other procurement methods.\n b) Does this facility receive fuel in a method other than utility interconnection? \u2610 Yes \u2610 No i. If Yes, by which method is"] [-1.687055230140686, 14.452577590942383, ".If Yes, attach supplementary fuel storage documentation to this form and proceed to\nSection 3.\nii.If No, proceed to Form B1.\n 3. FUEL STORAGE OVERVIEW\n Fuel Storage Name:\n Storage Manager Name:\n Storage Manager Position:\n Phone Number:\n Emai"] [-1.6819446086883545, 14.452707290649414, "he facility require heating, cooling, or lighting to properly operate? \u2610 Yes \u2610 No\nh. Are there security systems that rely on power to operate? \u2610 Yes \u2610 No\ni. Does the facility have handicap or disability systems that rely on power to\noperate? \u2610 Yes \u2610 "] [-1.6316804885864258, 14.506523132324219, "ent Title:\n Roles and Responsibilities Development Date:\n Facility Outage Manager Name:\n Manager Position:\n Phone Number:\n Email Address:\n Facility Outage Manager Responsibilities:\n Power Asset Manager Name:\n Manager Position:\n Phone N"] [-1.6825710535049438, 14.453900337219238, "he Emergency Response Plan Checklist incorporates procedures for the following action\ntypes:\ni.\u2610 Emergency Notifications or Communication Plans\nii.\u2610 Power Asset or Generator Management iii.\u2610 Fuel Management\niv.\u2610 Facility Power Consumption Management\n"] [-1.6861889362335205, 14.4489107131958, "lated to power outages? \u2610 Yes \u2610 No\ni.If Yes, attach the after action report to this form for application submission, complete\nSection 3, and proceed to Form D2.\nii.If No, either develop an after action report aligned with best management practices an"] [-1.6857186555862427, 14.451904296875, "ation Plan Description:\n You have completed Form D1. Continue to Form D2.\n 48\n DAMAGE REPORT\nFORM D2\nInstructions: Applicants must review this form with all relevant damage report information and provide supplemental documentation. This form is t"] [-1.69171941280365, 14.437858581542969, "the damage prior to filling out this report? \u2610 Yes \u2610 No If Yes, has the utility developed a plan for responding to and repairing the damage? \u2610 Yes \u2610 No\n Damage Description:\n Applicant Notes:\n You have completed Form D2. Review all forms prior t"] [-1.6960278749465942, 14.344038963317871, "criteria that stakeholders considered important to a power outage resiliency certification. In recognition of this list\u2019s deficiencies, we bolstered the list with exhaustive records of energy and power outage resiliency metrics from the literature (W"] [-1.7267848253250122, 14.224078178405762, "dris, \u201cPower System Resilience: Current Practices, Challenges, and Future Directions,\u201d IEEE Access, Vol. 8, 2020, pp. 18064\u201318086.\nBie, Zhaohong, Yanling Lin, Gengfeng Li, and Furong Li, \u201cBattling the Extreme: A Study on the Power System Resilience,\u201d"] [-1.704978585243225, 14.23611068725586, " England Becoming More Extreme? Statistical Analysis of Extreme Rainfall in Massachusetts, New Hampshire, and Maine and Updated Estimates of the 100-Year Storm,\u201d Journal of Hydrologic Engineering, Vol. 16, No. 3, 2011, pp. 203\u2013 217.\nDouglas, Ellen M."] [-1.7160395383834839, 14.280624389648438, ", and Aseem Prakash, \u201cIncentivizing Self\u2010Regulation: Federal vs. State\u2010Level Voluntary Programs in US Climate Change Policies,\u201d Regulation & Governance, Vol. 6, No. 4, 2012, pp. 445\u2013473.\nHussain, Akhtar, Van-Hai Bui, and Hak-Man Kim, \u201cMicrogrids as a"] [-1.7551865577697754, 14.154572486877441, "pment as a Strategy for Community-Driven Development,\u201d Development in Practice, Vol. 13, No. 5, 2010, pp. 474\u2013486.\nMukhija, Vinit, \u201cN of One Plus Some: An Alternative Strategy for Conducting Single Case Research,\u201d Journal of Planning Education and Re"] [-1.76400887966156, 14.191290855407715, "atellite-Based Assessment of Electricity Restoration Efforts in Puerto Rico After Hurricane Maria,\u201d PLOS ONE, Vol. 14, No. 6, 2019, article e0218883.\nRusco, Frank, Electricity Grid Resilience: Climate Change Is Expected to Have Far-Reaching Effects a"] [-1.723096251487732, 14.253509521484375, "h National Climate Assessment, Vol. I, Washington, D.C.: U.S. Global Change Research Program, 2017.\nXDI, \u201cAdaptInfrastructure,\u201d webpage, undated. As of March 8, 2022:\nhttps://xdi.systems/xdi-platform/adaptinfrastructure/\nZamuda, Craig D., Thomas Wall"] [-1.678951382637024, 14.395149230957031, "tly community power outage resil- ience is and identify methods to assess effectiveness and certify whether plan- ning actions and project implementations have made communities resilient. For example, existing research on power outage resilience is p"] [13.861103057861328, 4.604579925537109, "ehavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflict"] [13.579721450805664, -2.2980029582977295, " Los Angeles County\u2019s Preparedness for California\u2019s\nEdible Food Recovery Mandate (SB 1383): An Examination of Food Recovery Logistics and Other Challenges\nAlina I. Palimaru, Joslyn Fleming, Jay Balagna, Marcy Agmon Marc Robbins, Sarah B. Hunter\n CO"] [13.578624725341797, -2.2976300716400146, "80 / Motion Array; P. 17: Pelagija / Motion Array;\nP. 18: Claudio Divizia / Motion Array; P. 19: Anastasiya / Motion Array; Food Recovery logo, illustrations, and original layout: courtesy of Glory Film Co. Philanthropy.\n Two Separate Problems, One P"] [13.580191612243652, -2.2991509437561035, "for human consumption by 2025.\u201d10\nThe law is being implemented through a progressive schedule by local jurisdictions, such\nas cities or counties.12 Jurisdictions are ultimately responsible for implementing edible food recovery\nprograms and ensuring c"] [13.580766677856445, -2.2988059520721436, " stores, and 90,000 restaurants,13 though not all meet the size criteria for edible food recovery requirements.12 There are also at least 800 FROs.13 Within each jurisdiction, some organizations must comply beginning on January 1, 2022 (Tier 1), whil"] [13.581385612487793, -2.298663377761841, " charts logistical considerations from the moment donated food leaves EFGs to the point of delivery to recipients: i.e., HSAs and individual consumers). Organizational flexibility to collect, receive, store, sort, process, and distribute different fo"] [13.580459594726562, -2.2991180419921875, "ding streams\n4. Interorganizational relationships: disincentives to collaborate and lack of coordination\nPractice: Consider funding that is better suited to food recovery.\nPractice: Explore how funding models can incentivize interorganizational colla"] [13.580833435058594, -2.29917573928833, "ainties of other donated food: for example, cooked food or seasonal variations in perishables. For these organizations, an increase in small\ndonations would be disruptive to the scale of existing workflows. Smaller organizations, on the other hand, a"] [13.5831298828125, -2.2973220348358154, " is needed to acquire capital assets and human resources; per statute, SB 1383 gives jurisdictions the authority to charge and collect fees to recover the local jurisdiction\u2019s costs incurred in complying with the regulations.10 Several jurisdiction-l"] [13.583586692810059, -2.2976279258728027, "r\nfood recovery program, including exploring opportunities to support FROs and FRSs and match EFGs with FRSs and FROs. Others were considering contracting with nonprofit agencies to run their food recovery program. Each jurisdiction will have its own"] [13.581486701965332, -2.299165964126587, ", individual FROs working\non their own with multiple EFGs, or (in some\ncases) both. The second issue was the reporting requirement at the jurisdiction level, since many FROs, FRSs, and EFGs operate across jurisdictions and, in some cases, across mult"] [13.579910278320312, -2.298832893371582, "emit (most often, waste management). Some of the aspects of\nSB 1383, such as food recovery, were seen to be outside their traditional competence, requiring jurisdictional agencies to learn and understand the motivations of FROs and EFGs.\n8 | System C"] [13.580288887023926, -2.2990143299102783, "and geographic scope of this review may preclude a more robust set of recommendations, the data suggest the following potentially actionable observations at this\ntime that all stakeholders should consider (see Figure 5):\n17\n \u2022 Consider funding model"] [13.579745292663574, -2.2988040447235107, "eemptive waste avoidance at the food retail level.\nAlthough we interviewed only Tier 1 participants, many of them will also be involved with Tier 2 implementation, including FRSs, FROs, HSAs, and jurisdictions. Some of their suggestions point to the "] [0.9129103422164917, 12.268133163452148, "d Management, Vol. 25, No. 4, Fall 2006, pp. 921\u2013942.\n10. Short-Lived Climate Pollutants: Methane Emissions: Dairy and Livestock: Organic Waste: Landfills, California Senate Bill 1383, 2016. As of May 31, 2022: https://leginfo.legislature.ca.gov/face"] [13.579431533813477, -2.2989001274108887, "20-08/business-case-for-reducing-food-loss-and-waste.pdf\n25. Let\u2019s Get Healthy California, \u201cWaste Not OC Coalition: Ending Hunger in Orange County,\u201d webpage, undated. As of April 23, 2022: https://letsgethealthy.ca.gov/innovation-challenge/how-to-mak"] [17.421798706054688, 6.9129438400268555, " Intimate Partner Abuse Solution\nPrograms\nIdentifying High-Priority Needs Within the Criminal Justice System for Programs Focused on Intimate Partner Violence Prevention\nLynn Langton, Madison Fann, Duren Banks, Michael G. Planty, Dulani Woods, Michae"] [17.425655364990234, 6.906222343444824, "er with multiple sectors across the community should be developed and implemented.\nProgram implementation\n\u2022 Rigorous research should be conducted that includes out- comes that are not just recidivism, are informed by survivor voices, and are most rel"] [17.426050186157227, 6.906475067138672, "ms are implemented and whether best practices vary across different types of partici- pants; (3) ensure that programs are not operating in isolation from community and advocacy groups; and (4) employ research strategies that shed light on best practi"] [17.423789978027344, 6.9063262939453125, "scope of measures that should be used to assess success creates addi- tional challenges for researchers attempting to determine whether IPAS programs are effective at addressing IPV.\n\u2022 Findings from IPAS program research are not often trans- lated fo"] [17.414993286132812, 6.9271135330200195, "ogram models that are most com- monly used: the Duluth Model and cognitive behavioral therapy (CBT) interventions. These programs are described next, but many IPAS programs combine elements from each of the different models, and it is rare for any pr"] [17.42299461364746, 6.921191692352295, "g the workshop\u2014 because it is consistent with the nature and focus of these programs. Accordingly, we use IPAS participants to refer to the perpetrators who engage in the programs. However, it should be noted that there was not consensus on officiall"] [17.412208557128906, 6.924191951751709, "iolent recidivism and \u201cpromising\u201d for reducing victimiza- tion and the CBT model as having \u201cno effects\u201d on recidivism or victimization (NIJ, 2013b). However, specific CBT pro- grams\u2014such as Evolve, which operates in Connecticut, and Strength at Home "] [17.42339324951172, 6.904239177703857, "olent offenders? If so, how?\n\u2022 What evaluation designs, data collection approaches, and other methods can provide the most-rigorous and action- able findings related to IPAS programs? What are the barri- ers to implementing those methods?\nMETHODOLOGY"] [14.913189888000488, 2.022113561630249, "interviews, RTI staff drafted a list of about 30 specific needs. In the context of the PCJNI, a need refers to the pairing of a potential solution to a problem or an opportunity for advancing promising innovations.\nDuring the second stage of the work"] [17.42584991455078, 6.906084060668945, "d on the same problem or opportunity could be ranked or categorized differently through their perceived impact and likelihood of success, meaning that not all needs associated with a certain problem or opportunity were ranked in the same tier.\n Table"] [17.42473793029785, 6.906672477722168, "t innovative approaches to engage and actively partner with multiple sectors across the community, including victim advocacy services, public health, medical service providers, faith communities, and university research partners.\nDirect more programm"] [17.42146110534668, 6.910121440887451, "mandate clients to participate and the clients are required to pay for the program.\nPrograms are limited by a lack of information from survivors about ongoing interactions with the participant.\nPotential Solution\nConduct rigorous research that includ"] [17.399925231933594, 6.9075398445129395, " are tough to implement in some contexts.\nRCTs are tough to implement in some contexts.\nResearch findings are not always framed for practitioners and are therefore either not used or misinterpreted.\nResearch findings are not always framed for practit"] [17.425649642944336, 6.906334400177002, "r context from the workshop discus- sion on the high-priority needs for advancing our understand- ing of the effectiveness of and how best to implement IPAS programs. Statements in this section are derived from assertions made by workshop panelists a"] [17.426738739013672, 6.904548645019531, "s avail- able research and information about both risk and protective factors and trauma-informed care practices that could form the foundation of IPAS programming. However, because such information is not widely available to practitioners, there is "] [17.424924850463867, 6.906620025634766, "should be conducted to assess outcomes in addition to recidivism, such as measures related to survivors\u2019 satisfaction and safety.\nThe next key challenge discussed was that most IPAS programs do not provide any aftercare or follow-up with participants"] [17.426305770874023, 6.90654182434082, "Finally, panelists shared that when desired outcomes are not achieved in IPAS programs, it is difficult to determine whether that is a result of a problem with the program model, the model implementation, or another factor that could be completely ex"] [17.42278480529785, 6.9072794914245605, "nism. Similarly, participants also noted the challenge that IPAS programs often operate in isolation from other community and criminal justice responses. Participants discussed that IPAS programs are often too dependent on the courts for referrals, a"] [17.42374038696289, 6.907330513000488, " IPAS programs. For starters, research findings may not be generalizable because of the many conceptual and logistical variations in IPAS programs. Panel- ists noted that some programs may claim to be using a certain model but are only implementing s"] [17.42216682434082, 6.912708282470703, "hers, practitioners, and other stakeholders to identify and implement approaches to measure success that go beyond binary measures of program completion or recidivism. Potential measures of success raised in the discussion were impacts on survivors, "] [14.967058181762695, 2.0459883213043213, "presented in the main report. The descriptions here are drawn and adapted from previous PCJNI publications and reflect the adjustments to the needs identification and prioriti- zation process implemented at this workshop.\nWorkshop Scope and Panel Sel"] [14.93993091583252, 1.9461679458618164, "unities to improve performance by adopting or adapting a new approach or prac- tice (e.g., applying a new technology or tool in the sector that had not been used before). After identifying and refining the needs, we used a voting process based on the"] [14.84695816040039, 1.8370219469070435, "ential solutions that they had previously identified. The panelists\u2019 combined lists for each topic were displayed one by one on the screenshare portion of Zoom using Microsoft PowerPoint slides that were edited in real time to incorporate participant"] [14.788684844970703, 1.7472859621047974, " we multiplied the final (second-round) ratings for importance and probability of success to produce an expected value. We then calculated the median of that product across all of the respon- dents and used that as the group\u2019s collective expected val"] [14.782711029052734, 1.697482943534851, "ne the point value of a single vote,\nwe divided the full range of expected values by the number of participants voting.\nTo prevent the (somewhat rare) situation in which small numbers of votes have an unintended outsized impact\u2014for example, when some"] [14.781407356262207, 1.7005689144134521, "not physical violence, does not necessarily occur between intimate partners, and should be inclusive of interventions, treatment, or both that are trauma-informed and comprehensive enough to enable funding or other resources from multiple sources.\nIs"] [14.782567024230957, 1.7009228467941284, "ht) the round 3 votes were applied. In many cases, the round 3 votes increased the calculated score of needs (their expected value) enough to move them into a higher-priority tier.\n Tier 1 Tier 2 Tier 3\nRound 2\n Round 3\n 15\n 20 40 60 8020 40 60"] [17.426231384277344, 6.905405521392822, "cing conditions, such as structural inequality), and develop innovative and sustainable solutions for addressing these different contexts and different motivations.\nDevelop and implement innovative approaches to engage and actively partner with multi"] [17.42283058166504, 6.906604766845703, "ure that it is implemented as designed and there is a fully funded RCT evaluation to assess its effectiveness.\nConduct rigorous research that includes outcomes that are not just recidivism, are informed by survivor voices, and measure the outcomes th"] [17.42255973815918, 6.904959678649902, "programs, research findings may not be generalizable.\nRCTs are tough to implement in some contexts.\nPotential Solution Tier\nDevelop guidance and training on program implementation that follows a specific, evidence-informed theory of change and mainta"] [17.419872283935547, 6.909714221954346, " are using different theoretical models (and are already being used).\nTranslate research and evaluation findings into digestible documents written for and disseminated to practitioners.\nRequire that funded research develop and follow a plan for resea"] [17.420129776000977, 6.911185264587402, " factors affect participation (e.g., opportunities related to approaches that only became realistic when the pandemic occurred).\nWhen desired outcomes are not achieved, it is difficult to know whether that is a result of a problem with the program\u2019s "] [17.42490005493164, 6.904052734375, "ecause of the many conceptual and logistical variations in IPAS programs, research findings may not be generalizable.\nRCTs are tough to implement in some contexts.\nPrograms are typically designed around or required to follow a prescribed approach.\nSy"] [17.424951553344727, 6.908215045928955, ".\nLook to other disciplines, practitioners, and IPAS program participants to identify and adapt sustainable funding models, including allowing for insurance funding of these programs.\nDevelop technology to support engagement and offer a variety of op"] [17.405717849731445, 6.9283127784729, "pproaches.\nImplement fatherhood programs more widely as a source of referrals.\nProvide programs with funding for conducting community outreach; establishing earlier contact with people who commit IPV; and maintaining contact with perpetrators, family"] [17.360666275024414, 7.025125980377197, "e Review and Recommendations for Next Steps, Pittsburgh, Pa.: University of Pittsburgh, March 2011.\nCotti, Chad, Joshua Foster, M. Ryan Haley, and Shannon L. Rawski, \u201cDuluth Versus Cognitive Behavioral Therapy: A Natural Field Experiment on Intimate "] [17.367536544799805, 7.002554893493652, "020: https://www.rand.org/pubs/research_reports/RR820.html\nMills, Linda G., Briana Barocos, and Barak Ariel, \u201cThe Next Generation of Court-Mandated Domestic Violence Treatment: A Comparison Study of Batterer Intervention and Restorative Justice Progr"] [13.923069953918457, 4.21317720413208, "men, who assisted with the development of the workshop and identification of panelists. Finally, the authors acknowl- edge the valuable contributions of the peer reviewers of the report, Coreen Farris of RAND and Julia C. Babcock of the University of"] [13.918379783630371, 4.179144382476807, "Maryland. He holds an M.S. in agricultural economics (applied economics).\nMichael J. D. Vermeer is a physical scientist at RAND. His expertise covers topics related to science and technology policy, criminal justice, national security, cybersecurity "] [13.89631175994873, 4.249092102050781, "J. D. Vermeer, Duren Banks, Dulani Woods, and Brian A. Jackson, Counter- ing Technology-Facilitated Abuse: Criminal Justice Strategies for Combating Nonconsensual Pornography, Sextortion, Doxing, and Swatting, Santa Monica, Calif.: RAND Corporation, "] [16.054826736450195, 10.390756607055664, "Just in Reach Pay for Success\nImpact Evaluation and Cost Analysis of a Permanent Supportive Housing Program\nSARAH B. HUNTER, ADAM SCHERLING, MATTHEW CEFALU, RYAN K. MCBAIN\n Sponsored by Corporation for Supportive Housing\n CORPORATION\nFor more informa"] [16.009708404541016, 10.457574844360352, "uded individuals diverted by the Office of Diversion and Reentry and placed into housing over the course of two years, from October 2017 to September 2019. In this report, we provide information about program implementation, including housing placeme"] [16.05004119873047, 10.406315803527832, " Costello and others at the Corporation of Supportive Housing were instrumental to our project. We also thank the members of the Just in Reach Pay for Success Executive Steering Committee who reviewed drafts of this report. This report would not have"] [16.072540283203125, 10.441373825073242, "to provide an overall picture of the intervention\u2019s benefits and costs to Los Angeles County.\nWhile sample sizes are too small to meaningfully analyze causal program effects by race/ethnicity, we do examine housing stability over time across racial/e"] [16.069372177124023, 10.439314842224121, "lso examined whether the results were different among the JIR PFS participants who were housed for at least 12 months (82 percent of the sample) and found that the results were relatively similar, except that the reductions in jail days increased to "] [16.069984436035156, 10.435430526733398, "side of the scope of the JIR PFS initiative. This transitional period includes interim housing and related supports, which we describe in this report in order to provide a more holistic view of the broader ODR housing program in which the JIR PFS pro"] [16.087976455688477, 10.443023681640625, "rvice costs are likely accounted for in our analyses, policymakers may consider the significant savings associated with PSH, primarily to the Los Angeles County jail and secondarily to the inpatient and emergency health care systems. The study result"] [16.07147216796875, 10.453436851501465, "....................................................................................11\nChapter 3. Results..........................................................................................................................14 Enrollment ........."] [16.084674835205078, 10.458137512207031, "19 Figure 3.2. Proportion of JIR PFS Participants Who Remained in PSH over Time, by Race\nand Ethnicity..........................................................................................................................25 Figure C.1. Percentage "] [15.890995979309082, 10.239642143249512, "..........................51 Table D.7. Estimated Service Use in the Post-Housing Year 1 Period by Treatment Group .......52 Table D.8. Estimated Service Costs in the Post-Housing Year 1 Period by Treatment Group.....53\n x\nTable D.9. Estimated Averag"] [15.872809410095215, 10.121264457702637, " Institute, 2020). Recidivism rates throughout California over the past decade have remained close to 50 percent (California Department of Corrections and Rehabilitation, 2019).\nRecidivism and Housing\nA broad body of research shows that lack of stabl"] [15.819616317749023, 10.45119571685791, "ing physical and mental health conditions are likely to suffer even worse health outcomes as a result of housing insecurity. Compared with the general U.S. population, individuals experiencing homelessness are more likely to suffer from unmanaged chr"] [16.062665939331055, 10.355817794799805, "ically, PSH program costs range from $10,000 to $30,000 per person annually (Hunter et al., 2017), with programs in California on the higher end of this spectrum because of housing costs.\nHomelessness is also associated with social service and justic"] [16.088939666748047, 10.421638488769531, "ate- sector entities invest funds for a project, and these funds have the potential to be paid back\u2014with interest\u2014by the government once specific milestones are achieved, such as improved client outcomes. This framework has the potential to create a "] [16.081005096435547, 10.422676086425781, " matched comparison group to examine differences in service use and associated costs prior to jail release and after JIR PFS PSH entry. We also examined the program effects for the subgroup of participants who remained stably housed in PSH for at lea"] [16.07897186279297, 10.440939903259277, "he organization\u2019s institutional review board.\nAs an initial step, we summarized demographic characteristics among program enrollees and examined enrollees\u2019 progression through key program milestones, including jail release and JIR PFS program entry. "] [16.089656829833984, 10.467300415039062, "individual to be placed into PSH. Over the course of the two-year period, 349 individuals were placed into the JIR PFS program. Thirteen of these individuals were excluded from this analysis for one of the following two reasons, leaving a treatment g"] [16.080121994018555, 10.415506362915039, " use data were provided from these agencies to the CIO and then (in turn) provided to us.\nSpecifically, we received data on health service use and costs provided by DHS, mental health service use by DMH, substance use treatment services by the LA Cou"] [16.075428009033203, 10.423715591430664, "ousing support and intensive case management services. Regarding housing, clients were provided with a housing rental subsidy through LA County\u2019s Flexible Housing Subsidy Pool (Los Angeles County Department of Health Services, undated), a locally fun"] [16.092044830322266, 10.441368103027344, " outcomes for the treatment group (i.e., what the treatment group outcomes would have been, if program participants had not been enrolled in JIR PFS), which avoids potential confounding caused by the balanced covariates.\nPrior to performing the prope"] [16.073802947998047, 10.417071342468262, "y), and other selected variables. This allowed us to determine whether program enrollment led to more (or less) service use and costs relative to the matched comparison group. We also modeled binary outcome variables indicating the use of homeless se"] [16.092500686645508, 10.454056739807129, "days in an interim housing setting (range: 44\u20131,068 days), where they received medication management and onsite clinical supervision prior to placement in PSH. As noted earlier, all JIR PFS participants were enrolled within a two-year period, between"] [16.1868896484375, 10.529373168945312, "ng temporary forms, such as emergency shelter, hotel/motel voucher, rapid re-housing or transitional housing, as well as more permanent forms, such as receipt of a housing subsidy/voucher) was fewer than ten for both groups and was not statistically "] [16.13042449951172, 10.39869499206543, "ic\nJustice LASD\nProbation Homeless services\nHousing DHS\nInpatient Emergency Outpatient\nDMH Inpatient\nCrisis stabilization\nOutpatient Total cost\nTreatment Mean (SD)\n$108,881 ($51,810) $444 ($685)\n$513 ($2,074)\n$1,805 ($10,552) $1,012 ($2,479) $312 ($1"] [16.09650421142578, 10.436075210571289, " average total costs for JIR PFS participants in the one-year post-housing period remained relatively stable to the transition period costs ($55,377 for the post-housing period and $56,254 for the transition period; see Appendix D). However, the JIR "] [16.092496871948242, 10.445545196533203, "avings of $1,643 per participant.\nWe also found a significant increase among JIR PFS participants related to the PSH costs. Specifically, in the first year of the program, there was an average increase of 336 days of PSH among the treatment group, re"] [16.083637237548828, 10.443928718566895, ".001 (330.88, 341.96)\n0.47 (\u20130.16, 0.35)\n0.03 (\u20131.49, \u20130.06)\n0.004 (\u20130.53, \u20130.10)\n<0.001 (15.58, 26.12)\n0.01 (\u20134.27, \u20130.47)\n0.11 (\u20130.39, 0.04)\n\u2013\n(SE)\n\u2013$16,891 ($4,609)\n$672 ($72)\nNA Shelter/temporary \u20130.22 <0.001 \u2013$1,643\nSignificance (95% CI)\n<0.001 "] [16.083044052124023, 10.457130432128906, "up, the net total cost per participant in JIR PFS was $13,773 in the first year (see Appendix D; Table D.9) and $11,535 in the second year, with the former statistically significant at the 0.05 level and the latter not statistically significant.\n22\n "] [16.061634063720703, 10.469161987304688, "ree years after PSH placement. We note that the Hispanic and other race/ethnicity groups begin losing individuals from PSH immediately after PSH placement, and this pattern is not observed among Black or White participants. The difference in the prop"] [16.092248916625977, 10.436407089233398, " for jail costs and overall costs; in both models, this interaction term was negative, large (nearly $30,000 per year), and not statistically significant. In essence, since only a small portion of the outcome period overlapped with COVID-19, there is"] [16.02383804321289, 10.490213394165039, " first year post-housing placement were offset by cost decreases in other areas.\n 27\nWe also performed a sub-analysis examining only participants who maintained housing for the full 12-month post-PSH placement period to determine whether there were a"] [16.028820037841797, 10.421403884887695, "rtant to put these findings into context with other recent PFS and supportive housing initiatives, including those in Santa Clara County, California (Raven, Niedzwiecki, and Kushel, 2020), and Denver, Colorado (Cunningham et al., 2021; Gillespie et a"] [15.9745454788208, 10.406588554382324, "l participants assigned to the treatment were housed and not all participants assigned to the control group were unhoused during the follow-up period, the results from this study suggest that PSH interventions for older, medically fragile individuals"] [16.078357696533203, 10.413498878479004, "ostly health care services were not observed, but there were reductions in emergency shelter and emergency psychiatric care. The Denver initiative focused on a younger, criminal justice\u2013 involved population receiving significant amounts of homeless s"] [16.0596923828125, 10.459012985229492, "rogram should not be the only driver of policy decisions regarding the program\u2019s value. It is inappropriate to apply a standard that PSH should result in cost savings when other social and health interventions do not adhere to the same standard. Nota"] [16.06511878967285, 10.405363082885742, "same time period. Other studies have ignored this in the construction of the comparison group (e.g., see Hollander et al., 2021). By design, this also makes it more challenging to identify a treatment effect because we must account for the drop in us"] [16.205575942993164, 10.331304550170898, "8 per day\n\u2022 ER, medical: $1,784 per encounter\n\u2022 Outpatient, medical: $1,356 per encounter\n\u2022 Inpatient, psychiatric: $2,804 per day\n\u2022 ER, psychiatric: $4,506 per encounter\n\u2022 Outpatient, psychiatric: $1,202 per encounter\n\u2022 Inpatient: $802 per day; Resi"] [16.08094024658203, 10.45982837677002, " from jail into ODR custody, and the PSH move-in and move-out dates. The analytic periods were then defined as follows:\n\u2022 The pre-program period was defined as the 12-month period preceding the release from jail into ODR custody.\n\u2022 The transition per"] [16.07036590576172, 10.363208770751953, "le to the data available on the comparison group members.\nRace/Ethnicity\nThe demographics data provided to us by CIO often included several different race/ethnicity data points per individual, originating from different county agencies or even the sa"] [16.044361114501953, 10.43907642364502, "ent services, a uniform per-diem rate was applied to each event based on the length of time between admission and discharge. If the inpatient discharge date was the same day as the admission date, half the per-diem rate was applied. Inpatient events "] [16.04157829284668, 10.420755386352539, "ate.\nLA Homeless Services Authority\nThe CIO provided us with enrollment data from the LA County HMIS (administered by the LAHSA) representing a variety of housing and non-housing services. The data contained project name, project type, entry date, mo"] [16.072546005249023, 10.459027290344238, " were applied to the probation data by applying a per-diem rate, as described in Appendix A.\n40\nAppendix C. Substance Abuse Prevention and Control Data\nNext, we provide summaries of substance use disorder treatment service use by analytic period (i.e"] [16.191137313842773, 10.529422760009766, "s appendix, we present detailed information about the distributions across the service use and cost variables by treatment group and time periods.\nTable D.1 presents the mean, standard deviations, minimum value, median value, and maximum values on a "] [16.203781127929688, 10.507983207702637, "0 $0 $0 $0 $0\n$0 $0 $0 $0\n$0 $0\n$0 $107,910\nMax\n$239,361 $2063.81\n$16,934\n$135,753 $18,690 $9,953\n$33,736 $33,782\n$27,201 $261,183\nMean (SD) $110,687 ($54,606)\n$603 ($762) $482 ($2,188)\n$1,745 ($12,176) $866 ($2,147) $294 ($887)\n$685 ($2,983) $548 ($"] [16.170682907104492, 10.501226425170898, " D.5. Estimated Annualized Service Costs in the Transition Period by Treatment Group\n Treatment (n = 336) Mean (SD) Min Median\n$9,476 ($24,873) $0 $0 $1,451 ($890) $0 $1,974\n$0 $0 $0\n$926 ($5,474) $0 $0\n$590 ($2,009) $0 $0 $1,021 ($3,173) $0 $0\n$40"] [16.1649227142334, 10.489599227905273, "rison (n = 672)\n Service Use Characteristic\nJustice\nLASD (days)\nProbation (days) Homeless services\nShelter/temporary housing (days)\nDHS\nInpatient (days)\nEmergency (days)\nOutpatient (events) DMH\nInpatient (days)\nCrisis stabilization (events) Ou"] [16.088350296020508, 10.466078758239746, "0, 27.69)\n0.02 (\u20134.99, \u20130.44)\n0.11 (\u20130.43, 0.04) \u2013\n(SE)\n\u2013$21,291($5,017)\n$715 ($79)\nNA \u2013$1,703 ($358)\n$29,576 ($54)\n$59 ($173) \u2013$3,687 ($1,902) \u2013$843 ($276)\n$2,791 ($441) \u2013$1,432 ($548) \u2013$512 ($295) $3,537 ($5,507)\nSignificance (95% CI)\n<0.001 (\u2013$31,"] [16.05213737487793, 10.434264183044434, "ot having received any subsidized permanent housing in the post- period. Treatment effects from a set of linear models analogous to those presented in Table 3.4 were also very similar to the main analysis, and are presented in Table E.1.\nFigure E.1. "] [15.739773750305176, 10.275843620300293, "\u2013340.\nAidala, Angela A., William McAllister, Maiko Yomogida, and Virginia Shubert, Frequest Users Service Enhancement \u2018FUSE\u2019 Initiative. New York City FUSE II Evaluation Report, New York: Columbia University, Mailman School of Public Health, 2014.\nAu"] [15.816465377807617, 10.307735443115234, ", Just in Reach Pay for Success, Annual Report 2020, 2021. As of December 3, 2021: https://www.csh.org/wp-content/uploads/2021/10/JIR-PFS-2020-Annual-Report- compressed-1.pdf\nCouloute, Lucius, \u201cNowhere to Go: Homelessness Among Formerly Incarcerated "] [15.748414039611816, 10.28795337677002, "tal Health Commission of Canada, 2014. As of November 2, 2020:\nhttp://www.mentalhealthcommission.ca\nHamai, Sachi A., Interim Chief Executive Officer, County of Los Angeles, \u201cPay for Success Initiative: Recommended Project and Next Steps,\u201d memorandum "] [15.781842231750488, 10.243986129760742, " C. Barnes, Jordan M. Hyatt, and Brook W. Kearley, \u201cThe Impact of Residential Change and Housing Stability on Recidivism: Pilot Results from the Maryland Opportunities Through Vouchers Experiment (MOVE),\u201d Journal of Experimental Criminology, Vol. 14,"] [15.739571571350098, 10.298851013183594, "les Homeless Services Authority, \u201cEmergency Housing Vouchers (EHVS) Through CES,\u201d June 25, 2021. As of August 25, 2021: https://www.lahsa.org/news?article=837-emergency-housing-vouchers-ehvs-through-ces\nMazzella, Danielle M., and Lindsay Rosenfeld, L"] [15.688894271850586, 10.33782958984375, "ncy Medicine, Vol. 24, No. 1, 2017, pp. 63\u201374.\nRidgeway, Greg, Daniel F. McCaffrey, Andrew R. Morral, Lane F. Burgette, and Beth Ann Griffin, Toolkit for Weighting and Analysis of Nonequivalent Groups: A Tutorial for the R TWANG Package, Santa Monica"] [15.81643009185791, 10.251442909240723, "n Patterns and Expenditures in Los Angeles County over One Fiscal Year, Los Angeles, Calif.: Los Angeles County Chief Executive Office, Service Integration Branch, Research and Evaluation Services Unit, 2016. As of March 17, 2022: https://dpss.lacoun"] [13.90647029876709, 3.999190092086792, " Research Report\nBOB HARRISON, JAMES DIMAROGONAS, JARRETT CATLIN, RICHARD H. DONOHUE, THOMAS GOUGHNOUR, JOHN S. HOLLYWOOD, JASON MASTBAUM,\nKRISTIN VAN ABEL, JAY BALAGNA\nBroadband Communications Prioritization and Interoperability Guidance for Law En"] [13.531228065490723, 1.8273061513900757, " to identify state and local agencies leading in the deployment of these technologies, to study existing and conceptual network architectures, to evaluate operational deployments, and to synthesize the results into a guidance document. The RAND Corpo"] [13.533951759338379, 1.760215401649475, "old, Inc., a pioneer in mobile broadband, who generously gave his time to discuss FirstNet. This report would not be possible without input from many stakeholders across multiple law enforcement and emergency responder agencies, service provid- ers a"] [13.544035911560059, 1.7713708877563477, "ces to law enforcement customers, such as a private core for enhanced security and service management, preemption and prioritization for public safety in times of emergency, and interoperability across broadband platforms. All 50 states and five U.S."] [13.534825325012207, 1.7597477436065674, "enance and to oversee software and network administration). The type of network provider selected\u2014a single network provider, a dual-provider option, or a single provider with an integrated LTE (Long-Term Evolution)/LMR device\u2014is a decision that invol"] [13.54464054107666, 1.7704967260360718, " which to ensure desired outcomes for public safety, they are on differing broadcast bands and use different equip- ment while offering similar capabilities. Law enforcement agencies must ask for clear, specific details before contracting for service"] [13.552572250366211, 1.7855826616287231, "nologies ........................................................................ 9 NG911....................................................................................................................... 15 SatelliteCommunications .............."] [13.568387031555176, 1.8016767501831055, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Confusion..................................................................."] [13.520502090454102, 1.7408567667007446, ",1,900MHz................................................................................... 80\nB.4. CellularTower,4GHz......................................................................................... 81\nB.5. ConsumerCellularHandset ........."] [13.519458770751953, 1.7436437606811523, "n the authority to execute the mandate with grants or contracts with \u201cindividuals, private compa- nies, and Federal, State, regional, and local agencies\u201d (Pub. L. 112-96, 2012, Section 6206(b)(4)(A)). In March 2017, FirstNet awarded a 25-year contrac"] [13.557360649108887, 1.7840445041656494, " transition, and what services and capabilities are necessary to perform agency- specific duties requires a good understanding of the technical differences between available broadband options. Some agencies do not possess this capability in house and"] [13.557899475097656, 1.7862011194229126, "ion\n \u2022 prioritizing law enforcement and public safety broadband devices on selected bandwidth to ensure continuity of communications during emergencies through over-the-top PTT (OTTPTT) or \u201cmission- critical\u201d PTT (MCCPTT)\n\u2022 enabling interoperability "] [13.55086898803711, 1.7802404165267944, " be enacted and sustained?\n3\nBroadband Communications Prioritization and Interoperability Guidance for Law Enforcement\n \u2022 Does the service provider have a road map that provides gateway solutions to incorporate LMR/LTE solutions into existing LMR/PSA"] [13.558871269226074, 1.7806729078292847, "\nLiterature Review\nWe conducted an extensive literature review on the topics of broadband communications and related tech- nologies, their application to law enforcement and emergency responders, and the acquisition and manage- ment of such networks."] [13.522741317749023, 1.7436295747756958, "rstNet handset were both assessed at 778 MHz. The FirstNet hand- set was shown to have a significant advantage in signal quality; however, if the \u201cusable\u201d range is consid-\nered equally good enough to achieve the mission, the two handsets are roughly "] [13.557448387145996, 1.786080241203308, "allowed us to more fully observe the impacts of the pandemic on law enforcement communications. We were also able to assess the outcomes of police communications issues that arose with protests, riots, and similar activity in cities across the United"] [13.575493812561035, 1.7524229288101196, "ntended to highlight key features and uses of each technology.\nMobile Data Platforms\nPolice departments have been experimenting with the use of mobile data terminals (MDTs) since 1988, when a police agency introduced notebook computers into its patro"] [13.467988014221191, 1.6947308778762817, "eral generations that demarcate increasing complexity and utility.\nIt can be useful to briefly review the generations of mobile broadband to better understand how each plat- form built upon its predecessors and informed the broadband generations to f"] [13.493427276611328, 1.7194033861160278, "net protocol (IP) traffic. In 2005, 3GPP began work to develop LTE and Systems Architecture Evolu-\n10\nUnderstanding Core Communications Technologies\n tion standards. This created standards for a fourth generation of mobile communications (Hill, Chand"] [13.51209545135498, 1.7353498935699463, "the United States\u201d in a \u201creliable, secure broadband network dedicated to public safety\u201d (First- Net.gov, undated). Although the original intent of FirstNet\u2019s mission was to create a nationwide cellular system for first responders alone, the cost of s"] [13.517864227294922, 1.7375338077545166, " agencies do not equip their officers with phones (Jackman, 2017). FirstNet will provide SIM cards to enable existing smartphones to access its net- work, but those phones will need specific apps to optimize the reception and security of photos, vide"] [13.497148513793945, 1.7139036655426025, "s) to enable a 14-hour delivery window to an emergency request for support. AT&T\u2019s capabilities include three \u201cFlying COWs\u201d (for \u201cCells on Wings\u201d) and \u201cFirstNet One,\u201d a deployable blimp (Sambar, 2019). FirstNet\u2019s COWs also can deploy an all-weather \u201c"] [13.509138107299805, 1.73213791847229, "on a local or regional basis that are attractive to a chief or sheriff as they work to limit costs for this capability.\nVerizon is the most prominent broadband provider to challenge AT&T\u2019s build-out of FirstNet, matching many of AT&T\u2019s service and te"] [13.509183883666992, 1.7334343194961548, "h comments that it submitted to the U.S. Department of Commerce on November 9, 2012 (Verizon, 2012). At that time, Verizon recommended a \u201cdiverse nationwide network\u201d for FirstNet as a public-private partnership instead of a standalone public safety b"] [13.514966011047363, 1.7379264831542969, "nched Band 14 coverage in 700 markets and reached 80 percent of the nationwide coverage by the end of fiscal year 2020 (Hill, 2021).\nAT&T has a persuasive advantage in bandwidth allocation, since Band 14 is dedicated solely to public safety needs. Ve"] [13.532905578613281, 1.7553119659423828, "not been modernized as public communication systems have migrated to digi- tal platforms. According to APCO, in existing 911 networks, the public can make primarily voice and tele- type calls, with only data that includes automatic number identificat"] [13.51882266998291, 1.7388314008712769, "thout the need for fixed cellular infrastructure. Artificial satellites are also unaffected by natural or manmade distracters that might disable existing cellular infrastructure and thus provides a backup communications pathway. We previously mention"] [13.534557342529297, 1.7532823085784912, "roduce their own interoperability problems if they work with one vendor\u2019s LMR networks but not another\u2019s.\nGateway\nA gateway is a dedicated device to which an LMR handset from one talk group is connected on one side and an LTE broadband device from a "] [13.565559387207031, 1.7921910285949707, "g., warning signs of a potential heart attack), alerting if the officer has just been involved in a high-impact event, or alerting if the officer has pulled their weapon\n\u2022 location trackers for police vehicles and on-person trackers\n\u2022 networks of sho"] [13.521570205688477, 1.7417606115341187, " (future) P25 SATCOM SATCOM or LTE LMR (varies)\n Fielded devices (For mobile: phones, tablets, in-car modems, etc. For LMR: handheld, in-car)\n Wi-Fi (short range in buildings, shops, etc.)*\nFirstNet (AT&T/ Band 14)\nOther 5G (future) LMR- LMR- SAT"] [13.56212043762207, 1.8043525218963623, "AFECOM and National Council of State- wide Interoperability Coordinators, 2018, p. iv)\nWhile understanding the variety of available technologies is one key step in building a broadband commu- nications capability, first responder networks also requir"] [13.542346954345703, 1.782222867012024, "nance that establishes clear lines of authority, establishes priorities for investment, and ensures functional operation when necessary. As one of our interview subjects reported, governance is \u201cone of the keys for transitioning to broadband\u201d given t"] [13.560098648071289, 1.8368195295333862, "eration between governance bodies. At the state and federal levels, this has included CISA\u2019s 2010 establishment of the National Council of Statewide Interoperability Coordinators (NCSWIC) for the coordinators \u201cfrom the 56 states and territories\u201d (CIS"] [13.556730270385742, 1.7932358980178833, "tegration.\nAny regional governance must account for the specific needs, resources, and inherited legacy systems of agencies participating in that governance process. Determining the appropriate governance system and how to operate it depends on the t"] [13.584932327270508, 1.8150018453598022, "the\nmember represents.\n\u2022 Provide multiple means to participate in meetings (e.g., in person, videoconference, webinar, teleconference) while advancing information-sharing and transparency.\n\u2022 Identify sustainable funding for existing and future public"] [13.572073936462402, 1.8033807277679443, "overnance and Operational Requirements\n Daily Operations for Patrol Officers\nThis case, shown in Figure 4.1, reflects the day-to-day operations of officers in the field\u2014supporting officers on patrol, responding to routine calls, conducting stops, and"] [13.579813957214355, 1.83253014087677, "hown in amber are those that have been identified as being useful during routine operations but are less central. For the mobile user, these tend to be reference materials, such as agency files on past incidents, public building floor plans, and admi"] [13.568103790283203, 1.80384361743927, "ert panel on needs for law enforcement broadband (Hollywood et al., 2016) and a prior NIJ-funded technology assessment of law enforcement information exchange issues and needs (Hollywood and Winkelman, 2015).\n 28\nGovernance and Operational Requiremen"] [13.541996002197266, 1.770977258682251, "and network\n Preemption activated\nPreemption for first responders is critical\n Interconnect (LMR)\nData Voice\n IP network (backhaul, commercial, agency net)\n PSAP/operations center/station\nTo mobile devices\n\u2022 CAD\u2014data\n\u2022 RMS\n\u2022 Databases about peop"] [13.53707218170166, 1.7634034156799316, " car)\n COWS/ COLTs\nLMR\u2014 LMR\u2014 P25 legacy\nMobile base station\nSATCOM radio\n Wireless broadband network\nSATCOM\nLMR\n Preemption activated\n Interconnect (broadband\u2014agency)\n Interconnect (SATCOM)\n Interconnect (LMR)\n IP network (backhaul, commercial, a"] [13.534781455993652, 1.7641996145248413, "ecause of the disaster. Whereas, in the major event case, the portable communications systems are supplemental, in this case they form the bulk of the communications network. This case requires being able to provide sufficient portable communications"] [13.53242301940918, 1.7607674598693848, "cy)\n Interconnect (SATCOM)\n Interconnect (LMR)\n IP network (backhaul, commercial, agency net)\n PSAP/operations center/station\nTo mobile devices\n\u2022 CAD\u2014data\n\u2022 RMS\n\u2022 Databases about people and items: criminal history, NCIC, warrants, license plates\n\u2022 I"] [13.590703964233398, 1.8657561540603638, "ewed department in the southwestern United States\u2014other concerns, such as cost and redundancy, began to dominate decisionmaking. Rather than voicing specific concerns about Band 14 avail- ability, fire department users described the end-user goals of"] [13.581204414367676, 1.822699785232544, " purchase or purchases?\nDoes the agency use grants to fund IT/communications needs? 7 Does the agency use private donations to fund IT/communications needs? 1\n NOTE: Respondents could indicate more than one funding mechanism.\n35\nBroadband Communica"] [13.544734954833984, 1.7741161584854126, "grants to help with needs (Gallagher, 2018; FEMA Grant Programs Directorate, 2021; FEMA Grant Programs Directorate, 2022). This is con- sistent with what we heard from the chief of police for a police department in Southern California in an interview"] [13.569181442260742, 1.8134498596191406, " police budget. The source of funds really depends on what money is available.\u201d\n\u201cHave used grants in the past\u2014purchased about four or five tablets and associated applications with that. Certain grants [are] only eligible every so many years\u2014we got ma"] [13.575688362121582, 1.786415696144104, "500\u20139,999 $1,319,686 2,499 or fewer $300,802\nSOURCE: Brooks, 2020.\nPer-Employee Budget\n$142,617 $130,540 $130,411 $134,860 $132,000 $116,431 $104,846 $81,009 $54,130\n \u2022 mobile device management (MDM) systems, which provide administration and configu"] [13.626432418823242, 1.9221986532211304, ", \u2018I need this.\u2019 Being small lets us pull the trigger faster. We say, as a command staff, \u2018That seems like a good idea\u2019; we can just go out and get it. Replacing all in-car trunked systems. If something goes out to bid, the city council will be invol"] [13.560592651367188, 1.7878835201263428, "20\nChief of police, PD in MA, February 2020\nChief of police, PD in MA, February 2020\nIT personnel, sheriff\u2019s department in Southern CA, April 2020\nComment\n\u201c[We] talk to the surrounding communities; this is my go-to. [A local city police agency] is on"] [13.624551773071289, 1.8522275686264038, "people have the tools to get the job done. We also do extensive proof-of-concept tests.\u201d\nBroadband Communications Prioritization and Interoperability Guidance for Law Enforcement\n Market Research\nAfter the discussions on needs identification, we soug"] [13.582590103149414, 1.8542771339416504, "1, the following departments had open RFPs for communica- tions technology or IT consultants:\n\u2022 East Windsor, Connecticut: \u201cThe Town of East Windsor is seeking proposals for Professional Consult- ing Services for an analysis of our current radio syst"] [13.57473373413086, 1.9624488353729248, "nto decisionmaking are how technologies are implemented in departments and what maintenance consists of. While our interviews did not yield a great deal of information about implementing systems or technology, one participant noted that training is a"] [13.61027717590332, 1.9162825345993042, "CI Systems, a regional radio network provider] is going to be a monthly fee per radio. Everyone around us is either already on ICI or going to ICI, so that\u2019s why we are going that direction. ICI transition will be in the next year.\u201d\n\u201cFor big projects"] [13.580435752868652, 1.8445582389831543, " try to use state contracts; [it\u2019s] more efficient for us because we\u2019re small.\u201d\n\u201cThis is the red tape; [we] have to go through the purchasing department and get it approved by auditing. Then we can order it. It\u2019s time consuming. We use the state cont"] [13.559767723083496, 1.7675057649612427, " = police department. City and agency names are withheld to protect interviewees\u2019 anonymity.\n44\nCHAPTER SIX\nBroadband Communications Costs for Law Enforcement Agencies\nAs a follow-up to the discussion of funding and acquisition in the previous chapte"] [13.530047416687012, 1.746669054031372, "tent is to inform decisionmakers about the types of activities and costs that their organizations must consider when adopting broadband communications.\n2 Cradlepoint (owned by Ericsson), Sierra Wireless, and Peplink routers are examples of available "] [13.535104751586914, 1.7070531845092773, "\u2019s specific range of anticipated uses.\nDual-Service Option\nIn the second scenario, agencies might wish to operate on more than one network, perhaps because of cov- erage issues associated with a single provider or for redundancy capability in the eve"] [13.608860969543457, 1.6750633716583252, "nd replacement of lost or stolen devices (Harris and Romesburg, 2002; Imel and Hart, 2003; Salmensuu, 2019). These management services can be conducted in house by the agency (i.e., using its own dedicated staff), or the work can be outsourced to a t"] [13.607547760009766, 1.6734342575073242, "vision and configure Wi-Fi access; install and manage enterprise applications, such as email; and address any problems that arise on a device. It also allows IT to enforce device security, such as locking a device and wiping data if the device is los"] [13.581438064575195, 1.6975003480911255, "9.00 per device each month for MDM and MAM services (Oxford Economics, 2018). Our research into publicly available pricing on vendor websites suggests that this range is a reasonable estimate, although we found some vendors that offer very basic plan"] [13.583927154541016, 1.6973546743392944, "eir services. For organizations that are unsure of the best MDM, MAM, or UEM solution, it might be worth testing various vendors on a trial basis before committing to a vendor, especially on an annual or perpetual basis. Another observation was that "] [13.570915222167969, 1.7028943300247192, "roid) (Lastovetska, 2022). Some of the key cost drivers in app development are vendor type and location, app complexity and number of features, back-end infrastructure and connected application programming inter- faces, complexity of user experience "] [13.528502464294434, 1.7477370500564575, " integrate mobile apps and back-end databases. In addition to the nonrecurring cost to develop the interface, there will be a need to maintain it as required by the vendor to update apps or the databases with which they interface. This report does no"] [13.531087875366211, 1.753139615058899, " build and operate that network under the management of the FirstNet Authority Board. As states agreed to join FirstNet and cooperate with the development and deployment of the network, other broadband provid- ers created similar networks and infrast"] [13.530184745788574, 1.7541264295578003, "alized policing approach; it is also a hindrance when the ultimate goal is interconnecting police resources and deploy- ing a seamless interoperable network of communications that can talk and share data across agencies and platforms.\nTo resolve issu"] [13.537019729614258, 1.7609915733337402, "nteracts with LMR; the system\u2019s interop- erability with other segments of government, both within a jurisdiction and for interjurisdictional needs; planned additions to coverage and capabilities, as articulated in a contract for services; the presenc"] [13.5449800491333, 1.765450358390808, " capabilities, both present and future, is more difficult; commercial provid- ers, including AT&T/FirstNet.com, do not publicly state the specifics of their coverage or capabilities because of those data being a source from which their competitors co"] [13.566176414489746, 1.7947793006896973, "eholders working to create the future of mobile broadband for their law enforcement and first responder organizations, there were many comments that are relevant to the themes and issues being experienced nationally. We include them in this section s"] [13.59260368347168, 1.8859330415725708, "urrently, only detective or sergeant and above get department-issued phones. If CAD/RMS was more\nfriendly on the phones, we would give all officers phones.\u201d7\n\u2022 \u201c[We\u2019re] not going to go to mobile CAD-RMS given Cal-DOJ compliance. It\u2019s too hard to get "] [13.564537048339844, 1.7992864847183228, " for training?\u2019\u201d15\n\u201c[It] will probably be easier for younger, tech-savvy officers to acclimate to and a struggle for older offi- cers to learn a new system.\u201d16\nBroadband Communications Prioritization and Interoperability Guidance for Law Enforcement\n"] [13.543755531311035, 1.7693346738815308, "and chief of innovation for a police department in Southern California on January 31, 2020.\n 58\nBarriers and Issues\n \u2022 \u201cIn a perfect world, everything would be done on a single device\u2014doesn\u2019t have to be a phone, but should be able to access all syste"] [13.536036491394043, 1.757964849472046, "chnology for a police department in Massachusetts on February 7, 2020.\n21 Interview with the head of technology for a police department in Massachusetts on February 7, 2020.\n22 Interview with the business services administrator for a police departmen"] [13.536428451538086, 1.75819993019104, "hes are the best technology and configuration to ensure usefulness and survivability, yet different technologies might present differing advantages.\nA critical aspect of reliability is the ability of a communications systems to interoperate smoothly "] [13.540990829467773, 1.7668167352676392, " bandwidth. It is therefore important that agencies acquire broadband communications systems in ways that allow for relatively easy and inexpensive upgrading later, as technologies and demands advance, as opposed to having to pay the expensive, long-"] [13.569049835205078, 1.7969175577163696, "and scan social media and offender registries to advise the police of crime and suspect data.2\nKey Questions\nWhen considering a transition to the NPSBN or another broadband platform, it is essential that deci- sionmakers choose their path forward kno"] [13.59720516204834, 1.8336418867111206, "we envision policing and the impact of broadband tech- nologies in 20 years. It is important to understand that this story is not a prediction of what will happen, but it does rely on current trends, events, and developments as a foundation for a pos"] [13.608020782470703, 1.825472354888916, "eo from UAVs or other personnel, or incident command informa- tion to report or receive critical data almost an intuitive activity.\nThe devices in the hands of law enforcement, firefighters, and other first responders are individually authenticated v"] [13.499478340148926, 1.7240625619888306, "ht come next. They know what their contemporaries in 2022 knew\u2014that it was not as important to know the future as it is to make good decisions today to enable it to emerge.\n65\nAPPENDIX A\nCurrent and Emerging Broadband Technologies\nGenerations of Broa"] [13.49283504486084, 1.7218466997146606, "es per second (MBps) (Ghosh et al., 2011). Although 3G technologies afforded users much faster data speeds and more-reliable voice communications, the inability of CDMA and GSM technology platforms to support mobile devices (as evidenced by Verizon\u2019s"] [13.490373611450195, 1.7172602415084839, "oadband, which means that transfer speeds would be an order of magnitude faster than 3G download and upload speeds\n1 The specific dates on which various 2G and 3G systems will be turned off vary from country to country, and the announced dates of dec"] [13.515698432922363, 1.7384737730026245, "Phone in 2007 integrated data and voice functions through a touchscreen display, web browsing, time and geoloca- tion services via GPS, cameras, and motion sensors, and the iPhone remains the standard against which all other portable communications d"] [13.508244514465332, 1.7277956008911133, "d Clark, 2014). Phase II began even as the more advanced LTE standard in commercial mobile phone networks encouraged the development of hybrid radio devices for first responders that have both smartphone capabilities (LTE) and P25-compliant LMR funct"] [13.498608589172363, 1.7227245569229126, "radio resources (GSMA, 2017).\n5G\nTo sum up the current state and probable future of broadband communications, 1G is analog cellular. 2G technologies, such as CDMA, GSM, and Time Division Multiple Access (TDMA), were the first generation of digital ce"] [13.577978134155273, 1.805216908454895, "logy (or combination of technologies) is deployed by law enforce- ment for public safety broadband, there are applications that have already come online that will affect not\n71\nBroadband Communications Prioritization and Interoperability Guidance for"] [13.543317794799805, 1.7813410758972168, "PSBN (FirstNet) is now offering tethered UAVs as part of its emergency response fleet. These are \u201cflying COWs\u201d that relay Band 14 communications. Their flying height is 400 ft; in contrast, cell towers are typically below 350 ft. As of 2019, FirstNet"] [13.475642204284668, 1.6955411434173584, " built.\nPublic safety agencies and their LMR-LTE providers might want to assess the cell capacities of their sys- tems in normal and emergency operations and plan for ways that COW and COLT deployment can support communications during natural disaste"] [13.502860069274902, 1.7199833393096924, "mmunications Prioritization and Interoperability Guidance for Law Enforcement\n geographic reach and is faster than low band. To enable 10-gigabyte-per-second (GBps) speeds, however, net- works must use mmWave (mid band is 1 GBps) (Finley and Pearlste"] [13.51807975769043, 1.7437233924865723, " ecosystem to deploy\nrobots, have devices interact, and enhance safety measures for workers\n\u2022 smart cities, which will become the norm, with 5G speeds tracking traffic conditions, parking availabil-\nity, refuse pickup, and guidance to smart vehicles "] [13.519043922424316, 1.7422184944152832, "ercial infrastructure (instead of mission-critical, public safety\u2013grade broadband sites, which are only loosely defined), it is unknown whether the planned system would remain functional in the case of a significant seismic event, another large-scale"] [13.513474464416504, 1.7331815958023071, "et still poor; and green indicates a reliable signal strength, one that an end user would see as a \u201c3- to 5-bar\u201d connection on their device. The figures in this appendix depict repeater coverage at four cell frequencies (778 MHz, 850 MHz, 1,900 MHz, "] [13.475574493408203, 1.6933808326721191, "equal to \u201390 dBm but less than \u201370 dBm is considered weak but potentially usable and shown as yellow; and greater than or equal to \u201370 dBm is considered a good\nconnection and shown as green. Areas with none of these colors have no reception.\nWe chose"] [13.506379127502441, 1.7210440635681152, " the mission, then the two handsets are roughly comparable.\nFor our LMP/P25 examples, we considered any received signal strength of greater than \u2013110 dBm (DAQ [data acquisition] 3.4 or better) to be a good signal and colored the area green. We consid"] [13.521024703979492, 1.7439683675765991, "d web browsing.\nThe fourth generation of mobile broadband, also known as Native internet protocol.\nThe first iteration of 4G. LTE leveraged the dependability of data-optimized 3G broadband and delivered performance roughly equivalent to wired broadba"] [13.528059005737305, 1.7541329860687256, "eroperability and enhance public safety communications. A component of the Cybersecurity and Infrastructure Security Agency.\nThese can also be referred to as drones, unpiloted aerial systems, unpiloted aerial vehicles, unpiloted ground systems, or ro"] [13.484464645385742, 1.700585961341858, " More to Boost Gameday Look and Feel,\u201d TechRepublic, February 5, 2021.\nAlleven, Monica, \u201cT-Mobile Makes Public Safety a 3-Way Race\u2014Sort Of,\u201d Fierce Wireless, May 22, 2020. \u2014\u2014\u2014, \u201cVerizon Beefs Up C-Band Deployment to 175M by End of 2022,\u201d Fierce Wirel"] [13.523930549621582, 1.7459787130355835, "rporation, February 2014.\nCISA\u2014See Cybersecurity and Infrastructure Security Agency.\n91\nBroadband Communications Prioritization and Interoperability Guidance for Law Enforcement\n City of Albany, New York, \u201cRequest for Proposals for the Provision of C"] [13.507311820983887, 1.7248846292495728, "ent Agency, February 2021. As of July 11, 2022: https://www.fema.gov/sites/default/files/documents/FEMA_2021-Preparedness-Grants-Manual_02-19-2021.pdf\n\u2014\u2014\u2014, FEMA Preparedness Grants Manual, version 3, Federal Emergency Management Agency, May 2022. As "] [13.524855613708496, 1.6723064184188843, ". As of April 26, 2021:\nhttps://www.androidcentral.com/how-much-data-does-streaming-media-use\nHill, Kelly, \u201cKey Takeaways from FirstNet\u2019s Annual Report,\u201d RCR Wireless News, March 3, 2021.\nHill, Simon, Simon Chandler, and Paula Beaton, \u201c4G vs. LTE: Th"] [13.504617691040039, 1.7144159078598022, "-lte-in-depth-guide-to-its-differences/\nKozlowski, Jonathan, \u201cSpotlight On: Verizon,\u201d Officer.com, July 10, 2020. As of July 11, 2022: https://www.officer.com/command-hq/technology/communications/article/21143122/ spotlight-on-the-verizon-public-safe"] [13.51728630065918, 1.7329657077789307, "Forbes, March 6, 2019.\nNilsson, Jeff, \u201cAlbert Einstein: \u2018Imagination Is More Important Than Knowledge,\u2019\u201d Saturday Evening Post,\nMarch 20, 2010.\nNIST\u2014See National Institute of Standards and Technology.\nNPSTC\u2014See National Public Safety Telecommunicatio"] [13.51054573059082, 1.7248178720474243, "ves Committee on Energy and Commerce Subcommittee on Communications and Technology on November 1, 2017, Washington, D.C., 2017. As of June 27, 2022: https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/ Testimony-"] [13.512001037597656, 1.7259939908981323, "df\nU.S. Government Accountability Office, \u201cDecision,\u201d T-Mobile USA, Inc., File B-418394, April 8, 2020. As of June 28, 2022:\nhttps://www.gao.gov/assets/b-418394.pdf\n\u2014\u2014\u2014, Public-Safety Broadband Network: Congressional Action Required to Ensure Network"] [13.532920837402344, 1.7459686994552612, "bility. For various reasons, this has not happened. Every law enforcement and first responder agency has legacy systems and equipment for mobile broadband uses and is faced with a complex set of decisions about its broadband communications infrastruc"] [20.033761978149414, 11.731893539428711, " Research Report\nJULIA ROLLISON, JULIA BANDINI, KATIE FEISTEL, ALLYSON D. GITTENS, MEGAN KEY, ISABELLE GONZA\u0301LEZ, WEILONG KONG, TEAGUE RUDER, JASON MICHEL ETCHEGARAY\nAn Evaluation of a Multisite, Health Systems\u2013 Based Direct Care Worker Retention P"] [20.00592041015625, 11.7080078125, "raining, and one-on-one coaching. RAND exam- ined the THRIVE program in light of its targeted outcomes and also identified areas for program improve- ment. This report is intended for stakeholders interested in supports for direct care workers and wa"] [20.04031753540039, 11.734635353088379, " Foundation funded three health systems (hereafter referred to as \u201csites\u201d) to support the implementation of a new program: Transformational Healthcare Readiness through Innovative Vocational Education (THRIVE). This one-year program was designed to h"] [20.03856658935547, 11.732816696166992, "and race emerged as significant predictors of retention in both program years;\nthose in the lowest pay category and individuals who identified as black had a higher likelihood of termination (voluntary or involuntary) than those in the highest pay ca"] [20.036758422851562, 11.733922958374023, "ears 1 and 2, given program costs; in other words, it would not have been possible to break even,\ngiven the observed program average expenditures per caregiver.\n\u2022 What lessons learned would other sites need to leverage when implementing an interventi"] [20.046226501464844, 11.729188919067383, "esandTables.......................................................................................................... xi\nCHAPTER ONE\nIntroduction........................................................................................................."] [20.034320831298828, 11.731816291809082, ".............................. 65 SummaryofFindings..................................................................................................... 65 SummaryofLimitations.........................................................................."] [20.030399322509766, 11.726361274719238, "................... 54\nG.1. Comparison of Cross-Sectional Approach with Survival................................................ 92\nTables\n1.1. InitialPlannedComponentsofTHRIVE................................................................... 2\n2.1."] [20.028196334838867, 11.72488784790039, " require both technical and interpersonal skills for providing physical and emotional support to care recipients and communicating with other members of the care team and family members. Direct care workers are predominantly women and people of color"] [20.037494659423828, 11.733370780944824, "s related to decisionmaking, problem-solving, communication, and relationship-building as well as tar-\n1 The health systems also provided some funding support to cover expenses such as fringe benefits for participating caregivers.\n 1\nMultisite Healt"] [20.037464141845703, 11.732637405395508, "provided resources (e.g., information on tuition reimbursement or scholarships) to caregivers to supplement their experience and address certain identified needs (e.g., transportation, uniforms).\nThe foundation and the implementing health systems eng"] [20.03774642944336, 11.73384952545166, "?\n\u2022 What are the strengths and opportunities for improvement of the THRIVE intervention, including the intervention content, modality, and skill and knowledge of those delivering the content?\n\u2022 Can THRIVE break even or generate a positive return on i"] [20.038589477539062, 11.734439849853516, "ts helped demonstrate the potential influencing factors on THRIVE from the beginning of the program and were used to guide the development of data collection instruments as well as analyses. While we attempted to include as many variables as pos- sib"] [20.035797119140625, 11.729494094848633, "en found to be drivers of engagement and retention, particularly among young employees (Gilsdorf, Hanleybrown, and Laryea, 2017). In terms of benefits and compensation, higher wages, work schedule flexibility, health insur- ance, overtime pay, and pa"] [20.03944206237793, 11.737174034118652, "he time of hire\n\u2013 Part-timeversusfull-timeposition\n\u2013 Workload in number of hours, night shifts\n\u2022 Termination status (voluntary or involuntary) and reason\n\u2022 Organizational-levelcharacteristics\n\u2013 Direct care worker staffing level (e.g., number of worke"] [20.033964157104492, 11.731155395507812, "reas for improvement following each round of observations.\nInterviews. RAND conducted three rounds of interviews with staff members in the spring of 2020, the fall of 2020, and the spring of 2021 (see Appendix C for sample staff interview guide). Sta"] [20.036392211914062, 11.732658386230469, "nclud- ing worker type, shift (day/night shift), and hours worked (full time, part time). Participants were primarily women. Both job and demographic characteristics largely aligned with the characteristics of the overall pop- ulation served by THRIV"] [20.020954132080078, 11.727285385131836, "btaining approvals and the early program pause, the survey was administered only once (i.e., in February, March, and July 2021 at the different sites).\nThe survey could be sent only to active caregivers (i.e., enrolled in THRIVE at the time, not thos"] [20.01443862915039, 11.710468292236328, "ng each round of obser- vations. The observational data were integrated with the interview data to formulate key findings across sites and data type.\nWe analyzed interview and observational data simultaneously throughout data collection during the co"] [20.0365047454834, 11.73282241821289, " selection of a survival model, plus we complete a sub-analysis for the subset of employment episodes for which we have 12 months of data.\nOur analysis was limited to hires who were eligible for THRIVE, whether they actually completed the training. T"] [20.033123016357422, 11.728911399841309, " for all factors (burnout \u03b1 = .84; teamwork climate \u03b1 = .78; perceived supervisor support \u03b1 = .94; perceived organizational support \u03b1 = .94; core training; \u03b1 = .84; Bring Back Day sessions; \u03b1 = .83; coaching \u03b1 = .97). For outcomes (e.g., caregiver in"] [20.034259796142578, 11.729220390319824, "predictor variable and the outcome variable might be different (i.e., nega- tive) because of the presence of the other predictor variable.\n 11\nMultisite Health Systems\u2013Based Retention Program\n expenses, and other materials and expenses) and benefits "] [20.03813362121582, 11.73362922668457, "on, absenteeism, or recruiting many years beyond the hiring date that could be estimated but this would require data collection beyond the grant period.\nThe evaluation\u2019s interviews and surveys were limited by the sampling universe. Although we employ"] [20.040935516357422, 11.737861633300781, "ic approach given available data, it does not provide insight into the effects of COVID-19 on THRIVE.\n13\nCHAPTER THREE\nEvaluation Findings\nTo provide some context for the findings of this report, we begin this chapter with descriptive information reg"] [20.04216194152832, 11.739171981811523, "ing Caregiver Job Characteristics\n Characteristic\nRole\nNurse assistant (PCNA, CNA, NA)\nPatient care technician or aide (PCT, PCA)\nOther Job status\nFull-time Part-time PRN\nShift\nWork involves night shift\nWork does not involve night shift\nYear 1 Percen"] [20.041200637817383, 11.736806869506836, "ose scoring less than \u20134 are assigned a \u201chigh\u201d risk category, those scoring between \u20134 and +4 are assigned a \u201cmedium\u201d risk category, and those scoring +4 are assigned a \u201clow\u201d risk category.4\n\u2022 Coaching assessment. During their initial meeting with ea"] [20.04248046875, 11.737679481506348, " Caregivers\u2019 Risk Levels as Identified by SuccessGPS Versus Those Assessed by Coaches\n SuccessGPS Risk Level\nLow Medium High Total\nCoach Risk Level Rating\nLow Medium High\n429 542 252 388 646 366 30 107 104 849 1,296 726\nTotal\n1,224 1,403 241 2,8"] [20.043254852294922, 11.738280296325684, " eliminating certain group activities that required participants to be in close proximity).5 In the interviews, some caregivers and staff expressed challenges with the curricu- lum activities that were restricted due to COVID-19 because they were not"] [20.0439395904541, 11.739901542663574, "oughout the year, the ability to complete the offered sessions beyond the one-year program period. Because of the COVID-19 pandemic, much of the content of Bring Back Days moved from in person to virtual or computer-based learning and was delivered i"] [20.041810989379883, 11.737295150756836, "l. These check-ins were intended to be interspersed throughout the year with other activities such as Bring Back Days (see Table 3.7).\nActual caregiver participation in coaching ranged from zero to 12 sessions over the program year and did not always"] [20.037378311157227, 11.732290267944336, ". . . It\u2019s the speed-bump meetings with the nurse managers: \u201cHi, I was just here to see so and so. Any questions or concerns that I should know about?\u201d It takes two minutes of the time but builds the relationships with the nurse managers.\u2014Staff\nUnfor"] [20.033994674682617, 11.7296142578125, " Thus, one of the core objec- tives of this evaluation was to assess whether caregiver retention improved during THRIVE implementa- tion. RAND used administrative data for the comparison year (Year 0) and intervention years (Years 1 and 2) to describ"] [20.03434944152832, 11.729524612426758, " Year 2 for 12 months). This analysis revealed results similar to those of the main analysis, but with a significant difference between Year 1 and Year 0 (p < 0.05) in retention, with retention worse in Year 1 than in Year 0.\nrates (accounting for 9."] [20.033376693725586, 11.728453636169434, " (p < 0.05). There were no significant differences between Year 0 and Year 1 for either voluntary or involuntary reasons. Overall, voluntary terminations account for a larger proportion of dropouts (i.e., lower retention rates), as reflected in Figur"] [20.018714904785156, 11.713409423828125, "ager)\nNon-return or -reinstatement after leave of absence All other reasons\nMissing\n101\n 54\n 38\n 43\n 33\n 14\n10 0\n2 14 1 9 2 5 0 5 3 29\n131 812\n52 283 16 127\nEvaluation Findings\n TABLE 3.9\nReasons for Termination Through December 31, 2021\nYear 1 Reaso"] [20.032405853271484, 11.726337432861328, " a lot of managers are hiring people who aren\u2019t qualified just because they need a body on the unit. Just to try to get that help on the unit because they\u2019re so short. And then when they get on the unit, they are so freaked out about everything that\u2019"] [20.033878326416016, 11.729042053222656, " 2 were significantly higher than in Year 0.\n\u2022 There were no significant differences in retention between the nine months prior to COVID-19 in Year 1\nand the same nine months in Year 0.\n\u2022 Several staff members perceived THRIVE to positively affect re"] [20.033727645874023, 11.729071617126465, "ated with a higher likeli- hood of terminating involuntarily in both Years 1 and 2. Specifically, individuals identifying as black had a relative risk ratio (RR) of 3.2 (p < 0.01) in Year 1 and 2.9 in Year 2, while caregivers identifying as other had"] [20.040307998657227, 11.734374046325684, "ec- ognized this possibility, too. Caregivers also mentioned that scheduling and location of the health system could affect their decision to stay or go; this was especially the case for caregivers who had other personal responsibilities including ch"] [20.03984260559082, 11.735241889953613, "as possible because it\u2019s completely toxic. My boss is probably a great person, but when it comes to me and my issues, it seems he is turning a blind eye and places the blame on me and thinking it\u2019s all my fault, even though it could not be.\nSimilarly"] [20.038694381713867, 11.733491897583008, " system. For example, a caregiver mentioned considering leaving the health system if staffing ratios were to worsen:\nThat does bother me. I went in one day and I had had 34 patients [in] one day. How can I give my attention to my patients if I have 3"] [20.045995712280273, 11.74272632598877, "cated that THRIVE helped them improve, on a scale from none to a great deal, in areas ranging from attendance to relationships with colleagues and managers to the quality of their work (see Figure 3.6).\nThe findings in this section focus on potential"] [20.041152954101562, 11.735933303833008, " ing, respectively).\nTo explore potential factors predicting intent to leave, we examined job-related factors (i.e., measures of caregiver burnout, teamwork climate, supervisor support, and organizational support) and program factors\u2014i.e., measures o"] [20.04194450378418, 11.736627578735352, "gram factors were examined as predictors of relationships in two separate models (i.e., one with managers and one with other colleagues), Bring Back Day sessions were also the only significant predictor for relationships with managers (\u03b2 = 0.97,\n34\nE"] [20.034650802612305, 11.730860710144043, "a result attributed their perceived improvement in providing care to THRIVE components.\nTHRIVE staff conceptualized the effectiveness of the THRIVE program as related to outcomes other than retention, including gaining calmness, confidence, and commu"] [20.044633865356445, 11.73906135559082, "egression indi- cated three significant predictors (F (4, 64 = 31.8, p < 0.05, model R2 = 0.67): core training (\u03b2 = 2.14, p < .05), Bring Back Day sessions (\u03b2 = 1.38, p < 0.05), and coaching (\u03b2 = \u22120.97, p < 0.05). This finding suggests that caregiver"] [20.0421085357666, 11.737964630126953, "f the THRIVE curriculum.\nWe asked specific questions about the components of THRIVE including the core training, Bring Back Days, and coaching on the survey, although the number of questions was limited due to length of the survey (see Appendix E). M"] [20.046663284301758, 11.74031925201416, "acted to THRIVE either very positively or very negatively:\nI can\u2019t thank Ralph Wilson Jr. [Foundation] enough and all the staff who do the leg work for this program because this program was life-changing for me. . . . I learned so much about myself a"] [20.042320251464844, 11.738408088684082, "ssessment and coaches\u2019 own assessment of risk based on their interactions with caregivers both as they pro- gressed through THRIVE and started working on their floors or units. In some instances, coaches thought that the risk assessment may not accur"] [20.04304313659668, 11.738565444946289, " agree side and they accidentally hit strongly disagree.\nThe accurateness of the tool varies. I have [caregivers] that answer strongly agree to every barrier, and when I am on my call with them, I will say I see that you struggle with childcare, tran"] [20.097532272338867, 11.79232120513916, "2) the classes provided an opportunity for caregivers to become oriented to the health system and meet other new caregivers.\n40\nEvaluation Findings\n Core Class Content and Delivery\nIn the interviews, many caregivers and THRIVE staff shared that the c"] [20.054040908813477, 11.746150970458984, "d in the interviews that by interacting with and getting to know other caregiv- ers in the core classes, caregivers were able to create a support network during their time at the health system. Caregivers found this support from interacting with thei"] [20.048912048339844, 11.741412162780762, "n a scenario that we didn\u2019t need to be in. We could have just had a simple conversation about it and moved on. . . . It was a little dragged out with the implementation of arts and crafts. Which I understand for engagement purposes, textbook-wise it\u2019"] [20.04411506652832, 11.738781929016113, "VE staff described strengths of the Bring Back Days in terms of their (1) content and (2) delivery and facilitation.\nContent\nTHRIVE caregivers appreciated that Bring Back Days provided an opportunity to revisit curriculum topics from the core classes"] [20.045442581176758, 11.739620208740234, "ng and atten- dance, (2) content, and (3) delivery and facilitation.\nScheduling and Attendance\nCaregivers and staff mentioned logistical challenges around scheduling and attendance for Bring Back Days that were offered virtually in a synchronous or a"] [20.04553985595703, 11.739890098571777, "s also\n44\nEvaluation Findings\n suggest that time management could be improved in reviewing topics previously covered in the core classes. Caregivers stated that they would have preferred the topics presented in the Bring Back Days to be more rel- eva"] [20.043527603149414, 11.73814582824707, "sessions, both for asynchronous and synchronous learning.\nHonestly, I felt like the virtual conference is pointless because we were set at one hour or two hours and the other participants\u2014there was no cut off for them. They were just talking and talk"] [20.04485511779785, 11.738336563110352, " caregivers, responding to texts and phone calls when needed in addition to their regular check-in outreach.\nCoaching Support\nSome caregivers described how their coaches provided support related to their jobs and work environment. Coaches served as a"] [20.045251846313477, 11.738710403442383, "just keeping me focused.\nI know that [coach] has always been there for me, and she would talk to me if I wanted for hours on end just to see how I\u2019m doing and what it is that she can help me with, and what if there are any improvements or if there is"] [20.04291343688965, 11.73681640625, " in the ratio of caregivers to coaches may be needed to improve the coaching. Some THRIVE staff across all three sites noted that coaches may have too many caregivers on their caseload, which affects the quality of their individual coaching. Staff re"] [20.039342880249023, 11.735337257385254, "vided to THRIVE partici- pants. Some caregivers expressed their appreciation for these connections:\nWhatever I need, whether it is personal or work related, they\u2019ll support you in any way. I love the coaches; they text you. It\u2019s so personal. They\u2019ll "] [20.036325454711914, 11.731524467468262, "s, and gain support for it. Many caregivers also noted that their manager was supportive of their participation in THRIVE, enabling them to attend Bring Back Days or coaching sessions.\nOpportunity for Cross-Site Collaboration\nTHRIVE staff mentioned t"] [20.040380477905273, 11.735182762145996, " minimal stuff about the program and what the purpose is and the contract. I probably reread the coaching manual like 50 times trying to narrow it down, and then I would go on and research some of the topics on my own too just to get comfortable and "] [20.040557861328125, 11.734970092773438, " is critical for the program\u2019s success:\nI think we have some difficult personalities on our team that can be very challenging and maybe even toxic sometimes that kind of put their feet in and just won\u2019t do things.\nAwareness of THRIVE and Buy-In to th"] [20.039443969726562, 11.734007835388184, "ioned anything to me about the THRIVE program.\nI don\u2019t think my manager knows what THRIVE is. I mean she probably does, but I don\u2019t think we\u2019ve ever spoken about it. My manager is rarely on the unit. I\u2019ve talked to her like five times in the year.\n[T"] [20.038883209228516, 11.73316478729248, " challenges related to organizational staffing shortages, local requirements, and COVID-19.\n\u2022 There seems to be an overall indifference to THRIVE among caregivers and a lack of understanding of what THRIVE is when beginning the program.\n\u2022 Reported st"] [20.036033630371094, 11.730544090270996, "ime workers would be reduced.13 We con- verted benefits into dollars but there are other potential benefits such as improved satisfaction or morale or productivity that we were not able to monetize. Due to the historical nature of the comparison, the"] [20.039794921875, 11.73560619354248, "y $265 in Year 1 and $299 in Year 2), the ROI would reach a breakeven point.\nAs a reminder, the average costs per caregiver were $1,772 in Year 1 and $2,263 in Year 2.15 When compar- ing these numbers with the majority of costs for the program (i.e.,"] [20.0360164642334, 11.73043155670166, "allowed them to involve a range of organizational representatives and truly integrate the effort into organizational operations (e.g., alignment with human resources, corporate onboarding). Sites felt this planning time was critical to early successe"] [19.99810218811035, 11.692378044128418, "rything or they\u2019re not going to. If they don\u2019t, they find ways around and try to get their people out of it. They need to see the benefit of it, with communication with those.\nSites also noted that there may be some resistance from clinical sites and"] [20.038679122924805, 11.73291015625, ", others felt that cross-training of these roles would provide staff with additional connection to caregivers on their caseload and alleviate an imbalance in work- loads between educators and coaches. The composition of the THRIVE staff team should a"] [20.03635025024414, 11.73286247253418, "d tracking systems and ensure technology is in place to sup-\nport virtual or web-based options for the program.\n58\nCHAPTER FOUR\nRecommendations\nThis chapter presents RAND\u2019s recommendations based on findings to date (i.e., largely reflecting program Y"] [20.040252685546875, 11.734766960144043, "e similar design elements.\nClearly articulate the goals to leadership, managers, and caregivers up front. Successfully implement- ing a program of this magnitude (i.e., mandatory attendance for all newly hired caregivers) requires multiple levels of "] [20.038808822631836, 11.734051704406738, "her challenges that could inhibit internal quality improvement efforts as well as external evaluation efforts.\nAlternative Interventions to Improve Retention\nAs findings from the outcome evaluation pointed to no change in retention, RAND recommends e"] [20.03822898864746, 11.73353385925293, "andatory or \u201cone-size-fits-all\u201d approach to the intervention. Caregivers across health systems represent a diverse workforce in terms of age, race and ethnicity, education, work expe- rience, and more. Our findings revealed a fair number of caregiver"] [20.037845611572266, 11.7334566116333, "gs of being undervalued within the care team. While not an explicit area of a priori focus for our evaluation, we learned about systemic issues that warrant attention moving forward. That is, if systemic issues are not addressed adequately, any inter"] [20.035625457763672, 11.730611801147461, "omes or performance may be masked or heavily influenced by\nTABLE 4.1\nSample Guiding Evaluability Assessment Questions\n Area\nModel design\nInformation availability\nInstitutional context\nGuiding Questions\n\u2022 Are the long-term outcomes for the model clea"] [20.040603637695312, 11.732504844665527, "While RAND collected demographic data and controlled for these variables in its analysis, there were no explicit questions around the potential disparities in short- and long-term outcomes among certain segments of the workforce (e.g., women, individ"] [20.03706932067871, 11.732780456542969, "k had a higher likelihood of termi- nating than those in the highest pay category or those who identified as white. Other predictors included part-time status, identification as \u201cother\u201d race, and gender for certain years or types of terminations (i.e"] [20.038286209106445, 11.733734130859375, "tion, ensuring strong leadership support, encouraging collaboration and ongoing idea generation among participants, and clarifying THRIVE staff roles and ensuring diversity across staff backgrounds.\nSummary of Limitations\nThe evaluation included seve"] [20.037708282470703, 11.733274459838867, "also encourage developers to think creatively and comprehensively about potential interventions that may be more effective for the specified goals (i.e., retention). Further, we would suggest considering alter- natives to a mandatory or \u201cone-size-fit"] [20.040006637573242, 11.735991477966309, " These data were collected via Excel for program numbers and via SurveyMonkey for other questions.\nSite Information\n1. Choose your health system:\n2. WhatwasthedateofyourfirstTHRIVEtraining?[Askedonlyforfirstadministrationoftracker]\n3. How many THRIVE"] [20.04438018798828, 11.741938591003418, "ling\nFlipped Classroom/Modules\nActivity: Lessons and Hopes Reflection and Kahoot Review\nThere Is No \u201cI\u201d in Team\nCan We All Get Along\nTeam of Teams\nDevelopmental Goals Discussion\nReflective Portfolio/Journaling\nTHRIVE Journey Sharing\nTHRIVE Wrap Up\n7."] [20.044097900390625, 11.741363525390625, "on administrative, management, and other tasks noted above, how frequently have you engaged in any of the following activities since THRIVE began?\n Never\nOnce or twice\nAt least monthly\nAt least weekly\nDaily\n Held discussions or gave presentations to "] [20.042436599731445, 11.73898696899414, "components of THRIVE where there is more or less engagement?\n[If repeat] Have there been any changes in the level of involvement or engagement of caregivers over the past six months?\n9. [If new] What are common issues you see that THRIVE caregivers a"] [20.047367095947266, 11.74487018585205, "d you recommend THRIVE to a friend or new hire interested in caregiving? Why or why not?\nOrganizational Culture\n15. How has COVID-19 impacted your ability to do your job? 16. What do you like about working at [Facility/Site of Care]?\n 79\nMultisite"] [20.0647029876709, 11.767379760742188, "16 18.0 30 33.7\n5 5.6 35 38.9 50 55.6\n Night shift work\nN\n%\n Weekend work\nN\n%\n11. In the past 3 months, how many days or shifts did you miss work due to illness, injury, extra rest, etc. (not including approved days off)? (n = 90)\n Missed shifts\nN\n%\n"] [20.04869270324707, 11.746050834655762, "\n27.0\n27.0\n31.5\n33.7\n28.7\n 17. To what extent has THRIVE helped you improve in the following areas?\n None\n Little\n Some\n Quite a bit\n A great deal\n Ability to attend work more consistently (n = 89)\nRelationship with manager (n = 89)\nRelations"] [12.863391876220703, 14.032865524291992, "2 9 65\n20.7 31.0\n32.2 20.7\n36.1 15.1\n40.2 8.1\n18.6 8.1\n29.9 16.1\n23.0 26.4\n21.8\n21.8\n19.5\n20.7\n24.1\n14.9\n16.1\n16.1\n26.4\n21.8\n19.8\n14.0 10.5 75.6\n31.0\n20.7\n11.6\n5.6\n8.1\n5.8\n27.6\n9.3 90.7\n0 0 0 0\n Turnover intention\nN\n%\n SD\n D\n N\n A\n SA\n 4."] [12.925395965576172, 14.085963249206543, "ed household income\nN\n%\nLess than $40,000\nBetween $40,001 and $60,000 Between $60,001 and $80,000 Between $80,001 and $100,000 More than $100,001\n53 63.9 18 21.7 4 4.8 4 4.8 4 4.8\n30. How many people are living or staying at your home? Include yourse"] [16.24570083618164, 7.652707576751709, "served as our assurance of compliance with the regulations of 17 federal departments and agencies. According to this assurance, the HSPC is responsible for review of all research, regardless of the source of funding. The HSPC monitors research on an "] [20.035432815551758, 11.730009078979492, "r- mination reason (if applicable), age, gender, race, ethnicity, full-time status, type of work shifts, setting (i.e., hospital, nursing home, or home health care), and pay rate. Following receipt of data, we held phone discus- sions and corresponde"] [20.03478240966797, 11.73006534576416, "program was then put on pause and thus Year 3 data were not collected due to this pause and anticipated changes to the intervention.\n2 If a site did not provide this information, RAND used termination reasons to exclude such individuals.\n 91\nMultisi"] [20.03609848022461, 11.731046676635742, "e the time period before the COVID-19 pandemic began (i.e., the first nine months of the first program year [Year 1]); and (4) an uncensored version of the main analysis following Year 1 hires for a full 12 months after hiring.\n92\nSurvival approach\nM"] [20.03727149963379, 11.73166561126709, "enominator of this equation, for example, limiting to up-front fixed costs, such as computers, furniture, and construction. We chose the most inclusive definition, which will result in lower estimated losses per investment dollar.\n 95\nMultisite Hea"] [20.036678314208984, 11.726932525634766, "rganization.\n 96\nMethods for Assessing Return on Investment\n TABLE H.2\nProgram Benefit Categories\n Category\nCost saving areas\n(Reported to RAND in Excel; rate information from administrative data)\nInputs\nHiring and recruitment\nBringing on b"] [20.024478912353516, 11.719161987304688, "7, No. 3, 2002, pp. 565\u2013573.\nEspinoza, R., 8 Signs the Shortage in Paid Caregivers Is Getting Worse, Bronx, N.Y.: PHI, 2017.\nFaul, F., E. Erdfelder, A. Buchner, and A. G. Lang, \u201cStatistical Power Analyses Using G*Power 3.1: Tests for\nCorrelation and "] [20.0258731842041, 11.722419738769531, "As of April 22, 2022: https://www.phinational.org/resource/direct-care-workers-in-the-united-states-key-facts-2/\nRAND Center to Address Racial Equity Policy, webpage, undated. As of June 30, 2022: https://www.rand.org/well-being/racial-equity-policy."] [6.426269054412842, 15.552678108215332, "2020 California Neighborhoods Count\nValidation of U.S. Census Population Counts and Housing Characteristic Estimates Within California\nLANE F. BURGETTE, BEVERLY A. WEIDMER, ROBERT BOZICK, AARON KOFNER, MICHAEL TZEN, JENNIE E. BRAND,\nHIRAM BELTRAN-SAN"] [6.408384323120117, 15.528372764587402, "al analysis, to determine the efficacy of using administrative records for small-area population and housing estimates, and to help measure the effectiveness of California Complete Count\u2014Census 2020 outreach efforts. This report summarizes the findin"] [6.416921138763428, 15.530292510986328, "fforts in advance of our in-field activities.\nWe appreciate the support of several individuals who provided input during the sampling design and the writing of this report: Ethan Sharygin, Fennis Reed, Tom Belin, and Paul Ong. Marc Elliott and Ann Ha"] [6.405667304992676, 15.52099895477295, "s, conducted by the U.S. Census Bureau, is critical to states because its results are used to reapportion seats in the U.S. House of Representatives; guide state and local redistricting; and form the basis for allocating federal funds, such as those "] [6.41302490234375, 15.525186538696289, ". In-field address canvassing subsequently verified the remaining 35 percent of addresses that were not able to be updated or verified through in-office address- canvassing operations. In contrast, the CNC team undertook a completely in-person physic"] [6.405271530151367, 15.524675369262695, "re of\nvii\nour study relative to the mandatory nature of the decennial census, which has greater outreach efforts, a larger workforce, and other resources.\nOur study identified 5 percent more housing units than the census. We 23,929 housing units in t"] [6.400660514831543, 15.518310546875, "lity data while facing pressures about costs, a fuller in-field address-canvassing operation, a shorter amount of time between phases, and additional statistical imputation methods could inform future census- related collection and processing efforts"] [6.40640115737915, 15.52293586730957, ".......................................................xi 1. Introduction .................................................................................................................................1\nBackground .................................."] [6.407642364501953, 15.517121315002441, "CNC Address-Canvassing Form Final Codebook ...................................................66 Appendix C. CNC Survey and Enumeration Form .......................................................................74 Appendix D. CNC Short-Form Survey ."] [6.4077935218811035, 15.528191566467285, ".....................................................27 Table 3.2. Response Rates by Structure Type...............................................................................28 Table 3.3. Response Rates by Occupancy Status ......................."] [6.401726722717285, 15.517556190490723, "other states, California has a disproportionate number of residents who are\n considered traditionally hard to count; these individuals include foreign-born residents, recent\n migrants, homeless individuals, renters, individuals living in homes withou"] [6.40297794342041, 15.517388343811035, "l-area population estimates produced from the 2020 Census. The primary sampling unit for the CNC is the census block, which is the lowest level of geography for which the U.S. Census Bureau provides publicly available population counts. Census blocks"] [6.398197174072266, 15.522980690002441, "o 105 potential strata. However, we identified only 57 unique strata because not all land-use types were present in each region.\nTo draw from the demographic sampling frame, we first identified five major cities to include alongside the original seve"] [6.4071478843688965, 15.519561767578125, "igure 2.1. Development of Strata for the Geographic and Demographic Sampling Frames\nGiven the extensive preparation required for data collection, the initial sample was drawn using the 2010 Census block designations because the block boundaries for t"] [6.395176887512207, 15.51779556274414, "g each block to identify and document every single housing unit and its corresponding address. In the third phase, we attempted to undertake a complete enumeration of all of the residents living in each housing unit identified during the address-list"] [6.389822483062744, 15.518750190734863, "t between our data collectors and their law enforcement agents. In addition, several agencies posted information about our study on their Facebook pages or requested electronic copies of the study brochure in order to post it on their community virtu"] [6.3926682472229, 15.510111808776855, "tion, we describe the activities conducted during each phase.\nPhase 1: Block Observations\nIn preparation for the listing of addresses in the sample of blocks selected for the study, the four field supervisors were tasked with driving to each of the b"] [6.375152111053467, 15.499899864196777, "quired the address lister to confirm or update the address for each structure on the block and code the structure type, the housing unit type, whether the housing unit appeared to be occupied or vacant, other housing unit characteristics (e.g., the p"] [6.394381046295166, 15.513910293579102, "ries, identifying the starting point for listing, and listing all of the structures on a block (residential, commercial, group quarters, or other). We also reviewed the process by which an interviewer needed to update or add an icon indicating a stru"] [6.390190124511719, 15.510154724121094, "g units took place between January 14 and March 13, 2020, and was conducted using an electronic form and an iPhone 8. Prior to going into the field, we loaded the most up-to-date block maps available (obtained from the U.S. Census Bureau in 2019) and"] [6.379982948303223, 15.50179386138916, "e or apartment number on the exterior of the dwelling. Once data collectors finished listing a block, they circled back to each housing unit where they were unable to confirm the address with a resident to see whether there was anyone at home who cou"] [6.3714599609375, 15.472525596618652, "nia on March 13, 2020, we were forced to send all field staff home and curtail field validation after validating only ten blocks (6 percent of all blocks). No major quality issues were identified in the blocks that were relisted for the purpose of qu"] [6.401905536651611, 15.517481803894043, "t each residential housing unit, including the dwelling type; any issues related to gaining access (e.g., secured building, gated community, guard dog, an ADU located at the back of a property); and, when available, information collected about the ho"] [6.389097690582275, 15.512155532836914, "wo forward translations, (2) a review of both translations by a bilingual reviewer, and (3) the resolution of any translation issues or differences between the forward translations by a committee made up of the translators, the reviewer, and a biling"] [6.38107442855835, 15.509112358093262, "rvey invitation letter and study brochure were printed in English on one side and Spanish on the other and included a note that listed the languages in which the survey was available. The homepage for the web survey included a drop-down menu that all"] [6.39076566696167, 15.509617805480957, "of people who could be in a room at the same time, we had to adapt our Telephone Survey Center operations to allow telephone interviewers to work remotely. This required the purchase of tablets and software that allowed telephone interviewers to secu"] [6.395817279815674, 15.511624336242676, "inutes, and most interviews were completed in the first visit to a household. In addition, interviewers provided respondents with brochures with a list of social services and COVID-19 resources in the area.\nField Staff Recruitment and Training\nStaff "] [6.3942975997924805, 15.511377334594727, "o keep interviewers and respondents safe (e.g., face masks, face shields, hand sanitizer, gloves, alcohol wipes). Finally, field interviewers were required to be shadowed by one of the field supervisors or a trainer before being allowed to work indep"] [6.395153999328613, 15.512850761413574, "cash for those who completed the survey in person with a field interviewer. Upon completion of the interview, respondents who participated in person received a postpaid incentive in cash and were required to sign a receipt for the incentive. Incentiv"] [6.402599334716797, 15.51052188873291, "y staff meetings, we identified and congratulated the highest-producing region and the highest-producing interviewers and field supervisor in each region and provided them with an additional bonus.\nQuality Assurance and Control\nThroughout the CNC enu"] [6.39207124710083, 15.508106231689453, " two interviewers drop out before the start of training and another two drop out during training. In addition, over the first eight weeks of data collection, we lost 20 field interviewers. Most of the interviewers quit over COVID-19 concerns or becau"] [6.389886856079102, 15.511585235595703, "d to conduct the survey outdoors from a distance of at least six feet. The use of protective equipment and the restrictions on where and how interviewers could conduct the survey made it challenging for them to establish rapport with respondents.\nCon"] [6.402143955230713, 15.517634391784668, "tly affected air quality, which affected interviewer productivity and contributed to staff turnover. Two of the field interviewers were forced to leave the project because they had asthma and were not able to work outdoors under the challenging condi"] [6.397733211517334, 15.507444381713867, "ere is not a one-to-one correspondence between our approaches and those of the federal census. To partially compensate for these differences, we strategically invested in a handful of processes where there were opportunities to improve upon those use"] [6.4163055419921875, 15.53542423248291, " respondents or other enumeration activities. The U.S. Census Bureau also used administrative records to impute\n24\nmissing data. Because our address-listing process was essentially its own stand-alone survey, we included a question to the resident of"] [6.438051223754883, 15.575393676757812, "e rates for eligible housing units that reported at least their TNR (partial response). We also report full response rates, which count households that provide demographics for all residents (full response). Some respondents filled out part of the su"] [6.43020486831665, 15.575048446655273, "tributed to this issue. In addition, housing units in blocks where relatively few households exclusively use English at home were less likely to respond. The CNC was also unable to obtain responses from most group quarters. As mentioned earlier, beca"] [6.45452880859375, 15.60367202758789, " 674 50 65 28 21 25\nExists in the fringea\nGroupquarters 14 0 0 \u2014 \u2014 \u2014\nResident-Level Characteristics**\n Structure Type\nAll\nADU\nEmpty trailer pad/ mobile home site\nHispanic\nRace Ethnicity Age Response Response Response\nRate Rate Rate (%) (%) (%)"] [6.462574481964111, 15.609061241149902, " residents who completed the respective race, Hispanic ethnicity, and age survey responses.\n* The denominator is the total number of eligible housing units. ** The denominator is the estimated total number of residents.\n29\nHousing Type\nAll\nApartment:"] [6.463274955749512, 15.616586685180664, "umber of residents\u201d survey item. Race response rate, Hispanic ethnicity response rate, and age response rate refer to the estimated percentages of total residents who completed the respective race, Hispanic ethnicity, and age survey responses.\n* The "] [6.464200019836426, 15.613340377807617, "eligible housing units.\n** The denominator is the estimated total number of residents.\n32\nprovided the total number of household\nTable 3.7. Response Rates by Urban Versus Rural Categorization Housing Unit\u2013Level\n Characteristics*\nFull TNR\nResponse R"] [6.465978622436523, 15.616718292236328, "\nTotal Eligible Housing Units (n)\nHispanic\nEthnicity Age Response Response\nRate Rate (%) (%)\n52 51\n58 57 55 54 47 46\nTotal Estimated Number of Residents (n)\n51,304\n12,267 16,655 22,382\n 23,929 39 54 50\n5,548 42 59 54\n7,407 40 55 51 10,974 37 5"] [6.4233622550964355, 15.530656814575195, "hbors; and multiple imputation via chained equations, where the conditional models considered include classification and regression trees and random forests. In combination with the imputation model itself, we considered several design choices that a"] [6.419158935546875, 15.523724555969238, "rmation. However, allowing the number of data elements that need to be imputed to vary by the value of another variable (i.e., having the number of race/ethnicity/age data elements vary according to the number of residents in the housing unit) is a n"] [6.425225257873535, 15.505620002746582, "algorithm should have relied more heavily on those data. The primary voter registration data elements that we used were voter names, which were translated into race/ethnicity probabilities through BISG. The address match rates for April and November "] [6.405942440032959, 15.516883850097656, "g unit h, found in a block b, nested in its demographic strata \ud835\udc51# (or geographic strata \ud835\udc54 ), with number of housing units #hu, we computed final weights \ud835\udc64\u2217\u2217 as\n$%\n! ! #huin\ud835\udc51 #huin\ud835\udc54 #huin\ud835\udc51 # # &\u2208\u22c3)! &\nThat is, a block was sampled, \ud835\udc43(\ud835\udc4f \u2208 \ud835\udc46), if it was "] [6.393827438354492, 15.499966621398926, " higher than that of the census. In total, the CNC identified 23,929 housing units, compared with 22,668 housing units identified in the 2020 Census.\nFigure 4.2 displays the same data as Figure 4.1 but focuses on differences; we can see that the CNC "] [6.408604621887207, 15.511869430541992, "g similar estimates in the two data sources.\nFigures 4.4 and 4.5 separate the block-level totals by demographic characteristics. Notably, the single-race Asian imputed estimates are generally lower in the CNC, and the single-race White imputed estima"] [6.408123016357422, 15.51729679107666, "correspondingly imputes many zeroes. Note also that, in the cases in which there is a substantial deviation between the CNC and the census (e.g., block 1224001011 in Santa Cruz County), the difference does not appear to be driven by abnormal shares o"] [6.404300689697266, 15.512009620666504, "ise, and zero (no difference) is well within the resulting 95-percent confidence intervals. These confidence intervals also ignore uncertainty associated with the differences across imputation approaches shown in Figure 4.8.\nTable 4.2. Survey-Weighte"] [6.404376983642578, 15.505764961242676, " provide evidence regarding the accuracy of the census counts.\nTable 4.4. Number of Housing Units in CNC and Census\n CNC Housing\nCounty Units\nCNC CNC Occupied Vacant\nCensus\nHousing Census\nUnits Occupied\nCensus Vacant\n Alameda 1,494 1,241 "] [6.411101818084717, 15.509354591369629, "and other complicating factors. Because of these difficulties, the CNC achieved a response rate that was lower than originally planned for.\nNonetheless, the study produced several findings that might be helpful for future enumeration efforts. Regardi"] [6.394092082977295, 15.51068115234375, "ions support the U.S. Census Bureau and state policymakers in making decisions that result in high- quality data collection in future efforts.\n53\nAppendix A. CNC Block Observation Form\nIn preparation for the listing of addresses in the sample of bloc"] [6.405839920043945, 15.543255805969238, "BLOCKID ABOVE BLANK? IF IT IS BLANK AND THIS IS A NEW STRUCTURE MAKE SURE YOU\u2019VE COPIED FROM A NEARBY STRUCTURE. IF IT IS INCORRECT PLEASE MAKE SURE YOU\u2019VE LAUNCHED FROM THE CORRECT STRUCTURE.\n NAME\n WORKER_NAME\n ANSWER\n Text\n NAME\n block_blank_"] [6.41303014755249, 15.54499626159668, "THE PROPERTY.\nTYPE int\nHOW MANY ADDITIONAL HOUSING UNITS IN ADDITION TO THIS [HOUSE/APARTMENT] ARE THERE AT THIS ADDRESS (ON THIS PROPERTY)? IF REFUSED, ENTER 98 ENTER #:\nTYPE Int\n NAME\n HU_OCCUPIED\n ANSWER\n Yes 1\n No 0 Could not observe 8\n NAME\n"] [6.417126178741455, 15.526633262634277, "/ Sent survey in from 3 different location\n 73\nAppendix C. CNC Survey and Enumeration Form\nThis appendix provides the CNC survey and enumeration form.\nCNC $15 Survey\n 74\n 75\n 76\n 77\n 78\n 79\n 80\n 81\n 82\n 83\n 84\n 85\n 86\n 87\n 88\n 89\n 90\n 91\nCNC $10 Sur"] [6.441295623779297, 15.56033706665039, " in California.\nWho is doing this study?\nThe study is being conducted by the RAND Corporation in collaboration with the State of California\u2019s Demographic Research Unit. RANDisanonprofit,nonpartisanresearchorganizationbasedin Santa Monica, CA. For mor"] [6.428200721740723, 15.550315856933594, "parte.\nEste estudio le da la oportunidad de\nproporcionar informacio\u0301n que ayudara\u0301 a\nmejorar co\u0301mo el Estado de California\nasigna los fondos para los programas y los servicios, y nos ayudara\u0301 a evaluar el e\u0301xito del Censo de 2020 en California.\n\u00bfQuie"] [6.419486045837402, 15.523271560668945, "HU_RESIDENTS NUMBER_OF_VISITS\nSTRUCTURE_TYPE\nage18ou \u2014 hisp_cat \u2014\nUsed to Impute Demographics\nVariable\nLC\nmos_dem\nmos_geo\nn_samp_obs_dem\nn_samp_obs_geo\npr_dem\npr_fin\npr_geo\npr0_geo\nqr_dem\nqr_dem_in_geo\nREGION\nSAMPLE\nsampled\nstrata_unif\nw_hu\nData Sour"] [6.419488430023193, 15.51540756225586, "\nCNC names (BISG)\nCNC names (BISG)\nVoter registration (April; BISG)\nVoter registration (April; BISG)\nVoter registration (April; BISG)\nVoter registration (April; BISG)\nVoter registration (April; BISG)\nVoter registration (April; BISG)\nVoter registratio"] [6.428953647613525, 15.522235870361328, "ample Designs: Sampling with Multiple Overlapping Frames,\u201d Survey Methodology, Vol. 37, No. 2, December 2011, pp. 197\u2013213.\nSperrin, Matthew, and Glen P. Martin, \u201cMultiple Imputation with Missing Indicators as Proxies for Unmeasured Variables: Simulat"] [20.784284591674805, 8.386153221130371, "Evaluation of the California County Resentencing Pilot Program\nYear 1 Findings\nLOIS M. DAVIS, LOUIS T. MARIANO, MELISSA M. LABRIOLA, SUSAN TURNER, MATT STRAWN\n Prepared for the California State Legislature\nSOCIAL AND ECONOMIC WELL-BEING\n For more inf"] [20.786901473999023, 8.38452434539795, "tor of the pilot program. The pilot term is September 1, 2021, through Sep- tember 1, 2024; the evaluation term is September 1, 2021, through January 31, 2025. The evaluation comprises three components: a descriptive and outcome analysis of data coll"] [20.788116455078125, 8.384514808654785, "ion 1170, paragraph (1), subdivision (d) of the California Penal Code to reduce sentences of eligible prisoners. In June 2022, SEC. 8 Section 1170.01 was amended and renumbered to 1172 (California Legislative Information, 2021). Nine Cali- fornia cou"] [20.787830352783203, 8.385655403137207, "PDs indicated overall support for the program.\n\u2022 The DA office and PD office staff we interviewed all expressed their commitment to and interest in the opportunities the pilot program afforded their counties to address discrepancies in sentencing for"] [20.785886764526367, 8.384989738464355, " a sentence enhancement.\n\u2022 We caution the reader about drawing firm conclusions at this early stage of the pilot, as the patterns we identify may change over time as we analyze more cases and the counties have the chance to fully develop their pilot "] [20.786176681518555, 8.386967658996582, "................... 9\nCHAPTER THREE\nEarlyInterimResults....................................................................................................... 13 DAResentencingReviewResults ............................................................"] [20.771007537841797, 8.398221969604492, "rosecutor-Initiated Review and Resentencing Process Discussed in\nThisReport..................................................................................................... 14\nTables\n1.1. Summary of Funding for California County Resentencing Pilo"] [20.776090621948242, 8.413569450378418, " 20\n3.14. Years Added to Original Sentence Length for Enhancements Among Cases Considered\nbyaCountyDAforResentencing:September1,2021,ThroughFebruary28,2022................. 20\n3.15. Years Served by Individuals Considered by a County DA for Resentenci"] [20.78683853149414, 8.386275291442871, "o programs to help reduce recidivism (Pew Charitable Trusts, 2017, p. 1; Mauer, 2019).\nThe public is in favor of less punitive options. A 2018 national poll indicated that three-quarters of Ameri- cans feel the justice system needs improvements, with"] [20.784400939941406, 8.387052536010742, "the county DA office and PD office and may include a CBO within each pilot county.\nFor the nine counties engaged in the pilot program, the pilot runs from September 1, 2021, through Sep- tember 1, 2024. Table 1.1 summarizes the funding provided to th"] [20.783485412597656, 8.38984203338623, "uals from the county who are cur- rently incarcerated in state prison. Several of the county DA offices also have indicated that they expect their inclusion criteria to evolve.\nAB 2942, 2018, the first prosecutor-initiated resentencing law in the nat"] [20.784215927124023, 8.388915061950684, "-referral from the incarcer- ated individual or their family, or from a CBO. The county DAs, as discussed in Chapter Four, vary in terms of what sources of referral they will accept.\n4\nTABLE 1.3\nCommon Criteria Used to Exclude Cases from Resentencing"] [20.788097381591797, 8.385456085205078, " experiences regarding how these cases are handled and processed by the county DA and PD offices.\nAs shown in Figure 1.2, cases referred to the court for resentencing are eventually heard and a decision rendered. The decision may result in the resent"] [20.80078887939453, 8.382392883300781, "ds.\nOutcomes and Other Measures Study\nThis component of the study will measure the characteristics and outcomes at each phase of the resentenc- ing process, including characteristics of the incarcerated individuals; offenses and sentences of the revi"] [20.75223159790039, 8.40473461151123, "e visits will be conducted to the pilot counties.\nCost Study\nThe legislation requires that the evaluation include a cost study to estimate the resources required to imple- ment the pilot activities, including both new expenditures on personnel and ot"] [20.763673782348633, 8.408019065856934, "ts discussed in Chapter Three. Appendix D con- tains the implementation interview instrument.\n8\nCHAPTER TWO\nCalifornia County Resentencing Pilot Program: Context\nThis chapter reviews recent resentencing efforts and summarizes other relevant sentencin"] [20.490068435668945, 8.66464614868164, "islation to reduce the size of the prison population. Table 2.2 shows key legislation and policies related to prison downsizing in California\n 9\nEvaluation of the California County Resentencing Pilot Program\n TABLE 2.1\nSelect Resentencing in Californ"] [20.433210372924805, 8.698261260986328, "ertain individuals convicted of lower-level offenses were to serve their sentences locally rather than be sent to state prison. These individuals were referred to as \u201cnon-non-nons\u201d\u2014nonserious, nonviolent, non-sex offenders. Second, certain individual"] [20.492677688598633, 8.78946590423584, "014 Increased credits certain inmates earn for maintaining good behavior; created release consideration for certain nonviolent inmates with third-strike sentences\n2016 Expanded inmate eligibility for release consideration; increased CDCR\u2019s authority "] [20.75261116027832, 8.441694259643555, "Prop 47. Additional senate bills passed between 2017 and 2019 reduced or made optional the use of certain sentencing enhancements for individuals.\nThe inmate population has been under the Three Judge Panel cap since 2015\u2014over seven years. As of early"] [20.78319549560547, 8.391498565673828, " period. Therefore, we focus discus- sion of early results primarily on the DA review portion of the resentencing process.2 Figure 3.1 replicates the illustration of the prosecutor-initiated review and resentencing process first presented in Figure 1"] [20.784976959228516, 8.38888931274414, "59 cases for which a referral review was initiated by the nine pilot county DA offices. Nearly four out of five cases were identified for review internally within the DA offices. Among other sources of referral, self-identification by the incarcerate"] [20.784337997436523, 8.388964653015137, "14 21 60 76 reviews initiated\nSOURCE: Data provided by county DA offices, March and April 2022.\nFebruary\n2022 Total Cases\n51 259\n included in this reporting) may still have been occupying staff already in place. For example, Los Angeles initiated a "] [20.774290084838867, 8.398919105529785, "g were overwhelmingly male. As reported in the county DA data, only three of 259 individuals were female.3 Table 3.6 displays the distribution of race and ethnicity of the individuals reviewed by the pilot DA offices over the reporting period. Over 4"] [20.766199111938477, 8.412535667419434, "ases\n259\n171 88\n SOURCE: Data provided by county DA offices, March and April 2022, and CDCR, June 2022. NOTE: Percentages might not sum to 100 because of rounding.\nTABLE 3.8\nAge at Time of DA Review for Resentencing: September 1, 2021, Through Februa"] [20.812192916870117, 8.472238540649414, "nd-strike cases carry determinate sentences, while third-strike cases carry indeterminate sentences. Percentages might not sum to 100 because of rounding.\nreported separately from all other determinate sentences, and sentences of indeterminate length"] [20.773488998413086, 8.436432838439941, "reporting period. As displayed in Table 3.13, just under 75 percent of reviewed cases had at least one sentence enhancement attached to their sentence, and 36 percent of cases had at least three enhancements. Cases with the greatest number of enhance"] [20.796289443969727, 8.393498420715332, " among reviewed individuals with indeter- minate sentences until they reach their MEPDs. As parole is not necessarily granted as soon as eligibility is reached, some reviewed individuals with indeterminate sentences were beyond their MEPDs at the tim"] [20.77269744873047, 8.418096542358398, "for resentencing\nPercentage 1 Year or Less Remaining\n15.1\n17.6 9.1\nPercentage 1+ to 3 Years Remaining\n23.3\n25.5 18.2\nPercentage 3+ to 5 Years Remaining\n21.9\n23.5 18.2\nPercentage 5+ to 10 Years Remaining\n30.1\n25.5 40.9\nPercentage Over 10 Years Remaini"] [20.777019500732422, 8.396333694458008, "on recidivism for individuals who are resentenced and released. We will obtain automated criminal history records from the California Department of Justice (DOJ) and record convictions at one-year post return to the community. We will break down conv"] [20.76827621459961, 8.40186595916748, "lop a robust application and reentry plan. Still, one county DA felt that it is the job of the individual to develop a strong application packet, includ- ing a reentry plan. This interviewee did not feel that it was necessarily the role of the DA to "] [20.78691864013672, 8.386589050292969, "ion, we are handicapping these people; we are depriving them of some of the preparation that goes with reentry planning and being on parole.\nCurrent Status of Implementation of the Pilot Program\nTo conduct the work of resentencing efficiently, counti"] [20.786603927612305, 8.386871337890625, "he level of PD office involvement, though, varies across the counties; some PD offices meet regularly with the DA office, and others meet rarely. Counties with a history of engaging in resentencing work and DA/PD office collaboration tend to be furth"] [20.787635803222656, 8.386224746704102, "nsideration. Specifically, the pilot counties obtain from CDCR a list of all individuals incarcerated within the county. The DA office then analyzes the data to identify indi- viduals who fall within their tier of cases for review.\nThe pilot counties"] [20.786951065063477, 8.387507438659668, "eir websites with respect to the resentencing guidelines, an application form, and/or FAQs to provide guidance to individuals who would like to be considered for resentencing.\nWhen a case has been identified as eligible for resentencing consideration"] [20.782806396484375, 8.390482902526855, "o the courts for consideration.\nWhen the DA files a resentencing request, a court date may be set to hear evidence and arguments on whether to reduce an individual\u2019s sentence. The packet of information is presented to the judge. In some instances, th"] [20.787708282470703, 8.386796951293945, " resentenc- ing but who did not have a strong enough application (e.g., their reentry plan was weak, they had an RVR within the past three years), some DAs will let an individual know what the issues are and that if they address those deficits, then "] [20.786144256591797, 8.387103080749512, "tiated resentencing, the intent of the legislation was that the participating DA and PD offices would work collaboratively on this initiative as summarized above. Over- all, these two agencies in each of the pilot counties are trying to collaborate a"] [20.78691291809082, 8.38749885559082, "n the pilot, the PD did not fully understand the DA\u2019s eligibility criteria and instead reached out to a number of their clients and obtained their C-files, bringing forward too many cases to consider. Also, the interviewee noted that there was disagr"] [20.73038101196289, 8.416507720947266, "of the pilot. The community-based organization shall have experience working with currently or formerly incarcerated individuals and their support networks, and shall have expertise in at least two of the following areas: (1) Supporting and developin"] [20.78594970703125, 8.387312889099121, "uals to access upon release from prison. These offices have made it a requirement for resentencing consideration that individuals agree to waive any excess credits to increase the likelihood that they will be put on parole and so be able to access re"] [20.787721633911133, 8.3843355178833, "ew and resentencing process is the amount of time it can take to reach out to victims under Marsy\u2019s law (CDCR, undated-b) to notify them that an individual is being considered for resentencing and to get their input. As stated on the Los Angeles DA\u2019s"] [20.78898811340332, 8.385347366333008, "hat influences the time it takes to obtain an individual\u2019s C-file is the length of time they have been incarcerated. If an individual has been incarcerated for a long time, some prison facilities may only have paper records that will need to be scann"] [20.796274185180664, 8.38003158569336, "esentencing\nAs discussed in Chapter One, CDCR has been sending referrals for resentencing consideration to the courts since 2018. 1170(d) provides the CDCR secretary broad authority to look at various factors, such as type of sentence, enhancements, "] [20.78721809387207, 8.385904312133789, " to obtain CDCR data to aid them in selecting candidates for resentencing consideration. Furthermore, the counties had to decide\n35\nEvaluation of the California County Resentencing Pilot Program\n whether to create new resentencing units or use existi"] [20.784048080444336, 8.391521453857422, "ple, \u2018individual has done a lot of programming while incarcerated, has no rules violations,\u2019 whereas another individual may be struggling to get the programming he or she needs or may have mental health issues.\u201d It takes time to sort this out. Fur- t"] [20.785831451416016, 8.386434555053711, "the reporting period. Of those initiated, 163 cases (63 percent) were still pending at the end of the reporting period and eight had been referred for resentencing. We presented data summaries of DA sentencing review uptake, characteristics of review"] [20.790687561035156, 8.382214546203613, " program, it takes time to stand up all the different components of a program and to put into place the processes and procedures for implementing it. We expect to see over time that many of these hurdles will have been addressed and that the pilot co"] [20.78427505493164, 8.388163566589355, ".\n(1) Develop and implement a written policy which, at minimum, outlines the factors, criteria, and processes that shall be used to identify, investigate, and recommend individuals for recall and resentencing. The district attorney\u2019s office may take "] [20.799074172973633, 8.372876167297363, "o later than October 1, 2021. The measures shall include, but not be limited to, the following:\n(1) A summary of expenditures by each entity receiving funds.\n(2) A summary of any implementation delays or challenges, as well as steps being taken to ad"] [20.785995483398438, 8.389120101928711, "allows for comparison between the pilot participant sites. This includes, but is not limited to, collection and reporting of data at the individual case level using the same definitions. Each pilot participant shall provide any information necessary "] [20.789159774780273, 8.382434844970703, "t shall include a calculation of the total number of days of incarceration avoided, and amount of time by which the person\u2019s earliest possible release date or minimum eligible parole date was advanced due to prosecutor-initiated resentencing for thos"] [20.787311553955078, 8.386899948120117, "ch stage of the resentencing process?\n 3. What is the impact of the resentencing pilot on case outcomes and recidivism?\n4. What is the tangible and intangible cost of the pilot program?\nTABLE B.1\nEvaluation Components and Sources of Data\nData Source "] [20.788423538208008, 8.387309074401855, "d the case to the court for recall of sentence, the date the court considered the motion for resentencing, the date the court responded to the motion, the date the court resentenced the indi- vidual, the date the individual was released from state pr"] [20.816204071044922, 8.35737419128418, "ne 2022. Given the timing of this report and the available complete data, results contained in this report cover this first data reporting period, through February 28, 2022. Future data delivery from the DA offices will occur quarterly throughout the"] [20.79420280456543, 8.380194664001465, "ing process, and will provide description of contem- poraneous variables to help place the time reductions into context. Given the early stage of the pilot term at the time of this report, current analyses will focus on univariate descriptions of var"] [20.78461265563965, 8.382556915283203, "m analysis\u2014it is too early. However, we anticipate that we will have enough cases for the second and final report. We will report on convictions during a one-year follow-up (longer if enough cases have been released to allow for longer follow-ups). S"] [20.77830696105957, 8.3833646774292, "lementation assessment interviews with each site, both the DA and PD offices, and supplementing the findings with additional interviews with other county-level stakeholders, CBOs and any technical assistance help, such as FTP.\nRecidivism information "] [20.76128578186035, 8.416901588439941, "nditures for the pilot program, regardless of the funding source.\n6 We use project quarters versus the state\u2019s fiscal quarters because the legislation requires that counties report their cost data on a quarterly basis for the pilot program, which beg"] [20.765888214111328, 8.410528182983398, " CA Penal Code Section 666 for additional specific details).\nTABLE C.3\nDrug Crime Cases Considered by Pilot DAs for Resentencing: September 1, 2021, Through February 28, 2022\n Cases considered by DA\nBy DA review outcome\nPending or referred for resen"] [20.78667640686035, 8.384233474731445, "et\u2019s get started.\nII. Description of Jurisdiction\n1. What are the most common local crime problems?\n2. Describe the structure of the Prosecutor\u2019s Office.\n3. How many felony and misdemeanor cases are prosecuted yearly?\n4. Is an annual statistical repo"] [20.788667678833008, 8.384652137756348, " interviewed during a prior site visit, ask if their job title and responsibilities have changed since you last spoke, and how long they have been in the new role.\n2. How many prosecutors work on the resentencing pilot program? How many paralegals wo"] [20.78866195678711, 8.384531021118164, " pilot program in September 2021\n57\nEvaluation of the California County Resentencing Pilot Program\n 2. Please explain the process of working with the court. VIII. Partnerships\n1. Are you partnering with any community-based organizations to implement "] [20.462005615234375, 8.681859016418457, "AND provided?\n2. Do you create your own regular performance reports of any kind?\n59\nAbbreviations\nAB Assembly Bill\nCBO community-based organization\nCDCR California Department of Corrections and Rehabilitation\nC-file California Department of Correctio"] [20.49436378479004, 8.65434741973877, "August 29, 2022: https://www.cdcr.ca.gov/news/2021/12/08/california-department-of-corrections-and-rehabilitation-announces- changes-to-good-conduct-credits-staff-misconduct-and-disciplinary-process/\nCalifornia Department of Corrections and Rehabilita"] [20.491405487060547, 8.662885665893555, "s of September 23:\nhttps://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB483\nCalifornia Senate Bill 678, Criminal Recidivism, October 11, 2009. As of September 23, 2022: https://leginfo.legislature.ca.gov/faces/billNavClient"] [20.483394622802734, 8.671833992004395, "isan-approach-to-public-safety-reform\nPrison Law Office, \u201cPenal Code 1170(d) CDCR Resentencing Recommendations,\u201d San Quentin, Calif., September 2018. As of August 1, 2022: https://prisonlaw.com/wp-content/uploads/2018/09/PC1170d-CDCR-resentencing-AB-"] [12.995888710021973, 4.274860382080078, " Reducing Deaths in Law\nEnforcement Custody\nIdentifying High-Priority Needs for the Criminal Justice System\nDuren Banks, Michael G. Planty, Madison Fann, Lynn Langton, Dulani Woods, Michael J. D. Vermeer, Brian A. Jackson\nCongress enacted the Death i"] [12.984354972839355, 4.278496742248535, "tality.\n\u2022 A taxonomy of deaths or critical incidents that occur in law enforcement custody should be developed to provide necessary context to understand law enforce- ment\u2019s role.\nData and reporting\n\u2022 Challenges that law enforcement agencies (LEAs) a"] [12.984956741333008, 4.280869960784912, "create efficiencies and reduce burden on reporting agencies\n\u2022 clear guidelines to support accurate and timely reporting, including the specification of who is responsible for report- ing, what data elements, and when\n\u2022 a foundation for translating kn"] [12.979405403137207, 4.280490875244141, "deaths of (1) any person detained, under arrest, or in the process of being arrested by any officer of law enforcement, or (2) any person incarcerated, detained, or en route to be incarcerated or detained at government facilities. DCRA further requir"] [12.974437713623047, 4.28623628616333, "ed alternate data collection strategies and DOJ determined what agency should be responsible for collecting the information mandated by DCRA. Supplemen- tary homicide reports, collected through the Federal Bureau\nof Investigation\u2019s (FBI\u2019s) Uniform Cr"] [12.975968360900879, 4.287423610687256, "e data. The officers employed by these agencies represent 54 percent\nof federal, state, local, and tribal sworn officers in the United States (FBI, undated). The Office of Management and Budget (OMB) has stipulated that limited data from the National"] [12.985597610473633, 4.235162258148193, "\u2019s (NIJ\u2019s) Prior-\nity Criminal Justice Needs Initiative (PCJNI), a 2016 panel explored specific needs surrounding mortality in correctional settings (Russo et al., 2017). BJS reports that approximately 1,000 inmates die in U.S. jail facilities each y"] [12.983057022094727, 4.277407169342041, "ram estimated that each year 1,000 individuals die from a police shooting; 1,200 deaths result from all types of law enforcement use of force (including police shootings and other uses of force); and 1,900 deaths of all manners occur in law enforceme"] [12.988717079162598, 4.266268253326416, "surrounding these deaths; information needs of practitioners, policymakers, and the public; and opportunities to improve policies and practices that may prevent or reduce deaths occur- ring in law enforcement custody while also ensuring public safety"] [12.996253967285156, 4.257967472076416, " enforcement custody, and the public.\nAs an initial step in the development of the engagement, RTI staff reviewed relevant literature (e.g., scientific studies, technical reports) on the challenges of collecting comprehen- sive, national-level inform"] [14.674829483032227, 2.1649670600891113, "given an opportunity to review the rankings of needs following the workshop and vote to move needs up or down\nin terms of importance. For a more detailed description of the prioritization methodology that we employed, including iden- tified limitatio"] [12.984694480895996, 4.270016193389893, "cidents that could result in fatali- ties, including all incidents in which law enforcement deploy deadly force and deaths occurring in law enforcement custody that meet other inclusionary criteria described in DCRA: accidents, suicides, deaths due t"] [12.986772537231445, 4.274658203125, " engagement (e.g., with other LEAs, advocates, policymakers) to institutionalize LEA reporting.\n\u2022 Leverage existing reporting platforms and coordinate across providers to create efficiencies and reduce burden.\n\u2022 Conduct user experience research to un"] [12.982220649719238, 4.28014612197876, " a Multiple needs were associated with this issue, but the others did not fall in the top tier. See the technical appendix for a complete list of needs.\nity occurring during an incident involving active law enforce- ment response and (2) any incid"] [12.980640411376953, 4.280843734741211, "imately, the participants cautioned against expanding the collection beyond nonfatal incidents that were the result of law enforcement use of force. The group felt that including serious injuries of bystanders in an accident would likely create chall"] [12.984786987304688, 4.276263236999512, "ere was no need to start from scratch with\na new data collection; instead, they recommended focusing on understanding and addressing the challenges to participating\nWorkshop participants determined that there\nwas no need to start from scratch with a "] [12.98241138458252, 4.277965545654297, "ational Use-of-Force Data Collection and the BJA\u2019s deaths in custody program, and they may also be reportable to state and local systems.\nLEAs may also find reporting to be challenging because\nof their concern about who has access to the information "] [12.978452682495117, 4.286731719970703, "changes to law enforcement training or policy. Although many train- ing programs and policies designed to prevent fatal incidents are in place, there is no rigorous evidence on whether any of these programs reduce fatalities, serious injuries, or unw"] [12.973109245300293, 4.296218395233154, "ategies (GAO, 2021). The FBI\u2019s National Use-of-Force Data Collection may be discontinued by December 2022 if participation in the current data collection approach remains insufficient.3 GAO further recommended that \u201cthe Attorney General should assign"] [14.924491882324219, 2.127985715866089, "ssional and social networks (e.g., LinkedIn) and by reviewing literature published on the topic. We then extend an invitation to those individuals and provide a brief description of the workshop\u2019s focus areas.\nFor this workshop on deaths in law enfor"] [14.926140785217285, 1.931666612625122, "had not been used before). After identifying and refining the needs, we used a vot- ing process based on the Delphi method to elicit prioritization information from the group about the identified needs (RAND Corporation, undated).\nPrior to the COVID-"] [14.86913776397705, 1.8705843687057495, " slides that were edited in real time to incorporate participant revisions and comments.\nOnce the group reached consensus on a group of needs, we conducted a real-time voting prioritization exercise using Del- phi techniques. We asked the panel to an"] [14.720985412597656, 1.838485836982727, "s the group\u2019s collective expected value score for the need.\nWe clustered the resulting expected value scores into three tiers using a hierarchical clustering algorithm. The algorithm we used was the \u201cward.D\u201d spherical algorithm from the \u201cstats\u201d libra"] [14.629156112670898, 1.9424175024032593, "nded outsized impact\u2014for example, when some or all of the needs in one tier have the same or very similar expected values\u2014we also set a threshold that at least 25 percent of the workshop participants must\nhave voted on that need (and then rounded to "] [12.988495826721191, 4.270735263824463, "ty is responsible for providing the information.\n\u2022 Define the lead agency for reporting purposes.\n\u2022 Develop and implement protections that address privacy\nconcerns. Specify appropriate uses of the data for disclo- sure and research purposes and provi"] [12.984339714050293, 4.280365467071533, "y for one or more aspects of the data collection(s) that could inform deaths that occur in law enforcement custody or use-of-force incidents, or both. This can create duplicative reporting and additional burden confusion for data providers.\nPotential"] [12.977117538452148, 4.287267208099365, "e incidents result in nonfatal or fatal injuries.\nThere is a lack of information about policies and practices to recognize and respond to a person experiencing a mental health crisis and general crisis intervention models and programs.\n Table A.1\u2014Co"] [12.981593132019043, 4.280546188354492, " law enforcement custody. LEAs and other stakeholders disagree on which manners of death should be reported.\n20\nTable A.1\u2014Continued\nProblem or Opportunity\nData providers or gatekeepers are concerned about disclosing active case information, respectin"] [12.981035232543945, 4.284461498260498, "n or when an officer discharges a firearm at or in the direction of a person.\n3 OMB stipulated that if the FBI did not achieve 60-percent partici- pation by the end of 2022, the FBI was to end the data collection effort and explore alternatives for c"] [13.013287544250488, 4.245080471038818, "s in United States Vital Statistics and News-Media-Based Data Sources: A Capture-Recapture Analysis,\u201d PLOS Medicine, Vol. 14, No. 10, October 2017.\nGAO\u2014See U.S. Government Accountability Office.\nGBD 2019 Police Violence US Subnational Collaborators, "] [13.89722728729248, 4.159097194671631, "dy: Identifying High-Priority Needs to Reduce Mortality in Correctional Facilities, Santa Monica, Calif.: RAND Corporation, RR-1967-NIJ, 2017. As of February 2, 2022: https://www.rand.org/pubs/research_reports/RR1967.html\nU.S. Government Accountabili"] [13.920584678649902, 4.180497646331787, " multiple national data collection projects on victimization and law enforcement issues. He holds a Ph.D. in justice, law, and society; public administration; and public policy.\nMadison Fann is a public health analyst in the Division for Applied Just"] [13.87968921661377, 4.074193000793457, "quirements & Resources Consortium (RRC) and is intended to support innovation within the criminal justice enterprise. For more information about the RRC and the Priority Criminal Justice Needs Initiative (PCJNI), please see www.rand.org/well-being/ju"] [13.858506202697754, 4.606316089630127, " of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law"] [-3.026461124420166, 8.816950798034668, " Societal Impact of\nResearch Funding for\nWomen\u2019s Health\nIN LUNG CANCER\nMatthew D. Baird Annie Chen Andrew W. Dick Chloe E. Bird Melanie A. Zaber Molly Waymouth Grace Gahlon Denise D. Quigley Hamad Al-Ibrahim Lori Frank\n CORPORATION\n THE WHAM REPO"] [-2.958606004714966, 8.887661933898926, "ouraged through the generous support and collaboration from the following organizations:\nAmerican Heart Association (AHA) is a relentless force for a world of longer,healthier lives dedicated to ensuring equitable health for all\u2014in the United States "] [-2.995094060897827, 8.851696014404297, "ze existing data with sex as a biological variable, to work together to spark new projects, to hire new faculty to build key research areas, to communicate via The WHAM Report, and to establish an ignition point for new leadership in the scientific f"] [-3.000685930252075, 8.84469223022461, ", Neurobiology and Behavior, University of California, Irvine\nRobynne Chutkan, MD, Founder and CEO, Digestive Center for Wellness\nRichard J. Davidson, PhD, William James and Vilas Research Professor of Psychology and Psychiatry, University of Wiscons"] [-3.0067567825317383, 8.837861061096191, " Epidemiology and Prevention, and Professor of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine\nLisa Mosconi, PhD, Director, Women\u2019s Brain Initiative; Director, Alzheimer\u2019s Prevention Clinic; Associate Professor, Neurosci"] [-3.056058883666992, 8.786730766296387, "ith immediate relevance for use by funders, advocacy organizations, researchers, and other stakeholders.\nSoo Borson, MD, Professor of Clinical Family Medicine, University of Southern California; Professor Emerita, University of Washington School of M"] [-3.0579750537872314, 8.784139633178711, "rms of age incidence, mortality, and quality of life yields the following results:\n\u2022 For the U.S. population age 25 and older, more than 22,700 years can be saved across 30 years, with substantial gains in health- related quality of life.\n\u2022 Approxima"] [-3.0575978755950928, 8.784706115722656, "s limited. Even today, the value of research investment on women\u2019s health is not widely accepted. The impact of this oversight is far-reaching.\nAlso unknown is the potential impact of accelerating and increas- ing funding for women\u2019s health research."] [-3.0580899715423584, 8.784699440002441, "Costa, 2021). Research on lung cancer to date has yielded some benefits, but lagging attention to women leaves a knowledge gap.\nQuantifying the impact of research funding investment is a rela- tively new area of inquiry (Adam et al., 2018). Microsimu"] [-3.0570623874664307, 8.784889221191406, "erminology guidance from the NIH, which states the following:\n\u2022 \u201cSex\u201d refers to biological factors and processes (e.g., sex chromo- somes, endogenous hormonal profiles) related to differentiation between males (who generally have XY chromosomes) and "] [-3.0577199459075928, 8.784574508666992, "ife years\nDecreased lung cancer years\nIncreased nursing home years\nMore QALYs\nFewer lost productivity years for patients\nFewer lost productivity years for informal caregivers\nImpact of health improvements on costs\nMore nursing home years\nHealth care "] [-3.0582387447357178, 8.78409481048584, "sing funding for health research on women in terms of economic outcomes. These economic outcomes included the mon-\nMETHODS 11\n 12 SOCIETAL IMPACT OF RESEARCH FUNDING FOR WOMEN\u2019S HEALTH IN LUNG CANCER\netary value of workers being able to stay in the "] [-3.0877199172973633, 8.754495620727539, "bstracts in this research portfolio using NIH RePORTER, the publicly available interface\nof funded extramural NIH projects (NIH, 2020b). The terms used\nto search the retrieved titles and abstracts to determine the total number of women-focused projec"] [-3.0597732067108154, 8.780360221862793, "the impact is three times larger for women than men.\nLost Productivity for People with Lung Cancer\nHealth improvements increase employment and earnings of the lung cancer population in two ways. Fewer years of lung cancer create fewer lost earnings, "] [-3.0579564571380615, 8.784028053283691, ")\nNOTE: Figure shows a 0.1 percent health impact for mortality and incidence and a 0.01 percent impact for QALYs, which is three times larger for women than men.\nRESULTS 17\n 18 SOCIETAL IMPACT OF RESEARCH FUNDING FOR WOMEN\u2019S HEALTH IN LUNG CANCER\n "] [-3.0573880672454834, 8.783394813537598, " when modeling using labor force participa- tion and earnings is selection of earnings profiles. We chose to apply earnings of non-Hispanic white males for all races and ethnicities and genders in the informal caregiving population. This has the adva"] [-3.0576326847076416, 8.78407096862793, "nagement, in terms of the impact on health and quality of life outcomes, can aid with tracking investment impacts in the future, given the findings here of the potential for impact on health-related quality of life of women with lung cancer. The foll"] [-3.0571539402008057, 8.784337043762207, "for- mation, email sbp@rand.org.\n SOCIAL AND BEHAVIORAL POLICY PROGRAM 23\n References\nAdam, Paula, Pavel V. Ovseiko, Jonathan Grant, Kathryn E.\nA. Graham, Omar F. Boukhris, Anne-Maree Dowd, Gert V. Balling, Rikke N. Christensen, Alexandra Pollitt,"] [-3.0593903064727783, 8.782584190368652, "in Lung Carcinogenesis and Lung Cancer Treatment,\u201d Frontiers in Medicine, Vol. 8, 2021.\nScott, Troy J., Alan C. O\u2019Connor, Albert N. Link, and Travis J. Beaulieu, \u201cEconomic Analysis of Opportunities to Accelerate Alzheimer\u2019s Disease Research and Devel"] [2.7806456089019775, 4.248939514160156, "Examining Interventions to Address Infant Mortality\nin Allegheny County, Pennsylvania\nDANA SCHULTZ, SUSAN L. LOVEJOY, EVAN D. PEET\n SOCIAL AND ECONOMIC WELL-BEING\nSponsored by the Richard King Mellon Foundation\nFor more information on this publicati"] [2.7788798809051514, 4.2462992668151855, "ms that affect well- being. For more information, email sbp@rand.org.\n iii\nContents\nPreface............................................................................................................................................ iii Figures......."] [2.783278226852417, 4.2510833740234375, "Interventions ...................................................................................................................... 45 Timing of Intervention............................................................................................"] [2.7765066623687744, 4.244706153869629, "................................. 90\nUnderstanding Participation in Select Programs, Services, and Supports in Allegheny\nCounty .........................................................................................................................."] [2.779128074645996, 4.245788097381592, "..................................................................................................................................... 153\nReferences......................................................................................................"] [2.7724010944366455, 4.238707065582275, "re 15. Factors Related to the Maternal and Infant Context in the Infant Mortality Prediction System with Intervention Management Database................................................................. 80 Figure 16. Correlation of Intervention Parti"] [2.7898030281066895, 4.256476402282715, "........................................................................................ 105 Figure 32. Causal Effects of Preconception/Interconception Care on Infant Mortality ............. 107\nFigure 33. Causal Effects of Specific Types of Preconce"] [2.781263828277588, 4.247994899749756, "7\nviii\nTables\nTable 1. Linkage Between Underlying Factors and Leading Causes of Infant Mortality .............. 8 Table 2. Summary of Data Sources in the Infant Mortality Prediction System with Intervention\nManagement Database ......................."] [2.782932996749878, 4.2522664070129395, "................................. 93 Table 20. Summary of Intervention Effectiveness ..................................................................... 122 Table 21. Summary of Intervention Effectiveness by Risk Factor and by Other Interventions ."] [2.784395694732666, 4.252071857452393, " birth outcomes and infant death. These factors fall into five broad, interrelated categories of risk: maternal health, mental health, stress, risky behaviors, and the context in which the mother lives. Many women, particularly those with low socioec"] [2.7759015560150146, 4.2430009841918945, "er\u2019s utilization of publicly funded social services such as Women, Infants, and Children (WIC); housing assistance; Family Support Centers; substance use disorder services; and mental health services from the Allegheny County Department of Human Serv"] [2.7911489009857178, 4.258851528167725, "Together, the results of the two components of the project provide information that can help health care and community-based social service providers and policymakers identify those pregnant women most at risk for infant mortality, decipher the appro"] [2.8054966926574707, 4.2708282470703125, "ons include legislative or regulatory changes that address social determinants of health or funding decisions for programs such as the Title V Maternal and Child Health Services Block Grant program. Others include efforts such as perinatal regionaliz"] [2.7950940132141113, 4.2617011070251465, " mortality prevention, including breastfeeding and safe sleep. The Pennsylvania Perinatal Partnership facilitates efforts of the Healthy Start projects in the state, the maternal and child health programs organized by the Department of Health\u2019s Burea"] [2.7801337242126465, 4.248194694519043, "ting infrastructure and the need for expanding or improving access and engagement with existing interventions, or for introducing new interventions.\nOverall, Allegheny County has programs, services, and supports that span medical-setting intervention"] [2.766599416732788, 4.237407207489014, "dJAtlantic2Mother\u2019s2\nMilk2Bank Allegheny2County2\nBreastfeeding2 Coalition\n WIC MidJAtlantic2Mother\u2019s2\nMilk2Bank Allegheny2County2\nBreastfeeding2 Coalition\nBehavioral2 health2 services\n Sojourner2House POWER Familylink\u2019s Family2\nTreatment2Centers The2"] [2.7858903408050537, 4.253415107727051, "hers, the infant mortality rate was 10.3 per 1,000; it was 13.8 per 1,000 births when the previous birth occurred less than 1.5 years before.\nIntervention Participation\n\u2022 Seventy-five percent of women received one or more prenatal care visits; among "] [2.7875726222991943, 4.254775524139404, "terms of the size of the effect and the degree of accuracy.\nxx\nIntervention Category\nMedical interventions were estimated to have the largest impact. From the causal inference models, the estimated effects of prenatal care were found to be large and "] [2.7898027896881104, 4.257357120513916, " offerings (e.g., services include prenatal care), or the approach used (e.g., program based on evidence-informed model).\nAmong behavioral health services, the effects of substance abuse services were large and significant, particularly at higher lev"] [2.782724142074585, 4.250585079193115, "men with opioid use disorder, which may reflect more about women struggling with substance abuse issues than it does about the interventions. Both WIC and behavioral health services, on the other hand, did reduce the risk of infant mortality for wome"] [2.783405065536499, 4.250998497009277, "y a key role in whether an intervention is successful.\n\u2022 Educate health care and community-based social service providers about available and effective interventions. Successful referral to interventions often depends on health care and community-bas"] [2.7863423824310303, 4.254542827606201, " coordinated, consistent, and targeted efforts that are initiated as early as possible. The\nxxiv\nearlier health care and community-based service providers can engage with women, particularly those at high risk of poor birth outcomes, the better able "] [2.7790701389312744, 4.246673107147217, "nt evidence is somewhat limited for some of the approaches recommended for expansion (e.g., enhanced prenatal care and doula support) or introduction (e.g., mobile applications). W hen these are implemented, it will be important to examine their effe"] [2.779042959213257, 4.24834680557251, "h syndrome\nUPMC University of Pittsburgh Medical Center WIC Women, Infants, and Children\nxxviii\n1. Introduction\nThe rate of infant mortality, calculated as the number of deaths before age one among 1,000 live births, is widely used as a measure of ma"] [2.755915641784668, 4.24257755279541, " the southwest part of Pennsylvania, with Pittsburgh as its regional hub, Allegheny County has a population of about 1.22 million, with an average age of just over 40; 80 percent of the population is white and 13 percent is black. The median househol"] [2.7652621269226074, 4.244725704193115, ".50 1.00 0.50 0.00\n 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 N a t i o n a l P e n n s y l v a n i a A l l e g h e n y \u0000C o u n t y\nSOURCE: CDC, n.d.b.\nAccess to Perinatal Care\nThe relatively high rate of infant m"] [2.783473014831543, 4.255156517028809, " rate of 5.93 per 1,000. Only in two years (2014 and 2016) in the span between 2003 and 2016 was Allegheny County\u2019s infant mortality rate below 6.00 (Figure 1). A 10-percent reduction in the disparity between black and white infant mortality would dr"] [2.787666082382202, 4.255206108093262, "varied maternal factors that increase risk for poor birth outcomes and infant death (CDC, 2019) (Figure 3). These factors fall into five broad, interrelated categories of risk: maternal health, mental health, stress, risk behaviors, and the context i"] [2.8045523166656494, 4.271397113800049, "ence that\n6\nuntreated maternal depression increases the odds of preterm birth and low birth weight (Grigoriadis et al., 2013; Szegda et al., 2014; Jarde et al., 2016). Anxiety and depression are also both risk factors for maternal complications of pr"] [2.79557204246521, 4.262829303741455, "t. Higher maternal age (34 and older) may increase risk for birth defects and maternal complications of pregnancy (Huang et al., 2008; Bayrampour and Heaman, 2010; de Queiroz Herkrath et al., 2012), whereas lower maternal age (younger than 18 years) "] [2.777418613433838, 4.2450947761535645, "ystem with Intervention Management (IMPreSIv) database. The database includes vital statistics records of all births and infant deaths from ACHD, the social services database from the Allegheny County Department of Human Services (ACDHS), the Magee O"] [2.767428159713745, 4.234085559844971, ", services, and supports addressing the underlying causes of infant mortality; and the causal inference framework to examine intervention effectiveness.\n\u2022 Chapter 3 summarizes the evidence base for interventions that address the underlying causes of "] [2.779168128967285, 4.2466230392456055, "ated keywords for the period 2006\u2013 2016. The results from each search were combined into one master EndNote library with results from each underlying cause grouped into individual folders within the library. All duplicates between database and outcom"] [2.7443149089813232, 4.211370468139648, "tion\n\u2022 eligibility criteria\n\u2022 areas served\n\u2022 year started\n\u2022 referral sources\n\u2022 annual referrals\n\u2022 recruitment methods\n\u2022 annual number served\n\u2022 capacity\n\u2022 number and type of staff\n\u2022 program or service components\n\u2022 intervention model, measures, or tool"] [2.760979175567627, 4.227237701416016, "on participation with the data we observe, then we can mitigate the bias caused by selection. So, just as the University of Pittsburgh team built models to predict infant mortality, as the first step in the causal inference framework we built models "] [2.776278257369995, 4.243300914764404, "s on the causal inference framework and steps in the model development process are provided in Appendix B.\nInfant Mortality Prediction System with Intervention Management Database\nOur causal inference framework is built on and responsive to the IMPre"] [2.7724902629852295, 4.2392072677612305, "f information regarding social, economic, and demographic characteristics of the mother and, in some cases, the father. These include parental education and insurance status. Major maternal and child health risk factors, such as gestational diabetes "] [2.7748348712921143, 4.2415876388549805, "a range of health care and community-based social service providers, we divided the data by type and time period. If the models within the framework rely too heavily on information available only to health care providers, such as blood tests and ultr"] [2.774608850479126, 4.241138458251953, "igure 5 describes the overall data structure by type and time period. Reportable data during the preconception period represent the smallest portion of the overall database, and health care data in the postdelivery period include all of the available"] [2.7587196826934814, 4.225333213806152, "ey identified as important were also included in our models. We then extended this work by developing our own models to predict infant mortality using each type of data at each point in time. We used machine learning algorithms that iteratively impro"] [2.767150640487671, 4.2339324951171875, " participation. Additionally, in order to make the results as relevant as possible for a range of health care and community-based social service providers, we modeled intervention participation using the three data types described. The main results o"] [2.7853708267211914, 4.253022193908691, "rence model enable us to predict who will participate in the interventions, describe the effectiveness of the interventions for different risk factors, and suggest individualized referrals based on the overall risk profile. The main results of this s"] [2.7906529903411865, 4.258367538452148, "y-based organizations, such as Healthy Start.\nPreconception Care\nPreconception care consists of a group of preventive screenings and services designed to reduce modifiable risk factors before a first pregnancy to improve pregnancy outcomes, as well a"] [2.793057441711426, 4.260398864746094, "se; weight loss for obese women; and smoking and alcohol use cessation. While interventions for smoking and alcohol use have been shown to be effective among some populations, they have not been as effective for injection drug users and polysubstance"] [2.787163019180298, 4.254964351654053, "ve life planning, is a vehicle to provide counseling about modifiable preconception health risks at every health care visit and to potentially discuss the prevention of unintended pregnancies. Several approaches to initiating discussions of reproduct"] [2.8124747276306152, 4.279533863067627, "report\u2019s release, national legislation expanded Medicaid eligibility to low-income pregnant women and children, and many states further expanded eligibility and eased the enrollment process for pregnant women. Attention then turned to the content of "] [2.7957677841186523, 4.26326322555542, "ication adopted by the U.S. Preventive Services Task Force to rate the quality of evidence as \u201cgood,\u201d \u201cfair,\u201d or \u201cpoor.\u201d\n 27\nreceive a comprehensive risk assessment at their first prenatal visit, and that the frequency of visits thereafter should be "] [2.803128957748413, 4.269979476928711, " baby from 24 weeks of pregnancy to 7 days after birth (13 studies). Women also had higher rates of spontaneous vaginal birth (12 studies). There were no differences in the rate of cesarean births between the intervention and control groups (Sandall "] [2.799912691116333, 4.266759872436523, "aches, there was a reduction in the rate of elective deliveries between 37 and 39 weeks from 9.6 to 4.3 percent of all deliveries. The \u201chard stop\u201d approach led to the largest decrease in elective early term delivery.\n29\nIn South Carolina, the Birth O"] [2.808756113052368, 4.2755818367004395, " Early elective delivery reduction\n\u2022 Some evidence of successful strategies to reduce early elective deliveries such as strict hospital enforcement of the policy\n Preconception/ interconception care\n \u2022 Strong evidence for improved birth outc"] [2.8224618434906006, 4.22710657119751, "nd a reduction in pregnancy-induced hypertension, few studies have demonstrated a positive effect on pregnancy outcomes (Gomby, Culross, and Behrman, 1999; Ciliska et al., 2001; Olds, 2002; Issel, 2011). In a study from Olds and colleagues (1986), pr"] [2.814361572265625, 4.279644966125488, "omes for families enrolled in Medicaid or the Children\u2019s Health Insurance Program. The 2012 to 2017 evaluation is part of the CMMI\u2019s Strong Start for Mothers and Newborns Initiative.\nSafe Sleep Education\nSafe sleep education to prevent SIDS and other"] [2.8166401386260986, 4.282520294189453, "ost parents will model the behavior of the hospital staff with their babies at home (National Institute for Children\u2019s Health Quality, 2015).\nAnother intervention that is increasingly being promoted to prevent SIDS is pairing safe sleep education wit"] [2.8201358318328857, 4.284142017364502, " the group that had home visitors (Roberts, Kramer, and Suissa, 1996). In a subsequent review that included studies of the impact of home visiting and pediatrician-based education on accident prevention, families receiving the interventions had a low"] [2.7905328273773193, 4.258946418762207, "k, Anderko, and Stetzer, 2011; Hillemeier et al., 2015). Results include reductions in low birth weight, preterm delivery, infants transferred to the NICU, infant mortality, and medical costs. Two studies examined the effect of the amount of coordina"] [2.794433116912842, 4.261444091796875, "ion in maternal stress is not known.\nSeveral cities, including Baltimore and New York, have adopted doula programs to address disparities in infant mortality rates (Ollove, 2017). In Baltimore\u2019s program, doulas are also trained to connect women to ho"] [2.7926418781280518, 4.260381698608398, "e provided through various programs and policies, such as local breastfeeding coalitions, WIC programs, hospital staff interactions with mothers, home visitors, and workplace facilitation (Association of Maternal and Child Health Programs [AMCHP], 20"] [2.7976722717285156, 4.26558780670166, " have been implemented in a variety of settings to support breastfeeding, with mixed evidence.\n\u2022 Peer counseling programs have been shown to increase the rate and duration of breastfeeding among low-income women with term and preterm infants (Merewoo"] [2.786325454711914, 4.254087448120117, "erate- to high-quality evidence on the effectiveness of psychosocial interventions on smoking cessation in pregnancy (Chamberlain et al., 2017). It found that the interventions decreased the number of women smoking late in pregnancy by 35 percent, in"] [2.787304401397705, 4.255817413330078, "ons may be needed in addition to brief behavioral interventions and medication and may be coupled with case management and assistance with housing, transportation, childcare, and employment services.\n\u2022 Intensive outpatient treatment provides women 9 "] [2.791428565979004, 4.258625030517578, "Evidence for Support and Referral Interventions\nCare coordination \u2022 Emerging evidence of the effectiveness of maternity care coordination on birth weight, preterm births, NICU stays, and infant mortality\n Support and Referrals\n Summary of Evide"] [2.8343820571899414, 4.3018999099731445, "erritorial Health Officials, 2014). Levels of maternal care have also been proposed by the ACOG and the Society for Maternal- Fetal Medicine. Regionalized systems assign risk-appropriate levels (I through III) to hospitals to ensure that facilities h"] [2.822005033493042, 4.289842128753662, "nt of the 476 very preterm infants born\n43\noutside Level III hospitals were transferred within 24 hours of delivery. The Illinois network is focused on educating health care providers and raising patient awareness of nearby hospitals and their design"] [2.793611764907837, 4.260939121246338, "creased infant mortality risk (Bhatt and Beck-Sague\u0301, 2018).\nIncome Supplements for Pregnant Women\nLow-income women are at high risk for stress, poor nutrition, and smoking or drinking during pregnancy, and they are more likely to have preterm births"] [2.8022079467773438, 4.269703388214111, "mes. Research on the effectiveness of most of the health promotion and education efforts is\n45\nscarce, although there is some limited evidence of positive effects on certain risk behaviors known to lead to poor outcomes. Home visiting has been widely"] [2.8063955307006836, 4.274168968200684, "on timing for programs, services, and supports clusters in the prenatal and postnatal periods, with relatively few appropriate for delivery in the preconception period (Figure 7).\n47\nFigure 7. Categories of Programs, Services, and Supports by Interve"] [2.7798213958740234, 4.246867656707764, "ngle mother are less likely to be retained in programs (Roggman et al., 2008) and that ethnicity or minority status is also related to attrition, with some groups more likely to engage with services while others are less likely (Brand and Jungmann, 2"] [2.806321382522583, 4.269547462463379, "recruitment, retention, and participation. For instance, there is potential to incorporate principles like default opt-in for appointment scheduling (Chapman et al., 2010), gains-framed messaging about behavioral changes or treatments (Toll et al., 2"] [2.799139976501465, 4.264553070068359, "evention and intervention services\n\u2022 ensuring access to high-quality, patient-centered care\n\u2022 investing in prevention and public health at the community level\n\u2022 fostering health equity by eliminating disparities and unequal treatment\n\u2022 developing dat"] [2.8304171562194824, 4.295179843902588, ", 2019).\nOutside the federal government, other national efforts to prevent and reduce infant mortality include the March of Dimes\u2019 Prematurity Campaign, which focuses on reducing prematurity, the leading cause of infant mortality (March of Dimes, 201"] [2.8149235248565674, 4.2797746658325195, "eceived a Medicaid waiver that covered long-acting reversible contraception for women on Medicaid.\nIn 2009, Ohio\u2019s Infant Mortality Task Force issued a report with a series of recommendations that included the formation of a statewide organization to"] [2.8127195835113525, 4.278561115264893, " and Infant Mortality Rates in 2009, 2012, and 2015\n Initiative Launched\n Location\nPrimary Focus\n2009\nInfant Mortality Rate\n 2012\n2015\n Black\nWhite\nBlack\nWhite\nBlack\nWhite\n Baltimore (city) Milwaukee (city)\n"] [2.802323579788208, 4.26937198638916, "per 1,000. When Cradle Cincinnati launched, the infant mortality rate stood at 8.4 per 1,000. While the infant mortality rate returned to 9.4 per 1,000 in 2015, it is still too soon to examine the possible impact of the strategies just outlined.\nStar"] [2.817038059234619, 4.282709121704102, "nsin\nWisconsin\u2019s Lifecourse Initiative for Healthy Families was launched in 2009 to reduce disparities in birth outcomes between black and white infants (Lifecourse Initiative for Healthy Families, n.d.). In Milwaukee, the initiative\u2019s Community Acti"] [2.7551512718200684, 4.223371505737305, " strategies, and implementing specific activities. Last, client-centeredness is at the core of many of the initiatives, such that the strategies and activities are designed and carried out to maximize engagement.\n58\n5. Inventory of Allegheny County P"] [2.7816925048828125, 4.250241279602051, "x family medicine practices\n 59\naffiliated with UPMC participate in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Using Continuous Quality Improvement Techniques) interconception care project, which involves maternal sc"] [2.7822928428649902, 4.250556468963623, " Start initiative that tested the effectiveness of the birth center model, and it continues to offer a suite of pregnancy and childbirth supports to its mothers.\nThe Birth Circle, part of the UPMC Department of Family Medicine, is a doula program tha"] [2.7838687896728516, 4.252036094665527, "rams. Pregnant and postpartum women can also access these programs directly or through referrals from other programs or services.\nACHD supports three nurse home visiting programs. The Nurse-Family Partnership program follows the evidence-based nation"] [2.7569730281829834, 4.224762916564941, "ormation on program components, capacity, and reach.\nTable 10. Allegheny County Health Promotion and Education Interventions\nHome Visiting Programs\n Program Components\n Capacity and Reach\n Allegheny Link\n Nurse-Family Partnership\nH"] [2.7494049072265625, 4.217212200164795, "effectiveness in improving birth and infant outcomes.\nCare Coordination\nPregnant women in Allegheny County with Medicaid coverage can access maternity care coordination, which has emerging evidence of improving outcomes such as birth weight, preterm "] [2.746664047241211, 4.214452743530273, "ch operates out of Homewood Children\u2019s Village, offers education, resources, and support to expectant parents and parents of young children.\nPregnant women in Allegheny County have access to Text4baby and its weekly information texts through local pa"] [2.7772674560546875, 4.246743202209473, "ent services, and an in-home substance abuse assessment and mentoring program. Familylinks\u2019 two Family Treatment Centers prioritize pregnant women for its residential treatment program.\nTwo outpatient clinics situated within hospitals offer services "] [2.7395639419555664, 4.207761287689209, "e evidence-based or evidence-informed models\nServes about 6,000 children and families annually\n Genesis House\nAssistance in finding permanent housing after delivery, counseling sessions, classes on prenatal care, parenting, smoking cessation, a"] [2.747809410095215, 4.21581506729126, "o six months postpartum)\nHalfway house program: Residential treatment with psychiatric and health care services\nOutpatient program: Partial hospitalization, intensive outpatient programming, counseling, therapy, and resource coordination\nIn-home serv"] [2.783008098602295, 4.251924514770508, " Supports (as of 2018)\n Preconception Prenatal\nNeonatal Postneonatal\n Medical Setting\nPreconception/ interconception care\n One Key Question PATH\n IMPLICIT ICC\nOne Key Question PATH\nPrenatal care/ enhanced prenatal care\n Healthy Beginnings P"] [2.783687114715576, 4.251180648803711, "ram\nHealthy Start Life Skills Classes\nHealthy Start Fatherhood Program\nAIU Responsible Fatherhood Program\nHealthy Start Life Skills Classes\n 72\n6. Allegheny County Birth Outcomes, Risk and Contextual Factors, and Intervention Participation\nTo"] [2.7941529750823975, 4.262260437011719, "ry (14 percent); SIDS or other ill-defined causes\n74\n(12 percent); and perinatal respiratory or cardiovascular disorders (9 percent). The remaining 21 percent of infant deaths were caused by other factors, including perinatal infections, fetal blood "] [2.7946481704711914, 4.262101173400879, "e\n 30%\n25%\n20%\n15%\n10%\n5%\n0%\n20.9%\n9.7% 9.6%\n26.6%\n14.5% 11.5%\n 0.2% 0.9% 1.2% 0.7% 1.5%\nInfant mortality (% of total)\nGestational diabetes (n = 6,123) Pre-pregnancy obesity (n = 19,496)\nLow birth weight (% of total)\nAnemia (n = 88,633) Infe"] [2.798339605331421, 4.265717029571533, "8.3 per 1,000 births, whereas the rate among women who smoked during pregnancy was 9.3 per 1,000 (Figure 14). Among all\n 78\nbirths, the rates of low birth weight and preterm births were close to 215 per 1,000 among women with any substance a"] [2.7815663814544678, 4.248926162719727, "These were the only interventions for which we had participation information from any of the data sources that fed into the IMPreSIv database. For all of the other programs, services, and supports described in Chapter 5, we were not able to obtain da"] [2.8217620849609375, 4.289434909820557, "es Mental health support services\nPreconceptiona Pregnancy Postpartum\n \u2705\n 82\nbetween WIC and income benefits was 0.55. However, what this figure shows most starkly is that there is almost no correlation between the medical-setting inter"] [2.7863991260528564, 4.254045486450195, " UPMC system. Among these deliveries, infant mortality rates ranged from 10.2 per 1,000 live births for contraceptive counseling to 13.7 per 1,000 for genetic counseling, with all of the rates well above the average rate for Allegheny County (see Fig"] [2.7699053287506104, 4.237656593322754, " 63.1 per 1,000 for women who had a birth doula were both below the rates across all deliveries (see Figure 19 note).\n86\nFigure 19. Birth Doulas in the Infant Mortality Prediction System with Intervention Management Database\n 1 00\n75\nRate per 1,000 "] [2.759822130203247, 4.228937149047852, "or all deliveries, the infant mortality rate was 6.49 per 1,000 live births, the low birth weight birth rate was 86.52 per 1,000, and the preterm birth rate was 109.61 per 1,000.\nBehavioral health services represent another category of support and re"] [2.7626328468322754, 4.229059219360352, "s of infant mortality generated during this step fit the three types of data described in Chapter 2 (reportable information, potentially reportable information, and health care information) and the different time periods of our analysis (preconceptio"] [2.730829954147339, 4.197702407836914, "service providers and health care providers have access to different information, the different data types reflect the information each type of provider may be able to obtain.\nWith these predictors, missing data could be handled by excluding observat"] [2.7824041843414307, 4.249578952789307, "ry. On the other hand, when predicting behavioral health service participation after delivery, we add indicators of other intervention participation postdelivery, as well as preconception and during pregnancy.\n93\nPredictors of Intervention Participat"] [2.773216485977173, 4.239912509918213, "f receiving any prenatal care were the race or ethnicity of the father, insurance status, and mother\u2019s smoking behavior. Finally, missing birth interval information was another important predictor. Birth interval is recorded in the birth certificate "] [2.7775516510009766, 4.24540901184082, "s. It is important to note that Family Support Centers offer a wide array of services for parents, some of which pertain to pregnant or postpartum women but many of which do not. Further, each Family Support Center offers its own unique mix of servic"] [2.768235445022583, 4.234609127044678, "ikely to utilize. Methodologically, greater accuracy in the predictive models enables us to control for selective intervention participation. The most common and accepted measure of model accuracy is the AUC scores, which combine the true positive ra"] [2.707547903060913, 4.174948215484619, "ders can also utilize the accurate predictions of intervention participation to better understand which women are most likely to use specific interventions and direct them to programs, services, and supports to meet their needs. Overall, the models p"] [2.7822256088256836, 4.248132705688477, " these methods enable us to interpret our estimates as causal with only one reasonable assumption, conditional unconfoundedness. This assumption means that our predictions of infant mortality and intervention participation account for enough of what "] [2.7536544799804688, 4.22165060043335, " effects indicate more effective reduction of infant mortality risk, even small effects are important. This is because of the terminal and dichotomous nature of the infant mortality outcome. For example, an estimate of \u22121 percent would mean that the "] [2.789414644241333, 4.2567548751831055, "sisted housing). The limitations section of Chapter 10 has a fuller discussion of the limitations of our methods (including the conditional unconfoundedness assumption, missing data, selective observation, and multiple hypothesis testing).\n105\nMedica"] [2.796978712081909, 4.264415740966797, "of preconception/interconception care were observed only for those who received services at a UPMC-affiliated facility. Vaccinations, genetic counseling, and contraceptive counseling were also offered by other health care providers, such as FQHCs, Pl"] [2.795581340789795, 4.263059139251709, "ll women. The estimates for contraceptive counseling, genetic testing, and vaccinations are clustered, large, and increasing as the risk of infant mortality grows. In contrast, the estimated effects of preconception exams are near zero and generally "] [2.7935473918914795, 4.2566657066345215, "lity during different time periods, or it could be a by-product of having fewer observations with which to detect statistically significant differences (see Appendix C for results).\nDoula Support\nThe effectiveness of doula support (i.e., having a dou"] [2.7863705158233643, 4.250938892364502, " in the risk of infant mortality for each level of risk above 50 percent, with the effects ranging from 2.1 to 10.0 percent across the risk levels (Figure 38). However, the estimated effects of home visiting after delivery were not statistically sign"] [2.7925970554351807, 4.259775161743164, "d\n 114\nby the wide array of services and supports available at Family Support Centers, many of which are unrelated to pregnancy, and the differences across centers in the mix of services offered, this does not explain how Family Support Centers could"] [2.788712739944458, 4.252752304077148, "educed risk of infant mortality (Figure 41). Participating in Family Support Center services for two years doubled the effect to a 3-percent reduction in the risk of infant mortality (multiplying two years by 1.5 percent gives this estimate). Longer "] [2.783273458480835, 4.250687122344971, "fant deaths occur shortly after birth, it is likely that the nutrition counseling drives this result. The estimated impact increased as the risk level increased, as did the size of the confidence interval (Figure 42). For those predicted at a greater"] [2.781132936477661, 4.248350620269775, "articipation in behavioral health services during specific time periods (Figure 44). However, for participation in behavioral health services before conception at the greater than 50 percent predicted risk level, the estimated effect is a statistical"] [2.7740678787231445, 4.241444110870361, "or Medicaid. Given the correlation between socioeconomic status and infant mortality risk, it may be that the women who participate in ACDHS-funded behavioral health services have higher overall risk profiles than the women who participate in behavio"] [2.816284418106079, 4.282181739807129, "lower bounds of the true effects.\nIntervention category. The results demonstrate that medical interventions, which are the most targeted to the health of the mother and baby, were estimated to have the largest impact. While our estimates of the effec"] [2.7968835830688477, 4.26357364654541, " Further, the effects of home visiting during pregnancy were magnified as the risk level increased. This indicates that earlier involvement in home visiting programs may pay off with better outcomes, particularly for those most at risk for poor birth"] [2.784900665283203, 4.25220251083374, "ns are designed to achieve other objectives, they play an important role in community-based efforts to reduce infant mortality, particularly for those most at risk of poor birth outcomes. Since estimated intervention effects varied by risk level, the"] [2.792457103729248, 4.259825706481934, "ically, first pregnancy).\nNext, for each intervention, we explored how the effects of the interventions are altered when combined either with other interventions or with income, medical, or other benefit programs. Any given intervention is unlikely t"] [2.8038525581359863, 4.271236419677734, "s for us to assess their combined effects (for reference, see Figure 16 in Chapter 6).\nSecond, the results in this chapter focus on those with a predicted risk of infant mortality greater than 50 percent. Focusing on those with a greater than 50 perc"] [2.823413133621216, 4.290785789489746, "ffect of preconception care/interconception care was a significant increase in risk of infant mortality by about 10 percent. This finding may be related to the multiple hypotheses being tested, which can produce results that incorrectly appear to be "] [2.8046438694000244, 4.268752098083496, " Education\nWithin the health promotion and education intervention category, the IMPreSIv database includes information on home visiting, including the Healthy Start, Early Head Start, and Nurse- Family Partnership programs.\nHome Visiting\nOf all the d"] [2.792109727859497, 4.259456157684326, " of ever receiving WIC benefits for women with the specific risk factors and a greater than 50 percent predicted risk of infant mortality (Figure 53). Among the demographic risk factors examined, WIC was estimated to be most effective for teens, youn"] [2.8026485443115234, 4.269552230834961, "21). We also present results describing the effects of the interventions for women with additional risk factors in Appendix C.\nTable 21. Summary of Intervention Effectiveness by Risk Factor and by Other Interventions\nMedical Setting\nDoula support Tee"] [2.809736728668213, 4.277318477630615, " For these women, the estimates of increased effectiveness for most of the interventions suggest that the programs, services, and supports are reaching high-risk populations and having an impact. The findings related to these demographic risk factors"] [2.781728506088257, 4.2494049072265625, "women with an opioid use disorder. Similar to its effect for smoking, the effect of WIC in reducing risk for women with opioid use disorder may represent the program\u2019s general focus on nutrition and other factors that contribute to healthy developmen"] [2.781982898712158, 4.2491655349731445, "ticipation, parental characteristics, maternal health risk factors and behaviors, pregnancy and delivery observations and diagnostics, postdelivery observations and diagnostics, and socioenvironmental risk factors. The quantity and quality of informa"] [2.7823922634124756, 4.250819206237793, "ons.\n \u2022 Provider awareness of the availability and effectiveness of different types of interventions for a range of issues may be limited.\n\u2022 Effectiveness of many interventions is magnified when combined with other interventions addressing differ"] [2.786684989929199, 4.2549896240234375, "n, interconception, and prenatal care are particularly pronounced among black women.\n\u2022 Early and regular care addressing maternal health has potentially cascading effects for infant health.\n 8. Leverage opportunities to connect with women early durin"] [2.785552740097046, 4.253724575042725, "re able to accurately identify women at high risk of infant mortality. This is critical because the estimates show that interventions are most effective for women with the highest predicted risk of infant mortality. Identifying women most at risk for"] [2.783704996109009, 4.251740455627441, "ervention categories, we found virtually no correlation between the medical-setting interventions (preconception/interconception care, prenatal care, and doula support) and the non-medical-setting interventions in the health promotion and education c"] [2.7839736938476562, 4.251589298248291, "ed risk. The risk assessment and referral tool (see recommendation 1) will help health care and community-based service providers to understand the individual risk profiles and make referrals to interventions based on the predicted risk of infant mor"] [2.7615108489990234, 4.229331016540527, "ctions of intervention participation that will be implemented in the risk assessment and referral tool to better understand which women are most likely to use specific interventions, and provide optimized referrals to additional programs, services, a"] [2.7854132652282715, 4.253543853759766, "viders is important but not sufficient to coordinate medical and nonmedical care and to ensure that the wide-ranging needs of high-risk women are met. Previous studies have demonstrated that care coordination in the health care setting can generate s"] [2.783413887023926, 4.251352787017822, "rdinator, and the client engagement grant program.\nBecause our models demonstrate that infant mortality can be accurately predicted using a limited set of information available either during pregnancy or preconception, the risk assessment should be c"] [2.744114637374878, 4.211940288543701, "st pregnancies likely generates longer- term benefits that we could not observe in this study. Whether the interventions contribute to women feeling better informed about pregnancy and childbirth, address risky behaviors, provide breastfeeding suppor"] [2.784348726272583, 4.2519450187683105, "who make up 2.8 percent of the population in the city of Pittsburgh. With Allegheny County\u2019s growing immigrant population, programs that provide doula support, such\n150\nas the Allegheny Health Network\u2019s Immigrant Health Program, should be expanded so"] [2.779789686203003, 4.2463531494140625, " by the risk assessment and referral tool.\nLimitations\nOur approach has several limitations, including two types of missing data, selective observation, conditional unconfoundedness, and multiple hypothesis testing.\n151\nMissing data. While the IMPreS"] [2.814840078353882, 4.282620429992676, " examined (vaccinations, genetic counseling, and contraceptive counseling) were observed only for those who received services at a UPMC-affiliated facility. However, these services are also offered by other health care providers not included in the d"] [2.7885591983795166, 4.255661964416504, "ense, this study is a combination of many studies. Consequently, we cannot recommend focusing too heavily on any one of the many hypotheses that we tested. We can be most confident in the lack of a statistical aberration for the results that contribu"] [2.7840137481689453, 4.251532554626465, " implemented, their progress in improving birth and infant outcomes, and their sustainability\u2014and the opportunities to build on successes. The integration of a risk assessment and referral tool into systems and practices in different health care and "] [2.799337863922119, 4.267664909362793, "icians and Gynecologists.\nAlhusen, J. L., E. Ray, P. Sharps, and L. Bullock, \u201cIntimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes,\u201d Journal of Women\u2019s Health, Vol. 24, No. 1, 2015, pp. 100\u2013106.\nAllegheny County Health Departmen"] [2.8358097076416016, 4.302274227142334, "pe 1 Diabetes Mellitus: A Systematic Review and Metaanalysis,\u201d Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 11, 2009, pp. 4284\u20134291.\nBayrampour, H., and M. Heaman, \u201cAdvanced Maternal Age and the Risk of Cesarean Birth: A Systematic "] [2.813068151473999, 4.279098987579346, "rics and Gynecology, Vol. 216, No. 2, 2017, pp. 185.e1\u2013185.e10.\nBrooten, D., J. M. Youngblut, L. Brown, S. A. Finkler, D. F. Neff, and E. Madigan, \u201cA Randomized Trial of Nurse Specialist Home Care for Women with High-Risk Pregnancies: Outcomes and Co"] [2.815640687942505, 4.282228469848633, "s and Newborns Initiative: General Information,\u201d last updated February 11, 2019. As of June 12, 2019:\nhttps://innovation.cms.gov/initiatives/strong-start/\n159\nChamberlain, C., A. O\u2019Mara-Eves, J. Porter, T. Coleman, S. M. Perlen, J. Thomas, and J. E. "] [2.8517134189605713, 4.3180084228515625, "isk of Adverse Perinatal Outcomes: A Meta-Analysis,\u201d JAMA, Vol. 295, No. 15, 2006, pp. 1809\u2013 1823.\nConnor, K. A., D. Cheng, D. Strobino, and C. S. Minkovitz, \u201cPreconception Health Promotion Among Maryland Women,\u201d Maternal and Child Health Journal, Vo"] [2.8454270362854004, 4.311460494995117, "iedmann, I., E. M. Dahdouh, P. Kugler, G. Mimran, and J. Balayla, \u201cMaternal and Obstetrical Predictors of Sudden Infant Death Syndrome (SIDS),\u201d Journal of Maternal-Fetal and Neonatal Medicine, Vol. 30, No. 19, 2017, pp. 2315\u20132323.\nFrisch, R., and F. "] [2.83379864692688, 4.299903392791748, "4\u201326.\nGrigoriadis, S., E. H. VonderPorten, L. Mamisashvili, G. Tomlinson, C. L. Dennis, G. Koren, ... J. Martinovic, \u201cThe Impact of Maternal Depression During Pregnancy on Perinatal Outcomes: A Systematic Review and Meta-Analysis,\u201d Journal of Clinica"] [2.8529837131500244, 4.318837642669678, " of Stillbirth: A Systematic Review,\u201d Canadian Medical Association Journal, Vol. 178, No. 2, 2008, pp. 165\u2013172.\nHuang, Q. T., Q. Huang, M. Zhong, S. S. Wei, W. Luo, F. Li, and Y. H. Yu, \u201cChronic Hepatitis C Virus Infection Is Associated with Increase"] [2.823718786239624, 4.2899250984191895, ". Stewart-Brown, and L. Polnay, \u201cParenting Interventions and the Prevention of Unintentional Injuries in Childhood: Systematic Review and Meta-Analysis,\u201d Child: Care, Health and Development, Vol. 34, No. 5, 2008, pp. 682\u2013 695.\nKochanek, K. D., S. L. "] [2.83310604095459, 4.2991719245910645, "dical Informatics, Vol. 5, No. 1, 2017, p. e3.\n166\nLifecourse Initiative for Healthy Families, homepage, n.d. As of June 12, 2019: https://lihf.wisc.edu/\nLogan, C., E. Holcombe, J. Manlove, and S. Ryan, \u201cThe Consequences of Unintended Childbearing: A"] [2.8537964820861816, 4.320146083831787, "merican Journal of Preventive Medicine, Vol. 50, No. 5, 2016, pp. S13\u2013S19.\nMay, Linnea Warren, Serafina Lanna, Jordan R. Fischbach, Michelle Bongard, Shelly Culbertson, Rebecca Kiernan, Ricardo Williams, Elizabeth DeWolf, Victoria Lawson, and Julia B"] [2.8291122913360596, 4.293095111846924, ", 2012, pp. 219\u2013228.\nOhio Collaborative to Prevent Infant Mortality, Ohio Infant Mortality Reduction Plan 2015\u2013 2020, 2015. As of June 10, 2019: https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/infant-and-fetal- mortality/reports/mortality-p"] [2.8401777744293213, 4.306874752044678, "hman, \u201cNo Health Without Mental Health,\u201d The Lancet, Vol. 370, No. 9590, 2007, pp. 859\u2013877.\nQuigley, M. A., G. Henderson, M. Y. Anthony, and W. McGuire, \u201cFormula Milk Versus Donor Breast Milk for Feeding Preterm or Low Birth Weight Infants,\u201d Cochrane"] [2.8864049911499023, 4.352805137634277, "ng in the Extended Postpartum Period,\u201d International Journal of Gynecology and Obstetrics, Vol. 124, No. 3, 2014, pp. 193\u2013197.\nSrinivasan, S., L. Schlar, S. E. Rosener, D. J. Frayne, S. G. Hartman, M. A. Horst, J. L. Brubach, and S. Ratcliffe, \u201cDeliv"] [2.816826820373535, 4.283754348754883, "urnal of Medicine, Vol. 360, No. 2, 2009, pp. 111\u2013120.\nToll, B. A., S. S. O\u2019Malley, N. A. Katulak, R. Wu, J. A. Dubin, A. Latimer, B. Meandzija, T. P. George, P. Jatlow, J. L. Cooney, and P. Salovey, \u201cComparing Gain-and Loss-Framed Messages for Smoki"] [2.8471267223358154, 4.313283443450928, "whamglobal.org/whamblog/316-advisory-charts-steps-to-make-pa-a-leader-in- maternal,-child-health\nWitt, W. P., K. Litzelman, E. R. Cheng, F. Wakeel, and E. S. Barker, \u201cMeasuring Stress Before and During Pregnancy: A Review of Population-Based Studies "] [12.700373649597168, 13.828020095825195, "COVID-19 and the Experiences of Populations at Greater Risk\nDescription and Top-Line Summary Data\u2014Wave 2, Fall 2020\nKATHERINE GRACE CARMAN, ANITA CHANDRA, DELIA BUGLIARI, CHRISTOPHER NELSON, CAROLYN MILLER\n Sponsored by the Robert Wood Johnson Founda"] [12.68373966217041, 13.735060691833496, "bsequent top-line reports will update these findings.\nResearchers from RAND and RWJF jointly conducted the research reported here; the report is intended for individuals and organizations interested in learning more about public attitudes about a Cul"] [12.883563995361328, 14.14188003540039, "..................................2 Survey Length .......................................................................................................................................6 Survey Sample Selection........................................"] [12.912137031555176, 14.411397933959961, "...................................................................................15\nQ4. [w2_wellbeing1-w2_wellbeing6] Below are a number of things people might say they feel. How much of the time in the past week, did you . . . ...................."] [12.8628511428833, 14.46630573272705, " coronavirus (COVID-19) (through a nasal swab or\nblood test)? ...................................................................................................................................20 Q13a. [w1_covidexp1- w1_covidexp14] Are you experienci"] [12.88666820526123, 14.442577362060547, "harder for them to get the care they need than it is for those who live in urban areas, or is there not much of a difference? ............................................................................................27\nQ21. [w2_pocimpact1] People o"] [12.845181465148926, 14.338639259338379, "...30 Views, Mindset, and Expectations: Understanding What Drives Health................................................31\nQ29. [w1_drivers1-w1_driver4] Here is a list of some things that may affect people\u2019s health and well-being. Please rate each on"] [12.696382522583008, 13.81773567199707, "e listed groups. ..........................................................35\nSurvey Respondent Demographics .........................................................................................................37 Respondents by Age Group, in Year"] [12.783934593200684, 13.917407035827637, " context of COVID-19, RAND and RWJF have partnered again to build from the NSHA to implement a longitudinal survey to understand how these health views and values have been affected by the experience of the pandemic, with particular focus on populati"] [12.837013244628906, 13.962850570678711, "me under $125,000. The ALP sample limited White individuals to those with household incomes under $125,000 but imposed no income limits on Black, Hispanic, or Asian respondents. We were most interested in understanding the experiences of historically"] [12.71778678894043, 13.84618091583252, " color and low- to middle-income households. This report describes the second of four surveys conducted as part of the COVID-19 and the Experiences of Populations at Greater Risk Survey, a survey that RWJF and RAND Corporation researchers developed a"] [12.725221633911133, 13.866044998168945, "; Carman et al., 2019) and the report describing the first wave of this survey series (Carman et al., 2020).\nSurvey Design Process\nOur survey was designed with the goals described above in mind. Where possible, survey questions were drawn from existi"] [12.65794849395752, 13.78612232208252, "Lab\nLydia Saad, \u201cIn U.S., More Fear COVID-19 Illness Than Financial Harm,\u201d Gallup, April 16, 2020. As of October 9, 2020: https://news.gallup.com/poll/308504/fear-covid-illness- financial-harm.aspx\nNORC at the University of Chicago, \u201cAmerican Health "] [12.741434097290039, 13.887293815612793, "g America Study\nUniversity of Southern California, \u201cUnderstanding America Study: Understanding Coronavirus in America,\u201d webpage, undated. As of October 9, 2020: https://covid19pulse.usc.edu\n A large section of our survey was focused on measuring r"] [12.832265853881836, 13.93424129486084, " 2, we broadened the question asking about protesting for whatever issues respondents believe in.\nWe added two questions. First, in wave 1, more than 70 percent of respondents reported that the pandemic could be an opportunity for positive change (w1"] [12.841262817382812, 13.984979629516602, "rstanding the experiences of the historically underserved individuals in U.S. society. The income limits allow us to focus on individuals in households that were likely eligible to receive the federal COVID-19 stimulus checks. In both panels, we over"] [12.875133514404297, 14.01111125946045, "e randomly selected to participate, whereas all panelists of\n7\nother races or ethnicities were invited to participate.3 This resulted in a sample of 1,331 panel members being invited to participate in the first wave survey. Of those, 1,098 (82.5 perc"] [12.870780944824219, 14.010564804077148, "rman et al., 2016; Carman et al., 2019). In our previous work, we took several steps to assess the appropriateness of combining these data. First, we took care to ensure that the implementation of the survey in the two panels was the same. Both panel"] [12.854391098022461, 13.99280071258545, " the characteristics of the U.S. population as estimated in the CPS. The survey sample distributions represent characteristics of the ALP and the KnowledgePanel at the time of sampling.6 Some households had changes in income or other characteristics "] [12.87238883972168, 13.991769790649414, " the two panels when controlling for demographic differences, we might not be able to discern from the social and demographic profiles of the sample every underlying difference regarding attitudes and perspectives. However, this combining of panels h"] [12.908323287963867, 14.073094367980957, "urvey data, who might apply other weighting approaches in their analyses. Weighted demographic characteristics are shown in Table 1.4.\nWe report the percentage of respondents who chose not to answer each question and label this as \u201cmissing.\u201d None of "] [12.903373718261719, 14.412446975708008, "st Some of none of the time time\nAll of the time\nMissing\n Wave 1\nWave 2\nSOURCE: Santa Monica Well-Being Survey.\n25.9 54.1 25.0 53.4\n4.3 0.1 4.3 0.2\n D. Have a lot of energy Sample\nNone or almost Some of none of the time time\nAll of t"] [12.898776054382324, 14.427838325500488, "d not have work due to coronavirus (COVID-19) pandemic related reduction in business\n(including furlough)\nI am/was laid off due to coronavirus (COVID-19) pandemic\nMy employment closed temporarily due to the coronavirus (COVID-19) pandemic\nMy employme"] [12.884577751159668, 14.447171211242676, " the coronavirus (COVID-19) has affected you.\nQ11. [w2_coviddx] Has a doctor or other health care provider ever told you or a loved one that you or they have coronavirus (COVID-19)?\n Yes No\nMissing\n 29.0 70.7 0.3 X X X\n Select only one answe"] [12.882913589477539, 14.44554328918457, "4 0.4\n w2_exp6. Disruption in childcare or schooling for children in your household\nSample Yes No\nWave 2 13.2 85.9 0.9\n w2_exp8. Difficulty caring for a chronic condition (yours or others)\nMissing\nMissing\n Sample Yes\nWave 2 10.8 SO"] [12.884492874145508, 14.45439624786377, "g\n Wave 1 Wave 2\n2.1 13.4 2.0 13.9\n79.8 0.8 81.0 0.6\n 24\n C. Food stamps (SNAP) or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)\n Yes, my household was already receiving assistance from this program befo"] [12.885022163391113, 14.444756507873535, "ed\n1.5 1.6\nNo, my household has not received nor applied for assistance from this program since coronavirus (COVID- 19) started\nMissing\n Wave 1 Wave 2\n94.4 0.9 94.7 0.7\n H. Programs related to caring for my children (including school-based"] [12.869336128234863, 14.46564769744873, "\n 27\nQ22. [w2_pocimpact2] People of color (e.g., African Americans, Latinos) are facing more of the financial impact of coronavirus (COVID-19) than whites.\n Sample\nSomewhat Strongly agree agree\nNeither agree Somewhat Strongly nor disagre"] [12.874570846557617, 14.437352180480957, " people in need\n Sample Most of the time\nSome of the time\nRarely Never\nMissing\n Wave 1 37.6\nWave 2 36.2 SOURCE: Developed by RWJF and RAND.\n47.7 48.8\n10.7 3.8 0.2 10.5 3.9 0.6\n 29\nViews, Mindset, and Expectations: Views of Government R"] [12.885881423950195, 14.420175552368164, "they were born (their genetics/DNA)\nNo effect\nSample 1 2 3 4 5 Missing\n Very strong effect\n Wave 2: Not asked X\nSOURCE: Developed by RWJF and RAND.\nX X X X X\n 31\nViews, Mindset, and Expectations: Views on Future U.S. Approac"] [12.876570701599121, 14.440543174743652, "eloped by RWJF and RAND.\n8.2 12.6 10.8 13.8\n13.9 18.5 46.3 0.4 15.5 19.8 39.6 0.5\n 33\nQ35. [w2_protest] I think it is worth protesting for things I believe in, even if it may pose a health risk to myself or my family.\nSelect only one answer.\nNo"] [12.876264572143555, 14.42883014678955, "ity\nWave 2 16.1\nMedium priority\n25.2\nMedium priority\n50.5\nLow priority\nMissing\n 4.2 1.5\n Low priority\nMissing\n 31.9 1.4\n 35\n H. Children ages 0\u201318 with serious illness who are at high risk of dying from the coronavirus\n Samp"] [12.805063247680664, 14.00312328338623, "arried\n22.5 21.6\n Respondents by Number of Household Members\n 9 or Sample 1 2 3 4 5 6 7 8 more\n Wave 1 29.1 33.0 15.2 11.5 6.1 Wave 2 29.9 33.9 14.7 11.1 5.7\nRespondents by Level of Family Income, in Dollars\n2.9 2.8\n1.1 0"] [12.71185302734375, 13.840052604675293, "ixes to the Report on the Economic Well-Being of U.S. Households in 2019\u2014May 2020,\u201d webpage, last revised May 21, 2020. As of October 9, 2020: https://www.federalreserve.gov/publications/2020-supplemental-appendixes-report- economic-well-being-us-hou"] [12.715860366821289, 13.850136756896973, "20. As of October 9, 2020: http://www.igmchicago.org/surveys/policy-for-the-covid-19-crisis/\nUniversity of Southern California, \u201cUnderstanding America Study: Understanding Coronavirus in America,\u201d webpage, undated. As of October 9, 2020:\nhttps://covi"] [16.53227996826172, 6.909852504730225, " AUSTRALIA\nMEAGAN CAHILL, RYAN ANDREW BROWN, GARRETT BAKER, DIONNE BARNES-PROBY, HANNAH SANDRINI\nAustralia\u2019s Third Action Plan of the National Plan to Reduce Violence Against Women and Their Children, Priority Area 2\nAboriginal and Torres Strait Isl"] [16.506511688232422, 6.921471118927002, "ii Figures...................................................................................................... vii Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [16.471525192260742, 6.904017925262451, ". . . . . . . . . . . . . . . . . 58 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66\nCHA"] [16.49795913696289, 6.928326606750488, " Journal Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n5.1. The Getting to Outcomes Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [16.532405853271484, 6.924417018890381, "hes Used in the Prior Two Weeks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63\n3.6. Therapeutic Approaches Used in the Prior Two Weeks by Program Type . . . . . . . . . . . . 63\n3.7. CommonChallengesEncountered................."] [16.5423641204834, 6.925583362579346, "uation\nPM&C provided funding to 14 different service providers across Australia that work specifi- cally on family issues in Aboriginal communities. These sites are mostly located in remote and sparsely populated areas, creating challenges for servic"] [16.532238006591797, 6.9330973625183105, "valuation approaches such as quasi-experimental designs.\nThe second major challenge to our work was the time taken to receive approval from the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS), which provides review of "] [16.538375854492188, 6.934762954711914, "tions focus on ways to improve the implemen- tation process and on strategies for building evaluations into implementation of similar programs in the future.\nEvaluation of Third Action Plan\nData Collection\nInside Policy, the organisation providing te"] [16.542186737060547, 6.9207634925842285, "rams that were able to engage informal and formal institutions in communi- ties, from law enforcement to local clubs, created extended systems of support for\nprogram clients that had positive impacts on program goals.\n3. Clinicians noted that storyte"] [16.54263687133789, 6.932684421539307, "e things smoother by clearly identifying the roles and responsibilities for the regional and national offices, and for the sites. Throughout implementation, the national office staff may have ben- efited from more engagement with the regional office "] [16.539648056030273, 6.922885894775391, "ers called \u201cGetting to Outcomes\u201d (Chinman, Imm and Wandersman, 2004). The recommendations drawn from our evaluation of the 3AP effort start at the very beginning of the process\u2014when an agency decides to put funding towards a specific social need, in "] [16.535215377807617, 6.919885635375977, "pted therapeutic frameworks. We need instruments that capture such subtleties.\nLessons Learned for Program Success\n1. Understand that the timeline for change is long and requires sustained invest- ment. Sites emphasised that family violence is an iss"] [16.5324764251709, 6.934324264526367, "e of locally developed, culturally grounded measurement approaches. These include custom scales developed by and validated in the com- munity context, as well as methods to quantify narrative or descriptive information.\n9. Focus on evaluating impleme"] [16.504491806030273, 6.953253746032715, "NIAA National Indigenous Australians Agency\nNPYWC Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women\u2019s Council\nNT Northern Territory\nPM&C Department of the Prime Minister and Cabinet\nPUTP Picking Up the Pieces\nRCT randomised controlled trial\nRSES Ros"] [16.530855178833008, 6.916770935058594, "the National Plan framework for more than a decade (COAG, 2012). The Second Action Plan, implemented from 2013 to 2016 and called \u201cMoving Ahead\u201d, focused on using evidence gathered during the First Action Plan to identify and address gaps in the appr"] [16.532089233398438, 6.918107986450195, " policy was officially abolished in 1972, but one of the last schools that housed stolen chil- dren did not close until the early 1980s. An official public document acknowledging the Stolen Generations was released in 1997, with an official apology c"] [16.51801872253418, 6.871867656707764, "r, 2020a). Although the Intervention officially ended in 2012, many of its policies remain in effect today in some form under the current Building Stronger Futures policies (Aus- tralians Together, 2020a).\nImpacts on Child Well-Being\nFor at least a c"] [16.5194091796875, 6.9041242599487305, "cted to a disproportionately high rate of family violence, especially when compared with the non-Indigenous population in Aus- tralia (Braybrook, 2015). According to the AIHW (2018), just over one out of every five Indigenous Australians indicated th"] [16.535690307617188, 6.920436859130859, "ity as opposed to more individu- alised approaches, and Walker and Shepherd (2008) present two model interventions\u2014 addressing child literacy and child health and family well-being\u2014that demonstrate the importance of cultural considerations in these e"] [16.543460845947266, 6.914592266082764, "an Aboriginal Child Care Agency (VACCA)\nMen\u2019s Outreach Service (MOS) Rekindling the Spirit (RTS) Yoowinna Wurnalung\nBirrang Maranguka\nKornar Winmil Yunti Aboriginal Corporation (KWY)\nMookai Rosie Wurli-Wurlinjang\nAboriginal Family Legal Services Sout"] [16.526329040527344, 6.918247699737549, "es\n SOURCE: Esri, HERE, Garmin, USGS, Intermap, INCREMENT P, NRCan, Esri Japan, METI, Esri China (Hong Kong), Esri Korea, Esri (Thailand), NGCC, 2018; overlay by RAND.\nTable 1.1\nThird Action Plan Intensive Family-Focused Case Management Program Chara"] [16.543548583984375, 6.9205546379089355, "nal and Torres Strait Islander people who are traumatised by family violence or sexual assault.\nParticipants will be women who have experienced family violence, specifically those with complex needs and a child at risk.\nAboriginal women who are victi"] [16.53911590576172, 6.931244373321533, "\nInside policy\nRoles:\n\u2022 Conduct 3 Design Shops\n\u2022 Assist sites with implementation\nRAND\nRole: Conduct process and outcomes evaluation\n Intensive family\u2014 focused case management\nprograms\n 1. Birrang/Maranguka 2. KWY\n3. Mookai Rosie\n4. Wurli-Wurlinj"] [16.512039184570312, 6.9691033363342285, "ties for the period and make funding decisions. Thus, pro- grams funded as part of 3AP had at maximum three years for implementation, but in real- ity implementation had happened for just over two years.\nThus, we expected that 3AP programs were likel"] [16.539913177490234, 6.9273762702941895, " Strait Islander peoples, all project-related data collection efforts were paused until AIATSIS approval was received. Several rounds of submissions, revisions and resubmissions took place over a one-year period.\nAIATSIS is part of the PM&C funding p"] [16.53167152404785, 6.940445423126221, "e design for 3AP programs, including details such as defining the client population, outlining the intended services provided, the process by which such services would be provided, and expected outcomes. This information was used to develop logic mod"] [16.545330047607422, 6.937196731567383, " 3AP-funded programs. We used the ideas generated during these sessions to further refine the sites\u2019 logic models and to frame analysis related to possible outcome evaluations in a culturally sensitive manner.\nProject Background 11\n12\nAustralia\u2019s Thi"] [16.528181076049805, 6.928245544433594, "d versions from Inside Policy for analysis (see Appendix A). In preparation for the site visits and phone calls with sites starting in October 2017, we analysed the logic models for specific sites and refined the stated activities, outputs and outcom"] [16.527353286743164, 6.936683654785156, " interview protocols from these early interviews).\nIn October 2017, team members visited six sites over a two-week period:\n\u2022 KWY\n\u2022 Mookai\n\u2022 NAAFLS \u2022 NPYWC \u2022 Yoowinna \u2022 VACCA\nWe selected these sites based on availability of program staff, travel logis"] [16.4971866607666, 7.004543304443359, "erimental design \u2013 program enrolment\n\u2013 data collection.\nAt the time that the evaluability assessments were conducted, all sites were early in their implementation periods. The assessment helped us to determine which sites were advanced enough in orga"] [16.537702560424805, 6.915063858032227, "ll available data col- lected throughout the evaluation period, including baseline information gathered through early 2018 and from interviews with all sites in 2019\u20132020. The summaries put this infor- mation into the context of the logic model, whic"] [16.54916000366211, 6.913402080535889, "sational capacity to provide services to families in need.\nInputs\nPUTP included four service components: case management, individual trauma-informed clinical interventions, family functioning therapy, and referrals for additional services (e.g., subs"] [16.541946411132812, 6.912031173706055, "prevent them from being exposed to the perpetrator or his family.\nObserved Outcomes\nIn 2019, Birrang staff reported that the services they were able to give clients\u2014and mothers in particular\u2014as part of 3AP funding led to real change for clients and f"] [16.547876358032227, 6.904513359069824, "communities of Adelaide and the Riverland and as a result reduce the number of children entering the out of home care and juvenile justice systems by breaking the cycles of family violence\u201d. Short-term goals for the program included engaging clients "] [16.5579833984375, 6.902132987976074, " CEO as one of their primary implementation challenges. KWY staff did not feel that keeping client data in Excel was efficient for the staff. KWY aimed to col- lect extensive data on each of their clients through dynamic risk assessments and behav- i"] [16.54388427734375, 6.912196636199951, " been using for some time now and are experienced with. One individual oversees all data in the system. In 2018, Mookai reported interest in tracking how their cli- ents interact with Australia\u2019s legal, justice and education systems. They discussed w"] [16.546253204345703, 6.913897514343262, "d it employed local Aboriginal staff. The organisation had a community liaison office to ensure client feedback was incorporated into service design and keep its finger on the pulse of changes in the community. Wurli also employed two community engag"] [16.542144775390625, 6.9265899658203125, " to their families, and to the land itself. VACCA staff reported their approach has allowed some families to connect to their extended families\u2014their clans or \u201cmob\u201d. This also allows family members to connect or reconnect to country, including visiti"] [16.54629898071289, 6.92279577255249, " historical and structural context in mind.\nVACCA has made several changes and developments in its therapeutic process over the years of 3AP funding. For example, they have started to build an internal culture of evaluation, assisted in part by evalu"] [16.535240173339844, 6.935407638549805, "complemented by on-country activities, such as cultural camps, with plans to conduct a check-in with the client at 12 months.\nInitially, MOS planned a five-person team (with four full-time employees) for Change \u2019Em Ways comprised of one senior clinic"] [16.529767990112305, 6.9346089363098145, "her assistance. For Burubi, RTS was funded to run an early intervention program providing a wide range of supports for the perpetrator; the program was designed to be complementary to RTS\u2019s existing behaviour change program.\nThe six-week program cons"] [16.542158126831055, 6.899142742156982, "am has been refunded for the next three-year funding cycle, and the team hoped to keep demonstrating the successes of their program to sustain funding into the future. RTS reinforced the necessity of consistency in funding to measure outcomes and mai"] [16.543964385986328, 6.902911186218262, "vism, increased employment and trained workers, and increased feelings of safety among women and children. At the community level, the organisation aims to inspire greater awareness of family violence and its impacts, establish \u201ccommunity champions\u201d "] [16.54967498779297, 6.909201145172119, "hey sought to provide support that was broader than merely addressing clients\u2019 legal needs.\nThe services that AFLSSQ had previously worked with for counselling services were unable to provide counselling for its 3AP program. It was difficult to hire "] [16.517906188964844, 6.93104362487793, " we\u2019ve assisted very well is a lady who went from being very intimidated in relation to dealing with her children to being more confident, a turnaround in personality, it took 12 months. And I was shocked, but the information she received that enable"] [16.56583023071289, 6.902041912078857, "people who were recently or previously victimised by family violence and/or sexual assault. As of December 2017, the program was monitoring and refining specific procedures for recruiting and referring clients, as well as the caseload for the two soc"] [16.557538986206055, 6.918286323547363, "ding higher-quality and more comprehensive care. The staff used a well-being scale from 1 to 10 to rate how clients were doing in different areas, although it is unknown whether and how this measure may be repeated and tracked over time across sessio"] [16.549182891845703, 6.911229133605957, "ice clients, they wanted to cap the number of clients that the social workers can have and monitor their caseloads to make sure they did not feel overwhelmed or experience burnout.\nIndividuals were generally referred to the social work services after"] [16.551340103149414, 6.909282207489014, "e new programming.\nMarninwarntikurra Women\u2019s Resource Centre\nMWRC works with children and families affected by domestic and family violence and provides legal services to these groups through its Family Violence Prevention Legal Unit (FVPLU). MWRC ex"] [16.54117774963379, 6.910747528076172, "s was approximately 650 km from the main office in Darwin; the counselling team, always travelling in pairs for safety, would go out on a Monday and return at the end of the week \u201ctotally exhausted from the long travel\u201d. Also, because the communities"] [16.547609329223633, 6.914459228515625, "ve experience working in such communities.\nSite Profiles 31\n32 Australia\u2019s Third Action Plan of the National Plan to Reduce Violence Against Women and Their Children\nFocus on developing the workforce in this area would be beneficial to programs acros"] [16.556367874145508, 6.911384582519531, "mat by every staff member. While the data collection provided excellent narrative histories of clients\u2019 progress, it would not be conducive to more formalised evaluation.\nBecause of the mode of data collection and because the 3AP program is closely i"] [16.538393020629883, 6.9323410987854, "program staff were working to manualise the program they had developed, establish training for their legal staff on family violence, and embed the social service part of the organisation into the existing legal service activities.\nSite Profiles 33\nCH"] [15.134176254272461, 13.621517181396484, "ultiple interviews with different program staff that were conducted individually. We uploaded these 14 transcripts (one for each of the fourteen 3AP sites) to the cloud-based collaborative qualitative analysis software platform Dedoose (SocioCul- tur"] [16.547006607055664, 6.923491477966309, "g child codes and writing up content were often responsible for differ- ent parent and grandparent codes than they were assigned during Coding Step 2. This allowed team coders to check through each transcript as they created child codes and read thro"] [16.55628776550293, 6.944911003112793, "y\n\u2013 future plans for sustainability\n\u2013 advice for PM&C on sustainability.\nInteractions with Department of the Prime Minister and Cabinet, Inside Policy or Other Third Action Plan programs\nType and Level of Interaction\nInterviewees from all 14 3AP site"] [16.545867919921875, 6.932723045349121, "heir work\u2014typically involving program funding or cost. Also, interviewees from four sites discussed some type of miscommunication or disagreement with PM&C that had to be settled. For example,\nMy view is that Canberra were number crunching and saw fr"] [16.552562713623047, 6.940810203552246, "a good bridge between us and PM&C on a fed- eral level. I was quite impressed.\nAnother site\u2019s interviewee echoed those thoughts regarding Inside Policy\u2019s helpfulness:\nThey were good\u2014really good. Especially initially when we were putting framework pap"] [16.555757522583008, 6.942013740539551, "dy\u201d. An interviewee from this same site also mentioned that while PM&C didn\u2019t support their site in their challenges, they conceded that it \u201cmight have been our fault because we didn\u2019t contact them much about it until we did the report . . . from the"] [16.544246673583984, 6.912440299987793, "as not enough opportunity to have effective sharing of models and best practices among sites:\nWhat I really think is that out of that meeting, the initial get together with all the partners who were funded by 3AP, I think that was a wasted opportunit"] [16.532882690429688, 6.926006317138672, "er, they receive comprehensive support to address all needs as they arise.\nThe holistic approach to care was also described as evolving over time and starting with meeting families where they are. One site\u2019s interviewee discussed how they sought to m"] [16.55828285217285, 6.902266025543213, "ut in one of the cases the client had no other options for the care of an older child, so we informed [the client] that we had the facilities and vacancy at our women centre to do this.\nTo address these gaps as they were identified, programs brought "] [16.562061309814453, 6.906343936920166, " support and doubled the number of group sessions being offered:\nThe reason that we did that was because we found in the 4\u20135 weeks [that clients were with the program] there were a couple of issues. Firstly, it was too short of time to be able to del"] [16.54868507385254, 6.9195556640625, "er that date. If it was a 3-year contract at that time, [the social workers] would have stayed.\nBarriers to service delivery. One of the biggest challenges to program implementa- tion was the numerous barriers to delivering services to the target pop"] [16.54429054260254, 6.913469314575195, "s, two days a week, and after that [we] follow up with 10\u201311 months of coun- selling. We only have a couple of guys that have maintained that all the way through, they have been consistent with their change, but the men coming through the justice sys"] [16.515453338623047, 6.929352760314941, " of [as a sign of our success] is that we have a waiting list, and communities and agencies are wanting to send Aboriginal men to us, and some of these men have gone through other men\u2019s behaviour change programs and have still main- tained being viol"] [16.548486709594727, 6.907705783843994, "les, including that \u201cthey [men] might drink and all that but they don\u2019t drink as much, or their kids have said that. When they come back from school, Daddy isn\u2019t lying on the lounge and growling at me, but that they have come home, and Dad is sitting"] [16.5291805267334, 6.945279121398926, "tes recognised the need to develop programming for chil- dren. For example,\nWe have also just finished piloting a children\u2019s program because we really want to develop a trauma informed program for the women and children. So, we have just finished run"] [16.4951114654541, 6.950207233428955, "rviewees reported that their sites used some type of data system, typi- cally for case notes. The systems used by sites included CLASS (two sites), NFILES, Penel- ope, and IRIS (each used by one site), while one site did not specify the type of data "] [16.533889770507812, 6.9237847328186035, "staffing, outreach meth- ods, cultural reference groups of an advisory nature, participatory activities, and education tools as means of community involvement.\nProcess Evaluation 49\n50 Australia\u2019s Third Action Plan of the National Plan to Reduce Viol"] [16.55293846130371, 6.909986972808838, "ams, this conversation recognised the role of men in perpetuating violent behaviour, encouraging accountability, sharing stories and recognising change. One program interviewee mentioned that the community responded by asking questions, seeking clari"] [16.54862403869629, 6.9144463539123535, "t the organisational focus from the individual to the family. 3AP funding also provided for the upskilling of workers at one site.\nOne site\u2019s interviewee noted that 3AP funding provided \u201centhusiasm and drive\u201d to consider different initiatives around "] [16.55571746826172, 6.899822235107422, "victims of violence felt more empowered and were able to stand up for their own rights and life goals as a result of participating in the 3AP program:\nAn example of this is a woman that has been a client of the service for about 20 years. . . . The a"] [16.55174446105957, 6.9265360832214355, "the cycle of violence because they [clients] have a connection to something. All of us human beings need to belong to something, we need to believe in something, it\u2019s part of our human nature, and when they have a connection to their country, to thei"] [16.546262741088867, 6.911143779754639, "f the National Plan to Reduce Violence Against Women and Their Children\nAlso, interviewees from two sites mentioned that they felt they just could not provide enough services; one of these interviewees indicated they thought couples counselling was i"] [16.54867935180664, 6.913773536682129, ". Interviewees from three sites indicated that an increased understanding of family violence in the community encouraged responsibility among community members for creating change; the program became sustained by the community. Meanwhile, inter- view"] [16.587055206298828, 6.8764328956604, "bed by one site as being \u201cgenerational\u201d, requiring significant time. One site\u2019s interviewee mentioned that the size and number of communities that required assis- tance was a significant barrier for their program. They noted that for \u201cthe community a"] [16.53302001953125, 6.908189296722412, " with police, which is why they [the police] are coming to us to set up the vulnerable people\u2019s unit. . . . Police are first responders to domestic violence so if they can refer to us, we know it\u2019s a win.\nAn interviewee from one site mentioned that a"] [16.54257583618164, 6.909570217132568, "ncy plan involves employing and training local residents to the extent possible and encouraging empowerment and education among community residents. Eventually the community will no longer need the program if they have sustained it themselves. Inter-"] [16.544981002807617, 6.920712471008301, "Evaluation 57\n58 Australia\u2019s Third Action Plan of the National Plan to Reduce Violence Against Women and Their Children\nInterviewees from four sites called for greater cultural understanding from PM&C in the future. This included more flexibility and"] [16.531007766723633, 6.965023040771484, "Surveys\nMethods\nEarly in the implementation of 3AP programs, we collected survey data from program staff and program managers regarding the progress of implementation and program details. The idea for these surveys came from one of the 3AP providers "] [16.509807586669922, 6.980283737182617, "beginning each survey, participants were provided information about the confidentiality and voluntary nature of the survey as well as contact details to direct questions about their rights as participants. The respon-\nFigure 3.2\nMonthly Manager Surve"] [16.456472396850586, 7.024348735809326, "uld also be related to your organisation or management.\n5. Please describe one lesson learnt over the past fortnight.\nThe lesson learnt can be small, such as a minor adjustment in how you work with clients, or it could be more significant, such as le"] [16.526596069335938, 6.969183444976807, "received 124 surveys from 50 client-facing staff. Table 3.3 provides the response rates for staff and managers for each wave of the survey; managers took the survey monthly so response rates from only three surveys are reported for those respondents."] [16.53912353515625, 6.981414318084717, "management surveys administered three times during that period. Staff respon- dents replied to between zero and six surveys. Among staff who completed at least one survey, the average was three surveys completed per staff member. All management respo"] [16.537919998168945, 6.928395748138428, "therapy\nCBT\nStrength-based approaches Active or deep listening Client-led or centred approaches Risk, needs assessments\nFocus on Aboriginal traditions and cultures Motivational interviews\nTrauma-focused approaches Communication\nIntensive Family- Focu"] [16.537029266357422, 6.912904262542725, "bstance abuse treatment or mental healthcare not offered at their organisation. Respondents also reported discord between staff within agencies, sometimes stemming from general dislike of other staff, but sometimes reporting more serious concerns. In"] [16.542531967163086, 6.9290547370910645, "ts in sessions, receiving training on specific techniques, or even realising their need for specific types of training. This also included more informal lessons, such as learning to \u201ctrust but verify\u201d client reports of their situation, and personal s"] [16.542800903320312, 6.916223526000977, "nd broader social networks within communities. Such an approach yielded positive results in terms of program interest, engagement, retention and reductions in family violence.\n2. Programs that were able to engage informal and formal institutions in c"] [16.541797637939453, 6.93839168548584, "re hands-off and waited for sites or the national PM&C to indicate a need for assistance.\n3. At the outset, the national office could have made things smoother by clearly iden- tifying the roles and responsibilities for the regional and national offi"] [16.384628295898438, 7.3553147315979, "out the intervention period. In this chapter, we provide insights that we were able to extract from each data set and suggest a way forward for future out- come evaluations.\nClient-Level Quantitative Data\nOne of the 3AP intervention sites, RTS, colle"] [16.368078231811523, 7.371827602386475, "cale (URICA; Habits Lab at UBMC, n.d.)4 and the RTS-Q. The research team calculated the overall scale and subscale means and standard deviations (SD; see Table 4.1).\n2. Differences in Men Who Completed the Intervention\nWe reasoned that men who comple"] [16.450143814086914, 7.230236053466797, "100 16 100 16 81 14 71 16 75 16 75\n16 6 16 88 16 94 16 6 12 67 17 76 17 100 17 88\nOutcome Evaluation 71\n When you are violent or aggressive, do you see that as a problem?\nWhen you are violent or aggressive, do you feel powerful?\nWhen you are vio"] [16.52212142944336, 6.952454090118408, "ales.5\nClient Case Vignettes\nTwo additional sites provided de-identified client case vignettes with narrative data on cli- ents and their families, including basic demographic data; which types of therapies were provided; and challenges, successes an"] [16.531845092773438, 6.943140029907227, " explained how VACCA is developing more knowledge and confidence with respect to the uniqueness of its own approach, and that it is currently engaging in a process to develop a customised scale to measure progress along the healing pathway among Abor"] [16.528589248657227, 6.932326793670654, "llect the array of data that was initially planned and thus unable to conduct rigorous analyses of potential program outcomes, this report has significant limitations. We are not able to draw any conclusions as to the actual effective- ness of any of"] [16.525196075439453, 6.9308295249938965, " are such activities as assessing community needs for programming; developing a logic model (including the goals, activities and outcomes of the program); determining community \u201cfit\u201d so that any new program complements without duplicat- ing existing "] [16.573665618896484, 6.91522741317749, "e the program development process as part of the implementation evaluation, gather rel- evant information about each site that can be incorporated into the evaluation plan, and work with the technical assistance provider to help sites develop systems"] [16.548721313476562, 6.929923057556152, "e that all hands (including technical assistance) are on deck to assist programs consistently. Large implementation programs like 3AP necessarily involve many different agencies and entities, some of which could have been formally brought into the pr"] [16.555988311767578, 6.9313788414001465, "ally thought their program would be implemented in one way before attending the Design Shops and then completely redesigning their approach. Our observation, then, is that this process was not sufficient to prepare sites for implementation.\nContinuin"] [16.54285430908203, 6.934199810028076, "sed programming but on their capacity and willingness to work through a robust needs assessment and design and implementation process. While more resource-intense at the front end, this approach may result in increased program longevity and success.\n"] [16.5343017578125, 6.929008960723877, "me degree, better coordi- nation with regional PM&C offices (and between regional and national staff) could help to address this. However, local variability in drivers of family violence, cultural dynamics and other ecological challenges (including l"] [16.530841827392578, 6.92922830581665, "sions (and preparation for data collection) should have started much earlier in the process. Further exacerbating this challenge was the time taken to secure ethics approval and the subsequent pause in interacting with 3AP sites, as discussed earlier"] [16.532485961914062, 6.9181671142578125, "upport for an inclusive, coordinated effort would ben- efit more community service providers.\nAny tools implemented should also accommodate the various Aboriginal- centred approaches to treatment that may be used, such as efforts to create connec- ti"] [16.539615631103516, 6.91353702545166, "hildren is commendable for its bold vision over a long time frame, implementation of the plan is broken into three-year periods, and fund- ing for the 3AP sites was initially provided for only two years. Several 3AP sites did receive follow-on fundin"] [16.542938232421875, 6.9201812744140625, " for program clients, increased the pro- grams\u2019 ability to refer clients to other needed assistance, and made positive progress towards their goals.5\n11. Storytelling and narrative therapy are critical for success.\nStorytelling and narrative therapy "] [16.538326263427734, 6.920489311218262, "d, and no sites indicated it was needed, we believe identify- ing local cultural advisory structures in each of the sites would have improved our findings. This effort requires planning time and resources to establish but would increase the likelihoo"] [16.51924705505371, 6.94681978225708, "uantita- tive tools (Muir and Dean, 2017; Palinkas, 2014).\n15. Emphasise the use of locally developed, culturally grounded measurement approaches.\nThe need for culturally appropriate measurement tools was discussed above under Recommendation 7. That "] [16.532939910888672, 6.905288219451904, "ainst Women and Their Children\nthe program design and implementation phases (i.e., building it into the structure of the program) would support long-term sustainability by allowing sites to better plan for the changing needs of the communities they s"] [16.50082778930664, 6.8810930252075195, "s client goes back to partner\n Community: \u2022 Decreased\nFV incidents and crime in community\n\u2022 Increased connectedness\n\u2022 Economic inclusion of Aboriginal families\nOrganisational: \u2022 Increase\nin quality partnerships and networks\n\u2022 Become a lead provider"] [16.49342918395996, 6.89677619934082, "llors\nStaffing:\n Kornar Winmil Yunti Aboriginal Corporation Logic Model\nFigure A.2\nNOTE: This logic model was modified by RAND (as a part of the outcome evaluation) to include additional information gleaned from qualitative interviews with program "] [16.526004791259766, 6.88657283782959, "lop strategies to be implemented in\n\u2022 One-to-one counseling\u2014men, women,\n\u2022 Lateral violence\u2014together and all\n\u2013 staff training CNS and city based\n\u2022 For community to use/promote\n\u2022 Workshops\u2014staff training and\n\u2022 Health assessment and service\n\u2022 Family the"] [16.510334014892578, 6.882812976837158, "ation\n\u2022 Children and family gain awareness of DV and coping strategies and\n\u2022 Minimisation of involvement by TFs services trauma trauma skills\n trauma transfer assessment process\n\u2022 Community staff\n\u2022 Increase inter-agency\n\u2022 Improve stakeholder\n\u2022 Comm"] [16.528486251831055, 6.895660400390625, "s and communities are free from family violence\nBlue = TF Red = 10YP Orange = OL Green = FVTI Black = LTU\n Outcomes (6\u201312 months)\nRecreational well-being, social and cultural connectedness\n Increased ability to sustain positive relationships\n Stronge"] [16.473413467407227, 6.873309135437012, "ily and community relationships, membership of CRG is reconstituted greater connection to extended culture, and country, and are more \u2022 Clients (partner and children) have engaged in societal activities. \u2022 The Terms of Reference and based upon lesson"] [16.492694854736328, 6.88787317276001, "\nwith partner and children.\nParticipation:\nCultural Mapping (stage 2), for\nhas been formed, and members\n\u2022 Cultural Reference Group (CRG)\n\u2022 Clients have undergone CEW\nparticipation in the workshop\nunderstand role (ToR).\n(stage 3).\nCulture:\nengaged, wh"] [16.49791717529297, 6.865980625152588, " 0\u20132 years) Changes in knowledge, awareness, convenience, motivation, etc.\n OUTPUTS Units of service delivered to stakeholders/to meet project objectives\nabusive behaviour on self,\n\u2022 Raise awareness of positive\n\u2022 Raise awareness of the impacts of v"] [16.500959396362305, 6.8907790184021, "retation services\n\u2022 Advisory group/board\n\u2022 Community based\n\u2022 Mediator\nchampions\ncountry\nStaffing:\n\u2022 Data input systems and IT\n\u2022 Policies and procedures\n(e.g., for recruitment)\n\u2022 Operational support\n\u2022 Accreditation\nProcesses:\n\u2022 Winnebago for travel\n\u2022 "] [16.505395889282227, 6.885105609893799, "oject objectives\n ACTIVITIES Events or processes to meet needs/ objectives\n\u2022 Client support officer accompanies client to\n\u2022 Counsellors do narrative\n\u2022 Advertise to community about services on offer\n\u2022 Engage with existing\nnetwork services\n\u2022 Refer to"] [16.48539161682129, 6.8995513916015625, "rs\nprocedures\nStaffing:\nworker\n\u2022 Manager\nProcesses:\n\u2022 Finance\n\u2022 New marketing materials\n\u2022 New office space\nResources:\n Figure A.10\nFar West Logic Model\nNOTE: This logic model was modified by RAND (as a part of the outcome evaluation) to include add"] [16.512020111083984, 6.881375312805176, "ng mediation\n\u2022 Training/upskilling\nincluding board\nhealing space and\n\u2022 Redesigning of\nto discuss needs\nworkshops\nstakeholder\nresources\nservice\n\u2013 Staff\n INPUTS\nStaff, money,\nprevious research\n\u2022 Internal knowledge/\nresearch including\ncultural (such a"] [16.49991798400879, 6.891704559326172, "ional:\nstakeholders.\nand policies\n INPUTS\n \u2022 Professional development\nmember (advising)\n\u2022 Capable staff\n\u2022 Elders and TO and\n\u2022 Interpreters\nStaffing:\n\u2022 Promotion\nlegal and social services to\n(e.g., for recruitment)\n\u2022 Create barriers between\nprotect"] [16.517946243286133, 6.889917850494385, "fident life home care be drastically\n\u2022 Ongoing commitment from and parents to be involved\n\u2022 Changes in attitude toward\n\u2022 Improvement in well-being functioning, well-being and\n\u2022 Exit plan\u2014as long-term\n\u2022 Want clients to be happy with pride and free fro"] [16.518104553222656, 6.9057440757751465, "commitment\n\u2013 1x part-time support\n\u2013 Training for all staff\nsocial workers (SW)\n\u2022 History of region:\n(cultural/security/\n\u2022 Understanding the\ndifferent language\n\u2022 Outreach induction\n\u2013 2x social workers\nin Geraldton and\nand all staff\n\u2022 AFLS induction\nfr"] [16.497501373291016, 6.8785810470581055, "ence that this includes in the community you serve?\n 101\n102 Australia\u2019s Third Action Plan of the National Plan to Reduce Violence Against Women and Their Children\nb. [low priority] How did the family violence issue originate? [less important\u2014skip if"] [16.48390769958496, 6.8853912353515625, " specific data they will track, etc.]\n1. [high priority] What types of data will you be keeping from the clients\nwho are in your program?\na. [high priority] Will you keep case notes for each client? What is\nincluded in those case notes? v. Are there "] [16.504253387451172, 6.883947372436523, "er context of your community and then we will speak more specifically about your program.\n1. Tell me about your community. [We are looking for broad contextual information about the community; we will talk more specifically about family violence and "] [16.49949073791504, 6.884403228759766, "ird Action Plan effort\ni. Specific activities undertaken as a result of the funding\nii. If/How it is changing from the original proposal to PM&C iii. Do you have sufficient resources to do the work?\nf. [low priority\u2014important to know so we can determ"] [16.502500534057617, 6.881659507751465, "ges to [organisation]\u2019s program. This will help us to ensure we understand the context of the issues with violence your community faces, and the ethical considerations we should follow while we work together. Over time, we\u2019ll be talking with people a"] [16.491073608398438, 6.876645088195801, "funding . . . other?]\ng. [high priority] What are best long-term solutions to reducing family violence?\ni. What are persistent barriers to solving the issue? [probe on systemic, dis- crimination, resources, etc.]\nii. What solutions have been tried al"] [16.504512786865234, 6.881856441497803, " more than an hour.\nI will be leading today\u2019s discussion and [NAME] may ask additional questions for clarification. [NAME] will be taking notes.\nDo you have any questions before we begin?\nThe first half of our interview will focus on the broader cont"] [16.547407150268555, 6.927816867828369, "e new program aligns with other organisational services\nii. Is there any program you\u2019re currently running that is most similar to the new program?\n1. Do you believe this or any of the other programs you offer through your organisation could be suitab"] [16.546581268310547, 6.931838512420654, "hat aspects of your interaction with regional PM&C staff did you feel worked well? What aspects of your interactions could have been improved? Were regional PM&C staff accessible? Responsive to requests? Hands-off or too involved? Open to discussing "] [16.54010009765625, 6.918243885040283, "lence? SOURCE: Data from 3AP site, analysed by RAND.\nWhat were the goals of the 3AP program? How did this change over time?\n\u2022 What populations did you plan to serve? How did this change over time?\n\u2022 What was your staffing plan? How did this change ov"] [16.53384780883789, 6.918822765350342, ".au/getmedia/b0037b2d-a651-4abf-9f 7b-00a85e3de528/aihw-fdv3-FDSV-in-Australia -2019.pdf.aspx?inline=true\nAustralians Together, \u201cThe Intervention,\u201d webpage, last updated January 14, 2020a. As of August 22, 2020:\nhttp://www.australianstogether.org.au/"] [16.511947631835938, 6.895500659942627, "97. As February 19, 2020: https://humanrights.gov.au/sites/default/files/content/pdf/social_justice/bringing_them_home_report.pdf\n\u2014\u2014\u2014, Closing the Gap: Prime Minister\u2019s Report 2017, Canberra, ACT: Department of the Prime Minister and Cabinet, 2017. A"] [16.495018005371094, 7.231828689575195, "ogy and Law, Vol. 19, No. 1, pp. 104\u2013117, 2012.\nEckhardt, Christopher I., and Angela C. Utschig, \u201cAssessing Readiness to Change Among Perpetrators of Intimate Partner Violence: Analysis of Two Self-Report Measures,\u201d Journal of Family Violence, Vol. 2"] [16.527618408203125, 6.938494682312012, "01_2016/3-1-respectful-relationships-evaluation -summary-of-findings.pdf\nLevesque, Deborah A., Richard J. Gelles, and Wayne F. Velicer, \u201cDevelopment and Validation of a Stages of Change Measure for Men in Batterer Treatment,\u201d Journal of Cognitive The"] [16.525827407836914, 6.93304967880249, " Adolescent Psychology, Vol. 43, No. 6, pp. 851\u2013861, 2014.\nPiper, Alana, and Ana Stevenson, \u201cThe Long History of Gender Violence in Australia, and Why It Matters Today,\u201d The Conversation, July 14, 2019. As of September 14, 2020: https://theconversati"] [16.538063049316406, 6.913471221923828, "er\nand Cabinet\u2019s (PM&C\u2019s) Third Action Plan (3AP) of the National Plan to Reduce Violence Against Women and Their Children, and specifically 3AP\u2019s Priority Area 2: Aboriginal and Torres Strait Islander Women and Their Children. PM&C provided funding\n"] [22.98692512512207, 14.098642349243164, " Research Report\nANDREW R. MORRAL, TERRY L. SCHELL, BRANDON CROSBY, ROSANNA SMART, ROSE KERBER, JUSTIN LEE\nPreliminary Findings from the Aerial Investigation Research Pilot Program\nIn this report, we provide a preliminary description of the clearanc"] [22.986286163330078, 14.098257064819336, "reet jus- tice because they do not believe going to the police will produce results. In addition, low clearance rates could undermine community support and coopera- tion with police if citizens believe that the police have little interest in solving "] [22.98688316345215, 14.098835945129395, "e June, a second plane began to be used, and it was declared fully operational by PSS staff on July 6, 2020. The AIR pilot program col- lected an average of 5.7 hours of imagery per day\nin May, 7.7 hours of imagery per day in early June, and 9.1 hour"] [22.986764907836914, 14.098956108093262, "t least one of the crimes associated with a case has been cleared by arrest or by exception, accord- ing to either the database used by the investigating detective or the BPD records management system. Case status updates in the record management sys"] [22.987018585205078, 14.099167823791504, "icts, and clearance rates vary across districts. Similarly, AIR cases consist of a higher percentage\nof homicides than non-AIR cases, and homicides\nare cleared at a higher rate than other MOU crimes. Therefore, we would expect cases with AIR evidence"] [22.98691749572754, 14.099051475524902, "when the suspect is arrested at the crime scene (Cook et al., 2019). These cases close before AIR evidence would ever need to be used. The primary benefit of the AIR pilot might be expected to be found among the more-difficult cases that are not reso"] [22.986722946166992, 14.098960876464844, " Were Not Cleared on the Day of the Crime or the Next Day\n100\n75 Percentage closed/solved 50 25\n0\nAIR Non- Matched AIR non-AIR\nProvisionally cleared\nAIR\nNon- Matched AIR non-AIR Provisionally solved\n NOTES: Sample sizes for AIR and non-AIR cases"] [22.986658096313477, 14.098905563354492, "o AIR cases also has limitations. Although the matched cases do, on average, occur at times\nand places comparable to AIR cases, they might still differ from AIR cases in important and systematic ways that make them a misleading comparison group. For "] [22.98722267150879, 14.099226951599121, "vestigates the crime, they enter a more accurate crime description in Lotus Notes. Information in the Lotus Notes\u2013based data system and RMS is later reconciled through a formal UCR review, although this review sometimes occurs months after the crime "] [22.984786987304688, 14.097273826599121, "hursday day:Friday day:Saturday day:Sunday month:5 month:6\nmonth:7\nmonth:8 month:9 month:10 time:12am_2am time:2am_4am time:4am_6am time:6am_8am time:8am_10am time:10am_12pm time:12pm_2pm time:2pm_4pm time:4pm_6pm time:6pm_8pm time:8pm_10pm time:10pm"] [22.983427047729492, 14.096779823303223, "e sample size of the matched non-AIR group. More-difficult cases = all MOU cases that did not close on the day of the crime or the next day.\nAerodrome Report data from Baltimore/Washington International Thurgood Marshall Airport describ- ing cloud co"] [22.986541748046875, 14.09838581085205, "ases (difference = 6 per- centage points, t = 1.27, p = 0.2). (Recall that this was also true for the analysis with the full sample of MOU cases.)\nFIGURE A.1\nRates at Which Crimes Were Provisionally\nCleared and Solved, July 1 to October 31 Subset\n100"] [13.90304946899414, 4.442045211791992, "bberies, and carjackings. The pilot began on May 1, 2020, and continued until October 31, 2020. In this preliminary report, we provide an initial description of the clearance rates achieved by the BPD during the six-month pilot test, which might prov"] [4.56192684173584, 24.14164924621582, " CORPORATION\nBENJAMIN M. MILLER, DAVID METZ, JON SCHMID, PAIGE M. RUDIN, MARJORY S. BLUMENTHAL\nMeasuring the\nValue of Invention The Impact of Lemelson-MIT Prize Winners\u2019 Inventions\n For more information on this publication, visit www."] [4.5136494636535645, 24.0631046295166, "cuses on such topics as infrastructure, science and technology, community design, community health promotion, migration and population dynamics, transportation, energy, and climate and the environment, as well as other policy concerns that are influe"] [4.585304260253906, 24.167091369628906, "ocial Impacts .............................................................................................................23 3. Boyer and Cohen: Recombinant DNA Technology ..................................................................26 Overview"] [4.599722862243652, 24.181570053100586, "............................................................................59 Applied Biosystems ............................................................................................................................60 Amgen ..................."] [4.569302082061768, 24.150039672851562, "...............................................................................90 Bibliography ..................................................................................................................................94\nA separate appendix (R"] [4.572033405303955, 24.15300941467285, "tions by Year, 1990\u20132019 ...................................78 Figure 5.6. Bertozzi\u2019s International Collaboration on Scientific Publications..............................79 Figure 5.7. Distribution of Bertozzi\u2019s Patents by Technology Sector.........."] [4.573006629943848, 24.154176712036133, "......................................................................................76 Table 5.2. Summary of Bertozzi\u2019s Publications............................................................................78 Table 5.3. Summary of Bertozzi\u2019s Tech"] [4.5664472579956055, 24.146690368652344, "cases, the inventions of the Lemelson-MIT Prize winners not only provided the scientific and technological foundation for new companies but were revolutionary ideas that\n1 In addition, 22 more of these companies were involved in acquisitions for whic"] [4.560612201690674, 24.139930725097656, " Evidence suggests that a lack of exposure to role models and support networks is limiting diversity in the population of inventors. Programs and policies that support the development of both inventions and inventors remain important for ensuring eve"] [4.558620929718018, 24.138525009155273, ", and more-productive lives. They provide new ways to build, move, communicate, heal, learn, and play.1\nThe potentially life-changing benefits of invention make it important to ensure that policies, programs, and initiatives support the development o"] [4.562376976013184, 24.14272117614746, "assachusetts Institute of Technology (MIT) Prize. The Lemelson- MIT Prize was one of the most prominent efforts to recognize and reward invention.\nThis report is not an assessment of the effectiveness or impact of the Lemelson-MIT Prize or similar pr"] [4.562665939331055, 24.14298439025879, "pt of the award.\nChapters 3 through 5 of this report focus on the impacts of the inventions created by winners of the Lemelson-MIT Prize from three particular years: 1996 (Herbert Boyer and Stanley\n3 For studies showing that ex post technology prizes"] [4.560405254364014, 24.140975952148438, "a better world. Jerome Lemelson was one of the most prolific independent inventors in the United States, amassing more than 600 patents.4 The Lemelson-MIT Prize was created to recognize highly accomplished and highly promising mid-career inventors wh"] [4.562035083770752, 24.14196014404297, "llecting, analyzing, and publishing statistical data related to the U.S. business economy\u201d (U.S. Census Bureau, undated).\n8\n4\n3\n3\n3\n2\n2\n1\n1\n1\n1\n1\n 4\nNearly half of the Lemelson-MIT Prize winners produced inventions in the field of research and de"] [4.571748733520508, 24.153228759765625, "rch and development in the physical, engineering, and life sciences (except nanotechnology and biotechnology); U.S. Office of Management and Budget, Economic Classification Policy Committee, 2017.\n5\nIn addition to\u2014or often, in the process of\u2014providin"] [4.561954975128174, 24.142271041870117, "old patents than their peers in the top 1 percent of parent income (Bell et al., 2019). Furthermore, as of 2016, the \u201cwomen inventor rate\u201d had reached only 12 percent (increasing from less than 5 percent in 1976), and growth in that metric has been s"] [4.563509941101074, 24.142955780029297, "a key role in the promotion of their inventions, design, production, and distribution functions are typically addressed by new or existing organizations, which may or may not be led by said inventor.\nOften, many organizations are involved in the deve"] [5.2888383865356445, 8.118260383605957, "cture Fogarty\u2019s device. Today, Edwards Lifesciences still\n manufactures Fogarty\u2019s balloon catheter, which it sells to medical professionals worldwide.\n Ultimately, the balloon catheter is estimated to have saved the lives or limbs of as many as 15 mi"] [4.562629222869873, 24.14208984375, " objects on the road to improve artificial intelligence for Google\u2019s Waymo autonomous driving systems (Healy and Flores, undated; Kidd, 2019).\n1 The quotes and information in this paragraph, as well as the statistic on the number of patients affected"] [4.572259426116943, 24.152082443237305, " category, inventions must have provided a foundation for a public or private company to grow over time and remain an independent entity that exceeds the U.S. Small Business Administration\u2019s threshold for a small business. These thresholds vary by in"] [4.55990743637085, 24.1401424407959, " SOURCE: RAND analysis of data sourced from Yahoo! Finance, Dun & Bradstreet, and other financial news sources.\nThe most-frequent pathways of invention proliferation among the 26 Lemelson-MIT Prize winners include commercializing an invention as a "] [4.562438011169434, 24.143054962158203, " a lot of pressure. It was well beyond the technology at this point, right? It\u2019s branding, it was operations, it was [a] tough, tough business. (DeSimone, 2013)\nA decision by Congress to not pass an anticipated tax credit that would have favored the "] [4.564068794250488, 24.145076751708984, "ed with existing businesses, and the majority remained successful smaller companies or were start-ups attempting to commercialize new ideas or technologies. Many companies did not succeed.\nThe combined technologies, resources, and capabilities of the"] [4.574212551116943, 24.154903411865234, "unt for each inventor, we searched the author field within the WOS database using the author\u2019s last name, followed by their first initial. We then identified a publication that we knew to have been written by the target inventor to serve as a confirm"] [4.561638832092285, 24.142120361328125, "e issue of variability in a given article\u2019s impact by also examining prize winners\u2019 citations (i.e., the number of instances in which a scientific peer has cited a winner\u2019s publication portfolio).\nFindings\nTable 2.1 summarizes the aggregate scientifi"] [4.566939353942871, 24.148174285888672, " 49\n 48\n 43\n 41\n 40\n 39\n 37\n 35\n 34\n 34\n 34\n International co-authorship can be used to measure the extent of international scientific collaboration; it also reflects"] [4.568286418914795, 24.14922332763672, "Third, patents can be filed strategically to prevent other firms from using an innovation (Blind, Cremers, and Mueller, 2009; Noel and Schankerman, 2013; Thumm, 2004), and even the choices of which citations to cite as prior art may be a strategic de"] [4.5356292724609375, 24.116506576538086, " Langer\nMead\nFogarty\nKurzweil\nKamen\nHood\nHolonyak\nNorris\nFergason\nSwager\nDeSimone\nMirkin\nBertozzi\nRogers\nQuake\nBelcher\nBhatia\nWhitacre\nRaskar\nZhang\nvonAhn 12 128 49 Friesen 87 37 22\n831 7,487 1,369 90 2,824 414 215 8,259 795 117 883 232 479 4,5"] [4.56214714050293, 24.142940521240234, "e winners. During the patent application process, patents are assigned International Patent Classification (IPC) codes by patent examiners to facilitate subsequent applications\u2019 search for prior art. IPC codes classify a given invention in terms of i"] [4.550408363342285, 24.132522583007812, "nces in several\n21 In addition, 22 more of these companies were involved in acquisitions for which our research team was not able to find publicly available financial details.\n 3% 11%\n 34%\nInstruments\nChemistry\nElectrical engineering Mechanical"] [4.587223529815674, 24.169082641601562, " inventions in these contexts\u2014although the inability to do so does not diminish the impacts of the inventions because the benefits may be diffuse and not solely\n22 Financial data are not available for all companies, including many privately held comp"] [4.591621398925781, 24.173812866210938, "cientists, generated billions of dollars in revenues, and would have some of the largest public offerings in U.S. history at the time. In 2009, Genentech would become one of the first biotechnology companies to achieve a market valuation exceeding $1"] [4.6023640632629395, 24.18466567993164, "Linn and Arber, 1968; Meselson and Yuan, 1968; Smith and Wilcox, 1970). Boyer and others envisioned that restriction enzymes would be useful for cutting, recombining, and characterizing DNA. In 1972, Robert Yoshimori, a graduate student in Boyer\u2019s la"] [4.590308666229248, 24.172622680664062, "oyer presented on the properties of EcoRI, Cohen recognized that this restriction enzyme could be a potential solution to the challenges of inserting plasmid DNA into bacteria for cloning. One evening after the conference, Boyer and Cohen met at a lo"] [4.590150833129883, 24.172639846801758, "nvention\nrDNA technology\nBeneficiaries\nrDNA technology gave rise to the field of genetic engineering and laid the foundation for the biotechnology industry, opening the door to gene therapy and the manufacturing of new drugs and existing synthetic bi"] [4.594061851501465, 24.176342010498047, " Cohen created a novel combination of antibiotic resistance genes. Conveying unease within the scientific community, a majority of conference attendees voted to send letters to the National Academy of Sciences and the National Institute of Medicine r"] [4.567264556884766, 24.149513244628906, "tologous, Homologous, and Heterologous Normal Skin Grafts in the Hamster Cheek Pouch\u201d in the Proceedings of the Society for Experimental Biology and Medicine (Cohen, 1961). Since 1961, Boyer and Cohen have published an additional 247 WOS-indexed arti"] [4.586724281311035, 24.168668746948242, "cription of Eukaryotic DNA in Escherichia coli,\u201d which were published by the Proceedings of the National Academy of Sciences of the United States of America in 1973 and 1974, have been cited 1,172 times and 364 times in WOS publications, respectively"] [4.605984687805176, 24.18751335144043, "al limitation of Kelly et al., 2018, is that text-based measures focus on scientific value rather than market value; however, the literature finds these tend to be related (Hall, Jaffe, and Trajtenberg, 2005; Nicolas, 2008; Odasso, Scellato, and Ughe"] [4.592230796813965, 24.174097061157227, "these patents around the time it financed the acquisition of Gen-Probe Incorporated by Hologic, Inc. in 2012.\n36\nTable 3.4. Notable Inventions with Forward Citations from Boyer and Cohen\u2019s Patent Portfolio\n Citing Organization\nGenentech\nGoldman Sa"] [4.593061447143555, 24.175668716430664, "company and Swanson departing the firm. Swanson would later approach Boyer with a business proposal.\nBy 1978, Cetus Corporation had finally completed construction of genetic engineering research facilities to conduct their first rDNA experiments. Cet"] [4.588002681732178, 24.17059898376465, "lergic reactions in some humans. rDNA technology could replicate human insulin, which would pose lower risk of an adverse reaction and mitigate a global insulin shortage. The company\u2019s goal would be to license the genetically engineered bacteria to a"] [4.592715263366699, 24.174942016601562, " of directors.\n 39\nhormone and rapidly approve Genentech\u2019s human growth hormone. Genentech would gain exclusive rights to sell recombinant human growth hormone under the brand name Protropin in the United States, while KabiVitrum would sell it intern"] [4.589552402496338, 24.17219352722168, "ch generated sales of about $7.5 billion (about $9.7 billion measured in 2018 dollars). In 2018, the same four products accounted for approximately $21.1 billion in sales for Hoffman-La Roche (Trefis Team and Great Speculations, 2019). Figure 3.7 sum"] [4.585855484008789, 24.1684513092041, "ed-b). Estimated national expenditures for cancer care in the United States were $150.8 billion in 2018 (National Institutes of Health, National Cancer Institute, 2020). Modern rDNA drugs and protein therapeutics are used in cancer treatments for mil"] [4.586397171020508, 24.168827056884766, " $10,000 plus downstream royalties based on a percentage of final product sales (Hughes, 2011). Over the lifetime of the patents, which jointly expired in December 1997, the technology was licensed to 468 companies, resulting in more than $35 billion"] [4.577565670013428, 24.159868240356445, "wide impacts cannot be solely attributed to individual inventors, they reflect the enormous and prolonged impact of invention. They might not have happened nearly as quickly\u2014or at all\u2014without the determination of the inventors and the risks they took"] [4.5882720947265625, 24.171218872070312, "s for diabetes, growth hormone deficiency, leukemia, AIDS, hepatitis B, and multiple sclerosis\u2014all of which have reduced the risk of premature death and provided tangible quality of life improvements for many.\n46\n4. Hood: The DNA Sequencer and Modern"] [4.589837074279785, 24.17271614074707, "impacts.\n 47\nOverview of Inventions\nIn 1960, Hood completed a B.S. in biology at California Institute of Technology (Caltech) and enrolled at the Johns Hopkins School of Medicine, where he was granted an M.D. in 1964. Hood then enrolled in the bioche"] [4.588202476501465, 24.17119026184082, "nk-jet oligonucleotide arrays synthesizer.\n2 Discretizing the innovative contributions of a researcher as prolific as Hood is inexact, here our assessment is consistent with that of Hood himself. In a 2002 article providing a personal account of his "] [4.59060525894165, 24.173404693603516, "science, zoology, neuroscience, agronomy, parasitology, toxicology, and polymer science.4 Hood and his colleagues used the instrument to sequence platelet-derived growth factor (a human blood hormone), which showed that the N-terminal\n3 Based on a se"] [4.594599723815918, 24.17766761779785, "t important scientific contributions of the DNA synthesizer was facilitating the synthesis of oligonucleotides. The DNA synthesizer was used to assemble oligonucleotides in an important study on genetic disease detection methods (Barany, 1991). The D"] [4.595793724060059, 24.178611755371094, "pidly determine the order of the four bases. The DNA sequencer also allowed rapid genotyping, a related process that focuses on determining the precise genetic variants that an individual possesses. Of the instruments invented at Caltech, Hood descri"] [4.583589553833008, 24.165868759155273, "e student at Caltech, published his first WOS-indexed article, \u201cEvidence for Amino Acid Sequence Differences Among Proteins Resembling the L-Chain Subunits of Immunoglobulins,\u201d in the Journal of Molecular Biology (Bennett et al., 1965). Over the cour"] [4.584415435791016, 24.167369842529297, "ns in which at least one co-author from each country was also listed on a publication with Hood. The network graph depends on data from Hood\u2019s WOS-generated author profile. As described earlier, we found Hood\u2019s author profile to undercount his scient"] [4.575974941253662, 24.158512115478516, "ation has been cited more than 14,000 times in WOS-indexed articles and more than 25,000 times according to Google Scholar.\n11 Publications are reported as of October 15, 2020; therefore, the 2020 data may be incomplete. 55\n Technological Impact\nAs o"] [4.586066246032715, 24.16880989074707, "s,13 and Applied Biosystems (which merged with Invitrogen Corporation and later was acquired by Thermo Fisher Scientific). The separate appendix provides a summary of the top citing organizations to Hood\u2019s patent portfolio.\nTable 4.3 provides example"] [4.588188648223877, 24.17091941833496, "cientific evidence.\n58\nEconomic and Social Impacts\nHood laid the technological foundation for genomics and proteomics through the invention of cutting-edge scientific instruments incorporating automation with integrated laser and computer technology."] [4.587169170379639, 24.17023468017578, "immerman, 2016). Hood\u2019s lab at Caltech, with funding from the U.S. Department of\n59\nEnergy and the National Institutes of Health, became one of dozens of research centers in the United States, Europe, and Asia that were sequencing the human genome. T"] [4.587757587432861, 24.17074203491211, "orporated, initially Genetic Systems Company (GeneCo), was founded in 1981 in Foster City, California, to commercialize the technology developed by Hood and his colleagues. Its first commercial instrument, the Model 470A Protein Sequencer, was releas"] [4.61305570602417, 24.195911407470703, "ed cost\n\u2022 Contributed to development of expressed sequence tags, a revolutionary new method for gene discovery and sequencing\n\u2022 One of the key technologies that enabled the completion of the Human Genome Project\n\u2022 Produced high yields of high-quality"] [4.577568054199219, 24.160490036010742, "ientific in 2014 for approximately $13.6 billion (Berkrot and Kelly, 2013).\nAmgen\nIn 1980, William Bowes recruited George Rathmann from Abbott Laboratories and Winston Salser from the University of California, Los Angeles, to found Amgen (originally "] [4.577364444732666, 24.16046714782715, "9\nKyprolis\nXgeva\nProlia\nNplate\nVectibix Sensipar/Mimpara Neulasta\nEnbrel\nAranesp Neupogen\nEpogen\n In 2019, Amgen had about 22,000 employees and revenues of $23.4 billion, and invested more than $4 billion in new research and development (Amgen, 2"] [4.5873236656188965, 24.170780181884766, "eatments pose the risk of serious side effects that must be weighed against the potential benefits of treatment.\nIn addition to becoming one of the most successful biotechnology companies, Amgen endeavored to make a positive social impact. In 1994, A"] [4.592696666717529, 24.175704956054688, "esearch/Project\nRegulatory network for glioblastoma using systems genetics network analysis (published in Cell Systems)\nHigh-resolution mapping of Huntington\u2019s disease in mice (published in Human Molecular Genetics)\nThe Human SRMAtlas\nProject Feed 10"] [4.59067440032959, 24.174142837524414, ") for $76 million in 1997. SyStemix\u2019s pioneering work in stem cell research was shut down by Novartis in 2000. Weismann was able to license key technologies from Novartis, and more than a decade later, resumed research to grow and deliver blood stem "] [4.590156555175781, 24.17357635498047, " and Phenogenomics Corporation (a biotechnology company seeking to develop rapid methods for detecting proteomic interactions\n68\ndesigned to discover new antibody-based drugs for cancer treatment) (Agilent Technologies, 2019).\nIn 2003, Hood co-founde"] [4.586925506591797, 24.168601989746094, "et, and other financial news sources. Note that in Chapter 2 where we reported the collective impacts of all of the Lemelson-MIT Prize winners, we only included economic and financial data for companies founded by the inventors, but not other compani"] [4.594364166259766, 24.17613410949707, "still in their infancy, and the full scale of her work\u2019s impact is yet to be realized. Nevertheless, Bertozzi has already published hundreds of scientific articles, developed more than 60 patents, and co-founded seven companies.\nOverview of Invention"] [4.600253105163574, 24.18159294128418, "om the 1990s suggested that such chemical reactions might exist or [at] least could be invented with some clever mechanistic thinking.\u201d (Sletten and Bertozzi, 2011). In 2003, Bertozzi\u2019s team published the first use of the term bioorthogonal (Hang et "] [4.599502086639404, 24.181011199951172, "ls at the site of their action\u201d (Devaraj, 2018). In other words, a bioorthogonal reaction could be used to assemble a medically effective compound at the site of disease, rather than trying to direct a prefabricated medical compound to the right loca"] [4.5951313972473145, 24.177106857299805, "son, the ultimate impacts of Bertozzi\u2019s work remain to be seen. She has co- founded seven different companies based on different aspects of her research, but medical applications of her discoveries are still in trial phases, so the final outcome is u"] [4.61224365234375, 24.19391632080078, ", and with high accuracy.\nEnables research advances in such areas as oncology, autoimmunity, metabolism, and neurology.\nThe goal is to discover and develop \u201cfirst-in-class therapeutics that degrade extracellular and membrane-bound proteins that drive"] [4.589101791381836, 24.170928955078125, "ublish frequently, having more than 300 WOS publications. Figure 5.5 depicts Bertozzi\u2019s annual publication output from 1990 to 2019 (the most recent year for which complete data are available), and Table 5.2 provides statistics on her publications an"] [4.588728904724121, 24.170642852783203, "ornia, Berkeley; 14 co-authored papers), Jeremy Baskin (another alumnus of Bertozzi\u2019s University of California, Berkeley lab; 13 co-authored papers), Steven Rosen (a biology professor whom Bertozzi worked for as a postdoctoral researcher at UCSF, and"] [4.600890636444092, 24.18111801147461, "Center at Oakland. The separate appendix provides a summary of the top citing organizations to Bertozzi\u2019s patent portfolio.\nTable 5.4 provides examples of new inventions among the top 25 citing organizations (i.e., entities with the highest number of"] [4.586605548858643, 24.168336868286133, "cusses each organization\u2019s activities and describes their potential impacts.\nThios Pharmaceuticals\nThe first company Bertozzi co-founded was Thios Pharmaceuticals, which she co-founded with Steve Rosen, Stefan Hemmerich (another former postdoctoral r"] [4.598621368408203, 24.18076515197754, "ite-specific protein modification tool. The technologies developed by Redwood \u201cenable the generation of homogenous bioconjugates engineered to improve performance and ease of manufacturing.\u201d This \u201cenables the identification of superior drugs from lib"] [4.615163326263428, 24.197265625, "lop additional treatments for additional diseases\u2014seems promising.\nEnable Biosciences\nIn 2015, Bertozzi co-founded a third company, Enable Bioscience, along with Jason Tsai, Peter Robinson, and David Seftel; Tsai and Robinson are both graduate studen"] [4.610090255737305, 24.192405700683594, "1 diabetes, and the presence of any two or more of these autoantibodies generally causes type 1 diabetes to occur (Ziegler et al., 2013). These autoantibodies can be present well in advance of\n84\ndisease symptoms; they can be present at as early as s"] [4.612597465515137, 24.19500732421875, "ies of receptors known as Siglecs turn off that response whenever they bind to any one of many sialic acid\u2013containing glycans that cover the surface of the cancer cell. Targeting this \u201coff switch\u201d has been difficult because there are many different t"] [4.642795085906982, 24.21796226501465, "dditional parts of the body, but only 20 percent of ovarian cancers are detected in earlier stages because the disease is typically asymptomatic in early stages and an effective screening test is not available.3 Ovarian cancer is the fifth-most commo"] [4.618826866149902, 24.192541122436523, " a variety of drugs are available to cure cases of the disease, but the drugs must be taken for six to nine months. Some strains of tuberculosis are becoming resistant to certain drugs because patients stop taking the drugs too soon (Centers for Dise"] [4.592306137084961, 24.174259185791016, "ich Bertozzi has recently published several papers (Ahn et al., 2020; Banik et al., 2019). It has been suggested that Lycia has now advanced beyond the information described in Bertozzi\u2019s publication (Tong, 2020). At this point, further details on th"] [4.541850566864014, 24.123289108276367, " as an excellent mentor to students of all ages, including postdoctoral fellows, graduate students, undergraduate students, and K\u201312 students. Many of Bertozzi\u2019s companies and scientific publications are collaborations with students whom she has ment"] [4.567802429199219, 24.14918327331543, " the inventions was integral to the selection of the winners of the Lemelson-MIT Prize. However, there have been and will continue to be many highly successful and impactful inventors beyond this small group.\nChapters 3 through 5 presented case studi"] [4.563456058502197, 24.144128799438477, "nia National Primate Research Center to work on optimizing convalescent plasma therapy for COVID-19 patients (Lee, 2020). InterVenn Biosciences (another company co- founded by Bertozzi), announced in October 2020 that it had \u201cidentified marked differ"] [4.575281143188477, 24.149930953979492, "n is an ongoing social investment\u2014not a largely depleted checklist of opportunities. Future work should be focused on shaping such efforts to address inequality and assessing their effectiveness.\nSeveral notable efforts are already underway. For exam"] [4.609378337860107, 24.18982696533203, "20.\nAlbert, M. B., D. Avery, F. Narin, and P. McAllister, \u201cDirect Validation of Citation Counts as Indicators of Industrially Important Patents,\u201d Research Policy, Vol. 20, No. 3, 1991, pp. 251\u2013 259.\n\u2014\u2014\u2014, \u201cSurvival Rates for Ovarian Cancer,\u201d webpage, "] [4.62218713760376, 24.20471954345703, "Genetic Disease Detection and DNA Amplification Using Cloned Thermostable Ligase,\u201d Proceedings of the National Academy of Sciences of the United States of America, Vol. 88, No. 1, 1991, pp. 189\u2013193.\nProceedings of the National Academy of Sciences of "] [4.603652000427246, 24.184276580810547, "11, pp. 651\u2013653.\n Blind, Knut, Katrin Cremers, and Elisabeth Mueller, \u201cThe Influence of Strategic Patenting on\n Companies\u2019 Patent Portfolios,\u201d Research Policy, Vol. 38, No. 2, 2009, pp. 428\u2013436.\n 96\nBonifacio, Ezio, \u201cPredicting Type 1 Diabetes Using "] [4.610576629638672, 24.193218231201172, "74, pp. 1030\u20131034.\n\u2014\u2014\u2014, \u201cConstruction and Characterization of Amplifiable Multicopy DNA Cloning Vehicles Derived from the P15A Cryptic Miniplasmid,\u201d Journal of Bacteriology, Vol. 134, No. 3, 1978, pp. 1141\u20131156.\nChetty, Raj, John N. Friedman, Nathani"] [4.605903625488281, 24.18877601623535, " 4, No. 8, 2018, pp. 952\u2013959. As of January 26, 2021: https://pubs.acs.org/doi/10.1021/acscentsci.8b00251#\nDiamond v. Chakrabarty, 447 U.S. 303, 1980.\nDrake, Penelope, \u201cCatalent\u2019s SMARTag\u00ae ADC Stands Out in the Crowd of HER2-Targeted Conjugates,\u201d ADC"] [4.60930061340332, 24.191898345947266, " Reticulum,\u201d Journal of Biological Chemistry, Vol. 264, No. 36, 1989, pp. 21522\u201321528.\nFlynn, Gregory C., Jan Pohl, Mark T. Flocco, and James E. Rothman, \u201cPeptide-Binding Specificity of the Molecular Chaperone BiP.\u201d Nature, Vol. 353, 1991, pp. 726\u201373"] [4.607942581176758, 24.190406799316406, " Jaffe, and Manuel Trajtenberg, \u201cMarket Value and Patent Citations,\u201d RAND Journal of Economics, Vol. 36, No. 1, 2005, pp. 16\u201338.\nHall, Bronwyn, Jacques Mairesse, and Pierre Mohnen, \u201cMeasuring the Returns to R&D, National Bureau of Economic Research,\u201d"] [4.605956077575684, 24.187437057495117, "icago: University of Chicago Press, 2011.\n\u201cHuman Insulin Market Size, Share & Industry Analysis, By Type (Analogue Insulin, Traditional Human Insulin), By Diabetes Type (Type 1, Type 2), By Distribution Channel (Retail Pharmacy, Hospital Pharmacy, On"] [4.608752250671387, 24.191341400146484, "t, William V. Treuren, Neil Martinson, Rainer Kalscheuer, Bavesh D. Kana, and Carolyn R. Bertozzi, \u201cRapid Detection of Mycobacterium Tuberculosis in Sputum with a Solvatochromic Trehalose Probe,\u201d Science Translational Medicine, Vol. 10, No. 430, 2018"] [4.637389659881592, 24.219980239868164, "in, Scott T., Jeremy M. Baskin, Sharon L. Amacher, and Carolyn R. Bertozzi, \u201cIn Vivo\n Imaging of Membrane-Associated Glycans in Developing Zebrafish,\u201d Science, Vol. 320, No.\n 5876, 2008, pp. 664\u2013667.\n Lee, Tim, \u201cCerus Forms Group to Research Optimal "] [4.643965721130371, 24.227933883666992, "en to Medicine and Farm,\u201d New York Times, May 20, 1974.\nMeselson, Matthew, and Robert Yuan, \u201cDNA Restriction Enzyme from E. Coli,\u201d Nature, Vol. 217, 1968, pp. 1110\u20131114.\nMontague, P. Read, Carolyn D. Gancayco, Mark J. Winn, Richard B. Marchase, and M"] [4.617229461669922, 24.200223922729492, "ynthesis of Porcine Cardiodilatin 88,\u201d\n Journal of the American Chemical Society, Vol. 110, No. 23, 1988, pp. 7847\u20137854.\n 107\nOlson, Maynard, Leroy Hood, Charles Cantor, and David Botstein, \u201cA Common Language for Physical Mapping of the Human Genome,"] [4.6422224044799805, 24.224653244018555, "ts, 2009\u20132019. As of January 21, 2021: https://www.roche.com/investors/downloads.htm\nRogers, Mary A. M., Catherine Kim, Tanima Banerjee, and Joyce M. Lee, \u201cFluctuations in the Incidence of Type 1 Diabetes in the United States from 2001 to 2015: A Lon"] [4.6167168617248535, 24.199909210205078, " Molecular Biology, Vol. 51, No. 2, 1970, pp. 379\u2013391.\nSmith, Lloyd M., Jane Z. Sanders, Robert J. Kaiser, Peter Hughes, Chris Dodd, Charles R. Connell, Cheryl Heiner, Stephen B. Kent, and Leroy E. Hood, \u201cFluorescence Detection in Automated DNA Seque"] [4.612421035766602, 24.189626693725586, "ffice, \u201cGlossary,\u201d webpage, 2021. As of January 16, 2021: https://www.uspto.gov/learning-and-resources/glossary\nUSPTO\u2014See U.S. Patent Trademark Office.\nU.S. Small Business Administration, \u201cTable of Small Business Size Standards Matched to North Ameri"] [4.651923656463623, 24.23307991027832, "ses 1 and 2 in Mouse Collagen-Induced Arthritis,\u201d\n BMC Immunology, Vol. 7, No. 1, 2006.\n 112\nYoshimori, Robert, Daisy Roulland-Dussoix, and Herbert W. Boyer, \u201cR Factor-Controlled Restriction and Modification of Deoxyribonucleic Acid: Restriction Muta"] [15.909687042236328, 10.509668350219727, "Health Service Utilization and Cost Outcomes from a Permanent Supportive Housing Program\nEvidence from a Managed Care Health Plan\nSARAH B. HUNTER, ADAM SCHERLING, RYAN K. MCBAIN, MATTHEW CEFALU, BRIAN BRISCOMBE, WILLIAM MCCONNELL, PRIYA BATRA\n Sponso"] [12.6547269821167, 13.588313102722168, "ronmental Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was con"] [16.031679153442383, 10.472861289978027, "............................................................................................ 5 Statistical Analysis ................................................................................................................................... 8\n"] [16.0195255279541, 10.597122192382812, ".. 19 Figure 3.4. Estimated Effect of Treatment on Health Care Costs, with 95-Percent\nConfidence Intervals ............................................................................................................. 20 Figure 3.5. Share of Treatment"] [15.942707061767578, 10.55858039855957, "........................................................ 42 Table C.5. Number of Home Health Claims................................................................................. 42 Table C.6. Number of Inpatient Health Claims ....................."] [15.971868515014648, 10.560853958129883, "ocument the short-term programmatic costs of the PSH program.\nOur previous work (McBain et al., 2020) demonstrated that members enrolled in the program were high health care utilizers with one or more chronic health conditions and high service costs "] [15.846179008483887, 10.46944808959961, "alo School of Social Work and Jeanne Ringel at RAND.\n ix\nAbbreviations\nACG The Johns Hopkins ACG\u00ae System ADG Aggregated Diagnosis Groups\nASMD absolute standardized mean difference COPD chronic obstructive pulmonary disease DME durable medical equipme"] [15.921956062316895, 10.543140411376953, "duals maintain independence and autonomy (Rog et al., 2014). Research has demonstrated that PSH can increase housing stability among individuals who were formerly homeless (National Academies of Sciences, Engineering, and Medicine, 2018). Although it"] [15.933055877685547, 10.550016403198242, "nter et al., 2017). Because of shortages in affordable housing in Southern California, housing providers report that it often takes several months to obtain an appropriate unit (Hunter et al., 2020). In the meantime, PSH programs can have significant"] [15.91423225402832, 10.552377700805664, "(i.e., first six months) health care service utilization and associated costs of members enrolled in a PSH program, compared with a similar cohort of individuals who were not enrolled in the PSH program\n\u2022 to better understand the interim housing and "] [16.04813575744629, 10.712468147277832, "lacement) periods. Together, these factors allowed us to take a preliminary look at the costs and the benefits of the program.\nData and Sources\nHealth Plan Member Demographics\nThe managed health plan provided the following health plan member characte"] [15.962079048156738, 10.569466590881348, "35.6% 64.4%\n19.8% 27.7% 39.8% 12.7%\n44.6% 55.4%\n36.7% 46.3% 16.9%\n NOTE: ACG risk category refers to groupings based on ADGs experienced by patients using the ACG System.\nHealth Care Services and Associated Costs\nThe program provided health care"] [15.990652084350586, 10.576642990112305, "Additionally, we did not capture a preponderance of behavioral health services provided to patients, because, in most cases, these services were carved out within the counties\u2019 behavioral health departments. In characterizing costs, the aim of this r"] [16.00759506225586, 10.504907608032227, "h sample size equal to the ESS. Similarly, when reporting the weighted mean of a particular characteristic of the comparison group (e.g., mean health care cost), we report the weighted sample size as the sum of the propensity score weights (i.e., the"] [16.02097511291504, 10.645893096923828, "teristics\nDescriptive Characteristics Before and After Weighting\nTable 3.1 provides descriptive information about the treatment and comparison group members, before and after weighting. We calculated absolute standardized mean differences (ASMDs) com"] [16.033042907714844, 10.618253707885742, "16.31\n3.88 26.01 5.20 24.8\n31.72 2.38\n$2,757 $2,530 $1,167 $31,316 $338 $1,406 $2,769 $2,873\n$5,147 $4,062 $6,582 $8,722 $13,441 $7,773\nUnweighted (n = 354)\n0.56 0.82a 0.08 0.13a 0.08a 0.17a 13.03a\n1.82a 20.12 3.34 17.05a\n20.87a 0.91a\n$437a $2,909 $2"] [16.004127502441406, 10.604769706726074, "pendix B, Table B.3). The total cost during the transitional period was $3,463,229, compared with $1,022,796 during the PSH period.\nComparison group. As shown in Table 3.3, the propensity score\u2013weighted total cost associated with health service utili"] [16.013486862182617, 10.631518363952637, "9\n$611,766 $596,726 $491,914 $465,589 $415,226 $306,813 $229,394 $186,240\n$448,561\n$122,093 $2,279,906 $7,407,755\nTotal Exp\n$387,459 $203,460\n$346,523 $618,096 $309,508 $612,714 $226,389 $152,756 $143,030 $86,109\n$430,010 $143,707 $826,264 $4,486,025"] [15.995031356811523, 10.598617553710938, "ommon procedure type.\nb Pharmacy as a health condition refers to the dispensing of medications to patients, which may take place at a physical pharmacy or else in other settings, such as ERs or inpatient facilities.\n17\n88\n6,422 $2,170,428 $24,592 $33"] [16.02381134033203, 10.593156814575195, "estimate of the treatment effect on the change in total costs, as shown by the large 95-percent confidence interval for the outcome labeled \u201cTotal.\u201d This is largely attributable to inpatient costs, which contribute a large proportion of the total val"] [15.980695724487305, 10.566643714904785, "rspective. From April 2018 to March 2020, total programmatic costs amounted to $4,292,201, or $26,495 per enrollee (n = 162). The typical individual was enrolled for 11.0 months over this period, translating to $2,405 PMPM. Segmented by enrollment pe"] [15.965959548950195, 10.568604469299316, " hospital discharge who do not have a place to recuperate, while custodial care reflects longer-term supportive health services for patients in need of more-consistent medical monitoring.\nAmong the 162 enrollees, 116 clients received transitional hou"] [15.985432624816895, 10.573848724365234, "er reduction in health care costs between pre- enrollment and post-enrollment periods (see Tables 3.2 and 3.3). Specifically, program enrollees observed an $18,035 reduction in health care costs between baseline and intervention periods, while nonenr"] [15.964234352111816, 10.560445785522461, "d in the PSH program. Finally, we examined the PSH costs since program start-up and examined PSH costs in relation to individual health service utilization to explore whether any cost offsets were observed. In summary, we found the following:\n\u2022 PSH e"] [15.935694694519043, 10.511556625366211, "ing into an independent living arrangement (i.e., PSH). Interim housing provides an added level of care (e.g., recuperative care) that can add to the transitional costs observed during this period.\nOverall, our findings are similar to those of other "] [15.989501953125, 10.556782722473145, "lly significant effects between the treatment and comparison groups.\nBecause of the program design, the health plan had more information about the status of PSH program enrollees than members in the comparison group. For example, we prorated the data"] [15.96246337890625, 10.565872192382812, "enrollment periods. This uncertainty is due, in part, to the high volatility and the highly skewed nature of health\n30\nclaim costs (and, in particular, inpatient costs). It is also due, in part, to the short-term observational window of six months po"] [15.97242546081543, 10.531322479248047, "tation was the time between enrollment and housing placement. The average time was about three months, with a range of ten to 258 days. The time was highly variable, primarily based on the health status of participants. The length of time is also par"] [16.02487564086914, 10.60495376586914, "n group, ten candidate enrollment dates were generated by adding a number of days drawn from the aforementioned distribution to the Z59.0 diagnosis date. After candidate enrollment dates were selected, a propensity score model was fit to estimate the"] [16.042957305908203, 10.693803787231445, " Group Characteristics\n ASMD\n Age Gender\nMale Ethnicity\nBlack\nHispanic\nNot reported/other\nCounty Riverside\nACG risk category High risk\nRising risk Preexisting conditions\nBehavioral\nUnweighted (n = 354)\n0.34 0.15\n0.12 0.17 0.23\n0.10\n1.00 0.30\n0.0"] [15.995850563049316, 10.619617462158203, " All other locations\nTotal cost\n162 664 $87,991 $543 $133 158 506 $124,260 $786 $246 162 11,468 $7,407,755 $45,727 $646 162 10,636 $4,486,025 $27,692 $422\nTable B.2. Place of Service and Related Health "] [16.003225326538086, 10.617681503295898, "s Patient (n) Events\n4 13 16 191\n4 10 27 174 28 154\n6 8 9 134 7 90 8 58\n14 79\n103 893 80 682 113 1,720 162 4,206\nEvent\nPer- Per-\n $5,411\n a Among medical claims with this assigned classification, \u201csystem-generated recuperative car"] [16.095491409301758, 10.882240295410156, "isk 2.21 Number of DME claims 0.28\nNOTE: p = probability value; t = t-test statistic.\nSD Error\n13.34 4.51\n0.19 5.07 4.10 5.95 6.05 3.96\n6.42 5.55 0.33\nt p\n\u20130.82 0.42 \u20130.41 0.68\n0.79 0.43 \u20131.28 0.20 0.55 0.58 1.16 0.25 0.63 0.53 \u20131.31 0.19\n0.93 0.35 0"] [16.101806640625, 10.900383949279785, "p\n0.22 0.82 1.83 0.07\n\u20130.04 0.96 \u20131.90 0.06 0.39 0.69 0.71 0.48 \u20131.77 0.08 \u20131.14 0.26\n0.94 0.35 0.94 0.35 1.92 0.06\n 42\n Variable\nTable C.6. Number of Inpatient Health Claims (n = 516, ESS = 228) Estimate SD Error t p\n Inte"] [16.1002254486084, 10.89655876159668, " 516, ESS = 228)\n Variable Estimate\nIntervention\nBaseline (intercept) \u20131.65 PSH enrollment (treatment) \u20130.26\nDemographic characteristics\nAge 0.03 Gender: male \u20130.10 Ethnicity: black 1.31 Ethnicity: Hispanic \u20130.18 Ethnicity: not reported/other 0.2"] [16.102615356445312, 10.895079612731934, "pt) \u201344.40 PSH enrollment (treatment) \u20136.83\nDemographic characteristics\nAge \u20131.24 Gender: male \u201366.51 Ethnicity: black 72.96 Ethnicity: Hispanic 105.19 Ethnicity: not reported/other 65.63 County: Riverside \u201323.55\nBaseline health characteristics\nACG: "] [16.10194206237793, 10.899360656738281, "ic Ethnicity: not reported/other County: Riverside\nBaseline health characteristics ACG: rising risk\nACG: high risk\nEstimate\n\u2013325.86 140.34\n4.37 148.86 \u201318.06 \u2013150.52 \u2013243.20 44.23\n\u201311.10 \u2013164.58 \u20134.70\nSD Error t p 245.30 \u20131.33 0.18\n114.02 1.23 0.22\n4"] [15.648483276367188, 10.325287818908691, "gett, Travis P., Samantha S. Liauw, and Stephen W. Hwang, \u201cCardiovascular Disease and Homelessness,\u201d Journal of the American College of Cardiology, Vol. 71, No. 22, 2018, pp. 2585\u20132597.\nBossarte, Robert M., John R. Blosnich, Rebecca I. Piegari, Linds"] [15.707338333129883, 10.31297492980957, "meless Definition,\u201d 2019. As of June 1, 2020: https://files.hudexchange.info/resources/documents/HomelessDefinition_RecordkeepingReq uirementsandCriteria.pdf\nHunter, Sarah B., Melody Harvey, Brian Briscombe, and Matthew Cefalu, Evaluation of Housing "] [15.712972640991211, 10.306346893310547, "n-021120.pdf\nRaven, Maria C., Lina Tieu, Christopher T. Lee, Claudia Ponath, David Guzman, and Margot Kushel, \u201cEmergency Department Use in a Cohort of Older Homeless Adults: Results from the HOPE HOME Study,\u201d Academic Emergency Medicine, Vol. 24, No."] [19.96062469482422, 14.7998046875, " VIOLENT\n EXTREMISM\n IN AMERICA\nInterviews with Former Extremists and Their Families on Radicalization and Deradicalization\nRYAN ANDREW BROWN TODD C. HELMUS RAJEEV RAMCHAND ALINA I. PALIMARU SARAH WEILANT ASHLEY L. RHOADES LIISA HIATT\n CORPORATION\n"] [19.94559097290039, 14.782065391540527, "t the world. This research was conducted 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 "] [19.958465576171875, 14.795223236083984, "clusion............................................................................................\n. 11 . 12 . 19\n20 24 26\nCHAPTER THREE Methods.............................................................................................. ProjectDes"] [19.945690155029297, 14.807411193847656, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 MainFindings........................................................................................ 86 Recommendations......"] [19.962360382080078, 14.797908782958984, "Pittsburgh, Pennsylvania, were grim fore- shadowing of the latest incident.\nGiven this evolving, ongoing threat, the U.S. government, research institutions, and private-sector partners have made significant investments in attempting to under- stand a"] [19.946392059326172, 14.80556583404541, "embers, and two friends. Together, these interviews covered 32 separate cases of radicalization and deradicalization. Of all 32 cases, 24 were white supremacists (eight females and 16 males), and eight were Islamic extremists (one female and seven ma"] [19.959270477294922, 14.798563957214355, "ctor was mentioned in 17 of the 32 cases. Mental health challenges were cited as presenting obstacles throughout the individual\u2019s life. Some identified such symptoms as overwhelming anger as a driver of their join- ing extremist organizations. Trauma"] [19.95997428894043, 14.805191040039062, "s noted how they felt rewarded for contributions to the cause and group.\nAmong the 32 cases, many cited instances of an observable behavior change in the early stages of radicalization. Two Islamic extremists showed outward signs of reli- gious conve"] [19.968345642089844, 14.796659469604492, "ailed Interventions\nIn 19 cases, interviewees indicated that they experienced interventions that failed. These cases most often involved family members who tried to intervene. Punitive interventions by law enforcement also often led to paradoxical ef"] [19.96383285522461, 14.80350112915039, "ing in the area are summarized in Table S.1.\nTable S.1\nSummary of Study Findings and Recommendations\nStudy Findings\nNegative life events are part of, but not\nthe sole cause of, radicalization. Abuse or trauma, difficult family situations, bullying, a"] [19.967329025268555, 14.803322792053223, "tudy Findings\nExtremist groups nurture a self-reinforcing social milieu. This includes shared purpose, camaraderie, friendship, and joint activities, all of which can involve both risk and emotional rewards.\nRecommendations\nCommunity organizations: H"] [19.966371536254883, 14.806200981140137, "ght place at the right time, can encourage both processes.\nTable S.1\u2014Continued\nStudy Findings\nHeavy-handed attempts by formal institutions to deradicalize individuals often fail. Such measures taken by intelligence and law enforcement agencies are un"] [19.933727264404297, 14.807133674621582, "ill) and Beyond Barriers (led by Jeff Schoep), for entrusting RAND with connections to their members and associates and for all the collaborative work throughout the project. We would also like to thank Katheryn Giglio for her commu- nications expert"] [19.93253517150879, 14.818102836608887, "ical- ization, No. 6, Spring 2016.\n2 As we note later, white supremacists refers to those who espouse the belief that the white race is superior to and should exert control over other races.\n 1\n2 Violent Extremism in America\nnumber grew to 53 in 2017"] [19.93671417236328, 14.81174087524414, "2020; Campbell Robertson, Christopher Mele, and Sabrina Tavernise, \u201c11 Killed in Synagogue Massacre; Suspect Charged with 29 Counts,\u201d New York Times, October 27, 2018.\n5 Brian Michael Jenkins, \u201cThe Battle of Capitol Hill,\u201d RAND Blog, January 11, 2021"] [19.95894432067871, 14.80091381072998, " to and Processes Associ- ated with Radicalization and Extremism Amongst Muslims in Western Societies,\u201d International Review of Psy- chiatry, Vol. 27, No. 1, 2015.\nIntroduction and Background 3\n 4 Violent Extremism in America\npile and analyze case st"] [19.961732864379883, 14.79507064819336, "016: A Review of Data, Methods, and Authorship,\u201d Terror- ism and Political Violence, Vol. 32, No. 5, 2018.\n15 Schuurman, 2018.\n16 Kamaldeep S. Bhui, Madelyn H. Hicks, Myrna Lashley, and Edgar Jones, \u201cA Public Health Approach to\nUnderstanding and Prev"] [19.962522506713867, 14.801824569702148, "erable to extremist ideology or violence. Family and friends of individuals who have radicalized may be an especially vulnerable group. Ensuring that families and friends of those who have radicalized are supported after learning that their family me"] [19.963451385498047, 14.801085472106934, "h suicide and extremism are distinct (though sometimes overlapping) phenomena, they share important attributes. First, they are both relatively rare events. Second, cases are rarely available to be interviewed because they are dead or, in the case of"] [19.952436447143555, 14.787276268005371, "sample are more common than among a comparable group of individuals who did not join extremist organizations, which prohibits the calculation of risk or identification of risk factors.\nThere are other biases in our approach, some of which are common "] [19.943580627441406, 14.781067848205566, "m the relevant body of literature to provide background for our interview analysis. In Chapter Three, we describe how we recruited individu- als to be interviewed, our interview process, and our analysis of the qualitative data (appendixes at the end"] [19.984960556030273, 14.78031063079834, "tes.\na National Consortium for the Study of Ter- rorism and Responses to Terrorism, Univer- sity of Maryland, Profiles of Individual Radi- calization in the United States, database, undated-a.\nb National Consortium for the Study of Ter- rorism and Re"] [19.96921157836914, 14.803568840026855, "ome studies suggest that individuals with cognitive disabilities or other cognitive issues may be more vulnerable to manipulation or recruitment or be predisposed to engage in extremist behavior.d\n\u2022 Mental health issues: Mental health issues, such as"] [19.95578956604004, 14.795202255249023, " al., 2016.\nc Stevan Weine and Osman Ahmed, Building Resilience to Violent Extremism Among Somali-Americans in Minneapolis-St. Paul, College Park: National Consortium for the Study of Terrorism and Responses to Terrorism, University of Maryland, Augu"] [19.962797164916992, 14.798293113708496, "ole of pov- erty or material incentives in domestic radicalization. The PIRUS data suggest that low socioeconomic status does not seem to be a major driver of radicalization in the United States, with only about 25 percent of radicalized individuals "] [19.947681427001953, 14.808672904968262, "t issues with U.S. foreign policy toward and media coverage of Somalia engen- dered feelings of resentment and marginalization among some in the community and contributed to the perceived social legitimacy of violent extremism.11 Another notable theo"] [19.962888717651367, 14.80395221710205, "view of the Literature 15\n 16 Violent Extremism in America\nWhen people perceive themselves as rejected, divested of control, or as victims of injustice, they feel belittled and disrespected; consequently, they are motivated to restore their sense of "] [19.958385467529297, 14.799077987670898, "lly, married individuals and those who have strong family units (including youth with strong parental supervision and support) tend to be less susceptible to radicaliza- tion and recruitment.19\nDemographic Characteristics and Other Attributes of Radi"] [19.955297470092773, 14.823454856872559, "nstein, \u201cPre-Radicalization Crimi- nal Activity of United States Extremists,\u201d College Park: National Consortium for the Study of Terrorism and Responses to Terrorism, University of Maryland, January 2018.\n21 Jensen, James, LaFree, and Safer-Lichtenst"] [19.966272354125977, 14.799345970153809, " A substantial percentage of radical- ized individuals in the PIRUS data and in the groups of former radicalized individuals interviewed in other studies engaged in crime prior to radicalization (in PIRUS, a mean of 39 percent across groups). This su"] [19.965532302856445, 14.806875228881836, "overnment experiences.27\nProcesses of Exiting Extremist Organizations\nAnother set of questions we explored through the literature review concerned pro- cesses of exiting extremism. Our review sought to answer the following questions: What are the pro"] [19.96322250366211, 14.809118270874023, "rmer White Supremacists,\u201d American Sociological Review, Vol. 82, No. 6, 2017.\n29 Bubolz and Simi, 2015, p. 5.\n30 Simi et al., 2017.\n31 Bubolz and Simi, 2015.\n32 Simi et al., 2017.\n33 Bubolz and Simi, 2015, quoting R. W. Balch, \u201cWhen the Light Goes Ou"] [19.96419906616211, 14.80636978149414, "ture 23\n Push factors\n Pull factors\n \u2022 Disillusionment\n\u2022 Inability to maintain employment\n\u2022 Experiencing negative effects of violence\n\u2022 Burnout or exhaustion: According to one study, \u201csome\nindividuals may begin to burn out because of the demanding li"] [19.9572811126709, 14.795575141906738, "rmers\u201d or family mem- bers, friends, and others touched by radicalization felt that the experience they went through could have been prevented or minimized, a topic we cover in Chapter Seven. However, there is a limited evaluation literature describi"] [19.957181930541992, 14.79811954498291, "t Extremism: Toward a Theory of Vicarious Help-Seeking,\u201d Behavioral Sciences of Terrorism and Political Aggression, Vol. 8, No. 1, 2016; Frenett and Dow, 2014.\n48 Brian A. Jackson, Ashley L. Rhoades, Jordan R. Reimer, Natasha Lander, Katherine Costel"] [19.953771591186523, 14.794868469238281, "therine Costello, and Sina Beagh- ley, \u201cBuilding an Effective and Practical National Approach to Terrorism Prevention,\u201d Homeland Security Oper- ational Analysis Center operated by the RAND Corporation, RB-10030-DHS, 2019a.\n50 See Ashley L. Rhoades, T"] [19.959102630615234, 14.799935340881348, "unity members to identify and engage with at-risk individuals\n\u2022 Build the capacity of positive and influential members or leaders of the community to credibly counter violent extremist ideology\n\u2022 Create environments accepting of minority groups\n\u2022 Pro"] [19.961383819580078, 14.806968688964844, "e environment while amplifying these credible voices via social media and public speaking to improve understanding of this complex issue. Parents for Peace established an independent helpline for people with concerns about a loved one becoming involv"] [19.9443302154541, 14.807087898254395, "rview data available, but recognize that the focal individuals may otherwise self-identify.\n 30 Violent Extremism in America\nTable 3.2\nExtreme Organization and Group Involvement\n White Supremacist Organizations and Groups\nAmerican Nazi Party\nCreativ"] [19.936349868774414, 14.774017333984375, "skinheads, one of whom was also involved with the KKK and NSM.1 Only two of the cases mentioned having been in the military, and a third had military training during adolescence.\nInterview Process and Protocol\nWe conducted most (31) interviews over t"] [15.151872634887695, 13.607172966003418, "ts (22 percent of the sample) independently, then met with the project leader (Ryan Andrew Brown) to discuss and reconcile codebook development, code definitions, and coding rules.4 Codebook development was discussed in terms of bal- ancing grounded "] [15.12964916229248, 13.64072322845459, "istics, shifts in social network, and community context. Although a formal check of intercoder reliability was not performed due to time constraints, our team is confident that the coders\u2019 deep involve- ment in both the codebook\u2019s development and its"] [19.953075408935547, 14.796053886413574, "on processes. Our coding scheme covered these processes from a variety of perspectives\u2014for example, \u201csuccessful interventions\u201d was one code, as was \u201crole of institutions.\u201d Thus, the lead author (Brown) created a case summary table of common character"] [19.961904525756836, 14.796402931213379, "ample, one former white suprema- cist explained: \u201cI also have, like, a learning disorder. . . . The military won\u2019t take me. Like, I\u2019ve been denied numerous jobs. . . . That\u2019s, like, something I\u2019ve always struggled\n1 National Institute of Mental Healt"] [19.944910049438477, 14.818763732910156, "Background Characteristics of Radical Extremists 37\nthe antithesis of what you\u2019d expect until time came and something would just snap in my head where I felt like it was, you know, the fight-or-flight response.\u201d\nTraumatic Experiences\nWe recognize tha"] [19.969924926757812, 14.8073091506958, "s identified substance use as the primary driver of their radicalization, although former radicals described engaging in violence fueled by substance use.\n2 Angela Sweeney, Beth Filson, Angela Kennedy, Lucie Collinson, and Steve Gillard, \u201cA Paradigm "] [19.96415901184082, 14.80530071258545, " in which violent intent was either not present or it was impossible to determine from the interviews, only five of them had two or more of the factors listed above (criminal history, mental health, trauma, and substance use).\n3 Michael A. Jensen, An"] [19.915313720703125, 14.82087516784668, "iduals also experienced physical, emotional, or sexual abuse by a family member.4 Three of these five cases were catego- rized as someone with violent intent during their careers as violent extremists. Notably, however, there were also cases in which"] [19.964061737060547, 14.806978225708008, "as that happened, it\u2019s been Fox News.\u201d\nNeighborhood Demographics, Marginalization, and Discrimination\nSixteen focal individuals (13 white supremacists and three Islamic extremists) talked about feeling victimized, stigmatized, or marginalized where t"] [19.965187072753906, 14.805837631225586, "ts\u2019 accounts. Fewer than half the sample explicitly framed personal substance use, trauma, and physical health as drivers of radicalization, and though mental health and financial hardship were mentioned in many cases, they were inconsistently linked"] [19.96858787536621, 14.812150955200195, "transcripts and applied codes, it became apparent that such a reorienting event took place in at least a small subset of participants.3\nWe observed this phenomenon in four Islamic extremist cases and seven white supremacist cases. Across many of thes"] [19.939115524291992, 14.81484603881836, "ut the whole antisocial nature of [the Third Reich] appealed to me. . . . [I]f I\u2019m so smart and I still can\u2019t even make it, something\u2019s screwed up with the world. . . . And I started checking out different websites and just kind of looking into some "] [19.963315963745117, 14.802323341369629, "r right-wing extremists, being present in nine individual cases. Specific modes and outlets included YouTube videos, 4chan, the Daily Stormer and the Stormfront websites, and even old-fashioned chatrooms that were prominent in the late 1980s. One for"] [19.959218978881836, 14.799673080444336, "and contact information for right-wing extremist groups that ulti- mately led him to join the NSM. Another individual highlighted the importance of Third Reich books, including The Life and Death of Adolf Hitler by James Giblin. He noted, \u201cin feeding"] [19.955041885375977, 14.806148529052734, "ith his speeches, with his sermons . . . and started to talk about strong religion. It was like an orgasm. The young people felt like they existed. They had more power, because there was someone who rep- resented them. And so that\u2019s the notion among "] [19.9572811126709, 14.802350997924805, "e time of day for us. And now suddenly, you\u2019re here.\u201d\nFor white supremacists, however, the cases more clearly reverberate as bottom-up. With their constitutional protections, white supremacists and other right-wing groups are free to publicize their "] [19.95315933227539, 14.807660102844238, "es, negative experiences or conflicts within one group led an individual to leave and join another. One individual who reported making friends in a local book club that was affiliated with the Daily Stormer website ultimately left and transitioned to"] [19.9560489654541, 14.808711051940918, "tivating him to look up a local Islamic group that advocated violent attacks. Similarly, a white supremacist described his graduation from the neo-Nazi group National Vanguard to the NSM by highlighting that the latter \u201cseemed more official\u201d and that"] [19.927459716796875, 14.824520111083984, "lieve you can help fix it and we need you.\u2019 And to give that kind of messaging was just, to me at that time, just absolutely intoxicating. And I just went all in really fast.\u201d Another reported: \u201cI just found people of like mind, most\nPathways to Radi"] [19.958789825439453, 14.804522514343262, "needed people like me.\u201d Another noted how, although miserable, he refused to leave because he was \u201crevered\u201d and had a \u201chuge inflated identity in the movement.\u201d He went on to explain, \u201cI was kind of legendary [in radical group], and in the real world "] [19.962827682495117, 14.798018455505371, "noticed by his mother. These included being removed from a school field trip for wearing \u201cradical clothes\u201d and lying to his mother about it, drafting Hitler-themed comics, and making racist taunts during schoolyard fights.\nConclusion\nOur respondents "] [19.96625328063965, 14.809771537780762, " still undergo- ing cognitive and emotional deradicalization. These individuals sometimes expressed a lack of regret over prior involvement or even indicated that their ideological views had not changed.\nOf those who had not exited and not deradicali"] [19.940980911254883, 14.820795059204102, "Violent Right-Wing Extremist,\u201d Behavioral Sciences of Terrorism and Political Aggression, Vol. 9, No. 2, May 2017.\n3 During their time in radical organizations, some individuals described how the stress of involvement in extremism led to suicidal ide"] [19.961997985839844, 14.809738159179688, "ism. In the other two cases, they experienced betrayal and hypocrisy by other group members, which motivated them to find a way out of the groups.\nwhy I didn\u2019t kill myself was because my kids. I was just like, oh, I\u2019m still going to go to hell but I "] [19.966062545776367, 14.810734748840332, "vidual\nwell, or otherwise challenges focal individual\u2019s extremist assumptions\nIndividual provides (often 11 1 12 unexpected) support and kindness\nto focal individual when they are in\ndifficult circumstances\nIndividual provides alternate source 3 2 5 "] [19.964305877685547, 14.828401565551758, "mic extremists) was experiencing personal acceptance and emo- tional support. In some cases, this emotional support came as a surprise\u2014that is, the focal individual was expecting hate or rejection and instead experienced the opposite. For example, on"] [19.963058471679688, 14.813755989074707, "se institutions fell into three categories: religious, law enforcement, and secular nonprofit (e.g., 12-step programs, the Museum of Tolerance, Homeboy Industries). Of these 11 cases that received institutional interventions, nine (seven white suprem"] [19.963945388793945, 14.807717323303223, ", a lot of time to recap your whole life, he realized that those people steered him in the wrong place. That they convinced him to do something terrible. He felt bad; he felt horrible about it. He wished that he could turn back the hands of time. . ."] [19.96752166748047, 14.80357837677002, "the Constitution even though I thought, \u2018Okay it\u2019s not Islamic but this is a really good document and I really like it.\u2019\u201d\nA former white supremacist described how he found God and religion after facing a life-threatening health diagnosis, which event"] [19.970970153808594, 14.806817054748535, "y knees,\u201d or something like, \u201cYou might have given up but I haven\u2019t.\u201d And I regret saying that to this day because of the look that I got. But he tried to get me out at that point as well. No effort could get through to me when I was in there because"] [19.987159729003906, 14.825682640075684, ". . . . I am very scared that I\u2019m not really deradicalized, that I\u2019m still going to be kind of racist or sexist or something, and that I\u2019ll wind up doing more harm than good. And I\u2019m scared of that.\nSimilarly, one respondent described how they were a"] [19.964868545532227, 14.801570892333984, "rom developing extremist ideologies, preventing them from joining extremist organizations, or deradicalizing those who have joined those organizations. It is important to note that their recommendations are anecdotal and based on their own experience"] [19.963674545288086, 14.804543495178223, "wever, we do convey when recommendations were made by either a single respondent (to indicate interpretive caution) or many respondents (to highlight high- frequency recommendations from our sample).\nRespondents\u2019 Perspectives on Preventing Radicaliza"] [19.972675323486328, 14.80405044555664, "nt white supremacist said: \u201cSchools need to do a whole lot more of educating about what causes extremism, how to notice it, how to identify it in their own schools. . . . And it starts in the schools. That\u2019s where all the propaganda begins, I\u2019m telli"] [19.9671688079834, 14.801461219787598, "ht have been effective at counter- ing what the former white supremacist heard \u201cgrowing up in [their] own house\u201d: \u201cThat really had a very negative impact on my way of thinking.\u201d A separate theme stressed that schools \u201chave to change that whole mindse"] [19.969545364379883, 14.8031644821167, "sking the questions and get any kind of answer at all was, you know, leaders of [country\u2019s] largest hate group.\nProviding Activities for Youth\nBeyond education, at least three respondents mentioned the need for prosocial activities for youth.6 A form"] [19.967227935791016, 14.800345420837402, " youth access to adult mentorship and provide opportunities for social- ization. See, for example, Amelia Johns, Michele Grossman, and Kevin McDonald, \u201c\u2018More Than a Game\u2019: The Impact of Sport-Based Youth Mentoring Schemes on Developing Resilience Tow"] [19.970687866210938, 14.802988052368164, "s just this conversation-stopper where you either have to just shut up and back\n7 Todd C. Helmus, Erin York, and Peter Chalk, Promoting Online Voices for Countering Violent Extremism, Santa Monica, Calif.: RAND Corporation, RR-130-OSD, 2013.\n8 Paul K"] [19.97751808166504, 14.800968170166016, "ated: \u201cI don\u2019t think we can address any of these issues without addressing economic inequality, health care, mental health care, the breakdown of the family, drug addiction, and just the broken souls of these people. Like what do they have to live fo"] [19.96937370300293, 14.807047843933105, "radicalization\u201d section in this chapter), it was specifically mentioned by only two respondents as an important intervention for preventing radicalization. \u201c[I]f I could have been on the medication then that I\u2019m now [Adderall], that would have helped"] [19.986711502075195, 14.82392406463623, "dents also provided recommendations to facilitate deradicalization. In particu- lar, they spoke of the need to reach extremists at the right time and place and provided recommendations on who delivers the message (e.g., former extremists), social sup"] [19.96554183959961, 14.804956436157227, "t all with this stuff? Like I could just walk away and I could just never talk about it again. That is an option, and I don\u2019t think anybody would blame me if I took it.\nIn fact, former extremists have played a critical role in helping to counter viol"] [19.96923828125, 14.804694175720215, " these organizations. The father of a former white supremacist explained: \u201c[I]t\u2019s somebody to talk to . . . those individuals are so alone now. They don\u2019t have friends any more because the only friends they had were their comrades or whatever they ca"] [20.00931167602539, 14.8431396484375, "w individuals discussed the importance of exposures to people of different races or cultures as important for deradicalization. A former white supremacist told us: \u201cI believe that one of the best ways to deal with people during their disengagement is"] [19.971216201782227, 14.80532169342041, "g else, and that\u2019s why I think kindness is such an important asset.\nThere is an extensive body of research, stemming from Allport\u2019s \u201ccontact hypoth- esis,\u201d originally published in 1954,16 that examines whether intergroup contact, as rec- ommended by "] [19.972261428833008, 14.804579734802246, "e wrong. I was terrified. I felt like I was stepping on my [family member\u2019s] toes, but you have to be that bigger person to where it\u2019s like they\u2019re not loving theirself right now. They\u2019re not happy with theirself. They need you to be that person to h"] [19.968698501586914, 14.805023193359375, ".\u201d\nThird, there was criticism about the prison environment and the lack of program- ming. A parent of an Islamic extremist in Europe described daily life:\nThey have an hour of freedom a day. They can get out of their cell three times, 20 minutes each"] [19.971776962280273, 14.802406311035156, " going to explode.\nMental Health Interventions\nAs described in an earlier section, formers discussed the process of deradicalizing as both a very lonely and isolating experience. Some spoke of either formal or informal mental health interventions to "] [19.965208053588867, 14.800713539123535, "through his own study. He told us: \u201cI\u2019ve worked very, very hard over the years; different kinds of mental health-type stuff. I\u2019ve studied a lot of philosophy and psy- chology on my own. I\u2019ve spent hours and hours reading and listening to podcasts and"] [19.962575912475586, 14.799875259399414, "of recommendations.\nThese recommendations should not be viewed as based on formal scientific evi- dence, but it is important to consider them from a citizen science perspective. More importantly, in a field with very few evidence-based interventions "] [20.01058578491211, 14.845881462097168, "xtremism in America\nMain Findings\nOur sample was highly heterogeneous, covering cases of radicalization occurring across multiple decades, in multiple geographic regions, and with a wide variety of groups and ideologies. Moreover, we interviewed a mi"] [19.977182388305664, 14.802812576293945, "tances and priorities.5 Both radicalization and deradi- calization often rely on other key individuals being in the right place at the right time (and having the right relationship with the focal individual) to encourage that individual to radicalize"] [19.972034454345703, 14.806089401245117, "re review and interview analysis, we believe the following directions in research, policy, and practice are critical for research organizations, poli- cymakers, and practitioners to pursue. We first present critical directions for future research, fo"] [19.969844818115234, 14.806754112243652, "xposure to \u201cmainstream\u201d contexts after feeling stigmatized or targeted for their beliefs, leading to further radicalization in \u201cniche\u201d information environments. Ongoing work indicates that noncon- frontational challenges to incorrect beliefs are more"] [19.966617584228516, 14.805459976196289, "environments. The population of the United States is too vast and the base rate of extremism too low to offer geographical conformity in detection and mitigation policies. It will hence be critical to more carefully identify community locales and dem"] [19.98379898071289, 14.791537284851074, "- ists told us directly that less sensationalistic media coverage and educational approaches that emphasized critical thinking could be helpful in preventing radicalization. Educational efforts may cover the role of rules, codes of ethics, and editor"] [19.967079162597656, 14.80243968963623, "Efforts that can help at-risk families (or those families residing in locales at high risk of extremist recruitment and activity) identify and quickly respond to markers of extremism and other childhood behavioral problems may help reduce the risk of"] [19.96005630493164, 14.79898452758789, "f studies,1 we expanded our search parameters slightly to include analyses of the information contained in the PIRUS database and studies based on this database. PIRUS, which is a database of \u201c2,226 Islamist, far-left, far-right, and single-issue ext"] [19.92599105834961, 14.764469146728516, "do not have the same level of rigor and objec- tivity as the interviews and analysis conducted as part of academic studies. Finally, we excluded studies that drew only on secondary sources and did not include original research; as the bulk of our dat"] [19.93566131591797, 14.777226448059082, "m.\n5 See, for instance, these reports that discuss the methodological issues with interviewing terrorists: John Horgan, \u201cInterviewing the Terrorists: Reflections on Fieldwork and Implications for Psychological Research,\u201d Behavioral Sciences of Terror"] [19.918861389160156, 14.772826194763184, "ies employed a snowball sampling technique, asking each individual interviewed for additional contact suggestions; this approach helped research teams access more individuals than they would otherwise\nOn the Importance of Drinking Tea and Other Metho"] [19.952438354492188, 14.79251480102539, "for inclusion in the dataset. Random sampling techniques were used to maximize (although not guar- antee) the representativeness of the dataset at all points in time that are covered by the project (see question below regarding the representativeness"] [19.935033798217773, 14.806010246276855, "ique to approximate a fully blocked experimental design. Using the matched data, we then calculate the conditional odds ratio for engaging in violent extremism and estimate\n13 Jensen et al., 2016.\n14 National Consortium for the Study of Terrorism and"] [19.951152801513672, 14.777007102966309, "identify and redirect individuals who might be experiencing similar changes or chal- lenges in their lives.\nI would like to stress that your participation in this discussion is completely vol- untary. We can stop at any point or skip any question. Th"] [19.958303451538086, 14.795421600341797, "g this time?\n\u2022 Attempts to intervene\n\u2013 Did any friends, family members, or others say notice these and say anything to you about them? If so, how did you respond to them?\n\u2013 What sort of help or advice do you wish you had, in retrospect?\n\u2022 Focalevent\n"] [19.952537536621094, 14.787528038024902, "periencing similar changes or chal- lenges in their lives.\nI would like to stress that your participation in this discussion is completely vol- untary. We can stop at any point or skip any question. There are no consequences if you decline to partici"] [19.957210540771484, 14.794191360473633, "arning signals and turning points\n\u2013 When did you first notice that something had changed in their personality or behaviors? What did you notice? How did you notice this?\n\u2013 What stands out to you as a sign that something was different about [NAME] dur"] [19.939905166625977, 14.781067848205566, ": A Multi-Level Analysis of Muslim Community and University Based Student Leaders\u2019 Perceptions and Experiences,\u201d Journal for Deradicalization, No. 6, Spring 2016, pp. 231\u2013271.\nAldrich, D. P., \u201cFirst Steps Towards Hearts and Minds? USAID\u2019s Countering "] [19.953495025634766, 14.795180320739746, ", Bryan F., and Pete Simi, \u201cLeaving the World of Hate: Life-Course Transitions and Self-Change,\u201d American Behavioral Scientist, Vol. 59, No. 2, 2015, pp. 1588\u20131608.\nCavanagh, J. T. O., A. J. Carson, M. Sharpe, and S. M. Lawrie, \u201cPsychological Autopsy"] [19.95574951171875, 14.79499626159668, "411.\nFederal Bureau of Investigation, \u201cWhat Is Violent Extremism?\u201d \u201cDon\u2019t Be a Puppet\u201d website, undated. As of January 17, 2021: https://www.fbi.gov/cve508/teen-website/what-is-violent-extremism\nFrenett, Ross, and Moli Dow, One to One Online Interven"] [19.95450210571289, 14.79653549194336, "s on Fieldwork and Implications for Psychological Research,\u201d Behavioral Sciences of Terrorism and Political Aggression, Vol. 4, No. 3, 2012, pp. 195\u2013211.\nHorgan, John, Mary Beth Altier, Neil Shortland, and Max Taylor, \u201cWalking Away: The Disengagement"] [19.93994903564453, 14.804848670959473, "n Stevenson, and Herbert Tinsley, Empirical Assessment of Domestic Radicalization (EADR), College Park: National Consortium for the Study of Terrorism and Responses to Terrorism, University of Maryland, 2016.\nJensen, Michael A., Anita Atwell Seate, a"] [19.95502281188965, 14.79629135131836, "am-webster.com/dictionary/white%20supremacist\nMoonshot CVE, \u201cMental Health and Violent Extremism,\u201d 2019. As of January 20, 2021: https://moonshotcve.com/wp-content/uploads/2019/07/ Moonshot-CVE-Mental-Health-and-Violent-Extremism.pdf\nMuseum of Tolera"] [19.955686569213867, 14.796989440917969, "ajeev, Enchante\u0301 Franklin, Elizabeth Thornton, Sarah Deland, and Jeffrey Rouse, \u201cOpportunities to Intervene? \u2018Warning Signs\u2019 for Suicide in the Days Before Dying,\u201d Death Studies, Vol. 41, No. 6, 2017, pp. 368\u2013375.\nRenstro\u0308m, Emma A., Hanna Ba\u0308ck, and"] [19.955379486083984, 14.79641056060791, " November 2016.\nSinger, Peter W., and Eric B. Johnson, \u201cThe Need to Inoculate Military Servicemembers Against Information Threats: The Case for Digital Literacy Training for the Force,\u201d War on the Rocks, February 1, 2021. As of February 10, 2021: htt"] [19.957969665527344, 14.799979209899902, "itage_Front\nWilliams, Michael J., John G. Horgan, and William P. Evans, \u201cThe Critical Role of Friends in Networks for Countering Violent Extremism: Toward a Theory of Vicarious Help-Seeking,\u201d Behavioral Sciences of Terrorism and Political Aggression,"] [19.95958137512207, 14.797237396240234, "ize the importance of incorporating the voices of those with personal experience and knowledge of ideological extremism into future research designs and efforts\n to prevent radicalization and promote deradicalization.\n$22.50\n ISBN-10 1-9774-0679-3\nIS"] [18.135356903076172, 3.7317135334014893, "Brian A. Jackson Michael J. D. Vermeer Dulani Woods Duren Banks Sean E. Goodison Joe Russo Jeremy D. Barnum Camille Gourdet Lynn Langton Michael G. Planty Shoshana R. Shelton SiaraI.Sitar AmandaR.Witwer\n THE U.S.\nCRIMINAL JUSTICE\nSYSTEM IN THE\nPANDE"] [18.124650955200195, 3.730677604675293, "otests in many areas and cities once again raised the issue of criminal justice reform. The responses by the justice system to the pandemic are diffi- cult to fully separate from the changes made during and after the protests. It is also difficult to"] [13.94581413269043, 4.1382880210876465, "pt to large-scale disruptions in the social and physical environments.\nOther recent products of the PCJNI that might be of interest are\n\u2022 Brian A. Jackson, Michael J. D. Vermeer, Kristin J. Leuschner, Dulani Woods, John S. Hollywood, Duren Banks, Sea"] [18.113962173461914, 3.7478749752044678, ".......... xi Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Acknowledgments.."] [18.071969985961914, 3.7905986309051514, " . . . . . . . . . . . . . . . . . . . . . . . . Funding and Defunding During the Pandemic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Taking Stock and Moving Forward. . . . ."] [18.07707977294922, 3.7502238750457764, "Numbers of Individuals Virtually\nand at a Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Managing Community Corr"] [18.140117645263672, 3.7638919353485107, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 Building Toward a Safer and More Just Future While Weathering the Long-Term\nConsequences of the Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [18.16427230834961, 4.117519378662109, "tober 2020 . . . . . .\n5.1. CorrectionsAgencies............................................................................\n5.2. Cases of COVID-19 in Correctional Facilities, by State, March\u2013September 2020 . . . . .\n5.3. Fatalities from COVID-19 Amon"] [18.130720138549805, 3.723132848739624, "ial phase of the pandemic. They endured early spring spikes of the disease and had to wrestle with the effects on their governmental, health, local economic, and criminal justice systems. Spikes in infection and disease burden occurred later in state"] [18.055740356445312, 3.7269623279571533, "em; an individual accused of a crime passes through the different steps with the relevant actions taken and decisions made in sequence.\nAlthough it is frequently thought of as a purely governmental function, effective and efficient criminal justice d"] [18.011301040649414, 3.8188188076019287, "different areas might have very different constraints on how they can manage their populations in custody and under supervision. How these agencies\u2014and the service providers on which they depend\u2014are funded also varies significantly. Some agencies are"] [18.148618698120117, 3.7601215839385986, "nt for taking stock of the responses to the pandemic, planning for the future, and identifying lessons that are useful broadly and those whose value depended much more on the specific circumstances of the agencies or areas where they were used.\nThe C"] [18.1064395904541, 3.7307004928588867, "ce agencies had to address. Although trends appeared to differ across the country, there were substantial shifts in crime and victimization during the pandemic. Trends also dif- fered with time, with analyses performed early in the pandemic reaching "] [18.092073440551758, 3.7305667400360107, " because if we don\u2019t get it right, we can set the whole community, state, country back.\n\u2013 Court system panelist\nxviii The U.S. Criminal Justice System in the Pandemic Era and Beyond\nTensions Between Justice System Roles and the Groups the Justice Sys"] [18.176496505737305, 3.7532577514648438, "eaning that when change in the justice system must be made\u2014whether because of immediate need to respond to the threat of a global pandemic or because of a desire for longer-term reform\u2014these tensions can make such changes much more difficult to navig"] [18.169301986694336, 3.733961343765259, "cating the challenge of policing during the pandemic.\nPast efforts to explore the potential role of criminal justice agencies in response to a pandemic, and the role of law enforcement agencies in particular, emphasized that close rela- tionships and"] [18.117387771606445, 3.686255931854248, "RTI International, and the Uni- versity of Denver on behalf of the U.S. Department of Justice\u2019s National Institute of Justice (NIJ)\u2014held a virtual summit made up of separate online workshops that explored the justice system\u2019s response to the COVID-19"] [18.107786178588867, 3.723978042602539, "ives of national organizations, and participants with knowledge of how changes in the sector had affected communities and justice-involved individuals. In the workshop that focused on victim services, we sought out representatives from organizations "] [18.105531692504883, 3.747239351272583, "end the reader do so as well. Indeed, many of the gener- alizations drawn are useful for further examination of key problems and promising solutions.\nSummary xxi\nxxii The U.S. Criminal Justice System in the Pandemic Era and Beyond\nThe Response to the"] [18.104482650756836, 3.763686180114746, "the justice system, the following common themes emerged with respect to successes in dealing with the pandemic and lessons that could be valuable to maintain in the long term:\n\u2022 Shifts in crime and need that occurred during the pandemic had implicati"] [18.085662841796875, 3.8139848709106445, " more difficult and to continue, although some counseling and rections system, with pandemic recedes. supervisees, increas- and reach crime vic- positive, suggesting person interaction, ing greater contact demic, but provid- ing efficiency, allow- ti"] [17.99762725830078, 3.7091238498687744, "echnology had tions for both super- visees and providing supervision and ser- vice delivery were \u2022 Transitions to vir- continue.\ntions that already had other institutions did tablets for connectiv- bly, inmate access to invested in digital infrastruc"] [18.07012939453125, 3.8088185787200928, "t their\nefforts to connect with\nhealth initiatives very\nproblematic. Although\ndoing so effectively\npolice and the public.\nwere much more dif-\nvention and violence\ninterruption efforts\nand restricted entry\n\u2022 The national environ-\njustice reform protes"] [18.11213493347168, 3.767934560775757, "\nCourt System\nLaw Enforcement\nthe needs of crime crimes\u2014including responded to some it tougher to meet nonarrest or rapid courts in how they individuals\u2014made by police and the release of some \u2022 Changes made victims.\nBecause of backlogs in intense in "] [18.171894073486328, 3.7695326805114746, "more challenging.\nfiling fees or specific\nsure on the funding\nThese constraints\nconstraints and have\n\u2022 Because of pres-\nstreams on which\nof the COVID-19 pan-\nnomic consequences\nthe police\u2014will create\ndemic, police agen-\ntions in budgets. Such\n\u2022 As a "] [18.061643600463867, 3.7030484676361084, "d.\nFrom one perspective, those challenges raise questions about what the true capacity of existing justice system infrastructure should be and whether it should be much lower than the pre-pandemic approaches of high-density facilities (unless investm"] [17.987253189086914, 3.6813721656799316, " the issue of the digital divide came up across essentially all of our panels. Not every jus- tice agency or supporting organization has invested in technology that will allow it to rapidly \u201cgo virtual.\u201d7 Not everyone in every area of the country has"] [18.143630981445312, 3.745084524154663, "ion stops at the point where a person might be losing [their liberty] over Zoom. . . . [T]here\u2019s something about being in the courtroom that makes the gravity of the situation real.\n\u2013 Court system panelist\nWe really hope that the things that have ser"] [18.09712028503418, 3.717660903930664, "so don\u2019t know the long-term health consequences of COVID. For instance, there seems to be some lasting consequences on heart health, which we already know is a big concern in the law enforcement community. So we don\u2019t know whether survivor benefit cl"] [18.09549903869629, 3.7072558403015137, "nt with the early narrative that the pandemic would pass through the country quickly\u2014they were not enough for a longer-term crisis. Over the course of the pan- demic, strategies of deferral managed the current crisis at the price of a future one, and"] [18.103151321411133, 3.733029365539551, "ted because of the justice system\u2019s organizational and technological risk aversion. The COVID-19 pandemic changed that, with the pressure to continue operations breaking such barriers and, in the assessment of some of our panelists, causing the syste"] [18.046062469482422, 3.789184331893921, " one of the very few things that consistently\u2014in the last five or ten years\u2014has been a bipartisan issue that pretty much everybody can agree that we want to cut back incarceration.\n\u2013 Institutional corrections panelist\n I think there\u2019s a real opportun"] [18.021121978759766, 3.67341947555542, "ringing\n\u2022 Maintain routine virtual\nto have improved access\nresolved, the value of vir-\nefficiency but also appears\nments of in-person pro-\ntion and voir dire\u2014would\neasier and less costly for\nthe courts. The ability of\nindividuals to attend court\nindi"] [18.057533264160156, 3.7814760208129883, "ties, provid- tions careers more ing flexible work of corrections. models as part practice must be Although many Institutional Corrections attractive. home were valuable in the pandemic, courts were pur- suing paperless processes for courts. Even bef"] [18.070341110229492, 3.7673871517181396, "s.\n Table S.2\u2014Continued\nSector-specific issues\n Summary xxxix\n Key Research and Evaluation Questions Identified from Panel Discussions\nTable S.3\nVictim Services\nCommunity Corrections\nInstitutional Corrections\nCourt System\nLaw Enforc"] [18.19110870361328, 3.936025381088257, "ase-testing policies, or infection- control actions taken of tests, their costs, from the signifi- of that information) or negative result? ferent experiences? infectious disease in that explain the dif- correctional institu- strategies are effec- mo"] [18.06899642944336, 3.825070858001709, "ent officers be\ncalls that has been\neffective ways to\n\u2022 Are there more-\nImproved disease management (continued)\n xlii The U.S. Criminal Justice System in the Pandemic Era and Beyond\n Victim Services\nCommunity Corrections\nInstitutional Corrections\nC"] [17.981245040893555, 3.663717031478882, "par-\ncases are allocated\nprioritization to ensure\ncould be held in the\n\u2022 Can tools be devel-\ndistanced or wearing\nalternative facili-\neffect on case out-\nlog reduction?\nface coverings?\nactively identify\ncommunity?\nand law enforcement\ntive work schedu"] [17.970754623413086, 3.6372249126434326, "future\nthe experience of serv-\ncourt design and secu-\nhave a different per-\n\u2022 Could online dispute-\n\u2022 In virtual proceedings,\nappearance options\nreduced failure-to-\n\u2022 Does the potential\n\u2022 How has the shift\nmaintaining proce-\nmaintaining the rep-\ndo o"] [18.115726470947266, 3.7016854286193848, "\nefforts arguing for\n\u2022 Given likely funding\ninteract with reform\nthe reallocation of\nbudgets?\nImproving justice\nfunding models\n delivery of justice Assessing virtual (continued)\nservices\nxlvi The U.S. Criminal Justice System in the Pand"] [18.11031150817871, 3.723996162414551, "for justice-involved individuals and their communities and how the intermingling of responses to mental health issues, substance abuse, and crime has affected the system\u2019s overall effective- ness.11 Beyond such concerns, the pandemic made it undeniab"] [18.082412719726562, 3.6985859870910645, "elists talked about the inherent tension that exists between the desire to craft justice interventions that are effective at the individual level and responding uniformly across large categories of people, offenses, or problems. Responses to the pand"] [18.21844482421875, 3.942509174346924, "iversity of Pennsylvania, and the anonymous NIJ reviewers of the final report. We are also grateful for the contributions of Babitha Balan, Kristen Meadows, Sandra Petitjean, Blair Smith, and Chandra Garber from RAND\u2019s Publications and Research Commu"] [18.1463623046875, 4.087203025817871, "191 corrections staff members had died from COVID-19, and more than 46,000 staff have been infected.5 COVID-19 fatalities alone exceed the number of cor- rections workers killed in 2018 by between six and 12 times.6\n1 See Johns Hopkins University Sch"] [18.179988861083984, 3.778043508529663, "people in an effort to reduce population density to enable social distancing for infection control. To respond to the spread of the disease, agencies had to make major changes quickly, adjusting what they were doing to balance the risks of the pandem"] [18.13510513305664, 3.715142011642456, "ng practices and implemented civilian oversight of justice agencies.8 Both the law enforce- ment actions and policy actions taken in response to the protests differed significantly across the country. However, national-level reactions to extremely lo"] [18.123533248901367, 3.7155544757843018, "parate online workshops that explored the justice system\u2019s response to the COVID-19 pandemic. The goal of our efforts was to focus on the pandemic,\n8 See Andrew Welsh-Huggins, \u201cIn Cities Across U.S., Voters Support More Police Oversight,\u201d Associated "] [18.10006332397461, 3.723900079727173, "nts of the justice system\n\u2022 institutional corrections operations and services (which we abbreviate to the institu- tional corrections workshop), including staff safety and workforce issues, inmate safety and contagion prevention, technology issues, a"] [18.105695724487305, 3.7223587036132812, "tion process, when invitees were unable to participate, substitutes were identified by the research team or alter- nates were suggested to the team by our initial invitees. Where the discussion in the workshops suggested the need to consult with indi"] [18.084796905517578, 3.698687791824341, "oyees, correctional staff, and others\u2014but also on the broader populations with an interest in the justice system. As a result, this virtual summit, which is made up of our seven separate workshops, included orga- nizations serving victims of crime an"] [18.15594482421875, 3.7759289741516113, "se repeatedly. In some cases, it was because specific actions to reduce infection risk largely focused on one population at the expense of the needs of the others. In many cases, it was because rapid responses in an effort to contain the toll of COVI"] [18.1015567779541, 3.7475228309631348, "cross the chapters discussing each sector\u2019s response to the pandemic. Chapter Eight concludes by summarizing common challenges and innovations across sectors, key research and evaluation needs, and the potential for lessons learned to support broader"] [18.063344955444336, 3.7239294052124023, "se charges were dropped or were acquitted at trial, and there are even more options: Depending on the context and the programs that are available, other paths might be available to divert people from that central flow. For example, there is prearrest"] [18.087013244628906, 3.727991819381714, "ch larger jurisdictions. Court systems in dif- ferent states have different administrative and management structures, which means that legal options that might be available in one state could be off the table in another. Corrections sys- tems in diff"] [18.180089950561523, 3.853039503097534, "y endured early spring spikes in case counts and had to wrestle with the effects on their governmental, health, local economic, and criminal justice systems. Spikes in infection and disease burden occurred later in states in the South and Midwest, pu"] [18.196086883544922, 3.9895880222320557, "al in Albany, Georgia, with more than 100 attendees. . . . In the weeks after these events, amplifications in the host loca- tions contributed to increasing U.S. case counts (Anne Schuchat, \u201cPublic Health Response to the Initiation and Spread of Pand"] [18.213687896728516, 3.8710877895355225, "Anna Petherick, Toby Phillips, Sam Webster, Beatriz Kira, Noam Angrist, and Lucy Dixon, \u201cCorona- virus Government Response Tracker,\u201d University of Oxford, Blavatnik School of Government webpage, undated; Chris- topher Adolph, Kenya Amano, Bree Bang-J"] [18.214740753173828, 3.879261016845703, "r week, or only one person can leave at a time). The middle shade indicates a requirement for people to stay at home, with exceptions for daily exercise, grocery shopping, and essential trips. The light- est shade indicates a recommendation for peopl"] [18.20610237121582, 3.859981060028076, "l Aug Mar Apr May Jun Jul Aug\nNOTES: The intensity of each color indicates progressively more-stringent implementation of measures (e.g., from a recommendation to a requirement). Data on all\nmeasures except mask mandates are from Hale et al., undated"] [18.15158462524414, 3.756324052810669, "ime and Service Demand\nThe pandemic and the measures taken to control it would be expected to have an effect on crime. Changes in the nature of crime\u2014and other behaviors, such as substance use\u2014would be expected to shift the needs of individuals serve"] [18.17742347717285, 3.7689695358276367, "July 2020.\n5 For example, some service providers saw drops in calls for service in the first few months of the COVID-19 pandemic, which then rebounded either to similar or higher levels than were observed before the pandemic.\n6 Some of our participan"] [18.160869598388672, 3.7502658367156982, "ople who were arrested and brought into the system.\n Our crime that\u2019s associated with juveniles . . . seems to be ticking down. As our calls for services dropped off, our officers had more time to virtually connect . . . with com- munity members. And"] [18.14224624633789, 3.7343592643737793, "ervations of crime shifts during this period, significant local variation appears to apply for violence. In their data collection, IACP and GMU saw almost half of respondents reporting decreases in violent incidents, with a much smaller percentage re"] [18.122629165649414, 3.7659168243408203, "89, September 2020, p. 104241; Mohler et al., 2020; and National Emergency Number Association, 2020.\nFor analyses showing rates in line with seasonal variation, see Jennifer M. Reingle Gonzalez, Rebecca Molsberry, Jona- than Maskaly, and Katelyn K. J"] [18.030738830566406, 3.756800889968872, "icle, more control by the male partner, particularly if they\u2019re both involved in a lockdown. I also think some women might think that some services might be best saved for people with COVID . . . particularly hospital services, they may be both fearf"] [18.076025009155273, 3.7825000286102295, "sexual assault, child abuse, physical abuse, who [because of stay-at-home orders] are literally stuck at the scene of the crime with the person who is harming them.\n\u2013 Victim services panelist\nIn addition, the pandemic itself was cited as a tool of ab"] [18.21745491027832, 3.7196311950683594, "ies was observed in many analyses. Changes in the timing of crime also occurred, reflect- ing changes in individual behavior.18 Unlike the decrease in burglary, some areas saw increases in theft of and from vehicles, which were used less during lockd"] [18.14384651184082, 3.733527898788452, "ement operations panelist\n[With respect to fraud and identity crime,] we have actually seen a swift and significant increase in the demand for our services, our one-on-one contact center services are up about 20 or 25 percent. And, as far as our web-"] [14.404645919799805, 12.813880920410156, "perienced anti-Asian hate amid the COVID-19 pandemic.\u201d26 Some academic efforts to assess the level of hate crime occurring during the pandemic saw similar effects: For example, a survey conducted by researchers at Florida State University indicated t"] [18.23627471923828, 3.7321410179138184, "g, decreases in traffic accidents (to which law enforcement generally respond to assist) would be expected. IACP and GMU\u2019s data call showed decreases in crashes and fatalities in the majority of departments, and literature analyses showed the same.30"] [18.184329986572266, 3.7420148849487305, "d getting a \u201cslingshot effect.\u201d\n\u2013 Law enforcement operations panelist\n 28 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nfindings in a survey of PSAPs across the country.33 Participants in our law enforcement panel also indicated maj"] [18.136524200439453, 3.731065034866333, "ysis of multiple cities\u2019 data, Rosenfeld and Lopez found a 41-percent decrease in drug offense rates, although because such effects were deprioritized by many law enforcement organizations during the pandemic, crime data would appear to be less valua"] [18.193866729736328, 3.708326816558838, "ectious environment, changes in crime and victimization associated with trying to reduce infection risk, or some combination thereof.\n Postmortem toxicology is now through the roof because of the impact that a lot of these opioids and so forth have h"] [18.17341423034668, 3.7078146934509277, "pulations as a result of pretrial detention and the eventual incarceration of individuals convicted of crimes. Other activities, such as the issuance of citations and traffic enforcement, can require individuals to come to court for hearings or pay a"] [18.22434425354004, 3.7167892456054688, "a result, although the smaller num- bers of staff might reduce the risk of contracting COVID-19, the capacity of a forensic lab for specific kinds of investigative analyses could depend on a relatively small number of staff mem- bers, making the func"] [18.295185089111328, 3.7345547676086426, "nd such supporting roles as assisting in securing health facilities or testing centers.3 However, as we described in Chapter Two, the measures a state or locality took in response to the pandemic varied widely, so the context in which a law enforceme"] [18.27681541442871, 3.7392642498016357, "ustice protests triggered by the killing of George Floyd, made law enforce- ment support for the public health response to the pandemic difficult in many jurisdictions. Some law enforcement departments explicitly and publicly rejected the enforcement"] [18.241668701171875, 3.7407240867614746, "ning of the pandemic, uncertainty surrounding COVID-19 and national chaos around such issues as the availability of protective equipment complicated police depart- ments\u2019 planning.7 Our panelists described vastly different assumptions about the likel"] [18.2662296295166, 3.837455987930298, "ess than one-tenth of agencies reporting that 5 percent or more of their officers were on sick leave as a result of COVID-19. More than half of agencies reported no noticeable officer sick leave because of COVID-19.10\nIt is clear, however, that COVID"] [18.298099517822266, 3.8520469665527344, "f COVID. We have two that have yet to come back because they have tremendous upper respiratory issues. . . . And then the others . . . are absolutely fine.\n\u2013 Law enforcement management panelist\n Law Enforcement Agencies, Forensic Laboratories, and Cr"] [18.249807357788086, 3.72605037689209, "ignificant changes in the early stages of the pandemic. These adjustments affected agencies\u2019 outward-facing inter- actions and their internal management activities.16 In the initial months of the pandemic, several efforts were carried out that sought"] [18.21533966064453, 3.7395212650299072, "artments made significant shifts to virtual service delivery. Although some departments had taken steps toward virtual service delivery before the pandemic, it pushed the changes and increased public receptive- ness to online and virtual police respo"] [18.219615936279297, 3.7248713970184326, "e Public\nIn an effort to limit the infection of law enforcement officers and to reduce the flow of indi- viduals into the justice system, many police departments made substantial changes to how they did business. These changes were focused on meeting"] [18.152210235595703, 3.7240166664123535, "hone or online.20\nIn both of our law enforcement panels, participants emphasized that the transition from in-person response to online or telephone options has been important for reducing risk. How- ever, similar to technological initiatives that wer"] [18.131000518798828, 3.7259225845336914, "was we started doing videoconferencing with people so they actually see a police officer taking their report. So that kind of calmed their fears some without actually having an officer respond to take the report.\n\u2013 Law enforcement management panelist"] [18.189878463745117, 3.7263853549957275, "revention Initiatives 43\noration and trust-building efforts all the more important.24 For example, in a scan of changes made early in the pandemic, Jennings and Perez summarized that\n[a]cross the U.S., various community-oriented policing and outreach"] [18.061288833618164, 3.679032325744629, " in the Pandemic Era and Beyond\n [I do] regularly scheduled Zoom meetings with members of our business community, key community leaders, community of faith leaders, even our elected officials who still aren\u2019t meeting face to face, keeping [them] plug"] [18.069774627685547, 3.7492353916168213, "n interventions similarly depend on\nLaw Enforcement Agencies, Forensic Laboratories, and Crime-Prevention Initiatives 45\nbringing community organizations and actors together to intervene with groups of individu- als who are at risk of perpetrating vi"] [17.992887496948242, 3.783961534500122, "c health, counseling, and other service agencies (see discussion in Brian A. Jackson, Ashley L. Rhoades, Jordan R. Reimer, Natasha Lander, Katherine Costello, and Sina Beaghley, Practical Terrorism Prevention: Reexamining U.S. National Approaches to "] [18.095947265625, 3.6792824268341064, "ed to bring together com- munity actors, service providers, and others with at-risk individuals, constraints for infection prevention can be a major barrier.\n31 Irshad Altheimer, Janelle Duda-Banwar, and Christopher J. Schreck, \u201cThe Impact of Covid-1"] [18.175294876098633, 3.7142159938812256, "t we can do to limit our interactions with people, to limit the number of people that we were incarcerating. We just had to really tell our officers to use the best discretion they could.\n\u2013 Law enforcement operations panelist\nAnecdotally, I\u2019ve heard "] [18.175161361694336, 3.7612743377685547, "using data collected from departments within single states produced similar results (e.g., Shjarback and Magny,\n2020).\n35 National Conference of State Legislatures, \u201cCriminal Justice System Responses to COVID-19,\u201d webpage, November 16, 2020.\n36 The s"] [18.190149307250977, 3.7217164039611816, "ation efforts there (we discuss these efforts further in Chap- ter Five).\nAs we discussed earlier, the choices of approach for addressing minor offenses in particu- lar have significant consequences for how the effects of the pandemic on this part of"] [18.195247650146484, 3.7136945724487305, "] creating some addi- tional safety guidelines for performing breath alcohol tests. I will say that since April, we have seen about a 30-percent reduction in evidential breath tests across the state due to less enforcement in that area I think. We\u2019ve"] [18.151582717895508, 3.7303335666656494, "e now more available and familiar to staff.\nAgencies, and forensic labs in particular, also made major changes to allow staff to work from home for some portion of their time. Having staff be able to do work while not physically present helped suppor"] [18.177038192749023, 3.7317843437194824, " have an overabundance of rely- ing on paper records. . . . We\u2019ve bought these lockboxes so that people can take case files home with them . . . so that they can do some case review at home. But we really have started moving toward seeing what steps "] [18.023426055908203, 3.696457624435425, "esult, accessibility and usability limitations to protect data\u2014participants were impressed by how quickly technical change happened.\n The other thing we realized is [about] our virtual meetings. I don\u2019t know for quite some time [whether] we will go b"] [18.31033706665039, 3.7862510681152344, "ges made to allow for the virtual delivery of police services were moti- vated primarily by officer safety concerns; minimizing contacts reduced the probability of an officer encountering a carrier of COVID-19. However, because such contacts could no"] [18.286067962646484, 3.7716169357299805, "intaining a healthy workforce.\n\u2013 Law enforcement management panelist\n[Beyond taking calls completely over the phone,] patrol officers would sometimes use their phone to minimize contact\u2014they still may go to the scene and either observe what\u2019s going o"] [18.271930694580078, 3.7854819297790527, "tom and we didn\u2019t know if it was COVID or not. . . . For several weeks, that was quite a challenge to have to quarantine an officer just because we couldn\u2019t find adequate testing, just because of the hotspot [in our] area.\n\u2013 Law enforcement operation"] [18.248842239379883, 3.7858781814575195, "ment that publicly prohibited its staff from wearing respira- tory protection while on duty.48 According to an unscientific poll conducted by the publica- tion Police1 of responders in general (although most respondents were police), a high per- cent"] [18.265348434448242, 3.7585079669952393, "emos, But LA Cops Still Aren\u2019t Wearing Masks,\u201d LAist, July 6, 2020.\n58 The U.S. Criminal Justice System in the Pandemic Era and Beyond\n I\u2019m not sure if others have faced this as . . . one of the things that we\u2019ve experienced was just getting officers"] [18.259666442871094, 3.781574249267578, "ies, and Crime-Prevention Initiatives 59\nProviding COVID-19 Infection Data to Police as a Staff Protection Measure\nIn an effort to protect officers from exposure to COVID-19, some departments also had \u201cdispatchers seek to screen for COVID-19 exposure"] [18.344343185424805, 3.858102560043335, "utive Order Giving COVID Case Data to 911 Dispatch Centers,\u201d WCCO CBS Minnesota, April 11, 2020).\n55 US Department of Health and Human Services, Office for Civil Rights, COVID-19 and HIPAA: Disclosures to Law Enforcement, Paramedics, Other First Resp"] [18.278873443603516, 3.784771680831909, " Breach in South Dakota,\u201d Associated Press, August 21, 2020.\n61 In a particularly compelling example, an officer involved in a multiagency enforcement operation tested positive,\nexposing tens of other officers to the virus and requiring their quarant"] [18.304290771484375, 3.772005558013916, "ohorts, with two covering a 14-day period with officers working 12-hour shifts (seven days per cohort) while the other two cohorts iso- lated for 14 days. Participants in our panels described similar arrangements, with groups of staff (both sworn and"] [18.26766014099121, 3.7516696453094482, "enforcement and other emergency responder agencies to help manage workload and ensure continuity of response operations.\nAlthough platooning and other models for breaking up the workforce and limiting overall agency risk worked well for larger depart"] [18.252702713012695, 3.735787868499756, "ispatchers are all confined in a very small area by the nature of their work. . . . Because of the very, very small area they\u2019re in, if one gets sick, you could lose the entire shift. And then what do you do?\n\u2013 Law enforcement management panelist\nWe\u2019"] [18.231412887573242, 3.7437424659729004, "eople more stressed out and anxious. . . . It\u2019s stressful for you, stressful for everyone.\n\u2013 Law enforcement management panelist\nJust as schools being closed and other consequences of the pandemic have affected a large portion of the country\u2019s workfo"] [18.252357482910156, 3.7335598468780518, "with new ways and give them a lot more flexibility with their scheduling.\n\u2013 Law enforcement management panelist\nGiven the confluence of stresses staff were dealing with during the pandemic, there was an expanded need for mental health support for off"] [18.203184127807617, 3.7062606811523438, " as possible with all the officers on the patrol squad.\n\u2013 Law enforcement operations panelist\nAgencies [need to] have a good [employee assistance program] that officers know is going to be confidential . . . where they feel that the process is legiti"] [18.206836700439453, 3.744450330734253, "n you try to put in place things to minimize the risk of that in-person activity.\n\u2013 Law enforcement management panelist\nRecruiting and Training Virtually\nBecause training programs\u2014both initial academy training and in-service training efforts\u2014bring to"] [18.18035125732422, 3.7086026668548584, "d flexibility they provide.\n The state academy was closed for a time. They\u2019re now open again. But they\u2019ve cut about 80 hours of hands-on training specifically with defensive tactics and training scenarios out of their instruction. So we are now tryin"] [18.290809631347656, 3.726166009902954, "ning quicker, like within a month or two, once they hit the streets. So I think those critical things we have to do hands on.\n\u2013 Law enforcement management panelist\n[For command-level training from places like the FBI Academy,] we are certainly feelin"] [18.32561683654785, 3.7558441162109375, "- cussed previously, some law enforcement organizations publicly rejected roles in public health enforcement measures,77 while others were more actively enforcing compliance with public health disease control efforts.78 There also have been publicly "] [18.314517974853516, 3.745805501937866, "t knowing what our authority was if we got backed into a corner. Most of this ended up falling on our state partners, so we would pass those complaints over to state police and they finally stood up some frameworks for dealing with that.\n\u2013 Law enforc"] [18.32529067993164, 3.7743356227874756, "public health restrictions that did not exempt religious institutions. While most state and federal courts have also rejected challenges to public health orders, an unprecedented number of courts have sided with the challengers and substituted the co"] [18.322607040405273, 3.7306478023529053, "t and would take the burden off of us, but he . . . essentially kicked it back to the local county sheriffs and said, \u201cYou do whatever you want. You decide.\u201d So in [the county next to us], they said, they\u2019re not essential. And they went about basical"] [18.309978485107422, 3.742806911468506, "part of that group. We were present in helping people to avail themselves of testing. And then we had to back off because of the issues related to social unrest.\n\u2013 Law enforcement operations panelist\nMembers of our panel cited examples of alternative"] [18.370399475097656, 3.7460620403289795, "ften took on the vernacular of public health . . . and what we found is the relationship\u2014even the perceived rela- tionship\u2014between law enforcement and public health was undermining trust in public health initiatives.\n\u2013 Community organization panelist"] [18.36336326599121, 3.8172993659973145, "sing concerns about equity in traditional policing activities and use of force, concerns were raised about how law enforcement agencies in different areas were enforcing public health directives and whether they were being enforced fairly in differ- "] [18.247861862182617, 3.716648817062378, "were] sitting in jail for [an extended period] before they were able to have their day in court. And that\u2019s just not fundamentally what the role that police officers should be put into is to take someone\u2019s freedom away . . . without any type of judic"] [18.26274299621582, 3.7282071113586426, "nd personally, and we will only get through it if we work together.\u201d\n\u2013 Law enforcement operations panelist\nIn some cases, police departments relied directly on other agencies for very tangible sup- port. In both of our panels, participants spoke abou"] [18.23296546936035, 3.7328569889068604, "ending people to the hospital. [We should] talk to the hospitals in advance and say, \u201cWhen people call us, what do we want to tell them?\u201d You know, people call the police for all kinds of things. They may even call when they don\u2019t necessarily have a "] [18.250551223754883, 3.7379791736602783, "espondents expected their police departments to be \u201csignificantly impacted.\u201d90 Data, including responses to questionnaires distributed by PERF91 and as part of the IACP and GMU data-collection effort,92 that have been collected directly from groups o"] [18.34559440612793, 3.7217068672180176, "equests \u201con how your entity demon- strated enforcement efforts\u201d as part of the pandemic response.93\nTaking Stock and Moving Forward\nIn considering the path forward through the remainder of the pandemic and preparation for future public health crises,"] [18.351177215576172, 3.814929246902466, " in contact with members of the public, and because of variation in the use of such measures as respiratory protection to reduce the chance of infection, the num- bers of current officers who might have long-term consequences from COVID-19 exposure i"] [18.181407928466797, 3.721616506576538, "on and the poten- tially available evidence of officers\u2019 compliance with those decisions could affect whether an individual claim for compensation is successful.95\nPromising Practices from the COVID-19 Pandemic Response\nIn considering the future stat"] [18.238262176513672, 3.7187318801879883, "se their job for having to make that court appearance. Whereas now, if they can, if they could show up to court remotely for a traffic ticket for a misdemeanor charge. I think that\u2019s a net positive for society.\n\u2013 Law enforcement operations panelist\nI"] [18.256017684936523, 3.743013620376587, "ement\u2019s roles in communities because law enforcement, much like our school teachers, have been handed a whole lot of problems that are better handled by other agencies and other service sectors.\n\u2014Community organization panelist\nIn spite of the fact t"] [18.200057983398438, 3.7257704734802246, "e implemented a civil citation program for marijuana posses- sion and a few other low-level felonies and city ordinance violations. And, of course, the knee-jerk reaction was . . . \u201cUh we\u2019re going to see increases in crime.\u201d Just the exact opposite h"] [18.18796730041504, 3.7011232376098633, "\u2019t in many of these cases. . . . So many of the things that from a research perspective, we\u2019ve been asking [about] for dozens of years: Does this work? We have the unfortunate opportunity to really use this as an experiment, to really find out, what "] [18.190065383911133, 3.7250988483428955, "nt Agencies, Forensic Laboratories, and Crime-Prevention Initiatives 87\nmore-trusted departments been more effective or been provided with access to sensi- tive data or other resources to enable pandemic response? Are there other roles that law enfor"] [18.01774024963379, 3.6600377559661865, "he implica-\ntions of the types of programs and initiatives that will be cut? How do such cuts interact with reform efforts arguing for the reallocation of resources from police budgets?\nAnswers to all of these questions will contribute to moving beyo"] [18.025676727294922, 3.658961296081543, " multiple cases are heard in a major courthouse simultaneously, mean that the courthouse is a point where people from different places come together to do the justice system\u2019s business.\nIndividuals who are affected by the crimes at issue have rights\u2014"] [18.114343643188477, 3.671138286590576, "VID-19 pan- demic began. In 2016, a task force managed by the National Center for State Courts and the State Justice Institute published a benchbook laying out those legal frameworks.1 However, it\n1 National Center for State Courts, Preparing for a P"] [18.11787986755371, 3.708638906478882, "lity emphasized that considering the changes made is relevant for the longer term and determining what further adaptations will be required for the next phases of the pandemic.\n2 The environment surrounding COVID-19 response\u2014which included communicat"] [18.01959800720215, 3.6201040744781494, "s.\n\u2022 Because virtual hearings are viewed as inappropriate by many for serious felonies and other cases requiring a jury trial, large backlogs of unresolved cases have formed in many court systems, raising concerns about the rights of the accused. Thi"] [18.016521453857422, 3.6552910804748535, ") \u201cthe protec- tion of vulnerable people, such as elders, children and those who suffer from disabilities;\u201d (2) \u201cpreliminary hearings, bail hearings and arraignments for criminal defendants;\u201d (3) \u201chear- ings related to quarantine orders and other pub"] [18.12005615234375, 3.601020336151123, "ld, courts automatically issued continuances,10 and granted extensions on many court deadlines, including extending time to pay fines and fees.11 Some courts suspended the collec- tion of fines and fees entirely, both as a protective measure and as a"] [18.00861358642578, 3.585275650024414, "gnificantly extend the timeline that an accused individual had to wait before trial, suspending jury trials often required courts to suspend speedy trial requirements.\nThe Court System 95\n There\u2019s a huge tension, obviously, between defendants who\u2019ve "] [18.083271026611328, 3.6405210494995117, "g the flow of people into jails (e.g., during pretrial detention) or into prisons to serve custodial sentences. Moving through the stages of the process, we explore changes in charging decisions, changes in warrants, reductions in pretrial detention,"] [18.114988327026367, 3.6763243675231934, "thout bail which lim- ited jail populations. Early in the pandemic, California went to a zero-bail schedule across its court system in an effort to relieve stress on jail populations, driven in part because of limits in judges\u2019 situational awareness "] [18.118505477905273, 3.6361355781555176, "5 Comments from Keir Bradford-Grey in Council on Criminal Justice, 2020a.\n Settling Pending Cases\nTo reduce pressure in the system, focused efforts were made to resolve pending cases, generally prioritizing individuals who were in custody. Many of th"] [18.061426162719727, 3.6597628593444824, "e Court System 99\n The plea bargaining system depends on defendants and everybody believing that, if you don\u2019t take this offer, we\u2019re going to take you to trial and things will get worse. Right now I\u2019m not sure that we have that credible threat [of a"] [18.076770782470703, 3.6339592933654785, "to the survey covered 40 states and the District of Columbia, the respondents were not a representative sample of agen- cies across the country (i.e., the National Association of Pretrial Services Agencies described its results as \u201cpurely anecdotal e"] [18.014814376831055, 3.6674673557281494, " systems helped courts implement alternative ways of assisting people at a distance, which was not unlike the innovations made by police in the use of electronic means of reporting crime or police response via video calls.\n Fortunately, we did alread"] [17.95555877685547, 3.622102737426758, " services were a driver to make courts accessible in person during the pandemic. However, as the pandemic continued, some participants reported an increasing drive to move activity onto telepresence platforms.39\nIn addition to navigating the new tech"] [18.007585525512695, 3.638129711151123, "tion\nThese efforts achieved their main benefit for many court systems: cutting in-person activity and reducing infection risk, with participants in our panel reporting that their systems had completed hundreds, thousands, or even 1 million hours of p"] [17.933944702148438, 3.5881826877593994, "or litigants to be present in court; travel time and long waits in a courthouse for a case to be called for a short hearing can essentially be eliminated. One participant in our panel said that in some types of cases, \u201cthe number of defaults has kind"] [18.009754180908203, 3.645421266555786, "wyers in a case might have key files locked in commercial buildings that were closed as a result of the pandemic, and how to sufficiently verify participants\u2019 identities virtually.\nMembers of the panel also emphasized some issues that are more unique"] [18.003698348999023, 3.663787603378296, "il on Criminal Justice, 2020a.\n 106 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nFlorida state attorney, \u201cI do think there has been a silver lining at least for our operations. Necessity has forced our hand. We have a three-year st"] [17.981962203979492, 3.619504451751709, "lson, state attorney, Florida\u2019s 4th Judicial Circuit, in Council on Criminal Justice, 2020a.\n52 Brandon Marc Draper, \u201cAnd Justice for None: How COVID-19 Is Crippling the Criminal Jury Right,\u201d Boston College\nLaw Review, Vol. 62, No. 9, E. Supp. I.-1, "] [17.97890281677246, 3.622041940689087, "observe, to those held in the virtual realm has the potential to eliminate that access and therefore raise questions about whether such pro- ceedings pass constitutional muster. Civil-society actors who are concerned with the implica- tions of reduce"] [17.905542373657227, 3.5757176876068115, "ld happen with public bail hearings . . . if that were to continue after this [pandemic] slows down, I think that would be a serious detriment to the system. And it would cause much more incarceration than we\u2019re currently seeing. . . . And I would be"] [17.970317840576172, 3.652562141418457, "o get employment and to get housing. And it can brutally impact on people\u2019s families, especially their children. I think there\u2019s a very big difference between the idea that individuals of the public who really want to take trouble to come in and list"] [17.873991012573242, 3.580923557281494, "ialty and treatment courts, and the requirements to safeguard participant treatment data also meant that those courts\u2019 virtual systems had to be compliant with regulations for protect- ing personal health information.61\nBeyond basic technological lim"] [18.055967330932617, 3.6437876224517822, "ed concern that the lack of juror bonding could impact deliberations. In a civil summary jury trial conducted in Collin County, Texas, one juror left to take a phone call. During another civil trial, jurors appeared to sleep, exercise, or tend to the"] [18.049821853637695, 3.643219232559204, " it. And we\u2019re not at full capacity.\n\u2013 Court system panelist\nThe idea expressed by multiple panelists is that these cases are accumulating behind the choke point of jury trial suspension like water building behind a dam, and the number of cases is ge"] [18.041526794433594, 3.6255710124969482, "ed: Both on our panel and in public news reporting, there were examples of incidents where indi- viduals brought COVID-19 into the courtroom, exposing everyone involved in the process.67\nThe risk is not just to the public. Multiple panelists pointed "] [18.019081115722656, 3.608989715576172, "rns also are raised about whether fear of infection will make in-person juries less representative. A participant whose system had resumed in-person proceedings indicated that they had not seen a large increase in no-shows, and the resulting jury poo"] [18.05508041381836, 3.5806565284729004, "hose rooms that are suf- ficiently equipped with filtration devices and reduce court calendars to accommodate the reduced number of courtrooms\u201d (Wisconsin Courts COVID-19 Task Force, 2020, pp. 10\u201311).\n71 For a discussion of federal court modification"] [18.00810432434082, 3.613151788711548, " move closer to the jury, jury can\u2019t deliberate in a jury room. The public probably can\u2019t watch from [where they would normally] because now the jury is seated there, the courtroom is flipped around backward. It just looks really different, and the q"] [17.97954750061035, 3.598839044570923, "at level of capacity would not be sufficient to stop the backlog from increasing.\n [If] witnesses [are] in masks, one of the things is jurors can\u2019t size up the facial expres- sions of the person, and [if] lawyers [are] wearing masks and the jurors ca"] [18.0186824798584, 3.618781328201294, "eard in the virtual space or capacity will be exhausted. This will require con- tinuing case prioritization for in-person action using criteria that are similar to those discussed for prioritizing action in virtual proceedings. According to the Wisco"] [18.061601638793945, 3.6463141441345215, "hat\u2014that everything\u2019s going to be fine. And so when they sit there and hear [the case], it better be something that\u2019s important.\n\u2014Court system panelist\nSo meanwhile, how do I do [thousands of] felony cases when we\u2019ve done six trials in the last six m"] [18.058731079101562, 3.6477372646331787, "tem\u2014like those elsewhere in the criminal justice system and in the country writ large\u2014would have been well matched to a scenario in which the pandemic was a short-term event. Halt- ing operations and building case backlogs for a few weeks would have "] [18.06209373474121, 3.6804304122924805, " improvements in information technology. Although models that allowed easy work from home were valuable in the pandemic, they also would improve efficiency after the pandemic.\n\u2022 Continuing virtual elements of in-person processes: Although a return to"] [18.021888732910156, 3.69273042678833, " will take to at least for the preliminary stages of voir dire, which would include answering the summons, reporting in, doing hardships, and perhaps doing question- naires . . . And I think in terms of customer service for our public, they\u2019ll like t"] [18.072996139526367, 3.6713223457336426, "ll. And that\u2019s the pushback that I\u2019m getting, but things are going to change and we\u2019re going to have to involve the community more. And we\u2019re going to have to reduce the load of the court so that the court can handle the most serious, violent cases t"] [18.094823837280273, 3.709930658340454, "nelists were clear that, although the outcomes of these efforts appear to be positive now, the ability to maintain them beyond the immediate needs created by the pandemic will require evidence that they are indeed beneficial. Research must also take "] [17.95701789855957, 3.6214818954467773, " discussion:\n\u2022 Have remote-appearance options reduced failure-to-appear rates?\n\u2022 Has the significant reduction in pretrial detention and money bail had an effect on\nappearance rates?\n\u2022 Can the effects of the pandemic on plea bargaining behavior and o"] [18.084632873535156, 4.010545253753662, " that time in a correctional facility\u2014e.g., prisons, jails, or other custodial facilities (Figure 5.1). Many of these facilities are operated by government departments of corrections at the federal, state, county, or local level, but others are opera"] [18.158727645874023, 4.045950412750244, "on, so strategies like those adopted in other parts of the justice system to move activities outside are relevant only to a limited extent\n\u2022 the population density inside some correctional facilities is very high. The scale of incar- ceration in the "] [18.16453742980957, 4.035480499267578, "ilt over 30 years ago, it\u2019s falling apart.\n\u2013 Law enforcement management panelist\nEarly on, we kept hearing talk about, \u201cYou need to socially distance your inmates.\u201d Well, I was always asking, how do you socially distance, [thousands of] people in a f"] [18.16842269897461, 4.065047264099121, "emic. Broad reviews of actions taken across the country show wide variation,8 and exami- nations of the spread of responses echoed the conclusion that differences in response mirrored the fragmentation of the broader national response to the pandemic"] [18.168350219726562, 4.073309898376465, "ross the country, illness among residents of the corrections system varied over time and in intensity, but COVID-19 accounted for thousands of deaths and hundreds of thousands of cases to date (Figure 5.2). Efforts that have focused on specific popul"] [18.17652702331543, 4.089488506317139, "riesbach, and Danya Issawi, \u201cStates Are Shutting Down Prisons as Guards Are Crippled By Covid-19,\u201d New York Times, January 1, 2021.\n 132 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nFigure 5.2\nCases of COVID-19 in Correctional Faci"] [18.15585708618164, 4.049165725708008, "strategic planning, Law Office of the Cook County Public Defender, in Vera Institute of Justice, \u201cCOVID-19 and Jail Releases Webinar,\u201d video, YouTube, April 17, 2020a.\nLeast fatalities Some fatalities Most fatalities\n 134 The U.S. Criminal Justice Sy"] [18.163312911987305, 4.013463973999023, "was \u201cit\u2019s going to be weeks, or it\u2019s only going to be a few more weeks or a few more months.\u201d And then people start to have that belief in their head. And now we\u2019re having like a COVID burnout in our employees because they\u2019re just tired of having to "] [18.154495239257812, 4.016011714935303, "ystem in the Pandemic Era and Beyond\n Key Findings from Institutional Corrections Agencies\u2019 Response to the COVID-19 Pandemic\n\u2022 Corrections facilities are limited by the space they have, and facilities that were overcrowded before the pandemic had gr"] [18.15935707092285, 4.112569808959961, "rison populations (ranging from 2 percent to just more than 37 percent).18 Other analyses echo these findings, noting more-substantial decarceration in jails than in prisons.19 Some early data suggest that the strategy was effective, likely in part b"] [18.186878204345703, 4.051732063293457, "Urban Jail in the United States,\u201d Annals of Epidemiology, Vol. 53, January 2021).\n21 Wang et al., 2020.\n22 National Conference of State Legislatures, 2020.\n23 See discussion in Council on Criminal Justice, \u201cCorrections and COVID-19: Challenges and St"] [18.17924690246582, 4.048044681549072, "OVID-19, more than 7,000 inmates have\n24 Anna Harvey, Orion Taylor, and Andrea Wang, COVID-19, Jails, and Public Safety, Washington, D.C.: Council on Criminal Justice, National Commission on COVID-19 and Criminal Justice, updated December 2020.\n25 Re"] [18.17413902282715, 4.026069164276123, "use sending someone carrying COVID-19 out of a facility into the community would not serve public health even if it reduced the correctional population. This required quaran- tine processes before release and added to testing requirements (which, at "] [18.182432174682617, 4.038313865661621, "lasses is reduced.\n\u2013 Institutional corrections panelist\nOne of the issues though, was everything going on in [our city] with violence and national issues around race relations and things like that. So unfortunately we saw our population go right back"] [18.174100875854492, 3.991265296936035, "he course of the pandemic. In addition, other measures focused on isolating new arrivals and controlling flows of people as much as possible.\n We still do temperature checks and the standard health screening questions at entrances. And whenever we ha"] [18.178939819335938, 4.056093215942383, "t \u201cI don\u2019t have it at all. I won\u2019t get it.\u201d You could be tested today and be asymptomatic and be negative on the test. But like I said, by the end of the week, you can be positive and it\u2019s some- thing you can\u2019t test every single day for, number one, "] [18.1252384185791, 3.969426393508911, "l professionals, and inmates themselves for security and other purposes. In a pandemic, each person coming and going becomes a potential introducer of the virus.37 In response, facili- ties sought to limit movement as much as they could. In-person vi"] [18.152328491210938, 4.018965244293213, "nstituted line staff distributing worksheets to resident youth).39 Furthermore, the cessation of interfacility transfers cut off a path for accessing programs (e.g., moving someone to a different facility that had a program they needed) and managing "] [17.978229522705078, 3.9187874794006348, "re individuals to return to the jail each night to sleep.41\n We reconstituted . . . a work release program for sentenced individuals. . . . There are two forms of electronic monitoring that we stood up. Not everyone released in that pro- gram needs e"] [18.142595291137695, 4.050384044647217, "ver, doing so successfully required both policy change and implemen- tation by staff in collaboration with incarcerated individuals.\n [A significant change was] the acknowledgment as part of the pandemic that we gave the reins with respect to certain"] [18.175243377685547, 4.044521808624268, "ay-to-day basis. There is a need for collaborative approaches to overcome these obstacles\u201d (p. 20).\nInstitutional Corrections: Prisons, Jails, and Other Custodial Facilities 147\nMasks and Hygiene Measures Were Central Prevention Strategies for Many F"] [18.17707633972168, 4.0829691886901855, " New York: New York City Department of Corrections, 2020.\n44 See, for example, discussion in Nelson and Kaminsky, 2020.\n45 Widra and Hayre, 2020.\n46 According to Supreme Court of Georgia Justice Michael Boggs,\nThe real issue is not how many you\u2019re re"] [18.180580139160156, 4.055668354034424, "9\u201d in the jail.48 Some facilities that did have dormitory-style portions emptied them as much as possible, enabling inmates to distance and limit contact with one another.49 Others adopted cohorting strategies, grouping a set of staff and a set of re"] [18.177753448486328, 4.051959037780762, "\nThe way that we started housing people was we had isolation. We then had quarantine, which for us, we basically quarantined any unit that had one to two people come from that tier who tested positive or were symptomatic. Those sick people would go i"] [18.178998947143555, 4.053897380828857, "s, solitary confinement should be eliminated as a corrections practice, but] isolating someone for public health reasons or infection control is [not] the same thing. . . . The problem or the risk [in] supermax [solitary confinement] practices is arc"] [18.16010093688965, 4.01030969619751, "m profusely for their contribution to enhancing sanitation and other services, [doing] laundry and other protocols that helped us keep running.\n\u2013 Institutional corrections panelist\nCOVID-19 Strained Correctional Health Care Delivery Systems\nA major c"] [18.1658992767334, 4.071079730987549, "at out very quickly once we started testing and as we continue to test.\n\u2013 Institutional corrections panelist\nThe importance of testing cannot be overstated. We had the experience where, in our first phase, you just didn\u2019t have the capabilities. The c"] [18.164505004882812, 4.037996292114258, "s that we do every day in medicine that goes with that. And I\u2019d like to see CDC and others push more to give guidance and things for corrections on that point of care in isolation. Cause it\u2019s going to be a hard winter.\n\u2013 Institutional corrections pan"] [18.17356300354004, 4.040299892425537, " takes your temperature. We distributed those to housing units so that people could take their own temperature. And so giving folks in custody back a little bit of autonomy and control over their health and their circumstance. I think was really valu"] [18.162309646606445, 4.0294318199157715, " The health system was able to bring in some additional nursing staff and medical staff. We were able to put up a couple of different tents and basically operationalize that as being our isolation unit.\n\u2013 Institutional corrections panelist\nMaintainin"] [18.163681030273438, 4.030568599700928, "a were collected some time ago, a CDC survey done in 2012 indicated that \u201c[f]or inpatient and outpatient medical, dental, and emergency care, most states delivered services using a combina- tion of on-site and off-site care locations\u201d (Karishma A. Ch"] [18.172636032104492, 4.027204990386963, "hospital.\n\u2013 Institutional corrections panelist\nBecause the participants on our panels came from a selection of jail and prison systems, their experiences cover only a fraction of systems across the country. Furthermore, some par- ticipants were purpo"] [18.139278411865234, 4.044605255126953, "ns among staff about infection.\n A number of correctional facility chaplains [indicated] just not really feeling equipped to address some of these unique mental health needs that have emerged within the correctional facilities. [Asking] how do they a"] [18.100963592529297, 3.9896137714385986, "cing) rather than cancelling,\u201d and to \u201cbal- ance infection control measures (e.g., social distancing, group cancellations) with measures to maintain psychiatric stability, recognizing that in some cases the exacerbated mental illness may pose a great"] [17.89653968811035, 3.8196680545806885, "bilities [for virtual technology for] delivering academic edu- cation. We have many relationships with outside colleges. They\u2019re not coming in yet. We\u2019re looking to leverage our tablet technology, we\u2019ve connected with a secure mes- saging [platform] "] [18.023300170898438, 3.7929325103759766, "s noted that this increased communication\u2014directly from inmates to their families and others\u2014helped control the spread of rumors about conditions within the facility that caused problems in some areas, given trust and other issues that could affect t"] [18.025524139404297, 3.813868999481201, "cation [for video visits]. So that pushed us to accepting family members being able to [join a video] visit [from] a website or their phone. . . . [The pandemic] forced us to move a little quicker. We would have been apprehensive. We would have been "] [18.14748764038086, 3.9751837253570557, "ing for many years because of the difficulty of the job, compensation, and stress.75 In the COVID-19 pandemic environment, the potential for staff to become infected at work and bring the virus home to their families did not make the career more attr"] [18.15462875366211, 4.013452053070068, "he pandemic, however, the risk of infection was real, and panel members raised the issue that corrections workers (both before and during the pandemic) are not given the same recognition and respect as other first responders. Contractors within facil"] [18.132020950317383, 4.014957904815674, ", and issuing PPE.77\nHealth Screening\nOne goal of resident intake was to keep COVID-19 out of facilities, and, similarly, processes were put in place to screen staff members for symptoms before entry and to encourage staff who did not feel healthy to"] [18.163822174072266, 4.0183234214782715, "d of forced us to allow more of the staff to work from home. We were issuing laptops right and left, and . . . identifi[ed] employees who had the capa- bility to work from home. I don\u2019t think some of that is [ever] going to go away. I think we\u2019re goi"] [18.13546371459961, 4.024904251098633, "t now we\u2019re having a hard time with that. It seems like we\u2019re in that struggle where they just don\u2019t want to do things because we\u2019re asking them to do it, and have forgotten about COVID and the importance of wearing masks. . . . So trying to get them"] [18.123868942260742, 3.9735565185546875, "gs that we\u2019re accustomed to doing and have to do, but [dealing with] COVID on top of that. Because COVID is just a full-time job for everybody.\n\u2013 Institutional corrections panelist\n 81 See, for example, Dionne Hart, \u201cHealth Risks of Practicing Correc"] [18.146764755249023, 3.9358818531036377, " Echoing points made by law enforcement, institutional corrections panelists noted that it was inappropriate for an individual officer\u2019s decision to arrest someone to lead to them being detained for a significant period without their day in court.\n17"] [18.11994743347168, 3.9618613719940186, "uld feel more educated, informed, more sense of control about what\u2019s going on in the world.\n\u2013 Institutional corrections panelist\nAlthough external oversight and advocacy are important for catalyzing system change, practitioner participants expressed "] [18.135343551635742, 3.9195213317871094, " It\u2019s nothing different than what hospitals are doing and, yeah, we get the inmates complaining and making phone calls and sending out messages on how cruel we are and how we\u2019re treating them. We have to explain what we\u2019re doing a lot to the courts a"] [18.152755737304688, 3.9400691986083984, " corrections funding based only on short-term reductions in population would sacrifice the chance to make progress on outcomes, and\u2014if progress can be made\u2014to potentially realize more-substantial future efficiencies and cost savings resulting from le"] [18.15818214416504, 3.9991626739501953, "le bit of a phenomenon that occurs when you have this kind of threat to the entire system that I think people\u2014and, when I say people, I mean all staff, all incarcerated individuals\u2014understand . . . the risk. That this virus is not going to differ- en"] [18.015451431274414, 3.8248472213745117, "nit, where we have a lot of folks with . . . really the tougher cases of mental illness, but who can survive in a more social setting instead of just a lone cell or a two-man cell, that\u2019s worked out very well. We can get them services on the floor, e"] [18.136587142944336, 4.014991760253906, "ly would have never considered it and certainly not to the magnitude that we have.\n\u2013 Institutional corrections panelist\nTo the credit of the courts, this has been a great impetus for change, for things that we\u2019ve been pushing for decades: doing more "] [18.149002075195312, 3.973970413208008, "heir disaster planning pro- cess. . . . If necessary, state governors should compel area hospitals to accept patient transfers when needed.\u201d87\n It seems so obvious to me now that we should be having quarterly meetings with all these hospital administ"] [18.116666793823242, 3.8359944820404053, " corrections panelist\nThe broader outcomes of this strategy\u2014beyond enabling more distancing and infection control within facilities\u2014have not yet been fully assessed. However, like in other panels, there was a general view among our panelists, based o"] [18.129512786865234, 3.943369150161743, "19\u2014will then become a research opportunity.\n A number of states are tracking recidivism rates specifically for those populations that qualified for early release under COVID. So [I] think it will be interesting. I know a lot of states are looking to "] [18.104734420776367, 3.9217443466186523, "riences?\n\u2022 What have been the mental health effects of the pandemic on both incarcerated popula-\ntions and correctional staff, and how long do such effects last?\n\u2022 What disease-testing strategies are effective in minimizing infectious disease in corr"] [17.978294372558594, 3.9136815071105957, "munity supervision agencies\u2014and service providers both inside government (e.g., departments of public health or other social services agencies) and outside government (e.g., nonprofit service providers, medical and other treatment organizations, fait"] [17.932260513305664, 3.9099059104919434, "l routes to further reform and improve the supervision system.\n\u2022 Meeting the needs of individuals receiving treatment for substance use or mental health concerns was more difficult, requiring significant changes in models for treatment delivery.\n\u2022 Co"] [18.06504249572754, 3.9442121982574463, "vely support reentry and desistance from recidivism. Treatment for mental health, addiction, and other concerns often is delivered in group settings, both to make it possible to help more people and because of the group dynamics and support that can "] [18.057870864868164, 3.88724684715271, "corrections panelist\nPanelists from service-provider organizations also identified instances where they were called on to contribute in unusual ways, playing backfill and other roles where needed.\n One of the advantages of being a nonprofit is that a"] [18.104148864746094, 3.935089588165283, " mem- bers of the community corrections panel noted that, at least initially, the assumption that the COVID-19 pandemic would be a short-term crisis versus a very long-term challenge affected how they planned and responded. For this sector, this diff"] [18.056991577148438, 3.9543683528900146, "y cited totals of practitioners who have lost their lives to COVID-19.9\n The first week, one of my offices had a staff meeting in a courthouse jury room with the entire office in there for four hours. And after the staff meeting, one of the people te"] [17.96115493774414, 3.680262804031372, "ment on individuals and communities.\nCorrectional Populations, Agencies, and Service Providers Face Significant Digital Divides\nOne common problem for both supervision and service delivery was a significant digital divide, which was a challenge acros"] [17.93478012084961, 3.668536424636841, "enter- ing populations\u2014notably housing instability\u2014were mentioned as contributing to the digital divide: If someone did not know where they would be living from day to day, they would have similar uncertainty about their ability to connect to the int"] [17.99106216430664, 3.863438606262207, "idth. Increases in use from many government agencies simultaneously swamped net- work capacity in some cases.16\n If you\u2019re paper-based, it\u2019s difficult to telework. If you have, you know, 135,000 files that haven\u2019t been scanned.\n\u2013 Community correction"] [18.14112091064453, 3.937385082244873, " Measures to Coronavirus for Parole, Probation, and Clemency, Brooklyn, N.Y., March 18, 2020.\n 190 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nguidance on how to \u201cration\u201d supervision and time resources in the event that caseloads "] [17.96780776977539, 3.8915536403656006, ", Md., September 18, 2020.\n22 ExiT: Executives Transforming Probation and Parole, undated.\n23 Swan, Campbell, and Lowe, 2020, p. 4. See also United States Courts, 2020a, for a discussion of virtual home visits\nusing video streaming apps.\n24 National "] [17.98603057861328, 3.8867790699005127, "ent\u2019s home, we made exceptions to those rules so we could maintain the six feet or more social distancing when we saw the clients in the field. That made a huge difference. I mean, if you go in a parole office today, when you would normally have 20 t"] [17.971649169921875, 3.8887457847595215, "and batteries dying\u2014and because they usually must be inspected to ensure that they are still being worn by the individual, have not been tampered with, and are func- tioning as expected\u2014contact might be required to keep a device running even after it"] [17.963302612304688, 3.7913942337036133, "the use of drug test- ing, and the National Partnership for Pretrial Justice data call found similar results.29 In some cases, respondents made infrastructure changes (e.g., adding a window to restrooms) so that collections could be observed while ma"] [17.9772891998291, 3.9123170375823975, " incarcerated populations.35 In both the APPA/Abt Associates and National Partnership for Pretrial Justice data, on the order of half of respondents indicated that their agencies had suspended or reduced revocations of supervision for most violations"] [17.981204986572266, 3.8789279460906982, " 2020, the Council of State Governments found that three-quarters of the 126 programs that responded to their call for information had either \u201cstopped providing some services or closed operation entirely.\u201d42 The majority of the respon- dents to the d"] [18.001663208007812, 3.8552944660186768, "act of COVID-19 on the economy and certain occupational sectors, voca- tional service providers have also had to adapt services. For example, distance learning was being used to provide some vocational training as a replacement for transitional jobs."] [17.961626052856445, 3.910501003265381, "ction in activity, has reduced the services, and that\u2019s been very significant in terms of counseling, in terms of reentry, in terms of all kinds of things.\n\u2013 Community organization panelist\nWhat we\u2019re seeing is rising need. We\u2019re seeing rising need a"] [17.945281982421875, 3.9637527465820312, " continuity, in some cases, institutional correc- tions agencies sent individuals home with a longer supply of needed medications and with a prescription to allow for more time to connect with care as part of reentry supervision.53\n One of the things"] [17.952251434326172, 3.9558959007263184, "sily and safely transitioned back into the community was, for many jails, a barrier to letting people with serious mental illnesses go, even if they met the local juris- diction\u2019s assessment of charge and risk that would have allowed them to be relea"] [17.920103073120117, 4.0154547691345215, "ere using tele- health services for substance use treatment.60 In addition, mirroring the effort to not reincar- cerate people because of technical violations of their supervision, in some areas, there were efforts that sought to limit reincarceratio"] [17.953813552856445, 3.9580440521240234, "nd agility at which governmental systems and regulatory bodies move to respond to conditions on the ground. And many times, we\u2019re seeking guidance\u2014sometimes per- mission\u2014and support to carry out our work or even sometimes broaden our scope of work. A"] [17.962373733520508, 3.9258928298950195, "s. And their skill sets may not be aligned with the new economy as it ramps up, and they\u2019re going to be the last ones hired anyway. So what is that going to do? Our officers are scrambling a little bit about, where do I focus now? . . . But really eq"] [17.994787216186523, 3.91078782081604, "al things?\n\u2013 Community corrections panelist\n Community Corrections: Supervision and Service Provision 203\nof shelters that had to be shut down because of infection.68 And if people in transitional hous- ing do not have places to which to transition, "] [17.996828079223633, 3.9049954414367676, "ty Struggles to Stop Covid-19\u2019s Spread,\u201d The New School, Center for New York City Affairs, May 5, 2020.\n73 Steve Bullock, Governor, State of Montana, \u201cDirective Implementing Executive Orders 2-2020 and 3-2020 Related to State Correctional and State-C"] [17.98401641845703, 3.862273693084717, " prior to this, we were only spending six minutes of time per offender [in] face-to-face field contacts. Virtually, on average, we were spending 23 minutes of time with these individuals. So obviously, core correctional practices, the more time you s"] [17.944501876831055, 3.872603416442871, "ommunity corrections leaders could place clients virtually in programs anywhere in their state, which could make it possible to get treatment started much more rapidly.78\nVirtual models also had convenience and other benefits for supervisees. Just as"] [17.956993103027344, 3.83479905128479, " strengthen some of the relationships that we had with our clients.80\nThat comfort and the willingness to open up has the potential to make supervision more effective and improve the benefits clients get from the process.\n On the client side . . . we"] [18.03350830078125, 3.854240655899048, "een able to shower. There are huge things we cannot do. And our dose of contact has diminished dramatically. So there are things we\u2019ve learned. There are things we\u2019re not going to do again, if we can possibly get out of them.\n\u2013 Community corrections "] [17.992069244384766, 3.8495306968688965, "ll areas, the requirement to minimize risk by distributing the workforce reduced resistance to flexible working models in some agencies.\n People have been pressing us [to be] able to work from home, especially in investiga- tions and that kind of stu"] [17.985307693481445, 3.8348729610443115, "Community corrections panelist\nBecause of the connections among components of the justice system, virtualization in the courts also affected community corrections. Panelists made similarly positive points about the convenience and savings associated "] [18.045841217041016, 3.943459987640381, "els.\n We took into consideration appropriate PPE, like everyone else has done, [but] kind of slowly went that way. I remember back in March where like nobody [was wearing] a mask, we tried to follow the CDC guidelines. And then it made us sound like "] [18.02031135559082, 3.894125461578369, " also increased work stresses because supervisees calling at odd hours made it more difficult for practitioners to maintain a separation of work and home life.\n We joked, \u201cHey, telecommuting is fun when it\u2019s your choice, but nobody\u2019s liking it right "] [17.997913360595703, 3.9018239974975586, "nches of the justice system. Immediate actions taken to reduce infection risk (e.g., by increasing releases form jails and prisons) meant that an initial wave of supervisees came to the community cor- rections system. However, in the longer term, the"] [18.0164852142334, 3.861067771911621, "at midnight that don\u2019t have a place to go. I mean, it\u2019s almost cruel. Not everyone has family to pick them up. Not everybody has transportation. Some of the shelters were shut down. Some of the nonprofits really did take a long time to be able to shi"] [17.970314025878906, 3.899528741836548, "ppen when the courts open back up and we have to be prepared to absorb those high volume of cases? I think we\u2019ve been around long enough that there\u2019ll be a lot of blue-light specials going on just to move them onto our caseloads. And we certainly hav"] [18.076026916503906, 3.842404842376709, " improve the perceived legitimacy of anti-crime efforts.91\nSuch cuts also have hindered some agencies\u2019 ability to shift to technology approaches that would make it easier for them to continue operating effectively through the pandemic. As a result, t"] [18.01911163330078, 3.929957389831543, "agues found that the suspension of fee collection was relatively rare, although a larger number of agencies were not issuing violations for late fee payment.93\nOur participants emphasized that the consequences of these resource shortfalls could be di"] [18.057104110717773, 3.857442855834961, "think having a broader swath of concern than your individual agency is really important right now, protecting the services that you rely on is really important.\n\u2013 Community corrections panelist\nTaking Stock and Moving Forward\nThe effects of the pande"] [17.981924057006836, 3.852494716644287, "ut . . . pretty much continue [their] work unabated.\u201d\n The best thing about this, it\u2019s made us realize that you have to adapt to situations. Not that you hope for a pandemic, but . . . this has given us an opportunity to do things which maybe should "] [17.977827072143555, 3.8473594188690186, "f virtual models while minimizing potential concerns about efficacy.\n To be able to have the conversations and the connections virtually you have to have had a relationship first. I think it\u2019s much harder to build that first relationship phase virtu-"] [17.95254135131836, 3.914452075958252, "chool resistance prevailed,\u201d now we\u2019re really considering it. And it could be that it\u2019s the best approach.\n\u2013 Community corrections panelist\nIn looking toward the future, participants viewed the cost pressures created by the pan- demic as a likely imp"] [18.004003524780273, 3.8914573192596436, "ments around showing that supervision did not have to be done in a community corrections office or other facility\u2014and that what probation officers and service providers did was about the people being served and not the place where that service was be"] [17.93006134033203, 3.893824577331543, "rking that way in a . . . lot of places in the United States. And so the big picture for me is post-pandemic we\u2019re not going to try to go back to exactly what we were before. . . . And we\u2019ve learned that there are these populations that were in jail "] [18.01580047607422, 3.8146939277648926, "that the softer side of me is shown when I\u2019m working with people,\u201d because they\u2019re really understanding that not only is it hard for just every- body, but it\u2019s particularly hard for people who have criminal records, for people who have already diffic"] [18.009593963623047, 3.8942923545837402, "re not on the medicines, you\u2019re going to have bad outcomes. So if you can keep the focus on that, they may not need your [community corrections] services. Likewise, somebody who\u2019s got a mental illness but is not getting the help they need for their m"] [18.00010108947754, 3.79364013671875, ". . . I worry about misuse of data. In New York State [we] have seen major bail reform. And what we\u2019ve seen is misuse of data, blaming rise in violence on bail reform. When the numbers just don\u2019t bear it out, but it works as a story and it works in t"] [18.03418731689453, 3.7405145168304443, "228 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nmental health practitioner, direct provision of food assistance\u2014which was risky for both the individuals needing support and the paid staff or volunteers involved in delivering that "] [18.039461135864258, 3.7398390769958496, "ed many victim needs. Such actions as stay-at- home orders appear to have pressurized domestic violence or family abuse situations; they also made it more difficult to identify cases of abuse and for victims to reach out for help. Such\ncrimes as iden"] [18.039119720458984, 3.739206314086914, "forcement agencies within those regions in general.\n\u2013 Victim services panelist\n230 The U.S. Criminal Justice System in the Pandemic Era and Beyond\nThe actions of the remainder of the justice system are shaped by existing inequalities and structural i"] [18.02587127685547, 3.749258279800415, "hey are not] get getting the assistance. It\u2019s just another barrier for them.\n\u2013 Victim services panelist\nThe challenges created by the pandemic for providers of victim services required signifi- cant innovation and adaptation.1 Such groups and agencie"] [18.019620895385742, 3.7302825450897217, "ecca Pfeffer, Impact of COVID-19 on North Carolina\u2019s Victim Service Providers, Washington, D.C.: RTI International, 2020.\n232 The U.S. Criminal Justice System in the Pandemic Era and Beyond\n I think it\u2019s creating unprecedented times for us to adapt o"] [17.968639373779297, 3.71886944770813, "the transition to virtual operations was much easier for organizations that had made previous technology investments and were not starting from limited capability when the pandemic hit. The smoothest transition required an organi- zation to already h"] [17.978681564331055, 3.712474822998047, "emic Era and Beyond\narea where a phone conversation could be held without being overhead.5 However, even ubiq- uitous methods, such as texting, have cybersecurity vulnerabilities; abusers could use various types of spyware or tracking software \u201cto co"] [18.00014877319336, 3.7229983806610107, "o services, giving victims more control over how they participate, who they have with them when they participate, when they talk to people [and] for how long, [and] that\u2019s been an incredibly positive thing that\u2019s come out of it.\n\u2013 Victim services pan"] [17.963924407958984, 3.6931488513946533, "ound over time.\n Most of the providers that we work with have tried to move to remote services, but had to restrict intakes. . . . I think they\u2019re focusing their responses on folks who are coming back into contact, and those cases that they have with"] [17.961315155029297, 3.7220351696014404, "stributing solar chargers so that individuals without stable housing still had access to their mobile devices and could stay in touch with outreach teams and caseworkers.\u201d10 Such efforts are needed because if the populations that services are intende"] [17.93712615966797, 3.687403678894043, "hing is done remotely. So the technology gap has been really spotlighted on the fact that many people do not have access to the internet. They don\u2019t have computers at home. They don\u2019t know how to navigate through setting up a Blue Jeans call or [othe"] [17.961414337158203, 3.7297723293304443, "tion with both parents and siblings can be arranged and moni- tored by the person in charge of supervision so that the visit can be controlled and recorded if required (this is particularly easy with software such as Zoom). Conferencing can also be u"] [18.00872802734375, 3.786694288253784, "he \u201cpotential for permanent psycho- logical harm if children are unable to see their parents and siblings, especially during a time of crisis, and call for continued in-person visits in lower risk cases, based on guidance from public health officials"] [18.049463272094727, 3.734260320663452, "v- ernment]\u2014reaching those in the community to let them know that the police were still responding, that shelters were still open, the hotline was still available 24/7, that you could still, even though the courts shut down, you could still petition "] [18.015697479248047, 3.756667137145996, "to be tested, providing an alternative opportunity to reach victims who might be sheltering with their abusers.\n Some places worked really hard to let people know that \u201cshelters were still open, that they would put you up in a hotel if they would nee"] [17.985157012939453, 3.787126064300537, "ustrophobic behind the mask. Mask-wearing also was cited as a cause of serious stress for some people of color because of concerns about interacting with police and others with their faces covered and about how it would be perceived.\nConstraints arou"] [17.997922897338867, 3.7798221111297607, "from two hotel brands and, with a service provider on the ground, we\u2019re able to coordinate and provide hotel stays for people kind of as a stop- gap between accessing some sort of more stable housing situation. Pre-pandemic, a lot of what we saw was "] [18.006336212158203, 3.7751169204711914, "heir cars to get away from the abusers.\n\u2013 Victim services panelist\n We also have a lot of sites where there\u2019s not a lot of redundancy in victim service pro- grams, so there\u2019s only maybe two victims service providers for an entire agency. And we\u2019ve ha"] [17.986492156982422, 3.8116977214813232, "have the time and resources to develop safety plans. One panelist said that it would be \u201cuntenable\u201d for them to go back to in-person options. Given the demands on their time in attempting to serve their backlog of clients, there is simply not time av"] [18.03628921508789, 3.7579705715179443, "s impact. Working from home increases the difficulty in separating work life from home life, potentially magnifying stress. Because many provider staff members also are members of minority groups, the national protests focused on social justice and e"] [18.023324966430664, 3.762089490890503, "e terrified at the idea of residents being able to kind of come and go on their own and potentially bring the virus back in. So we\u2019re still trying to figure out when we reopen . . . what that means now that the [state-imposed] restrictions are a litt"] [18.008155822753906, 3.7576446533203125, " hire skilled staff who were laid off by financially struggling hospitals. Finding staff who are already trained is valuable; panelists cited similar challenges to other justice agencies in onboarding and hiring new employees. In this case, the chall"] [18.03592872619629, 3.7254576683044434, "icipation during COVID, [with] most of them citing a risk level that they weren\u2019t willing to take on for nonemployed personnel. . . . And that of course affects service [delivery].\n\u2013 Victim services panelist\nThere are some programs that eliminated se"] [18.040725708007812, 3.7095019817352295, "rsus a patrol response unit, many of the investigators were [reassigned to] frontline positions. They were taken off inves- tigative details. . . . And [the victim service personnel] weren\u2019t reassigned along with the investigator or sworn personnel t"] [18.03744888305664, 3.731456756591797, "rimes that were deprioritized were \u201cless serious,\u201d that did not mean that they did not have victims and, as a result, the decision to take broad categorical action to limit case flow by offense type missed key individual differences that might exist "] [18.069507598876953, 3.7658448219299316, "m notification, or making the victim aware that the accused, who might have been arrested only hours before, was already being released as a result of pandemic limitations on jail custody. In addition to citing examples where this did not happen, pan"] [18.044086456298828, 3.7373037338256836, "conomy, we\u2019re anticipating\u2014it hasn\u2019t happened yet, knock on wood\u2014 that we\u2019re going to see hits to our budget. It\u2019s going to impact staffing and also [funds available for client assistance]. . . . So as the need goes up, sadly, the funding will poten-"] [17.993070602416992, 3.754199504852295, "nks so that people can wash their hands and not have to go into the bathroom\u201d . . . or \u201cWe need to get rid of carpeting and put down like laminate flooring to be able to just kinda hose it down with Lysol.\u201d Normally you would work with a local plumbi"] [18.02719497680664, 3.749208927154541, "that hadn\u2019t worked with [Housing and Urban Development] funding before, it\u2019s hard.\n\u2013 Victim services panelist\nSites have been reporting to us that a lot of people doing the work aren\u2019t necessarily specialized in understanding grant processes, procure"] [18.020158767700195, 3.7434463500976562, "he pandemic that appeared valuable to carry forward than members of our other panels. However, the pan- elists did note the importance of partnerships and collaborations in accessing resources and facilitating service delivery in ways that would not "] [18.038240432739258, 3.680938482284546, "e who might not otherwise have been identified, and therefore would not have been served previously. One of our panelists pointed out that the only crime\u2014and, therefore, the only victims\u2014the criminal justice system is aware of are the ones that get r"] [18.06707000732422, 3.723047971725464, "parts of the justice system, the pressures of the COVID-19 pandemic were seen by panelists as pushing changes that have been considered in the broader context of crimi- nal justice reform. This was less the case for victim services, which is not surp"] [18.064577102661133, 3.729390859603882, "r that\u2014of the three perspectives on change in the justice system: justice agencies, justice-involved individuals and their communities, and victims of crime\u2014the needs of the latter might have been the least considered or reflected in the strategies f"] [17.953075408935547, 3.677579164505005, "essed in research and evaluation studies?\n\u2022 Given concerns about the digital divide significantly affecting the ability of victims from locations with low broadband or little communications infrastructure accessing services and participating in the j"] [18.10093116760254, 3.7140631675720215, "rly on you, on your department, on the system as a whole, [and so] it\u2019s a very, very risk-averse system.\n\u2013 Community organization panelist\nOur parole board, they were slapping GPS on every single person they parole . . . [because they] were fearful o"] [18.056398391723633, 3.7590370178222656, "tter response to such concerns as domestic violence going forward. The nature of the pandemic created needs within the justice system, causing stress among incarcerated indi- viduals and practitioners across justice organizations that built on simila"] [17.947446823120117, 3.671098232269287, "ned that\u2014particularly for counseling and service delivery\u2014the effectiveness of virtual modes might not be suf- ficient. And although there are clearly some types of virtual interactions and processes that are entirely unproblematic (e.g., providing i"] [18.112537384033203, 3.684309959411621, " agencies (National Commission on COVID-19 and Criminal Justice, 2020b, p. 33).\n 266 The U.S. Criminal Justice System in the Pandemic Era and Beyond\npart of the system affected others and, although those choices might have been unavoid- able in the f"] [18.113861083984375, 3.674513339996338, "do, including the choice to not arrest many people and not require many individuals to complete their original sentences or periods of detention for some crimes and violations. Lessons can be learned from\n3 One of the final recommendations of the Nat"] [18.115171432495117, 3.6498167514801025, "ightened the touch of the justice system on society for an extended period. As more than one of our panelists observed, those changes were in line with reforms that some organizations and communities have argued should be made for some time. Their im"] [18.080318450927734, 3.7991232872009277, " concerns about to better understand of the pandemic on and ethnic groups on different racial the burden of dis- \u2022 What have been the populations and cor- and disparities in rectional staff, and both incarcerated how long do such ease across demo- in"] [18.101520538330078, 3.7566909790039062, " their abil-\nity to contribute to\nHave more-trusted\nplay in public health\npolice is appropriate\ntions and categories\ndepartments been\nsensitive data or other\ncould productively\nresources to enable\nplan for future pan-\nconflicts and impreci-\nsion in p"] [18.11035919189453, 3.7956299781799316, "e distin- tural or other retro- on the capacity of carceral facilities\u2019 \u2022 How has the reduc- \u2022 Are there architec- tional institutions of the changes made effects of other ini- already underway in tion affected crime tion in detention, fitting option"] [17.940414428710938, 3.6337380409240723, " effective are virtual assessment of the impact with providers using per- low broadband or little communications infra- vices remotely? Similar models for delivering better mapped to inform comes (including virtual services to victims, and the justic"] [17.987363815307617, 3.729954242706299, " technologies\ndispatchers to work\namong different\nprovision of virtual\nalternative models\ndiffer from those of\ntrained in person?\n\u2022 Did digital divides\nWere alternatives\nofficers who were\nremotely)?\nresources?\nAssessing virtual justice services deliv"] [18.0853328704834, 3.6464807987213135, " in the lives of the poorest people in the community. But there\u2019s also tremendous resistance. . . . I think it\u2019s going to be up to researchers to be able to really evaluate the impact of COVID and bail reform and these arguments around police legitim"] [18.12854766845703, 3.7474310398101807, "community organizations panelist in the introduction to this report noted, there are at least the following three fundamental perspectives from which such changes need to be examined:\n\u2022 the justice system itself and how changes affect its functioning"] [18.091331481933594, 3.774597644805908, "ing. As a result, in considering the path forward, how major changes affect different populations served by the justice system will be important.\nHowever, even with the difficulty in finding changes that meet the needs of all three of these groups si"] [18.102169036865234, 3.7871243953704834, "This is an opportunity to the extent that it allows us to thin [the] prison population, have people put onto supervision, and then also give supervision a chance to thin those people that they cannot manage because of the numbers that are being relea"] [18.100921630859375, 3.736280679702759, "t of the system that will mean that the justice system\u2019s recovery will be a long- term process. That recovery will be complicated by the scars that the pandemic almost cer- tainly will leave on municipal budgets, on the philanthropic funding streams "] [18.06102752685547, 3.733368158340454, "ustice in the hope that any future infectious disease outbreak will find a system that is better positioned to weather the storm.\nMany of the responses by justice agencies to the COVID-19 pandemic came out of policy experiments and innovations that e"] [18.05014991760254, 3.6633942127227783, "lic safety and fairer to those who become justice-involved. In our discussions, panelists talked about the inherent tensions that exist within the system between the desire to craft justice interventions that are effective at the individual level and"] [17.549060821533203, 8.263882637023926, "ciation\nSan Diego County Sheriff\u2019s Department (California)\nNew York City Department of Probation\nMaryland Parole Commission and International Association of Paroling Authorities\nBowling Green State University\nUniversity of Florida\nThe Safe Sisters Ci"] [18.273420333862305, 3.9531357288360596, "Community Supervision\nMichigan Supreme Court\nNicoletti-Flater Associates\nFayetteville Police Department (North Carolina)\nAlameda County District Attorney\u2019s Office and California District Attorney Association\nFortune Society\nGeorgia Southern Universit"] [18.262069702148438, 3.935512065887451, "ber 8, 2020: https://www.americanbar.org/advocacy/the-aba-task-force-on-legal-needs-arising-out-of-the-2020-pandem/\nAmerican Correctional Association, \u201cThe Wall of Honor,\u201d webpage, undated. As of December 7, 2020: http://www.aca.org/ACA_Prod_IMIS/ACA"] [18.258752822875977, 3.940838098526001, "ries 616, 2020.\nBella, Timothy, \u201cA GOP Sheriff Vowed Not to Enforce Arizona\u2019s Coronavirus Restrictions. Now He\u2019s Tested Positive,\u201d Washington Post, June 18, 2020.\nBender, Adam, \u201cCOVID-19 Could Change Views Toward Remote 911 Operators,\u201d Communications"] [18.23419761657715, 3.9754621982574463, " \u201cCourt Adaptations During COVID-19 in the World\u2019s Two Largest Democracies,\u201d SSRN, May 24, 2020.\nCarter, TaLisa J., \u201cCOVID-19 in the Common Area: The Pandemic Is Reinforcing the Interconnected Nature of Corrections,\u201d Urban Wire blog, June 16, 2020. A"] [18.255773544311523, 3.950929641723633, "sponse to COVID-19,\u201d MacArthur Foundation Safety and Justice Challenge blog, April 8, 2020. As of December 8, 2020: https://www.safetyandjusticechallenge.org/2020/04/how-interagency-trust-can-foster-an-optimal-jail-respon se-to-covid-19/\nReferences 2"] [18.29490089416504, 3.940613031387329, "nse in New York City: Initial Lessons,\u201d Journal of Applied Gerontology, Vol. 39, No. 7, July 1, 2020, pp. 690\u2013699.\nEmezue, Chuka, \u201cDigital or Digitally Delivered Responses to Domestic and Intimate Partner Violence During COVID-19,\u201d JMIR Public Health"] [18.29300880432129, 3.912914752960205, "ucts/wmd-equipment/ppe/articles/ face-masks-heres-what-cops-firefighters-medics-and-cos-have-to-say-about-use-policy-and-effectiveness- oy4meLGHK1wzg57H/\nFTC\u2014See Federal Trade Commission.\nGonzalez, Jennifer M. Reingle, Rebecca Molsberry, Jonathan Mas"] [18.295860290527344, 3.9298624992370605, "y, \u201cRural Victimization and Policing During the COVID-19 Pandemic,\u201d American Journal of Criminal Justice, Vol. 45, July 17, 2020, pp. 731\u2013742.\nHart, Dionne, \u201cHealth Risks of Practicing Correctional Medicine,\u201d AMA Journal of Ethics, Vol. 21, No. 6, Ju"] [18.29269790649414, 3.9427311420440674, "e to COVID-19,\u201d webpage, April 15, 2020c. As of December 8, 2020: https://www.theiacp.org/resources/document/law-enforcement-officer-exposure-to-covid-19\nInternational Association of Chiefs of Police, \u201cSupporting Victims of Domestic Violence During t"] [18.279232025146484, 3.9382617473602295, "olicy Community of Practitioner-Scholars,\u201d Police Forum, Vol. 29, No. 1, April 2020, pp. 48\u201353.\nJones, Van, \u201cAtlanta Police Shooting Is About Probation, not Just Police,\u201d CNN, June 18, 2020.\nJordan, Alison O., and Melvin H. Wilson, Addressing COVID-1"] [18.31630516052246, 3.9669084548950195, "ovid-rules/\nLageson, Sarah Esther, \u201cThe Perils of \u2018Zoom Justice,\u2019\u201d The Crime Report, September 1, 2020.\nLantz, Brendan, and Marin R. Wenger, Bias and Hate Crime Victimization During the COVID-19 Pandemic,\nTallahassee, Fla.: Florida State University C"] [18.256744384765625, 3.9666502475738525, "ersity, June 25, 2020b.\nMarcum, Catherine D., \u201cAmerican Corrections System Response to COVID-19: An Examination of the Procedures and Policies Used in Spring 2020,\u201d American Journal of Criminal Justice, Vol. 45, 2020, pp. 759\u2013768.\nThe Marshall Projec"] [18.278852462768555, 3.9635326862335205, "nd\nMonares, Freddy, \u201cBozeman Attorneys Quarantining After Defendant Tests Positive,\u201d Bozeman Daily Chronicle, July 10, 2020. As of December 8, 2020: https://www.bozemandailychronicle.com/coronavirus/ bozeman-attorneys-quarantining-after-defendant-tes"] [18.290117263793945, 3.9730467796325684, "sion COVID-19 Guidance and Tips, Washington, D.C., 2020.\nNational Emergency Number Association, How 9-1-1 Is Changing in a COVID-19 World: 9-1-1 and COVID-19 Report Series, Alexandria, Va., May 8, 2020.\nNational Law Enforcement Officers Memorial Fund"] [18.263769149780273, 3.940159559249878, "ptember 17, 2020.\nNew Jersey State Bar Association, Report of the Committee on the Resumption of Jury Trials of the New Jersey State Bar Association Pandemic Task Force: Part Two, New Brunswick, N.J., September 2, 2020a.\nNew Jersey State Bar Associat"] [18.29737091064453, 3.898494243621826, "n K., \u201cCriminals Work from Home During Pandemics Too: A Public Health Approach to Respond to Fraud and Crimes Against Those 50 and Above,\u201d American Journal of Criminal Justice, Vol. 45, 2020, pp. 563\u2013577.\nPERF\u2014See Police Executive Research Forum.\nPhi"] [18.26596450805664, 3.952831745147705, "t - 3 9 5 6 6 5\nReed, Allie, and Madison Alder, \u201cVirtual Hearings Put Children, Abuse Victims at Ease in Court,\u201d Bloomberg Law, July 23, 2020. As of December 8, 2020: https://news.bloomberglaw.com/us-law-week/virtual-hearings-put-children-abuse-victi"] [18.270137786865234, 3.9514987468719482, "s://www.rand.org/pubs/research_reports/RR3213.html\nRusso, Joe, Dulani Woods, John S. Shaffer, and Brian A. Jackson, Caring for Those in Custody: Identifying High-Priority Needs to Reduce Mortality in Correctional Facilities, Santa Monica, Calif.: RAN"] [18.27889060974121, 3.9319775104522705, " Face One-Two Punch: Defund Protests and Coronavirus,\u201d NBC News, June 28, 2020. As of December 8, 2020:\nhttps://www.nbcnews.com/politics/politics-news/ police-departments-face-one-two-punch-defund-protests-coronavirus-n1232182\nSmith, Carl, \u201cAll Rise:"] [18.29408836364746, 3.9719057083129883, ", and Grace Kao, \u201cThe Anxiety of Being Asian American: Hate Crimes and Negative Biases During the COVID-19 Pandemic,\u201d American Journal of Criminal Justice, Vol. 45, 2020, pp. 636\u2013646.\nUCLA\u2014See University of California, Los Angeles.\nUnited States Comm"] [18.292308807373047, 3.9510653018951416, "Guidance for Preventive and Responsive Measures to Coronavirus for Parole, Probation, and Clemency, Brooklyn, New York, March 18, 2020.\nVermeer, Michael J. D., Dulani Woods, and Brian A. Jackson, Would Law Enforcement Leaders Support Defunding the Po"] [18.317781448364258, 3.9836223125457764, ",\u2019\u201d The Marshall Project, June 9, 2020. As of December 8, 2020: https://www.themarshallproject.org/2020/06/09/ have-covid-19-cops-may-have-your-neighborhood-on-a-heat-map\nWelsh-Huggins, Andrew, \u201cIn Cities Across U.S., Voters Support More Police Overs"] [18.14851188659668, 3.8267576694488525, "ericans focused attention on equity and fairness in the justice system, resulting in significant pressure for reform.\nThe conditions faced by organizations across the justice system differed widely, and responses to address the risk of infection vari"] [-3.0070154666900635, 8.837162971496582, " Societal Impact of\nResearch Funding for\nWomen\u2019s Health\nIN ALZHEIMER\u2019S DISEASE AND ALZHEIMER\u2019S DISEASE\u2013RELATED DEMENTIAS\nMatthew D. Baird Melanie A. Zaber Andrew W. Dick Chloe E. Bird Annie Chen\nMolly Waymouth Grace Gahlon Denise D. Quigley Hamad Al-"] [-2.997518301010132, 8.849261283874512, "thewhamreport.org/report/brain to learn more about using these data and citing this report.\n WHAM\u2019s LEAD PARTNERS\nWHAM\u2019s sponsorship of this research project was enabled through the generous financial support from the following partners.\nAmerican Hea"] [-3.0039355754852295, 8.841980934143066, "M BOARD\nCarolee Lee, Founder and Chair\nFounder, AccessCircles, Founder and Former CEO of CAROLEE\nMeryl Comer, Vice Chair and Global Chair Co-Founder, UsAgainstAlzheimers/ WomenAgainstAlzheimers\nChair, Global Alliance on Women\u2019s Brain Health\nAnula Jay"] [-2.9987399578094482, 8.846661567687988, "omen\u2019s Hospital Paula A. Johnson Associate Professor of Psychiatry in the Field of Women\u2019s Health, Brigham and Women\u2019s Hospital\nDr. Wendy Klein, MD, MACP, Former Medical Director, Health Brigade\nDr. JoAnn Manson, DrPH, MD, Michael and\nLee Bell Profes"] [-3.0340232849121094, 8.804845809936523, "th Outcomes, Policy, and Economics (CHOICE) Institute, School of Pharmacy, University of Washington\nHadine Joffe, MD\nVice Chair for Research, Department of Psychiatry, Executive Director, Mary Horrigan Connors Center for Women\u2019s Health and Gender Bio"] [-3.03420090675354, 8.80453109741211, "h research.\nThe results establish the potential for investment in women\u2019s health research on AD/ADRD to realize gains beyond additional gen- eral research investment and point the way to a concrete, actionable research and funding agenda. Large socie"] [-3.035024881362915, 8.803679466247559, "n invest- ment. Leaders across multiple other business sectors need to understand the consequences of underinvestment for workforce productivity and the health care burden associated with AD/ADRD. These communities are key to informing future researc"] [-3.0506412982940674, 8.789103507995605, "ress the gap in knowledge about investment in women\u2019s health research (see, for example, Grant and Buxton, 2018). Women\u2019s health research as used in this report refers both to analyses that address sex and/or gender within general sample or populatio"] [-3.055283784866333, 8.7852201461792, " in health research gener- ally and women\u2019s health research in particular. The results using NIH funding levels can be considered a lower bound on the possibilities for research investment.\nThe goal of the analyses is to serve as a foundation for dev"] [-3.059558868408203, 8.780595779418945, "CH FUNDING FOR WOMEN\u2019S HEALTH IN ALZHEIMER\u2019S DISEASE AND ALZHEIMER\u2019S DISEASE\u2013RELATED DEMENTIAS\nExpenditures were estimated as a function of age, gender, care status, and disease severity. For example, severe AD/ADRD is asso- ciated with higher nursin"] [-3.055600643157959, 8.78430461883545, "acts, first separately and then assum- ing that all three impacts occur together:\n1. decreased age incidence of disease (probability of onset at a given age)\n2. delay in progression to more-severe levels of disease, with the assumption that innovatio"] [-3.057654619216919, 8.781597137451172, " billion dollars, and 12 percent of that amount was invested in women-focused projects in 2019, according to the method described in this section (NIH, 2020a; Sekar, 2020). Models examined a doubling of the 12 percent. All costs are presented in 2017"] [-3.0589065551757812, 8.777633666992188, "545\n\u20131,431\n \u2013894\n A 0.01 percent health improvement results in more than 5,500 fewer life years with AD/ADRD for women and nearly 900 fewer life years with AD/ADRD for men.\n FIGURE 3\nHealth and Economic Improvements for U.S. Population Age 35-Plus: "] [-3.058650255203247, 8.781012535095215, "over 30 years, in 2017 dollars. Approximately 40 percent of that cost reduction is a result of fewer nursing home stays. Noncare health care costs demonstrate a very small increase as a result of fewer years of formal institutional care. The costs of"] [-3.0582194328308105, 8.783041954040527, "der-neutral or gender-inclusive research yields results that are less applicable to women than to men. Assuming that women benefit from women-focused research investment at a rate of three to one com- pared with men may underestimate the actual benef"] [-3.058786392211914, 8.780588150024414, "erm outlook for treatments. Disease modification that yields a differ-\nent severity profile\u2014for example, longer time in moderate-to-severe\n22 SOCIETAL IMPACT OF RESEARCH FUNDING FOR WOMEN\u2019S HEALTH IN ALZHEIMER\u2019S DISEASE AND ALZHEIMER\u2019S DISEASE\u2013RELATE"] [-3.045781135559082, 8.793988227844238, "h. A key focus of this evaluation must be on the ways in which women\u2019s research careers are disadvantaged relative to men\u2019s because of family factors, such as a differential caregiving burden for women, and because of systemic factors, such as an imp"] [12.65817642211914, 13.60734748840332, "ocial and Behavioral Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populations and communities throughout\nthe world. This resea"] [-3.0538854598999023, 8.784686088562012, " to Medical Research Funding,\u201d BMJ Open, Vol. 8, No. 9, 2018.\nHansen, Johan, Natasha Azzopardi Muscat, Ilmo Keskima\u0308ki, Anne Karin Lindahl, Holger Pfaff, Matthias Wismar,\nKieran Walshe, and Peter Groenewegen, \u201cMeasuring and Improving the Societal Imp"] [-3.048283100128174, 8.790087699890137, "shington, D.C.: Congressional Research Service, R43341, updated May 12, 2020. As of November 20, 2020:\nhttps://fas.org/sgp/crs/misc/R43341.pdf\nYang, Zhou, and Allan Levey, \u201cGender Differences: A Lifetime Analysis of the Economic Burden of Alzheimer\u2019s"] [23.197362899780273, 10.045544624328613, "Provisional Caseload Standards for the Indigent Defense of Adult Criminal and Juvenile Delinquency Cases in Utah\nReport for the Utah Indigent Defense Commission\nNICHOLAS M. PACE, DULANI WOODS, ROBERTO GUEVARA, CHAU PHAM, SHAMENA ANWAR\n Sponsored by U"] [23.16190528869629, 9.963966369628906, "l spend on criminal and delinquency matters within various case type categories.\n\u2022 The second effort was a survey of attorneys who had previously been identified as indigent defenders practicing in Utah. In the survey, the results of the first effort"] [23.153154373168945, 9.948158264160156, "xviii\n1. Introduction................................................................................................................................. 1\nBackground ......................................................................................"] [23.179689407348633, 9.972334861755371, ".................. 44 Final Results ........................................................................................................................................... 49\n5. Provisional Caseload Standards and Case Weights ...................."] [23.179887771606445, 9.972681999206543, "stribution of Identified Indigent Defenders and Survey Respondents, by County\nType ...................................................................................................................................... 34 Table 3.2. Types of Appointme"] [23.197509765625, 10.055190086364746, " 63\nvii\nSummary Background\nIn 2019, the Utah Indigent Defense Commission (IDC) asked the RAND Corporation for assistance in developing a provisional set of maximum caseload standards for providers of indigent legal representation in the courts of the"] [23.16431999206543, 9.967890739440918, "gs, or other legal matters; the adjective indigent as used here simply refers to a person\u2019s overall eligibility for appointed counsel, and not necessarily to their financial status.\n viii\nTexas, and Virginia, have conducted rigorous studies intended"] [23.191804885864258, 9.985915184020996, "to appear with the defendant when the defendant is informed of the filed charges at the initial court appearance, or to address collateral consequences, such as suspension of driving privileges. The recommended average of 11 hours of attorney time ac"] [23.175127029418945, 9.979525566101074, "ories.\nThe second effort was a survey of attorneys who had previously been identified as indigent defenders practicing in Utah. In the survey, the results of the first effort\u2019s time analysis were presented to participants as evidence of current time "] [23.1258544921875, 9.923482894897461, "ose who participate in assigned counsel programs are listed on a roster of available defenders, and, if appointed by the court to represent an indigent defendant, they might be paid by the hour, by the case, or by each event in a case. Defenders who "] [23.177734375, 9.972248077392578, "ase types and the final set of categories ultimately utilized by the expert panel, along with detailed descriptions of the relevant defining statutes, are set forth in Table S.1. It should also be noted that the categories exclude criminal cases invo"] [23.193950653076172, 9.987384796142578, "ction for which probation was originally ordered only involved misdemeanor charges.\nTable S.1. Case Type Classifications Used in This Study\n Interim Case Type Category (Time Analysis and Attorney Survey)\n Final Case Type Category (Expert Panel a"] [23.145719528198242, 9.927717208862305, " that at least some attorney time was recorded) at some point during the five-month period from June 2019 through October 2019 (the \u201cstudy period\u201d). A total of 11,703 adult criminal cases active during the study period and involving one of the client"] [23.192018508911133, 9.964188575744629, " hearings can be thought of as the functional equivalent of trials and subsequent sentencings in District and Justice Courts. Such adjudications result in a finding by the court as to whether a petition\u2019s allegations that a juvenile committed acts co"] [23.155065536499023, 9.952753067016602, "able S.2 reflect the experiences of a specific segment of the Utah indigent defense bar: attorneys working for the two public defender offices in the state\u2019s most populous and densely populated county. As such, the nature of their practices, the size"] [23.163827896118164, 9.954856872558594, "survey were sent to all 355 attorneys who had been identified by the IDC as accepting indigent defense appointments. A total of 183 respondents began the survey and 141 completed the questionnaire to the end, yielding a response and completion rate o"] [23.20672607421875, 10.00058364868164, "inquency\nJuvenile Delinquency\nJuvenile Delinquency\nTime Analysis\nInterim Case Type (N; % Agreed/Less/More) Results Non-Capital Murder 206.0\n(N = 53; 62%/4%/34%)\nFelony DUIs 8.5 (N = 88; 67%/3%/30%)\nOther Felonies 8.4 (N = 95; 52%/8%/40%)\nMisdemeanor "] [23.16988182067871, 9.95301342010498, "efense.\nThe inquiry only addressed the issue of attorney time. Although support staff resources ultimately play a major role in delivering an adequate defense, our interest for the instant work was solely focused on attorney time expenditures. The pa"] [23.17740249633789, 9.959285736083984, "no further discussion would be useful. CoVs exceeding 0.8 would indicate a poor degree of consensus, and, unless the range of results could be tightened, the case type would need to be dropped from the standards-setting process. The RAND facilitator "] [23.218006134033203, 9.98625659942627, "nors\n Provisional Caseload Standards and Case Weights\nAnnual Case-Related Duty Hours\nTo develop caseload standards, we first need to decide on a value that represents the amount of time an indigent defen"] [23.193052291870117, 9.9850435256958, " this type might consume most of an attorney\u2019s working hours over the course of a year. But if the consensus estimates of average attorney hours yielded by the expert panel are taken at face value, an indigent defense system must, at least for planni"] [23.202001571655273, 10.036538124084473, "of their time compared with the activities of\nxxiv\nattorneys in other offices and law firms across the state (and thus the dramatic increases over time expenditures arising from the experts\u2019 recommendations would be greatly reduced if we had better t"] [23.20198631286621, 10.030198097229004, "tantial part of their practices despite possibly receiving fewer appointments over the course of a year. Even in the smallest or least populated jurisdictions in the state, plans must be in place for alternative counsel to quickly and seamlessly abso"] [23.213722229003906, 10.044828414916992, " of shepherding this project from conception to realization, and we are thankful for her thoughtful guidance and support at every step of the process. Commission staff members Leslie Howitt, Gregory Bates, Katriina Adair, Jojo Liu, and Darien Hickey "] [23.210317611694336, 10.051087379455566, "by an attorney over the course of a specific time period (such as \u201cno more than 150 felonies in a year\u201d), are a useful tool that administrators of indigent defense programs, the courts that appoint indigent defense counsel, and policymakers who decid"] [23.172704696655273, 10.013235092163086, "address issues that, left unresolved, would increase the likelihood of recidivism. Without a reliable metric available to flag (and subsequently remedy) instances where workloads for an individual attorney, a law firm, or the indigent defense system "] [23.221593856811523, 10.054808616638184, "ven months after that recommendation was published, the Utah Legislature established the IDC with the goal of ensuring that the state meet its \u201cobligations for the provision of indigent criminal defense services, consistent with the United States Con"] [23.214046478271484, 10.06448745727539, "al Council Study Committee, 2015, p. 2. 12 Utah Senate Bill 155, 2016, Section 6.\n13 Utah Code \u00a7 78B-22-404.\n 3\nFor purposes of this standard, the term case means a single charge or set of charges concerning a defendant (or other client) in one court"] [23.224096298217773, 10.06364631652832, "seload standards should in no event be exceeded,\u201d citing the numbers in NAC Standard 13.12); Washington State Office of Public Defense, Washington State Supreme Court Standards for Indigent Defense, 2012, Standard 3.4; and American Council of Chief D"] [23.217422485351562, 10.050148010253906, "ourt Innovation, October 2014.\n24 Nicholas M. Pace, Dulani Woods, Shamena Anwar, Roberto Guevara, Chau Pham, and Karin Liu, Caseload Standards for Indigent Defenders in Michigan: Final Project Report for the Michigan Indigent Defense Commission, Sant"] [23.172943115234375, 9.966974258422852, "rk that simply measures current mean time expenditures is in the use of expert opinion to develop recommended averages that account for all effort needed to deliver effective assistance of counsel conducted pursuant to prevailing professional norms. "] [23.212444305419922, 10.007237434387207, "ve assistance conducted pursuant to prevailing professional norms. The average increase of one hour might, for example, allow for increased time working with the client to review the prosecution\u2019s evidence, to appear with the defendant when the defen"] [23.207271575927734, 10.034436225891113, " and marshal resources appropriate for meeting the demand. That said, a maximum caseload standard should not be viewed as an inflexible target for defenders to strive for when accepting new clients. As always, attorneys have an ethical responsibility"] [23.115999221801758, 9.926017761230469, " case, or by each event in a case (the manner of compensation depends on the program\u2019s rules and the nature of the appointment). Assigned counsel can be solo practitioners or members of private law firms. Defenders who participate in contract defende"] [23.16915512084961, 9.975728988647461, "unties and could, for example, function as assigned counsel in one location and as contract defenders in another. And there are indigent defenders who are not staff of a public defender office, are not on an assigned counsel roster, or have not enter"] [23.225849151611328, 10.047088623046875, "ssues with support staff availability. This statewide body regulating indigent defense in Utah might, for example, decide to phase in the implementation of the standards over time as a result of budgetary considerations, or modify them on the basis o"] [23.14580535888672, 9.937320709228516, "cific period of time, whereas other studies were able to analyze existing timekeeping information already collected by defenders as a routine business practice (see \u201cTime Analysis\u201d in Table 1.1). When special time studies were employed, participation"] [23.17169761657715, 9.963994026184082, "ologically is in the nature of the information provided to the panel for its deliberations. One approach ensures that the panel is familiar with the results of the time analysis regarding current average time expenditures and with the findings of the"] [23.17709732055664, 9.96921157836914, " adult criminal, 1 juvenile,\n2 family\nTime Analysis\nMandatory time study over\n16 weeks\nVoluntary time study over\n12 weeks\nNone\nMandatory time study over\n6 months\nApproach\nYes, using 26 task types\nYes, using 13 task types\nYes, using 11\u201313 task types d"] [23.150279998779297, 9.947992324829102, "groups specified both the amount of additional time needed per case and the percentage of cases in which this additional time was required.\nAmount of time required, on average, to accomplish each task within each case type\nAverage amount of time that"] [23.15753746032715, 9.952361106872559, " weeks\nMandatory time study over\n7 weeks\nUsed existing timekeeping data covering 6 months\nNo, task data only informed expert decisions\nYes, using 35 task types\nYes, using 12 task types\n15\n Jurisdiction and Primary Researchers or Sponsors (Cita"] [23.159976959228516, 9.956825256347656, "tion would be voluntary (the voluntary nature of the data collection meant that the duration of the study would have to be limited, perhaps as short as eight weeks, to avoid participant fatigue and subsequent dropout). We would not utilize a task-bas"] [23.15669059753418, 9.953407287597656, "55 attorneys, though we were well aware that some of the names on the list identified individuals who were no longer practicing law at all or only doing so in areas outside of interest to this study, were now deceased, or who had new (and unknown) co"] [23.12335777282715, 9.919347763061523, "ntained as part of their normal business practices, and spend a nontrivial amount of time at the end of each work day thinking about what they did for their clients and recording such activities in an organized manner. Such a task would be made much\n"] [23.160493850708008, 9.951345443725586, " activity would eliminate the not-inconsiderable timekeeping burden that would have been placed on the defenders who volunteered for the proposed time study. Factoring into the decision was our understanding that the IDC was in the process of launchi"] [23.160940170288086, 9.960123062133789, " the influence of alcohol, drugs, or a combination of both or with specified or unsafe blood alcohol concentration (\u00a7 41-6a-503(1)).\nJail sentence of up to 1 year. Examples: Manufacturing or delivering drug paraphernalia (\u00a7 58-37a-5(2)(b)); Assault o"] [23.196996688842773, 9.990450859069824, "ile a highly granulated breakout of the two offices\u2019 caseloads would certainly be useful for a research perspective when developing maximum caseload standards, recording the information necessary for such an analysis (typically a listing of the relev"] [23.180978775024414, 9.971718788146973, "cy Juvenile Delinquency\nCase Type Category\nNon-Capital Murder\nFelony DUIs\nOther Felonies\nMisdemeanor DUIs\nOther Misdemeanors\nProbation Violations\u2014Felonies Probation Violations\u2014Misdemeanors\nFelonies\nMisdemeanors\nStatus Offenses\nOrders to Show Cause\nPr"] [23.178667068481445, 9.979599952697754, "xamples include aggravated arson of a habitable structure or vehicle (\u00a7 76-6-103(2)), burglary of a dwelling (\u00a7 76-6-202(2)), and odometer violation with intent to defraud (\u00a741-1a-1319).\nThird-degree felony charges for violations of Utah Code \u00a7 41-6a"] [23.177167892456055, 9.96801471710205, " and Class C misdemeanor charges would be assigned to the \u201cClass A Misdemeanors\u201d case type because that category precedes \u201cClass B and C Misdemeanors\u201d in the list. Indigent defense appointments that fall outside the categories described in the table "] [23.141305923461914, 9.926322937011719, " June 2019 for those cases with a start date prior to the beginning of the study period and for imputing attorney time for cases that were still pending at the time of the analysis.48 To do so, we used a relatively simple imputation technique for est"] [23.146602630615234, 9.934158325195312, " within 161 days, and 95 percent within 637 days, and 1 percent were open longer than 1,147 days.\nWe used this special closed case dataset to calculate median days from opening to closure for those matters that remained open beyond different time thr"] [23.158912658691406, 9.94542121887207, "d total number of days open based on the number of known\nopen days.\nFor all of these scenarios, imputed total hours were calculated as follows:50\nImputed total hours = actual hours recorded \u0301 (total open days / recording days).\nIt should be remember"] [23.14013671875, 9.92992877960205, "t case number for each newly filed criminal complaint or information. For an indigent defender, the representation of a client as a result of an appointment is likely to begin about the same time as the court case, and it is likely to end about the s"] [23.183414459228516, 9.971868515014648, "nt juvenile defense bar is made up of multiple private law firms or solo practitioners, it is possible that Juvenile Court will appoint one attorney to handle a juvenile\u2019s first representation and appoint a different one for a subsequent involvement "] [23.157636642456055, 9.925300598144531, " facing charges arising from all events allegedly occurring within a span of a few weeks or\n52 Utah Sentencing Commission, 2015 Juvenile Disposition Guidelines, January 2015, p. 9. 29\n months of each other. As such, all of the offenses that are addre"] [23.165098190307617, 9.952984809875488, "Case Type\nMean hours for attorney time expenditures in the cases included in the time analysis are set forth in Table 2.1. As would be true with any mathematical analysis, as the size of a sample grows, its mean gets closer to the average of the whol"] [23.096202850341797, 9.89537525177002, "ool, better opportunities will exist in\n31\nsubsequent years for assessing the changing nature of defender time expenditures, particularly in regard to private attorneys, to attorneys outside Salt Lake County, and to attorneys in small and medium-size"] [23.15548324584961, 9.953730583190918, "oele, Utah, Wasatch, and Weber. Office of Management and Budget, Revised Delineations of Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Combined Statistical Areas, and Guidance on Uses of the Delineations of These Areas, OMB Bull"] [23.169614791870117, 9.958251953125, "and the 90th percentile (the value in which 90 percent of the respondents were below and 10 percent were above) was 60 hours. Public defenders reported slightly greater weekly hours than attorneys in other types of practices (Table 3.3).\nTable 3.3. A"] [23.13881492614746, 9.931129455566406, "d about office size and support. Single-person offices were common (44 percent) among attorneys who received appointments through contracts, assigned counsel programs, or other means (Table 3.6). About 18 percent of non-public defenders reported that"] [23.206268310546875, 9.99882984161377, "s shortcoming. We can, however, use the 90th and 95th percentiles in Table 3.7 to identify instances where active attorneys are shouldering a particularly large caseload in one of our interim study types. For example, 10 percent of all respondents re"] [23.2080078125, 9.990480422973633, "more \u201cOther Felonies\u201d each year, and 10 percent (likely a different 10 percent) had more than 600 adult criminal cases.\nTable 3.8. Reported Annual Caseloads for Attorneys with Adult Criminal Focus and Half or More of Workweek Devoted to Criminal or J"] [23.199737548828125, 9.97111701965332, "the results for the specialist respondents in Table 3.8 and Table 3.9 by adjusting their caseloads by both the number of average weekly work hours they reported and the percentage of weekly work hours devoted to their primary practice areas. Using 40"] [23.233835220336914, 10.021451950073242, "ve been repeatedly criticized as allowing far too many cases annually given the current professional and ethical demands on indigent defense attorneys today, limited felonies to just 150 per year. It should be kept in mind that those respondents repo"] [23.16449737548828, 9.95370101928711, " hours to be used for planning purposes. Specifically, we requested that the attorneys consider\nthe amount of time, on average, that [they] believe an attorney should plan on spending for a particular type of case in order to provide an adequate and "] [23.155515670776367, 9.947546005249023, "tever your determination, please base your entries on your personal experience and upon what you believe to be the average amount of lawyer time that would be required to afford a client adequate and effective aid in the defense of a case of that typ"] [23.18608856201172, 9.98150634765625, "he average hours necessary to deliver effective representation. Their deliberations were informed by the results of the earlier data collections, as well as by current guidance on the ethical and professional standards for criminal and juvenile defen"] [23.16472625732422, 9.955342292785645, "t Lake City\nUtah County Public Defender Association, Provo\n Though the information we sought to elicit from the expert panel paralleled that of the attorney survey (panel members were also asked to provide an opinion as to the average amount of ti"] [23.147445678710938, 9.936128616333008, " was provided to help the panelists think about the question of the amount of time is needed, on average, to represent clients in different types of cases in Utah and render, as described in Strickland v. Washington, \u201creasonably effective assistance\u201d"] [23.167192459106445, 9.950770378112793, " way, any recommended average time expenditure should be the same for all attorneys representing clients in the case type categories of interest.\nDetailed information about the two data collection efforts was also provided, covering such topics as pr"] [23.182205200195312, 9.965359687805176, "sensus, making further discussion about the case type in question unnecessary. CoVs exceeding 0.5 but less than or equal to 0.8 would be considered less satisfactory, and additional discussion would be recommended for the purpose of enhancing consens"] [23.176597595214844, 9.955020904541016, " for sex-related crimes due to the complexities of the defense and the potential for an outcome in the case that would trigger offender registration and associated consequences. The changes instituted by the expert panel will address some of those co"] [23.153467178344727, 9.93509292602539, " so the choice of statistic to use to report a typical result need not be limited to the mean.\n49\n Table 4.2. Expert Panel Session Recommended Hours Compared with Time Analysis and Survey\n Subject Are"] [23.21162986755371, 10.000062942504883, "s. We use the results of the attorney survey in which participants reported spending an average of 11.8 percent of their workweek in the practice of law but not working on specific cases (Table 3.4). When these assumptions are plugged into the formul"] [23.23654556274414, 10.030863761901855, "e 5.2. Provisional Caseload Standards Expert Panel Recommended\nMaximum Annual Caseload Standards\n6 12\n 48\n 71\n 89\n 71\n 149\n 298\n 357\n 25\n 71\n 89\n 298\n 357\n Subject Area"] [23.2233943939209, 10.018778800964355, " paying clients or court appointments.\nCase Weights\nThere are essentially two types of time-based case weights: absolute (the weight reflects the average time measured for a particular type of case) and relative (the weight reflects how the average t"] [23.21808624267578, 10.008008003234863, "eloads when a mix of client matters is being handled. Assume that a solo practitioner who works only on adult criminal indigent appointments receives a contract to take on 60 Class A misdemeanors over the course of a year. For planning purposes, it m"] [23.224822998046875, 10.02122974395752, "plated by those weights. As indicated previously, the case types chosen for this work represent adult criminal and juvenile delinquency client matters that are believed to consume most of a defender\u2019s workday, but there were some exceptions. For exam"] [23.227380752563477, 10.034698486328125, "ly adhere to the NAC caseload standards that have essentially functioned as the default guidance for indigent defender workload limits throughout the nearly five decades since their publication.59\nFor the sake of comparability, we made several decisi"] [23.22104835510254, 10.018797874450684, "ut parole) Felony\u2014life without parole\nMurder\nMurder\nMandatory sex and kidnap registration felonies First-degree murder (includes capital)\nClass 2 felony\nMurder/manslaughter\nHomicide (average)\nMurder/homicide\nNonmurder with possible life sentence Supe"] [23.259798049926758, 10.058990478515625, " weight (25 hrs.) Standard\nCase weight (24.13 hrs.) Standard\nStandard\nCase weight (22 hrs.) Case weight (21.99 hrs.) Case weight (19.12 hrs.) Standard\nStandard\nStandard\nCase weight (838 min.) Case weight (766 min.) Standard\nStandard\nStandard\nStandard"] [23.27744483947754, 10.075247764587402, " weight (137 min.) Case weight (93 min.)\nMaximum Cases\n71\n81\n89\n 91\n 106\n 125\n 141\n 142\n 148\n 149\n 153\n 203\n 216\n 225\n 232\n 234\n 236\n 244\n 265\n 300\n 300\n 3"] [23.244382858276367, 10.041908264160156, "ion revocation\nModifications/sentence reviews, circuit (average)\nViolations of probation, circuit\nModifications/sentence reviews, district (average)\nExtradition\nProbation violation, misdemeanor Violations of probation, district Preliminary hearings, "] [23.219324111938477, 10.010255813598633, "200 Case weight (7.4 hrs.) 241 Standard 250 Case weight (397 min.) 270 Standard 298 Case weight (348 min.) 308 Case weight (317 min.) 338 Standard 351 Standard 357 Case weight (4.6 hrs.) 388 Case weight (2.3 hrs.) 776\n offender\n(average)\n"] [23.2026424407959, 9.99769401550293, "t majority of indigent defenders in Utah), adoption of the provisional standards, if accompanied by a surge in attorney availability, will certainly cause a major sea change in the delivery of services to indigent defendants.\nWe do have some evidence"] [23.19341468811035, 9.985638618469238, "red\n15,000 142,050\n643,319 14,375 116,360 466,125 1,324,992 90,204 184,035\nExpert Panel Recommended Average Hours\n300 150\n 37\n 25\n 20\n "] [23.20113754272461, 10.029226303100586, "bmitted by many of the attorneys who participated in the survey evidence deep frustration over a lack of resources and inadequate time to do the job that they believe is necessary for effectively fulfilling their professional responsibilities to thei"] [23.235055923461914, 10.062845230102539, " over on a moment\u2019s notice, courts will have little choice but to continue to appoint those who are at risk of excessive workloads.\nIDC must also regularly revisit the issue of caseload standards in the future, in part to make sure that caseload maxi"] [23.131811141967773, 9.921579360961914, "individually identifiable information.\n1. A metric worth exploring may not be time on task, but a time frame in which to complete the task. For example, counsel may have a \u201ceureka\u201d moment for a case after having sat with it for several weeks; but mea"] [23.140745162963867, 9.927972793579102, "e. Most clients are in need of treatment. Support staff and additional attorneys are essential.\n 67\n6. Having the assistance of investigators that can work with IDC funds would be helpful in all cases. I would love to be able to get an investigator t"] [23.112165451049805, 9.89938735961914, "fense is that if you are choosing which cases to give more of your time, it undoubtedly comes at the expense of another (perhaps less serious) case. That practice seems to undercut the quality of representation. More qualified bodies to handle cases "] [23.10892105102539, 9.896533966064453, "ven the caseload. Right now, it is an inconvenient truth that indigent defenders do not have sufficient time to provide an adequate defense to indigent clients. Everyone knows this. Hopefully, this will change but I am skeptical.\n17. If the data refl"] [23.116369247436523, 9.906758308410645, "t defense is funded by each county, something needs to be done in order to offer juvenile defenders, especially those who solely do juvenile defense, a livable salary.\n20. In the State of Utah, the public defenders are compensated by counties instead"] [23.108652114868164, 9.896299362182617, " because there\u2019s too many clients and too little time.\n26. More resources need to be spent on treatment, housing and early intervention to avoid the cycle of clients.\n27. Most counties pay the lowest bidder. Further, all counties don\u2019t pay based on e"] [23.100950241088867, 9.888168334960938, "stigate and pursue defenses, even if it doesn\u2019t go to trial. DUIs are not that much different from run of the mill felonies, but they are the only special category separated out in this survey. The study should also look at types of cases by content "] [23.08287811279297, 9.873210906982422, "t is not appropriate for attorneys balancing those caseloads to continue to balance the rest of their full caseload, which is probably too big to start with.\n36. Re: misdemeanor appeals. I wasn\u2019t clear if this contemplated an appeal de novo from just"] [23.103403091430664, 9.892431259155273, " events will add an average of at least 100 hours to the time the appeal would take from beginning to end.\n39. The current going rate for indigent appeals is shockingly low. Rough math suggests that, for example, Salt Lake County Legal Defenders Asso"] [23.07487678527832, 9.86375617980957, "to adequately represent my clients. Third, establish a group of expert witnesses that we can go to in order to obtain assistance to adequately represent our clients. A group of experts in all the typical fields involved in the criminal justice system"] [23.21837615966797, 10.01695442199707, " and mental health clients. And with the indigent population, that\u2019s about 90% of the clients.\n47. Utah\u2019s indigent defense funding is 49th in the US. Washington County is the least funded county in Utah. Enough said.\n48. We have been tracking our tim"] [23.242931365966797, 10.08935832977295, "lated to Excessive Workloads, August 2009. As of October 3, 2020: https://www.americanbar.org/content/dam/aba/administrative/legal_aid_indigent_defendants/ ls_sclaid_def_train_eight_guidelines.authcheckdam.pdf\nAmerican Bar Association, Criminal Justi"] [23.22210121154785, 10.064676284790039, "hrough Public Defense Delivery Systems, 2nd ed., Washington, D.C., 2008.\nNew York State Office of Indigent Legal Services, A Determination of Caseload Standards Pursuant to \u00a7 IV of the Hurrell-Harring v. The State of New York Settlement, December 8, "] [23.182748794555664, 10.00246810913086, ", Boston, Mass., October 2015.\nUtah Indigent Defense Commission, Core Principles for Appointed Attorneys Representing Youth in Delinquency Proceedings, 2018. As of December 15, 2020: https://idc.utah.gov/wp- content/uploads/2018/06/DelinquencyCorePri"] [12.6945161819458, 13.81678295135498, "COVID-19 and the Experiences of Populations at Greater Risk\nDescription and Top-Line Summary Data\u2014Wave 3, Winter 2021\nKATHERINE GRACE CARMAN, ANITA CHANDRA, DELIA BUGLIARI, CHRISTOPHER NELSON, CAROLYN MILLER\n Sponsored by the Robert Wood Johnson Foun"] [12.696117401123047, 13.751952171325684, "op-line report will update these findings after the final survey.\nResearchers from RAND and RWJF jointly conducted the research reported here; the report is intended for individuals and organizations interested in learning more about public attitudes"] [12.878960609436035, 14.144993782043457, "......................................................2 Survey Length .......................................................................................................................................6 Survey Sample Selection...................."] [12.9179105758667, 14.40493106842041, "y your health is excellent, very good, good, fair,\nor poor?.........................................................................................................................................15\nQ4. [w3_wellbeing1-w3_wellbeing6] Below are a numbe"] [12.900883674621582, 14.427292823791504, "in a community during a major stressful event like a natural disaster, economic challenge like a\nplant closure, major incident of community violence?.................................................................21\nCOVID Impacts: COVID Experience.."] [12.892906188964844, 14.43945026397705, "ericans, or is there not\nmuch of a difference? ...................................................................................................................27\nQ19. [w3_access_lat] When Latinos need health care, do you think it is easier or hard"] [12.881346702575684, 14.414080619812012, "g., the governor\nor state legislature) is doing enough in dealing with the impact of coronavirus (COVID-19)\nto look out for the interests of all people, regardless of a person\u2019s race, how much money\nsomeone makes, where people live, or other factors."] [12.885438919067383, 14.42833423614502, "......................................................................35 Q35a [w2_positivechg] (if w2_positivech = strongly agree or somewhat agree) What is the\nmost important positive change that you would like to see change?........................"] [12.72310733795166, 13.8563814163208, ".............................................................42 Respondents by Education Level........................................................................................................42 Respondents by Marital Status...................."] [12.814114570617676, 13.957907676696777, "final survey.\nThe questions in this COVID-19 survey focused specifically on experiences related to the pandemic (e.g., financial, physical, emotional), how respondents viewed the disproportionate impacts of the pandemic, whether and how respondents\u2019 "] [12.8102388381958, 13.952705383300781, " These oversamples will allow for research that compares subgroups based on income or race and ethnicity.1 We created weights to align the distribution of characteristics in our sample as closely as possible to the distribution of characteristics of "] [12.708283424377441, 13.83443546295166, "eriences, views, and perceptions of a nationally representative sample of groups living in the United States and historically at greater risk as they face the COVID-19 pandemic, economic recession, and social injustice. The objectives of this survey "] [12.72463321685791, 13.859423637390137, "rld. Our survey content was reviewed by a group of researchers conducting surveys about COVID-19 impacts. The survey design process balanced the urgency of capturing real-time experiences with COVID-19 with finding survey items that at least had reas"] [12.718396186828613, 13.851170539855957, "Katherine Grace Carman, Anita Chandra, Sarah Weilant, Carolyn Miller, and Margaret Tait, 2018 National Survey of Health Attitudes: Description and Top-Line Summary Data, Santa Monica, Calif.: RAND Corporation, RR-2876- RWJF, 2019. As of October 9, 20"] [12.764445304870605, 13.940192222595215, "een measured in other surveys, and there were few existing survey questions to draw from, so many survey questions were developed de novo.\nWe conducted a series of meetings with a group of researchers implementing surveys about the impacts of COVID-1"] [12.841254234313965, 13.99017333984375, "xtent to which respondents\u2019 ability to engage in well-being activities has been affected by COVID-19.\nOne question was modified. In wave 1, more than 70 percent of respondents reported that the pandemic could be an opportunity for positive change (w1"] [12.834978103637695, 13.979202270507812, "ispanic, or Asian respondents. We were most interested in understanding the experiences of historically underserved individuals in U.S. society. The income limits allow us to focus on individuals in households that were likely eligible to receive the"] [12.829066276550293, 13.946017265319824, " with incomes between $75,000 and $125,000, non-Hispanic White panelists were randomly selected to participate and all panelists of other races or ethnicities were invited to participate.3 This resulted in a sample of 1,331 panel members being invite"] [12.853265762329102, 13.984910011291504, "h wave and each panel.\nTable 1.3. Summary of Field Dates and Sample Sizes\nALP KnowledgePanel Total\nSample Participation Sample Participation Sample Participation\n Wave Field Dates\n1 June 29\u2013July 22, 2020\n2 October 9\u2013November 2, 2020\n3 Februa"] [12.861878395080566, 13.999001502990723, "gender and age, as well as household income interacted with household size. To calculate the weights, we combined the two samples and matched the distribution of characteristics of the pooled sample to the distribution of the CPS. In other words, our"] [12.860390663146973, 13.991364479064941, "nown as the margin of error [MOE]) based on the 95-percent confidence interval. If a study were repeated 100 times, the 95-percent\n11\nconfidence interval would contain the true value 95 percent of the time. The MOE is a function of the sample size an"] [12.884760856628418, 14.15807819366455, "reater Risk Survey. For each question in the survey, we present the text as it was presented to survey respondents, as well as a variable name for those who use the data. All responses were listed in the order presented in the top line unless otherwi"] [12.931902885437012, 14.349888801574707, "ral, would you say your health is excellent, very good, good, fair, or poor?\nSelect only one answer.\n Sample\nExcellent Very good Good\nFair Poor\nMissing\n 7.0 32.2 40.1 6.4 33.2 39.1 6.3 31.4 41.4\nQ4. [w3_wellbeing1-w3_wellbeing6] Below are"] [12.907340049743652, 14.413904190063477, " 17\nQ6. [w3_chronic] Do you personally currently have one or more chronic health conditions (e.g., diabetes, asthma, depression, heart disease, high blood pressure, substance use disorder)?\nSelect only one answer.\nSampl"] [12.893913269042969, 14.43300724029541, "ut do not have to take leave\nWave 1\nWave 2\nWave 3\nSOURCE: Developed by RWJF and RAND.\nI am receiving\nunemployment No, I receive\ninsurance no pay\nSample\nYes, I use paid leave\nYes, I receive partial pay\n1.1 1.4 1.5\nMissing\n 1.1 1.1 0.6\n2.6 1.2 1."] [12.900500297546387, 14.454649925231934, " for coronavirus (COVID-19) (through a nasal swab or blood test)?\n Sample Yes\nNo Missing\n Wave 1\nWave 2\nWave 3\nSOURCE: Modified from COVID Impact Survey.\n11.7 88.0 0.3 26.2 73.4 0.4 44.9 54.7 0.3\n 21\nQ14a. [w1_covidexp1- w1_covidexp14] Are y"] [12.89122486114502, 14.441818237304688, "n wave 1, and if w3_exp11, w3_exp4 or w3_exp5 selected in wave 3) [w3_finhard] How long do you think you will have trouble affording your basic expenses?\nSelect only one answer.\nNote: The question wording was modified slightly from wave 1, which read"] [12.883842468261719, 14.458895683288574, "tance from this program before coronavirus (COVID- 19) started\nYes, my household started receiving assistance from this program since coronavirus (COVID-19) started\nMy household applied or asked for but has not received assistance from this program s"] [12.889607429504395, 14.443717956542969, "- 19) started\nMissing\n Wave 1 Wave 2 Wave 3\n94.8 0.8 94.9 0.6 94.4 0.7\n 26\n H. Programs related to caring for my children (including school-based programs, meals)\n Yes, my household was already receiving assistance from this program before "] [12.877530097961426, 14.458124160766602, " Wave 1\nWave 2\nWave 3\nSOURCE: Developed by RWJF and RAND.\n30.9 27.6 30.1 27.9 29.1 28.4\n Sample\nSomewhat Strongly agree agree\nNeither agree Somewhat Strongly\nnor disagree disagree disagree Missing\n32.2 6.5 8.7 0.2 32.0 7.3 7.7 0.4 31"] [12.849018096923828, 14.47227668762207, "f coronavirus (COVID-19)\n Sample\nWave 1 Wave 2 Wave 3\nMost of the time\n36.4 43.2 46.8\nSome of the\ntime Rarely Never\nMissing\n 48.3 12.0 3.2 0.2 45.0 8.9 2.7 0.3 42.4 8.0 2.4 0.4\n B. The people in my community are taking action "] [12.893248558044434, 14.41446590423584, "Missing\nWave 1 2.6 3.1 22.2 24.7 47.3 0.1 Wave2 XXXXXX Wave3 XXXXXX\nB. The place they live (e.g., community conditions, housing)\nVery strong No effect effect\nSample 1 2 3 4 5 Missing\nWave 1 3.9 5.8 30.8 30.4 28.8 0.3 Wave2 XXXXXX Wave3 XXXXXX\n "] [12.88848876953125, 14.43332290649414, "r agree Somewhat Strongly agree nor disagree disagree disagree\nMissing\n Wave 1\nWave 2\nWave 3\nSOURCE: Stanford Mind & Body Lab Mindset Measures for COVID-19 study.\n35.4 33.2 35.8\n37.2 18.1 4.4 4.5 0.4 37.5 20.8 3.5 4.5 0.6 34.9 20.8 3.5 4.6 0.3\n"] [12.876887321472168, 14.451639175415039, "nly one answer.\nNote: This is a new question added in wave 3.\nSomewhat Neither agree Somewhat Strongly Sample Strongly agree agree nor disagree disagree disagree\n31.0 30.0 29.7\n19.4 19.1 9.5 20.5 0.4 21.0 19.2 10.0 19.2 0.6 21.5 20.0 9.1 19.1 0.5\n "] [12.859321594238281, 14.436771392822266, "s about who gets the vaccine first. Please indicate the level of priority that should be given for each of the listed groups.\nNote: This question was not asked in wave 1 or wave 3.\n A. Front-line medical care staff working with coronavirus pati"] [12.830138206481934, 14.035408973693848, "dents only (n = 4,031)\nRespondents by Age Group, in Years\n Sample\nWave 1 Wave 2 Wave 3\n18 to 24\n4.0 2.8 2.2\n25 to 44\n29.1 27.2 26.5\n45 to 64 65+\n37.5 29.4 38.0 32.0 37.6 33.7\n NOTES: Our sample from the ALP is not representative of indiv"] [12.719220161437988, 13.851866722106934, ", Katherine Grace, Anita Chandra, Sarah Weilant, Carolyn Miller, and Margaret Tait, 2018 National Survey of Health Attitudes: Description and Top-Line Summary Data, Santa Monica, Calif.: RAND Corporation, RR-2876-RWJF, 2019. As of August 24, 2020: ht"] [12.715049743652344, 13.850406646728516, "Values Survey,\u201d webpage, undated. As of October 9, 2020:\nhttps://www.pewresearch.org/politics/values/\n\u2014\u2014\u2014, \u201cExplore the Data,\u201d webpage, 2020. As of October 9, 2020: https://www.pewresearch.org/pathways-2020/covid_econopen/total_us_adults/us_adults/\nP"] [12.128679275512695, 9.044868469238281, " CORPORATION\nSIERRA SMUCKER, ESTHER M. FRIEDMAN, MEAGAN CAHILL, JIRKA TAYLOR, JOHN DALY, REGINA A. SHIH\nAn Initial Evaluation of the Weinberg Center for Elder Justice\u2019s Shelter Model for Elder Abuse and Mistreatment\n For more information on this pub"] [12.652793884277344, 13.587652206420898, "uals experiencing EM, public payers, and society.\nSocial and Behavioral Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populatio"] [12.078349113464355, 8.994105339050293, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 FinancialAnalysis...................................................................................... 8 Analysis of Cost Sa"] [12.093544960021973, 8.983860969543457, " . . . . . . . . . . . . . . . . . . . . . . Other Plausible Savings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Benefits Other Than Cost Sa"] [12.0847806930542, 8.999185562133789, "een the First and Second Assessments. . . . .\n4.3. Share of Clients by Reported Cognition over Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n4.4. Change in Clients\u2019 Cognitive Impairment Between the First and Second Assessments."] [12.128684997558594, 9.0390625, "ults of Ciara\u2019s Vignette: Population-Level Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n6.7. Results of Dmitry\u2019s Vignette: Individual Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n6.8. Results of Dmi"] [12.113061904907227, 9.049283981323242, "on of the nation\u2019s first elder-specific shelter\u2014the Harry and Jeanette Weinberg Center for Elder Justice, which is part of the Hebrew Home at Riverdale. Located in the Bronx, New York, the Hebrew Home is a nonprofit residential health care facility ("] [12.085728645324707, 9.008065223693848, "portant to note that this is an initial evaluation with a scope limited to describ- ing the model and providing illustrative examples of ways the model could lead to cost savings. A full evaluation would employ a rigorous experimental design, includi"] [12.097973823547363, 9.01683235168457, "enter, with more patients improving than declining. Although statistical tests of the trajectories of Weinberg Center were not incorporated into the present analysis, the relatively low frequency of deterioration among the client group is noteworthy "] [12.083093643188477, 9.006897926330566, "berg Center clients have stable health and functioning throughout the duration of their stays in the Hebrew Home. Our analysis of medical data for select health indicators suggests that the health status of Weinberg clients is relatively stable\u2014and, "] [12.13489818572998, 9.039966583251953, " they entered the Weinberg Center. These data would help establish the uniqueness of the Wein- berg Center interventions over and above services available to Weinberg Center clients elsewhere. These data would also provide insights into the nature of"] [12.132830619812012, 9.046417236328125, "ical and sexual abuse; neglect; and financial exploitation. Globally, an estimated 16 percent of community-dwelling adults aged 60 and older reported experiencing some form of EM in the prior year, with 12 percent psychological abuse, 7 percent finan"] [12.116548538208008, 9.039374351501465, "service provider, work together to resolve difficult cases, and provide opportunities for learning about different strategies and resources (Morris, 2010; Schecter and Dougherty, 2009; Teaster and Wangmo, 2010).\nAlthough multisystem team approaches h"] [12.116854667663574, 9.0431489944458, "RiNG Alliance advocate for shelter, offer peer-to-peer support, and gather annually to share best practices.\nThe distinctive features of the Weinberg Center compared with family violence and homeless shelters are that it combines a shelter model of p"] [12.108369827270508, 9.030466079711914, "when EM is suspected. The Weinberg Center also works to help replicate the shelter model in other communities and to advocate for policies and laws that seek to address and prevent EM. Expected impacts of the Weinberg Cen- ter\u2019s direct services to cl"] [12.107924461364746, 9.029067039489746, "also conducted a cost-benefit analysis involving vignettes to identify the cost saving of the Weinberg Center to key stakeholders: public payers, private insurance, and the public.\nInterviews with Weinberg Center Staff\nTo learn more about the Weinber"] [12.084376335144043, 8.999914169311523, "2019 (n = 100); this date range was chosen to ensure that at least 100 clients were represented in the data for our analysis. The first assessment takes place at intake, with subsequent assessments done on a quarterly basis until the client leaves th"] [12.076216697692871, 9.000036239624023, "o using ERs or hospitals. Efficient care could also play a role in creating savings when treating previously unmet needs (the first pathway). Thus, these two pathways are not mutually exclusive, but viewing them separately provides a useful framework"] [12.081351280212402, 9.005887985229492, "e with the benefits achieved through the Center\u2019s intervention (\u201cbenefits\u201d). These benefits, ideally determined through an outcome evaluation (i.e., an evaluation that measures program effects by assessing the attainment of outcome that the program h"] [12.077553749084473, 9.002396583557129, "eeds and Weinberg Center interventions for exemplar indi- viduals allows us to provide an initial assessment of whether these elements could be expected to create cost savings and benefits, using data from existing literature instead of needing data "] [12.072477340698242, 8.998361587524414, "curring attributable to Weinberg\nCenter intervention\n\u2022 Pi = population of Weinberg Center clients receiving the intervention\n\u2022 Ci = costs of delivering the Weinberg Center intervention.\nParameters\nTo populate this equation with parameters appropriate"] [12.110472679138184, 9.033069610595703, "er interventions are dependent on what support its clients would be able to access else- where. In our discussion of the vignettes, presented later in this report, we make a series of informed assumptions about the counterfactual, but there are uncer"] [12.111227035522461, 9.034720420837402, "York City shelters are not equipped to support the health and cognitive needs of older adults experienc- ing EM. Many clients spend time in the hospital as a social admit until they feel home is safe, but hospital stays are not a long-term option and"] [12.108488082885742, 9.033824920654297, "assistance with financial awareness (e.g., the Center runs credit reports and helps\nprovide sense of financial standing)\n\u2022 legal services, including representation in court, prepping clients for court dates,\ntestimonies, facilitating clients\u2019 meeting"] [12.105441093444824, 9.029139518737793, "on of the abuser was a specific cost mentioned in one interview as something staff would like to address but are currently unable to do.\n18\nInitial Evaluation of Weinberg Center\u2019s Shelter Model for Elder Abuse and Mistreatment\n\u2022\n\u2022 \u2022 \u2022\nThe Center face"] [12.071551322937012, 8.991117477416992, "k at other outcomes, such as housing, social func- tioning, or resolution of legal issues, because data on those outcomes are not available for Weinberg Center clients.\nIn this chapter, we evaluate four indicators of Weinberg Center client health and"] [12.084020614624023, 8.997550010681152, "he Center with moderate depression, 21 percent with mild depression, and 59 percent with mini- mal depression. Over the course of four assessments, there was little change in the composition of the cohort in terms of depression severity.\nThis stabili"] [12.080409049987793, 8.99744701385498, ". By the fourth assessment, nine months after entering the Hebrew Home, 62 percent of clients report- edly had some degree of cognitive impairment, while 39 percent were cognitively intact.\nFigure 4.4 shows changes in clients\u2019 cognition between the f"] [12.0819730758667, 8.998150825500488, "clients who received their first and second assessment (96 clients).\n45%\nSeverely impaired Moderately impaired Cognitively intact\n Cognitively intact Increase in cognition Unchanged cognition Decrease in cognition\n24 Initial Evaluation of Weinberg Ce"] [12.069504737854004, 8.986750602722168, "ssessment one and two.\nMobility\nTo assess Weinberg Center clients\u2019 mobility, we examined clients\u2019 reported mobility \u201con unit\u201d (i.e., in his or her room or adjacent corridor) during their stays. The results are presented in Figure 4.9. Our analysis of"] [12.050737380981445, 8.969316482543945, "results suggest that between 2013 and 2019, most clients served by the Weinberg Center faced significant and persistent mobility issues.\nNext, we investigated whether client mobility changed between the first and second assessment. Figure 4.10 presen"] [12.067605018615723, 8.988773345947266, "use of any specific treatment from the Weinberg Center. This point\nImproved self-locomotion on unit\nNo change in self-locomotion on unit Decline in self-locomotion on unit\n Changes in Health Conditions Among Weinberg Center Clients 29\ncognitive issue"] [12.076366424560547, 9.0004243850708, "thout incurring additional operating costs to the Center. Historically, 80 percent of Weinberg clients are eligible for Medicare and/or Medicaid, which offsets the costs incurred by the Hebrew Home. For the remaining 20 percent of clients, the Hebrew"] [12.013219833374023, 8.93817138671875, "the number of patient-days recorded over the same period.\nFigure 5.3 provides a breakdown of Weinberg Center operating costs by type. It shows that most Weinberg Center operating costs were incurred through the provision of legal services and mental "] [12.07418441772461, 8.999144554138184, "er month and other)\nIndirect overhead costs\nFurniture and household setup\nMental health services Total legal services\n Percentage\n100\n 90\n 80\n 70\n 60\n 50\n 40\n 30\n 20\n 10\n 0\n 2013 2014\n2015 2016\n2017 2018 2019\nFigure 5.4\nComposition of Weinberg "] [12.079800605773926, 9.000500679016113, "me of potential savings, but we return to the discussion of the distribution of costs and benefits later in this chapter.\nVignette 1: Armando\u2019s Untreated Condition\n Box 6.1\nVignette 1: Armando\u2019s Untreated Condition\n\u2022 Armando is a 65-year-old man who "] [12.070414543151855, 8.997056007385254, "arameter, the reduction in risk attributable to Wein- berg Center intervention, Armando\u2019s case assumes that the provision of hyperten- sion treatment at the Weinberg Center prevented Armando from requiring ER care and subsequent hospitalization in th"] [12.070536613464355, 8.995633125305176, " respect to the reduction in the risk, a recent systematic review and meta- analysis based on 123 studies (Ettehad et al., 2016) found that treatment for hyperten- sion, which results in a 10mm Hg decrease in systolic blood pressure, reduces risks of"] [12.070481300354004, 8.997079849243164, "f the savings, presented above, assumes that none of the Weinberg Center cohort were previously treated for hypertension. However, any clients already receiving treatment should be removed from the population count. Second, the parameters for risk re"] [12.062478065490723, 9.00603199005127, ". To estimate the cost of a hospital, stay for older patients with dementia, we turn to the literature. Zhu et al. (2015) under- took a longitudinal study of Medicare beneficiaries residing in Northern Manhattan admitted to a hospital between 1999 an"] [12.053366661071777, 8.999385833740234, "rg Center services) or by the Weinberg Center (for individuals supported by the Center).\nTable 6.3\nResults of Belinda\u2019s Vignette: Individual Analysis\nParameter\nCosts of an adverse event that the Weinberg Center intervention aims to avoid\nReduction in"] [12.0758056640625, 9.001568794250488, " to the remaining vignettes.\nIn sum, the vignette indicates that, if the situation described in Belinda\u2019s case, approximates the situation experienced by Weinberg Center clients, there is a potential for sizable savings to payers and governments. How"] [12.068370819091797, 8.996885299682617, "rs pertaining to the costs of adverse events can be retained and\n7 We thank one reviewer for pointing out that Adult Protective Services may only keep track of significant losses and not include smaller losses which could bias our estimates. However,"] [12.068821907043457, 8.99643611907959, "m his physician, Dmitry visited the ER three times a year.\n\u2022 After being referred to the Weinberg Center, its legal team helped Dmitry enroll in Medicaid,\nwhich he can use to pay his co-payments for his medical care.\n\u2022 By providing this service, the "] [12.042716979980469, 8.971168518066406, "Center intervention aims to avoid\nReduction in the risk of the adverse event occurring attributable to Weinberg Center intervention\nPopulation of Weinberg Center clients receiving the intervention Savings stemming from the Weinberg Center interventio"] [12.06632137298584, 8.992912292480469, "ation for all patients hospitalized during the study period. In this hospital\u2019s database, data are recorded for each patient, and a profile of resources consumed and billed to a patient can be generated to estimate the cost of his or her hospital sta"] [12.06743335723877, 8.996296882629395, "cause of support or encouragement from Weinberg Center staff. It is critical to understand whether clients would have requested and created advance directives without the sup- port of Weinberg Center staff or not. We do not currently have this type o"] [12.080910682678223, 9.003721237182617, "Osteoporosis 17\nHeart failure 15\nThyroid 15\nStroke (cerebrovascular accident, 15 transient ischemic attack, or stroke)\nChronic obstructive pulmonary disease 14\nCataracts, glaucoma, or macular 14 degeneration\nAnxiety disorder 13 Benign prostatic hyper"] [12.084375381469727, 9.007664680480957, ", 2019). This method is frequently used to compare the effectiveness of various therapies and inform clinical decisions. QALY gains associated with the type of interventions provided by the Weinberg Center provide an indication of the scope of potent"] [12.065185546875, 8.992198944091797, "ngs, the same caveats about transferability of lessons from existing literature to the context of the Weinberg Center and the absence of clear counterfactual data apply.\n10 To illustrate the debate about appropriate cost-effectiveness cutoffs, the th"] [12.068666458129883, 8.995783805847168, "he scenario might result in savings. Table 6.13 provides an illustrative indication of the distribution of savings across individual classes of stakeholders involved in the vignettes. Green text represents possible gains, and red represents possible "] [12.083009719848633, 9.003596305847168, "f life\nImproved quality \u2022 of life\nCosts associ- ated with provi- sion of health services\nSome reduction in future health care costs\nCosts associated with provision of legal services\nCosts associated with provision of legal services\nCosts associated w"] [12.061150550842285, 8.98116683959961, "d Mistreatment\nplausibly lead to savings that exceed multiple times the amount it normally costs to run the Center.\nHowever, substantial uncertainties remain on both sides of the equation. On the savings side, estimates of savings depend on the exten"] [12.118802070617676, 8.988945007324219, "eintegration. In addition to helping achieve positive reintegration outcomes, the bridge is an opportunity to collect some follow-up data during the program, although this effort does not address the question of a longer follow-up. The bridge program"] [12.090485572814941, 9.004585266113281, "rred to Adult Protective Services, where they receive case management, with a greater likelihood of outpatient care provision.\nConclusions and Recommendations 57\nAPPENDIX A\nAdditional Details on Changes in Selected Health Indicators Among the Weinber"] [12.084127426147461, 9.004866600036621, "ain\nIn our analysis, pain severity is classified using a scale of 0 to 10 found in the MDS. Trained staff at the Weinberg Center as patients to consider the intensity of their worst pain during the previous five days, where 0 is no pain and 10 is the"] [12.095579147338867, 9.02112102508545, "Evaluation of Weinberg Center\u2019s Shelter Model for Elder Abuse and Mistreatment\nTransfer\nThe MDS defines transfer as \u201cHow resident moves between surfaces including to or from a bed, chair, wheelchair, or standing position (excludes to or from the bath"] [12.082683563232422, 9.004156112670898, "can draw on already existing infrastruc- ture and accompanying resources.\nAccounting for these additional costs is difficult because of the deeply inter- twined nature of the Weinberg Center and the Hebrew Home. However, when assess- ing the overall "] [12.073732376098633, 8.998918533325195, "ained relatively constant during this period, ranging from $276 in 2015 to $311 in 2013. Bed charge figures for 2019 are notably lower, although this is likely attribut- able to billing delays. This means that services provided in late 2019 might hav"] [12.07811450958252, 9.004327774047852, "Reduction\n(RR; relative to no treatment)\nRelative CV risk reduction 10\u201344%\nRelative CV risk reduction 17\u201334%\nTotal mortality (RR 0.57,\nCI 0.39\u20130.78), coronary mortality (RR 0.53, CI 0.29\u2013 0.74), coronary morbidity (RR 0.46, CI 0.25\u20130.71)\nRR of CV mor"] [12.109747886657715, 9.032994270324707, " Train social workers and staff to screen for EM on newly admitted patients and residents at the Hebrew Home\n Design and implement educational and marketing material: brochures, website, press releases, newsletters, and other forms\n Partner and tr"] [12.121071815490723, 9.041072845458984, "r abuse and neglect\nProfessionals trained on EM and referral process in cases of suspected abuse\nOrganizations and older adults provided with resources on\nEM prevention and intervention strategies\nResources, strategies, and information shared to comb"] [12.075793266296387, 8.99001407623291, "rnal of Medicine, Vol. 371, 2014, pp. 1793\u20131802.\nBroeders, Mireille, Sue Moss, Lennarth Nystrom, Sisse Njor, Ho\u0302kan Jonsson, Ellen Paap, Nathalie Massat, Stephen Duffy, Elsebeth Lynge, Eugenio Paci, and EUROSCREEN Working Group, \u201cThe Impact of Mammog"] [12.13447380065918, 9.04227352142334, "w and Implications for Practice,\u201d Journal of the American Geriatrics Society, Vol. 63, 2015, pp. 1214\u20131238.\nDong, XinQi, and Melissa Simon, \u201cAssociation Between Elder Self-Neglect and Hospice Utilization in a Community Population,\u201d Archives of Geront"] [12.086555480957031, 8.993806838989258, "ect Hope), Vol. 24, No. 1, 2005, pp. 263\u2013270.\nFJC\u2014See NYC Family Justice Centers.\nFolstein, M. F., S. E. Folstein, and P. R. McHugh, \u201cMini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician,\u201d Journal of Psy"] [12.076260566711426, 8.991474151611328, "yle Modification Programmes for Patients with Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials,\u201d European Journal of Preventive Cardiology, Vol. 20, No. 4, 2013, pp. 620\u2013640.\nJongenelis, K., A. M. Pot, A. "] [12.153790473937988, 9.072402954101562, "e Bet Tzedek Legal Services Model: How a Legal Services Model Addresses Elder Abuse and Neglect,\u201d Journal of Elder Abuse and Neglect, Vol. 22, Nos. 3\u20134, 2010, pp. 275\u2013280.\nMusich, S., S. S. Wang, J. Ruiz, K. Hawkins, and E. Wicker, \u201cThe Impact of Mob"] [12.167734146118164, 9.080869674682617, " \u201cManagement of Chronic Pain in Older Adults,\u201d BMJ,\nFebruary 13, 2015.\nRichards, S. H., L. Anderson, C. E. Jenkinson, B. Whalley, K. Rees, P. Davies, P. Bennett, Z. Liu, R. West, D. R. Thompson, and R. S. Taylor, \u201cPsychological Interventions for Coro"] [12.128487586975098, 9.052312850952148, "ulse Pressure and Risk of Cardiovascular Events in the Systolic Hypertension in the Elderly Program,\u201d American Journal of Cardiology, Vol. 88, No. 9, 2001, pp. 980\u2013986.\nVillanti, A. C., Y. Jiang, D. B. Abrams, and B. S. Pyenson, \u201cA Cost-Utility Analy"] [22.435562133789062, 5.252474784851074, " Online Dispute Resolution\nPerspectives to Support Successful Implementation and Outcomes in Court Proceedings\nAmanda R. Witwer, Lynn Langton, Duren Banks, Dulani Woods, Michael J. D. Vermeer, and Brian A. Jackson\nCourt-based online dispute resolutio"] [22.436443328857422, 5.25337553024292, " needs.\nIncreasing access to justice\n\u2022 Potential strategies and partners, such as local com- munity centers and libraries, should be identified for addressing the digital divide and providing access to ODR, including via telephone assistance.\n\u2022 Featu"] [22.436941146850586, 5.253287315368652, "ODR program engagement.\nBroadly, workshop participants noted that the use of ODR could remove barriers to access to justice, but the potential barriers to engagement in ODR also need to be better under- stood and addressed. Courts need guidance to un"] [22.435707092285156, 5.252490043640137, "ernization Initiative, Pew Charitable Trusts\nAlex Sanchez\nDispute resolution department, Franklin County Municipal Court (Ohio)\nDoug Van Epps\nDirector, Office of Dispute Resolution, Michigan Courts\nLinda Warren Seely\nDirector, Section of Dispute Reso"] [22.436962127685547, 5.253357410430908, " court systems across the United States have found themselves grappling with growing numbers of disputes and have looked to technology for solutions. Moreover, an increasing empha-\nsis on procedural justice (i.e., processes that promote fair and tran"] [22.396032333374023, 5.217187404632568, "0; also see Jackson et al., 2021). In response to the ongoing public health crisis, court systems across the country have shifted away from in-person proceed- ings and toward virtual forums. Against this backdrop, judicial interest in online dispute "] [22.435504913330078, 5.25236177444458, "t system, and providing feedback to the courts\n\u2022 increased court efficiency by streamlining the resolution of disputes outside the courtroom and, in doing so, reduc- ing case backlogs and delays in case adjudication\n\u2022 improved case outcomes, such as "] [22.43100929260254, 5.2545294761657715, "iency. The rate of voluntary dismissal of court cases also is significantly higher among participants in Franklin County\u2019s small claims ODR program, particularly for defen- dants from low- and middle-income neighborhoods (Sanchez and Embley, 2020). A"] [22.430627822875977, 5.251055717468262, " variation in virtual platform origin, functionality, and integration within existing processes. In accordance with these findings, the scope of the workshop was structured to encompass the following topics:\n 1. ODR\n2. other existing court applicatio"] [22.43419647216797, 5.252077102661133, " of needs on two dimensions: their importance and their feasibility. For a more detailed description of the methodology employed in this virtual meeting, see the technical appendix.\nRESULTS\nThe primary output of the workshop was a prioritized list of"] [22.436725616455078, 5.253347396850586, "actors. To address this opportunity, participants voiced the need for guidance from objective sources about why, when, and how to reimagine court processes with ODR in mind. Addi- tionally, courts need to be provided with approaches to better underst"] [22.436870574951172, 5.2533063888549805, "the access needs of their user bases and build- ing these considerations into the design of ODR platforms, including where these platforms could complement\u2014rather than replace\u2014face-to-face interactions. Courts need to develop strategies and partnersh"] [22.435461044311523, 5.252455711364746, "of digital media as a tool for ensuring that potential ODR users understand their rights and available options.\nEvaluating ODR Programs\nThe final category of top-tier needs related to the evaluation of ODR programs. In this category, workshop partici"] [22.436885833740234, 5.253370761871338, "ce to help courts identify the technological requirements to discuss with vendors and providers.\n\u2022 Provide guidance for courts on how to effectively communicate the require- ments for due process and other legal protections in the technological platf"] [22.43668556213379, 5.253121376037598, "ms that emphasize user-centered design and features, including mobile-accessible ODR systems that do not require users to have an email address.\n \u2022 Promote the development of self-help resources, vignettes, and other infor- mational materials as a b"] [22.436641693115234, 5.2530388832092285, "ions from individual interviews with workshop participants. Presented with this\nlist at the start of the discussion, participants first determined whether the list encompassed the full scope of problems and\nopportunities and then considered the propo"] [22.436809539794922, 5.253210544586182, "could lead to more-just processes, but only if other important factors, such as fairness and transparency, are maintained.\nWhen ODR is viewed as a means to replicate in-person processes, it is key for courts to understand the appropriate processes an"] [22.436817169189453, 5.253566265106201, "the technology often think about only the existing processes, and the people who think about changing the processes do not necessarily understand the technology. There must be a way\nto merge the two perspectives; one way to start is for courts to thi"] [22.436769485473633, 5.253325462341309, " work to rectify by exploring differ- ent strategies for making potential users aware of their options and the benefits and drawbacks of those options. Participants noted that digital media is one tool for helping the public better understand ODR and"] [22.435476303100586, 5.252396106719971, "onduct evalua-\nCourts should be given opportunities to partner with researchers and should be granted the freedom to experiment with ODR approaches.\ntions, and do not have the capacity to conduct rigorous studies of the impact of ODR. Courts should b"] [22.436182022094727, 5.252785682678223, " programs. These high-priority needs relate to the design and implementation of ODR programs and platforms, strategies\nto improve access to justice, opportunities to engage potential ODR users, and the rigorous research and evaluation of ODR programs"] [14.921088218688965, 2.066091299057007, "mall group of experts. To limit the effect of that reality on the representativeness of the results, we strove to make the group as representative as possible of different disciplines, perspectives, and geographic regions. However, the final output o"] [14.930164337158203, 1.9479690790176392, "scussed and refined problems related to each category and identified potential solu- tions (or needs) that could address each problem. In addition, needs could be framed in response to opportunities to improve performance by adopting or adapting a ne"] [14.916094779968262, 1.913474440574646, "l Sessions\nOnce each participant had been interviewed and the needs had been consolidated, we held four two-hour virtual meetings using Zoom, a virtual meeting platform. These meetings were config- ured such that the participants could see each other"] [14.825921058654785, 1.8115830421447754, "ail contained a column with two dimensions: importance and probability of success. We asked each participant to score each need and associated strategies to address those needs in the document using a 1\u20139 scale and return it to us by email. Fig- ure "] [14.78650188446045, 1.7872270345687866, "the priorities that should be the primary policymaking focus, the middle-tier needs should be examined closely, and the bottom- tier needs are probably not worth much attention in the short term (unless, for example, they can be addressed with exist-"] [22.436941146850586, 5.253329277038574, "mation and best practices.\n\u2022 Develop guidance for incorporating security and privacy consid- erations into the adoption and administration of an ODR system.\n\u2022 Develop protocols for screening approaches that are specific to relevant case types, such a"] [22.43703269958496, 5.253353595733643, "nding, chatbots, connections to legal assistance por- resolving a dispute, navigating the court system, tals, and embedded features within ODR platforms; educate users; and providing feedback to the courts. and document that the user understands thei"] [22.43710708618164, 5.253504276275635, "to serve account the differences in urban, suburban, and the needs of rural jurisdictions.\nrural jurisdictions.a \u2022 Identify and develop communication channels through which suc-\ncessful ODR models can be shared with and adopted by jurisdic- tions tha"] [22.436935424804688, 5.253165245056152, "at which users are more likely to disengage (e.g., serving a process.a notice in person).\nDigital media can help engage the public in the \u2022 Develop approaches to identify and connect ODR users with court system through strategies for helping users av"] [22.431657791137695, 5.2516350746154785, "al intelligence or other emerging technologies in ODR systems to support user engagement.\n\u2022 Conduct rigorous longitudinal studies examining the impact of ODR systems on a broad variety of outcomes for ODR providers and ODR users.\n\u2022 Provide funding fo"] [13.991904258728027, 3.9888083934783936, "y and Other Needs for Improving Court Operations and Outcomes, Santa Monica, Calif.: RAND Corporation, RR-1255-NIJ, 2016. As of March 31, 2021: https://www.rand.org/pubs/research_reports/RR1255.html\nJackson, Brian A., Joe Russo, John S. Hollywood, Du"] [14.033458709716797, 4.099212169647217, "h-Pajama-Court-and-Resolving-Cases-Online.html\nRAND Corporation, \u201cDelphi Method,\u201d webpage, undated. As of April 5, 2021:\nhttps://www.rand.org/topics/delphi-method.html\nSanchez, Alex, and Paul Embley, Access Empowers: How ODR Increased Participation a"] [13.917913436889648, 4.178124904632568, "d victim responses to crime, violence against women, victim services, police-community relations, and survey methodology. Prior to joining RTI, she was chief of the Victimization Statistics Unit at the Bureau of Justice Statistics. She holds a Ph.D. "] [13.915736198425293, 4.1902265548706055, "n and virtual platforms for case navigation and resolution. This report presents the proceedings of that workshop, topics considered, needs that the panel participants developed, and overarching themes that emerged from the panel discussions. This re"] [13.86550235748291, 4.581443786621094, "ions of its research clients and sponsors. R\u00ae is a registered trademark.\n This publication was made possible by Award Number 2018-75-CX-K006, awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The op"] [15.692303657531738, 19.46733856201172, " CORPORATION\nLLOYD DIXON, JAMIE MORIKAWA\nImproving the Availability and Affordability of Pandemic Risk Insurance\nProjected Performance of Proposed Programs\n For more information on this publication, visit www.rand.org/t/RRA1223-1.\nAb"] [15.693860054016113, 19.47730255126953, "es the distinguishing features of the most-visible proposals and develops a quantitative model that shows their potential consequences. Proposed programs are evaluated in terms of the proportion of revenue decline replaced (efficacy), efficiency, aff"] [15.696379661560059, 19.47665786743164, "D improved the flow and clarity of the exposition, and Rebecca Fowler skillfully edited the document.\nContents\n AboutThisReport................................................................................... iii Figures and Tables. . . . . . . . ."] [15.698259353637695, 19.478309631347656, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51\nv\nvi Improving the Availability and Affordability of Pandemic Risk Insurance\nExpected Annual Government Outlays . . . . . . . . . . . . . . . . . . . "] [15.69905948638916, 19.479686737060547, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61\n5.2. Premium for Large Firms as Pandemic Return Period Used by Insurers Varies................................................."] [15.689695358276367, 19.4737606048584, ". 30\n3.6. MajorContagiousDiseaseIncidentsSince1918.....................................37\n4.1. ProgramPerformanceatBase-CaseParameterValues............................. 44\n4.2. Ranking of Modeled Programs by Program Metric at Base-Case Parameter Valu"] [15.6988525390625, 19.47948455810547, "ss Interruption Reinsurance program (Pandemic Re), which is open to firms with more than 500 employees.\n\u2022 TheZurichPreliminaryPandemicProposalproposesaflexibleprogramthat allows insurers to choose how much risk to bear.\n\u2022 ThePandemicRiskInsuranceActo"] [15.697708129882812, 19.47872543334961, "s were evaluated in terms of efficacy, efficiency, affordability, risk borne by commercial insurers, expected annual government net outlays, and policyholder subsidy.\nResults\nThe relative performance of the modeled programs under the base-case parame"] [15.698281288146973, 19.479156494140625, " 3 2 1\n00 Small and medium-sized firms Large firms\nto purchase coverage at these rates, remembering the large government-funded Pay- check Protection Program (PPP) in the current pandemic.\nThe premiums for large firms are comparable to those for smal"] [15.697603225708008, 19.47934341430664, "arametric insurance policy is triggered by a metric or index that is easy to determine rather than property damage or other loss suffered by the insured. In the context of pandemic risk insurance, payment would be triggered following a government dec"] [15.698591232299805, 19.47929573059082, " the amount of risk borne by commercial insurers is likely a better indicator of overall net government out- lays than direct government outlays through the pandemic insurance program.\nProjected outcomes are sensitive to several underlying model para"] [15.696050643920898, 19.478214263916016, "sured property\n\u2022 whether parametric policies would result in some firms receiving more compensa- tion than they need and others less (basis risk).\nIn this analysis, we have in effect assumed that gaps are filled, thereby resulting in the right amount"] [15.693774223327637, 19.479347229003906, "ance can create incentives to reduce risk by providing premium reductions to poli-\ncyholders that adopt risk mitigation measures. It is not obvious, however, whether insurance can create similar incentives to mitigate pandemic risk. As an example, co"] [15.695443153381348, 19.480422973632812, "s based on a number of underlying parameters, and we reviewed economic and insurance literature and data to develop reasonable values for these parameters. We also consulted with experts in the field about what values would be reasonable.4 For each p"] [15.666635513305664, 19.448081970214844, "osal 1: Business Continuity Protection Program\nThe Business Continuity Protection Program (BCPP)\u2014proposed by the American Property Casualty Insurance Association, the National Association of Mutual Insur- ance Companies, and the Independent Insurance"] [15.692684173583984, 19.474063873291016, "w the firm to maintain payroll and survive until the policy limit is reached. For a policy limit equal to three months of preshutdown payroll, benefits, and ongoing operating expenses, the coverage would last for three months under a complete shutdow"] [15.698266983032227, 19.479408264160156, " be affected? It might be more expensive for an insurer to set up coverage with a new policyholder than to add pandemic coverage on to an existing policy\nProposal 2: Chubb Pandemic Business Interruption Program\nChubb\u2019s Pandemic Business Interruption "] [15.698675155639648, 19.478652954101562, "ays of payroll and fixed costs for benefits, and\nbenefits, and\nbenefits, and\nbenefits, and\nBI policy\nparametric BI policy, ongoing expenses\nongoing expenses\nongoing expenses\nexpenses, capped at\ncapped at $50M per\n$20M per month for\nsame as underlying"] [15.696605682373047, 19.47686004638672, "e for \u0000500 employees\nVaries by\nindustry (90% for accommodations and food services, 30% for utilities); 65% economy-wide\nPandemic Risk Business Continuity Insurance Act (PRIA) Coalition (BCC) Program\nIncluded in premium\nNot discussed\n Government will "] [15.69942569732666, 19.47994613647461, "00 businesses with more than 500 employees is voluntary, with no strong opt-out or requirement that insurers offer cov- erage to large firms.\nPolicy Features\nThe policy again looks similar to those offered by the BCPP and Chubb\u2019s BEIP: Payroll and ex"] [15.703295707702637, 19.482650756835938, "le experience.7\nLike the BCPP and Chubb proposals, insurers participating in the ZPPP must offer coverage to their customers with fixed property coverage. In contrast to the BCPP and Chubb proposals, insurers are required to participate in the ZPPP.\n"] [15.696105003356934, 19.483436584472656, "c\n8 The federal subsidy in the federal crop insurance program amounts to approximately two-thirds of the premium.\n9 Rate on line is premium as a percentage of the amount of coverage provided.\n10 Zurichwouldimplementasubsidybyallowingthegovernmenttous"] [15.699959754943848, 19.481130599975586, "al applies to all P&C policies, including workers\u2019 compensation, commercial general liability, directors and\n14 BusinessContinuityCoalition,homepage,undated.\n15 Business Continuity Coalition, \u201cPandemic Risk Insurance Act Business Continuity Coalition"] [15.698149681091309, 19.47958755493164, "adjust the risk they retain over time by modifying the distribution of policies across pools.\nTo reduce the costs of simultaneously adjusting a large number of claims, all but one of the proposals rely at least in part on a parametric trigger. The Ch"] [15.6979398727417, 19.47832489013672, " BCC programs. The ZPPP can perform quite similarly to the BCPP if insurers decide to retain only a very small portion of the risk or perform more like the Chubb program if insurers retain more risk. Zurich projects that 99 percent of risk will be tr"] [15.70002269744873, 19.479873657226562, "the risk, program and policy features, take-up rate for the BCPP, and the price elas- ticity of demand. It then predicts outputs, such as insured loss, the premium, program expenses, and the allocation of cost and risk between the private and public "] [15.696418762207031, 19.478635787963867, ".1 Model Inputs\nInput\nFirms affected\nRequired revenue replacement\nReturn period\nLosses covered\nPolicyholder waiting period Policyholder co-pay\nCoverage duration Policy limit\nFirms eligible\nProgram cap Insurer deductible\nInsurer co-pay\nG&SE\nLAE ratio\n"] [15.697821617126465, 19.47888946533203, "iscussed later is this chapter, we take a different approach because the premium does not reflect the full costs of the program in some cases. To calcu- late costs of adjusting and paying claims, an LAE ratio is applied to insured loss. The ratio dep"] [15.697083473205566, 19.4791316986084, "te\nDescription\nNumber of firms purchasing coverage; projected separately for small and medium-sized firms (<500 employees) and large firms (\u0000500 employees)\nShortfall in revenue needed to sustain payroll, benefits, and ongoing operating expenses regar"] [15.696657180786133, 19.478731155395508, " proportion of insured losses (using the LAE ratio) and differ depending on whether a traditional indemnity policy or parametric policy is used.\nAnnual G&SE: These expenses are the brokerage, commission, and other selling costs associated with placin"] [15.698922157287598, 19.479902267456055, " about the return period used by insur- ers and the government in setting prices. In some cases, the insured loss relevant to pricing is only the part of overall insured loss that is the responsibility of private insur- ers. In others, it is the tota"] [15.698197364807129, 19.47943687438965, "or firms that participate in the program\nRatio of claim payments to overall program costs\nAnnual premium per firm and per $1,000 payroll\nPremium per $1,000 coverage\nInsurer incurred loss and LAE should an event occur\nCapital required by commercial in"] [15.700203895568848, 19.475971221923828, "ovide for uninsured losses. For example, if the government covered all uninsured losses, the government would ultimately cover all losses less the amount of claim payments funded by commercial insurers. Direct government outlays through the program a"] [15.67607307434082, 19.45832061767578, " We do not include these firms in our analysis. Even though the $1.29 trillion in receipts for nonemployee firms is small relative to the $37.4 trillion in receipts for firms with employees, providing revenue replacement assistance for nonemployee fi"] [15.579438209533691, 19.385528564453125, "able firms to keep payroll and benefits at prepandemic levels and cover ongoing expenses.10 However, the economy will not completely shut down. Many businesses will continue to operate, perhaps at reduced levels.\nOne measure of the economic impact of"] [15.674070358276367, 19.4549617767334, "ll, benefits, and ongoing expenses\n6.00M\n$12B\n5% of losses above insurer deductible\n$750B\n Revenue Replacement Needed to Sustain Prepandemic Payroll, Benefits, and Ongoing Expenses for 12 Months\nTable 3.5\u2014Continued\nParameter\nG&SE per policy for s"] [15.692696571350098, 19.474328994750977, "bb proposal (see Table 2.1). To facilitate compari- son of the different proposals, we assume a 20 percent co-pay for each program. As discussed in Chapter Two, the coverage provided under PRIA would be the same as the underlying BI policy, and a num"] [15.696158409118652, 19.478723526000977, " of G&SE to the premium. The ratio was 0.176 for the P&C industry overall over the last five years (Table D.1 in Appendix D).18 Using a G&SE ratio to calculate G&SE in this study presents chal- lenges because we do not have a full premium to which to"] [15.697875022888184, 19.478412628173828, "Resources Agency, August 2018). Dividing $2.11 billion by 9.5 million policies results in $222 per policy.\nModeling Approach and Base-Case Parameters 33\n 34 Improving the Availability and Affordability of Pandemic Risk Insurance\nNational Association "] [15.697856903076172, 19.479433059692383, "igation, generating substantial LAE. Data on the LAE for BI indemnity policies are not available, but it stands to reason that the LAE ratio for BI policies is higher than the 0.11 for the commercial multiple peril, nonliability line, as a whole. On "] [15.700117111206055, 19.48129653930664, "tal for Insurance Companies,\u201d Geneva Papers on Risk and Insurance, Vol. 25, No. 1, January 2000, p. 16. Kielholz\u2019s analysis focused on the use and cost of equity. He pointed out that although insurers do use debt financing, it is typically a small po"] [15.700263023376465, 19.481874465942383, "on debt to support the risk. In addition, a short return period may be necessary to convince investors to provide capital at rates that have typically been paid by the industry (see the preceding discussion of the cost of capital). Some of those with"] [15.696216583251953, 19.478763580322266, " Control and Prevention, National Center for Emerging and Zoonotic Infectious Disease, Division of High-Consequence Pathogens and Pathology, Viral Special Pathogens Branch, \u201c2014\u20132016 Ebola Outbreak in West Africa,\u201d webpage, last reviewed March 8, 20"] [15.702203750610352, 19.471107482910156, "ms with fewer than 100 employees, and according to the Census data, there are about 5.88 million firms with fewer than 100 employees.28 This sug- gests a substantial take-up rate BI coverage, but, as discussed in Appendix A, there are\n25 SeeDixonetal"] [15.762950897216797, 19.410409927368164, "he cost of terrorism coverage for certified events in the United States. In cases when the policy covers both terrorism and other perils (\u201cembedded policies\u201d), the Federal Insur- ance Office found that insurers provide terrorism coverage at no additi"] [15.68389892578125, 19.4890079498291, "he percentage change in the number of firms that purchase coverage to the percentage change in premiums. Their analysis also excluded smaller firms.\nPrice elasticities in other settings are potentially also relevant. The price elasticity of demand fo"] [15.698689460754395, 19.480445861816406, "he BCPP program, expectations of the program proposers, and review of take-up in other settings, we assume that take-up in the BCPP would be 65 percent. The take-up rates for the other programs are then adjusted from the 65 percent baseline based on "] [15.703028678894043, 19.471485137939453, "remium is $0.98 per $1,000 payroll (see Table 4.1). In contrast, workers\u2019 compensation coverage averaged $12.10 per $1,000 in the United States in 2018.1 The Federal Insurance Office puts the cost of terrorism coverage when embedded with other covera"] [15.700947761535645, 19.47899055480957, "$105,000\nTable 4.1\u2014Continued\nPerformance Metric\nGovernment outlays and revenue\nGovernment-incurred loss and LAE should an event occur\nPer participating firm\nTotal program\nAnnual government premium revenue\nSmall and Medium- Sized Firms\nBCPP Approach\nL"] [15.701045989990234, 19.47477149963379, "th fewer than 500 employees comes to $4,800 per firm.\nConsiderable uncertainty remains on the average cost of property and liability insurance for firms with fewer than 500 employees. But if the average property and liability insurance cost for busin"] [15.697259902954102, 19.478185653686523, "centage is lowest for the combined Chubb approach, but it is not high for any of the approaches.\nEfficiency\nThere is considerable LAE variation across the approaches, driven by the different loss adjustment approaches (see the \u201cEfficiency\u201d section of"] [15.698188781738281, 19.479541778564453, "ause indemnity policies are used for large firms in the Chubb proposal and for all firms in the PRIA proposal.\nAlthough a full assessment of the administrative and loan processing costs of the PPP has not been completed, initial information from the "] [15.696678161621094, 19.478723526000977, "the diversifiability index is set to 0.5 in the base case, which means that insurers need to hold half as much capital as would be the case if they treated the pan- demic coverage as entirely separate from insurance for other hazards. For comparison,"] [15.699535369873047, 19.47913360595703, "ons of net government outlays for large firms in BCPP and PRIA follow patterns similar to those for small and medium-sized firms. Because Pan-\nFigure 4.3\nExpected Annual Government Net Outlays per Participating Firm for Small and Medium- Sized Firms "] [15.7024507522583, 19.482257843017578, "e-Case Parameter Values\n250\n200\n150\n($ billions) 100\n50\n0\n\u201350\n0 10 20 30 40 50 60 70 80 90 100 Actual return period (years)\nFigure 4.8\nPolicyholder Subsidy for Small Firms\n100\nPercentage of program costs subsidized Expected annual government net outl"] [15.695977210998535, 19.47767448425293, "annual government net outlays and policyholder subsidy.\nThe greater efficiency of the BCPP and the ability of the government to price cov- erage using a much longer return period than the private sector results in the BCPP\u2019s lower premium. Although t"] [15.698114395141602, 19.479393005371094, "ecting the difficulty of insuring pandemic risk, is not particularly high in any of the programs. Chubb proposes that the insurer risk share double over time\u2014but even so, it will remain modest. One advantage of the insurer deductible in the PRIA appr"] [15.701815605163574, 19.481985092163086, "fiability index\nRate of return on capital\nValue Used in Baseline Projections\n5 years $100 $10,000 0.04 0.15 \u20130.50 0.50 9%\nPlausible Range\n[3, 100] [$50, $200] [$5,000, $20,000] [0.02, 0.06] [0.010, 0.200] [\u20130.75, \u20130.25] [0.25, 0.75] [6%, 12%]\n 59\n60"] [15.721900939941406, 19.502338409423828, "se. If insurers use a 30-year return period, the pre- miums in all three programs are quite close for small and medium-sized firms.\n1 State insurance regulators could potentially resist the use of such longer return periods, fearing that these longer"] [15.70141887664795, 19.481847763061523, "and large firms) Chubb (large firms)\n 0 10 20 30 40 50 60 70 80 90 100\nReturn period used by insurers in setting premium (years)\nSensitivity of Projections to Changes in Parameter Values 63\nFigure 5.4\nCapital Help by Insurers as Return Period Used"] [15.697745323181152, 19.47865867614746, " Chubb and PRIA approaches, and the diversifiability index has considerable impact on the amount of capital held by insurers in the Chubb and PRIA approaches.\nThe results of this sensitivity analysis suggest areas in which further work to narrow unce"] [15.701014518737793, 19.48115348815918, "\n[65, 65] [10, 10] [34, 32]\nAmount of Capital Held by Insurers ($ billions)\n[0, 0]\n[0, 0] [6.16, 5.98] [12.8, 12.4]\nExpected Annual Government Net Outlays ($ billions)a\n[18.6, 18.6] [\u20135.19, \u20134.70] [10.6, 11.7]\n[18.6, 18.6] [\u20134.79, \u20135.12] [11.5, 10.8]"] [15.698427200317383, 19.4789981842041, "insurers, the approach to paying claims, the extent to which the U.S. government receives a premium for the risk it bears, and the extent of policyholder subsidies.\nThe programs all leverage the deep capability of the commercial insurance indus- try "] [15.688733100891113, 19.47073745727539, "re order\n\u2022 whetherpoliciesbackedbyPRIAwillprovidecoverageforpandemiclosseswhen the underlying BI policies require physical damage to the insured property\n\u2022 whether parametric policies will result in some firms receiving more compensa- tion than they "] [15.666640281677246, 19.448959350585938, "e BI coverage included in the standard BOP. Others said that small businesses in the United States typically opt out of ordinary payroll coverage.\nContinuing normal operating expenses are not explicitly defined in the standard policy, which is one of"] [15.656914710998535, 19.439239501953125, "pport postshutdown level of pro- duction.\nThe firm makes zero profit in this situation.\nSubtracting the amount of income needed from the amount of income received\npostshutdown results in the amount of the insurance payment that is returned or reserve"] [15.696013450622559, 19.477230072021484, "mit \u0000 pholder _ deductible ) * (1\u0000 pholder _ copay ), program _ cap).\nThe amount of insured loss incurred by insurers should an event occur is\ninsurer _ claims =\n\u0000insured _ loss if insured _ loss \u0000 insurer _ deductible\n(C.3)\n(C.4)\n(C.5) (C.6)\n( C . 7"] [15.69791030883789, 19.47861099243164, "The premium becomes\npremiumPanRe =\ne v e n t _ p r o b * i n s u r e d _ l o s s * (1 + L A E _ r a t i o ) + \u0000 r o r \u0000 * p l o s s\nG&SE +\n1+ror *copay_industry \u0000\n\u0000\u0000\u0000 \u0000\u0000\u0000\n\u0000 \u0000 \u0000 .\n(C.12)\n premiumretained byinsurersPanRe =industry_copay*premium+ (1\u0000ind"] [15.697139739990234, 19.478614807128906, "usiness ($1,000s)\nFire 64,866,013 Homeowners multiple peril 466,275,407 Inland marine 113,496,742 International 339,248\nRatio of G&SE to Premium\n0.267 0.256 0.265 0.854 0.210 0.223 0.110 0.279 0.244 0.260\n0.212 0.229 0.290 0.475 0.181 0.210 0.241\n M"] [15.696246147155762, 19.47788429260254, "missioners data via S&P Global Intelligence, provided to RAND by the American Property Casualty Insurance Association.\nReferences\n American Property Casualty Insurance Association, \u201cProperty Casualty Insurance Industry Suffered Largest-Ever Drop in S"] [15.661250114440918, 19.44405746459961, ":\nhttps://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html\nCenters for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, \u201cHighly Pathogenic Asian Avian Influenza A(H5N1) Virus,\u201d webpage, last review"] [15.698138236999512, 19.46625518798828, "icy/cost\n\u2014\u2014\u2014, \u201cHow Much Does Business Interruption Insurance Cost?\u201d webpage, undated-b. As of April 5, 2021:\nhttps://www.insureon.com/small-business-insurance/business-interruption/cost\nInternal Revenue Service, Statistics of Income\u20142017: Corporation"] [15.677213668823242, 19.455148696899414, "Annual Payroll, and Preliminary Receipts by Enterprise Employment Size for the United States, All Industries: 2017,\u201d Excel file, March 6, 2020. As of May 5, 2021:\nhttps://w w w.census.gov/data/tables/2017/econ/susb/2017-susb-annual.html\nU.S. House of"] [15.69802188873291, 19.478918075561523, "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"] [13.273813247680664, 7.603471755981445, " CORPORATION\nSHAWN D. BUSHWAY, DULANI WOODS, DENIS AGNIEL, DAVID M. ADAMSON\nSmall Businesses, Criminal Histories, and the Paycheck Protection Program\nThere is a growing realization of the potential importance of business ownership for people with cr"] [13.272153854370117, 7.604303359985352, "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 ("] [13.275235176086426, 7.607005596160889, "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\n Abbreviations\nCI confidence interval\nCJARS Criminal Justice Administrative\nRecords System\nPPP Paycheck Protection Program\nSBA"] [13.261341094970703, 7.591428756713867, " 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"] [13.27531909942627, 7.608375549316406, "- 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\u2019s (2020) estimates and with our state-level "] [13.250689506530762, 7.5928754806518555, "g recent felonies.\nFirst, 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"] [13.278812408447266, 7.615680694580078, ", our estimate of affected employees could reasonably be considered a lower bound.\nEstimated National Prevalence of Small Business Owners with a Felony Conviction\nWe first estimate the number of small business owners who had at least one felony convi"] [13.28097152709961, 7.619053363800049, "ffected Businesses Under the Original and Revised Paycheck Protection Plan Restrictions\nWe estimate that under the revised 2021 PPP restrictions, the number of businesses affected dropped by 95 percent\u2014from 212,655 (0.47 percent of small businesses) "] [13.276302337646484, 7.615071773529053, "f businesses\n120,000\nNOTE: 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"] [13.27541446685791, 7.589563846588135, " 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"] [13.282572746276855, 7.625387191772461, "Public administration\nEducational services\nInformation\nArts, entertainment, and recreation\nFinance and insurance\nReal estate and rental and leasing\nAgriculture, forestry, fishing, and hunting\nHealth care and social assistance\nWholesale trade\nTranspor"] [13.263978004455566, 7.594916820526123, "7 (3,045\u20134,009) 29,698 (28,050\u201331,345) 59,960 (57,410\u201362,510) 54,046 (51,760\u201356,332) 32,224 (30,573\u201333,874) 13,223 (12,159\u201314,287) 19,978 (17,051\u201322,905)\nAffected Businesses, Revised PPP (95-percent CI)\n127 (97\u2013156) 1,453 (1,334\u20131,572) 3,308 (3,099\u20133"] [13.271635055541992, 7.6147871017456055, "findings would likely change but could be less accurate, as\nthe PPP restrictions apply only to individuals with a 20-percent or larger ownership stake.\nUsing this final sample frame, we asked DatabaseUSA to randomly sample its records by state and bu"] [13.274321556091309, 7.628127098083496, "nnesota\u2019s real-world equivalent; as a result, our estimate for any criminal activity for Minnesota should be viewed as a minimum estimate.\nSecond, name-based matching approaches will inevitably produce false positives (individuals incor- rectly match"] [13.299545288085938, 7.633919715881348, "tage)\n2.0\n1.0\n0\nAll criminal history\n 3.43\n 2.48\n2.54\n 0.82\n0.86\n 0.38\n 0.22\n 0.09\n0.13\n 3.0\n All Within felonies 5 years\nAll criminal All\nWithin 5 years\nAll criminal history\nAll felonies\nOther\nWithin 5 years\nConstruction\nNOTE: Data w"] [13.273149490356445, 7.6092963218688965, "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"] [13.273497581481934, 7.606651782989502, " 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 "] [13.230630874633789, 7.557181358337402, "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"] [13.266995429992676, 7.601048946380615, "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"] [13.270980834960938, 7.604034900665283, "were ignored. Nonetheless, written restrictions could have discouraged applicants who did not want to run afoul of federal rules (Brayne, 2014).\n2 For example, when working directly with state criminal history data, we checked for duplicate name and "] [13.269848823547363, 7.5801472663879395, "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\nBang, Heejung, and James M. Robins, \u201cDoubly Robust Estimation in "] [13.27664852142334, 7.590724945068359, ",\u201d webpage, undated-a. As of May 18, 2021: https://chs.state.mn.us/Home/Faq\n\u2014\u2014\u2014, \u201cSearch Public Criminal History,\u201d webpage, undated-b. As of May 18, 2021:\nhttps://chs.state.mn.us/Search/ChsSearch\nNorth American Industry Classification System Associat"] [13.274740219116211, 7.603123664855957, "- increases-lending-to-small-businesses-in-need-announces- changes-to-ppp-to-further-promote-equitable-access-to-relief\n 18\nAcknowledgments\nThe authors would like to thank Tim Pinkerton of DatabaseUSA for his patience through hundreds of iterations a"] [13.852702140808105, 4.5477681159973145, "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"] [16.18927764892578, 17.383378982543945, " CORPORATION\nDEBORAH R. HENSLER, JASMINKA KALAJDZIC, PETER CASHMAN, MANUEL A. GO\u0301MEZ, AXEL HALFMEIER, IANIKA TZANKOVA\nThe Globalization of Mass Civil Litigation Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n For more information on this publicat"] [16.175546646118164, 17.369651794433594, " more intriguing examples of this type of litigation, the recent Volkswagen (VW) \u201cclean diesel\u201d case, a global litigation that proceeded in parallel in multiple national jurisdictions. Many scholars and practitioners believe that this sort of transna"] [16.16782569885254, 17.361690521240234, "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 Grise\u0301 and Roger Trangsrud, for thei"] [16.179393768310547, 17.372974395751953, "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.\nThe roundtable discussion suggested that the VW litigation is not a \u201cone-off.\u201d Indeed, many p"] [16.205665588378906, 17.396944046020508, "........................................................ 8 Canada.................................................................................................... 9 Australia ........................................................................"] [16.17742156982422, 17.371850967407227, " FIVE\nLessons from the Volkswagen \u201cClean Diesel\u201d Litigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 APPENDIX\nAttendee List. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [16.180660247802734, 17.37486457824707, " services are manu- factured and sold worldwide, problems associated with these products and services inevita-\n1 In the popular press and many legal documents, this software was referred to as a defeat device.\n2 See, e.g., Margaret Moses, The Princip"] [16.173336029052734, 17.36713218688965, " 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"] [16.111820220947266, 17.30510139465332, "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"] [16.166759490966797, 17.360599517822266, "ns from 2007 to 2011,2 was a natural venue for the roundtable. RAND\u2019s 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"] [16.163738250732422, 17.3566837310791, "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"] [16.11964988708496, 17.30133056640625, " 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"] [16.08988380432129, 17.277217864990234, "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"] [16.150800704956055, 17.33991241455078, "Class Actions, 2005\u20132012,\u201d Fordham Law Conference, Vol. 87, No. 1, February 2018.\n8 Code of Civil Procedure, RSQ c C-25.01, Book VI, art. 571\u2013604.\n 9\nThe Globalization of Mass Civil Litigation: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n however"] [16.147531509399414, 17.338031768798828, " 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"] [16.163408279418945, 17.35566520690918, " 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"] [16.13978385925293, 17.314517974853516, "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 \u201cfree ride\u201d on "] [16.158960342407227, 17.348953247070312, "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"] [16.171051025390625, 17.363704681396484, "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).\n21 Haselhurst v Toyota Motor Corporation"] [16.172121047973633, 17.364076614379883, " Australian Law Reform Commission, Integrity, Fairness and Efficiency\u2014an 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"] [16.185705184936523, 17.3796329498291, "pMuG procedure is lim- ited to the field of prospectus liability and other claims based on alleged violations of capital market information duties.\nIn 2018, partly in response to the VW litigation, the Musterfeststellungsklage was created for consume"] [16.161481857299805, 17.353759765625, "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\u2019 Association), or it can be"] [16.158174514770508, 17.349571228027344, "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"] [16.15956687927246, 17.35149383544922, "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\u2014enacted between 1985 and 1990\u2014tha"] [16.155656814575195, 17.347002029418945, "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"] [16.169023513793945, 17.36159324645996, "ion: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n 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"] [16.1568660736084, 17.348133087158203, "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.\u201d63\nThe CPA vests Chilean judges with certain powers not commonly seen in ordinary"] [16.154203414916992, 17.345521926879883, "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"] [16.183382034301758, 17.3773250579834, "oved\nassociation\nExisting\nYes\nRepresentative\nTranssubstantive\nassociation\nand ad hoc\nfoundation\n Court Order? Certification or\nYes (court\nAggregate\n(model\nselects\n Aggregate or Representative\nScope Transsubstantive Transsubstantive\nJurisdiction\nRep"] [16.18307876586914, 17.37718391418457, " litigation through about June 2020, as reported in this chapter.\n1 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"] [16.204898834228516, 17.40068244934082, "the automobiles\u2019 emissions were many times greater than per- mitted under California\u2019s tough pollution-control standards.\nIn March 2014, the research team presented its findings at a conference in Southern California. In the audience were automobile "] [16.198762893676758, 17.393299102783203, "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 "] [16.188434600830078, 17.38295555114746, "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. \u201cWe select Judge Charles R. Breyer as the transferee judge,\u201d the panel wrote"] [16.2074031829834, 17.40242576599121, "rder, MDL 2672, December 8, 2015, p. 3.\n13 David Shephardson, \u201cBosch Concealed Volkswagen Use of \u2018Defeat Device\u2019 Software: Lawyers,\u201d Reuters, September 8, 2016.\n14 Judge Breyer, Cabraser, Giuffra, and Feinberg all participated in the Stanford-RAND ro"] [16.19561767578125, 17.390100479125977, "a- tives of the DOJ, federal EPA, and CARB, as well as plaintiff and defense counsel, he asked: \u201cWhat 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"] [16.199975967407227, 17.394994735717773, "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"] [16.203725814819336, 17.39859962463379, "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"] [16.208051681518555, 17.403356552124023, ".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"] [16.198152542114258, 17.392908096313477, "iller, \u201cAttorney Fees in Class Action Settlements: An Empirical Study,\u201d Journal of Empirical Legal Studies, Vol. 1, March 2004; Theodore Eisenberg and Geoffrey P. Miller, \u201cAttorney Fees and Expenses in Class Action Settlements: 1993\u20132008,\u201d Journal of"] [16.201669692993164, 17.396690368652344, ".G. Schneiderman Announces Volkswagen to Pay New York $32.5 Million\u2014Marking First-Ever NY State Environmental Enforcement Penalty Against an Automaker for Emissions Violations,\u201d press release, March 30, 2017.\n33 In re Volkswagen \u201cClean Diesel\u201d Litiga"] [16.199485778808594, 17.394207000732422, "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 \u201cclean diesel\u201d scandal is Germany, "] [16.198713302612305, 17.39402961730957, "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"] [16.200578689575195, 17.395578384399414, "intiffs\u2019 motion for certifi- cation for settlement purposes was granted in its entirety.51 The judge certified a class of \u201call persons\u201d (excluding residents of Quebec, who were members of a separate class action in that province) who were registered "] [16.207834243774414, 17.403194427490234, "ounsel C$9.9 million.\nIn 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"] [16.197031021118164, 17.390708923339844, "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\u2014nor precluded by\u2014the settlement agreement.\nTwo proposed securities class actions"] [16.190227508544922, 17.384536743164062, "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"] [16.175701141357422, 17.370431900024414, "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"] [16.199443817138672, 17.393619537353516, " 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"] [16.194643020629883, 17.385051727294922, "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"] [16.204116821289062, 17.399581909179688, "n class action litigation are an obvious problem in such jurisdictions as Australia, where the representative applicants may be liable to pay the respondents\u2019 costs if the litigation is unsuccessful.\nNotwithstanding the inordinate delay and substanti"] [16.19968032836914, 17.394365310668945, ", which is the holding company of the VW group. These actions are of a lower monetary volume but still approach \u20ac1 billion altogether. Many of them have been brought before the lower court in Stuttgart, where Porsche\u2019s headquarters are located. The l"] [16.196197509765625, 17.391395568847656, "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"] [16.199567794799805, 17.394203186035156, "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"] [16.195938110351562, 17.390268325805664, "sgerichtshof, 25 May 2020, VI ZR 252/19.\n83 \u201cBraunschweig ist Spitzenreiter bei VW-Klagen,\u201d NDR, July 6, 2018.\n84 Volker, 2019.\n 45\nThe Globalization of Mass Civil Litigation: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n the VW group consists of "] [16.2049617767334, 17.399431228637695, "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"] [16.199352264404297, 17.393308639526367, "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"] [16.199626922607422, 17.39418601989746, "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"] [16.200895309448242, 17.394861221313477, " 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"] [16.222408294677734, 17.417171478271484, "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"] [16.192537307739258, 17.385669708251953, "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"] [16.2012996673584, 17.395610809326172, "f Sa\u0303o Paulo) surpasses R$65 million (approximately US$12 million to June 2020).98 The first and largest one, for R$50 million\n96 Dia\u0301rio Oficial, Poder Executivo\u2014Sec\u0327a\u0303o I, Sa\u0303o Paulo: Imprensa Oficial, Vol. 129, No. 84, 2019, pp. 37\u201338. 97 Giorgio "] [16.206836700439453, 17.400794982910156, "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\n99 Brazilian Institute of the Environment and Renewable Na"] [16.202320098876953, 17.3977108001709, "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"] [16.208938598632812, 17.404653549194336, "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\u2019s own certification. Regarding the United States, the complaint specifically mentioned the criminal action filed agains"] [16.199079513549805, 17.39336585998535, "tec, it argued that it was wrongfully included in the complaint because it had no relationship with VW and that\nDitec\u2019s vehicles were different from those affected.\nIn September 2019, the parties requested that the court suspend the proceedings so th"] [16.2011661529541, 17.397262573242188, " US$18,000 value per consumer in buybacks and direct payments; a total of US$9.5 billion value to approximately 537,000 consumers\nOwners/lessees entitled to C$5,000\u2013$8,000, plus choice to\nsell or trade in the vehicle, terminate the lease without pena"] [16.192609786987305, 17.386917114257812, "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"] [16.200130462646484, 17.396316528320312, " set of facts, claimants, and potentially liable defendants\u2014that brought the roundtable participants together and engendered the lively discussion that took place in April 2019.\nLesson 2: On the surface, the VW litigation suggests that procedures for"] [16.181211471557617, 17.37344741821289, "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 "] [16.182523727416992, 17.37779426574707, "f Mass Civil Litigation: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n 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"] [16.193029403686523, 17.38797950744629, "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\n62\nLessons from the Volkswagen \u201cClean Diesel\u201d Litigation\n action m"] [16.1809139251709, 17.362199783325195, "g representative actions on behalf of consumer interests, which was deemed not to \u201csufficiently address the challenges relating to the enforcement of consumer law.\u201d See para. 9.\n 63\nThe Globalization of Mass Civil Litigation: Lessons from the Volkswa"] [16.222328186035156, 17.417884826660156, "at this would reduce expense and delay in global litigation. To for- eign defense counsel, opening up their court proceedings to \u201cU.S.-style discovery\u201d was anath- ema. And some were wary of sharing even more-general information among judges, as it\n64"] [16.180130004882812, 17.37468719482422, "ternational Court of Civil Justice, Cambridge, UK: Cambridge University Press, 2018.\n 65\nThe Globalization of Mass Civil Litigation: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n Lesson 9: In the long run, global mass civil litigation is more like"] [16.187664031982422, 17.381973266601562, "al University USA\nJutta Gurkmann Verbraucherzentrale Bundesverband Germany\n 67\nThe Globalization of Mass Civil Litigation: Lessons from the Volkswagen \u201cClean Diesel\u201d Case\n Axel Halfmeier Leuphana University Germany\nDeborah Hensler Stanford Law School"] [16.20302963256836, 17.398136138916016, "overnment, Federal Register of Information, Vehicle Standard (Australian Design Rule 79/04\u2014Emission Control for Light Vehicles), 2011, Sec. 2, Applicability and Implementation. As of October 5, 2020: https://www.legislation.gov.au/Details/F2012C00284"] [16.203197479248047, 17.398265838623047, "October 5, 2020: https://www.cand.uscourts.gov/judges/breyer-charles-r-crb/in-re-volkswagen-clean-diesel-mdl/ final-2-0-l-settlement/\nBreyer, Charles R., \u201cExecutive Summary of Final Class Settlement Program (3.0 Liter Engine Vehicles),\u201d U.S. District"] [16.20197868347168, 17.397310256958008, " 2020:\nhttps://www.huntonak.com/en/covid-19-tracker.html\nDia\u0301rio Oficial, Poder Executivo\u2014Sec\u0327a\u0303o I, Sa\u0303o Paulo: Imprensa Oficial, Vol. 129, No. 84, 2019, pp. 37\u201338.\nDiesel Emissions Justice Foundation, \u201cNews,\u201d webpage, undated. As of October 5, 2020"] [16.201419830322266, 17.39610481262207, "ne per i vertici di Volkswagen Italia,\u201d La Repubblica, April 20, 2020.\nFundac\u0327a\u0303o Procon\u2013Sa\u0303o Paolo, \u201cEmpresa utilizou software que mascara emisso\u0303es de gases na Amarok,\u201d November 15, 2015. As of October 2, 2020: https://www.procon.sp.gov.br/procon-s"] [16.198314666748047, 17.392332077026367, "page, undated. As of October 6, 2020: https://jade.io/j/\nJustice Que\u0301bec, \u201cFonds d\u2019aide aux actions collectives,\u201d homepage, undated. As of October 2, 2020:\nhttp://www.faac.justice.gouv.qc.ca/\nKalajdzic, Jasminka, Peter Cashman, and Alana Longmoore, \u201c"] [16.202180862426758, 17.396705627441406, "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,\u201d press release, July 19, 2016b. As of O"] [16.198440551757812, 17.392574310302734, "r-Fees-for.pdf\nOrganizacio\u0301n de Consumidores y Usuarios de Chile, \u201cQuie\u0301nes Somos,\u201d webpage, undated. As of April 26, 2021:\nhttps://www.odecu.cl/quienes-somos/\n76\nBibliography\n Parliament of Australia, \u201cLitigation Funding and the Regulation of the Cl"] [16.226104736328125, 17.421056747436523, "rofits and Pride at Stake, the Race for a Vaccine Intensifies,\u201d New York Times, May 2, 2020.\nSettlement Class Counsel\u2019s Statement of Additional Information Regarding Prospective Request for Attorneys\u2019 Fees and Costs, In re Volkswagen \u201cClean Diesel\u201d L"] [16.205650329589844, 17.40018653869629, "d in VW \u2018Dieselgate\u2019 Case,\u201d BBC News, April 6, 2020. As of October 5, 2020:\nhttps://www.bbc.com/news/business-52184229\nUnited Nations Economic Commission for Europe, Regulation 83, Uniform Provisions Concerning the Approval of Vehicles with Regard to"] [16.205785751342773, 17.400184631347656, "1-7-milliarden-euro/24457804.html?ticket= ST-209253-gIbVvEiCIaFkghvWLD69-ap1\n\u201cVW Faces \u2018Dieselgate\u2019 Lethal Threat in France,\u201d The Connexion, January 27, 2020. As of October 5, 2020: https://www.connexionfrance.com/French-news/Car-manufacturer-Volkswa"] [15.464385032653809, 3.182572603225708, " Community Supervision in a\nDigital World\nChallenges and Opportunities\nJoe Russo, Michael J. D. Vermeer, Dulani Woods, and Brian A. Jackson\nDelivering effective community supervision services has always been challenging; however, recent societal shif"] [15.45853042602539, 3.2062489986419678, "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\nor low-cost and sustainable (e.g., supported, regularly update"] [15.46894645690918, 3.1750571727752686, "rvision tool. Specifically, policy guidance and training are needed to high- light the issues surrounding monitoring individuals\u2019 activity on these sites (e.g., what the benefits are, when it is appropriate, what the proper techniques are, what the p"] [15.46722412109375, 3.1723644733428955, "hat stakeholders (e.g., legisla- tors, judges, prosecutors)\u2014whose decisions affect how community supervision agencies apply digital management strategies\u2014require better education. For example, broad-brush bans on accessing technology might be unreali"] [15.380926132202148, 3.1404757499694824, "e, computer-facilitated crime is growing rapidly. According to the Federal Bureau of Investigation\u2019s (FBI\u2019s) Internet Crime Com- plaint Center, more than 460,000 complaints were received\nin 2019, an increase of nearly 33 percent from the previous yea"] [15.450278282165527, 3.1746935844421387, "lectronic devices.\nThese special conditions of supervision serve as guidelines that set the stage for specific digital management strategies\nto help deter or detect criminal activity and/or behaviors that violate the conditions of supervision.1 Furth"] [15.466870307922363, 3.184004068374634, "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"] [15.393576622009277, 3.2579970359802246, "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\nprobation and pretrial "] [15.434072494506836, 3.2016994953155518, "essag-\ning and chat logs, file-sharing activity) of the device and will report any violations or keyword \u201chits\u201d to authorities. These systems are capable of blocking unauthorized sites and detect- ing attempts to tamper with or delete the monitoring "] [15.457526206970215, 3.180638074874878, " the presence of the supervisee). Monitoring an individual\u2019s 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"] [15.473556518554688, 3.1746301651000977, " ignored; it must be managed.\nAlthough 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"] [15.448616027832031, 3.1703529357910156, "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"] [15.39638900756836, 3.124998092651367, "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.\nOverall, more than one-third of all of the needs identified were related to the tools and training required to effec"] [15.360437393188477, 3.1069257259368896, "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"] [15.492748260498047, 3.179590940475464, "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.\n\u2022 Develop case studies to promote the benefits (e.g., cost-sh"] [15.472460746765137, 3.198166847229004, "agement that is required for supervisees.\nThere is a dearth of evidence around the effectiveness of digital management strategies.\n\u2022 Develop best practices, policies, and templates for a digital intake process (and periodic updates) that includes all"] [15.467961311340332, 3.1789298057556152, "ish a supervisee\u2019s individual baseline for cyber risk. This baseline could be informed by relevant information, such as\nan inventory of electronic devices an individual owns or to which they have access; software or applications to which they have ac"] [15.462858200073242, 3.202357530593872, "vices\n(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 "] [15.464469909667969, 3.170226812362671, "e.g., friends of friends), and protects the officer\u2019s 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 "] [15.470403671264648, 3.215944766998291, "society.\nThe 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"] [15.474746704101562, 3.182865858078003, "roups (e.g., sex offenders, gang members, violent offenders, financial criminals).\nThe participants recognized that identifying the most- appropriate measures of effectiveness will be challenging. In general, the more intensive the management approac"] [15.456584930419922, 3.2058777809143066, "oads, it is\nno 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"] [14.975028991699219, 2.1607112884521484, "ent additional details about the workshop agenda and the process for identifying and prioritiz-\ning technology and other needs related to community supervi- sion in a digital world. Through this process, we developed the research agenda that structur"] [14.928174018859863, 2.0404305458068848, "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"] [14.826285362243652, 1.813951849937439, "tionality from Turning Tech- nologies). We asked each participant to score each need and associated strategies to address those needs using a 1\u20139 scale for two dimensions: importance and probability of success.\nFor the importance dimension, participa"] [14.785762786865234, 1.757778525352478, " the respon- dents and used that as the group\u2019s collective expected value score for the need.\nWe clustered the resulting expected value scores into three tiers using a hierarchical clustering algorithm. The algorithm we used was the \u201cward.D\u201d spherica"] [14.780233383178711, 1.705087423324585, "mine the point value of a single vote, we divided the full range of expected values by the number of participants voting.\nTo prevent the (somewhat rare) situation in which small numbers of votes have an unintended outsized impact\u2014for example, when so"] [14.803319931030273, 1.6734098196029663, "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\u2019s prioritized results.\nThe complete list of identified needs is shown in Table A.2, and the needs are sorted by "] [14.762001991271973, 1.7182148694992065, "ble to upvote items in that tier).\n 20\nFigure A.4. How a Need\u2019s Increase in Expected Value Might Result in Its Movement Across Tier Boundaries\nHigher score\nTier 1 score range\n1\n 1\n1\n 2\n Tier 2 score range\n22\n2\n 2\n Lower score\nTier 3\nscore 333"] [15.529316902160645, 3.212780714035034, ".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 "] [15.472763061523438, 3.1896750926971436, "ome try to avoid risks\nby denying supervisees access to digital devices.\nNeed Tier\n\u2022 Develop educational materials for stakeholders that illustrate the importance of managed individual access to technology for prosocial activities (as opposed to outr"] [15.48397445678711, 3.1657512187957764, "ng opportunities to fully leverage the spectrum of supervisee digital information.\nAgencies have incorporated digital management into comprehensive supervision approaches for some individuals (e.g., sex offenders), but similar principles have not bee"] [15.366073608398438, 3.249669313430786, "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.\n2 For example, the Nevada Department of Public\nSafety"] [13.948052406311035, 3.7513363361358643, "port on Public Safety: Tools and Strategies to Help States Reduce Crime, Recidivism, and Costs, New York, July 31, 2018.\nDance, Gabriel J. X., and Michael H. Keller, \u201cTech Companies Detect a Surge in Online Videos of Child Sexual Abuse,\u201d New York Tim"] [13.984723091125488, 3.872083902359009, "nta Monica, Calif.: RAND Corporation, RR-A108-8, 2021. As of June 10, 2021: https://www.rand.org/pubs/research_reports/RRA108-8.html\nJohnson, Derek B., \u201cCongress Targets COVID Cyber Fraud,\u201d Federal Computer Week, June 17, 2020. As of November 6, 2020"] [13.94974136352539, 4.113432884216309, "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\nTanner, Jim, \u201cBeyond Prosecution: Improving Computer Management of Convict"] [13.919489860534668, 4.1813836097717285, " 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"] [13.903043746948242, 4.233789920806885, "sing Evidence-Based Practices, Santa Monica, Calif: RAND Corporation, RR-A108-5, 2020\n\u2022 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,"] [13.857645034790039, 4.603542804718018, "Corporation\nwww.rand.org\nThe 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"] [22.98597526550293, 14.09825611114502, "Evaluating Baltimore\u2019s\nAerial Investigation\nResearch Pilot Program Interim Report\nANDREW R. MORRAL, TERRY L. SCHELL, ROSANNA SMART, BRANDON CROSBY, JUSTIN LEE, ROSE KERBER\n Sponsored by Arnold Ventures\nSOCIAL AND ECONOMIC WELL-BEING\n For more informa"] [22.98784637451172, 14.100647926330566, "out their experiences with the program and (2) an analysis of cases that closed after receiving AIR evidence.\nThis report might be of interest to policymakers and the public interested in Baltimore\u2019s experience using increased surveillance as a means"] [22.987653732299805, 14.099605560302734, "... 19 CHAPTER FIVE\nSurvey of Detectives\u2019 Experiences with the AIR Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 CHAPTER SIX\nReview of Cases Closed with AIR Evidence . . . . . . . . . . . . . . . . . . . . "] [22.984731674194336, 14.096766471862793, " 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"] [22.987489700317383, 14.100017547607422, "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.,\nix\n Plane may re"] [22.98709487915039, 14.09917163848877, "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"] [22.984514236450195, 14.098018646240234, ".\nBecause 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"] [22.986413955688477, 14.099008560180664, "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"] [22.98621940612793, 14.097993850708008, "ze (8.0 per 1,000 population).\nIn 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\n1 The UCR definition of violent crime"] [22.98639678955078, 14.098400115966797, "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"] [22.986303329467773, 14.098517417907715, "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\u2019s homicides occurred).\n\u2022 With rare exceptions approved by the Commissioner, th"] [22.986398696899414, 14.098701477050781, " 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 "] [22.986648559570312, 14.098910331726074, " six months. The program involved collaboration between the BPD, PSS, several evaluation teams, and (to a lesser extent) the State\u2019s Attorney\u2019s Office, which handles prosecutions in Baltimore. Financial support from Arnold Ventures was used to pay PS"] [22.986421585083008, 14.098553657531738, "and the procedures for making such requests.\nIn 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"] [22.986783981323242, 14.098888397216797, " 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.\na request for AIR investigation (see Figure 2.4). AIR analysts would then examine a"] [22.986738204956055, 14.098661422729492, "s.\nTogether, these activities and the AIR evidence packages were expected to improve the BPD\u2019s 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"] [22.98694610595703, 14.098511695861816, "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"] [22.987384796142578, 14.098220825195312, "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"] [22.9868221282959, 14.098847389221191, "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"] [22.987041473388672, 14.098445892333984, "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"] [22.98697853088379, 14.09866714477539, "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.\nThe MOU allowed the possibility that AIR review might be requested for incidents"] [22.99105453491211, 14.103185653686523, "were in place for ensuring that the AIR program was notified to begin review of these cases.\n17\nCHAPTER FOUR\nMOU Crimes and Case Dispositions During the AIR Program\nDuring the six-month AIR program, 1,516 MOU crimes were reported across the city of B"] [22.98676872253418, 14.098780632019043, "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.\n 19\nEvaluating Baltimore\u2019s Aerial Inv"] [22.984722137451172, 14.099446296691895, " 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"] [22.987037658691406, 14.098909378051758, "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 "] [22.98697853088379, 14.098791122436523, "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.\nThis survey has a small sample size; the margin of error for percentages calcu"] [22.986919403076172, 14.09884262084961, "cene of crime\u201d was the most commonly selected response, while \u201cidentifying a key witness\u201d 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"] [22.988115310668945, 14.1005220413208, "ing responses about the utility of these improvements:\n\u2022 \u201cExtending program coverage to include nighttime hours\u201d (18 responding \u201cmuch more useful\u201d)\n\u2022 \u201cIncrease video resolution\u201d (18 responding \u201cmuch more useful\u201d)\n\u2022 \u201cExpand coverage areas to reduce ga"] [22.987150192260742, 14.099308967590332, "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\u2019s Lotus Notes"] [22.988033294677734, 14.10036849975586, "e received from the program.\nTherefore, 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 \u201chelpful\u201d (five cases) or \u201ccrit"] [22.987302780151367, 14.099241256713867, "he BPD in time for it to be included in this report.\n29\nCHAPTER SEVEN\nDiscussion\nThe AIR program launched before its requisite systems (including aircraft), detective train- ing, and policies and procedures were fully developed and operational. The p"] [22.987876892089844, 14.100516319274902, "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), "] [22.987884521484375, 14.100095748901367, "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"] [22.98588752746582, 14.097885131835938, "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"] [22.987642288208008, 14.099702835083008, "es.\nIdentification of Cases\nCases 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\u2019s Lotus Notes data system. This data system is used to record f"] [22.979957580566406, 14.099165916442871, "cs.\nPropensity 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"] [22.985387802124023, 14.098458290100098, "\n0.16\n 0.13\n0.10\n0.05\n0.03\n0.04\n0.05\n0.06\n0.07\n0.06\n0.10\n0.16\n0.17\n0.52\n0.17\n0.13\n0.10\n0.05\n0.03\n0.04\n0.04\n0.06\n0.06\n0.06\n0.09\n0.16\n0.17\n0.51\n0.16\n37\nEvaluating Baltimore\u2019s Aerial Investigation Research Pilot Program: Interim Report\n Table A.1\u2014contin"] [8.396116256713867, 4.379004955291748, " Vol. 18, No. 3, 2019, pp. 525\u2013551.\nCook, Philip J., and Jens Ludwig, \u201cPolicing Guns: Why Gun Violence Is Not (Just) a Public Health Problem,\u201d Items: Insights from the Social Sciences, blog post, November 6, 2018. As of January 19, 2021:\nhttps://item"] [22.979421615600586, 14.090922355651855, "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\nLim, Hyungjin, and Pamela Wilcox, \u201cCrime-Reduction Effects of Open-Str"] [13.832063674926758, 3.844480037689209, "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\nWelsh, Brandon C., and David P. F"] [6.367111682891846, 16.61534881591797, " CORPORATION\nJASON M. WARD\nThe Effects of Project Labor Agreements on the Production of\nAffordable Housing Evidence from Proposition HHH\nResearch Report\n For more information on this publication, visit www.rand.org/t/RRA1362-1.\nAbout RAND\nThe RAND"] [6.3480143547058105, 16.556325912475586, "ombining housing and labor policies. Consistent with the RAND Corporation\u2019s 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"] [6.387823581695557, 16.708816528320312, "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"] [6.3876261711120605, 16.706283569335938, ". 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 \u201cprevailing\u201d (union-level) wages that are specified annua"] [6.387785911560059, 16.70568084716797, " In contrast, there was one proposed project falling between 65 and 69 units.\nvi\nFigure S.1. Frequency Distribution of Project Sizes for HHH-Funded Projects\n Threshold for PLA\n 20\nNumber of projects\n10\n5\n0\n5 20\n15\n 35 50\n65 80 95\n110 125 140 1"] [6.379860877990723, 16.686420440673828, " foregone profits related to higher costs would create incentives similar to what might be expected of developers of market-rate housing.\nDeveloper concerns about the PLA adding uncertainty over costs and timelines may\nhave been an important factor. "] [6.386010646820068, 16.705936431884766, "...................... xii\n1. Introduction................................................................................................................................. 1 The High Costs of HHH-Funded Housing Projects .............................."] [6.385926723480225, 16.70966148376465, "...................................................................................................... 32 Limitations of the Cost Analysis ............................................................................................................ 34"] [6.39310884475708, 16.72026252746582, ".... 21 Figure 4.2. Distribution of Project-Size Shares by Funding Source............................................. 22 Figure 5.1. Per Unit Costs and Cost Differences by Project Size................................................. 24 Figure 5.2. "] [6.379831314086914, 16.66619110107422, "ternate Data Exclusions Around the PLA Threshold .............................................................................................................................. 61 Table B.7. Descriptive Statistics for Cost-Analysis Sample............."] [6.3658881187438965, 16.69193458557129, "t this achievement has been overshadowed by the impression that HHH has failed to deliver on its\n1 \u201cPermanent supportive housing\u201d (or sometimes simply \u201csupportive housing\u201d) is a broad term used to indicate housing units intended as permanent residenc"] [6.378336429595947, 16.708742141723633, " 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\n2 Most projects only have estimated costs at this time since they are either in the pre-construction or construction phas"] [6.386632919311523, 16.70134735107422, "s among HHH projects has focused primarily on non\u2013 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"] [6.389137268066406, 16.70395278930664, " important ramifications for the effectiveness of Proposition HHH, the PLA was not included in the language of the ballot initiative.6\n\u2022 During the debate between developers, trade union representatives, and the city over the structure of the PLA, no"] [6.387796878814697, 16.705781936645508, "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"] [6.3902907371521, 16.70762825012207, "disadvantaged (or \u201ctransitional\u201d) 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"] [6.385544776916504, 16.697521209716797, "e built are\n7 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"] [6.392985820770264, 16.71217918395996, " controversial and relatively scant.\nThe 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 "] [6.3897175788879395, 16.707752227783203, " 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"] [6.391055583953857, 16.709274291992188, "ess, among the studies conducted or funded by organizations with a policy position on PLAs, the findings are, in every case,\n10\nstrongly aligned with the policy positions of the organization, an association that does\nlittle to contribute to the quali"] [6.394489765167236, 16.713014602661133, "e associated with 25 percent higher construction costs (Bachman and Tuerck, 2006).\nA critical weakness of this series of studies is that projects subject to a PLA may differ in important ways\u2014such as geographic differences in construction costs and d"] [6.392509460449219, 16.709529876708984, "t and became statistically insignificant, suggesting that much of the estimated PLA association likely represented aggregated cost factors unique to Los Angeles.\nA pro-PLA 2015 working paper that is perhaps most conceptually relevant to the present s"] [6.406373977661133, 16.723085403442383, "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\nEvidence on the"] [6.386590003967285, 16.700374603271484, "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.\nTable C.1 presents all the main findings from the"] [6.3853020668029785, 16.70738983154297, "t is the nature of the threshold that triggers a project falling under the HHH PLA\u2014whether it comprises 65 or more housing units. Typical PLAs associated with the construction of a given project or set\n13 As discussed below, I also control for potent"] [6.386785507202148, 16.708070755004883, " 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"] [6.395887851715088, 16.715309143066406, "g the size of the standard errors but not the sign or magnitude of the estimate (Wooldridge, 2020).\nEvidence on the Comparability of the HHH and Non-HHH Data Samples\nThe validity of this study hinges, in significant part, on the comparability of the "] [6.389340400695801, 16.711759567260742, "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"] [6.375965118408203, 16.704286575317383, "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"] [6.389860153198242, 16.712560653686523, "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"] [6.388844966888428, 16.71630859375, "on.\nBasic cost tabulations showing how project size is associated with costs for HHH-funded and non\u2013HHH-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"] [6.418435573577881, 16.750202178955078, "o 60 units or going from 70 to 100 units is associated with a per unit construction cost decrease of $6,960.\nBy construction, the fitting of a single line to the data does not allow for the estimation of potential differences in construction costs as"] [6.398928165435791, 16.729007720947266, "rcise is simply to\n 26\nprovide the intuition behind the regression modeling approach used. The model used to generate the actual cost estimates in this report\u2014described below and in more detail in Appendix B\u2014 simultaneously uses the discontinuity-ba"] [6.386753559112549, 16.707786560058594, "phical example in panel B of Figure 5.2 above) are:\n20 Recent examples of this approach include Lemieux and Milligan (2008) and Cellini, Ferreira, and Rothstein (2010).\n 27\n\u2022 the number of stories\n\u2022 whether a project is subject to a requirement to pa"] [6.399301528930664, 16.729068756103516, "endix B.\n 28\ninterpreted in terms of an approximate percent change in construction costs associated with the HHH PLA.22\nFor each panel, I present the results of three specifications of the model. A brief explanation of each of these follows:\n\u2022 Specif"] [6.400120258331299, 16.733196258544922, "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"] [6.3926472663879395, 16.72100067138672, "t or more of the sample data, suggesting a persistent, robust statistical relationship.24\nAppendix 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"] [6.395622253417969, 16.724210739135742, "increased PLA cost in percent terms relative\nFigure 5.3. Interpreting HHH PLA Cost Estimates by Comparison with Larger Non-HHH Projects or Smaller HHH Projects\n 20\n15 Percent increase in construction costs 10 5\n0\nNon-HHH (65+ units)\nHHH (50-63 units"] [6.390933990478516, 16.716398239135742, " results (around 21 percent) found in this body of past research.\nOne 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"] [6.3943657875061035, 16.721237182617188, "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"] [6.389167308807373, 16.714998245239258, "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"] [6.426455020904541, 16.751556396484375, " them in a counterfactual setting where there was no HHH PLA.\nTable 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 "] [6.39408016204834, 16.719327926635742, "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.\nSince this simulation uses "] [6.386707782745361, 16.708187103271484, "ull HHH Pipeline\n Scenario 1\nScenario 2\n Additional housing units\nTotal housing units produced\nTotal cost savings (millions)\nPercent increase in total housing units\nObserved HHH Pipeline\n7,305\nHousing Output and Associated Savings\n666 7,9"] [6.389707565307617, 16.713777542114258, "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.\nSummary of St"] [6.382628440856934, 16.693721771240234, "ack\u201d 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"] [6.386539936065674, 16.707202911376953, "group that is unionized.\nIf, 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"] [6.3782057762146, 16.6807918548584, "pondents identifying as ethnically Hispanic and non-white, as is the case in the ACS).\nWhy Do These Findings Matter?\nIn the near term, the cost estimates in this report may aid in ongoing decisions regarding the expenditure of any remaining HHH funds"] [6.39031982421875, 16.712352752685547, "or utilization\n\u2022 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 "] [6.390097141265869, 16.71648406982422, "ulations from city of Los Angeles, TCAC, and CDLAC data.\nNOTE: 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.\n45\n["] [6.3937249183654785, 16.721698760986328, "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"] [6.399691104888916, 16.730571746826172, "ontribute to the average costs of projects that were subject to the PLA. This exclusion does\nnot qualitatively influence the cost estimates discussed. Its effect on construction costs is demonstrated in Table A.2. Panel A replicates the construction "] [6.391290187835693, 16.722782135009766, "ured either in $1,000s or the natural log of $1,000s\u2014for 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"] [6.39386510848999, 16.720632553100586, "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"] [6.393613338470459, 16.72174644470215, "\u2022 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 "] [6.3980712890625, 16.72947883605957, "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"] [6.407497406005859, 16.7521915435791, ".288 (13.441)\n25.868 (19.854)\n\u201330.917* (15.174)\n19.979 (37.336)\n102.501 (61.997)\n(3)\nAlso Exclude 64- to 74-Unit Projects\n\u20134.482 (30.889)\n20.639 (23.135)\n46.843* (22.572)\n0.483 (0.831)\n\u20132.877* (1.147)\n6.380 (10.299)\n3.692 (24.763)\n0.000 (.)\n16.434 (1"] [6.397878646850586, 16.728261947631836, "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.\n+ p<0.10,* p"] [6.397547721862793, 16.727994918823242, "** p<0.01.\nTable B.5. Estimated PLA Cost Effect Using Quadratic Modeling of Unit Size\n HHH PLA\nObservations Adjusted R2\nSingle Quadratic Specification\n44.877* (21.017) [0.037]\n86 0.735\nIndependent Quadratic Terms Above/Below Threshold\n45.457* (2"] [6.389969825744629, 16.710420608520508, " TCAC, and CDLAC data.\n 63\n Table C.1. Summary of Past Studies of Targeted Hiring Provisions with PLA Status\n Jurisdiction PLA\nCity of Cleveland\nCity of Oakland\nCity of Richmond\nWest Contra Costa USD\nCity College of San X Fra"] [6.37317419052124, 16.675634384155273, "ners 1\nD. L. Horn & Associates, LLC 2 Daylight Community Development 2\nDDCM Incorporated 1\nDecro Corporation 4\n Deep Green Housing and Community Development\n1 1\nDomus GP, LLC 4 EAH Housing 3\n East LA Community Corporation\n1 2\nFlexible PSH Solutions 2"] [6.384549140930176, 16.69584846496582, "nstitute, New York State Dormitory Authority Construction Project,\u201d 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\nBachman, Paul, William F. Bu"] [6.329021453857422, 16.55670928955078, "se/Home/California/CaliforniaCodeofRegulations?gui d=I47630370D45A11DEA95CA4428EC25FA0&originationContext=documenttoc&transitio nType=Default&contextData=(sc.Default)\nCalifornia Department of Housing and Community Development, \u201cMultifamily Housing Pr"] [6.352208137512207, 16.60420036315918, "nning.lacity.org/StaffRpt/InitialRpts/CPC-2017-3136.pdf\n\u2014\u2014\u2014, Rules and Regulations: Implementing the First Source Hiring Ordinance, Los Angeles: Bureau of Contract Administration, Office of Contract Compliance, 2016.\nCity of Los Angeles Department of"] [6.354913234710693, 16.53618812561035, "ifornia Environmental Quality Act Lawsuits and California\u2019s Housing Crisis,\u201d Hastings Environmental Law Journal, Vol. 24, No. 1, 2018, pp. 21\u201371.\nHolland, Gale, \u201cL.A. Officials Launch Campaign for Homeless Housing Bond Measure,\u201d Los Angeles Times, Se"] [6.358213901519775, 16.608911514282227, "rnia Needs More Affordable Homes. This Union Stands in the Way,\u201d 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\nMartindale, Scott, "] [6.359272003173828, 16.622940063476562, "UC Berkeley Labor Center, 2017. As of May 20, 2021: https://laborcenter.berkeley.edu/project-labor-agreements-and-bidding-outcomes/\nRaetz, Hayley, Teddy Forscher, Elizabeth Kneebone, and Carolina Reid, The Hard Costs of Construction: Recent Trends in"] [6.356050491333008, 16.59900665283203, "HH,\u201d Santa Monica: RAND Corporation, 2021. As of July 23, 2021: https://github.com/RANDCorporation/HHH-Project-Labor-Agreements\nWarth, Gary, \u201cGov. Newsom Proposes $12 Billion to House California\u2019s Homeless,\u201d Los Angeles Times, May 11, 2021. As of Jun"] [17.342748641967773, 11.131074905395508, "Project imPACT Cohort 1 Final Local Evaluation Report\nSTEPHANIE BROOKS HOLLIDAY, ALFONSO MARTIN, KATYA MIGACHEVA, AMY GOLDMAN, NICOLE BRACY, VERONICA AWAN, SARAH B. HUNTER\n Sponsored by the Los Angeles Mayor\u2019s Office of Reentry\nSOCIAL AND ECONOMIC WE"] [17.34791374206543, 11.171920776367188, " 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"] [15.063258171081543, 5.781606674194336, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Evidence Base for Employment-Focused Programs for Justice-Involved Individuals. . . . . . . . . . . . . . . . . Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [17.349231719970703, 11.176728248596191, ".....................\n. .1 . .2 . .3 . .5\n. .7 . .7 10 14\n.15 .15 17 22 22\n23 23 34\n35 35 36 46 47\nv\nvi Project impact Cohort 1 Final Local Evaluation Report\nCHAPTER SIX OutcomeEvaluationResults........................................................"] [17.337865829467773, 11.161459922790527, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79\nFigures and Tables\n Figures\n1.1. Project imPACT Logic Model. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [17.331758499145508, 11.159153938293457, "ct imPACT Completion Status . . . . . . . . .\n5.1. Barriers to Service Delivery and Uptake. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n5.2. Barriers Precipitated by the COVID-19 Pandemic. . . . . . ."] [17.34697723388672, 11.174564361572266, "laboration, (b) trauma-informed care, (c) cultural competence, and\n(d) focus on the Fellow\n4. improved employment outcomes\n5. reduced recidivism.\nRAND Corporation and Harder+Company (the evaluation team) conducted a mixed\nmethods process and outcome "] [17.35500717163086, 11.184064865112305, "ed, two of these outcomes (those related to employment and recidivism) overlap with the overarching project goals established by the Mayor\u2019s Office. The other two outcomes (improved decisionmaking and addressing barriers to employment) are based on t"] [17.360200881958008, 11.18771743774414, "ion data\nLack of physical space for services\nInsufficient training on topics such as trauma-informed care, or refresher trainings for CBT\nFellows have some remaining unmet needs, such as limited access to transportation, housing, or medical care; lac"] [17.352428436279297, 11.181234359741211, "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).\nWith respect to employment, a total of 192 Fellows obtained employment. "] [17.360782623291016, 11.190168380737305, "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\u2014particularly given technology-related challenge"] [17.371164321899414, 11.200185775756836, "s\nThough 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\nSummary xiii\nxiv Project impact Cohort 1 Final Local Evaluation Report\nCoh"] [17.354660034179688, 11.133228302001953, "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"] [17.354467391967773, 11.153473854064941, " criminal justice system, with priority given to programs that \u201creduce 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\u201d (Taylor, 2015, p. 8)"] [17.352577209472656, 11.177845001220703, "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 "] [17.346967697143555, 11.17424488067627, "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"] [17.349842071533203, 11.177583694458008, "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\nProject Description 3\n4 Project impact Coh"] [17.350887298583984, 11.180980682373047, "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\u2013July 2018) of Project imPACT in detail. It also described "] [17.348529815673828, 11.17766284942627, "ellows satisfied with their experience in Project imPACT?\nIn 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\n1 Most"] [17.354677200317383, 11.184782028198242, "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"] [17.351442337036133, 11.180785179138184, "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"] [17.349245071411133, 11.17501449584961, "Fellows are satisfied with service delivery\nDefinition\nNumber of individuals assessed for Project imPACT\nNumber of individuals enrolled in Project imPACT\nNumber of individuals assessed by service provider\nNumber of individuals receiving services by s"] [17.35737419128418, 11.185880661010742, "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"] [17.354093551635742, 11.177688598632812, "yment at 6, 9, and 12 months after placement, by full-time and part-time employment\nPercentage of Fellows convicted of a new crime, 6, 12 and 18 months after program completion\nNotes for Measurement/ Timeline\nTo be measured at baseline, completion of"] [17.354286193847656, 11.183612823486328, "/seasonal employment. In addition, the Mayor\u2019s 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"] [17.34611701965332, 11.175990104675293, "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\nUnfortunately, there were significant limitations to the use of self-reporte"] [17.353853225708008, 11.182092666625977, "\nTogether, 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"] [17.35277557373047, 11.182031631469727, "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"] [17.356853485107422, 11.18581485748291, "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"] [17.356029510498047, 11.18589973449707, "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"] [17.377830505371094, 11.208276748657227, "- 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"] [17.36092185974121, 11.191089630126953, "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"] [17.360652923583984, 11.188718795776367, "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"] [17.358400344848633, 11.187468528747559, "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"] [17.356597900390625, 11.186615943908691, "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"] [17.356184005737305, 11.186304092407227, "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"] [17.358327865600586, 11.188580513000488, "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"] [17.360300064086914, 11.187582015991211, "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"] [17.365331649780273, 11.197789192199707, "ate 0.9%\n7.1%\n SOURCE: Data submitted by regional providers.\nNOTE: The racial/ethnic categories were specified by the BSCC.\nTable 4.4\nPercentage of Fellows Receiving Services Across Regions\n Service Category\nEmployment Behavioral health Legal\nDo"] [17.373764038085938, 11.210504531860352, "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"] [17.364938735961914, 11.194714546203613, " (4.9)\n Employment Services, Overall and Regional\nTable 4.5\n1.68 (1.23)\n2.50 (1.52)\n62 (60.8)\nreadiness\nassessments\nreadiness\nworkshops\nCareer\nCareer\n88 (88.0)\nSOURCE: Data submitted by regional providers.\nNOTE: SD, standard deviation."] [17.366779327392578, 11.187382698059082, "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"] [17.365341186523438, 11.193135261535645, "2) 2.00 (1.59) 0.00 (0.00) 2.68 (1.43) 2.00 (0.58)\nTotal\nSessions Attended per Month M (SD)\n1.61 (0.89) 2.52 (1.87) 1.20 (0.42) 2.57 (1.44) 2.38 (1.26)\n SOURCE: Data submitted by regional providers. NOTE: SD, standard deviation.\nTable 4.9\nTo"] [17.36475944519043, 11.19497299194336, " Fernando Valley (n = 54)\nM (SD) No. of Hours\nReceiving No./ Services Percentage\n Legal Services, Overall and Regional\nTable 4.10\nM (SD)\nHours\nNo. of\nDowntown (n = 88)\nReceiving\nNo./\nPercentage\nServices\nLegal Service\nCategory of\nrepresentation"] [17.35161590576172, 11.180706024169922, "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"] [17.355247497558594, 11.184015274047852, "t imPACT\n24.60 (31.66) 3.02 (4.85) 1.72 (1.20) 24.50 (45.84)\n Association Between Use of Individual Services and Program Completion\nWe examined programmatic factors that may have contributed to a Fellow successfully com- pleting Project ImPACT. Firs"] [17.36029815673828, 11.189305305480957, "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"] [17.357574462890625, 11.186380386352539, "l Health Services\nEmployment 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"] [17.358781814575195, 11.185944557189941, "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"] [17.358455657958984, 11.18596363067627, "e.g., the CBT facilitation training), and there were not opportunities for these individuals to participate in the missed trainings.\nProvider Perspectives on Program Implementation 37\n38 Project impact Cohort 1 Final Local Evaluation Report\n Solutio"] [17.35368537902832, 11.179740905761719, "n when required by the court\nFrame services as an opportunity to alleviate\u2014not add to\u2014pressures, meeting Fellows where they are, serving as Fellows\u2019 support networks\nReferral to relevant mental health resources\nAll N/A\nUptake\nSevere mental health\ncha"] [17.360227584838867, 11.19006633758545, "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.\nFollowing up with Fellows to capture their lon"] [17.359216690063477, 11.189550399780273, "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"] [17.360000610351562, 11.189249038696289, "- employment relationship) and appealed to prioritize adding housing as the Project imPACT component. As a result of multiple discussions, the Mayor\u2019s Office created a housing services element, staffed by personnel from one of the behavioral health o"] [17.35802459716797, 11.187458038330078, "t the program establish or support special graduation ceremonies and certificates to celebrate Fellows\u2019 accomplishments, recognize their ability to complete a program with many requirements, and elevate the prestige of the program. Some regions have\n"] [17.358516693115234, 11.188264846801758, "llow\u2019s 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 "] [17.361915588378906, 11.182523727416992, "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"] [17.35964584350586, 11.189321517944336, "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"] [17.360445022583008, 11.191189765930176, "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.\nTrauma-informed care. All providers were acutel"] [17.357524871826172, 11.183917045593262, "ers to engagement arose, providers discussed their con- cerns with other providers and the Mayor\u2019s Office to identify solutions. Providers made sure to create environments where Fellows did not feel judged or pressured to follow directions that were "] [17.359500885009766, 11.18680191040039, " need for adequate training in trauma- informed approaches to work with reentry populations and the Mayor\u2019s Office prepared to facilitate one such training at the time of the writing of this report.\nProvider Perspectives on Program Implementation 47\n"] [17.358041763305664, 11.186101913452148, "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"] [17.36077880859375, 11.190750122070312, "I did initially.\nIt made me think different on the daily like, instead of doing something crazy, I\u2019ll just go calm down, and relax and breathe and take a walk.\nOther Fellows and alumni described an improved ability to identify their thinking pat- ter"] [17.363962173461914, 11.193140983581543, "Valley (n) (n) (n) 77 99 89 72 97 65 72 94 36 50 43 80 49 98 21 60 51 51 56 58 27 54 59 44 13 23 90\n25 7 39 43 15 4 14 4 12 14 3 58 11 6 3\n9 6 4\nTotal (n/%)\n367 (85.0) 335 (77.5) 290 (67.1) 270 (62.5) 263 (60.9) 251 (58.1) 230 (53.2) 225 (52.1) 185 ("] [17.353784561157227, 11.183213233947754, "d part time, and 3.7 percent were employed in a temporary or seasonal position (Table 6.5).\nWe found some significant regional differences in the rate of employment, with South Los Angeles having the highest employment rate (p<.05). South Los Angeles"] [17.33563232421875, 11.163259506225586, ") (32.3 percent) is nearly twice the percentage who exited without a job prior to COVID (July 2018\u2013March 2020) (16.4 percent). This suggests that COVID pandemic may have had an effect on Fellows\u2019 ability to find a job.\nOn average, Fellows participate"] [17.350231170654297, 11.179165840148926, "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"] [17.348188400268555, 11.177220344543457, "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"] [17.348798751831055, 11.179828643798828, " legal services experienced a smaller increase in income (r = \u22120.27, p < .01).\nRecidivism\nProject imPACT providers assess recidivism when conducting regularly scheduled follow-ups with Fellows at 6, 12, and 18 months after a Fellow completes Project "] [17.35901641845703, 11.189096450805664, "to Cohort 2.\nOutcome Evaluation Results 59\nCHAPTER SEVEN\nClient Perspectives\nGathering qualitative client feedback and experiences with Project imPACT is an important component of this evaluation. This feedback is solicited through semistructured foc"] [17.358272552490234, 11.18842887878418, "dedicated to success and accomplishing something and improving your life, Proj- ect imPACT is where you can do it.\nAnother shared:\nMy whole outlook was different when I came out and society had changed. Everything had changed and so I had to adjust. "] [17.359086990356445, 11.184728622436523, "ficult situations\n\u2022 Better understanding of root causes of behavior and learning coping skills\n\u2022 Opportunity to share thoughts and feelings in nonjudgmental space\n\u2022 Convenienceofcolocatedservices\n\u2022 No-cost legal services that address removing, sealin"] [17.360130310058594, 11.190120697021484, "ts to working with the peer navigator, who pro- vided a forum for sharing their experiences in a nonjudgmental space. As one alum indicated:\n[Having a peer navigator] helped because you were comfortable to just say what you were going through and jus"] [17.36139678955078, 11.190943717956543, " 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\u2019s what I loved about this program.\nA"] [17.35905647277832, 11.18863582611084, "like family. By us not being able to see, talk, whenever. Sometimes it\u2019s hard to get a hold on them. Maybe you\u2019re trying this, but now you can\u2019t. You can\u2019t find nowhere or nobody or you can\u2019t see nobody to get it out, so they don\u2019t give you an input "] [17.362789154052734, 11.192686080932617, "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, \u201cpeople have achieved a lot and when you see one achieve, it makes y"] [17.358997344970703, 11.189640998840332, "artners who might serve as referral pipelines, including probation, parole, and other community\u00adbased organizations serving justice\u00adinvolved individuals. These recruitment and enrollment numbers demonstrate the effectiveness of these referral pipelin"] [17.37074089050293, 11.201203346252441, "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 on\u00adsite, e"] [17.358911514282227, 11.188693046569824, " literature (e.g., Farabee, Zhang, & Wright, 2014; Redcross, Millenky, et al., 2012). More\u00ad over, Fellows who completed employment services were more likely to be employed than those who did not. This suggests an association between participation in "] [17.359617233276367, 11.19040584564209, ", the Mayor\u2019s Office collaborates with providers to develop solutions. A prime example is the establishment of housing services for\nSummary and Conclusion 71\n72 Project impact Cohort 1 Final Local Evaluation Report\nemployed Fellows. Our focus groups "] [17.355600357055664, 11.186083793640137, "were equipped to work with a diverse range of indi\u00ad 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\u00ad lows describ"] [17.35027503967285, 11.1812162399292, "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\u00ad ship, 2020). In addition, the fair m"] [17.352602005004883, 11.173564910888672, "ay the importance of peer navigators to the program\u2014in fact, providers described peer navigators as an essential part of their regional teams, and Fellows noted how valuable it was to have indi\u00ad viduals with lived experience involved with the program"] [17.361154556274414, 11.191193580627441, "who successfully completed the program to those who exited before completion (e.g., with respect to volume of services received); however, we missed the follow\u00adup data regarding employment and income outcomes for many of those who exited unsuccessful"] [17.35952377319336, 11.190814971923828, "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\u00ad ing ways to improve tr"] [17.361061096191406, 11.190662384033203, "s could integrate into their budgets if there is a need. Finally, the Mayor\u2019s Office has sought opportunities to formally add additional services to the Project imPACT model. Spe\u00ad cifically, after hearing the need for housing services, the Mayor\u2019s Of"] [17.349035263061523, 11.176312446594238, " data collec\u00ad 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"] [20.564599990844727, 9.087586402893066, "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"] [17.023906707763672, 7.919625759124756, "ss youth in a substance use and HIV-risk reduction program. Field Methods, 30, 22\u201336.\nGlaser, B., & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Mill Valley, CA: Sociology Press.\nHarder+Company (2015). Ce"] [16.979673385620117, 7.95101261138916, "fender employment programs and recidivism: A meta-analysis. Journal of Experimental Criminology, 1, 295\u2013315.\nWatkins, K., Hunter, S. B., Cohen, C. C., Leamon, I., Hurley, B., McCreary, M., & Ober, A. (2020). Organizational capacity and readiness to p"] [9.184955596923828, 10.146354675292969, " CORPORATION\nASHLEY M. KRANZ, ANITA CHANDRA, JAIME MADRIGANO, TEAGUE RUDER, GRACE GAHLON, JANICE BLANCHARD, CHRISTOPHER J. KING\nAssessing Health and Human Services Needs\nto Support an Integrated Health in All Policies Plan for Prince George\u2019s County"] [9.221785545349121, 10.185937881469727, "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"] [9.155861854553223, 10.120301246643066, " 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"] [9.135162353515625, 10.099687576293945, "...........................................................................4 Framework for Understanding Health and Human Services Needs.............................................5 Approach .........................................................."] [9.12761402130127, 10.093949317932129, "ounty, Maryland\nHealth Literacy.......................................................................................................................45\nHealth Behaviors ................................................................................"] [9.126005172729492, 10.087539672851562, "..............................................................................................................................90 School-Based Wellness Centers............................................................................................"] [9.125075340270996, 10.091104507446289, " Populations......... 119 Seniors..................................................................................................................................120 People Experiencing Homelessness .................................................."] [9.106671333312988, 10.073140144348145, "........................................................168\nPopulation Profile.................................................................................................................168 Health Outcome: Potentially Avoidable Health Care Utili"] [9.196616172790527, 10.16051197052002, "....................................207 Summary.................................................................................................................................208 Data Gaps and Limitations............................................."] [9.010558128356934, 9.977243423461914, "2014\u20132018...............................................................................................................15\n3.1. Mortality Rates per 100,000 Population for Heart Disease,\nby Race/Ethnicity, 2017........................................."] [8.991458892822266, 9.958597183227539, "Condition, 2017 .............................................................................................................75\n4.9. Rates of Inpatient Hospitalizations for Adults and Children per 100,000 Population\nin 2017, by Race and Ethnicity ..."] [9.037665367126465, 10.004087448120117, "f County and National Parks in Prince George\u2019s County, 2019...................150\n6.4. Land Cover Type, 2017..................................................................................................... 152\n6.5. Relative Lead Risk from Housing"] [9.05953598022461, 10.026205062866211, ".............199\n8.6. Total FY2018 General Fund Budget Spending for Health and Human Services\nper Person in Poverty, by County......................................................................................200\n8.7. Budgets for Selected County D"] [9.038625717163086, 10.005905151367188, "..................24\n3.5. Self-Reported Health Status for Adults, by Jurisdiction, 2017.............................................27\n3.6. Self-Reported Health Status for Adults in Prince George\u2019s County, 2017............................28\n3.7. Self"] [9.021821022033691, 9.988842010498047, ".........................46\n3.27. Self-Reported Health Behaviors for Adults, by Jurisdiction, 2017 .......................................48\n3.28. Self-Reported Unhealthy Behaviors Among Adults, by Jurisdiction, 2017...........................49\n3.29"] [8.99828815460205, 9.965883255004883, " for Adults per 100,000 Population,\nby District and Condition, 2017 .........................................................................................76\n4.14. Rates of ED Visits for Children per 100,000 Population, by District and Condition, 2"] [9.05335807800293, 10.018613815307617, "..............................93\n4.32. HIV Testing and Care Linkages Completed by the Prince George\u2019s County\nHealth Department, 2015\u20132019 .........................................................................................94\n4.33. Metrics for Se"] [9.028910636901855, 9.995747566223145, "...................... 114\n5.14. Percentage Who Are Unemployed or Working Poor in Prince George\u2019s County, 2009\u20132018........................................................................................................................ 115\n5.15. Perc"] [9.020190238952637, 9.989851951599121, "................................................................................ 141\n6.3. Percentage of Population in Overcrowded Housing in Prince George\u2019s County,\nby District.........................................................................."] [8.962699890136719, 9.93023681640625, " County Residents in 2018, by Citizenship and Place of Birth ............... 181\n7.7. Rates of ED Visits and Hospitalizations per 100,000 Population, 2017 ............................182\n7.8. Most Common Reasons for ED Visits for Adults, Percentage o"] [9.06199836730957, 10.027408599853516, "020). Prince George\u2019s 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"] [9.16430377960205, 10.127663612365723, "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\u2019s County is poise"] [9.191296577453613, 10.14941692352295, "oviders in DC\n Examines health care provision outside of traditional health care providers, including schools, fire/EMS and corrections\n Situates recommendations via Health in All Policies, inclusive of budget alignment and legislative action lev"] [9.183249473571777, 10.14576530456543, "commendations, we reviewed Prince George\u2019s County\u2019s 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"] [9.096982955932617, 10.062734603881836, "s a better option.\nSpending on health and human services is low.\n\u2022 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.\nIneffici"] [9.123390197753906, 10.086996078491211, "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"] [9.076271057128906, 10.04352855682373, " 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"] [9.20207691192627, 10.167210578918457, "s emer-\ngency 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"] [9.236557006835938, 10.20166301727295, "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).\nxxx An Integrated Health in All Policies Plan for Pri"] [9.191808700561523, 10.158287048339844, "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"] [9.197293281555176, 10.162081718444824, "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.\n2. Align In"] [9.207889556884766, 10.173086166381836, "s, focused on midstream and upstream determinants and drivers of health, which were then used to develop policy recommendations (Vermont Department of Health, 2018a).\n2.3 Better coordinate the nongovernmental organizations that address health and hum"] [9.201945304870605, 10.164461135864258, "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"] [9.156315803527832, 10.119099617004395, "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"] [9.107650756835938, 10.072925567626953, "ergency department\nEMS Emergency medical services\nEPA Environmental Protection Agency\nERS Economic Research Service of the U.S. Department of Agriculture FQHCs Federally Qualified Health Centers\nFTE Full time equivalent\nFY fiscal year\nHPSA Health Pro"] [9.180472373962402, 10.14431095123291, "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"] [9.17722225189209, 10.141944885253906, "has been the trend across the United States, the hospital mergers and acquisitions have changed the County\u2019s health care landscape (National Institute for Health Care Management Founda- tion, 2020). In 2019, Anne Arundel Medical Center and Doctors Co"] [9.14615535736084, 10.110151290893555, "ors in the County with clinical pharmacists to deliver care virtually, an approach known as \u201ctelepharmacy\u201d (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"] [9.169654846191406, 10.133001327514648, "nering for Health Equity: Strategies, Partnerships and Recommendations for Immi- grants\u2019 Health in Prince George\u2019s County from La Cli\u0301nica Del Pueblo (2018).\nMaternal and infant health\n\u2022 Maternal and Infant Health Report from the County Health Depart"] [9.184123992919922, 10.144943237304688, "l, economic, built, and natural environments.\n Offers insight into role of schools and human services departments in promoting health.\n Utilizes health care discharge data from both Maryland and District of Columbia (DC), highlighting key role of c"] [9.173345565795898, 10.13717269897461, "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"] [9.19194221496582, 10.145376205444336, "George\u2019s County Administration Building in Upper Marlboro. An online survey was also used to capture comments from residents who were unable to attend this meeting.\n\u2022 Three focus groups composed of 24 residents. These groups were distributed geograph"] [9.163156509399414, 10.128049850463867, " 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\u2019s County. Together, these data describe drivers of health affec"] [9.090521812438965, 10.056889533996582, "findings by populations that have special needs, such as pregnant\nwomen, seniors, and people experiencing homelessness.\n\u2022 Chapter Seven provides several exemplars illustrating the linkages of drivers of health\nand health outcomes for two populations "] [9.029200553894043, 9.998376846313477, "urveys (2014 to 2018).\n11\n12 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland Table 2.1.\nDemographics of Prince George\u2019s County Over Time, 2009\u20132018\n Year\n 2009 2010 2011\n24.7 23.7 23.5 31.7 33.3 33.3 34.1 33.5 33.4\n9.4 "] [9.005013465881348, 9.976127624511719, "nger than 18 years Aged 18 - 39 years Aged 40 - 64 years Aged 65 years or older\nSex\nFemale\nMale\nRace/Ethnicity\n24.5 23.4 22.4 27.1 28.0 29.4 35.4 34.0 33.6 13.0 14.6 14.6\n51.1 51.7 51.5 48.9 48.3 48.5\n53.1 44.5 51.4 18.2 17.7 29.3 0.2 0.1 0.2 17.7 14"] [9.044294357299805, 10.010645866394043, "ear Summary File, 2014\u20132018.\n16 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland Table 2.3.\nDemographics of Prince George\u2019s County, by District, Pooled 2014\u20132018\n County Councilmanic Districts\nPG 1 2 3 4 5 6 7 8 9\n Age\n"] [9.030279159545898, 10.004284858703613, "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.\n\u2022 District 3 has a higher proportion of White (21.8 percent) and Hispanic (27.2 percent)\n"] [9.169414520263672, 10.1333646774292, "d\n\u2022 \u2022 \u2022\n\u2022 \u2022 \u2022\nSubstance use disorder Sexual health\nMaternal and infant health\nAfter that, we summarize indicators of well-being, inclusive of\nHealth literacy Health behaviors Civic engagement\nWe end the chapter by sharing key themes that emerged duri"] [9.095385551452637, 10.061484336853027, "vior. Clinical care assesses a county\u2019s 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 "] [8.94595718383789, 9.909858703613281, "derably lower rates of YPLL. Within Prince George\u2019s County, the YPLL rate was greater for Black residents than White and His- panic residents.\nTable 3.3.\nYears of Potential Life Lost Rate per 100,000 by Jurisdiction and Race/Ethnicity, Pooled 2015\u201320"] [8.973356246948242, 9.939355850219727, "Death Rates\n250\n200 176 166 150\n100\n50 0\n180 192\n94\n64 8064\nSOURCE: Centers for Disease Control and Prevention, 2019b.\nNOTES: Data was accessed from CDC WONDER in 2019 and represents 2017. Rates are age-adjusted and presented per 100,000 population.\n"] [9.041136741638184, 10.007721900939941, "re and having a medical home is a known challenge in the County Assessment (Prince George\u2019s County Health Department, 2019b).\nFigure 3.3.\nDescriptions of Chronic Conditions\n Condition\n Description\n Prevention & Treatment\n Arthritis\n \u2022 Inflammation "] [9.039416313171387, 10.005940437316895, " adults had higher rates of cardiovascular disease and diabetes than the state and nearby counties.\nTable 3.5.\nSelf-Reported Health Status for Adults, by Jurisdiction, 2017\nMeasure\nSelf-rated health: Excellent, very good, or good\nDiagnosed arthritis\n"] [9.035776138305664, 10.002198219299316, "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).\nTable 3.7.\nSelf-Reported Health Status for Adults in Prince George\u2019s County, 2017\nDia"] [8.994633674621582, 9.961482048034668, "ction.\nCancer screening\nIn 2016, Prince George\u2019s 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).\nTable 3.8.\nSelf-"] [8.973390579223633, 9.939473152160645, "6 2007 2008\nAll Sites\nLung and Bronchus\n2009\nBreast Prostate\n2010\n2011\n2012 2013 2014\nColorectal Cervical\n SOURCE: Maryland Cancer Prevention, Education, Screening and Treatment Program, 2017. NOTES: 2006 incidence rates are lower than actual du"] [9.025222778320312, 9.990921020507812, "rince George\u2019s Maryland\n154.1 154.3 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\nSOURCE: Maryland Cancer Prevention, Education, Screening, and\nNOTES: HP 2020 Goal, indicates the Healthy People 2020 goal which serves as a fed"] [8.98041820526123, 9.94699478149414, "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 "] [9.029090881347656, 9.996474266052246, " diagnosed with depressive disorder than in other nearby counties or the state (Table 3.14).\nTable 3.14.\nSelf-Reported Mental Health for Adults, by Jurisdiction, 2017\n Measure\nDiagnosed depressive disorder\nReported days of \u201cnot good\u201d mental health pa"] [9.000875473022461, 9.967475891113281, "t killing themselves\nHigh School\nSeriously considered attempting suicide\nFelt sad or hopeless frequently\nBullying\nMiddle School\nBeen bullied on school property\nBeen electronically bullied\nHigh School\nBeen bullied on school property Been electronicall"] [9.000953674316406, 9.96731185913086, " 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.\nTable 3.18.\nSelf-Reported Binge Drinking by Adults in Prince George\u2019s County, 2017\nBinge Drinking\nOverall 12.8\nDemographics\nA"] [9.009928703308105, 9.975114822387695, "nce George\u2019s County, Maryland, 2007\u20132017\n3. Health and Well-Being 41\n Number of deaths\n120\n100\n 80\n 60\n 40\n 20\n0\n 2009 2010 2011\n2012\n2013\n2014 2015 2016\nFentanyl-Related Heroin-Related Alcohol-Related\nOpioid-Related\nPrescription Opioid-Related"] [8.984099388122559, 9.951244354248047, "52 7,365 1,282 1,832 2,001 81 110 143\n2018\n8,013 2,020 153\nMaryland\n30,658 510.4\nTB Prevention.\n SOURCE: Maryland Department of Health Infectious Disease Bureau, 2019. NOTE: *Includes both Primary and Secondary Syphilis.\nTable 3.22.\nChlamydia Infect"] [8.975226402282715, 9.94052791595459, "omen, 21 per 1,000 for Black women, and 6 per 1,000 for White women.\n44 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nTable 3.23.\nTeen Birth Rates (TBR) per 1,000, by Jurisdiction and Race/Ethnicity, Pooled 2011\u20132017\n"] [9.100659370422363, 10.065686225891113, "4.5\n3.8\n SOURCE: Maryland Vital Statistics Administration, 2019.\nNOTES: *Rates based on <5 deaths are not shown since rates based on small numbers are statistically unreliable.\nWell-Being\nWell-being encompasses the factors that describe a full and sa"] [9.060688972473145, 10.02733325958252, "teracy, an in person assessment of English language literacy among\na 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"] [9.036410331726074, 10.003520965576172, "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.\nTable 3.27.\nSelf-Reported Health Behaviors for Adults, by Jurisdiction, 2017"] [9.032544136047363, 9.999625205993652, "k and above Below $50k\nHas a personal doctor Has a personal doctor No personal doctor\nConsumed fruit one or more times per day\n63.2\n62.2 67.8\n64.9 60.8\n64.0 60.2 64.8\n64.7 58.2\n61.5 65.7\n62.0 65.4\nConsumed\nvegetables one or more times per day\n77.6\n77"] [9.00654411315918, 9.973254203796387, "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"] [9.200898170471191, 10.221460342407227, " (Table 3.34).\nTable 3.34.\nVoter Turnout, 2010\u20132018\nGeneral Election\n2010\n2012*\n2014\n2016*\n2018\nSOURCE: Maryland State Board of Elections, 2019. NOTES: *Indicates presidential election.\nStakeholder Insights\nPrince George\u2019s\nCounty Maryland\nPercent Per"] [9.115996360778809, 10.081732749938965, "ounty, Maryland\nlimited 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"] [9.147077560424805, 10.111946105957031, "d requesting funding. I didn\u2019t know about a lot of these programs. Why don\u2019t they coordi- nate what these programs are doing?\nOne participant noted several examples of social media partnerships that have improved communication about county services. "] [9.142206192016602, 10.10245132446289, "ends who are still alive. I have fewer men to call because they\u2019re not staying around.\nIn the area of health issues, stakeholders were particularly concerned about mental and behavioral health, including among people experiencing homelessness. In dat"] [9.148096084594727, 10.110483169555664, "ow to incorporate volunteers in an efficient way.\nAmong 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 "] [9.064823150634766, 10.0308256149292, "bacco use, lack of exercise, unhealthy diet) are more common among adults with less education.\n\u2022 Large inequities for infant outcomes were observed, with Black infants having the highest rates of low birthweight and infant mortality.\n\u2022 Concerns about"] [9.164636611938477, 10.125699996948242, "ing healthy habits earlier. These concerns are supported by data, as few high school students reported eating vegetables often.\nFinally, residents and stakeholders expressed concerns about mental health, and spe- cifically that of children and adoles"] [9.0780668258667, 10.043081283569336, "medical offices), first responders, public safety agencies, schools, and health and human services agencies. This chapter describes the types of health care providers serving Prince George\u2019s County, their roles, and the services provided.\n Key data"] [9.048739433288574, 10.015074729919434, " More Hispanic adults reported cost as a barrier to medical care than Black adults. Adults with less education were more likely to report cost as a barrier to medical care.\nTable 4.2.\nBarriers to Health Care Access and Utilization for Adults in Princ"] [9.020702362060547, 9.987460136413574, "h Care Service Environment 63\n Count\n2013 2014 2015\n174 182 181 293 288 290 123 118 117\n10 12 12 40 40 41 22 21 20 24 24 23 13 13 13 46 49 49 21 19 19\n51 54 59 6 4 4 33 32 34 42 39 35 12 10 10 8 8 8 5 6 6\n57 54 53 58 60 57 13 13 12\n22 23 25\nRate per "] [9.017845153808594, 9.98468017578125, "5 2.05\n1.87 1.72 0.09 0.37 1.06 1.76 1.00 1.51 0.31 0.75 0.25 0.60 0.28 0.21\n4.48 2.57 2.90 2.09 1.00 1.60\n0.53 0.71\nUnited States\n3.05\n3.65 1.83\n0.14 0.70 0.38 0.45 0.40 1.19 0.83\n1.20 0.20 0.58 0.81 0.32 0.25 0.14\n1.41 1.29 0.54\n0.35\n SOURCE: Healt"] [9.05819034576416, 10.023786544799805, "th Resources & Services Administration, 2019b.\nNOTES: HPSA, health professional shortage areas. health. HPSAs are identified based geography (e.g., lack of providers nearby) and population (e.g., lack of providers to serve specific populations, such "] [9.046547889709473, 10.01169490814209, "16\n25 25 14 9 28 28 67 62\n2017 2018 2019\n25 25 25 18 16 10 28 28 32 71 69 67\n SOURCE: Maryland Health Care Commission, 2019a.\nNOTES: Data from annual reports on licensed acute care beds by hospital and service. Acute care beds generally accommodate h"] [9.001520156860352, 9.967206954956055, ".1\n58.9 21.2\n51.3 54.9\n64.7 55.5 47.3\n61.4 39.5\n62.5 45.3\n54.9 47.8\n Sex\nFemale 68.4\nMale Race\nWhite, non-Hispanic Black, non-Hispanic Hispanic\nSocioeconomic characteristics\nEducational attainment Above high school High school or less\nHousehold incom"] [8.992424964904785, 9.96035385131836, "visits per 100,000 population to the 16 EDs serving county residents in Maryland and DC. The majority of visits were made to the 11 EDs in Maryland, with fewer visits made to EDs in DC (Table 4.10). More ED visits were made to Doctors Community Hospi"] [8.980371475219727, 9.948205947875977, "OURCE: Maryland Health Services Cost Review Commission, 2017; DC Hospital Association, 2017.\nNOTES: Includes 2017 ED discharges in Maryland and DC for Prince George\u2019s County residents. Children are younger than 18 years. Reasons are CCS codes which g"] [8.984983444213867, 9.953665733337402, "Figure 4.7.\nRates of ED Visits for Chronic Conditions for Adults per 100,000 Population, by Race and Ethnicity and by Condition, 2017\n ED visits per 100,000\n700\n600\n500\n400\n300\n200\n100\n-\n453 349\n577\n185\n389\n224 158\nDiabetes\nHispanic\n609\nNon-Traumatic"] [8.988777160644531, 9.956809043884277, "r Adults per 100,000 Population, by District and Condition, 2017\nCounty Councilmanic Districts\nPG 1 2 3 4 5 6 7 8 9\n All ED visits 32,315\nMental and behavioral\nhealth 1,178\nSubstance related 194 Diabetes 321 Heart disease 405 Hypertension 464 No"] [9.047642707824707, 10.012939453125, "ccess to a usual source of dental care.\nInpatient Hospitals\nInpatient hospital care is defined as involving an overnight stay at the hospital and therefore tends to include more serious and costly care. In fiscal year 2019, there were five hospitals "] [8.970405578613281, 9.937114715576172, "ated in Lanham, Maryland (Table 4.16). Children had 2,582 hospital discharges per 100,000 population to nine hospital EDs in Maryland and DC. The majority of hospital discharges for children (69 percent) were to Children\u2019s National Medical Center in "] [8.944978713989258, 9.913713455200195, "ents. Children are younger than 18 years. Reasons are CCS codes which group related diagnoses and procedures into meaningful categories.\nVariation in Hospitalization by Race/Ethnicity\nDuring 2017, rates of hospitalizations were highest for Black adul"] [8.959619522094727, 9.927257537841797, "hildren.\nFigure 4.11.\nRates of Inpatient Hospitalizations for Children per 100,000 Population in 2017, by Race and Ethnicity and by Condition\n4. Drivers of Health: Health Care Service Environment 81\n Hospitalizations per 100,000\n450\n400\n350\n300\n250\n2"] [8.99958610534668, 9.967816352844238, " 5 6 7 8 9\n All hospitalizations 2,582 Asthma 162\n2,646 2,836 3,083 108 150 130\n2,210 2,693 124 157 48 61\n198 297 * *\n2,521 2,908 2,433 2,158 204 252 184 169 82 52 72 111\n270 363 338 206 * 4 * 11\nDiabetes\nMental & behavioral health\nSubstancerela"] [9.04010009765625, 10.00505256652832, "aryland Health Care Commission does not report the number of hospice beds available by county. When examining the number of hospice agencies or organizations, the number in the County in 2018 was similar to nearby counties.\nTable 4.21.\nHospices, Hosp"] [9.010589599609375, 9.975691795349121, "County\n1,442 23 39 88 516 3,140 3,643 4,597 5,283 11 18,782\nMaryland\n3,316 291 326 769 4,901 27,603 28,820 30,509 28,360 24 124,919\n 541 24 33 105 706 3,713 3,939 3,459 2,424\n SOURCE: Maryland Health Care Commission, 2019b.\nNOTES: Data retrieved from"] [9.070099830627441, 10.035761833190918, "r were considered to be for non-urgent medical services. The percentage of 911 calls for non-urgent medical services varied slightly across districts, ranging from 22.5 percent in District 6 to 26.6 percent in District 7.\nTable 4.26.\nEmergency Calls "] [9.049565315246582, 10.0142183303833, "y in Prince George\u2019s County, health care services are primar- ily provided through contracts with local health care providers who come to the correctional facility to provide services. This facility houses inmates who are serving sentences of 18 mont"] [9.07838249206543, 10.041723251342773, "aryland\nconditions. Law enforcement agencies are increasingly working with the health care system and pursuing collaborative community-wide strategies to implement effective policing strategies for people with behavioral health conditions (Council of"] [9.083568572998047, 10.047796249389648, "ent two school years, the school-based wellness centers have had staffing vacancies for nurse practitioners (NPs). Additionally, it took until the fourth quarter of 2019 to fill all four social worker positions during the 2019 school-year.\nTable 4.28"] [9.070561408996582, 10.037335395812988, "rated Health in All Policies Plan for Prince George\u2019s County, Maryland\nor reduced price meals. In Prince George\u2019s County during the 2019-2020 school year, there were 45 schools designated community schools, of which most were elementary schools. Thes"] [9.080452919006348, 10.046359062194824, "f medical assistance programs that are intended to help families obtain health insurance, reduce barriers to access- ing health care, and promote receipt of needed care. For example, DSS helps residents to sign up for public health insurance programs"] [9.145434379577637, 10.109213829040527, "mental health screenings, follow-up care, and vaccinations for individuals <18 years.\n 94\nAn Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\n\u2022 \u2022 \u2022\n\u2022\nScreening and treatment for sexually transmitted infections.\nTesting fo"] [9.098596572875977, 10.061576843261719, "icare).\nThe state of Maryland offers crisis lines (phone and text) staffed by specialists for indi- viduals who are experiencing a mental health or substance use concern. Additionally, outpa- tient substance use disorder treatment services and mental"] [9.162095069885254, 10.12153148651123, "ception that there are few immu- nization clinics in the County and that this limits family\u2019s abilities to obtain neighborhood- based preventive care. School-based screenings were proposed by stakeholders as a potential option for obtaining preventiv"] [9.19317626953125, 10.15572452545166, "exist- ing health care outreach services and noted that community health workers can help facilitate this connection, but are underutilized.\nIn focus groups, residents noted their interest in having health care providers who reflect the community\u2019s d"] [9.130977630615234, 10.087122917175293, "related to the provision of health care, do not have the capacity to bill public insurance.\nMental and Behavioral Health\nAs noted in the prior chapter, mental and behavioral health was frequently mentioned by stake- holders as an important health nee"] [9.158188819885254, 10.106253623962402, "on in the school-aged population. Participants expressed the desire for more wellness centers at schools that foster mental health, including staff specially equipped for mental health counseling. One noted,\nOur teachers are struggling to manage educ"] [9.14707088470459, 10.102665901184082, "s tend to focus on sentencing and forensic-related guide- lines, but that it is important for them to also take into consideration health needs, such as access to outpatient primary care and behavioral health services, in the counseling phase.\nStakeh"] [9.037708282470703, 10.003700256347656, "7, where more than 3 in 4 residents are Black, ED visit rates are high for conditions better managed in primary care settings, like diabetes, heart disease, and hypertension for adults and asthma for children.\n\u2022 Challenges in obtaining dental care ex"] [9.057092666625977, 10.022415161132812, "vel and educational attainment. Further, our analyses suggest that many adults lack a usual source of dental care and are using the ED to treat dental conditions best cared for in a dental office. A variety of reasons may lead to inappropriate use of"] [9.155195236206055, 10.118934631347656, "t also individual-level interventions to educate residents about the role of different types of providers and when to call 911.\nFinally, the health care delivery system in Prince George\u2019s County includes more than just hospitals and other traditional"] [9.091293334960938, 10.05827522277832, "es of home ownership, a key mechanism of building wealth in the United States, have influenced rates of poverty in families and communities for genera- tions. Because the financing of public schools is partially based on local property taxes, ineq- u"] [9.079967498779297, 10.045774459838867, " 15\n2015 16\n2016 17\n2017 16\n2018 16\n2019 13\nSOURCE: County Health Rankings, 2019b.\nNOTES: Possible ranking out of 24 counties in Maryland.\nPoverty\nPoverty has long been recognized as a contributor to health and disease as it affects a variety of clin"] [9.0304594039917, 9.996733665466309, "nty residents are uninsured or insured by Medicaid than observed in nearby counties and the state.\nRates of uninsurance are driven by several factors, including income and eligibility requirements for public programs, like Medicaid. In Maryland, adul"] [9.028826713562012, 9.99534797668457, "district has a sizeable foreign-born population, which may be apprehensive or ineligible for government health insurance programs. These factors may con- tribute to this high rate of uninsurance.\nUninsured 10.8\nHas Medicaid\nHas Medicare\nHas private h"] [9.052247047424316, 10.019353866577148, "y\nBaltimore County Maryland\nHoward County\n SOURCE: Annie E. Casey Foundation Kids Count Data Center, 2019.\nNOTES: Raw data was obtained from the Maryland State Department of Education School Report Cards, 2000 \u2013 2018. Data not available for Howar"] [9.041064262390137, 10.007287979125977, " declined over time, from 8,266 in 2016 to 7,224 in 2019. Similarly, the percentage of new and re-applications approved slightly declined, from 25.6 percent in 2016 to 22.8 percent in 2019.\nTable 5.6.\nNew and Re-Applications Received and Approved for"] [9.0350980758667, 10.006547927856445, " Data was provided directly from the Office of Special Education and Student Services and are not publicly available. While no denominator was provided for these counts, in 2019 Prince George\u2019s County Public Schools had 208 schools and centers more t"] [9.030162811279297, 9.997523307800293, "indicator is comprised of two measures of a cohort of ninth grade students grad- uating within four years or five years, respectively. Graduation rates vary widely across race/ ethnicity in the County, with Asians having the highest graduation rate a"] [8.995281219482422, 9.961319923400879, "udents are\nLess than high school education\nHigh school diploma or equivalent\nSome college\nBachelor\u2019s degree or higher\n4.5 8.7 10.0\n14.0 13.3 24.8 20.2 18.9 25.6\n61.4 59.0 39.6\nPrince George\u2019s Baltimore County County\n13.5 8.9\n25.7 26.2 28.2 26.3\n32.7 "] [9.051719665527344, 10.01781940460205, "n Prince George\u2019s County have a higher median household income than other jurisdictions, excluding Howard County.\nTable 5.13.\nMedian Household Income, by Jurisdiction, Pooled 2014\u20132018\n Median household income, $\nBy race/ethnicity, $ White\nBlack\nAme"] [9.036802291870117, 10.003697395324707, " percentage of individuals in Prince George\u2019s County con- sidered working poor (5.4 percent) was higher than that of nearby counties and slightly higher than the state (5.2 percent). Additionally, the County unemployment rate was slightly higher than"] [9.023531913757324, 9.988533973693848, "sed Prince George\u2019s County School Climate Survey discusses parental concern on school safety (Keane & Swinton, 2017). While 91 percent of parents of elementary school students expressed a positive perception of safety and discipline at their child\u2019s "] [9.03286361694336, 9.998537063598633, "port estimated over 60 percent of the jail mental health population in Los Angeles County jail were likely appropriate candidates for mental health diversion (Holliday et al., 2020). A similar proportion of inmates may benefit from diversion in the C"] [9.0077486038208, 9.975825309753418, "37.9 379.4 * 746 746 111.6 *\n2011\n2,759.3 6,118.0 1,634.5 3,056.9 3,220.6 3,241.3 4,065.0 4,163.7 5,391.0 3,632.0 * 5,894.4 7,294.4 4,129.6 2,988.3 4,229.8 7,470.5 3,875.5 3,585.4 4,818.1 4,352.1 2,840.8 957.9 3,773.9 5,910.6 3,304.8 6,750.4\n2016\n1,6"] [9.07807445526123, 10.039989471435547, "ing primary data collection as having unique challenges in accessing health and human services. The challenges experienced by noncitizen immigrants were also often mentioned during primary data collection, and this subgroup is described in detail in "] [9.049734115600586, 10.015298843383789, "ile, 2014\u20132018.\n 122 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nSeniors compose 12.3 percent of the County population, which is less than in nearby counties (Table 5.20). Few County seniors lack health insurance (1"] [9.038018226623535, 10.004302024841309, ".7 percent of seniors are dually-enrolled in Medicare and Medicaid, a proxy for low-income status.\n124 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland Table 5.21.\nCharacteristics of Prince George\u2019s County Residents Aged"] [9.08119010925293, 10.046055793762207, "ices to enable individuals who meet an institutional level of care or who are chronically ill or disabled remain in their own homes or assisted living facilities. Services include personal assistance, nurse monitoring, home-delivered meals, home adap"] [9.047969818115234, 10.014019966125488, "rks (4,462 participants), and Yoga in the Parks (3,052 participants).\nPeople Experiencing Homelessness\nPeople experiencing homelessness are those who lack a primary nighttime residence or are living in a shelter. The experiences of people experiencin"] [9.030200958251953, 9.997627258300781, "ividuals and families experiencing homelessness has declined in Prince George\u2019s County since 2007. In 2018, there were 478 individuals identified as experiencing homelessness in Prince George\u2019s County (Figure 5.5), meaning these individuals did not h"] [9.036032676696777, 10.003312110900879, "Annual PIT Count of Persons Experiencing Homelessness.\nThe rate of persons experiencing homelessness within Prince George\u2019s County in 2019 was 0.5 per 1,000 people (Table 5.24). The County\u2019s rate is below the region average without DC\u2019s (0.7 percent)"] [9.027298927307129, 9.996001243591309, "ts conducted as part of the federally-funded Continuum of Care program and reported in the 2018 Annual Homeless Assessment Report to Congress. Point-in-Time counts provide a count of sheltered and unsheltered persons experiencing homelessness on a si"] [9.036883354187012, 10.003660202026367, "7 households entered emergency shelters, which was similar to what was observed in June 2017, but much higher than what was observed in June 2018 (327 households). The number of households establishing permanent housing increased from 120 in June 201"] [9.113863945007324, 10.075793266296387, "rwise meet the PSH or RRH project type descriptions\u201d (Orange County Homeless Management Information System, 2014). *3 permanent supportive housing programs were de-funded by HUD during the FY2016 competition. **Counts of emergency shelter beds provid"] [9.195566177368164, 10.137346267700195, "at promote employment. As one stakeholder explained, childcare and adequate clothing for an interview are often overlooked as critical human service needs, yet are important for obtaining employ- ment. The County is engaged in positive efforts around"] [9.138528823852539, 10.098519325256348, "n trafficking and wage theft. One stakeholder noted that the Hispanic population comprises 17 percent of Prince George\u2019s County residents yet makes up 31 percent of sex abuse cases. Stakeholders also mentioned that survivors of domestic violence also"] [9.103342056274414, 10.065448760986328, " equipped to handle students and families with English as a Second Language needs. Very few schools equipped for ESL. It impacts their ability to learn and communicate, as well as limits opportunity for parents to get involved.\n5. Drivers of Health: "] [9.023994445800781, 9.989991188049316, " support to help them stay in their homes, such as real estate tax credits. Assistance to modify their homes to comfortably maintain activities of daily living can support aging in place. Stakeholders shared,\nMany seniors are caught in what is called"] [9.100387573242188, 10.064535140991211, ", a higher percentage of residents remain in poverty and uninsured compared to neighboring counties. Poverty and low educational attainment are clustered in districts (2, 3, 5, 7) that border Washington, DC. Health risks are exacerbated without good "] [9.119876861572266, 10.08358383178711, "untry has declined over the past ten years. Additionally, more than 80 percent of individuals experienc- ing homelessness were sheltered in 2018. One concerning finding relates to the increasing number of veterans experiencing homelessness. Although "] [9.107992172241211, 10.078165054321289, "ture have all been associated with greater physical activity in children and adults (Smith et al., 2017). There is also evidence that these features may be associated with lower obesity (Papas et al., 2007), less cardiovascular disease risk factors ("] [9.074671745300293, 10.041346549987793, "enspace measurements which may affect the quality of pedestrian transit (County Health Rankings, 2019c).\nTable 6.1.\nCounty Health Sub-Rankings for the Physical Environment, Prince George\u2019s County 2010\u20132019\n Year\n2010 2011 2012 2013 2014 2015 2016 20"] [8.990331649780273, 9.958823204040527, "ing overcrowded households across districts in Prince George\u2019s County, overcrowded households is a large problem in Districts 2 and 3, where 16.1 percent and 8.1 percent of households, respectively, are overcrowded or severely overcrowded (Table 6.3)"] [9.114058494567871, 10.080243110656738, "ty Survey 5-Year Summary File, 2014\u20132018.\n6. Drivers of Health: Built and Natural Environments 143\nNeighborhood Design\nNeighborhood design plays a strong role in providing a supportive environment for a healthy lifestyle. The idea is that neighborhoo"] [9.114714622497559, 10.080513954162598, "y food options, we show supermarkets here because of the diversity of food choices they offer.\n144 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nThere are some limitations to the USDA ERS\u2019s definition of a food desert"] [9.062042236328125, 10.02873420715332, "nters serving the population of Prince George\u2019s County (6.2 per 100,000) is far lower than the pro- portion in the state of Maryland (11.5 per 100,000), as shown in Table 6.6. Data are available from the U.S. Census County Business Patterns which exc"] [9.110456466674805, 10.080568313598633, "y to begin and maintain a physically active lifestyle, neighbor- hoods that support walking for commuting and leisure are thought to encourage physical activity and promote a healthy lifestyle (Smith et al., 2017). The term \u201cwalkability\u201d is used to d"] [9.066325187683105, 10.037823677062988, "the risk for obesity and chronic disease (Smith et al., 2017). In addition, parks also provide opportunities for residents to interact with nature and each other, strengthening social capital and sense of place, and improving psychological health. Ta"] [9.057242393493652, 10.027085304260254, " a higher proportion of impervious surfaces than tree canopy. As noted earlier, these districts have many \u201cwalkable\u201d neighborhoods, due to their street connectiv- ity and diversity of residences and businesses. However, the lack of green space may de"] [9.029058456420898, 9.996649742126465, "bility and Commuting Habit, by Jurisdiction, Pooled 2014\u20132018\nVehicle availability among working population\nOne or more vehicles available\nNo vehicles available\nWorking population traveling to work by\nDriving alone Carpool\nPublic transportation Walki"] [8.954838752746582, 9.925383567810059, "2.6 12.2 6.4\n97.7 94.0 2.3 6.0\n73.6 66.0 8.2 11.4 10.2 17.2 1.4 1.4 1.2 1.5 5.3 2.5\n23.1 20.4 15.9 16.7 25.8 29.0 15.2 14.6 16.1 15.1\n4.0 4.3\n97.5 89.9 95.8 98.9 2.5 10.1 4.2 1.1\n70.0 61.4 67.4 75.8 9.1 10.3 11.3 9.4 15.7 23.2 15.1 9.6 0.7 1.3 1.4 1."] [9.020750999450684, 9.98939037322998, "ng based on the total number of houses and pro- portion of houses by year of construction. Each era of housing is adjusted with a factor that reflects proportionate risk for that era, according to the prevalence of lead-based paint hazards found in U"] [9.001434326171875, 9.9691801071167, "In 2017, 1.1 percent of tested children in Prince George\u2019s County had a blood lead level at 5\u20139 \u03bcg/dL and 0.3 percent of children had a blood lead level \u226510 \u03bcg/dL (Table 6.13). This proportion was similar to that observed in Mary- land, overall. Alth"] [9.137208938598633, 10.102103233337402, " are set at the federal level by the EPA and enforced by states. When a water system fails to meet an EPA-mandated drinking water standard, a drinking water violation can be issued, although reductions in enforcement activities have led to estimates "] [9.122538566589355, 10.087260246276855, "e data collection and understand complicated relationships describing the social and environmental determinants of health.\n160 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland Figure 6.7.\nSocial Vulnerability Index for P"] [9.154626846313477, 10.116101264953613, " lot of the County\u2019s developments now prioritize construction of new roads which encourages movement to remote areas. However, stakeholders thought there should also be a focus on developing older neigh- borhoods and improving land use in these locat"] [9.165828704833984, 10.126113891601562, "te exercise and outdoor activity. Com- munity centers and parks should be utilized both for exercise and for social engagement and bringing community members together. Residents felt that the County could have a large role in promoting physical activ"] [9.147697448730469, 10.109293937683105, "nd special transport options, in order to make health care appoint- ments. One stakeholder shared that although, in theory, the County has accessible taxis for seniors who are disabled, many residents do not know how to use this service. Further, som"] [9.112709999084473, 10.0773344039917, "ousing affordability is a primary concern of residents, which may contribute to overcrowding and have downstream health effects. District 2 has the highest rates of severely overcrowded housing and households paying more than 50 percent of monthly in"] [9.140607833862305, 10.108451843261719, ": Built and Natural Environments 165\nDistricts 2 and 7 have a lower proportion of parks per population than other districts. Barriers to transportation (evident in both the quantitative and qualitative analysis) may also contrib- ute to poor access t"] [9.082610130310059, 10.047072410583496, "o health care services shape long-term outcomes. Many stakeholders mentioned concerns about chil- dren\u2019s mental health and access to health care services in the County.\no Below, we describe linkages between drivers of health and barriers to pediatric"] [9.016013145446777, 9.980605125427246, "s County\n Total 22.5 Sex\nFemale 49.1\nMale 50.9\nRace\nWhite 14.7 Black 59.7 Asian 2.9 Other 17.9\n23.2 24.7 21.4 22.2\n48.8 50.6 51.4 47.1 51.2 49.4 48.6 52.9\n23.8 13.4 25.1 27.8 44.4 21.9 39.8 52.0 7.7 2.0 3.0 5.1 18.0 59.7 27.4 7.4 6.1 2.9 4.7 7.7\n32.4"] [9.06850528717041, 10.034996032714844, "ty, 2018). Because these types of visits are potentially avoidable, they may be indicative of poor health care management or inadequate access to care (Dowd et al., 2014).\nDrivers of Potentially Avoidable Health Care Utilization in Children\nAlthough "] [9.073134422302246, 10.038919448852539, "y Files, 2009\u20132018.\nHealth Care Environment: Provider Shortages\nInsurance solves only one part of the health care access and health management problem. Other barriers include a shortage of health care providers, not enough providers willing to see ch"] [9.073883056640625, 10.039938926696777, "k factors.\nTo overcome this limitation, and to provide a preliminary assessment of barriers to pre- ventative health care for children, we used data from the American Community Survey to better understand the prevalence of drivers for potentially avo"] [9.046272277832031, 10.014056205749512, " health care utilization. Many of these communities are in districts that border Washington, DC.\n174 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland Figure 7.3.\nCommunities with One or More Determinants of Potentially A"] [9.01005744934082, 9.975593566894531, "h close to one quarter of Hispanic high school students in the County considered overweight. High school students of other races also have a much higher than average rate of being overweight and non-Hispanic Black high school stu- dents have a slight"] [9.051270484924316, 10.017410278320312, "3 percent in 2013 to 13.2 percent in 2016 (Table 7.4). During each year of the survey this proportion has been higher than the Maryland-wide average. The group with the highest proportion not eating vegetables in the preceding week were Hispanic stud"] [8.995091438293457, 9.96211051940918, "kely indicates that there is a complicated relationship between the food environment and childhood obesity, likely influenced by mul- tiple drivers of health.\n178 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nFigure 7"] [9.024341583251953, 9.990608215332031, "ts in Prince George\u2019s County\nResearch suggests that immigrants encounter more nuanced challenges beyond policy and financial barriers such as discrimination and fear of deportation (Hacker, Anies, Folb, & Zall- man, 2015). Depending on their citizens"] [9.006707191467285, 9.972569465637207, "% 12% 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018\nSOURCE: U.S. Census Bureau, 2019a.\nNOTES: Data in figure were obtained from the American Community Survey 1-Year Summary Files, 2009\u20132018.\nAcross the County, noncitizen immigrants are more likel"] [9.00101089477539, 9.967310905456543, " immigrants. Communities with a low percentage of noncitizen immigrants were defined as ZCTAs below the 80th percentile, i.e., having fewer than 21 percent of their popu- lation composed of noncitizen immigrants.\nWe find that children in communities "] [9.024496078491211, 9.990474700927734, "ts. Adults are aged 18 years and older. Reasons are Clinical Classifications Software (CCS) codes which group related diagnoses and procedures into meaningful categories. Communities with a high percentage of noncitizen immigrants were defined as ZCT"] [8.982977867126465, 9.946293830871582, "ities with Fewer Noncitizen Immigrants, %\nOther upper respiratory infections 11.2 Viral infection 4.5 Ear infections and related conditions 3.4 Other injuries and conditions due to external causes 4.9 Superficial injury; contusion 4.5 Other gastroint"] [8.980910301208496, 9.947014808654785, "related diagnoses and procedures into meaningful categories. Communities with a high percentage of noncitizen immigrants were defined as ZCTAs at or above the 80th percentile, i.e., having 21% or more of their population composed of noncitizen immigr"] [9.000052452087402, 9.965886116027832, "hat noncitizens com- pose the greatest share of the uninsured in Districts 2 and 3 (79.1 percent and 62.5 percent, respectively). Conversely, native-born citizens compose the greatest share of the uninsured in Districts 6 (72.9 percent), 7 (69.3 perc"] [9.065982818603516, 10.029548645019531, "\n6.5 20.9\n SOURCE: U.S. Census Bureau, 2018.\nNOTES: Data in table were obtained from the American Community Survey One-Year Public Use Microdata Sample (PUMS), 2018.\n7. Connecting Drivers of Health with Health Outcomes: Examples for Children and Non"] [8.951192855834961, 9.918630599975586, "fore, we present county-level information on the housing experiences of noncitizen immigrants and also utilize information from the American Community Survey to better understand the housing experiences of communities with a higher percentage of non-"] [8.96923828125, 9.935752868652344, "i- grants and also a high percentage of housing with severe overcrowding. As illustrated by the red, these \u201chot spots\u201d of communities with high rates of severely overcrowded housing and noncitizen immigrants are primarily in District 2 and primarily "] [9.065037727355957, 10.02979564666748, " analyses are also intended to spur further thinking and analyses about other subgroups and the drivers of health that may be most salient to them. This chapter also can be used as the County progresses toward Health in All Policies, and must conside"] [9.139934539794922, 10.105299949645996, "on. When examining common reasons for adult hospitalizations, we found that five of the ten most common reasons for hospitalizations were related to birth and complications of birth for residents of communities with a high percentage of nonciti- zen "] [9.195481300354004, 10.161515235900879, " drivers of health described in prior chapters. Where relevant, we pull from prior reports and analyses conducted by the County.\nAs the data available reflect government spending, the findings noted in this chapter should be interpreted accordingly. "] [9.130144119262695, 10.097018241882324, " Because that data is not yet available, we offer potential next steps for County action with respect to health budgeting and investment alignment in the final recommendations chapter. We accompany that chapter with a proposed budget template to orie"] [9.109297752380371, 10.075762748718262, "e total investments directed to health and human services in the County is low (a point raised in the next section about relative County department budget allocations (see Chapter Nine for an associated recommendation).\nFigure 8.2.\nCounty Human Servi"] [9.111380577087402, 10.076363563537598, "ormation has important information on types of ser- vices and specific grant programs, more accurate coding of program documents (objectives, aims, populations served, outcomes) is needed to get this level of specificity.\n198 An Integrated Health in "] [9.063177108764648, 10.029552459716797, "Data was provided in an internal county presentation and conglomerates internal health and human services agencies from FY 2007 to FY 2018.\nWhen looking at spending for populations most in need, Prince George\u2019s County also spends less than nearby cou"] [9.174845695495605, 10.138348579406738, "d. Also, the accounting of health spending by health and human services departments may not be fully representative of total County health costs. A deeper analysis is important for understanding what types of health funding exist, for what services, "] [9.1590576171875, 10.120148658752441, "o identify areas of inefficiency. For instance, if there are programs in Human Services that are working to prevent frequent use of 911 or get ahead of chronic disease management for those who are frequent users of emergency departments, those effort"] [9.105884552001953, 10.07182788848877, "Services*\nCommunity Corrections (e.g., reentry services)\nPolice\nBureau of Patrol (e.g., community policing)\nFY2020 Proposed Budget (General Fund only)\n$139,110,500 $21,465,300\n$2,291,500 $2,619,000\n$182,559,000\n8. Exploring Prince George\u2019s County Bud"] [9.092657089233398, 10.057528495788574, "ose costs. Again, a more detailed coding on direct links to health would be warranted in a health budgeting effort, but this table provides a first place for consideration.\nTable 8.2.\nAddressing Poverty Efforts with Proximal Links to Health\nDepartmen"] [9.156087875366211, 10.121806144714355, "tly focuses on the design and placement of houses, community design, and where food establishments are located and what they serve. For illustration in this driver, we focus on supports for transporta- tion that may influence health (Table 8.4).\n "] [9.196800231933594, 10.15970516204834, "onal health care delivery system. The frame- work presented in the first chapter of this report can be used as a way to organize the findings of this report and to also offer a guide to the County when considering future policy and pro- gram decision"] [9.123185157775879, 10.087017059326172, "ervices are greatly influenced by drivers of health and systemic inequities and these inequities need to be addressed. Inefficient uses of health care services are both magnified and mitigated by greater attention to upstream drivers of health, along"] [9.061753273010254, 10.021838188171387, "th and human services.\n\u2022 Residents are often unaware of available services and resources or may not know\nhow to access or navigate known services and resources.\nLow spending on health and human services.\n\u2022 Estimated County spending on health and huma"] [9.131999969482422, 10.098572731018066, "apters. We describe the larger, cross-cutting limitations below.\nSub-county data. Prince George\u2019s County is large and diverse. Therefore, data available only at the County-level will not fully capture the experience of all residents. We used several "] [9.206929206848145, 10.165007591247559, "lar areas where relevant data gaps exist (e.g., oral health, unmet need, health care quality, and broader health and well- being) and discuss ways the County may consider addressing these gaps going forward. Fur- ther, as greater attention is given t"] [9.200846672058105, 10.164932250976562, "th Health in All Policies. Second, we provide comprehensive recommendations for imple- menting a comprehensive Health in All Policies approach. These recommendations, categorized as (1) creating a Health in All Policies system, (2) aligning investmen"] [9.223814964294434, 10.189455032348633, "ons as well as to offer suggestions to the County in terms of what may be helpful for monitoring the health and human services ecosystem going for- ward. Where relevant and available, we provide examples from other communities. We note LB where legis"] [9.177536010742188, 10.141288757324219, "nty reports and policies, relates to the challenge of how departments that serve residents\u2019 health and human services needs are connected and coordinated, mainly in the area of structure and governance across the various sectors that contribute to he"] [9.177322387695312, 10.139719009399414, "Budget, the body responsible for holding the county accountable for its pro- claimed strategies. Additionally, in 2013, Seattle & King County developed the Health and Human Services Transformation Plan to shift the human services from reactive to pre"] [9.18665885925293, 10.151248931884766, "ctivities of traditional health and human services to avoid duplication, minimize gaps in services, but also is key as the County moves towards stronger Health in All Policies actions that bring in departments beyond health and human services, such a"] [9.157757759094238, 10.126315116882324, "ome of these topics were covered in Prince George\u2019s County approved general plan, Plan 2035. Released in 2014, this plan outlines several strategies that align development plans with broader goals of community health and well-being as discussed in th"] [9.219846725463867, 10.186684608459473, "and recreation, biking, walking, and local cuisine. Another example is the Better Connections Program, which coordinates state and local funding sources to increase transportation options. Local municipalities in Vermont are encouraged to use funds t"] [9.191436767578125, 10.155619621276855, "rally specific approach \u201cthat reflects the needs and experiences of Black women and families\u201d (American Public Health Association, 2015).\nHarnessing whole community approaches to place-based investment. Given the role that non- governmental organizat"] [9.165792465209961, 10.122682571411133, "on, and workforce development in the revitalization of Detroit\u2019s neighborhoods. The City partners with the University of Michi- gan Poverty Solutions Lab to assist in teen pregnancy prevention through increased clini- cian engagement, the expansion o"] [9.20349407196045, 10.166637420654297, "ered regarding augmenting telemental health, especially for underserved areas, such as District Heights, or for individuals that may feel uncomfortable seeking care in person due to stigma. There was particular interest in enhancing mental health ser"] [9.196711540222168, 10.159368515014648, "d by a RWJF Data Across Sectors for Health (DASH) grant to integrate affordable housing and health data and can be layered with data on chronic disease to help guide policymakers in resource allocation (DASH Connect, 2019; Eyler et al., 2019).\n9. Con"] [9.180495262145996, 10.145584106445312, "gested that relaunching or reinvigorating such a program could help bring more individuals, particularly youth and seniors, into providing services that support and promote health and well-being. There was also interest raised about helping the most "] [9.191243171691895, 10.155470848083496, "h literacy integral to its mission, structure, and operations\n\u2022 Integrates health literacy into planning, evaluation measures, patient safety, and quality\nimprovement\n\u2022 Prepares the workforce to be health literate and monitors progress\n\u2022 Meets the ne"] [9.172009468078613, 10.13702392578125, "health and human services part of County government, inclusive of the Health Department, Department of Social Services, and Department of Family Services. Further, this is a challenge to broader Health in All Policies budgeting. Stakeholders also que"] [9.208174705505371, 10.172285079956055, " structure development. Since its establishment, the fund has transitioned to supporting health assessments, developing the Allegheny health improvement plan, and acquiring accreditation (Hacker, Monroe, & Yonas, 2017). Under the grant funds from the"] [9.191608428955078, 10.156133651733398, "irstly, the fund does not require annual approval through the appropriations committee and instead is a four-year commitment. Second, large hospitals and insurers are the funding source for the fund, rather than relying on taxpayer revenue. Lastly, t"] [9.18708324432373, 10.152039527893066, "tment submits budgets.\nAs noted earlier, the County puts forth its actual and anticipated budgets by department each year. These reports include important performance metrics, such as clients served, and some outcomes, such as change in percentage of"] [9.193049430847168, 10.157767295837402, " addressing the health outcomes or goals; and (4) using the aforementioned information to budget for the health outcomes or goals.\n\uf026Examples from the Field: Health Impact Assessments\nAlthough Prince George\u2019s County engages in health impact assessment"] [9.197697639465332, 10.162229537963867, "such as expanding greenspace and developing more smoke-free sites. The Health in All Policies\n9. Conclusions and Recommendations 225\n226 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nTask Force has been in the process"] [9.191276550292969, 10.155677795410156, "tment to identify and apply for funding for initiatives that promote Health in All Policies with nonprofits. Given the broader issue of both coordination and nonprofit capacity building, a few examples from other regions may be worth noting.\n\uf026Example"] [9.19977855682373, 10.163420677185059, "es aims to increase access to healthy foods and transportation and support programs for traumatic brain injury, abuse prevention, motor vehicle safety, and falls preven- tion. Another partnership with Tobacco Free Allegheny conducts a week-long campa"] [9.195817947387695, 10.157772064208984, "ures at a sub-county level would enable the County to identify neighborhood challenges and successes related to health and well-being. To obtain richer sub-county information about these indicators, Prince George\u2019s County could field a similar instru"] [9.183709144592285, 10.148407936096191, "ts use health care services in Washington, DC. Thus, to accurately measure residents\u2019 use of EDs and hospital services, data are needed from both Maryland and DC. While this assessment uses data from both sources, the most recent health assessment fr"] [9.21304702758789, 10.176949501037598, "munity-based organizations provide updates and feedback to clinical providers. The communication between the two entities allow for a more holistic integration of the patient. Any clinical-community partnership, in order to be formally recognized by "] [9.178872108459473, 10.142141342163086, "t the report, but those outcomes are not combined with performance measurement in a way that can be actively and holistically addressed through a common operating and actionable data portal and dash- board. Further, the County Health rankings while u"] [9.222270965576172, 10.185174942016602, " built, natural, and health ser- vices environments. Further, the study linked key insights from primary and secondary data to recommendations to foster aligned and integrated planning and budgeting across the County to promote health and well-being\n"] [9.196414947509766, 10.158349990844727, " ness, and also to the historical and systemic inequities impacting the health and well-being of many residents.\n9. Conclusions and Recommendations 231\nReferences\n Agency for Healthcare Research and Quality. (2016). Access and disparities in access t"] [2.8470518589019775, 4.313215732574463, " & Robling, M. (2018). The impact of pre and perinatal lifestyle factors on child long term health and social outcomes: A systematic review. Health Economics Review, 8(2), 2.\nBellinger, D. C. (2008). Very low lead exposures and children\u2019s neurodevelo"] [9.199631690979004, 10.149548530578613, "0, 2020:\nhttps://w w w.bjs.gov/content/pub/pdf/dudaspji0709.pdf\nBrown, D. L. (2015). Prince George\u2019s neighborhoods make \u2018Top 10 List of Richest Black Communities in America\u2019. The Washington Post. As of October 1, 2019:\nh t t p s : / / w w w . w a s h"] [9.18891716003418, 10.142318725585938, "Assessment and Planning Team (FAPT). As of January 10, 2020: https://www.vbgov.com/government/departments/human-services/about/Pages/fapt.aspx\nCohen, A., K., & Syme, S., L. (2013). Education: A missed opportunity for public health intervention. Ameri"] [9.195928573608398, 10.133861541748047, " M., Casey, P., H., Chilton, M., Cook, J., T., . . . Frank, D., A. (2011). U.S. housing insecurity and the health of very young children. American Journal of Public Health, 101(8), 1508-1514.\nCutuli, J. J., Ahumada, S. M., Herbers, J. E., Lafavor, T."] [9.177894592285156, 10.138326644897461, "nal of Homeland Security and Emergency Management, 8(1), Article 3.\nFleischhacker, S., E., Evenson, K., R., Sharkey, J., Pitts, S., B., J., & Rodriguez, D., A. (2013). Validity of secondary retail food outlet data: A systematic review. American Journ"] [9.175856590270996, 10.133508682250977, "ker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented\nimmigrants: A literature review. Risk Management and Healthcare Policy, 8, 175-183.\nHacker, K., Monroe, C., & Yonas, M. (2017). Innovative partnerships to"] [9.256465911865234, 10.170183181762695, "20: https://www.hudexchange.info/resource/5783/2018-ahar-part-1-pit-estimates-of-homelessness-in-the-us/\nHuman Services Research Institute. (2019). Baltimore public behavioral health system gap analysis. As of January 12, 2020:\nhttps://www.powerdms.c"] [9.183466911315918, 10.143128395080566, " p s : / / w w w . h e a l t h a ff a i r s . o r g / d o / 1 0 . 1 3 7 7 / h p b 2 0 1 8 0 8 1 7. 9 0 1 9 3 5 / f u l l /\nKing County. (2013). Health and human services transformation plan. As of July 22, 2019: https://www.kingcounty.gov/elected/exe"] [9.200366973876953, 10.160808563232422, "c/live_well_san_diego/indicators/Indicators_Fact_Sheet.pdf\nLive Well San Diego. (2018). Live Well San Diego food system initiative encourages residents to prevent food waste. As of September 9, 2019: http://www.livewellsd.org/content/livewell/home/al"] [9.03623104095459, 10.022851943969727, "coronavirus.maryland.gov\nMaryland Department of Health Dataset Query System. (2016). Behavioral Risk Factor Surveillance System. As of January 2020:\nhttps://ibis.health.maryland.gov/query/selection/brfss/BRFSSSelection.html\nMaryland Department of Hea"] [9.239174842834473, 10.190183639526367, "al and emergency department discharges, 2017.\nMaryland Institute for Emergency Medical Services Systems. (2018). Mobile integrated health (MIH) programs are growing in Maryland. Maryland EMS News. As of July 23, 2020: http://www.miemss.org/home/Porta"] [9.259427070617676, 10.211703300476074, "l of Public Health, 41(11), 3-28.\nMeltzer, R., & Schwartz, A. (2016). Housing affordability and health: Evidence from New York City. Housing Policy Debate, 26(1), 80-104.\nMensah, G., A., Mokdad, A., H., Ford, E., S., Greenlund, K., J., & Croft, J., B"] [9.132643699645996, 10.09596061706543, ", 2020: https://www.nihcm.org/categories/hospital-consolidation-trends-impacts-outlook\nNelson, C., Sloan, J., & Chandra, A. (2019). Examining civic engagement links to health: Findings from the literature and implications for a Culture of Health. Ret"] [9.079937934875488, 10.046063423156738, "ysis, FY2008 - 2018. Information shared by Prince George\u2019s County Council Budget and Policy Analysis Team.\nPrince George\u2019s County Department of Family Services. (2019). Department of Family Services 2019 Fiscal Year Approved Budget. As of January 15,"] [9.134953498840332, 10.098814964294434, "etwork. (2019). Prince George\u2019s County senior resource guide. As of February 3, 2020:\nhttps://www.princegeorgescountymd.gov/DocumentCenter/ View/24613/2019-Prince-Georges-Senior-Resource-Guide\nRegional Primary Care Coalition. (2018). The healthcare l"] [9.192831039428711, 10.156371116638184, "n and Physical Activity, 14(1), 158.\nStafford County. (2019). Children\u2019s services act for at risk youth and families: FAQs. As of March 3, 2020: https://staffordcountyva.gov/Faq.aspx?QID=218\nSubstance Abuse and Mental Health Services Administration. "] [9.172945976257324, 10.135865211486816, " 54-62.\nUniversity of Maryland School of Public Health. (2012). Transforming health in Prince George\u2019s County, Maryland: A public health impact study. As of October 1, 2019: https://sph.umd.edu/sites/default/files/files/TransformingHealth.pdf\nUrban H"] [12.696329116821289, 13.817154884338379, "The health and health care of U.S. prisoners: Results of a nationwide survey. American Journal of Public Health, 99(4), 666-672.\nYoung, R., F., & Severson, R., K. (2005). Breast cancer screening barriers and mammography completion in older minority w"] [9.179407119750977, 10.13698959350586, "sagree, strongly disagree, don\u2019t know) and used an online polling system, which enabled attendees to immediately see aggregated responses as part of the discussion. Prompts included the following:\n\u2022 There is good health care in my community (26 perce"] [9.26402473449707, 10.161172866821289, "esidents were conducted to obtain information about residents\u2019 opinions and experiences regarding health and human services in the County. The focus groups were conducted in English. The composition of these focus groups is described in Table A.1. Th"] [9.186820983886719, 10.147417068481445, " Health Department\n252 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\n\u2022 Prince George\u2019s County Department of Housing and Community Development\n\u2022 Prince George\u2019s County Department of Parks and Recreation\n\u2022 Prince George"] [10.84338092803955, 10.422840118408203, " with the best efforts (e.g., individuals experiencing homelessness and undocumented immigrants). Relatedly, the individuals who attend focus groups and town hall meetings may represent more engaged residents who may or may not share the same opin- i"] [9.191104888916016, 10.123395919799805, "e end of the study we will destroy the tapes. Is it all right if we audiotape this focus group? If you have questions about your rights as a research participant or need to report a research-related injury or concern, you can contact RAND\u2019s Human Sub"] [9.2095365524292, 10.168038368225098, "ife\ni. Let\u2019s start by thinking about a few questions that offer an indication of quality of life. For example, is my community a good place to raise children? A good place to grow old? Are there policies and laws that protect my health and the health"] [9.203324317932129, 10.1611909866333, "y can do to improve health in the County and to better serve the needs of residents.\nIn this discussion, we want to get your perspective on priority health issues in the County \u2013 and, importantly, your thoughts on the program and policy solutions to "] [9.172039985656738, 10.124823570251465, "e been the biggest barriers faced by your agency in improving these human\nservice needs? Probe \u2013 funding streams, resource allocation, political biases, county\nnorms\n5. Are there particular targeted populations that have been most challenging?\n6. Con"] [8.997479438781738, 10.041943550109863, "ry File\nAmerican Community Survey 1-Year Summary File\nAmerican Community Survey 1-Year Public Use Microdata Sample\nAmerican Lung Association, State of the Air\nBehavioral Risk Factor Surveillance System\nCDC National Center for Health Statistics, CDC W"] [8.986961364746094, 9.972378730773926, "r extreme heat days\nand number of extreme precipitation days. Available at https://ephtracking.cdc.gov/DataExplorer. Extreme heat days are days in which the daily maximum temperature exceeded the 90th percentile of the range of daily maximum temperat"] [9.06689739227295, 10.054401397705078, "County by the total number of children tested in the County. These data were obtained from the Childhood Blood Lead Surveillance In Maryland Annual Reports for each year, 2009 \u2013 2018. Reports are found on the Maryland Department of the Environment we"] [9.002717018127441, 9.980142593383789, "dexchange.info/resource/5783/2018-ahar-part-1-pit- estimates-of-homelessness-in-the-us/. Available December 2018. Accessed September 19, 2019.\nThe Pregnancy Risk Assessment Monitoring System (PRAMS) data are limited only to births within Maryland and"] [8.974337577819824, 9.99708366394043, "groups were placed into 20 quantiles by variable value. The block groups were then assigned a rank from 1 to 20 depending upon their quantile position. A ranked score of 1 was assigned to the block groups with the lowest relative values influencing w"] [6.40812349319458, 15.515793800354004, "uction, each of block is contained uniquely in a tract and in a ZCTA. To add district information to this block level file, we used a spatial join in ESRI ArcMap 10.7 between blocks and councilmanic districts.1 Almost all census blocks are uniquely c"] [9.028616905212402, 10.000941276550293, " downloaded from Prince George\u2019s Planning Department GIS Open Data Portal.\nAppendix B 263\n 264 An Integrated Health in All Policies Plan for Prince George\u2019s County, Maryland\nStatistics, CDC WONDER is a comprehensive database designed to promote i"] [9.02189826965332, 9.989569664001465, "\nI11\nI13 I20-I25 I26-I28\nI30-I51\nI10 I11 I12 I13 I15 I16\nK08.81 K08.82 K08.89\nCode Description\nDiabetes mellitus due to underlying condition Drug or chemical induced diabetes mellitus Type 1 diabetes mellitus\nType 2 diabetes mellitus\nOther specified "] [8.994891166687012, 9.962475776672363, "Behavioral Health Conditions per 100,000 Population in 2017, by ZIP Code\nSOURCE: 2017 Maryland data was obtained from the Maryland Health Services Cost Review Commission. 2017 DC data was obtained from the DC Hospital Association.\nNOTES: Includes 201"] [9.183586120605469, 10.144319534301758, "des 2017 inpatient hospital discharges in Maryland and DC for Prince George\u2019s County residents aged 18 years and older. Non-traumatic dental care identifies conditions that can be prevented or best treated in a traditional dental office. It is an ind"] [9.188790321350098, 10.151515007019043, "ell-\nbeing outcome\nof interest (e.g.,\neither outcome\ngoal to achieve)\n health services get\nDecrease in unmet\nwho need mental\nneed (i.e., those\nmental health\nservices without\ndelay or other\nbarrier)\n county plans are organized. A similar approa"] [9.206461906433105, 10.169082641601562, "r)\nget services\nStep 3: Given Steps 1, 1a, and 2, consider what programs and policies you would rate as most critical for addressing the outcome of\ninterest. Consider rating against three dimensions:\n\u2022 Interoperability - Can be executed with coordina"] [9.153325080871582, 10.1173095703125, "rden, including mental and behavioral health conditions\n\u2022 Desire to focus on health equity and address the role of systemic factors in influencing health\n\u2022 Increasing interest in health promotion policies, social determinants of health,\nand investmen"] [9.203163146972656, 10.16892147064209, "ing these services (in order to measure and reduce inequities).\n\u2022 Align information about what is being spent on these health services and information on reach, effectiveness, and impact on reducing inequities.\n\u2022 Require all nongovernmental organizat"] [9.206632614135742, 10.17090892791748, "er communities to situate recommendations in a Health in All Policies framework to foster aligned and integrated planning and budgeting across the county to promote health and well-being. Findings from the assessment indicate a shared interest among "] [12.279884338378906, 5.979094982147217, " Research Report\nSAMUEL PETERSON, DIONNE BARNES-PROBY, KATHRYN E. BOUSKILL, LOIS M. DAVIS, MATTHEW L. MIZEL, BEVERLY A. WEIDMER, ISABEL LEAMON, ALEXANDRA MENDOZA-GRAF, MATT STRAWN, JOSHUA SNOKE, THOMAS EDWARD GOODE\nUnderstanding\nSubgroups Within the"] [12.275935173034668, 5.980063438415527, "les County Counsel commissioned the RAND Corporation to conduct an independent research study on deputy subgroups within LASD. The study was commissioned to help the county and LASD learn more about how subgroups have affected community per- ceptions"] [15.047895431518555, 5.765284538269043, "........................... 7\nConclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nCHAPT"] [12.158695220947266, 6.143070697784424, "ups Within the Los Angeles County Sheriff\u2019s Department\nRecommendations Related to Subgroups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Conclusion........."] [12.120050430297852, 6.176878452301025, "puty . . . . . . . . . . . . . . . . . . . . . . . . . . . Midlevel Managers\u2019 Versus Deputies\u2019 Views Regarding the Impact of Subgroups on the\nDepartment and Individuals and Their Suggestions as to What LASD Can Do About\nSubgroups....................."] [12.106207847595215, 6.1936726570129395, "Cliques on the Workplace and LASD as a Whole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n8.5. Survey Respondents\u2019 Views About What LASD Should Do, if Anything, About\nDeputy Subgroups or Cliques . . . . . . . "] [12.090412139892578, 6.216445446014404, "to Join a Deputy Subgroup, Overall and by Tenure. . . . . . . 125\n8.4. At What Stage in Their Career Are Most Deputies First Invited to Join a Deputy Subgroup?......................................................................................... 1"] [12.266992568969727, 5.9768829345703125, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162\n10.1. Factors Involved in Organizational and Cultural Change. . . . . . . . . . . . . . . "] [12.267773628234863, 5.974353313446045, "estigations (not just those associated with subgroups), the\n1 In February 2020, LASD implemented a new policy, \u201c3-01/050.83: Employee Groups Which Violate Rights of Other Employees or Members of the Public\u201d (Los Angeles County Sheriff\u2019s Department Ma"] [12.28386116027832, 5.967341899871826, "station areas;3 interview data from 57 individuals, including members of LASD and other county stakeholders; and 1,608 survey participants. To preserve confidentiality and promote honest responding, surveys were conducted anonymously, and no informat"] [12.277048110961914, 5.975675106048584, " differential treatment by race, socioeconomic status, physical appear- ance, and other factors. Community members from the Central and North Patrol Division areas overall reported less-positive views of LASD. Stakeholders also pointed to the ways de"] [12.196471214294434, 6.071928024291992, "of deputy subgroups in media reports, legal claims, state- ments by public officials, and some of our interviews with LASD personnel and community members are that they are gangs that glorify violence and recruit only hard-charging crime fighters, es"] [12.197365760803223, 6.069474697113037, "ledge of and assessments of subgroups\u2019 characteristics and conduct.\n What Purpose Do Subgroups Serve?\nSubgroups vary significantly. Some are drinking groups. Others are closer to cliques or, as one respondent called them, \u201cpopular kids.\u201d And some enc"] [12.19594669342041, 6.071481704711914, "ime\u2014is a point of pride and means that one is competent enough to work anywhere in the department. Deputies at fast stations might be perceived as hard chargers, although deputies might choose slow stations for practical reasons, such as proximity to"] [12.203932762145996, 6.06315279006958, " often discussed as a potential reason for why people form subgroups or get invited to join subgroups, but some interviewees challenged this characterization. It is not clear why hard work and humility could not be recognized and rewarded through ord"] [12.175121307373047, 6.09871244430542, " supervision. Proper supervision was identified by LASD interviewees as critical for managing subgroups.\nAnother key role in the formation of subgroups identified by LASD personnel and in research literature is that of the frontline supervisor. This "] [12.144548416137695, 6.1373372077941895, "this leading to adverse behavior. For example, deputies might use unnecessary force to show how aggressive they are in an effort to be invited to join a subgroup. Thus, how a subgroup defines competence has implications for what behavior is valued by"] [12.183734893798828, 6.088939666748047, " they were asked to join a subgroup on the basis of their performance and declined without professional repercussions. In interviews, those who opted out mentioned some form of work-life balance, and command staff speculated that deputies working tow"] [12.205395698547363, 6.062314987182617, "this behavior could include efforts to get people to act in certain ways (e.g., make certain arrests) or to transfer out of the station. Many of the internal problems that can develop with subgroups involve pat- terns of disrespectful behavior toward"] [12.24791431427002, 6.012485504150391, "ups are accused of misconduct is too great a risk for the county and its residents. Efforts should be made to intervene early to prevent problems from escalating or occurring in the first place. Research on change management suggests that a critical "] [12.239298820495605, 6.022568702697754, " perceptions of problematic behaviors associated with subgroups are not universal among LASD respondents and tend to change over time given a set of con- ditions (e.g., poor supervision, subgroup leadership). Although LASD personnel perceive the more"] [12.256892204284668, 5.994377136230469, "nts and independence of the various units across LASD, chiefs and commanders should work with unit commanders to develop strategic plans for managing known subgroups.\n\u2022 Ensure that those in key roles are aware and accountable. Unit commanders are dir"] [12.338796615600586, 5.873447418212891, " disabilities, and building skills for interacting with people and displaying empathy. Some training recommendations were specifically about the practice of deputies starting their careers in the jails instead of in patrol stations, which community s"] [12.324783325195312, 5.892202854156494, "reimbursement).\n\u2022 Improve relationships with external oversight. This includes establishing community advisory councils, soliciting feedback on policies from the Los Angeles County Sheriff Civilian Oversight Commission, and building a productive work"] [12.26353931427002, 5.970499038696289, "ty of Los Angeles\nCalifornia Commission on Peace Officer Standards and Training Performance Reporting and Monitoring System\nProject Active Bystandership for Law Enforcement\nxxvii\nxxviii Understanding Subgroups Within the Los Angeles County Sheriff\u2019s "] [12.288016319274902, 5.952173233032227, "ke those described above damage public trust. Moreover, as indicated by allega- tions of community mistreatment (e.g., excessive force), the risk of harm to the community is a key reason why this issue is a matter of public discussion. This risk make"] [12.267658233642578, 5.978858947753906, "public demonstrations against police brutality, as well as several high- profile shootings committed by deputies that have contributed to tension with some com- munity members. These tensions also manifested in attacks on deputies, the most notable o"] [12.242435455322266, 6.024697303771973, " intent and reach of this policy, ongo- ing conflict with civilian oversight bodies regarding the department\u2019s approach to subgroups, and post-policy allegations of ongoing subgroup activity provide reasons to be wary. Addition- ally, recent depositi"] [12.255269050598145, 6.0010271072387695, "ions of LASD personnel and community members. This framework recognizes that subgroups and issues surrounding them exist within a broader context, which could have implications for group formation, group features, group member characteristics, and be"] [12.272997856140137, 5.98295783996582, " this case, interviewees, focus group participants, and survey respondents.4 Surveys were conducted anonymously; RAND does not have any information that could be linked to an individual.\nAdditionally, we present many of our qualitative findings with "] [12.245383262634277, 6.0051045417785645, "ers relevant inquiries and lawsuits into LASD subgroups over several decades and analyzes media coverage to see how frequently and in what context subgroups have been mentioned (primarily in the Los Angeles Times). The Kolts Commission provided the f"] [12.249656677246094, 6.00574254989624, " Los Angeles County Sheriff\u2019s Department\nMedia Coverage of LASD Deputy Subgroups\nWeb searches for \u201cdeputy cliques,\u201d \u201cdeputy gangs,\u201d and \u201cdeputy subgroups\u201d reveal cover- age from local, national (e.g., New York Times), and international (e.g., The Gua"] [12.241626739501953, 6.009254455566406, "bgroup), statements by county officials (e.g., the Sheriff, the Board of Supervisors), and potential investigations into deputy subgroups (e.g., by the FBI or the OIG). Researchers also analyzed the set of articles using RAND-Lex, a cloud-based text "] [12.32410717010498, 5.8596415519714355, "ent is formally organized into many workplace groups of various sizes\u2014across units, shifts, and areas of responsibility, and this structure can create a sense of isolation and localized patterns of behavior (Klinger, 1997; Hassell, 2007), which occas"] [12.256101608276367, 5.99409294128418, "s unclear; however, the NOPD at the time was mired in scandals related to various forms of corruption and outright criminal conduct (Frontline, 2009).\nOther groups have been identified following whistleblower accusations about pressure to use lethal "] [12.260381698608398, 5.9885430335998535, " Two Internal Affairs undercover investigators originally assigned to investigate were reportedly removed from the case after two and a half years; claiming they were reassigned and ostracized, the investigators filed a whistleblower retaliation laws"] [12.275045394897461, 5.969345569610596, "ding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nOperation Pandora\u2019s Box\nMore recently, the 2011 Operation Pandora\u2019s Box scandal resulted in federal charges and con- victions for former Sheriff Baca and Undersheriff Tanaka (Grad and "] [12.223628997802734, 6.027926921844482, "mbers of individuals who were killed in shootings committed by deputies. Community members\u2019 claims typically cite unreasonable search and seizure; unreasonable or excessive force; failure to train, supervise, and discipline; and munici- pal liability"] [12.24766731262207, 6.009913921356201, "behavior (e.g., Rathbun & Sexton v. County of Los Angeles).\nTogether, such complaints and lawsuits provide ample examples of subgroup members\u2019 alleged misconduct against both county residents and other deputies. However, the resolu- tion of these cas"] [12.241656303405762, 6.0164079666137695, "ly affecting these out- comes, such as supervision, discipline, and community engagement, among others. Here, we review key findings from these reports as they relate to subgroups or cliques and LASD culture generally and for recommendations related "] [12.232440948486328, 6.028837203979492, " community policing. Regarding the subgroups, the report recommended that LASD eradicate offensive station mascots and conduct an immediate internal affairs investiga- tion to identify and punish gang-like behavior. It recommended breaking up deputy "] [12.215256690979004, 6.044594764709473, "rengths and weaknesses of management, knowing what training had been received or is needed, and knowing whether subgroups are forming and what assistance has been given to the captain. This assistance included developing working plans with captains t"] [12.238774299621582, 6.017464637756348, "2011; Liebowitz et al., 2012). These reports\nPrior Reports and Media Coverage of LASD Subgroups 17\nidentified deficiencies in LASD\u2019s use-of-force policy; its training; and its reporting, investiga- tion, and discipline for excessive force and noted a"] [12.203787803649902, 6.067877292633057, "rom this report, one can infer that cliques were emblematic of a culture or subculture within the department that supported the use of force as a tool. The CCJV advocated culture change, noting that it would require committed supervisors, strong and "] [12.315317153930664, 5.906280517578125, "The agreement includes a vari- ety of recommendations related to stops, seizures, and searches; bias-free policing; community engagement; Section 8 enforcement; data collection; use of force; personnel complaints; and accountability. These recommenda"] [12.220481872558594, 6.028952598571777, "past investigations on deputy subgroups (Loyola Law School Center for Juvenile Law and Policy, 2021). The report distin- guishes between deputy subgroups or cliques and deputy gangs based on whether the group has engaged in gang-like behaviors, defin"] [12.237552642822266, 6.0210466384887695, "o them, instead focusing on disciplinary and other departmental processes. The OIG\u2019s recent report on the Banditos criminal investigation (OIG, 2020a) and the Loyola Law School Center for Juvenile Law and Policy report (Loyola Law School Center for J"] [12.248586654663086, 6.015751838684082, "eractions, and not condoning allegiances to sub- parts of the department.\nLASD disagreed with some of the findings and recommendations, typically noting their points of disagreement in response letters. LASD has, however, implemented several of the r"] [12.300012588500977, 5.824892997741699, "tting (e.g., \u201ctattoos associated with deputy cliques . . . have also in some instances been used as a reward for aggressive behav- ior\u201d; CCJV, 2012, p. 115). What has been missing in prior accounts of deputy subgroups is an explanation of why these g"] [12.387524604797363, 5.721863269805908, "ture is emergent\u2014that is, it is part of a creative process that is influenced by social action and group interactions and conflict. This includes the broader social context, and deputies bring their own beliefs, values, and worldviews to the job.\nPol"] [12.361418724060059, 5.779324531555176, ", which reflects an occupational culture within law enforce- ment. In relation, an organizational perspective posits that unique features within a particular agency lead to unique cultural adaptations that vary across agencies (Paoline and Terrill, 2"] [12.325065612792969, 5.83506441116333, "ilence is important for the mutual trust needed to perform well. In research surveys on this topic, officers tend to overwhelmingly endorse physical protection and emotional protection or the camaraderie/bond features of loyalty, while between 12 and"] [12.295631408691406, 5.875816345214844, "y themselves as a distinct group within the organiza- tion . . . and routinely take action on the basis of collective understandings unique to the group\u201d (Van Maanen and Barley, 1984, p. 38). The extent to which subcultures reflect other subcultures "] [12.3325834274292, 5.813480854034424, "evel of danger), (4) preferences and ideologies of command structures, and (5) types of crimes and legal authority commonly used (e.g., stops and searches for weapons). Both formal and infor- mal processes shape subunit culture and officer behavior.\n"] [12.307437896728516, 5.876471042633057, "ypical members are negative outliers (or \u201cfree riders\u201d) and \u201chigh-flyers.\u201d Rejecting the free riders is important for solidifying the ingroup prototype, while high-flyers can be tolerated as long as the group can take some ownership of their behavior"] [12.342178344726562, 5.813125133514404, "r police to avoid external scrutiny). In addition to the impact of peer groups, a key consideration for research in this area involves group processes. The idea of emergence\u2014how elemental content (e.g., individual orientations to aspects of police cu"] [12.336801528930664, 5.812202453613281, ", views about use of force (Oberfield, 2012; Roithmayr, 2016), misconduct (Chappell and Piquero, 2004; Ouellet et al., 2019; Quispe-Torreblanca and Stewart, 2019; Wood, Roith- mayr, and Papachristos, 2019), ethical decisionmaking (Blumberg, Papazoglo"] [12.32620620727539, 5.8320441246032715, "of these effects occur because of selection (i.e., \u201cbirds of a\nRelevant Research 29\n30 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nfeather flock together\u201d) or influence. Thus, research on social identity, self-categoriz"] [12.292503356933594, 5.897751331329346, "es or the extent to which workgroups share similar outlooks. However, other research has shown that fairness perceptions are associated with observed treatment of peers, and particularly more similar peers (Huang, Ryan, and Mujtaba, 2015). As mention"] [12.318550109863281, 5.949456691741943, "recognizes that the way an organization treats employees also can affect attitudes and behaviors and has implications for reforming LASD and implementing new policies. These concepts also have relevance for understanding orientations toward and inter"] [12.278640747070312, 5.980135917663574, "ess, LASD provided contact information for command staff in the custody1 and patrol divisions. We developed our survey approach through feedback from LASD stakehold- ers, which informed our decision to conduct a paper survey. LASD and ALADS also assi"] [12.312960624694824, 5.9478020668029785, "using referrals and independent searches to ensure that a variety of perspectives were represented. Ultimately, 46 community stakeholders agreed to participate, yielding a 45-percent response rate. For the focus groups, we recruited 95 English- or Sp"] [12.255653381347656, 6.00888729095459, "operates, awareness of deputy subgroups, impacts of deputy subgroups, and perspectives on how to address deputy subgroups.\nRecruitment\nIn October 2019, LASD sent out an email announcement giving personnel an overview of the various components of the "] [12.181313514709473, 6.102406024932861, "where subgroups are typically found within LASD\n\u2013 advantages of belonging to a subgroup\n\u2013 conduct, attitudes, and behavior of deputies who belong to a deputy subgroup \u2013 impact of subgroups on the workplace\n\u2013 supervisors\u2019 approach to subgroups\n\u2013 views"] [12.26956558227539, 5.998040199279785, "tment, and community levels.\nTo pretest the survey, we recruited 12 LASD personnel of varying ranks to partici- pate in cognitive interviews. Cognitive interviewing, which involves administering a survey while asking a respondent to elaborate on the "] [12.2621431350708, 5.983183860778809, "ntities investigating LASD, and would not provide confidential information to any outside entity, including the county. Infor- mation gathered as part of the survey would only be used for research purposes and would not be shared with anyone outside "] [12.211996078491211, 6.044013977050781, "or had been asked within the past five years to join a subgroup. We felt that the analyses that compared subgroup invitees with those had never been invited to join a subgroup were informative as to these respondents\u2019 knowledge of and assessments of "] [12.255084991455078, 6.02820348739624, "l. First, we used benchmarking to identify units that had signifi- cantly lower or higher levels of reported subgroup activity than we would expect, given the demographics of the individuals who responded. We compared these results with external\nMeth"] [12.287674903869629, 5.963076114654541, "ty for the department to change in response to public outrage or pressure from other county stakeholders. Therefore, we sought to understand community perceptions on this issue, as well as how those perceptions are related to views of LASD overall.\nT"] [12.313253402709961, 5.9336838722229, "es, station personnel, and leadership through their involvement in citizens groups and advisory panels. In addition, stakeholders in the North and Central divisions more frequently offered negative perceptions of LASD than community representatives i"] [12.288578033447266, 5.956851482391357, "ing with the commu- nity; and (3) community partnership, which varies from collaborating to address public\n Chapter Five Methods: Interviews and Focus Groups with Community Stakeholders\n\u2022 Our method is based on interviews and focus groups conducted w"] [12.315816879272461, 5.940037250518799, "nd-highest numbers of calls for service; Figure 5.1).1\nCommunity leaders and members offered several different perspectives on and experi- ences with department personnel and subgroups. The aim of this chapter is to present this information as it was"] [12.30506706237793, 5.939878463745117, "the people, not to the Board, but they control his budget, so they went after him [through the] budget. . . . The Board should drop their lawsuit and let [the Sheriff] do what he was elected to do.\nFunding\nSome participants expressed concern about th"] [12.31513786315918, 5.930058479309082, "es 45\n46 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nCompton Station to describe the present relationship between Compton and LASD. Commu- nity leaders in the North Division frequently mentioned the 2015 Antelope Valley"] [12.328036308288574, 5.866735935211182, "ASD programs, such as the Youth Activi-\n2 In 2011, the DOJ, Civil Rights Division, initiated an investigation of LASD to evaluate allegations of violations of the Fair Housing Act. DOJ found that LASD\u2019s Palmdale and Lancaster stations \u201chad engaged in"] [12.320549011230469, 5.90008020401001, "research suggests that supervisor expectations can affect whether officers engage in community policing or problem- solving (Engel and Worden, 2003), but much more research is needed to understand the opti- mal conditions for high-fidelity implementa"] [12.305121421813965, 5.93740177154541, "ture in nearly every focus group or interview in every division. However, community leaders\u2019 perceptions were more varied, with negative culture mentioned in a fourth of interviews in the South Division, approximately two thirds of interviews in the "] [12.319717407226562, 5.92484188079834, "vested in the community. Others described problems emerging when the majority of deputies do not represent the community culturally or demographically. A community leader noted that having stations represent the racial and ethnic composition of the c"] [12.309744834899902, 5.936763286590576, " was failing to provide necessary services for the community. This theme was especially prominent in the North and East divisions, with approximately half of discussions of those divisions describing inadequate service. This topic was raised far less"] [12.324385643005371, 5.919130802154541, "e\ncommunity. More community stakeholders from the North and South divisions mentioned having opportunities to interact with deputies than did those in the other divisions.\nDespite the importance of community interaction, some participants noted that "] [12.310131072998047, 5.915626049041748, "ness, some people felt unsafe so LASD ensured they had more presence with deputies. There is also a roving COPS [Com- munity Oriented Policing Services] team that comes to the community. It is proactive policing. They are very actively involved if th"] [12.425110816955566, 5.77443265914917, "fety decisions. Attempts to partner with the community might not be successful if station personnel have not engaged in relationship-building through community interaction. A community leader mentioned that the local station\u2019s attempts to solicit fee"] [12.290919303894043, 5.9664411544799805, "ders reported experiencing mistreat- ment by deputies\u2014including harassment, retaliation, and excessive force\u2014as well as differ- ential treatment. Community members described mistreatment in every interview and focus group, which was more often than i"] [12.340771675109863, 5.906612396240234, "d Central divisions.\nThe majority of the comments suggested that differential treatment was based on race (i.e., primarily Black and Hispanic individuals). A community member described the relation- ship between the Hispanic community and deputies th"] [12.307717323303223, 5.938511371612549, " leader attributed lower crime rates to successful partnerships between the deputies and the community and added that:\nit takes the community working with the sheriffs. Now, if the community doesn\u2019t care or isn\u2019t working with the sheriffs [you won\u2019t "] [12.28143310546875, 5.9695658683776855, "ity. For example, a com- munity leader said:\nThere were more programs in the community which made it more comfortable for them to understand who the community is. Now, it\u2019s \u201cI\u2019m going to shoot you, I\u2019m going to beat you.\u201d . . . I asked [deputies] to "] [12.235197067260742, 5.963039875030518, "ory good where I could really hear everything about that. It was just in a walk-by way, if that makes sense\u2014it wasn\u2019t the main point in the conversation, so I\nhadn\u2019t really thought about it. But I could believe it. I could believe it just based on th"] [12.212469100952148, 6.04911470413208, "ne community leader explained,\nI have seen those cliques make the community safer because they don\u2019t tolerate the things that are going on, so the crime rate has significantly reduced. These cliques are not out to hurt people. When I was in the servi"] [12.20013427734375, 6.067661285400391, "l Division (with only one additional comment from a community member in the East Division) and from community leaders in the South and North divisions.\nSubgroup Behavior\nPatrol Deputies\u2019 Behavior\nCommunity leaders and members gave examples of how pat"] [12.275775909423828, 5.974414825439453, "anguage of rival gangs.\nIn addition, some participants were reticent to file complaints about subgroup behavior because they said that the complaints would just go through fellow LASD personnel and would likely never be heard. Comments about the beha"] [12.222278594970703, 6.038323879241943, "that is because I was part of the military and I know how these rank-and-file companies are and how they are run. If you have a bad person running that company . . . when I think of the sheriff rank-and-file group, they teach the same kind of trainin"] [12.223834037780762, 5.992443561553955, "and kept the community safe, and a few said that there really was no impact on the community. In general, however, the predominant sentiment was that subgroups have a negative impact on the community. As we note later, this sentiment aligns with that"] [12.266268730163574, 5.983523368835449, "ors indicated the existence of and participation in subgroups.\nIllicit Behavior\nCommunity members and leaders described illicit behavior that they associated with sub- groups. One common and unlawful practice that participants discussed was dropping "] [12.305506706237793, 5.934505462646484, "e LA Times article came out last year, they did a good job communicating that the cliques aren\u2019t there now, so from my perspective and my neighbors\u2019 perspective, we don\u2019t really have a sense of that being there anymore. It might be more of a sense of"] [12.341724395751953, 5.871626853942871, "d for training to focus more on building skills for interacting with people (e.g., procedural justice) and display- ing empathy. One community member said:\n[They need p]eople skills, because you\u2019re dealing with people. You\u2019re dealing with the com- mu"] [12.346761703491211, 5.872724533081055, "responsible for the entire community.\nIn a similar vein, participants recommended that LASD overall engage in more community-oriented policing (COP).4 Participants described COP as working with the com- munity to advance public safety, engaging with "] [12.297287940979004, 5.972841739654541, "ment\nRecommendations for Internal Activities\nImprove Hiring and Training Practices\nBoth community leaders and community members had suggestions about improving hiring and training practices as a way of addressing issues of subgroups within the depart"] [12.249091148376465, 6.015529632568359, " was likely to be ineffective. A community member\u2019s comment underscored this point:\nThere needs to be investigations by independent bodies within the department of any sus- picions. I have doubts about any internal committees to be unbiased\u2014I don\u2019t t"] [12.259567260742188, 5.992298603057861, "groups; federal agencies, through consent decrees or federal injunctions, to keep the pressure on the department to do something about sub- groups; the Board of Supervisors and the COC exercising their power over the department to dismantle these gro"] [12.280522346496582, 5.9442830085754395, "eaders were also more likely to highlight the need for residents to be more involved in efforts to improve LASD community relations. Conversely, community members typically offered a less favorable assessment of LASD culture, station personnel behavi"] [12.239273071289062, 6.002507209777832, "and survey questions were aimed at helping us understand whether complexity (or lack of it) at LASD is a factor in deputy subgroups forming. RAND research- ers with expertise in qualitative data collection interviewed a total of 57 individuals, inclu"] [12.243239402770996, 6.015868186950684, "ly, patrol tends to be a more valued assignment than other assignments like custody and courts, and special assignments (Special Enforcement Bureau, Homicide Bureau) tend to be the most highly valued assignments.\n\u2022 Core organizational processes. The "] [12.26700210571289, 5.981921195983887, "who was ambushed and killed in the line of duty\u2014states: \u201cMy goals are simple, I will always be painfully honest, work as hard as I can, learn as much as I can and hopefully make a differ- ence in people\u2019s lives.\u201d We highlight these values and mottos "] [12.26359748840332, 5.990296363830566, "ge from urban areas to suburbs and from high-crime areas to low-crime areas. These differences contribute to deputies\u2019 perception of the experience to be gained by working at some stations (e.g., deputies in high-crime areas will be more likely to wo"] [12.266951560974121, 5.987619400024414, " earning the reputation of having favored assignments within LASD. According to one retired department member,\nWorking in [other areas], you were nothing. You weren\u2019t worthy of promotion. [One region] had the stigma of being the cowboy country. I was"] [12.269880294799805, 5.984824180603027, "on, this idea that certain assignments are more favorable feeds into department members\u2019 understanding of what leadership values. It is not clear how perva- sive these perceptions are today, as some interviewees reported that there is currently no cl"] [12.263934135437012, 5.9892258644104, "e there is a higher volume of serious crime, this could result in a trade-off in quality when it comes to writing reports, can hinder the development of skills to deal with less serious crimes or provide service, and can result in less diverse experi"] [12.259482383728027, 6.000654220581055, "rate as independent police departments.\nThis statement also recognizes that, rather than operating as districts or precincts within the same department, LASD stations are more like completely separate departments (Meyer and Rowan, 1977; Pfeffer and S"] [12.276100158691406, 5.971242904663086, " 2000/3000 to build your reputation as a hard charger and can handle ghetto. Those floors are associated with the station you want to go to. 3000 go to Compton. In patrol, they ask where did this guy work? Which floor? 2000 go to Century. NCCF [North"] [12.265033721923828, 5.990391254425049, "g., being close to home, a regular schedule).\nKey Organizational Processes\nAlthough a full examination of organizational processes is beyond the scope of this project, several of these processes were frequently mentioned in relation to both subgroups"] [12.268777847290039, 5.984084129333496, "ld also contribute to making the department \u201ctoo young\u201d because they could lead to people leaving custody too soon and being unprepared for patrol training. Conversely, contingent on county funding, if a hiring spree is followed by a hiring freeze, p"] [12.260520935058594, 5.999652862548828, "we need them to know. We have the field operations school for sergeants that\u2019s supposed to be had within a year [of promoting to sergeant], but 90 percent of the typical class has at least 3 years [on the job]. We have no training for sergeants or li"] [12.251805305480957, 6.009920120239258, "s a ringer in there. There would be a county rep or a city manager or someone that you\u2019d interview with, and they would tell the Sheriff who they wanted. And the Sheriff would ignore that and pick the person they actually wanted.\nThere is now apparen"] [12.245895385742188, 6.011629581451416, "pline varies across the department, and historical perspectives on discipline under different sheriffs.\nHistorically, several command staff noted a pattern of lax discipline during Sheriff Baca\u2019s tenure, primarily attributed to favoritism on the part"] [12.26713752746582, 5.989624977111816, "at we\u2019re trying to get our younger personnel to understand. Consistency is a good thing, but every situation should be looked at differ- ently. There should be minimum standards, but everything needs to be evaluated. If you\u2019re not going to own the mi"] [12.23833179473877, 6.01898717880249, " all, building trust, and ensuring that everyone is on the same page. The simplest aspect of this is walking around the station or facility and talking to people where they work rather than in an office. Captains deemed this to be critical for unders"] [12.244037628173828, 6.0169172286987305, "he importance of deputy leaders and TOs for implement- ing the goals of the department. Sergeants are also in important leadership positions, but as a supervisor, their role is slightly different in that they need to guide and monitor behavior withou"] [12.229146957397461, 6.034168720245361, "n important requirement because their deeper experience and knowledge of assign- ments in these areas will likely make them better leaders. However, \u201cif they make exceptions, then it\u2019s a huge drawback . . . people lose respect for leadership.\u201d\nFront-"] [12.2404146194458, 6.018216609954834, "ing or controlling activity, which could set LASD apart from other law enforce- ment agencies. This approach can present a tension with supervision, however, as people could feel that if a supervisor does \u201croll\u201d on a call (accompany the deputy when r"] [12.232268333435059, 6.035436153411865, " staff\nLASD Organizational Context 85\n86 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nmember noted, \u201cYears of service is more important than rank. On the surface, we\u2019re very com- pliant with the hierarchy. You have to se"] [12.226750373840332, 6.032315731048584, "geant\u2019s background could poten- tially inhibit his or her effectiveness when dealing with subgroup members.\nPromote and Remain\nOn the flip side of \u201cback-dooring\u201d is the idea of \u201cpromote and remain,\u201d or promoting from within the same station where one"] [12.237190246582031, 6.023118019104004, "nvestigation. Once that investigation starts, the deputy could be blacklisted or worse. Policy dictates the way the supervisor will supervise. . . . Even guiding someone, it affects the sergeant-deputy relationship. I can see these things being good "] [12.237421989440918, 6.020739555358887, "everything is education. If it is correctible, then education can be more effective than discipline. Discipline can make some depu- ties ineffective. But if the offense is bad enough, there\u2019s no problem firing the deputy. For instance, if a deputy ne"] [12.253174781799316, 6.008874893188477, "very station. They control how [the] deputy will go.\u201d Another outlined the characteristics of a good TO this way:\nGood TOs recognize what works with the trainees. There is no \u201cone size fits all.\u201d You have to be dedicated and willing to put in the hou"] [12.218034744262695, 6.046618938446045, "ted to take the position. If you as a supervisor are going to be respon- sible for managing the person, you should at least be able to weigh in on who gets the job.\nPeer Leaders\nInformal peer leaders were mentioned as having an important role in help"] [12.235221862792969, 6.02295446395874, "es are also expected to listen and learn, or, as one command staff put it:\n7 To \u201croll up\u201d means to leave patrol training before completing it and returning back to custody or another nonpatrol assignment.\n Trainees don\u2019t talk unless they have to talk"] [12.228567123413086, 6.034026622772217, " own approach to the job. Being labeled a hard worker could help a deputy advance or maybe even get one out of trouble. Some interviewees noted that deputies can occasionally be hard working to a fault, as in being too defined by work and having a wo"] [12.261680603027344, 5.999108791351318, "a sheriff, I thought, okay, I\u2019m going to do law enforcement\u2014I wasn\u2019t thinking, okay, I\u2019m going to help this person find a home, okay, I\u2019m going to help this person get into foster care. And they don\u2019t give people enough training to deal with that. It"] [12.26312255859375, 5.987368106842041, "uits is the question.\nConclusion\nLASD is a large and fragmented law enforcement agency, with each patrol station operating largely as an independent police department. Despite the size and fragmentation, individual reputation matters. A variety of fa"] [12.182354927062988, 6.087351322174072, "extent to which expectations for serving the community are embedded into key organizational processes is worthy of further exploration.\nCHAPTER SEVEN\nLASD Views on Subgroups\nAmong LASD staff, there is little agreement about the degree to which subgro"] [12.223215103149414, 6.047657489776611, ", and focusing on their personal lives or having family obligations that prevented socializing with colleagues above and beyond regular work interactions.\n 95\n96\nUnderstanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\n\u2022 What are th"] [12.217192649841309, 6.045373439788818, "humiliating, or intimidating behavior might try to deal with these behaviors on their own or put up with them until they become very serious. Many noted that the risks of more serious or criminal behavior are rare but can occur. Finally, some noted t"] [12.196870803833008, 6.068297863006592, " that is known to group members, but they are not officially recognized by LASD. Deputies typically join the subgroup by invitation only and may have to meet certain requirements for subgroup membership.\u201d\nOrganizational research on other professions "] [12.200398445129395, 6.06511926651001, "k ethic, the indi- viduals joining the group, the nature of the group, and the individual\u2019s own feelings about tat- toos, and unit-based versus LASD pride. The groups often form based on shared work experi- ence; as another interviewee explained, the"] [12.206539154052734, 6.053747177124023, "ains. They are elected by peers. They communicate information from the coaches. That\u2019s how I view subgroups. Subgroups are people of like minds. A true friend will communicate to you if you\u2019ve screwed up. The department needs more mentor- ing to help"] [12.163091659545898, 6.115824222564697, " and peer motivation fill in the gaps where supervision and formalized performance evalu- ations cannot. For instance, we repeatedly heard that the \u201ccounty only requires people to be competent and not good.\u201d There are five levels to the performance r"] [12.182655334472656, 6.091315269470215, "es a clear example of how groups that get too big lose their ability to provide distinctiveness to their members, which motivates people to find other ways to be distinctive\n(Hogg and Terry, 2000). Tension can also arise across groups or between memb"] [12.162714004516602, 6.114960670471191, " get involved in a shooting or a fight, that\u2019s it. You\u2019re in. [In custody], if a deputy was involved in a physical fight with an inmate, that was huge [for getting asked to join a sub- group]\u2014even though you could have de-escalated the situation! I\u2019v"] [12.184165954589844, 6.089132308959961, " be better. Show- boating is not cool, especially in this crowd.\u201d Some groups are noted for this. Being reserved about one\u2019s status in a subgroup could contribute to the secrecy and the allure of the subgroups. Notably, one LASD interviewee explained"] [12.180418968200684, 6.0876617431640625, "ing reports), and providing off-duty favors (such as hosting parties) or obliging egregious demands (such as \u201cpaying rent to work at a station\u201d). Some line-level and midlevel representatives were adamant that membership in some subgroups is contingen"] [12.18537712097168, 6.083932399749756, "ed that these individuals want to ensure that \u201cthere is no dirt on them, ever.\u201d This attitude toward subgroups stands in contrast to historical examples in which one\u2019s mem- bership in a subgroup, especially at specific stations, might have contribute"] [12.171699523925781, 6.1031107902526855, "saw subgroups as a means of reinforcing the standards of being a top-performing deputy, which raises the question of how similar subgroup standards are to LASD standards. A command-level staff member explained:\nYou\u2019re not going to get any points for "] [12.212518692016602, 6.061933994293213, "y to destress and decompress from all of this.\nInterviewees across ranks echoed the sense that subgroups \u201care just the way to decom- press\u201d and not an avenue for adverse actions.\nA command-level representative spoke about the role of healthy competit"] [12.187498092651367, 6.084848403930664, "gs because they have\na tattoo while others are not. To others, the divisiveness comes from the exclusivity associated with certain tattoos, which conflicts with the idea that the tattoos are supposed to represent unit pride. It also could contribute "] [12.176841735839844, 6.095454692840576, " workers was a common explanation for asking someone to get a tattoo, and the offer was often made by respected deputies at the station. As one respondent said:\nWhen you get to patrol, the cool group are the two-stripes deputies (Bonus Deputies). Sub"] [12.199850082397461, 6.0679731369018555, "ls of Visibility\nSecrecy, exclusion, alternative hierarchy\nEncouraging adverse behaviors such as ostracism and disrespect, overemphasis on aggressive policing, promoting unhealthy coping mechanisms, workaholism\nLASD Views on Subgroups 109\n Low v"] [12.174942970275879, 6.097151279449463, "erned that subgroups are by nature exclusionary. As one command-level representative said, \u201cThe tattoos are by invitation\u2014this is divisive because it\u2019s not all inclusive. This creates a wedge between the partners. Even though it\u2019s not a problem, it j"] [12.218879699707031, 6.044173240661621, " also report on a deputy\u2019s performance, and interviewees said that they felt pressure \u201cto please the TO.\u201d A line-level representative described training as follows:\nYou\u2019re put in this spot where you have to do whatever you have to do to get off train"] [12.16557788848877, 6.109256267547607, "hey have the brass thinking they\u2019re squared away and let them do anything they want. They tried to get him to sign off that he was failing patrol. I got him transferred.\nThis quote describes how subgroup members have reportedly tried to \u201croll up\u201d tra"] [12.165532112121582, 6.105952262878418, "pervised. . . . The two or three [bullies] who were extremely loud and powerful, they created chaos.\nThis interviewee noted that the individuals in question were also perceived to be hard workers, so other aspects of their job performance were not an"] [12.169157028198242, 6.103237152099609, "across staff levels described the intrinsic role of supervision as being either complacent or complicit in the formation and persistence of subgroups. A midlevel rep- resentative stated, \u201cThe slippage happens when supervisors start to turn a blind ey"] [12.196137428283691, 6.064730167388916, "ing contrast to the reports from some other interviewees that subgroup members are seen as the do-gooders who are unwilling to go against policy to accomplish their work. One interviewee recounted a past example of having to supervise deputies who ha"] [12.228872299194336, 6.038175582885742, "avor of saying [subgroups in gen- eral] are a problem\u201d but still acknowledged the risk of the separate codes of conduct that cer- tain subgroups have orchestrated. \u201cAny group that sets separate rules should not be allowed,\u201d he said. \u201cThe job isn\u2019t ab"] [12.16227912902832, 6.109723091125488, "get their hands dirty without disgrace, dishonor, or hesitation\u201d meant working late and not complaining, according to members of the group. The department did not agree that this creed reflected the values of the department, and several members or as"] [12.196245193481445, 6.069737911224365, "thout necessarily being overly aggressive. Additionally, a command-level representative spoke about subgroups as an isolated, historical issue:\nThe Viking5 issue was an anomaly. I\u2019m unsure how that occurred, but I haven\u2019t seen that type of non-commun"] [12.190023422241211, 6.082680702209473, " have protection. . . . It\u2019s no wonder they\u2019re drinking so much and their divorce and suicide rates are so high.\nThe previous quote and the next quote both highlight how the solidarity and support provided by being in a subgroup can contribute to soc"] [12.175600051879883, 6.104199409484863, " of camaraderie to one of problematic behavior. \u201cSubgroups open up the department to risk. If there\u2019s enough smoke there\u2019s probably fire,\u201d a command-level staff member stated succinctly. The running thread throughout interviews is that subgroups allo"] [12.1170072555542, 6.177160739898682, "ically (and as was detailed in Chapter Four), the survey focused on survey respondents\u2019 experiences with deputy subgroups, including\n\u2022 who gets invited to join these subgroups and the criteria for being invited\n\u2022 where within LASD these subgroups are"] [12.106084823608398, 6.190093517303467, "aking arrests) as a criterion.\n\u2022 Where within LASD are deputy subgroups or cliques typically found? Two-thirds of subgroup invitees and two-thirds of midlevel managers agreed that deputy subgroups exist in some, but not all, LASD stations. Half of ea"] [12.096282958984375, 6.205169677734375, "nd 30 percent of midlevel managers and 20 percent of invitees agreed with the statement that deputies\nLos Angeles County Sheriff\u2019s Department Survey Results 121\nin subgroups bully or harass nonmembers. Roughly one out of five midlevel managers agreed"] [12.082167625427246, 6.221120834350586, "em out to be.\n\u2022 What are their views regarding supervisors\u2019 approach to deputy subgroups or cliques? Half of midlevel managers and two-thirds of subgroup invitees agreed that supervisors were aware of subgroups\u2019 conduct. One out of four midlevel mana"] [12.140484809875488, 6.157379150390625, "ly, to report on survey respondents\u2019 assessment of the impact of subgroups on LASD and individuals, as well as their recommendations for what (if anything) LASD should do about subgroups, we first compare those who had ever been invited to join a sub"] [12.089632987976074, 6.217042922973633, "ed because they are more likely to be familiar with subgroups. This is underscored by the fact that the percentage of respondents who indicated \u201cdon\u2019t know\u201d for a particular response category was much higher for those who had never been invited. Depu"] [12.101880073547363, 6.201028347015381, "p or clique?\n Q4 and Q5. Have you ever been invited to join a deputy subgroup or clique? In the last five years, have you been invited to join a deputy subgroup or clique? For each question, survey respondents were asked to check either \u201cYes\u201d or \u201cNo"] [12.096548080444336, 6.20640754699707, "ubgroup invitees reported that these subgroups exist in some, but not all, LASD stations (Table 8.5). Only 24.7 percent responded that deputy subgroups exist in all LASD stations. In addition, 55.6 percent reported that these sub- groups are common a"] [12.097877502441406, 6.207903861999512, "1 100% 1,573 100%\n251 100% 1,319 100% 1,570 100%\n252 100% 1,322 100% 1,574 100%\n Invited\nNot invited\nOverall\n12.3% 6.3% 6.3% 6.1% 4.7% 9.8% 7.1% 5.0% 9.2%\n. . . exist in all LASD stations\nInvited\nNot invited\nOverall\n25.5% 15.1% 8.8% 25.2% 10.3% 9.9%"] [12.140998840332031, 6.145992279052734, "dback from several interviewees who commented that subgroups often can serve to motivate other members to be proactive about making arrests.\n130 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nFigure 8.2\nWhat Are the Percei"] [12.08706283569336, 6.218243598937988, "pe Disagree Disagree nor Disagree Agree Agree Don\u2019t Know\nRow Total\n253 100% 1,325 100% 1,578 100%\n254 100% 1,325 100% 1,579 100%\n254 100% 1,322 100% 1,576 100%\nInvited\nNot invited\nOverall\n21.3% 9.1% 11.1%\n10.3% 4.7% 5.6%\n11.1% 9.5% 9.8%\n16.6% 10.9% 1"] [12.09521484375, 6.209781646728516, "4%\n7.1%\n8.3% 11.7% 11.2%\n26.0% 19.3% 20.4%\n10.2%\n6.3%\n Q11 (a, b, c). The following statements to a deputy subgroup or clique. Please statements. (Survey respondents were Agree,\u201d plus a \u201cDon\u2019t Know\u201d option.)\nare about the\nindicate how strongly you ag"] [12.0996675491333, 6.204294204711914, "ndicated that not belong- ing to a subgroup had no negative impact (Table 8.9). Specifically, about two-thirds of these respondents\n\u2022 disagreed that not belonging limits a deputy\u2019s training opportunities\n134 Understanding Subgroups Within the Los Ang"] [12.118695259094238, 6.1802849769592285, "ther two-thirds indicated that deputy subgroups help motivate others within the station or unit (e.g., make more arrests, maintain better order of custody inmates).\nStill, some subgroup invitees noted a negative impact of these groups. A quarter indi"] [12.10142993927002, 6.201653480529785, "iques hurts morale within the station/unit.\nThe presence of deputy subgroups or cliques makes non-members want to leave or avoid certain stations/units.\nDeputy subgroups\u2019 or cliques\u2019 behavior has negatively impacted community perceptions of LASD.\nDep"] [12.08250904083252, 6.221263885498047, "% 8.9% 10.3%\n11.4% 7.3% 8.0%\n41.3% 9.4% 6.7% 20.7% 6.4% 7.6% 24.0% 6.9% 7.4%\n9.4%\n10.6% 15.9%\n11.1%\n11.0% 50.5% 44.1%\n Q14 (a, b, c, d, e). Now we want to ask you specifically about supervisors\u2019 (Lieutenants or Sergeants) approach to deputy subgroups"] [12.09119701385498, 6.215160846710205, "deputies indicated that the invitation had occurred prior to the past five years (Table 8.11).\nAt What Point in Their Career Are Most Deputies First Invited to Join a Subgroup?\nJust under half of midlevel managers and nearly one-fourth of deputies in"] [12.080405235290527, 6.227160453796387, "38%\n32%\n 23%\n 29%\n49%\n 49%\n140 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nTable 8.11\nWhether a Respondent Had Ever Been Invited to Join a Subgroup or Had Been Invited Within the Last Five Years (Midlevel Managers Ver"] [12.090633392333984, 6.215198040008545, "re likely than deputies to agree that deputy subgroups exist in some, but not all, LASD stations and are common at LASD stations in high-crime areas. Specifically, nearly three-fifths of midlevel managers either somewhat or strongly agreed that these"] [12.08676528930664, 6.219667911529541, "ist in some, but not all, LASD stations, and 13.8 percent responded that subgroups exist in all LASD stations (Table 8.13). More than a third of deputies agreed that these subgroups are common at LASD stations in high-crime areas. Note the higher per"] [12.082995414733887, 6.221141815185547, "her Agree nor Disagree\" and \"Don't Know.\"\n41%\n 40%\n23%\n 23%\n 38%\n21%\n12%\n17% 51%\n5% 4%\n39%\n38%\n55%\n 48%\n 72%\nRespondent Strongly Somewhat Neither Agree Somewhat Strongly\nType Disagree Disagree nor Disagree Agree Agree Don\u2019t Know\nRow Total\n394\n100% "] [12.088003158569336, 6.2155537605285645, "bgroups have their own code of conduct (Table 8.15). One out of five midlevel managers also agreed that subgroups encourage members to work outside the chain of command in situations that normally require supervisor involvement (e.g., use- of-force i"] [12.083121299743652, 6.22434139251709, "\n Respondent Strongly Somewhat Neither Agree Type Disagree Disagree nor Disagree\nSubgroups or cliques have their own code of conduct\nSomewhat Agree\nStrongly Agree\n15.3% 12.8% 13.5%\n33.0% 17.1% 21.3%\n10.4% 6.7% 7.7%\nDon\u2019t Know\n33.3% 50.2% 45.8%\n26.6% "] [12.067336082458496, 6.245413303375244, "ongly Agree\" and \"Agree\" responses, while the \"Disagree\" category represents \"Strongly Disagree\" and \"Disagree.\" Respondents also had the option of \"Neither Agree nor Disagree\" and \"Don't Know.\"\nof deputies about the impact of subgroups and suggestio"] [12.09097671508789, 6.213412284851074, "half of deputies indicated that these subgroups have no effect on the daily operations of their station or unit (Figure 8.9). Nearly two-\n150 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nFigure 8.9\nMidlevel Managers\u2019 Ver"] [12.084256172180176, 6.224352836608887, "el managers to report that they did not know what impact subgroups had on community perceptions of LASD.\nWith respect to the media\u2019s portrayal of subgroups, there was a large percentage of respondents who agreed that subgroups were not as harmful as "] [12.06308650970459, 6.241146564483643, ",104 100% 1,498 100%\n394\n100% 1,107 100% 1,501 100%\n Midlevel managers\nDeputies\nOverall\n4.3% 7.4%\n2.4% 2.7%\n2.9% 3.9%\n12.9% 28.2%\n9.8% 18.8%\n10.7% 21.2%\nSupervisors formally discipline improper or unethical behavior by subgroup or clique members\nMid"] [12.107649803161621, 6.190203666687012, "at subgroups are a way to recognize high-performing deputies, that the formal performance evaluation process was lacking in terms of being able to properly reward positive performance or correct poor perfor- mance, and that evaluations were not used "] [12.083587646484375, 6.2179131507873535, "were in similar agreement about whether promotions are handled fairly (40 to 49 percent agreement), while invitees and midlevel managers were more likely to disagree (41 and 37 percent, respectively). On the consistency of disciplinary action, 44 per"] [12.087523460388184, 6.191154956817627, "e who had not been invited to join a subgroup were more positive about executive leadership. Subgroup invitees were the least positive about leadership, with 41 percent disagreeing that executive leadership represents high ethical stan- dards. Midlev"] [12.114853858947754, 6.182393550872803, " analyses supported insights from the interviews that, according to survey respondents, those who were invited to join subgroups were typically deputies who are known as hard workers, are willing to work challenging assignments, and, in some cases, s"] [12.196904182434082, 6.078309059143066, "nagers and those who had not been invited to join a subgroup agreed that LASD should discourage deputies from joining subgroups or cliques and/or prohibit subgroups alto- gether. Among subgroup invitees, one-third agreed with discouraging deputies fr"] [12.206315040588379, 6.059004306793213, "dividual groups and individuals within those groups should be accountable for their own behavior and that it was unfair to label all groups or all people within a group based on the actions of others. This parallels some of the history and heterogene"] [12.258512496948242, 6.000658988952637, "a collection, so we also identify the findings that most prominently informed our recommendations after Table 9.1. This is then followed by a discussion of the main limitations of this study.\nWe base our recommendations on the following key findings:"] [12.12206745147705, 6.1665544509887695, "cent of those invited agreed;\n62 percent of midlevel management agreed)\n\u2022 Subgroups engage in behavior that may offend intimidate or endanger community members (15 percent overall agreed; 16 percent of those invited agreed)\nLASD is fragmented, and un"] [12.16694450378418, 6.111613750457764, "In custody], if a deputy was involved in a physical fight with an inmate, that was huge [for getting asked to join a subgroup]\u2014even though you could have de-escalated the situation!\u201d (line-level interview)\nWhat do subgroups do? What is their impact o"] [12.164555549621582, 6.11052131652832, "ercent overall agreed; 23 percent of those invited agreed)\n\u2022 limit opportunities for career advancement or promotion (22 percent overall agreed; 25 percent of those invited agreed)\nSubgroups might start out with honorable intentions, but there is a r"] [12.204694747924805, 6.054732799530029, "sivity, or problematic actions (Carton and Cummings, 2012). Secrecy is another form of control that enhances group cohesion and group identity (Costas and Grey, 2014). Problematic behaviors iden- tified by interviewees often target select individuals"] [12.243751525878906, 6.064634323120117, "ey would advocate for telling deputies to not join subgroups. Many survey respondents recognized the negative com- munity perceptions associated with subgroups. Lastly, survey respondents tended to indi- cate that something should be done, with 37 pe"] [12.240212440490723, 6.019497394561768, "ommendations\nLASD is not the only law enforcement agency that has been confronted with reexamining its policies and practices in the wake of scandal, nor is it alone in its need to show that it can be accountable to the public and acknowledge negativ"] [12.226217269897461, 6.040924549102783, "te responses. Some captains have responded by developing their own approaches to addressing issues with sub- groups, emphasizing direct communication and setting expectations. Although this approach could ameliorate problems in particular places, it "] [12.270218849182129, 5.98742151260376, " they are not aligned with cultural values and practices or if amending these values and practices does not make sense to the population that must adhere to them. Any strategy that does not recognize the significance of subgroups to a significant pro"] [12.245393753051758, 6.017453670501709, "hat even the best supervision can be circumvented if there is motivation to do so.\nAlthough it is worthwhile to uphold and enforce policies prohibiting subgroups, it is also important to consider that doing so could have unintended consequences. Proh"] [12.233813285827637, 6.020411491394043, "olicy as it currently exists, and consider potential negative unintended consequences and efforts that could mitigate or pre- vent them. Next, we focus on other ways that LASD could use a holistic approach to promote cultural change. This approach in"] [12.239415168762207, 6.0227251052856445, "ty. In the longer term, collaboration, stakeholders, training and resources will be important for driving lasting, sustainable change.\nImplementing the Policy on Employee Groups Which Violate the Rights of Other Employees or Members of the Public\nShe"] [12.24197006225586, 6.021723747253418, " ambiguous language that employees are \u201cadvised to avoid joining\u201d these groups. Being firm in setting and enforcing standards will be critical for this issue and has been identified elsewhere as being essential when implementing programs to enhance e"] [12.216790199279785, 6.0454936027526855, "s do come to light, it is critical that they are investigated thoroughly and swiftly. However, secrecy also makes these investigations challenging because information can be limited to insiders. Internal Affairs investigators should receive guidance "] [12.24046516418457, 6.020702838897705, " with LASD mission and values) and the desired cultural change that the department is heading toward, which could include acknowledging and com- municating a desire to separate the department from the past. A cultural stance on subgroups would convey"] [12.237553596496582, 6.023602485656738, "eriff\u2019s Department\nbehavior of deputies, and they must denounce retaliation (Mesmer-Magnus and Viswesvaran, 2005). Leadership must also clearly explain that retaliation will not be tolerated. For example, a recent anonymous report to Internal Affairs"] [12.233786582946777, 6.028674125671387, "rganizational identification, unit commanders should emphasize the common identity of working in a particular unit.5 In-group\n4 Recently, two deputies at the Compton station filed lawsuits against LASD with allegations that a subgroup allegedly named"] [12.209617614746094, 6.04808235168457, "ive conduct or bullying. Supervisors should understand and know to look for these behaviors and signs of conflict.\n\u2022 Supervisorsshouldalsobemadeawarethattheircurrentorpriormembershipinadeputy subgroup is a reportable conflict of interest should they "] [12.325294494628906, 5.906601428985596, "ntoring programs for sergeants to enhance supervisory behavior in general was recommended by several inter- viewees, although, again, research evidence is limited (Herrington and Schafer, 2019; Pearson- Goff and Herrington, 2014). Lastly, LASD should"] [12.304364204406738, 5.932614326477051, "t at the time, who mentioned efforts to get ahead of problems associated with cliques, although the article did not discuss what those were (Avins, 2000).\n84 percent of those at all ranks support a requirement to intervene if another officer is about"] [12.304189682006836, 5.92971658706665, " most critical factor is that depu- ties know they will be supported if they intervene, which is the responsibility of leadership (Mesmer-Magnus and Viswesvaran, 2005). Additionally, the goals of Project ABLE include redefining various features of la"] [12.199307441711426, 6.070491790771484, " departmental members (e.g., peer intervention requires that anyone can intervene with anyone else, regardless of rank or status).\nTransform How the Department Shares and Generates Information\nLessons Learned\nFrom our interviews and survey findings, "] [12.346171379089355, 5.881606578826904, "stances of subgroups pressuring individuals to leave a unit, this procedure could identify issues early. Information from these interviews should be reviewed regularly.\nDevote Resources to Enhancing Support for Employees\nLastly, ongoing devotion of r"] [12.329551696777344, 5.904201507568359, " improving respectful interactions with community members or inmates.\nRecommendations 179\n 180 Understanding Subgroups Within the Los Angeles County Sheriff\u2019s Department\nwith higher workload, more serious crime, and/or subgroups that prioritize aggre"] [12.374281883239746, 5.800915241241455, " \u201cGuardians\u201d Starting in the Academy\nAs noted above, organizational and cultural change needs to be built into organizational pro- cesses where possible. Rahr and Rice, 2015, contend that shifting to more of a guardian mind- set and recommitting to d"] [12.351521492004395, 5.853916168212891, "al justice components to the officer. This approach has the added benefit of creating interactions between supervisors and subordinates that are positive (i.e., nondisciplinary) while also training to reinforce procedural justice and positive behavio"] [12.483762741088867, 5.613203048706055, "al contacts with citizens and document the con- tact in the MDC [mobile data computer] system with a clearance code of 755 (community relations).\u201d The order instructed deputies to provide contact cards and instructed sergeants to brief and review dep"] [12.567959785461426, 5.425304412841797, "ed by community members (Fielding and Innes, 2006). Such mea- sures consist of key activities and outcomes identified as relevant to the given problem and solution (Alpert, Flynn, and Piquero, 2001). Common measures and methods for assessing communit"] [12.313729286193848, 5.914644241333008, "ble to investigate these complaints (OIG, undated). Additionally, it is not clear from its website how LASD handles anonymous complaints. Anonymous com- plaints can be valuable for documenting behavior, but that is likely the main benefit (Walker and"] [12.388236999511719, 5.743544578552246, "g polic- ing in specific ways and in accordance with a clear normative vision; 4) fact-finding; 5) the identification and promulgation of key experiences and narratives on both sides; 6) the specification of concrete changes in policies and practices"] [12.27409553527832, 5.973852634429932, "rust, legitimacy, effectiveness, and safety. For instance, Loyola Marymount University\u2019s StudyLA project has surveyed county residents about their general perceptions of LASD in the recent past,10 but its more-detailed recent survey on per- ceptions "] [12.22459602355957, 6.030223846435547, "nt steps that LASD and the county should take. As discussed in detail in this report, the long-term solution involves mitigating the pressures and assumptions that lead deputies to create exclusive subgroups in the first place and addressing the norm"] [12.456188201904297, 5.55833625793457, "Prison Project and ACLU Foundation of Southern California, Cruel and Usual Punishment: How a Savage Gang of Deputies Controls LA County Jails, September 2011. As of May 5, 2021: https://www.aclusocal.org/sites/default/files/field_documents/ 97165508-"] [12.514385223388672, 5.423903942108154, "eflects-on-sheriff-deputies-fight-raises/docview/865443591/ se-2?accountid=25333\nBarling, Julian, Kathryne E. Dupre\u0301, and E. Kevin Kelloway, \u201cPredicting Workplace Aggression and Violence,\u201d Annual Review of Psychology, Vol. 60, 2009, pp. 671\u2013692.\nBarr"] [12.504801750183105, 5.443942070007324, "Los Angeles County Sheriff\u2019s Department, Knock LA, March 30, 2021. As of August 25, 2021:\nhttps://knock-la.com/grim-reapers-jump-out-boys-lasd-gangs/\nChan, Janet, \u201cChanging Police Culture,\u201d British Journal of Criminology, Vol. 36, No. 1, Winter 1996,"] [12.584890365600586, 5.294172286987305, "Policing: An International Journal of Police Strategies & Management, Vol. 26, No. 2, 2003, pp. 186\u2013207.\nCrank, John P., Understanding Police Culture, 2nd ed., New York: Routledge, 2004.\nCronin, Matthew A., Laurie R. Weingart, and Gergana Todorov, \u201cD"] [12.524282455444336, 5.402787685394287, "isconduct,\u201d Police Quarterly, Vol. 17, No. 2, 2014, pp. 103\u2013126.\nEngel, Robin Shepard, \u201cThe Effects of Supervisory Styles on Patrol Officer Behavior,\u201d Police Quarterly, Vol. 3, No. 3, 2000, pp. 262\u2013293.\nEngel, Robin Shepard, and Robert E. Worden, \u201cPo"] [12.520598411560059, 5.412725448608398, "nt Review Annual Report, Los Angeles: Office of Independent Review, County of Los Angeles, 2012. As of May 5, 2021:\nhttps://oig.lacounty.gov/LinkClick.aspx?fileticket=yH9RxxIBbr4%3d&portalid=18\nGetty, Ryan M., John L. Worrall, and Robert G. Morris, \u201c"] [12.556665420532227, 5.343750476837158, "p. 216\u2013225.\nHassan, Shahidul, Jongsoo Park, and Jos C. N. Raadschelders, \u201cTaking a Closer Look at the Empowerment\u2010 Performance Relationship: Evidence from Law Enforcement Organizations,\u201d Public Administration Review, Vol. 79, No. 3, May\u2013June 2019, pp"] [12.707270622253418, 4.979102611541748, "ss-Lethal Force Policies: Examining the \u2018Transmission Belts\u2019 of Police Departments,\u201d Journal of Crime and Justice, Vol. 34, No. 3, 2011, pp. 221\u2013233.\nIngram, Jason Robert, Robert R. Weidner, Eugene A. Paoline III, and William Terrill, \u201cSupervisory In"] [12.50497817993164, 5.448653697967529, "\u2013306.\nKlinger, David A., \u201cOrganizational Accidents and Deadly Police-Involved Violence: Some Thoughts on Extending Theory, Expanding Research, and Improving Police Practice,\u201d Annals of the American Academy of Political and Social Science, Vol. 687, N"] [12.283180236816406, 5.898369789123535, "heriff\u2019s Department\nLos Angeles County Sheriff Civilian Oversight Commission, \u201cSecret Deputy Subgroups,\u201d webpage, last updated October 15, 2020. As of May 4, 2021: https://coc.lacounty.gov/Our-Work/Secret-Deputy-Subgroups\nLos Angeles County Sheriff\u2019s"] [12.666241645812988, 5.07565975189209, "nd the Use of Coercion in Police\u2013Suspect Encounters,\u201d Police Practice and Research, Vol. 6, No. 1, 2005, pp. 19\u201337.\nMcDowall, Almuth, Paul Quinton, David Brown, Indira Carr, Emily Glorney, Sophie Russell, Natasha Bharj, Robert A. Nash, and Adrian Coy"] [12.606973648071289, 5.230749130249023, " How Psychological Contract Violation Develops,\u201d Academy of Management Review, Vol. 22, No. 1, 1997, pp. 226\u2013256.\nMujal, Gabriela N., Meghan E. Taylor, Jessica L. Fry, Tatiana H. Gochez-Kerr, and Nancy L. Weaver, \u201cA Systematic Review of Bystander Int"] [12.454039573669434, 5.565236568450928, "Office of the Attorney General, State of California Department of Justice, \u201cAttorney General Becerra Launches Civil Rights Investigation of the Los Angeles County Sheriff\u2019s Department,\u201d press release, January 22, 2021. As of May 5, 2021:\nhttps://oag."] [12.581371307373047, 5.281906604766846, "f the Job, Durham, N.C.: Carolina Academic Press, 2013.\nParker, Martin, \u201cSecret Societies: Intimations of Organization,\u201d Organization Studies, Vol. 37, No. 1, 2016, pp. 99\u2013113.\nPatton, Michael Quinn, \u201cEvaluation, Knowledge Management, Best Practices,"] [12.547526359558105, 5.353137016296387, "y/2020-08-06/lapd-whistleblower-swat-mafia-homeless\nReisig, Michael D., \u201cCommunity and Problem-Oriented Policing,\u201d Crime and Justice, Vol. 39, No. 1, 2010, pp. 1\u201353.\nReuss-Ianni, Elisabeth, Two Cultures of Policing: Street Cops and Management Cops, N"] [12.538393020629883, 5.371666431427002, ". 2, Hoboken, N.J.: John Wiley & Sons, 2010. Shareef, Reginald, \u201cSubsystem Congruence: A Strategic Change Model for Public Organizations,\u201d\nAdministration & Society, Vol. 25, No. 4, 1994, pp. 489\u2013517.\nSherman, Lawrence W., Scandal and Reform: Controll"] [12.558920860290527, 5.397461414337158, " Vol. 41, No. 2, 2007, pp. 457\u2013492.\nTyler, Tom R., and Jeffrey Fagan, \u201cLegitimacy and Cooperation: Why Do People Help the Police Fight Crime in Their Communities?\u201d Ohio State Journal of Criminal Law, Vol. 6, 2008, p. 231.\nU.S. Department of Justice C"] [12.522024154663086, 5.420439720153809, "County Sheriff\u2019s Department and Condemning His Failure to Cooperate with Civilian Oversight,\u201d Los Angeles County Sheriff Civilian Oversight Commission, October 15, 2020. As of May 4, 2021: http://file.lacounty.gov/SDSInter/bos/commissionpublications/"] [4.666335105895996, 17.5257511138916, "Evaluation of Energy Systems Network\u2019s Moving Forward Initiative in Indiana\nInitial Program Outcomes and Potential Impacts\nNICHOLAS E. BURGER, AIMEE E. CURTRIGHT, JACOB DEWEESE, HARDIKA DAYALANI, RAHIM ALI, BRITTANY L. JOSEPH\n Sponsored by the Centra"] [12.647907257080078, 13.58109188079834, "med since the launch of its first phase in 2015, to allow ESN to continue to track performance as\nMF matures, and to provide insight into the potential replicability of the MF model.\nThis report is intended for several audiences. The first is ESN and"] [4.648984432220459, 17.540115356445312, "Affordable Housing Supply and Cost Burden in Indiana ........................................................... 1 Elements of the Cost of Living for Low-Income Families ......................................................... 4 Policy and Regulator"] [4.633975982666016, 17.54050636291504, "................................................................. 46 Additional Themes That Emerged During the Evaluation ....................................................... 48 Survey Results ......................................................"] [4.650692939758301, 17.539527893066406, "oving Forward Development Site Locations .......................................................... 27 Figure 2.4. Key Building Attributes and Innovative Technology Deployment for Moving\nForward 1.0\u20133.0 Developments .................................."] [4.607385635375977, 17.570280075073242, "5. Efficiency Design Elements and Specifications for Moving\nForward Developments......................................................................................................... 73\nTable B.6. Development Mobility and Transportation Metrics..."] [4.675661087036133, 17.51351547241211, "ble housing in Indiana outside of the standard Qualified Allocation Plan (QAP) used to approve funding for affordable housing projects. In 2015, ESN worked with IHCDA to develop a process for awarding these set-aside LIHTC funds and in so doing affor"] [4.6792192459106445, 17.50963592529297, " evaluation of the impact the program had. We laid out four broad research questions that focus on whether the program was being implemented effectively, whether the program produced the desired outcomes, what factors were associated with success, an"] [4.681819915771484, 17.505990982055664, "ncorporated many of the concepts and technologies introduced through the workshops, including multiple solar PV systems and energy-efficient building designs. Some developers felt MF pushed them to adopt new concepts and technologies, while other dev"] [4.68247127532959, 17.505836486816406, "ssing the program\u2019s core goals (i.e., outcomes) and ensuring that MF is structured, staffed, and resourced to achieve those goals:\n\u2022 Clarify which program goals are the priorities and ensure the program is structured and resourced to achieve those go"] [4.671077251434326, 17.520219802856445, "y aligning energy companies and project developers.\n\u2022 Build on partnerships, knowledge, and technology development as a starting place for successive phases.\n\u2022 Help developers engage with subject-matter experts following the workshops in a way that s"] [4.664953231811523, 17.527273178100586, "e, Jenna Rosswurm, Alisha Jones\n\u2022 MF 2.0, H38 East: Elva James, Jeff Ryan, Tyler McKee, Ronda Shrewsbury Weybright, Anna Rankin, Melanie Reusze, Donald Peters, Steven Jackson, Michelle Carter\n\u2022 MF 2.0, The Union: Melissa Benton, Robin Davis, James Ta"] [4.6508564949035645, 17.520263671875, "ffordable housing produced in Indiana by integrating enhanced energy efficiency, transportation, and access to services into the housing design and construction processes. An overarching goal of MF is to reduce household spending on housing\u2014including"] [3.6097829341888428, 17.28427505493164, "where 27 percent of renter households are ELI and only 38 affordable housing units are available for every 100 households, the shortage of rental homes available for ELI renters was more than 130,000 units in 2018. In terms of cost burden, 19 percent"] [3.682194709777832, 17.351003646850586, "ent of monthly income at the VLI threshold and 42 percent of monthly income at the ELI threshold (Dolin, 2019).\n8 In the following paragraphs, we report data on rental costs (i.e., rent payments). For some households, that payment will include some b"] [3.6426563262939453, 17.301729202270508, "(Lafayette)\nMedian Income for a 4-Person Family\n$75,547 $85,096 $84,412 $97,159 $94,307\n30 percent of Median Income for a 4-Person Family\n$22,664.10 $25,528.80 $25,323.60 $29,147.70 $28,292.10\nMax Monthly Rent and Utilities, 30 percent of Eligibility"] [3.7386114597320557, 17.385334014892578, " While \u201cother renters\u201d spent less than 10 percent of their income on utilities, both nationally\nFigure 1.2. Average Utility Cost as a Percentage of Median Household Income\nSOURCE: U. S. Census Bureau (2009\u20132017), U.S. Bureau of Labor Statistics (2009"] [4.488142013549805, 17.74996566772461, "d, whereas other renters\u2019 proportion spent on transport was relatively flat. Table 1.1 provides the calculation of how spending on utilities and transportation translate, on average, into a dollar amount in the counties where developments in the firs"] [4.528325080871582, 17.79349136352539, " local level (e.g., county, city, municipality). State and local governments typically adopt these established codes and standards and make changes to reflect local building practices or EE goals\n15 American Society of Heating, Refrigerating and Air-"] [4.570070266723633, 17.696022033691406, " Code based on the 2000 International Residential Code\u2014neither of these versions was adopted.\n18 The bill would have required adoption of the latest IECC and ASHRAE 90.1 codes at that time as well as requiring that subsequent updates be adopted withi"] [4.602881908416748, 17.614824295043945, " goals. The share of this\n20 These numbers were current as of September 9, 2020. See the HUD USER (undated) database summary and related FAQ (HUD USER, 2020).\ninvestors receive a dollar-for-dollar reduction in their federal tax liability in exchange "] [4.569592475891113, 17.70546531677246, " MF program showed a decline in the total points assigned to \u201cSustainable Development Characteristics\u201d as well as the percentage of total points for this category. Specifically, this category awarded a maximum\n25 points (of 195 total points, or less "] [4.5063557624816895, 17.81753921508789, "ce) was a novel concept, and the initiative served to increase visibility for and investments in energy efficiency for affordable housing (Schwartz et al., 2018). Consistent with these findings, the American Council for an Energy-Efficient Economy (A"] [4.669445037841797, 17.51061248779297, "g developers to improve energy performance and transportation connectivity. The initiative seeks to increase quality of life while also decreasing the cost of living for low- to moderate-income individuals and families in new Moving Forward developme"] [4.668941020965576, 17.50461769104004, "ble affordable housing developments where feasible.\nThis evaluation sought to achieve certain goals and explicitly did not seek to achieve others. We tried to gather perspectives from a range of stakeholders, primarily those involved in designing and"] [4.6567063331604, 17.53008460998535, "ion and analysis of MF, explaining how the program is designed to work. We focus in detail on the workshop element that is central to the program\u2019s design. We discuss MF funding briefly and then develop a theory of change for the program, which repre"] [4.677631855010986, 17.511856079101562, "e MF idea, IHCDA requested and received authorization to use the general set-aside to fund and promote the Moving Forward initiative, including selection of two MF development teams in each phase2 through a competitive request for qualifications (RFQ"] [4.666086196899414, 17.52389907836914, " phase 1.0 was energy efficiency to reduce housing and transportation costs for residents, which is the core focus of MF from its inception. In contrast, in MF 2.0, IHCDA asked applicants to add a supplemental focus on poverty alleviation and economi"] [4.682203769683838, 17.511308670043945, "ection processes. In 2016, 2017, and 2018, two of the total projects each year were MF projects, constituting\n$1.5 million, $1.8 million, and $1.86 million, respectively.\n5 For MF phases 1.0, 2.0, and 3.0, a request for qualifications (RFQ) had to be"] [4.672236442565918, 17.51979637145996, "ful creation of a development concept, were eligible to apply for up to $750,000 in annual Section 42 credits outside of the standard points-based QAP process.8\nAll three RFPs for MF 1.0 through 3.0 share common objectives for the creation of \u201cinnova"] [4.6708502769470215, 17.51833152770996, "the formal scope of this evaluation, the changes in emphasis for MF 2020 provide an illustrative example of shifting priorities and adding layers of complexity. Specifically, MF 2020 added a focus on populations with intellectual and developmental di"] [4.689666748046875, 17.498123168945312, "elop solutions that target stretch goals. The goal at the end of the workshop is to have a \u201chigh-level plan\u201d that development teams could further refine and ultimately implement.\nEach workshop begins with an open-minded visioning session where partic"] [4.682031154632568, 17.506105422973633, "ources of funding needed to support staffing, operations, and overhead associated with running the program. Nevertheless, we want to provide some general\n12 Because these materials were created expressly to support MF, they are all ESN\u2019s intellectual"] [4.681064128875732, 17.506681442260742, "and\n13 For example, in its first year, ESN applied for $120,000 from IHCDA to support the initial round of projects (ESN, 2015a), and each phase of Moving Forward received $100,000 to support the associated workshop. We emphasize that these are not c"] [4.678921222686768, 17.508995056152344, " the MF program or workshop process, so pro bono support was a key supporting activity.\nInputs and activities are designed to generate program outputs. Some outputs are intermediate and support other activities and outputs. For example, the minimum a"] [4.687546253204346, 17.499727249145508, "or some projects, while service coordination for other projects focused on off-site, nearby services.\n 25\nAside from impacts focused on residents, MF is also working to produce general social and environmental impacts, such as reduced greenhouse gas "] [4.6803059577941895, 17.50682830810547, "takeholders could use a TOC like this to identify the resources required to make it possible to achieve specific outcomes and impacts. Alternatively, they could use a TOC to assess the feasibility or desirability of outcomes/impacts based on constrai"] [4.662764072418213, 17.519865036010742, "d solar electricity (PV). Gray shading of text/icons indicates a planned feature that had not been completed at the time of this evaluation. Broadway Lofts (MF 3.1) is eligible for LEED certification but is not planning on going through the process o"] [4.675209045410156, 17.511924743652344, " we are limited in what we can conclude\n 29\nabout factors associated with success. In Chapter 4 we draw conclusions where possible, focusing on implementation-based outcomes.\n4. To what extent is the overall success of Moving Forward\u2014or successful el"] [4.675546169281006, 17.50252914428711, "ject was still actively conducting its initial leasing during our evaluation period, and MF 3.0 developments were still under development. Appendix B provides electricity bill data for one of the MF 1.0 developers that also manages properties and pay"] [6.341371536254883, 15.5513277053833, " cases, we interviewed multiple individuals from a single organization at the same time, and we have counted this as one \u201crespondent\u201d here.\n 31\nOur interviews were not without limitations, partly because of Covid-19. We conducted all interviews virtu"] [4.672281265258789, 17.513601303100586, "andemic restrictions. We discuss the limited survey results in more detail in Chapter 4, and in\n4 A $5 Amazon electronic gift code was included in the survey invitation letter, which the residents were able to redeem regardless of participation in th"] [4.695617198944092, 17.4920654296875, "ent possible, and include some highlights of our analysis, the details of which can be found in the technical appendixes at the end of this report. Then we turn to additional themes that emerged over the course of the research and that are also relev"] [4.679291248321533, 17.511802673339844, "le, when IHCDA added the supplemental focus areas starting in phase 2.0, having a design document, like a theory of change, would have allowed IHCDA and ESN staff to consider how the emphasis would interact with existing MF goals, what resources it w"] [4.6782121658325195, 17.5118350982666, "ment costs without necessarily conferring a commensurate benefit to residents and thus, in fact, could undermine the core program goals.\nThe supplemental focus areas layered onto the program in MF 2.0 and subsequent phases is another example of the p"] [4.6881890296936035, 17.500059127807617, "es of MF.\n 36\nprincipally the workshops.5 However, ESN does not separately budget or track costs for MF, so we were unable to look at program revenue and spending in detail.\nOne risk of the current funding model for MF is that the program has relied "] [4.7008843421936035, 17.48771095275879, "h they successfully conducted for each phase of MF. And all developers interviewed provided one or more positive comments or observations about the workshop. Along with the positive feedback, many of the developers also offered caveats by noting limi"] [4.67034387588501, 17.520984649658203, "ogies that exceeded standard affordable housing design, but both had to back down substantially from their workshop plans, with implications for cost and project timeline.11\n8 This characterization is consistent with RAND\u2019s own observation and analys"] [4.6957478523254395, 17.492231369018555, "program did not adapt to their different capabilities. For example, some developer teams had little experience with EE technologies or transportation-oriented design. In contrast, others had done extensive previous work on EE designs and had experien"] [4.676668643951416, 17.51491355895996, "path to final outcomes. Developers generally described a positive experience with the MF process, and there is some evidence of increases in developer knowledge and examples of engagement with nontraditional partners, such as community groups.\nSevera"] [4.677182674407959, 17.512807846069336, "ject] to another project.\u201d Additionally, interviewees noted that relative to the traditional LIHTC application process, MF allowed \u201ca little bit more time to do a more intentional project and really flesh out . . . [the more extensive] partnerships.\u201d"] [4.65924072265625, 17.541109085083008, "lar was able to include geothermal heating and cooling. The Leadership in Energy and Environmental Design (LEED) certification for the Posterity Heights Scholar House is a clear example of an outcome that followed directly from the aggressive project"] [4.663564682006836, 17.524423599243164, "ncluded this development in this tally. Water conservation: QAP points are awarded based solely on the inclusion of low/dual-flush toilets, whereas four of the five MF developments included in the tally above have multiple additional water-saving fea"] [4.6668829917907715, 17.523143768310547, "is investment (to the MF residents) relative to the overall fewer units that may be possible to produce in the state of Indiana with limited LIHTC funding, which would impact non-MF households in terms of the affordable housing supply in the state ov"] [4.676495552062988, 17.51188850402832, "ons in some cases. For example, one of the MF 1.0 teams engaged with BlueIndy, IndyGo, and Uber to explore options for providing \u201cintegrated housing development with transportation\u201d (ESN, 2016a). According to the developer, MF was their first signifi"] [4.691020488739014, 17.495771408081055, "ee mobility scores, and one scoring worse in all three. The two MF 3.0 projects both lack transit scores; on the other two scores, one is slightly better than the comparable properties while one is slightly worse. Therefore, as a group, the six MF pr"] [4.67933464050293, 17.509855270385742, " electricity generated will not directly offset utility costs because the project is not net metered. Increased awareness of these issues up-front, including more explicit discussion of barriers and challenges to solar integration during the workshop"] [4.7087860107421875, 17.47863006591797, "ects remain susceptible to changes in the political environment (e.g., a changed tax incentive value mid-project).\nMoving Forward developments were found to cost more than comparable developments by as little as 12 percent and as much as 100 percent "] [4.690427780151367, 17.497718811035156, "esentations on new or emerging technologies from external experts (ESN, 2018).\nFor one development team, the workshop provided a lot of big ideas, which they worked to incorporate and which took substantial effort to scope and design. However, in the"] [4.686609745025635, 17.50185775756836, "uding from IHCDA, for post-workshop support. ESN used the VISTA program to supplement support (e.g., through regular meetings with developers), but VISTA member capabilities were limited. On the other hand, ESN was able to conduct extensive follow-up"] [4.686168670654297, 17.502737045288086, "ly helpful. But at the end of the day, when you\u2019re really getting ready to implement it and you\u2019re constrained by budget and space, I don\u2019t know how helpful it is to think outside the box, because I don\u2019t think there was anything in that workshop tha"] [4.624940395355225, 17.5225772857666, "lopers expressed a relative lack of previous substantial experience with incorporating transportation and mobility options into their planning and design processes.\n 51\nfuture LIHTC projects. On balance, however, the developers as a group have likely"] [4.48677921295166, 17.577434539794922, "nd. Electricity bills range from $20\u2013$39 up to $140 or more. Of the seven respondents who answered the question about how their electricity bill compares to their previous residence (and who paid their bill separately at both residences), one reporte"] [4.6834893226623535, 17.502561569213867, " through our evaluation. For instance, Is MF achieving reductions in total housing costs on a life-cycle basis for residents, while still producing as many or more units as non-MF projects? Are the total benefits of MF larger than total program costs"] [4.68090295791626, 17.507938385009766, "the traditional approach to tax credit\u2013based affordable housing planning under IHCDA by encouraging developer teams to form first, then identify a potential project and carry out the design. We do not have enough evidence to definitively say this app"] [4.690602779388428, 17.500324249267578, "ansportation space.\nRevisiting the Workshop Structure and Goals\nThe workshop has been the central element of MF in its first five years. We found positive and negative aspects of the workshop, and we recommend taking the time to reflect on the worksh"] [4.679737567901611, 17.506332397460938, "rom earlier MF phases to inform subsequent phases. This could also be a unique opportunity for developer competitors to share lessons learned with peers and to avoid roadblocks experienced\u2014and leverage opportunities identified\u2014in ongoing or even earl"] [4.684525489807129, 17.504066467285156, "nefit from establishing standard metrics and information that developers would report, along with a reporting schedule. That process would allow ESN to have up-to-date information on process status and more effectively track how designs change over t"] [4.681636810302734, 17.506059646606445, "e that the added cost of engaging expertise to support innovative design may not be financially feasible or may require cost trade-offs.\nRecognize that knowledge of and access to cutting-edge technology is necessary but not sufficient for real-world "] [4.691050052642822, 17.494892120361328, "redit\u2013incentivized housing process was a goal, but the program has not been used this way formally. MF could be explicitly structured as a way to test out technologies, EE designs, financing options, or specific transit-oriented demand approaches, wh"] [4.70234489440918, 17.484376907348633, " to draw more precise conclusions about how MF improves outcomes for residents. It would also allow ESN to be able to explain to others the specific mechanics of the program: what resources are necessary and at what levels, what the most effective wo"] [4.615447521209717, 17.589025497436523, "building commissioning\nPermanent affordable and workforce housing\nSOURCE: ESN, 2015b.\na IAQ is indoor air quality.\nb VOC is volatile organic compound. c CO2 is carbon dioxide.\nd ppm is parts per million.\nStretch Goals\nMeet Living Building Challenge 3"] [4.632706642150879, 17.545106887817383, " Workshop\n Minimum Goals\nPersonal vehicles minimized (no more than one car for each person)\nViable transportation alternatives accepted by residents (reduce personal vehicle demand)\nParadigm change of residents\nVoice of customer in design phase\nSOUR"] [4.6504645347595215, 17.537744522094727, "ding solar in 2021\n\u2022 Unit-level metering\n\u2022 Planned on-site electric vehicle charging infrastructure for residents and car- share vehicles\na \u2022\nvehiclesc \u2022 Site selection made for access to\nmultiple transit lines\n MF Phase 2.0: Energy Efficie"] [4.625082969665527, 17.587425231933594, "visitors\n\u2022 On-site car share\n\u2022 Car-sharing will be provided by Sway Mobility\n\u2022 Bikeshare partnership currently in development\n\u2022 Transit access\n\u2022 Car-sharing will be\nprovided by Sway\nMobility\n\u2022 Transit access\n\u2022 ILFIf Petal certification\n\u2022 On-site rain"] [4.631123065948486, 17.576099395751953, "; local redevelopment plan; federally assisted revitalization award; off-site amenity and facility improvement within 0.25 mile of site; tax credit per unit; tax credit per bedroom; and internet access.\nb Subcategories include smart use training on-s"] [4.649679660797119, 17.522138595581055, "s across each of the relevant five geographic locations.2\n Table B.1. Moving Forward and Comparable Project Information\n ID #\nMF1.1\n1 2 3\nMF2.1\n6 7\nMF2.2\nProperty Name\nB-Line Heights\nCrawford Apartments II Kinser Flats\nSouthern Knoll\nH38 East\nCh"] [4.6217427253723145, 17.5634822845459, "ercent (MF 1.1), 14 percent (MF 1.2), 12 percent (MF 2.1), and 100 percent (MF 3.2) more expensive to build than their average comp costs. As a ballpark figure, BWI indicated during our interview that development of the Posterity Scholar House was \u201c1"] [4.613465309143066, 17.576740264892578, "ved finalized cost approximations from Pedcor and BWI. Other cost approximations are still pending for other Moving Forward projects.\na Cost estimates early in the project that incorporated Net Zero designs were in the region of $11.6 million. b Squa"] [4.616887092590332, 17.591476440429688, "category. So, among the 81 percent of developers that sought points for some type of building certification, the average score obtained was 83 percent of the maximum score possible in that category.\nThe categories and subcategories listed correlate w"] [4.615346431732178, 17.58627700805664, "0.050 0.055\n0.060\n2005 Indiana Residential Code\n2020 2018 Indiana International\nResidential Residential Code Code\n SOURCE: Indiana Administrative Code, Article 14, One- and Two-Family Dwelling Code; Indiana Residential Code 2005 Edition Ti"] [4.6428422927856445, 17.547903060913086, "Forward Developments\n ID #\nMF1.1\nMF1.2 MF2.1 MF2.2\nRoof Insulation\nProperty Name R-Value\nB-Line Heights R-24\nPosterity Heights N/A H38 East\nThe Union R-30\nBroadway Lofts\nHarbor Square R-54\nExterior Wall R-Value\nN/A\nN/A\nR-21 for fiber cement sidi"] [4.624893665313721, 17.57326316833496, "ospheric conditions, and allows for an apples-to-apples comparison between buildings. These differences are emphasized when comparing buildings in different climate zones or in different years within the same climate zone. There is no obvious differe"] [4.671517372131348, 17.49981117248535, " of gas and electricity, whereby a simple unit conversion can be made to adjust common gas units of cubic feet or British thermal units (BTU) to kWh. These calculations could be used, for example, to determine cost savings as well as cost-effectivene"] [4.646358966827393, 17.494171142578125, "o MF-specific goals and outcomes from the program theory of change, including more detailed questions on energy, transportation, and comfort outcomes. The first survey (administered on lease signing) should focus extensively on the resident\u2019s previou"] [4.234808921813965, 17.46767807006836, "s that you consider yourself to be. a. White\nb. Black or African American\nc. American Indian or Alaska Native d. Asian\ne. Native Hawaiian or Pacific Islander f. Other\n6. Thinking about all of your sources of income, which category best describes the "] [4.469000816345215, 17.5085506439209, "evious home for the same month(s)?\na. I pay more in my current home\nb. I pay the same in my current home\nc. I pay less in my current home\nd. I did not get a separate electricity bill at my previous residence\n19. How does the comfort of your current h"] [4.47794246673584, 17.676345825195312, "e, or gotten worse since moving to your current home?\na. Health care b. Child care c. Groceries d. Restaurants e. Recreation f. Libraries\ng. Entertainment\nh. Other city/county services\n30. Which are the top three services that are most important to y"] [4.505398273468018, 17.68134307861328, "fordability Index FAQ,\u201d webpage, undated b. As of December 23, 2020:\nhttps://htaindex.cnt.org/faq/\nCNT\u2014See Center for Neighborhood Technology.\nDOE\u2014See U.S. Department of Energy.\nDolin, Marissa, HUD PD&R Housing Market Profiles, Indianapolis-Carmel-An"] [4.5321245193481445, 17.61898422241211, " Innovation Workshop: Final Report Prepared for IHCDA,\u201d February 2016a.\n\u2014\u2014\u2014, \u201cMoving Forward 2.0 Final Report: Executive Summary,\u201d Indianapolis, December 2016b. As of December 30, 2020: https://www.in.gov/ihcda/files/Moving%20Forward%202_0%20-%20Exec"] [4.225639343261719, 17.77215576171875, "y,\u201d PD&R Edge, Office of Policy Development and Research, Washington, D.C., August 14, 2017. As of May 6, 2021: https://www.huduser.gov/portal/pdredge/pdr-edge-featd-article-081417.html#:~:text=Home %20%3E%20Featured%20Article-,Defining%20Housing%20A"] [4.4174885749816895, 17.968097686767578, " Herna\u0301ndez, and Arline T. Geronimus, \u201cEnergy Efficiency as Energy Justice: Addressing Racial Inequities through Investments in People and Places,\u201d Energy Efficiency, Vol. 13, 2019, pp. 1\u201314.\nLyons, Craig, \u201cHUD Approves Demolition of Contaminated Wes"] [3.574218988418579, 17.243192672729492, "n Wilson, Who Can Afford to Live in a Home? A Look at Data from the 2006 American Community Survey, U.S. Census Bureau, 2008. As of May 6, 2021: https://www.census.gov/housing/census/publications/who-can-afford.pdf\nState of Indiana, \u201c2016\u20132017 Qualif"] [4.4098992347717285, 17.91488265991211, "mer Expenditure Survey: Interview Survey and Detailed Expenditure Files,\u201d data file, 2009\u20132017. As of January 19, 2021: https://www.bls.gov/cex/pumd_data.htm\nU.S. Department of Transportation, \u201cHousing and Transportation Affordability,\u201d webpage, Augu"] [15.821538925170898, 9.922143936157227, "Examining Implementation of the Los Angeles County Office of Diversion and Reentry Supportive Housing Program\nSTEPHANIE BROOKS HOLLIDAY, ALEX R. DOPP, MALLIKA BHANDARKAR, SARAH B. HUNTER\nSponsored by The Rose Hills Foundation\n CORPORATION\nFor more i"] [12.658249855041504, 13.56769847869873, "cipant interviews to describe how the program is implemented, identify its key facilitators and challenges, and illustrate participant experiences. This report will be relevant to entities interested in alternatives to incarceration and permanent sup"] [15.791023254394531, 9.895879745483398, "............................................................... 13\n3. ODR Housing Program Description ......................................................................................... 14 Program Overview......................................."] [15.80529499053955, 10.261713981628418, "............................................................... 43 Enrollment .............................................................................................................................................. 44 Interim Housing..........."] [15.83989429473877, 9.929564476013184, "........... 15 Figure 6.1. Demographic Characteristics of People Experiencing Homelessness and\nIncarceration in Los Angeles County ................................................................................... 56\nTables\nTable 1.1. Summary of Fin"] [15.781147956848145, 9.892702102661133, "(2) describe program facilitators and challenges as expressed by program administrators and key service providers; and (3) obtain participant perspectives. We attended service-provider meetings and interviewed program administrators (n = 8), key serv"] [15.762896537780762, 9.84095573425293, "s an issue. Although the program was designed to link clients to the DMH Full Service Partnership (FSP) program for ongoing mental health services support, there have not always been enough slots available for the number of ODR clients in need. ODR d"] [15.791869163513184, 9.881479263305664, "aff training opportunities. This will ensure that staff from all organizations, including interim housing sites, are prepared to serve clients who have significant clinical needs.\n\uf0b7 Expand ODR\u2019s focus on equity in program implementation and outcomes."] [15.816283226013184, 9.922468185424805, " County)\nPSH permanent supportive housing\nRHO Returning Home-Ohio\nSAPC Substance Abuse Prevention and Control (Los Angeles County)\n xi\n1. Introduction\nIn 2015, the Office of Diversion and Reentry (ODR) was established in Los Angeles County. Housed wi"] [15.824612617492676, 10.256356239318848, "h shows that these programs can increase housing stability and reduce the use of crisis care (Aubry et al., 2020; Gilmer, Manning, and Ettner, 2009; National Academies of Sciences,\n1 Number of individuals diverted as of October 2020 (Health Services,"] [15.827156066894531, 10.248702049255371, "(Aidala et al., 2013; Thomas et al., 2020).\nOther program models feature elements similar to the FUSE model, such as combining PSH with mental health treatment. The Corporation for Supportive Housing Returning Home\n2 Note that we also include a preli"] [15.81988525390625, 10.200228691101074, "or example, in the first eight months of the D.C. FUSE program, 110 individuals were identified as potential participants; of those, 51 met with the program\u2019s transition coordinator, and only 14 were enrolled in the program (Fontaine, Gilchrist-Scott"] [15.890222549438477, 10.263660430908203, "duction) than a matched\nin permanent housing at one year and 86% at\nrespectively.\nwere 21 times more likely to be arrested in the\nfollow-up period.\nA preliminary-outcomes study found that 10 of\nSingle-group\nPSH; assertive community\ntreatment\nincarcer"] [15.867408752441406, 10.234906196594238, "es and\nwho were conditionally\n2.76 times more likely to commit a new offense\nagainst another person than those released to\nsignificantly different. RHO clients were 40%\nbehavioral health services\ncurrent risk of homelessness\n(Fontaine et al., 2012; F"] [15.796235084533691, 10.249029159545898, "experimental study of the New York/New York program (CUSC Institute, 2019) found that the subset of participants who had a history of justice-system involvement experienced significant decreases in days spent in prison or jail (Culhane, Metraux, and "] [15.798041343688965, 10.170531272888184, "lly significant reductions (Somers et al., 2013). These findings are similar to those of a study of a Housing First program in Australia, which also found that clients in scattered-site housing experienced a decrease in the mean number of justice-sys"] [15.85534954071045, 10.024435997009277, "ame unstable during the intervention (Kerman et al., 2018). By contrast, those who obtained housing later in the program then experienced a decrease in prison time. A study of New York/New York III, which focused on individuals with substance use dis"] [15.777671813964844, 9.906704902648926, "the Los Angeles County ODR Housing Program by doing the following: (1) describe the program\u2019s implementation, including the ways that participants are identified and enrolled, the services that are offered, and the resources that are needed to operat"] [15.78830337524414, 9.904006004333496, "ce after March 2020. Given that most data collection took place pre-COVID-19, our description of the program and its operation focuses on that time frame. However, the program has continued to evolve in response to COVID-19, and to the extent possibl"] [15.78499984741211, 9.940325736999512, "artner-organization settings), and (5) the process of implementation. The codebook was developed and refined by three members of the research team, using a combination of deductive and inductive coding. We deductively sought codes that fit within the"] [15.7922945022583, 9.900128364562988, "ews conducted by the master\u2019s level researcher. Our protocol was reviewed and approved by the RAND Institutional Review Board. All client responses were kept confidential. It was made clear during the consent process that there was no expectation tha"] [15.763254165649414, 9.856111526489258, " services agencies under contract with ODR. They also receive mental health services, typically provided in partnership with the Los Angeles County Department of Mental Health (DMH) Full-Service Partnership (FSP) program. Individuals directly enter i"] [15.701678276062012, 9.691617965698242, "an individual\u2019s legal history to determine whether there are factors that might bar them from candidacy (i.e., a judge is unlikely to view certain serious charges, such as murder or rape, as acceptable for diversion). If initial clinical and legal re"] [15.79030704498291, 9.875635147094727, "h the client to prepare their medications for release (e.g., shifting to a long-acting injectable medication). ODR also assigns an ICMS provider, who typically arranges to meet the client in jail, completes an intake assessment, and then requests pla"] [15.790380477905273, 9.895278930664062, "l Health, undated). However, there are a limited number of FSP slots, which means that, at times, no slots are available, especially in certain geographic areas. Given the clinical vulnerability of clients during their initial weeks in the program, O"] [15.807328224182129, 9.90569019317627, "m housing. ICMS case managers support clients\u2019 ability to attend their ongoing probation meetings. ODR clinical staff complete and submit FSP referrals to DMH on the client\u2019s behalf. In addition, when clients are released from jail, they typically ha"] [15.784178733825684, 9.880403518676758, "recommendation, input from interim housing providers, FSP providers, and legal stakeholders is a key consideration. ODR clinical staff review each recommended client. If a client is not approved, a plan is put into place to address the reasons the pe"] [15.78664493560791, 9.881095886230469, " work independently with their case managers to identify units; in this case, Brilliant Corners begins their involvement when the lease is signed. The lease is a standard renter\u2019s lease.\nOn behalf of ODR, Brilliant Corners pays rent for ODR participa"] [15.789582252502441, 9.890217781066895, ", it might be their permanent housing setting.\nResidential Care Facility\nSome ODR Housing clients have significant clinical needs that require a higher level of care. For these clients, PSH may be in the form of a licensed residential care facility, "] [15.773087501525879, 9.873130798339844, "to clear the warrant and are sometimes successful but that other times the client returns to custody. Clients may also be rearrested on new charges and return to custody.\nIn the case of a bench warrant or rearrest for a less serious charge, ODR will "] [15.784149169921875, 9.889479637145996, "s the program, staff members described the development of policies and practices as collaborative, with ODR willing to consider input from those directly serving clients. Second, there are regular meetings that provide an opportunity for interagency "] [15.786283493041992, 9.904160499572754, "al services, which can be difficult to achieve with such a high-need and chronically underserved client population. Indeed, the suggestion that supportive housing programs should be expected to produce cost savings has been rejected on ethical ground"] [15.879589080810547, 10.023221015930176, "he Los Angeles County Board of Supervisors in November 2021 provided the treatment and housing cost- estimates for interim housing (Los Angeles County Department of Health Services, 2020a). These estimates exceed the supportive housing costs typicall"] [15.776077270507812, 9.885622024536133, "ability hearing\nSuitability hearing\nCounty court\nPer hearing\nCourt holds hearings to make assignments\nPublic Defender/Legal Aid\nConditional release, interim housing, jail release,\nPSH placement\ninterim housing\nmonthly rate paid by ODR\nclients to achi"] [15.783600807189941, 9.899744987487793, "onse to provider input, client needs, and the expansion to other court hubs in Los Angeles County. The program also changed in certain ways as a result of the COVID-19 pandemic. Although the majority of our data collection with staff took place befor"] [15.774247169494629, 9.88880443572998, "tive housing. In the next chapter, we examine provider perspectives on the implementation of ODR Housing.\n31\n4. Provider Perspectives\nTo explore the factors that facilitated the implementation of ODR Housing, as well as challenges to implementation, "] [15.779413223266602, 9.897706985473633, "do more to promote clients\u2019 integration and functioning in the community, such as assisting with vocational opportunities and prosocial network-building.\n 32\nOther challenges related to the ODR Housing Program model were identified as well. One area "] [15.780107498168945, 9.896767616271973, "out \u2018Are we keeping you housed?\u2019 because that\u2019s what [we do], but \u2018Are you really able to thrive?\u2019\u201d (SH provider)\n\u201cWe have been operating for several years with a kinda one-size-fits-all housing. . . . We have clients who are in interim housing for q"] [15.781784057617188, 9.895562171936035, "using is having staff that\u2019s trained and equipped to deal with the client base . . . so working on de-escalation tactics, and understanding mental health on a deeper level.\u201d\n(ICMS provider)\n NOTE: SH = supportive housing (interim or permanent). Inne"] [15.789652824401855, 9.889089584350586, "k that is a lasting\neffect. . . . You need to teach how to fish, and [to do that], you don\u2019t need to give people the fish, you got to let them make mistakes.\u201d (ICMS provider)\n NOTE: SH = supportive housing (interim or permanent). Outer Setting\nFor p"] [15.802034378051758, 9.889162063598633, "s mental health services were described as not having enough capacity to take on clients. On the other hand, staff reported that Los Angeles County offers access to a robust social safety-net system for clients (e.g., Social Security, Medi-Cal, Count"] [15.790575981140137, 9.882877349853516, " in LA county?\u201d (SH provider)\n\u201cThe ones that can\u2019t make it through the program are probably our most severe cases. They need a higher level of care\u2014that\u2019s either drug rehab or something like that. It\u2019s mostly drugs. Sometimes a mental health issue. ."] [15.789972305297852, 9.898683547973633, "lates to where they are with their mental health.\u201d (ICMS provider)\n\u201cIt\u2019s hard to provide just case management, be asked to do clinical stuff, then have to tell the FSP you have to do x and y\u2014they don\u2019t like to be told what to do. There are a lot of c"] [15.778307914733887, 9.889872550964355, "relationships with local communities in advance of opening new housing options.\nMore generally, interviewees described how ODR Housing has rapidly grown as a program in the past few years. Overall, this was described as a facilitator and indeed a wel"] [15.722622871398926, 9.836636543273926, "roject-based housing [is needed] . . . housing that has all services onsite so it\u2019s not a fractured treatment team.\u201d (ODR staff)\nWe also have coming online our own Board and Care. . . . We\u2019ve worked for a year on getting this up and running\u2014that\u2019s th"] [15.779226303100586, 9.889771461486816, "he program based on feedback from providers and the needs of the clients.\nHowever, there have also been certain challenges to implementing ODR Housing. Though partnerships are a key element of the program, we learned that coordinating across so many "] [15.7797269821167, 9.891136169433594, "set of the pandemic, however, do not have a frame of reference for the \u201ctypical\u201d operation of the program, which means some of their impressions of the program and its services were likely shaped by the pandemic in ways they may not have even known o"] [15.777286529541016, 9.891776084899902, " facilities and assistance applying for jobs and completing benefits paperwork.\n\uf0b7 Challenges included problematic behavior by other residents and the need for additional staff support.\n\uf0b7 Clients in interim housing were largely aware of the steps need"] [15.775132179260254, 9.898565292358398, "nd those clients were sent to isolate in a separate location before being placed in their designated interim housing sites.\nInterim Housing\nWhen asked about the most helpful services received in interim housing, participant responses included the ava"] [15.782004356384277, 9.896255493164062, "nced a need to complete a checklist provided by ODR before looking for permanent housing:\nThey have a list, a checklist, to make sure we have our ID, make sure we have our social security, they make sure we have our income-verification form, and they"] [15.804926872253418, 9.911075592041016, "or and therapist appointments, and on other errands. They also assisted clients in\n46\nfinding jobs. Overall, the clients in permanent housing were extremely happy with the program, and many made some version of the comment, \u201cODR saved my life.\u201d\nBehav"] [15.815681457519531, 9.876516342163086, " helpful to stay inside rather than be outside and getting triggered to use.\nOther clients reported appreciating that they had a reason not to leave their apartments or not to have to travel to their ICMS provider\u2019s office, now that services were pro"] [15.787854194641113, 9.889347076416016, "you get jobs, help you get assistance. It\u2019s been a good program for people that want to straighten their lives up and get back on track.\n48\nSummary\nThese interviews provided important insights into client experiences in ODR Housing, including those e"] [15.788330078125, 9.863637924194336, "ers can prove challenging.\nThe ODR Housing Program provides wraparound services, including long-term housing subsidies, intensive case management, mental health services, and time-limited community supervision. These services are provided by differen"] [15.78981876373291, 9.833003044128418, "is challenge and of the need for continuity of mental health services immediately upon release from jail, ODR\nhas filled this gap by funding bridge mental health providers through the ICMS agencies, even though this comes at greater cost to the progr"] [15.765096664428711, 9.89118480682373, " Watkins et al., 2017). However, this has yet to become a widespread practice, and more resources are needed to support further integration of care for multiple co-occurring conditions that many participants experience.\nODR Housing serves clients wit"] [15.789776802062988, 9.894445419311523, "ir case managers or mental health providers, the clients we spoke with were largely satisfied with the services they received. Clients who had been in the program longer seemed to be more aware of the range of services available to them, which sugges"] [15.78833293914795, 9.880377769470215, "pandemic, when organizations were focused on adapting to the emergency situation.\nRegarding client interviews, we relied on program staff to advertise the opportunity for clients to participate in our data collection, so it is possible that the recru"] [15.793646812438965, 9.877666473388672, "o staff members who do not have formal clinical training, such as staff of interim housing sites. As the program establishes additional interim housing sites, standardized staff training opportunities may help to ensure high quality services across t"] [15.92040729522705, 10.3455810546875, "plore process measures, including early attrition rates.\nEarly reports on the program\u2019s outcomes evaluated only housing stability and new felony convictions among clients who had reached the PSH phase of the program (Hunter and Scherling, 2019). It a"] [15.787015914916992, 10.248459815979004, " terms were identified to capture these concepts, depending on the database. Wildcard characters were used to expand search terms (e.g., \u201cincarcerat*\u201d to capture both \u201cincarcerated\u201d and \u201cincarceration\u201d). Results were limited to English-language artic"] [15.770379066467285, 10.274992942810059, ",\nand Collins, 2013\nPre/post with\nmatched control\ngroup\ncommunity-based or site-based service support, or congregate-\ndiagnosis and a recent history of homelessness, either in shelters or\nSingle-group\nPermanent housing subsidies,\nVeterans experiencin"] [15.79720687866211, 10.283621788024902, "mary care services,\nN = 1,937\neither onsite or by referral.\nlong-term housing placement with case management for and assistance with income.\nwith a disability that limits their ability\n Target Population\nVeterans enrolled in a supported\nLos Angeles, "] [15.753159523010254, 10.27570915222168, "02\nhomelessness with behavioral\n62\n Various, Canada,\nUSA USA\n supportive housing in California Permanent\nHenwood, Katz, and Hickert and Taylor, Gilmer, 2015\n2011\nMentally Ill Offender Crime-Reduction\nEmergency Service\nSeattle Downtown\nCenter housin"] [15.80150318145752, 9.902837753295898, "Design\nKey Services\nand Sample Size\nGeographic Area\nProgram\ncontrolled trial\nvouchers, and placement\ntreatment providers.\nprogram. N = 1,160\nand peer supporter) or\nillness diagnosis. N = 2,255\nRandomized\nScattered-site units with Assertive\ntreatment-"] [15.776611328125, 9.898272514343262, "s receive while in interim housing?\n5) Tell me about the process of an individual getting permanent housing.\na. What is the wait-list process like?\nb. Are there milestones that clients have to achieve to enter housing?\n 65\nc. Are there different requ"] [15.77150821685791, 9.886140823364258, "th clients? How does this relate to service eligibility? (Potential probes: Housing readiness, substance use/mental health, physical health)\nCase Management Providers\n14) What type of screening or assessment(s) do you do with ODR Housing clients? (Po"] [15.7727632522583, 9.893818855285645, "g; other resources)\n28) What are the major resources that you and your agency need to deliver the program?\na. We would like to set up a separate meeting to discuss how we can track program costs and potential savings. Who from your agency should be i"] [15.745031356811523, 9.880810737609863, "\n[If additional clarification is needed: The case management providers may have a number of roles in your care, including linking you to services, helping to prepare you for the move to permanent housing, and overseeing your psychiatric medication.]\n"] [15.792531967163086, 9.935014724731445, "mination or unfair treatment since being in the program? This could include unfair treatment from any source, including providers, landlords, or neighbors, or based on any characteristic (age, race, gender, mental health status, criminal justice stat"] [15.780879020690918, 10.25522518157959, "/12/Report_FUFBooklet.pdf\n\u2014\u2014\u2014, Returning Home: Ending the Cycle of Homelessness and Criminal Justice Involvement Through Supportive Housing, New York, N.Y.: Corporation for Supportive Housing, 2011. As of February 9, 2021: https://d155kunxf1aozz.clou"] [15.786088943481445, 10.233369827270508, "of February 8, 2021: https://www.urban.org/sites/default/files/publication/25716/412632-Supportive-Housing-for -Returning-Prisoners-Outcomes-and-Impacts-of-the-Returning-Home-Ohio-Pilot-Project.PDF\n73\nFontaine, Jocelyn, Carey Anne Nadeau, Caterina Ro"] [15.764607429504395, 10.262218475341797, "15, pp. 80\u201387.\nHickert, Audrey O., and Mary Jane Taylor, \u201cSupportive Housing for Addicted, Incarcerated Homeless Adults,\u201d Journal of Social Service Research, Vol. 37, No. 2, 2011, pp. 136\u2013151.\nHilton Foundation, \u201cJust in Reach and Pay for Success Fac"] [15.747450828552246, 10.23798942565918, "odd P. Gilmer, \u201cImplementation and Outcomes of Forensic Housing First Programs,\u201d Community Mental Health Journal, Vol. 52, No. 1, 2016, pp. 46\u201355.\nLarimer, Mary E., Daniel K. Malone, Michelle D. Garner, David C. Atkins, Bonnie Burlingham, Heather S. "] [15.738901138305664, 10.238287925720215, "ahsa.org/documents?id=4558-2020-greater-los-angeles-homeless-count -presentation\nMalone, Daniel K., \u201cAssessing Criminal History as a Predictor of Future Housing Success for Homeless Adults with Behavioral Health Disorders,\u201d Psychiatric Services, Vol."] [15.737894058227539, 10.258797645568848, "L. Streiner, Helen-Maria Vasiliadis, Paula N. Goering, and At Home/ Chez Soi Investigators, \u201cEffect of Scattered-Site Housing Using Rent Supplements and Intensive Case Management on Housing Stability Among Homeless Adults with Mental Illness: A Rando"] [15.717728614807129, 10.259106636047363, "h Services Research, Vol. 48, 2021, pp. 707\u2013717.\nWatkins, Katherine E., Allison J. Ober, Karen Lamp, Mimi Lind, Claude Setodji, Karen Chan Osilla, Sarah B. Hunter, Colleen M. McCullough, Kirsten Becker, and Praise O. Iyiewuare, \u201cCollaborative Care fo"] [21.622390747070312, 15.325672149658203, " Research Report\nSHAMENA ANWAR, PATRICK BAYER, RANDI HJALMARSSON, MATTHEW L. MIZEL\nRacial Disparities\nin Misdemeanor Speeding Convictions\nCORPORATION\n Racial Disparities in Misdemeanor Speeding Convictions\nFor more information on this publication, "] [21.616302490234375, 15.33010196685791, "re are racial disparities in who benefits from this discretion and why these racial disparities might exist.\nJustice Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health an"] [21.612979888916016, 15.335387229919434, " court stages. Because of the relatively small numbers of individuals in other racial groups, our analysis focused on disparities between Black and White motorists.\nFindings on Racial Disparities in Misdemeanor Speeding Convictions Overall Racial Dis"] [21.616975784301758, 15.330495834350586, "ney present significantly lowered the likelihood that a motorist was convicted of a misde- meanor, but in Virginia, attorneys are not provided by the court for these violations and must be retained at the motorist\u2019s expense.\nAbout one-fifth of the ra"] [21.617624282836914, 15.330737113952637, ". 29 Regression Analysis at the Law Enforcement Stage .................................................................. 32 Regression Analysis and Oaxaca-Blinder Decompositions at the Court Stage................................... 36\nCHAPTER SIX\nCon"] [21.61552619934082, 15.330114364624023, "ts Cited by Officers Who Did Not Discount Speeds ............................................ 48\nTables\n2.1. Summary Statistics for the Main Analysis Sample......................................................... 9 3.1. How Court Pathways Differ Acr"] [21.619163513183594, 15.327589988708496, ". For instance, although Black individuals made up 13 percent of the U.S. population in 2015, they made up 27 percent of misdemeanor arrests (Natapoff, 2018). Mayson and Stevenson (2020) analyzed misdemeanor case filings in multiple jurisdictions and"] [21.621307373046875, 15.32589054107666, "g record, and can result in increased penalties for any future criminal conviction.\nFor several reasons, studying misdemeanor speeding violations presents a unique opportunity to under- stand both the overall disparities present in a misdemeanor offe"] [21.620819091796875, 15.32631778717041, "eive a charge reduction by the officer are generally required to go to court to adjudicate the charge, whereby the judge or prosecutor can reduce the charge to a simple traffic infraction. This allowance for discretion brings up a natural question: A"] [21.616071701049805, 15.332334518432617, "legally relevant reason that some of these controls are being taken into account. The models used for analysis here are directly informed by our process-mapping results. Because of the relatively small numbers of individuals in other racial groups, o"] [21.619327545166016, 15.32741641998291, "st, in our study, the benefits that motorists received from getting their speeds or charges dis- counted were quite different from the benefits noted in the earlier studies. In previously studied settings, only a higher fine (rather than a more serio"] [21.617826461791992, 15.329379081726074, " amend charges.\n 4\nCHAPTER TWO\nData and Analysis Sample\nData Sources, Cleaning, and Variable Construction\nCollecting data on speeding violations in Virginia requires obtaining data from the district courts. Virginia is composed of 95 counties and 38 "] [21.617874145507812, 15.329553604125977, "nts per county used in our analysis (Virginia Demographics, undated). These counties, however, are geographically dispersed through much of Virginia.\n1 Most counties had either no data or incomplete data for 2006. Only two of the counties (Shenandoah"] [21.617908477783203, 15.328804969787598, "ar, and thus driver age is unknown in our sample); city, state, and zip code of residence; and the county in which the alleged violation took place. We used the motorist\u2019s address to code whether they were an out-of-state driver.\nAlthough the data do"] [21.62326431274414, 15.324440956115723, "a felony are eventually convicted of a misdemeanor in those courts; the\n7\nRacial Disparities in Misdemeanor Speeding Convictions\n courts also handle probation violations. Our criminal history measure is thus a combination of whether the individual ha"] [21.618179321289062, 15.330110549926758, "arrested drivers were Virginia residents, and Virginia law enforcement officers are likely to mainly receive alerts from in-state incidents. Because we wanted to focus only on incidents in which the speeding violation was likely the only offense bein"] [21.61661720275879, 15.332019805908203, "ack individuals. Almost 60 percent of these drivers were from out of state, and almost two-thirds of the violations occurred in areas where speed limits were either 65 or 70 mph. Note that we report summary statistics as decimal num- bers (e.g., 0.58"] [21.616687774658203, 15.331977844238281, "d Brunswick Chesterfield Essex Fluvanna Fredericksburg Halifax\nLouisa Madison Mecklenburg Prince George Rockbridge Shenandoah Southampton Warren\nYork\nObservations\nOverall Black White\n0.650 0.624 0.667 0.287 0.301 0.277 0.063 0.075 0.055\n0.592 0.592 0"] [21.619279861450195, 15.328657150268555, "0 mph at any speed limit.1 This charge is classified as a first-degree misdemeanor, punishable by up to 12 months in jail. Motorists traveling over the speed limit but under the reckless speeding limits are to be charged simply with speeding, which i"] [21.621952056884766, 15.325833320617676, " charged with a reckless speeding violation that was\n1 Virginia Criminal Sentencing Commission, 2015, p. 133. As noted earlier, in Virginia, this violation is technically listed as reckless driving\u2014speeding, but for simplicity, we refer to it in this"] [21.613719940185547, 15.33495044708252, "officers in Virginia record only one speed on a citation and do not note whether this speed has been discounted, the easiest way to examine the extent to which discretion is used by law enforcement is to examine the data for the frequency distributio"] [21.615947723388672, 15.333423614501953, "rivers to be relatively continuous throughout the whole distribution.\nDistribution of Cited Speeds\nIn Figures 3.1\u20133.3, we present three histograms, each presenting the distribution of miles per hour above the misdemeanor cutoff that the motorist was "] [21.615510940551758, 15.334022521972656, " cutoff is that motorists intentionally drive at a speed just below the cutoff to avoid receiving the harsher penalty. Although there is potential that some of this bunching reflects motorist behavior, we believe, for several reasons, that the majori"] [21.615554809570312, 15.33322525024414, "14), we can employ the following measure as a proxy for the amount of discounting used:\nNumber of motorists cited at the misdemeanor cutoff\nNumber of motorists cited between the misdemeanor cutoff and 15 mph above the cutoff (inclusive)\n 17\nRacial Di"] [21.61489486694336, 15.339926719665527, " it is still a useful indication of how the use of discretion by law enforcement varies across groups. The value of this measure (i.e., the number of motorists cited at the misdemeanor cutoff divided by the number of motorists cited between the misde"] [21.629079818725586, 15.319615364074707, "on, which indicates that offi- cers are discounting charges at a substantial rate. In this section, we consider what factors might influence whether law enforcement officers choose to discount a misdemeanor charge down to an infraction.\nFigure 3.4 ma"] [21.627418518066406, 15.320905685424805, " in the previous section, law enforce- ment officers in our sample classified 58 percent of these motorists\u2019 cases as infractions. Although these motorists could still go to court to try and further reduce their charges, we considered that discounted"] [21.622425079345703, 15.325018882751465, "orist prepaid the fine (which means that the officer made the offer and the motorist accepted it). Whether motorists exer- cised the prepayment option depended heavily on the county of the stop: Almost all instances of prepaid mis- demeanor charges o"] [21.62108039855957, 15.32521915435791, " with upgraded charges had prepaid their tickets, so the data indicate that an upgrade typically happened only if the individual chose to challenge the original infraction citation in court.\n 21\nRacial Disparities in Misdemeanor Speeding Convictions\n"] [21.622692108154297, 15.324090003967285, " graded or dismissed. Table 3.1 shows the proportion of motorists with a given characteristic who prepaid the ticket, did not attend court, attended court without an attorney, or attended court with an attorney. We estimated the numbers in this table"] [21.623077392578125, 15.324589729309082, "ve the court outcome (n = 109,183). The table shows the proportion of each group in each court pathway.\nFIGURE 3.6\nPercentage of Motorists Who Attended Court and Had the Misdemeanor Charge Downgraded or Dismissed\n 100\n 90\n 80\n "] [21.62767791748047, 15.320561408996582, "tion can go to jail and can have their driver\u2019s license suspended by the judge, these two outcomes are relatively rare for motorists convicted of reckless speeding and are likely inflicted only on the very riskiest of drivers (who likely would not ha"] [21.623188018798828, 15.32542896270752, "xchange (generally, offenses for which fingerprints are collected).\n 25\nRacial Disparities in Misdemeanor Speeding Convictions\n Black applicants than for similar White applicants: A previous audit study by Pager (2008) indicated that the impact of a"] [21.650859832763672, 15.298351287841797, "ve the charge classified by law enforcement as an infraction, (3) charged with a misdemeanor by law enforcement but have the charge downgraded to an infraction or dismissed by the court, (4) or charged with a misdemeanor by law enforcement and convic"] [21.64387321472168, 15.30463695526123, "ls whose charge was amended to an infraction by the court, although the amount was still higher than if the motorist had been charged by law enforcement with an infraction. For motorists whose charge was amended to an infraction by the court, the fin"] [21.633459091186523, 15.315423011779785, "mit, motorists would receive 3 demerit points, and if the charge was amended to speeding between 10 and 19 mph above the speed limit, they would receive 4 demerit points (Virginia Department of Motor Vehicles, 2021). The table indicates that there is"] [21.623458862304688, 15.325494766235352, "isparities in outcomes, which we define as the racial disparities that exist when no other factors are controlled for. As noted in Chapter Three, there are four key outcomes that can occur when an individual is stopped for speeding in the reckless ra"] [21.6184139251709, 15.330313682556152, "ocess indicates that a much larger percentage of Black motorists than White motorists were forced to go to court to have the charge adjudicated. Furthermore, our discussion in Chapter Four on fines and license points indicates that one of the most pr"] [21.620941162109375, 15.327892303466797, "ppened at the law enforcement stage ((0.166\u22120.075) / 0.166 = 0.55), and the remaining 45 percent of the disparity occurred at the court stage. Next, we delve into what factors might explain the racial disparities at each of these stages.\n31\nBlack mot"] [21.617990493774414, 15.329909324645996, "aracteristics. How- ever, this coefficient can also reflect racial differences in relevant characteristics that we are not accounting for in our model. As we discussed in Chapter Three, these relevant variables include the actual speed at which the m"] [21.61700439453125, 15.332633972167969, "0.151 (0.003)*** 0.077 (0.003)***\n0.354 154,729\n0.055 (0.006)*** 0.055 (0.006)*** 0.053 (0.006)*** 0.054 (0.006)*** 0.029 (0.006)***\n0.178 25,739\n0.069 (0.006)*** 0.075 (0.006)*** 0.074 (0.006)*** 0.074 (0.006)*** 0.057 (0.006)***\n0.307\n26,546\n0.217 "] [21.619388580322266, 15.329489707946777, "s among that subsample who were either charged with a misdemeanor by law enforcement or cited with a speed at the cutoff (depending on the dependent variable used).\nThe results presented in Panel B of Table 5.1 indicate that driving record and crimin"] [21.61863899230957, 15.330536842346191, " for the speed limits of 65 or 70 mph are relatively small; this is likely because law enforcement officers rarely used discretion to classify speeds above the cutoff as an infraction at these high speeds. The low use of discretion implies a low oppo"] [21.616424560546875, 15.331988334655762, " be stopped in areas where all motorists were less likely to be cited for a speed at the cutoff. Unfortunately, we are unable to determine whether there is a race-neutral reason that, in counties in which a larger share of stops were of White motoris"] [21.61590576171875, 15.332910537719727, "ited motorists are actually driving at the cutoff. To the extent that speed- discounting is responsible for the disparity, researchers would need to determine whether there is a legitimate reason why officers in counties with more White motorists eng"] [21.617733001708984, 15.331290245056152, "ns (guilty, not guilty, or dismissed). To examine the\n36\nRacial Disparities in Misdemeanor Convictions\n raw racial disparity in misdemeanor convictions at the court stage, and to determine the extent to which this raw disparity can be explained by va"] [21.615676879882812, 15.334054946899414, "a in which the motorist was cited nor the addition of controls for previous driving violations or non-traffic criminal history seem to affect the central results.\nThe first key result is that, among this sample of individuals charged with a misdemean"] [21.61139678955078, 15.33758544921875, "paid control\nAdd attendance control\nAdd attorney control\nProportion of White motorists convicted of a misdemeanor\nSample\n0.168 (0.004)*** 0.146 (0.004)*** 0.144 (0.004)*** 0.144 (0.004)*** 0.158 (0.004)*** 0.140 (0.004)*** 0.144 (0.004)*** 0.050 (0.0"] [21.59583854675293, 15.346027374267578, "p in an outcome variable Y between Black and White individuals (denoted as B and W) can be split apart into two terms (Jann, 2008):\nYB -YW =(XB -XW )\u03b2W +XB (\u03b2B -\u03b2W ). (5.4)\nXB and XW represent the average values of all covariates included in Equation"] [21.618616104125977, 15.330024719238281, "dicate that court attendance was the largest driver of the racial disparity observed at the court stage. The racial gap in misdemeanor conviction rates would close by 7 percentage points if White\n5 A negative decomposition value attached to a covaria"] [21.62299346923828, 15.326370239257812, " generally are not provided indigent defense representation because the potential for jail time on these cases is typically waived in advance. Anecdotal evidence suggests that retaining a private attorney for these types of cases can cost about $500,"] [21.618267059326172, 15.328343391418457, "the most effec- tive intervention. That is, is it mainly important to implement interventions that encourage people to go to court or that get individuals to complete the driver\u2019s clinic? A necessary first step is for the court to record when drivers"] [21.617206573486328, 15.331491470336914, " played a role here. Overall, we were able to explain a higher percentage of the disparity at the court stage than at the law enforcement stage.\nData Limitations\nAll of our conclusions necessarily focus on racial disparities in misdemeanor speeding c"] [21.586528778076172, 15.368680953979492, " and send citations to speeding vehicles. These automated enforcement methods, which are common in Europe, are widely considered to reduce speeding- related crashes, fatalities, and injuries (NTSB, 2017; Wilson et al., 2010). Automated methods of enf"] [21.612346649169922, 15.337882041931152, " these two interventions had on court appearance rates for misdemeanor summons in New York City and found that redesigning the summons form reduced failures to appear by 13 percent, and text message reminders reduced failures to appear by 21 percent."] [21.61468505859375, 15.335002899169922, "is restriction dropped 33 percent of the observations in areas where the speed limit was 25\u201360 mph.1 The hallmark of officers speed-discounting when issuing cita- tions is that there is bunching right at the misdemeanor cutoff. Thus, to identify the "] [21.610496520996094, 15.338683128356934, "y fit either group, so we did not use these observations in analyses that compare outcomes for motorists stopped by officers who did and did not discount speeds.3 Figure A.1 shows the distribution of cited speeds in speed limit zones of 25\u201360 mph and"] [21.610759735107422, 15.338558197021484, "comes of stops by officers who did discount speeds. The fact that such a small subsample of the stops were conducted by officers who did not discount speeds indicates that this comparison is not likely to be too useful, because this small subsample m"] [21.61129379272461, 15.338227272033691, "were differences in the locations where Black and White motorists were cited that need to be controlled for, Table B.1 does not present straight speed tabulations for each of the four officer and motorist combinations, although the numbers can be int"] [21.61180877685547, 15.337759971618652, "from the rate that White motorists\u2019 speed was discounted.\ning columns 1 and 3 indicates that speed-discounting increases the proportion of Black motorists who were cited at the cutoff and reduces the proportion who were cited at speeds 1\u20135 mph above "] [21.596220016479492, 15.35202407836914, "s exploratory because we were able to include only a small (and somewhat nonrepresentative) portion of our full sample. Furthermore, the research design relies on comparing cited speed distributions among officers who did and did not discount speeds;"] [21.613525390625, 15.332669258117676, " 0.137 0.005 0.025 0.030 0.048\n116,107 276,621\nOverall Black\n0.499 1.000 0.501 0.000 0.739 0.711 0.615 0.721\n0.121 0.085 0.258 0.226 0.621 0.688\n0.047 0.041 0.044 0.032 0.027 0.007 0.181 0.258 0.020 0.020 0.008 0.006 0.005 0.002 0.015 0.011 0.028 0.0"] [21.61286163330078, 15.332147598266602, "ut Infraction Cited Above Classified as an\nCutoff Cited at the\nLocation\n0.506\n0.029\n0.477\n0.633\n0.181 0.046\n0.452 0.568\n0.570\n0.052\n0.518\n0.788\n0.139\n0.649\n0.861\n0.134\n0.727\n0.339\n0.006\n0.333\n0.529\n0.030\n0.499\n0.745\n0.114\n0.765\n0.215\n0.550\n0.838\n0.35"] [21.61661148071289, 15.330930709838867, "w of Law and Economics, Vol. 38, June 2014, pp. 11\u201324.\nAnwar, Shamena, and Hanming Fang, \u201cAn Alternative Test of Racial Prejudice in Motor Vehicle Searches: Theory and Evidence,\u201d American Economic Review, Vol. 96, No. 1, March 2006, pp. 127\u2013151.\nBeck"] [21.61573028564453, 15.330124855041504, "5, 2020. Luh, Elizabeth, \u201cEffects of Disparate Policing on Long-Term Outcomes: Evidence Using Chicago Parking\nTickets,\u201d working paper, March 20, 2020.\nLynn, Cheryl W., Wayne S. Ferguson, Nicholas J. Garber, and Jonathan C. Black, Executive Summary: A"] [21.615549087524414, 15.329011917114258, ", No. 2, 2021, pp. 1199\u20131253.\nSaez, Emmanuel, \u201cDo Taxpayers Bunch at Kink Points?\u201d American Economic Journal: Economic Policy, Vol. 2, No. 3, August 2010, pp. 180\u2013212.\nSpohn, Cassia C., \u201cThirty Years of Sentencing Reform: The Quest for a Racially Neu"] [13.930392265319824, 4.17198371887207, "ocuses on understanding the sources of racial disparities in the criminal justice system, as well as evaluating criminal justice system reforms. She holds a Ph.D. in economics.\nPatrick Bayer is a professor of economics at Duke University. His researc"] [-2.9983785152435303, 8.846529006958008, " Research Funding for Women\u2019s Health\nMODELING SOCIETAL IMPACT\nMatthew D. Baird Melanie A. Zaber Annie Chen Andrew W. Dick Chloe E. Bird Molly Waymouth Grace Gahlon Denise D. Quigley Hamad Al-Ibrahim Lori Frank\n CORPORATION\n A MESSAGE FROM WHAM\n T"] [-2.997385263442993, 8.848917961120605, "ese data and citing this report.\n WHAM\u2019s LEAD PARTNERS\nWHAM\u2019s sponsorship of this research project was enabled through the generous financial support from the following partners.\nAmerican Heart Association\nThe Association is a relentless force for a "] [-3.004692554473877, 8.842317581176758, "es, Founder and Former CEO of CAROLEE\nMeryl Comer, Vice Chair and Global Chair Co-Founder, UsAgainstAlzheimers/ WomenAgainstAlzheimers\nChair, Global Alliance on Women\u2019s Brain Health\nAnula Jayasuriya, Vice Chair and Chief Scientific Officer\nFounder an"] [-2.997828483581543, 8.848138809204102, "chiatry in the Field of Women\u2019s Health, Brigham and Women\u2019s Hospital\nDr. Wendy Klein, MD, MACP, Former Medical Director, Health Brigade\nDr. JoAnn Manson, DrPH, MD, Michael and\nLee Bell Professor of Women\u2019s Health, Medicine, Harvard Medical School Co-"] [-3.0366709232330322, 8.80616283416748, "ol of Pharmacy, University of Washington\nHadine Joffe, MD\nVice Chair for Research, Department of Psychiatry, Executive Director, Mary Horrigan Connors Center for Women\u2019s Health and Gender Biology, Paula A. Johnson Professor of Psychiatry in the Field"] [-3.052631378173828, 8.787641525268555, "EXECUTIVE SUMMARY 1\n 2 RESEARCH FUNDING FOR WOMEN\u2019S HEALTH: MODELING SOCIETAL IMPACT\nNIH portfolio for AD/ADRD, 4.5 percent for CAD, and 7 percent for RA. The impact of a current investment was assumed to occur in ten years, with benefits accruing a"] [-3.045105218887329, 8.79499340057373, " to help them plan investments that can yield the greatest public health benefits.\nAs part of an initiative of the WHAM nonprofit foundation, RAND Corporation researchers examined the impact of increasing funding for women\u2019s health, beginning with a "] [-3.059600353240967, 8.781136512756348, " For late onset AD/ADRD, gender differences in informal caregiv- ers are a prominent part of the differential gender impact, with more women than men serving as informal caregivers. The caregiving burden associated with CAD is not quite as high, and"] [-3.056011199951172, 8.783793449401855, "ng the Research Investment\nTo construct models of the impact of research investment, we used current levels of funding from the NIH. Certainly, the universe of fund- ing extends beyond the NIH and includes advocacy organizations,\nthe biopharmaceutica"] [-3.0798137187957764, 8.751686096191406, "f approxi- mately one million adults and simulated the pro- gression of each person\u2019s health in the sample over a 30-year time horizon. For CAD and RA, the focus was on working- age adults age 25 and older. For AD/ADRD, the cohort represents the U.S."] [-3.061142921447754, 8.779014587402344, "thetical cohort, we chose to base earnings calculations for everyone on the earnings of non-Hispanic white males. This avoids the gender- and race-based labor market discrimination that is inherent in the different (and lower) earnings for women vers"] [-3.0584068298339844, 8.782618522644043, " and reduced mortality due to disease.\nWe simulated the effects of increasing funding for health research on women in terms of economic outcomes, including the monetary value of patients being able to stay in the labor force longer as a result of dec"] [-3.060800790786743, 8.775574684143066, "e years with RA, and men have about 9,000 fewer life years with RA.\nIncreased Life Expectancy\nFor AD/ADRD, a 0.01 percent health improvement results in nearly 4,000 additional life years lived, more than 6,000 fewer years with AD/ADRD, and nearly 4,0"] [-3.088383436203003, 8.747564315795898, "regivers pick up the increased care need instead. Countering this effect is the smaller number of individuals with the disease, which ultimately reduces overall productivity loss for the informal caregivers.\nFor CAD, caregiver productivity drops by a"] [-3.0817277431488037, 8.752310752868652, "e not changing the onset or severity of the disease, decrease the burden of the disease for a given severity. For these reasons, the QALYs capture a much larger effect, which is represented by approximately 223,000 more life-year equivalents of\na ful"] [-3.0606484413146973, 8.775239944458008, "50,000 100,000\n50,000 0 \u201350,000\nWomen Men\n \u20134,514\n34,446\n 223,074\n \u201324,535\n \u20133,869\n\u2013732\n Lost productivity (self)\nLost productivity (caregivers)\nQALYs\nNOTE: Figure shows a 0.1 percent health improvement, which is three times larger for women "] [-3.0582199096679688, 8.781463623046875, "e next-largest driver. The overall reduc- tion in costs was around $10.5 billion over 30 years (in 2017 dollars). About 87 percent of the costs are from female patients, and 13 per- cent are from male patients. Approximately 90 percent of the cost re"] [-3.05715274810791, 8.782516479492188, " devoted to women\u2019s health relative to general research, according to the specifications used here.\nThe overall societal cost savings from modest investment in wom- en\u2019s health research could be $932 million for AD/ADRD, $1.9 billion for CAD, and $10"] [-3.0562992095947266, 8.786087989807129, "nal database, but these estimates are larger than some reports in the literature. Smaller estimates still result in large ROIs but change the nature of the health improvements.\n Policy Implications\nThe results of these analyses suggest several polic"] [-3.055567502975464, 8.785523414611816, " factors and, given the uncertainty of the future, requires assumptions. Future investment\nin women\u2019s health may result in large gains in condition status with resulting gains in health-related quality of life. The limitations that result from the im"] [-3.0529115200042725, 8.784869194030762, "y and Systems, Vol. 16, No. 1, February 8, 2018, p. 8.\nCommittee on Family Caregiving for Older Adults, Board on Health Care Services, Health and Medicine Division, \u201cEconomic Impact of Family Caregiving,\u201d in Richard Schulz and Jill Eden, eds., Famili"] [-3.063270330429077, 8.775230407714844, "ex and Gender Differences in Alzheimer\u2019s Disease and Alzheimer\u2019s Disease\u2013Related Dementias (AD/ADRD),\u201d August 5, 2020b. As of April 5, 2021: https://grants.nih.gov/grants/guide/notice-files/ NOT-AG-20-038.html\n\u2014\u2014\u2014 \u201cResearch Portfolio Online Reporting"] [-3.0557665824890137, 8.782732009887695, "Molinuevo, Matthew Norton, and Alireza Atri, \u201cTip\nof the Iceberg: Assessing the Global Socioeconomic Costs\nof Alzheimer\u2019s Disease and Related Dementias and Strategic Implications for Stakeholders,\u201d Journal of Alzheimer\u2019s Disease, Vol. 70, No. 2, 2019"] [-3.0548653602600098, 8.782753944396973, "s (RePORTER),\u201d updated November 7, 2020c. As of November 17, 2020: https://projectreporter.nih.gov/reporter.cfm\nNichols, Gregory A., Timothy J. Bell, Kathryn L. Pedula, and Maureen O\u2019Keeffe-Rosetti, \u201cMedical Care Costs Among Patients with Established"] [-3.054490089416504, 8.78572940826416, "uce, Bryan R., Josephine Mauskopf, Frank A. Sloan, Jan Ostermann, and L. Clark Paramore, \u201cThe Return on Investment in Health Care: From 1980 to 2000,\u201d Value in Health, Vol. 9,\nNo. 3, 2006, pp. 146\u2013156.\nNational Institute of Arthritis and Musculoskele"] [-3.012970209121704, 8.82694149017334, "\u2019s health research, with a focus on the following three disease areas: brain health, immune and autoimmune disease, and cardiovascular disease. Using microsimulation analyses, the research team studied the societal cost impact of increasing research "] [-3.01214337348938, 8.83273983001709, " Societal Impact of\nResearch Funding for\nWomen\u2019s Health\nIN CORONARY ARTERY DISEASE\nMatthew D. Baird Melanie A. Zaber Andrew W. Dick Chloe E. Bird Annie Chen\nMolly Waymouth Grace Gahlon Denise D. Quigley Hamad Al-Ibrahim Lori Frank\n CORPORATION\n A"] [-2.967315912246704, 8.879121780395508, "n more about using these data and citing this report.\n WHAM\u2019s LEAD PARTNERS\nWHAM\u2019s sponsorship of this research project was enabled through the generous financial support from the following partners.\nAmerican Heart Association\nThe Association is a re"] [-3.00789475440979, 8.83642292022705, "\nFounder, AccessCircles, Founder and Former CEO of CAROLEE\nMeryl Comer, Vice Chair and Global Chair Co-Founder, UsAgainstAlzheimers/ WomenAgainstAlzheimers\nChair, Global Alliance on Women\u2019s Brain Health\nAnula Jayasuriya, Vice Chair and Chief Scientif"] [-3.0085153579711914, 8.836469650268555, "iate Professor of Psychiatry in the Field of Women\u2019s Health, Brigham and Women\u2019s Hospital\nDr. Wendy Klein, MD, MACP, Former Medical Director, Health Brigade\nDr. JoAnn Manson, DrPH, MD, Michael and\nLee Bell Professor of Women\u2019s Health, Medicine, Harva"] [-3.0438220500946045, 8.798574447631836, "OICE) Institute, School of Pharmacy, University of Washington\nHadine Joffe, MD\nVice Chair for Research, Department of Psychiatry, Executive Director, Mary Horrigan Connors Center for Women\u2019s Health and Gender Biology, Paula A. Johnson Professor of Ps"] [-3.051922559738159, 8.788689613342285, " outcomes.\nInvesting in women\u2019s health research for CAD yields benefits simi- lar to investing in general research, with improved health-related qual- ity of life for women from women-focused research.\nThe results establish the potential for investme"] [-3.0494322776794434, 8.791215896606445, ", researchers, and policymakers to help them plan investments that can yield the greatest public health benefits.\nAs part of an initiative of the Women\u2019s Health Access Matters (WHAM) nonprofit foundation, RAND Corporation researchers exam- ined the i"] [-3.05631947517395, 8.784432411193848, "orbidity and mortality, investment in women\u2019s health could be expected to yield a favorable return for society.\nThe lack of societal-level evidence on the economic costs, ben- efits, and social impacts of attention to sex and gender in health researc"] [-3.055154323577881, 8.784239768981934, "CAD and examine the impacts of additional investments\n INTRODUCTION 7\n the future impact of funding on health outcomes and changes in soci- etal burden from CAD.\nDetermining the Research Investment\nWe used current levels of funding from the NIH as t"] [-3.0597076416015625, 8.779744148254395, "ed to disease impact and has been used as a metric for disease impact and impact of health innovation, incorporating length of life with the quality of life (Grant and Buxton, 2018).\nThe model assumes improved health as a result of increased fund- in"] [-3.0561046600341797, 8.785496711730957, "ls on health outcomes (Grant and Buxton, 2018). The return on research investment calculation was a function of the fol- lowing specific health outcomes: age incidence of disease, improved detection rates and earlier detection in the disease course, "] [-3.0602402687072754, 8.779921531677246, "ting in Women\u2019s Health\nResearch\nTo further understand investment impact, we also examined the prob- ability of success of research investment levels. We calculated the minimum probability of success of the investment to generate a target of 15 percen"] [-3.0635204315185547, 8.773271560668945, "0,000\n0 \u201320,000 \u201340,000 \u201360,000\n 540\n12,628\n 8,097\n35,712\n 19,538\n \u201339,524\n \u201313,496\n\u20138,297\n\u20133,410\n2,014\n Life years\nCAD years\nLost productivity (self)\nLost productivity (caregivers)\nQALYs\nNOTE: Figure represents the U.S. population age 25 and o"] [-3.054793119430542, 8.785748481750488, "atients)\nNOTE: Figure shows a 0.01 percent impact, which is three times larger for women than men.\n13\n7\n\u2013159\n32\n \u201378\n 9\n \u2013465\n \u20131,311\n Women Men\nRESULTS 19\n 20 SOCIETAL IMPACT OF RESEARCH FUNDING FOR WOMEN\u2019S HEALTH IN CORONARY ARTERY DISEASE\n Dis"] [-3.055626392364502, 8.784832000732422, "y through many path- ways. The models examined here focused on a small but important subset of potential impacts on population health using investment in women\u2019s health research. Although a cure and/or preventive interven- tion may be possible for CA"] [-3.052797794342041, 8.787386894226074, "men in the workforce.\nDISCUSSION 23\n 24 SOCIETAL IMPACT OF RESEARCH FUNDING FOR WOMEN\u2019S HEALTH IN CORONARY ARTERY DISEASE\nConclusion\nUnderstanding the full range of societal impacts from health research investment requires consideration of multiple "] [-3.0541069507598877, 8.784863471984863, "o. 1, February 8, 2018, p. 8.\nAmerican Heart Association, \u201cMaking Progress: Making a Difference,\u201d fact sheet, undated. As of December 10, 2020: https://www.heart.org/-/media/files/about-us/policy-research/ fact-sheets/ucm_497880.pdf?la=en\nBaird, Matt"] [-3.0552914142608643, 8.784784317016602, "Measuring and Improving the Societal Impact of Health Care Research,\u201d Eurohealth, Vol. 19, No. 3, 2013, pp. 32\u201335.\nLuce, Bryan R., Josephine Mauskopf, Frank A. Sloan,\nJan Ostermann, and L. Clark Paramore, \u201cThe Return on Investment in Health Care: Fro"] [-3.0342659950256348, 8.803604125976562, "randa R. Jones, \u201cAir Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide,\u201d Current Epidemiology Reports, Vol. 5, No. 4, December 2018,\npp. 370\u2013378.\nZhao, Min, Mark Woodward, Ilonca Vaartjes, Elizabeth R. C. Millett, Kers"] [-3.8238871097564697, 7.391907215118408, "Going to the Doctor\nRideshare as Nonemergency Medical Transportation\nLAURA FRAADE-BLANAR, TINA KOO, CHRISTOPHER M. WHALEY\n Sponsored by Lyft Healthcare\n CORPORATION\nFor more information on this publication, visit www.rand.org/t/RRA1019-1.\nAbout RAND\n"] [-3.826415538787842, 7.392746925354004, "del, the role of rideshare in NEMT, and the policies that support such a role. We conclude by considering how best to support NEMT broadly and optimize rideshare within NEMT specifically. This report is intended for a broad general audience. We condu"] [-3.827587842941284, 7.394099712371826, "et need for on-demand cost-effective solutions within the NEMT ecosystem. Current RB-NEMT capabilities are most appropriate for individuals with medical conditions that result in the need to request rides and those who use Door2Door, Curb2Curb, or Ar"] [-3.827302932739258, 7.394832611083984, "rtationVulnerable?CharacteristicsofPotentialNEMTandRB-NEMTUsers....... 7 MedicalBarriers ........................................................................................................... 7 LogisticalBarriers ................................"] [-3.8261964321136475, 7.392830848693848, ".................................................................. 17\n4.1. ChapterFour:TheBottomLine............................................................................. 22 5.1. ChapterFive:TheBottomLine......................................."] [-3.8267035484313965, 7.392202854156494, "number of patients must show up\u2014and show up punctually.\nNonemergency medical transportation (NEMT) services aim to improve health and health care delivery by facilitating access to medical care for transportation-vulnerable people. It is transport sp"] [-3.8266470432281494, 7.3940229415893555, "T is a mandatory Medicaid benefit: States are required to provide free or low-cost transportation to and from medical appointments if beneficiaries have no other means of accessing services. But what exactly is covered, how that coverage works, and s"] [-3.827514886856079, 7.395510673522949, "ecipients, to reduce costs (Price and Verma, undated), although protocol for applying for a waiver has changed with time and under different administrations. The potential for cost reduction is slight; NEMT comprises what the U.S. Government Accounta"] [-3.827362537384033, 7.394249439239502, "ies for the NEMT benefit and, if the ride is appropriate, will assign a transit mode. A broker works with multiple transportation providers available to fulfill a request. With rideshare- based NEMT (RB-NEMT), the TNC becomes such a provider.\n3 Addit"] [-3.8273632526397705, 7.393893241882324, " mile, and will the total ride be\nunder two hours?)\n\u2022 environmental conditions (e.g., is it over 100oF, below-freezing temperatures?)\n\u2022 what the ride involves (discussed more in Chapter Four); for example, because most modes, such as taxis\nor paratra"] [-3.8274619579315186, 7.394242286682129, "urer found a 66 percent decrease in rider complaints when using RB-NEMT, and a public health system in Oakland, California, found that using RB-NEMT led to a 73 percent decrease in no-show rates at a primary care clinic and a $400,000 annual savings "] [-3.8269879817962646, 7.393564701080322, "e requirements for their drivers, but these may not match state require- ments for NEMT drivers, such as that drivers learn first aid and be able to provide CPR. Currently, TNCs are\n5\nGoing to the Doctor: Rideshare as Nonemergency Medical Transportat"] [-3.827385187149048, 7.3942341804504395, "ions remain about what types of riders and what types of rides work best for NEMT provided by rideshare.\n6\nCHAPTER TWO\nWho Are the Transportation Vulnerable? Characteristics of Potential NEMT and RB-NEMT Users\nWho needs NEMT? Broadly, NEMT users are "] [-3.821833848953247, 7.39428186416626, ".1\nIndividuals with Transportation Challenges Among Those Who Have a Medical Condition That Makes It Hard to Travel (by Age)\n Number of people with a medical condition (millions)\n14 12 10\n8 6 4 2 0\n Ages\n16 to 19\n20 to 34 35 to 50 51 to 64 65 "] [-3.8179526329040527, 7.394845962524414, " steps Difficulty lifting ten pounds\nLimitation in physical functioning*\n 0 10 20 30 40 50 60 70 80 90 100 Percentage of respondents reporting stated limitation\nSOURCE: MEPS data (see Agency for Hea"] [-3.825559377670288, 7.393793106079102, "ese barriers can be based on the physical, cognitive, or sensory health of a patient, or logistical barriers relating to geography and car ownership, among other issues.\n\u2022 Thesebarriersresultinrealchangestotransportationpatterns\u2014forexample,avoidingpu"] [-3.8205268383026123, 7.389743328094482, " ambulatory, able to walk distances (e.g., a half-mile to a bus stop) independently and without strain, and able to enter a vehicle without assistance. People in this group could walk to a nearby medical service or to a public transit stop at some di"] [-3.8252995014190674, 7.39339542388916, "y one characteristic of the group. By nature, people are intersectional in their vulner- abilities; very few of us have only one morbidity. Thus, some morbidities affect the required level of service, and some do not. For example, an individual with "] [-3.8270397186279297, 7.393625259399414, "that can be provided to them.\nC2C or A2A transportation can accommodate various physical and cognitive challenges, depending on the severity and level of outside support needed.5 According to the 2017 NHTS, of respondents with a medi- cal \u201ccondition "] [-3.8271474838256836, 7.394282341003418, "ons dressing or bathing\nFIGURE 3.2\nRB-NEMT Groups Associated with Cognitive and Physical Ability\nWhich Riders Are Best for RB-NEMT?\n Level of assistance required Patient independence\n H2H D2D C2C A2A\nPossible RB-NEMT users Likely RB-NEMT users\n th"] [-3.827694892883301, 7.393720626831055, "rting technology. Recall that, in the pilot program with Lyft and CareMore described in Chapter One (footnote 1 in the Summary), smartphone apps were among the methods used to increase user comfort. Although owning (and being able to use) a smartphon"] [-3.8258473873138428, 7.391828536987305, "can broadly come down to three ques- tions:\n\u2013 How ambulatory is a patient on their own?\n\u2013 How much assistance is needed to carry items they have with them? \u2013 Cantheytravelalone?\n\u2022 Table 3.1 provides details on a selection of NEMT providers, along wit"] [-3.8271024227142334, 7.394017696380615, "them there, and another may drive them home.1 The rideshare driver driving to the appointment may have difficulty finding a ride going back to the small town, and the rideshare driver driving from the appointment may have difficulty finding a rider w"] [-3.827199697494507, 7.393970966339111, "astructure made it easy to book regular rides for an individual. Additionally, using RB-NEMT for regular travel by low-needs individuals (e.g., those traveling to a methadone clinic) freed up other NEMT resources for those who need more in-transit ca"] [-3.8272271156311035, 7.393831253051758, "t, and Sobhani, 2019).\nReciprocally, rideshare may increase interest in and use of NEMT. A focus group from the MACPAC (2021) noted that using rideshare helped normalize accessing NEMT and removed the stigma generated by using traditional NEMT vehicl"] [-3.8269436359405518, 7.393864631652832, "fficult. Part of this difficulty stems from the diversity of ways that NEMT is implemented in research and in practice and the need to match service level with personal needs and resources. The net result is an unusual situation where positive indica"] [-3.826981782913208, 7.393762588500977, "ing to the Doctor: Rideshare as Nonemergency Medical Transportation\n utes for traditional NEMT, and a difference-in-difference analytical approach in Philadelphia found fewer missed appointments in patients who used RB-NEMT services (Chaiyachati et a"] [-3.8272838592529297, 7.393875598907471, "ew York, 2018). GAO noted vulnerabilities in terms of how NEMT providers were selected, how NEMT was administered, and how eligibility was verified for patients (Yocom and Goldstein, 2016b), a concern supported by interviewee anecdotes of systemic mi"] [-3.827162027359009, 7.393856048583984, "re specifically, variation can result from the following scenarios:\n1. TNC performance and user experience differs between TNC providers (e.g., Lyft, Uber, Veyo), so results from a specific TNC may not be generalizable to other TNCs. Similarly, servi"] [-3.8265693187713623, 7.393740653991699, "s, along with other social determinants, such as health behavior, employment, and education (Health Research and Educational Trust, 2017; Healthy People 2030, undated). Recognizing the important role that transportation plays in accessing health care"] [-3.8224563598632812, 7.390064716339111, "al factors that determine an individual\u2019s required level of service, transportation needs can vary. As we articulated in Chapter Two, MA and Medicaid beneficiaries are more transportation-insecure because of logistical and medical factors. These indi"] [-3.82670259475708, 7.392520904541016, "t an expensive benefit: One interviewee put the average ride at $25 at the unit level. This cost compares with the costs of missed medical appointments, pegged by an industry publication as $200, or emergency room visits, at an average of $530 (Moore"] [-3.8271114826202393, 7.3939056396484375, "on may grow because of the aging of the U.S. population. TNCs may explore a tiered rideshare system, possibly starting with the four levels of service described in Chapter Three, where riders could request a driver with specific expertise, willingnes"] [-3.8260436058044434, 7.392655849456787, "re research and to think about best practices. Other important research areas include understanding how the rideshare model can be used to deliver needed health-related goods and medical services to individuals who cannot travel. These could and have"] [-3.8268115520477295, 7.393610000610352, "are system runs. Such enablers as NEMT broadly and RB-NEMT specifically deserve support.\n5 For example, Uber has worked with Meals on Wheels (Uber, undated).\n 29\nGoing to the Doctor: Rideshare as Nonemergency Medical Transportation\n BOX 5.1\nChapter "] [-3.807736873626709, 7.396230697631836, "014 was assigned where missing.\n\u2022 Living alone. We defined living alone as not married or living with a partner, relative, or other unrelated adult. Nursing-home residents were considered not living alone.\n\u2022 Functional limitations. Respondents who an"] [-3.825098991394043, 7.391716480255127, "rip files to describe the relationship between select household, per- sonal, and trip characteristics. Our analysis comprised 264,234 respondents and 923,572 trips. Estimates of personal characteristics, such as demographics and medical conditions, w"] [-3.8265750408172607, 7.389528751373291, "ce an Important Benefit?\u201d Health Affairs Blog, September 20, 2017. As of October 20, 2020: https://www.healthaffairs.org/do/10.1377/hblog20170920.062063/full/\nAgency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, "] [-3.825330972671509, 7.38895320892334, "ww.cms.gov/Research-Statistics-Data-and-Systems/Monitoring -Programs/Medicare-FFS-Compliance-Programs/Prior-Authorization-Initiatives /Prior-Authorization-of-Repetitive-Scheduled-Non-Emergent-Ambulance-Transport-\nChaiyachati, Krisda H., Rebecca A. Hu"] [-3.8246490955352783, 7.389437198638916, "& Medicaid Services, Department of Health and Human Services, April 24, 2019. As of December 23, 2020: https://www.cms.gov/Medicare/Health-Plans/HealthPlansGenInfo/Downloads/Supplemental_Benefits_ Chronically_Ill_HPMS_042419.pdf\neHealth, Inc., \u201cMedic"] [-3.818467617034912, 7.388857841491699, "-of-transportation-insecurity-an -exploratory-factor-analysis\nHealth Research and Educational Trust, Social Determinants of Health Series: Transportation and the Role of Hospitals, Chicago, Ill., November 2017. As of July 19, 2021: https://www.aha.or"] [-3.8236401081085205, 7.389091968536377, "\u201d Washington, D.C.: United States Securities and Exchange Commission, March 1, 2019. As of December 23, 2020: https://www.sec.gov/Archives/edgar/data/1759509/000119312519059849/d633517ds1.htm\nMACPAC\u2014See Medicaid and CHIP Payment and Access Commission"] [-3.823958158493042, 7.388960838317871, ", 2018. As of July 19, 2021: http://www.nadtc.org/wp-content/uploads/NADTC-Transportation-Options-Booklet-2018.pdf\nOkoro, Catherine A., Tara W. Strine, Stacy L. Young, Lina S. Balluz, and Ali H. Mokdad, \u201cAccess to Health Care Among Older Adults and R"] [-3.8251543045043945, 7.389439105987549, "tes Between 2016 and 2018,\u201d July 2018. As of October 20, 2020:\nhttps://www.statista.com/statistics/916253/ride-sharing-total-ridership-us/\nSyed, Samina T., Ben S. Gerber, and Lisa K. Sharp, \u201cTraveling Towards Disease: Transportation Barriers to Healt"] [-3.8256208896636963, 7.389551162719727, "ss/house-bill/133/text\nWeber, Chris, \u201cIntroducing Uber Health, Removing Transportation as a Barrier to Care,\u201d Uber Newsroom, March 1, 2018. As of October 20, 2020:\nhttps://www.uber.com/newsroom/uber-health/\nWestat, Main Study Retrieval Questionnaire,"] [15.903182029724121, 10.489988327026367, "Implementation and 12-Month Health Service Utilization and Cost Outcomes from a Managed Care Health Plan\u2019s Permanent Supportive Housing Program\nSARAH B. HUNTER, ADAM SCHERLING, RYAN K. MCBAIN, MATTHEW CEFALU, BRIAN BRISCOMBE, WILLIAM MCCONNELL, PRIYA"] [15.934245109558105, 10.524894714355469, "report, we provide an update from our previous reports in terms of program implementation through September 2020, describing participant characteristics, program referrals, enrollment timelines, housing placements, and program exits. We also assess t"] [15.957864761352539, 10.557247161865234, " the key social determinants of health, stable housing, but little is known about the associated program costs and potential impacts on health care utilization among insured populations. We sought to understand the program\u2019s implementation, the progr"] [15.94165325164795, 10.548749923706055, " the PSH program prior to 12 months had higher health care utilization and associated costs in the pre-enrollment and post- enrollment periods relative to enrollees who remained in stable housing through the PSH program.\n\u2022 The PSH program was associa"] [15.933140754699707, 10.466933250427246, "ity of life.\n\u2022 We observed that enrollees who exited the program before reaching 12 months of enrollment had higher utilization patterns and associated costs both before and after enrollment, relative to enrollees who were stably housed at 12 months "] [16.008214950561523, 10.517477035522461, "................... 9\n3. Findings .................................................................................................................................... 12 Program Implementation ........................................................."] [16.013690948486328, 10.584223747253418, " Health Care Costs in the Treatment and Comparison Groups\nPrior to and After Program Enrollment ................................................................................ 16 Figure 3.3. Change in Per-Member Health Costs Pre-Enrollment Versus Po"] [16.02268409729004, 10.596911430358887, " Group Demographics, Unweighted ....................... 8 Table 3.1. Characteristics of the Treatment and Comparison Groups, Before and After\nWeighting..................................................................................................."] [15.989818572998047, 10.634153366088867, "........................................................ 55 Table C.13. Monthly Custodial Health Costs ............................................................................... 56 Table C.14. Monthly Emergent Health Costs......................."] [15.906148910522461, 10.535493850708008, "dial Health Costs ............................................................................... 72 Table E.14. Monthly Emergent Health Costs ............................................................................... 73 Table E.15. Monthly Home"] [15.81537914276123, 10.435927391052246, "ed with poorer physical and mental health outcomes. For example, compared with the general U.S. population, people experiencing homelessness are more likely to suffer from unmanaged chronic physical health problems (Baggett, Liauw, and Hwang, 2018), "] [15.89613151550293, 10.539665222167969, "ealth care providers and public payers. Through the Affordable Care Act and state Medicaid expansion, many individuals experiencing homelessness are now eligible for Medicaid. Also, a growing movement away from fee-for-service models to bundled payme"] [15.92926025390625, 10.532505989074707, "adequately planning PSH program implementation.\nPrevious studies have also tended to report the average effects over a specified intervention period (e.g., six or 12 months) rather than exploring changes over time in service use and associated costs."] [15.928690910339355, 10.548019409179688, "cant component of services delivered included recuperative care for which members were provided shelter, meals, and transportation. Recuperative care has become an important service since the passing of California Senate Bill 1152 (Discharge Planning"] [15.993070602416992, 10.507128715515137, "lled in the PSH program. Data included member demographic information and records about individual use of health care services. For program enrollees, we received information about program referral and enrollment dates, receipt of supportive housing "] [15.920310020446777, 10.540517807006836, "CD-10)\ndiagnosis code Z59.0, indicating homelessness, between January 2018 and September\n2019 (coinciding with the recruitment period for the treatment group)\n\u2022 who were not enrolled in the PSH program during the analytic period.\nThis process identif"] [15.954763412475586, 10.596633911132812, "i.e., Current Procedural Terminology or Uniform Billing codes), place of service, ICD-10 diagnosis code, and net pay amount. A service event could include one or more health care claims or encounters. Costs, as ascribed to health care services and th"] [16.024208068847656, 10.597579002380371, "ogram enrollment on health care service utilization and costs (Austin, 2011). The use of a propensity score permits the analysis of an observational, nonrandomized study to mimic the characteristics of a randomized controlled trial by balancing treat"] [15.981008529663086, 10.554152488708496, "o that they sum to 162 to match the number of members in the treatment group.\nHealth Care Service and Cost Effects\nThe effects of the PSH program on health care service utilization and costs were examined using propensity score\u2013weighted regression mo"] [15.97392463684082, 10.515467643737793, "ervice) in each person-month\n2. a mixed effect linear regression predicting the number of services in person-months with at least one service\n3. a mixed effect linear regression predicting costs in months with at least one service.\nAll models control"] [16.021549224853516, 10.614112854003906, "anced the groups were before and after weighting. Group differences were deemed notable when the maximum ASMD was greater than 0.20 (Cohen, 1992).\nPropensity score weighting was effective in attenuating the observed differences between the treatment "] [16.006013870239258, 10.575332641601562, "rary lodging\n$710a\n(n = 162; ESS = 87.2)\n0.41 23.2\n5.01 40.62\n6.48\n31.35\n53.91 3.23\n$3,253 $4,661 $1,485 $46,518 $1,082 $1,072 $5,245 $2,048a\n$9,610 $11,864 $15,851 $7,417 $13,623 $7,383\n3.04\nTreatment (n = 162)\n0.35 21.96\n5.91 39.34\n8.52\n32.41\n51.69"] [15.968465805053711, 10.620031356811523, "osts during the post-enrollment period were segmented according to housing status (pre-housing transitional period, post-PSH placement period, and post-exit period among those who left the program), costs were notably lower during the period in which"] [16.021028518676758, 10.625608444213867, "36 percent and 66 percent; see Figure 3.3), while the number of patients served stayed relatively stable and the number of patient events increased.\n17\n Table 3.2. Most-Common Health-Related Costs: Permanent Supportive Housing Pr"] [16.00670623779297, 10.635422706604004, "mptoms\nAll other diseases\nTotal cost\nPatient N Events\n50 296 66 354\n45 193 42 354 59 503 31 360 27 177 22 174 21 125\n134 248\n158 4,655 132 1,867 158 10,365\n162 19,671\nTotal Exp\n$1,167,710 $793,802\n$935,990 $333,291 $413,614 $565,567 $323,279 $75,962 "] [16.01475715637207, 10.604138374328613, "acy General signs and symptoms All other diseases\n-49% -36%\n-60% -66%\n-44% -34%\n-37% -63%\n-67% -74%\n-47% -44%\n-40% -29%\n-38% -49%\n-6%\n 3% 9%\n24%\n10%\n16%\n34%\n-100% -80%\n-60% -40% -20% 0%\n20% 40%\n85%\n60% 80% 100%\n-43%\n-36%\n20\nTreatment Effects on Healt"] [15.995410919189453, 10.597404479980469, "hich constitute a majority of the observed health care costs (see Figure 3.9). Looking at costs in other settings, we were able to identify statistically significant treatment effects for home health and temporary lodging of $217 PMPM and $166 PMPM, "] [16.015987396240234, 10.572078704833984, "d health and social care so that high-cost health care events become less frequent (National Academies of Sciences, Engineering, and Medicine, 2018).\n 24\nFigure 3.7. Cumulative Share of Post-Enrollment Inpatient Costs, by Member, Treatment Group (n ="] [15.99255084991455, 10.534868240356445, "t 12 Months\n 27\nFigure 3.11. Monthly Health Costs for Members Who Left the Program, by Exit Reason\n 28\nThe Effect of Housing Versus Program Enrollment\nThe previously described modeling approach aggregates data into annual summaries\u2014i.e., the average"] [15.981905937194824, 10.557239532470703, "hs post-enrollment, we find that their probability of having any health care services is no different than had they not enrolled in the program.\nNext, we explore the effect of the program on the total number of health care services during months with"] [15.981266021728516, 10.571697235107422, "ere is a nonstatistically significant but meaningful decrease of $1,337 PMPM during months with at least one health care service after the receipt of housing relative to no enrollment.\nThe total effect of the program on health care costs is the combi"] [15.983149528503418, 10.565094947814941, "nt). Custodial care and recuperative care were infrequent after PSH housing placement.\nLooking at this 12-month window, total programmatic costs were $3,884,374, or $23,978 per participant (n = 162). The average cost per enrollee over the first 12 mo"] [15.983104705810547, 10.577466011047363, "\nHousing, ongoing Housing rental Housing utilities Damage mitigation\nEnrollee services Transportation\nMeals and food\nTotal $960,553\nGrand total $1,488,103\na The cohort perspective follows each enrollee over a 12-month period from\nenrollment.\n "] [15.993989944458008, 10.579655647277832, "ivariable regression analyses that adjusted for demographic differences between the treatment and comparison groups, we did not find a statistically significant difference between groups in terms of change in health care costs from the pre-enrollment"] [15.978940963745117, 10.567816734313965, "18\u2014a reduction of $21,418 over the period.\n\u2022 Those in the comparison group observed a similar reduction of $25,273 between the pre- and post-enrollment periods, despite not participating in the PSH program.\n\u2022 Health care costs declined further among "] [15.959596633911133, 10.57178783416748, "did not demonstrate cost offsets over the initial 12-month period of analysis, this may be partially due to high costs observed in the transitional period (the period after program entry but before receipt of PSH). Health care costs during the transi"] [15.935394287109375, 10.606010437011719, "etes care among enrollees following enrollment that occurred despite overall diabetes care costs remaining flat (see Appendix B, Table B.1). To examine whether these shifts in health care translated to improved health outcomes among enrollees compare"] [15.959877967834473, 10.566697120666504, "n those panel studies, an increase in pharmacy spending was observed in the post-PSH placement periods. Also, DeLia et al., 2021, did not observe net total health care cost savings after PSH placement: The reduction in emergent care costs was largely"] [15.978009223937988, 10.576608657836914, "t and comparison groups.\nSimilarly, we did not have information about the comparison group\u2019s status in terms of whether members of this group had died, moved out of the area, or lost insurance coverage. All\n39\nof these events might have resulted in a"] [15.98119068145752, 10.584683418273926, "he drop in utilization because of the spike prior to enrollment.\nWe also compare pre-enrollment and post-enrollment costs using nominal cost data unadjusted for inflation. This method slightly overestimates (in real terms) the costs associated with t"] [15.947203636169434, 10.556221008300781, " was primarily provided by another payer, and we did not consider other social service use, such as criminal justice utilization and associated costs.\nFurthermore, we do not advocate that the financial outcomes specific to the health plan should driv"] [16.023738861083984, 10.542850494384766, "s compared with the transitional period. Our findings should be of interest to PSH program planners who are interested in understanding PSH implementation, including programmatic costs and their relation to health care utilization and associated cost"] [16.020395278930664, 10.608256340026855, " the comparison group is larger than the treatment group, it was necessary to iterate through the treatment group members several times, each time in random order.\n 43\nPropensity Score Weights\nHaving identified enrollment dates for the comparison gro"] [16.044960021972656, 10.590153694152832, "ollment, using manual classifications based on CCSR.\nd This variable indicates that the member was diagnosed with at least one chronic condition in the 12 months prior to program enrollment, based on the chronic condition indicator from HCUP, 2020.\n4"] [16.001686096191406, 10.626144409179688, "atric facility Emergent\nER\nAmbulance Outpatient\nGeneral hospital Primary care facility\nUrgent care facility Nonmedical location\nCustodial care facility\nTemporary lodging\nHome health Other classifications\nPharmacy\nAll other locations\nPatient N Events\n"] [16.045530319213867, 10.683379173278809, "49 $480 $103 101 1,612\n$3,399 $3,399 123 4,696\n$16,147 $348 123 11,859\nTotal Cost\n$263,606 $154,131\n$274,465\n$471,224 $399,376 $202,677\n$164,104 $68,365\n$77,013\n$13,050 $490,174 $134,428\n$387,210 $3,099,823\nPerson Costa\n$2,143 $1,253\n$2,231\n$3,831 $3"] [16.10016441345215, 10.895342826843262, " 518, ESS = 249) Standard\n Variable\nIntervention\nBaseline (intercept)\nPSH enrollment (treatment)\nDemographic characteristic Age\nGender: male\nEthnicity: black\nEthnicity: Hispanic Ethnicity: not reported/other County: Riverside\nEstimate Error t p \u2013"] [16.10784912109375, 10.91002368927002, "orted/other County: Riverside\nEstimate Error t p \u20130.03 0.06 \u20130.50 0.62\n0.11 0.03 4.14 0.00\n0.00 0.00 0.07 0.94\n0.00 0.02 \u20130.16 0.87\n0.01 0.03 0.49 0.62\n0.01 0.04 0.35 0.73\n\u20130.03 0.03 \u20131.15 0.25 \u20130.01 0.02 \u20130.27 0.79\n NOTE: p = probabili"] [16.101438522338867, 10.898133277893066, "4 1.13 0.26 2.09 0.04\n\u20131.19 0.24 0.35 0.72\nTable C.14. Monthly Emergent Health Costs (n = 518, ESS = 249) Standard\nNOTE: p = probability value; t = t-test statistic.\n56\n Variable\nIntervention\nBaseline (intercept)\nPSH enrollment (tr"] [16.11861801147461, 10.93475341796875, " = probability value; t = t-test statistic.\nVariable\nIntervention\nBaseline (intercept)\nPSH enrollment (treatment)\nDemographic characteristic Age\nGender: male\nEthnicity: black\nEthnicity: Hispanic Ethnicity: not reported/other County: Riverside\nEstimat"] [16.11610221862793, 10.922283172607422, "Enrolled (not housed)\nMonths since enrollment\n\u201312\n\u201311\n\u201310\n\u20139\n\u20138\n\u20137\n\u20136\n\u20135\n\u20134\n\u20133\n\u20132\n\u20131\n0 (enrollment month) 1\n 2\n 3\n 4\n 5\n 6\n 7\n 8\n 9\n 10\n 11\nCounty\nRiverside\nSan Bernardino\nRace/ethnicity\n3.36 4.03\n2.77 3.47\n2.44 4.29\n3.2"] [16.103120803833008, 10.913022994995117, "h E.10 show the results for the number of health care services by type of claim, and Tables E.11 through E.20 show the results for the health care costs by type of cost.\nModels: Number of Monthly Services\nTable E.1. Total Number of Monthly Services ("] [16.104249954223633, 10.91231918334961, "p = probability value; t = t-test statistic.\n68\n Table E.6. Monthly Number of Inpatient Health Services (n = 445, ESS = 206) Estimate SD Error t p\n Variable\nIntervention\nBaseline (intercept)\nPSH enrollment (treatment)\nDemographic charact"] [16.11400604248047, 10.925347328186035, "phic characteristics Age\nGender: male\nEthnicity: black\nEthnicity: Hispanic Ethnicity: not reported/other County: Riverside\nEstimate\n\u2013783.10 1,230.40\n\u201324.26 \u20131,222.67 501.82 \u20131,454.67 \u20132,512.07 652.83\nSD Error\n1,707.54 735.97\n27.21 786.56 794.73 1,139"] [16.109745025634766, 10.924783706665039, "Intervention\nBaseline (intercept)\nPSH enrollment (treatment) Demographic characteristics\nAge\nGender: male\nEthnicity: black\nEthnicity: Hispanic Ethnicity: not reported/other County: Riverside\nEstimate\nSD Error t p\n \u2013389.47 1,573.05\n \u20130.25 0.80\n 7"] [15.825743675231934, 10.452953338623047, "oom\nESS effective sample size\nHCUP Healthcare Cost and Utilization Project\nICD-10 International Classification of Diseases, Tenth Revision ICMS intensive case management services\nPMPM per member per month\nPSH permanent supportive housing SD standard "] [15.730048179626465, 10.330150604248047, "gelo Asa, Wendy Hartogensis, Stephanie E. Cohen, Monica Gandhi, Elvin Geng, and Katerina Christopoulos, \u201cEvaluating the Impact of Housing Status on Gonorrhea and Chlamydia Screening in an HIV Primary Care Setting,\u201d Sexually Transmitted Diseases, Vol."] [15.717744827270508, 10.310800552368164, "alth Status of Homeless Adults Entering Permanent Supportive Housing,\u201d Journal of Public Health, Vol. 40, No. 2, 2018, pp. 415\u2013418.\nHollander, Mara A. G., Evan S. Cole, Julie M. Donohue, and Eric T. Roberts, \u201cChanges in Medicaid Utilization and Spend"] [15.693592071533203, 10.294007301330566, "ousing to Help Homeless Patients,\u201d JAMA, Vol. 321, No. 9, 2019, pp. 822\u2013824.\nKushel, Margot B., Sharon Perry, David Bangsberg, Richard Clark, and Andrew R. Moss, \u201cEmergency Department Use Among the Homeless and Marginally Housed: Results from a Commu"] [15.774421691894531, 10.341156959533691, " pp. 287\u2013294.\nSalem, Benissa E., Angela L. Hudson, Kartik Yadav, Jaemilyn Lucas, Joy Toyama, Stephanie Chen, Mark Faucette, Maria L. Ekstrand, and Adeline M. Nyamathi, \u201cCorrelates of Posttraumatic Stress Symptoms Among Formerly Incarcerated, Homeless"] [14.915400505065918, 13.840782165527344, "Translational Impacts of World Trade Center Health Program Research\nA Mixed Methods Study\nTHOMAS W. CONCANNON, LAURA J. FAHERTY, JAIME MADRIGANO,\nSEAN MANN, RAMYA CHARI, SAMEER M. SIDDIQI, JUSTIN LEE, LIISA HIATT\n Sponsored by the National Institute "] [12.724250793457031, 13.586936950683594, " (2) stakeholder perspectives gathered through focus groups and interviews, and (3) a review of program documentation. This report is intended to guide program planning by the World Trade Center Health Program leadership as it aims to maximize the im"] [14.913324356079102, 13.844897270202637, "WTC and related sites or located within the New York City disaster area during and after the terrorist attacks of September 11, 2001. Scientific research supported by the Program provides an evidence base for the health monitoring and clinical care o"] [14.927632331848145, 13.829514503479004, " existing research in future research, planning, policy, and care. Finally, we applied a machine-learning algorithm with these same words and uses of research to identify related text passages within thousands of pages of Program documentation and gr"] [14.921124458312988, 13.835358619689941, "earch?\n\u2022 Finding 5. Facilitators of research translation include a focused mission to improve care through research; research infrastructure, such as the colocation of researchers and clinicians at Clinical Centers of Excellence and the collection, m"] [14.943548202514648, 13.811236381530762, "ons. The scope and heterogeneity prevented a focused look within population and condition groups for summary effect estimates or strength of evidence assessments. Finally, as with all scoping reviews, some data items may be subject to misclassificati"] [14.917731285095215, 13.840313911437988, "...... xii 1. Introduction................................................................................................................................. 1\nBackground.................................................................................."] [14.921160697937012, 13.811854362487793, "................................................................ 48 Appendix C. Methods ................................................................................................................... 52 Appendix D. Scoping Review: Search Strategy"] [14.913689613342285, 13.837908744812012, "x .................................................................. 42 Table A.1. Representatives of Each of the Major Stakeholder Types .......................................... 47 Table B.1. Research Questions and Data Sources ..................."] [14.9148530960083, 13.845514297485352, "nt.\nExposure characterization can be accomplished through measurement or modeling or, in some cases, a combination of both methods.\nExamines associations between one or more exposures and health outcomes.\n xii\nGray literature\nGroup or population stud"] [14.910696029663086, 13.846189498901367, " to submit a petition in accordance with the \u201cPolicy and Procedures for Handling Submissions and Petitions to Add a Health Condition to the List of WTC-Related Health Conditions\u201d (WTC Health Program, 2021a).\nData compiled on a defined population, suc"] [14.903861045837402, 13.858487129211426, "survivors, referring to those present in the New York City disaster area in the dust or dust cloud on September 11, 2011; those who worked, resided, or attended school, childcare, or adult daycare in the New York City disaster area during or after Se"] [14.917679786682129, 13.840083122253418, "ers want to understand the impacts of research investments to date and how to maximize those impacts going forward. In 2017, NIOSH engaged the RAND Corporation to conduct a four-year, independent assessment of the translational impacts of Program-sup"] [14.926011085510254, 13.83421516418457, " answer the second research question (RQ2: To what extent is WTC health-related research translational?), we synthesized qualitative data from gray literature, Program documentation, focus groups, and interviews. From focus group and interview transc"] [14.917606353759766, 13.83830738067627, "rogram research.\n Although this report is of interest to a broad range of stakeholders, the primary audience is\n Program leaders who are charged with implementing the Program\u2019s research mission. Therefore,\n we offer a concise report that directly con"] [14.9241304397583, 13.835721015930176, "ed full-text articles with adjudication and quality review. Data were extracted using a customized electronic form implemented in DistillerSR (DistillerSR, undated). Data analyses were performed using DistillerSR, Python (Python, undated), and Micros"] [14.89645767211914, 13.864781379699707, "y types and funding sources have evolved over time. Figure 2.2 shows the distribution of study types by funding source (NIOSH and non-NIOSH) in three-year increments. Regardless of funding source, exposure-outcome linkage studies have predominated (b"] [11.795405387878418, 21.864669799804688, "ublications supported by other funding were less likely to report on studies of responders than of survivors (responders: N = 181 of 515, 35.1 percent; survivors: N = 316 of 515, 61.1 percent).\nMany studies included both populations, and because the "] [11.78111457824707, 21.899564743041992, " 100 percent.\n8\n4 0.9 6 0.8 18 4.0 21 2.7 22 4.9 28 3.6 12 2.7 49 6.2\n "] [14.917753219604492, 13.838144302368164, "sychiatric conditions when considering all funders (physical: N = 182, 39.7 percent; neuropsychiatric: N = 294, 64.1 percent). Among all publications that addressed a covered neuropsychiatric condition, we found high concentrations of research on PTS"] [14.920175552368164, 13.833710670471191, "t research should cover every ring and node of the diagram, nor that it should start at fundamental questions before proceeding to questions on the outer rings. Rather, study of a topic may start on any ring, may skip rings, and may follow a nonlinea"] [14.918424606323242, 13.834671020507812, "ng can be seen as an impact of the research, including its use for decisions about care, program planning, and policy. Using findings from stakeholder focus groups and interviews, Program documentation, and gray literature, we found that WTC health-r"] [14.917572975158691, 13.837287902832031, "porated into iterative cycles of program planning. Program leaders describe using research findings to \u201cmake better decisions in terms of programmatic efforts or clinical procedures or clinical protocols within our unique population.\u201d One Program lea"] [14.903432846069336, 13.85295295715332, "l and mental health conditions related to the September 2001 terrorist attacks, as well as diagnosis and treatment options for those enrolled in the Program (WTC Health Program, undated a). Specific emphasis was given to studies of biomarkers of expo"] [14.910003662109375, 13.846006393432617, " WTCHP Funding Announcement (August 2020)\nSOURCE: Author analysis of Program documentation.\nNOTE: WTCHP = World Trade Center Health Program. This figure shows that the rationale and priorities for the Program\u2019s research mission were established and"] [14.919532775878906, 13.836236000061035, "ralized as a disaster population.\u201d An FDNY focus group participant had a similar perspective: \u201cIt\u2019s really important for similar disasters down the line that we\u2019ve become the advocates for this . . . because of what we went through, it\u2019s going to be "] [14.93118953704834, 13.851802825927734, "udy establishes a link between 9/11 exposure and a certain outcome, that is considered a translational milestone in the Fundamental Questions ring of the framework and is denoted in Figures 2.6, 2.7. and 2.8 with a \u201c1\u201d next to the node that most clos"] [14.893324851989746, 13.86760425567627, "C disaster?\u201d We identify research on this question as translational milestone 1 in the Fundamental Questions ring (see Figure 2.6). A smaller proportion assessed clinical, health services, or policy interventions for mental and behavioral health, wit"] [14.921213150024414, 13.839292526245117, "d people across their life course looking at sort of the trajectories of PTSD and depression. And I would love to see that continue because I think\u2014just from pure research, nothing to do with the World Trade Center per se\u2014there\u2019s very little out ther"] [14.919568061828613, 13.83611011505127, "or practice.\nThe other group of publications on women\u2019s health addressed a program or intervention aimed at modifying health outcomes (outcome modification studies, N = 9). These publications described treatment programs and are indicated as translat"] [14.940149307250977, 13.814468383789062, "g. This large body of literature has also led to the publication of several synthesis studies focused on the same topics.\nTranslational Milestones in Research on Youth\nThis body of work addresses the question, What are the health outcomes of WTC-expo"] [14.909987449645996, 13.845865249633789, "me after adult mental health and respiratory disease (WTC Health Program Scientific/Technical Advisory Committee, 2016).\nThe SSC has continued to urge the Program to prioritize research on children, young adults, and women. During the SSC\u2019s September"] [14.924650192260742, 13.832650184631348, "lth, and a 2020 evaluation report shed light on the feasibility of creating a youth-focused cohort. Ongoing discussions will be needed to chart the best path forward for WTC youth-related health research.\nConclusion\nIn this chapter, we explain our co"] [14.92149829864502, 13.833829879760742, "search mission, infrastructure to support research, and investments in research communication and dissemination.\nA Focused Research Mission\nThe Program\u2019s research mission is to support translational bridges from research to improved clinical care. A "] [14.917923927307129, 13.837652206420898, "Es and the collection, management, and analysis of data by the Data Centers and Registry\u2014serves as a facilitator of translation.\nCCE-based research and care inform each other directly. Several researchers and CCE representatives who participated in f"] [14.9219331741333, 13.832194328308105, "requently contact Members to ascertain their preferred forms of engagement with the Program.\nThe Program has placed an increased emphasis in the past few years on using several communication channels and modalities for disseminating research findings"] [14.908099174499512, 13.84726333618164, "r, 2019).\n\u2022 For a study on longitudinal changes in PTSD symptoms in WTC survivors, a researcher identified a need for clinical trials to study different modalities of PTSD treatment and the effectiveness of those treatments (Rosen, 2019).\n1 These mee"] [14.897855758666992, 13.857349395751953, "ing medical education credit (Howard et al., 2018).\nPeer-Reviewed Publications\nProgram leaders emphasize the importance of disseminating Program-funded research in the peer-reviewed literature, recognizing that rigorous peer review of the quality of "] [14.916678428649902, 13.838983535766602, "tion: methodological limitations, fragmentation of the U.S. health care system, funding constraints, variable definitions of research translation, and misaligned expectations of research.\nMethodological Limitations\nAll health-related research\u2014in any "] [14.920211791992188, 13.83658218383789, "stions there are with respect to 9/11 and health impacts and how challenging it is for researchers to secure funding to conduct important studies. As with any research program, NIOSH leadership must make decisions about the research it will prioritiz"] [14.914464950561523, 13.839805603027344, "at WTC-related research can and should achieve, as well as what the Program could do with better evidence. We identified four types of expectations for WTC health-related research.\nSome Members who participated in our focus groups expressed a desire "] [14.92250919342041, 13.834711074829102, "s, and limitations of research, this misalignment leads to understandable frustration when different stakeholders perceive that they are not heard, understood, and responded to. The Program can enhance its efforts to engage stakeholders to overcome t"] [14.923140525817871, 13.826095581054688, "s to research translation include methodological limitations, fragmentation of the health care system, funding constraints, variable definitions of translation, and misaligned expectations about research.\n 36\nRQ4: To What Extent Has WTC Health-Relate"] [14.928882598876953, 13.827451705932617, "grant progress reports or presentations at the biannual research grantee meeting could be mined to identify translational accomplishments and nominate new research priorities. The Program can also consider analyses of the connections between related "] [14.925483703613281, 13.827679634094238, " decisions can be more effectively communicated to various internal and external Program stakeholders.\nWe identified the NIEHS framework as a promising model for describing and assessing research translation in the environmental health context. In Ch"] [14.931380271911621, 13.823451042175293, "rch along different translational pathways. These are all potential actions the Program could take to more actively, and more proactively, manage translational bridges.\nNIOSH and Program stakeholders might work together to develop case studies of tra"] [14.930787086486816, 13.822721481323242, "arch lifecycle, from planning research, to conducting research, to using it in communications and decisionmaking. An examination of the Program\u2019s efforts to use established engagement frameworks and guidance will help illuminate new engagement activi"] [14.931661605834961, 13.82343578338623, "\n Example: Research to Care community events are held to review care implications of recent intervention studies.\n Example: Research case studies using the NIEHS framework are codeveloped by researchers and the Program.\n Using r"] [14.90304183959961, 13.853843688964844, "ay of examining a body of research, is novel and may need extensive testing and validation. It is unknown whether this framework on its own can capture all the distinctiveness and complexities of the Program\u2019s research activities.\nConclusion\nMore tha"] [14.91010856628418, 13.847926139831543, "ygiene, the Registry is an ongoing epidemiological cohort study that was established in 2002. The largest registry in the history of the United States to follow the health effects of a disaster, it includes waves of surveys conducted approximately ev"] [14.916038513183594, 13.839224815368652, "ugh the FDNY Responder Health Program, the CCEs, and the NYC Health and Hospitals System WTC Environmental Health Center\n\u2022 Health system leadership\n\u2022 Policymakers (state, local, and federal [WTC Health Program science\nteam, CDC, other federal agencie"] [14.94763469696045, 13.802289962768555, "eting, etc.)\nIndependent data: peer-\nreviewed literature\nIndependent data: gray\nliterature\nIndependent data: in\nprogress research (NIH\nreporter)\nPrimary data collection:\ngroups and interviews)\nstakeholder views (focus\nOther (political context?)\nZadro"] [14.92296314239502, 13.843384742736816, "thesis of themes emerging from coded data. In this appendix, we also describe our approach to integrating quantitative and qualitative findings through the development of case studies of research impact.\nResearch Question Development and Refinement\nT"] [14.91887378692627, 13.84467887878418, " (5) collating, summarizing, and reporting the results (Chapter 2, \u201cImpacts of World Trade Center Health-Related Research\u201d).\nRecord Search\nWe used a systematic search strategy to find records in databases of peer-reviewed publications and gray litera"] [14.923185348510742, 13.807282447814941, "rocess are reported in the Preferred Items for Reporting on Systematic Reviews and Meta-Analyses (PRISMA) flowchart in Figure 2.1 (Liberati et al., 2009).\nFull-Text Review\nTo guide the abstraction of data from peer-reviewed publications, we developed"] [14.914529800415039, 13.858112335205078, "ation studies describe physical or chemical stressors in the environment. Exposure-outcome linkage studies examine associations between one or more exposures and health outcomes (including mental health). Outcome modification studies examine characte"] [14.914608001708984, 13.828561782836914, "r, other similar acute traumatic injuries. Cancer: Any cancer (cancer type not specified); blood and lymphoid tissue, digestive system, eye and orbit, female breast, female reproductive organs, head and neck, respiratory system, skin (melanoma and no"] [14.918729782104492, 13.821432113647461, "akeholders have, according to several different models for visualizing a body of research. Their selection does not imply an evaluation standard: for instance, that WTC evidence should equally cover every evidence type from prioritization to dissemin"] [14.91825008392334, 13.81410026550293, "decisionmakers compare the benefits and harms of various interventions and strategies for preventing, diagnosing, treating, and monitoring health conditions in real-world settings.\n\u2022 Evidence synthesis: The process of systematically reviewing, evalua"] [15.039384841918945, 13.706032752990723, "f these free-text options, creating a categorization scheme that we iteratively refined as we reviewed each free-text entry. The items include\n\u2022 intervention types under the categories of screening or testing, treatment or management, or other interv"] [15.085033416748047, 13.656832695007324, "his initial round was to test and improve the appropriateness of the preliminary codebook and identify the need for additional documentation. The preliminary codebook was refined on the basis of these findings and again compared with the focus group "] [15.080255508422852, 13.66829776763916, "nalysis. We used the focus group discussion guide, which was based on our research questions, to develop a priori codes. This codebook was developed in parallel with another codebook for Program documentation, described below. The two were frequently"] [14.941669464111328, 13.820064544677734, "engine of more than 1,200 think tanks and research centers that is maintained by the Harvard Kennedy School (Harvard Kennedy School, 2021). In Google, we carried out three searches, two with limits to domain type (.org and .gov) and one without domai"] [15.006165504455566, 13.750086784362793, "us group transcripts, Program documentation, and gray literature documents. This text was then processed using a \u201cbag of words\u201d natural language processing approach, in which each page is transformed into a list of commonly used words and two-word ph"] [14.945016860961914, 13.813583374023438, "findings from multiple data sources across the same condition or population of interest (e.g., WTC youth, PTSD), using the research questions as a guide. For instance, to address subquestions about the extent to which the research portfolio addresses"] [14.921773910522461, 13.829317092895508, "steps and connected directly to Program planning and policy. As detailed in Chapter 2, translational steps are depicted in this framework on five \u201crings\u201d corresponding to different kinds of research questions (fundamental questions, application and s"] [11.78174877166748, 21.89900016784668, "OR attack* OR catastroph* OR disaster* OR crash* OR (building* adj3 collaps*) OR (tower* adj3 collaps*) OR (building* adj3 burn*) OR (tower* adj3 burn*) OR (building* adj3 fire*) OR (tower* adj3 fire*) OR plane* OR airplane* OR jet* OR aircraft* OR \u201c"] [11.780290603637695, 21.895278930664062, "RMS: TI terror* OR AB terror* OR KW terror* OR TI attack* OR AB attack* OR KW attack* OR TI catastroph* OR AB catastroph* OR KW catastroph* OR TI disaster* OR AB disaster* OR KW disaster* OR TI crash* OR AB crash* OR TI crash* OR TI(building* N3 coll"] [11.775289535522461, 21.896663665771484, "g* N3 burn*) OR TI(tower* N3 burn*) OR AB(tower* N3 burn*) OR MW(tower* N3 burn*) OR TI(building* N3 fire*) OR AB(building N3 fire*) OR MW(building N3 fire*) OR TI(tower* N3 fire*) OR AB(tower* N3 fire*) OR MW(tower* N3 fire*) OR TI plane* OR AB plan"] [11.781715393066406, 21.89898109436035, "OR aircraft* OR burn* OR crash* OR hijack*) OR ABS(terror* OR attack* OR catastroph* OR disaster* OR collaps* OR tower* OR building* OR fire* OR plane* OR airplane* OR jet* OR aircraft* OR burn* OR crash* OR hijack*) AND (EXCLUDE (SUBJAREA , \u201cSOCI\u201d) "] [11.782434463500977, 21.896387100219727, "d Sep* to Sept*.)\nStatement #1: Common References to the Attack\nTS=(\u201cworld trade center\u201d) OR TS=(sept* NEAR/0 11) OR TS=(sept* NEAR/0 11th) OR TS=(\u201cground zero\u201d) Exclude: RESEARCH AREAS: (PLANT SCIENCES OR ENGINEERING OR REMOTE SENSING OR COMPUTER SC"] [11.779464721679688, 21.896488189697266, "ES OR INSTRUMENTS INSTRUMENTATION OR PHYSICS OR REMOTE SENSING OR FORESTRY OR HISTORY PHILOSOPHY OF SCIENCE OR ENERGY FUELS OR THERMODYNAMICS OR ENTOMOLOGY OR WATER RESOURCES OR ASTRONOMY ASTROPHYSICS OR AUTOMATION CONTROL\n 69\nSYSTEMS OR ZOOLOG"] [14.92128849029541, 13.83954906463623, "Application of Translational Research Frameworks\n\u2022 Evidence type (e.g., generation, synthesis)\n\u2022 NIEHS Translational Research Framework\n\u2022 NIH Translational Science Spectrum\nFree-Text Capture\n\u2022 Study objectives\n\u2022 Findings\n\u2022 Implications\n\u2022 Limitations\n"] [11.781001091003418, 21.900062561035156, "ard E., Joseph A. Boscarino, and Sandro Galea, \u201cAlcohol Use, Mental Health Status and Psychological Well-Being 2 Years After the World Trade Center Attacks in New York City,\u201d American Journal of Drug and Alcohol Abuse, Vol. 32, No. 2, 2006, pp. 203\u20132"] [11.779446601867676, 21.90176773071289, "radeep, Daniel Del Prado, Steven Karidas, Richard Neff, Michael Sadler, \u201cPenetrating Axillary Trauma in a Survivor of the World Trade Center Disaster,\u201d Emergency Radiology, Vol. 9, No. 5, 2002, pp. 300\u2013302.\n24. Albert, Pradeep, Jeremy Handel, Paula Y"] [11.784521102905273, 21.896522521972656, "g Rosen, Kim Davis, Greg Smith, and Malachy Corrigan, \u201c\u2018Stay Connected\u2019: Psychological Services for Retired Firefighters After 11 September 2001,\u201d Prehospital and Disaster Medicine, Vol. 22, No. 1, 2007, pp. 49\u201354.\n34. Ammar, Ali, Zahia Esber, Sunil "] [11.77994155883789, 21.903682708740234, "asilios Christodoulou, Michael D. Weiden, and David J. Prezant, \u201cAccelerated Spirometric Decline in New York City Firefighters with \u03b11- Antitrypsin Deficiency,\u201d Chest, Vol. 138, No. 5, 2010, pp. 1116\u20131124.\n43. Banauch, Gisela I., Atiya Dhala, Dawn Al"] [11.778053283691406, 21.897363662719727, "2. Beebe, Beatrice, Christina W. Hoven, Marsha Kaitz, Miriam Steele, George Musa, Amy Margolis, Julie Ewing, K. Mark Sossin, and Sang Han Lee, \u201cUrgent Engagement in 9/11 Pregnant Widows and Their Infants: Transmission of Trauma,\u201d Infancy, Vol. 25, No"] [11.783981323242188, 21.901004791259766, " Child and Adolescent Psychotherapy, Vol. 10, Nos. 2\u20133, 2011, pp. 286\u2013295.\n62. Bergman, Anni, K. Mark Sossin, Suzi Tortora, Lydia (Ryan\u2019s Mother), Phyllis Cohen, and Beatrice Beebe, \u201cThe Team Approach to the Treatment of a Traumatized Mother and Chil"] [11.781492233276367, 21.899511337280273, "ncy Dodson, Jeanne M. Stellman, Steven Southwick, Vansh Sharma, Robin Herbert, Jacqueline M. Moline, and Craig L. Katz, \u201cStories Behind the Symptoms: A Qualitative Analysis of the Narratives of 9/11 Rescue and Recovery Workers,\u201d Psychiatric Quarterly"] [11.818671226501465, 21.86365509033203, "ster: Implications for Mental Health Care,\u201d General Hospital Psychiatry, Vol. 26, No. 5, 2004, pp. 346\u2013358.\n82. Boscarino, Joseph A., Richard E. Adams, and Charles R. Figley, \u201cA Prospective Cohort Study of the Effectiveness of Employer-Sponsored Cris"] [11.782244682312012, 21.898988723754883, "ndro Galea, Jennifer Ahern, \u201cUtilization of Mental Health Services Following the September 11th Terrorist Attacks in Manhattan, New York City,\u201d International Journal of Emergency Mental Health, Vol. 4, No. 3, 2002, pp. 143\u2013155.\n93. Boscarino, Joseph "] [11.769194602966309, 21.91120147705078, "Grande, and James E. Cone, \u201cGender Differences in Probable Posttraumatic Stress Disorder Among Police Responders to the 2001 World Trade Center Terrorist Attack,\u201d American Journal of Industrial Medicine, Vol. 53, No. 12, 2010, pp. 1186\u20131196.\n103. Bow"] [11.780076026916504, 21.90177345275879, "Horowitz, and Joanne P. Reinhardt, \u201cThe September 11th Attacks and Depressive Symptomatology Among Older Adults with Vision Loss in New York City,\u201d Journal of Gerontological Social Work, Vol. 40, No. 4, 2004, pp. 55\u201371.\n112. Breysse, Patrick N., D\u2019An"] [11.779995918273926, 21.90120506286621, "ter the September 11th World Trade Center Attacks,\u201d Environmental Science and Technology, Vol. 38, No. 13, 2004, pp. 3514\u20133524.\n122. Buyantseva, Larisa V., Mark Tulchinsky, George M. Kapalka, Vernon Chinchilli, Zhengmin Qian, Robert Gillio, Arthur J."] [11.783032417297363, 21.89838218688965, "\u2013362.\n131. Caruana, Dennis L., Po Hsuan Huang, Jonathan C. Li, Keely Cheslack-Postava, and Anthony M. Szema, \u201cAllergy and Lung Injury Among Rescue Workers Exposed to the World Trade Center Disaster Assessed 17 Years After Exposure to Ground Zero,\u201d Jo"] [11.778945922851562, 21.90192413330078, "51, No. 1, 2002, pp. 1\u20135.\n87\n143. Centers for Disease Control and Prevention, \u201cPotential Exposures to Airborne and Settled Surface Dust in Residential Areas of Lower Manhattan Following the Collapse of the World Trade Center\u2014New York City, November 4"] [11.782877922058105, 21.90120506286621, " to the World Trade Center Attacks, PTSD Symptomatology, and Suicidal Ideation,\u201d Journal of Traumatic Stress, Vol. 24, No. 5, 2011, pp. 526\u2013529.\n154. Chemtob, Claude M., Yoko Nomura, and Robert A. Abramovitz, \u201cImpact of Conjoined Exposure to the Worl"] [11.78144359588623, 21.895797729492188, " Chiu, Sydney, Mayris P. Webber, Rachel Zeig-Owens, Jackson Gustave, Roy Lee, Kerry J. Kelly, Linda Rizzotto, Rita McWilliams, John K. Schorr, Carol S. North, and David J. Prezant, \u201cPerformance Characteristics of the PTSD Checklist in Retired Firefig"] [11.782673835754395, 21.90062713623047, "lementi, Emily A., Angela Talusan, Sandhya Vaidyanathan, Arul Veerappan, Mena Mikhail, Dean Ostrofsky, George Crowley, James S. Kim, Sophia Kwon, and Anna Nolan, \u201cMetabolic Syndrome and Air Pollution: A Narrative Review of Their Cardiopulmonary Effec"] [11.780036926269531, 21.900850296020508, "r Subsequent Decline in Function in a Sample of World Trade Center Responders,\u201d Scientific Reports, Vol. 9, No. 1, 2019.\n183. Clouston, Sean A. P., Jack Guralnik, Roman Kotov, Evelyn Bromet, and Benjamin J. Luft, \u201cFunctional Limitations Among Respond"] [11.779152870178223, 21.902416229248047, "chard E. Peltier, Judith Zelikoff, and Lung-chi Chen, \u201cAcute High-Level Exposure to WTC Particles Alters Expression of Genes Associated with Oxidative Stress and Immune Function in the Lung,\u201d Journal of Immunotoxicology, Vol. 12, No. 2, 2015, pp. 140"] [11.785369873046875, 21.89784049987793, ". Cone, James E., Sukhminder Osahan, Christine C. Ekenga, Sara A. Miller-Archie, Steven D. Stellman, Monique Fairclough, Stephen M. Friedman, and Mark R. Farfel, \u201cAsthma Among Staten Island Fresh Kills Landfill and Barge Workers Following the Septemb"] [11.779851913452148, 21.900772094726562, "Services, Psychiatric Services, Vol. 57, No. 9, 2006, pp. 1313\u20131315.\n95\n212. Cowell, Whitney J., Sally A. Lederman, Andreas Sjo\u0308din, Richard Jones, Shuang Wang, Frederica P. Perera, Richard Wang, Virginia A. Rauh, and Julie B. Herbstman, \u201cPrenatal Ex"] [11.784066200256348, 21.901113510131836, "pi, Robert, Elizabeth Brondolo, \u201cPosttraumatic Stress Disorder Post 9/11: A Review of the Evidence and Implications for Public Health Policy,\u201d TPM-Testing, Psychometrics, Methodology in Applied Psychology, Vol. 24, No. 3, 2017, pp. 363\u2013378.\n223. Cruz"] [11.783888816833496, 21.897581100463867, ". Crane, Julia R. Kaplan, Roberto G. Lucchini, Benjamin J. Luft, Jacqueline M. Moline, Susan L. Teitelbaum, Usha S. Tirunagari, et al., \u201cCohort Profile: World Trade Center Health Program General Responder Cohort,\u201d International Journal of Epidemiolog"] [11.779942512512207, 21.904727935791016, " Artery Diameter Is Associated with Reduced FEV1 in Former World Trade Center Workers,\u201d Clinical Respiratory Journal, Vol. 13, No. 10, 2019, pp. 614\u2013623.\n244. de la Hoz, Rafael E., Xiaoyu Liu, Juan C. Celedo\u0301n, John T. Doucette, Yunho Jeon, Anthony P"] [11.7877836227417, 21.891897201538086, "ckbill, Steven D. Stellman, and Mark R. Farfel, \u201cComparison of Health Outcomes Among Affiliated and Lay Disaster Volunteers Enrolled in the World Trade Center Health Registry,\u201d Preventive Medicine, Vol. 53, No. 6, 2011, pp. 359\u2013363.\n254. Dekel, Sharo"] [11.782135963439941, 21.90015411376953, "rld Trade Center Attacks,\u201d Psychological Trauma, Vol. 3, No. 1, 2011, pp. 1\u20137.\n266. Dewart, Tracey, Blanche Frank, and James Schmeidler, \u201cThe Impact of 9/11 on Patients in New York City\u2019s Substance Abuse Treatment Programs,\u201d American Journal of Drug "] [11.78194522857666, 21.900720596313477, " pp. 264\u2013273.\n275. DiMaggio, Charles, Sandro Galea, and Michael Emch, \u201cSpatial Proximity and the Risk of Psychopathology After a Terrorist Attack,\u201d Psychiatry Research, Vol. 176, No. 1, 2010, pp. 55\u201361.\n276. DiMaggio, Charles, Sandro Galea, and Guohu"] [11.775482177734375, 21.904510498046875, " City 6 Months After the WTC Attack,\u201d Journal of Traumatic Stress, Vol. 24, No. 5, 2011, pp. 553\u2013556.\n103\n287. Durmus, Nedim, Yongzhao Shao, Alan A. Arslan, Yian Zhang, Sultan Pehlivan, Maria- Elena Fernandez-Beros, Lisette Umana, Rachel Corona, Shei"] [11.781907081604004, 21.900320053100586, "and Robin Herbert, \u201cQuality of Spirometry Performed by 13,599 Participants in the World Trade Center Worker and Volunteer Medical Screening Program,\u201d Respiratory Care, Vol. 55, No. 3, 2010, pp. 303\u2013309.\n297. Eskenazi, Brenda, Amy R. Marks, Ralph Cata"] [11.78179931640625, 21.90286636352539, "Christina C. Ekenga, Sukhminder Osahan, Sharon E. Perlman, Lisa M. Gargano, Jennifer Imasuen, and Mark R. Farfel, \u201cRelationship Between Persistent Posttraumatic Stress Disorder and Human Remains Exposure for Staten Island Barge and Landfill Recovery "] [11.781315803527832, 21.900653839111328, "enihan, Marcella M. Johnson, Vandana Karri, and C. V. R. Reddy, \u201cCardiac Sequelae in Brooklyn After the September 11 Terrorist Attacks,\u201d Clinical Cardiology, Vol. 29, No. 1, 2006, pp. 13\u201317.\n316. Fernandez, William G., Sandro Galea, Jeff Miller, Jenn"] [11.77828311920166, 21.903865814208984, "o. 1, 2006, pp. 5\u201314.\n325. Freedman, T. G., \u201cVoices of 9/11 First Responders: Patterns of Collective Resilience,\u201d Clinical Social Work Journal, Vol. 32, No. 4, 2004, pp. 377\u2013393.\n326. Friedberg, Fred, Jenna L. Adamowicz, Indre Caikauskaite, Anthony N"] [11.778385162353516, 21.89873695373535, "r, Raluca M., Jeffrey S. Simons, Gerald A. Jacobs, David Meyer, and Erika Johnson-Jimenez, \u201cCoping Motives and Trait Negative Affect: Testing Mediation and Moderation Models of Alcohol Problems Among American Red Cross Disaster Workers Who Responded "] [11.771445274353027, 21.889144897460938, "88\u2013795.\n346. Garcia, Evangeline, and Denise A. Horton, \u201cSupporting the Federal Emergency Management Agency Rescuers: A Variation of Critical Incident Stress Management,\u201d Military Medicine, Vol. 168, No. 2, 2003, pp. 87\u201390.\n347. Gard, Betsy A., Josef "] [11.773852348327637, 21.901357650756836, "\u201cReview of Non-Respiratory, Non-Cancer Physical Health Conditions from Exposure to the World Trade Center Disaster,\u201d International Journal of Environmental Research and Public Health, Vol. 15, No. 2, 2018.\n358. Gargano, Lisa M., Ho Ki Mok, Melanie H."] [11.781035423278809, 21.896638870239258, "h Wicks, Michaeline Bresnahan, Cristiane S. Duarte, and Christina Hoven, \u201cComorbidity Classes and Associated Impairment, Demographics and 9/11-Exposures in 8,236 Children and Adolescents,\u201d Journal of Psychiatric Research, Vol. 96, 2018, pp. 171\u2013177.\n"] [11.785943984985352, 21.898698806762695, " Glaser, Michelle S., Neomi Shah, Mayris P. Webber, Rachel Zeig-Owens, Nadia Jaber, David W. Appel, Charles B. Hall, Jessica Weakley, Hillel W. Cohen, Lawrence Shulman, Kerry Kelly, and David Prezant, \u201cObstructive Sleep Apnea and World Trade Center E"] [11.781449317932129, 21.89961814880371, "ional Journal of Cancer, Vol. 145, No. 6, 2019, pp. 1504\u20131509.\n387. Graeff-Martins, Ana Soledade, Christina W. Hoven, Ping Wu, Fan Bin, and Cristiane S. Duarte, \u201cUse of Mental Health Services by Children and Adolescents Six Months After the World Tra"] [11.78206729888916, 21.900344848632812, "edy: Placing Children\u2019s Reactions to Trauma in a New Context,\u201d Cognitive and Behavioral Practice, Vol. 9, No. 4, 2002, pp. 286\u2013295.\n399. Haen, Craig, \u201cRebuilding Security: Group Therapy with Children Affected by September 11,\u201d International Journal o"] [11.779816627502441, 21.89834976196289, "treach and Peer-Delivered Mental Health Services in New York City Following September 11, 2001,\u201d Psychiatric Rehabilitation Journal, Vol. 32, No. 2, 2008, pp. 117\u2013123.\n409. Harville, Emily, Xu Xiong, and Pierre Buekens, \u201cDisasters and Perinatal Healt"] [11.775047302246094, 21.898324966430664, "efighters,\u201d Chest, Vol. 153, No. 1, 2018, pp. 114\u2013123.\n118\n420. Henley, Robert, Randall Marshall, and Stefan Vetter, \u201cIntegrating Mental Health Services into humanitarian Relief Responses to Social Emergencies, Disasters, and Conflicts: A Case Study,"] [11.782888412475586, 21.899951934814453, "Brennan, and Lisa Colarossi, \u201cEvent-Exposure Stress, Coping, and Psychological Distress Among New York Students at Six Months After 9/11,\u201d Anxiety, Stress, and Coping, Vol. 23, No. 2, 2010, pp. 153\u2013163.\n431. Hill, Matthew N., Linda M. Bierer, Iouri M"] [11.777071952819824, 21.896011352539062, "7.\n440. Hoven, Christina W., Cristiane S. Duarte, Wu P, et al., Parental Exposure to Mass Violence and Child Mental Health: The First Responder and WTC Evacuee Study, Clinical Child and Family Psychology Review, Vol. 12, No. 2, 2009, pp. 95\u2013112.\n441."] [11.783034324645996, 21.899755477905273, "\n450. Jack, Katherine, and Sherry Glied, \u201cThe Public Costs of Mental Health Response: Lessons from the New York City Post-9/11 Needs Assessment,\u201d Journal of Urban Health, Vol. 79, No. 3, 2002, pp. 332\u2013339.\n451. Jackson, Carlos T., George Allen, Susan"] [11.781638145446777, 21.895925521850586, "nn Difede, Ellen Klausner, and Lisa Spielman, \u201cAre Male Disaster Workers With Vietnam Military Service at Greater Risk for PTSD than Peers Without Combat History?\u201d Journal of Nervous and Mental Disease, Vol. 194, No. 11, 2006, pp. 859\u2013863.\n462. Jayas"] [11.78116226196289, 21.897811889648438, "ty Among Rescue and Recovery Workers and Community Members Exposed to the September 11, 2001 World Trade Center Terrorist Attacks, 2003\u20132014,\u201d Environmental Research, Vol. 163, 2018, pp. 270\u2013279.\n470. Jordan, Hannah T., Steven D. Stellman, Alfredo Mo"] [11.78342342376709, 21.89917755126953, "al, Vol. 111, 2018, pp. 268\u2013278.\n480. Katz, Craig L., Natalie Gluck, Andrea Maurizio, and Lynn E. DeLisi, \u201cThe Medical Student Experience with Disasters and Disaster Response,\u201d CNS Spectrums, Vol. 7, No. 8, 2002, pp. 604\u2013610.\n125\n481. Katz, Craig L.,"] [11.780970573425293, 21.899219512939453, "rigan, Steven B. Markowitz, Jacqueline M. Moline, David Z. Savitz, Andrew C. Todd, Iris G. Udasin, and Juan P. Wisnivesky, \u201cIncreased Rates of Asthma Among World Trade Center Disaster Responders,\u201d American Journal of Industrial Medicine, Vol. 55, No."] [11.786581993103027, 21.899648666381836, "imenez, Adam Gonzalez, Kathryn Guerrera, Julia Kaplan, Jacqueline Moline, et al., \u201cPosttraumatic Stress Disorder and the Risk of Respiratory Problems in World Trade Center Responders: Longitudinal Test of a Pathway,\u201d Psychosomatic Medicine, Vol. 77, "] [11.784902572631836, 21.9011287689209, "ack,\u201d Social Service Review, Vol. 93, No. 1, 2019, pp. 96\u2013128.\n510. Kung, Winnie W., Xinhua Liu, Emily Goldmann, Debbie Huang, Xiaoran Wang, Keon Kim, Patricia Kim, and Lawrence H. Yang, \u201cPosttraumatic Stress Disorder in the Short and Medium Term Fol"] [11.781679153442383, 21.900035858154297, "yed H. Haider, George Crowley, Erin J. Caraher, Dean F. Ostrofsky, Angela Talusan, Sophia Kwon, David J. Prezant, Yuyan Wang, Mengling Liu, and Anna Nolan, \u201cSynergistic Effect of WTC-Particulate Matter and Lysophosphatidic Acid Exposure and the Role "] [11.775589942932129, 21.89883804321289, "errorist Attack,\u201d International Journal of Emergency Mental Health, Vol. 8, No. 4, 2006, pp. 267\u2013274.\n529. Lederman, Sally Ann, Mark Becker, Stephen Sheets, Janet Stein, Deliang Tang, Lisa Weiss, Frederica P. Perera, \u201cModeling Exposure to Air Polluti"] [11.784924507141113, 21.89832878112793, "en Attending Prenatal Care,\u201d Journal of Prenatal and Perinatal Psychology and Health, Vol. 19, No. 4, 2005, pp. 275\u2013288.\n539. Li, Jiehui, Howard E. Alper, Lisa M. Gargano, Carey B. Maslow and Robert M. Brackbill, \u201cRe-Experiencing 9/11-Related PTSD Sy"] [11.776650428771973, 21.902130126953125, "r Tissue Samples from World Trade Center Responders,\u201d Journal of Translational Medicine, Vol. 16, No. 1, 2018.\n548. Lieberman-Cribbin, Wil, Stephanie Tuminello, Christina Gillezeau, Maaike van Gerwen, Rachel Brody, David J. Mulholland, Lori Horton, M"] [11.779165267944336, 21.90144157409668, "ast of the World Trade Center (WTC) in Lower Manhattan After the Collapse of the WTC 11 September 2001,\u201d Environmental Health Perspectives, Vol. 110, No. 7, 2002, pp. 703\u2013714.\n134\n558. Lipkind, Heather S., Allison E. Curry, Mary Huynh, Lorna E. Thorp"] [11.781923294067383, 21.900714874267578, "orld Trade Center Exposure on the Timing of Diagnoses of Obstructive Airway Disease, Chronic Rhinosinusitis, and Gastroesophageal Reflux Disease,\u201d Frontiers in Public Health, Vol. 5, No. 2, 2017.\n568. Locke, Sean, Angela-Maithy Nguyen, Liza Friedman,"] [11.782937049865723, 21.8995418548584, "No. 5, 2012, pp. 1069\u20131079.\n577. Lurie, Jacob M., Hazel Lever, Lucy Goodson, Daniel Jack Lyons, Robert T. Yanagisawa, and Craig L. Katz, \u201cInstilling Hope and Resiliency: A Narrative Photo-Taking Intervention During an Intercultural Exchange Involving"] [11.783323287963867, 21.900150299072266, "n, Mana, Jiehui Li, Mark R. Farfel, Carey B. Maslow, Sukhminder Osahan, and Steven D. Stellman, \u201cAdolescent Behavior and PTSD 6\u20137 Years After the World Trade Center Terrorist Attacks of September 11, 2001,\u201d Disaster Health, Vol. 2, Nos. 3\u20134, 2014, pp"] [11.77696418762207, 21.9000244140625, "l Qualitative Study,\u201d Social Work Research, Vol. 31, No. 2, 2007, pp. 121\u2013126.\n597. Matthieu, Monica M., Andre\u0301 Ivanoff, Sarah Lewis, and Kathryn Conroy, \u201cSocial Work Field Instructors in New York City After 9/11/01: Impact and Needs Resulting from t"] [11.783122062683105, 21.901630401611328, "l and Professional Experiences of 9/11 Mental Health Workers,\u201d Social Work in Mental Health, Vol. 18, No. 6, 2020.\n609. Mendelson, David S., Mark Roggeveen, Stephen M. Levin, Robin Herbert, and Rafael de la Hoz, \u201cAir Trapping Detected on End-Expirato"] [11.796771049499512, 21.907245635986328, "G. Crawford, S. James, C. L. Katz, L. E. Crowley, et al., \u201cPost-Traumatic Stress Disorder Dimensions and Asthma Morbidity in World Trade Center Rescue and Recovery Workers,\u201d Journal of Asthma, Vol. 54, No. 7, 2017, pp. 723\u2013731.\n141\n620. Moir, William"] [11.784481048583984, 21.89869499206543, "dies, Vol. 15, No. 6, 2006, pp. 733\u2013743.\n629. Moynihan, Patrick J., Jeffrey M. Levine, and Orlando Rodriguez, \u201cThe Experiences of Project Liberty Crisis Counselors in the Bronx,\u201d Community Mental Health Journal, Vol. 41, No. 6, 2005, pp. 665\u2013673.\n630"] [11.779406547546387, 21.9005126953125, "nd Sandro Galea, \u201cPatterns and Predictors of Trajectories of Depression After an Urban Disaster,\u201d Annals of Epidemiology, Vol. 19, No. 11, 2009, pp. 761\u2013770.\n640. Napier, Camille O., Ositadinma Mbadugha, Laura A. Bienenfeld, John T. Doucette, Roberto"] [11.784570693969727, 21.90272331237793, "e,\u201d New Solutions, Vol. 18, No. 1, 2008, pp. 3\u201322.\n649. Nicosia, Gregory J., Lorna Minewiser, and Amanda Freger, \u201cWorld Trade Center: A Longitudinal Case Study for Treating Post Traumatic Stress Disorder with Emotional Freedom Technique and Eye Movem"] [11.786017417907715, 21.898296356201172, "ol. 163, No. 6, 2009, pp. 531\u2013539.\n658. Norris, Fran H., Sheila A. Donahue, Chip J. Felton, Patricia J. Watson, Jessica L. Hamblen, and Randall D. Marshall, \u201cA Psychometric Analysis of Project Liberty\u2019s Adult Enhanced Services Referral Tool,\u201d Psychia"] [11.779167175292969, 21.902494430541992, "yees of New York City Companies Affected by the September 11, 2001 Attacks on the World Trade Center,\u201d Disaster Medicine and Public Health Preparedness, Vol. 5, Supp. 2, 2011, pp. S205\u2013S213.\n669. Offenberg, J. H., S. J. Eisenreich, L. C. Chen, M. D. "] [11.783838272094727, 21.8995418548584, "Heyde, Dori Reissman, and Vansh Sharma, \u201cThe Enduring Mental Health Impact of the September 11th Terrorist Attacks: Challenges and Lessons Learned,\u201d Psychiatric Clinics of North America, Vol. 36, No. 3, 2013, pp. 417\u2013429.\n678. Paasivirta, Maria E., C"] [11.779926300048828, 21.90188217163086, " 709\u2013714.\n689. Perera, Frederica P., Deliang Tang, Virginia Rauh, Kristen Lester, Wei Yann Tsai, Yi Hsuan Tu, Lisa Weiss, Lori Hoepner, Jeffrey King, Giuseppe Del Priore, and Sally Ann Lederman, \u201cRelationships Among Polycyclic Aromatic Hydrocarbon-DN"] [11.78325366973877, 21.899993896484375, "garet Altemus, Moonseong Heo, and Hong Jiang, \u201cSalivary Cortisol and Psychopathology in Children Bereaved by the September 11, 2001 Terror Attacks,\u201d Biological Psychiatry, Vol. 61, No. 8, 2007, pp. 957\u2013965.\n700. Pfeffer, Cynthia R., Margaret Altemus,"] [11.790152549743652, 21.907175064086914, "R. Ozbay, V. Sharma, et al., \u201cDimensional Structure and Course of Post-Traumatic Stress Symptomatology in World Trade Center Responders,\u201d Psychological Medicine, Vol. 44, No. 10, 2014, pp. 2085\u20132098.\n151\n711. Pietrzak, R. H., A. Feder, R. Singh, C. B"] [11.78456974029541, 21.90154457092285, "mas K. Aldrich, and Kerry J. Kelly, \u201cCough and Bronchial Responsiveness in Firefighters at the World Trade Center Site,\u201d New England Journal of Medicine, Vol. 347, No. 11, 2002, pp. 806\u2013815.\n722. Pridemore, William A., Adam Trahan, and Mitchell B. Ch"] [11.77975082397461, 21.902341842651367, " Community Members Exposed to World Trade Center Dust and Fumes,\u201d International Journal of Environmental Research and Public Health, Vol. 17, No. 18, 2020.\n732. Reibman, Joan, Nomi Levy-Carrick, Terry Miles, Kimberly Flynn, Catherine Hughes, Michael "] [11.784423828125, 21.898744583129883, "ng, and Joanna Legerski, \u201cEngagement in Trauma-Specific CBT for Youth Post-9/11,\u201d Journal of Emotional and Behavioral Disorders, Vol. 21, No. 1, 2012.\n743. Rodriguez, Jorge J., and Robert Kohn, \u201cUse of Mental Health Services Among Disaster Survivors,"] [11.784902572631836, 21.900880813598633, "4.\n753. Rubacka, Joseph M., James Schmeidler, Yoko Nomura, Rohini Luthra, Khushmand Rajendran, Robert Abramovitz, and Claude M. Chemtob, \u201cThe Relationship Between PTSD Arousal Symptoms and Depression Among Mothers Exposed to the World Trade Center At"] [11.784958839416504, 21.901838302612305, "\u201cGenetic Markers for PTSD Risk and Resilience Among Survivors of the World Trade Center Attacks,\u201d Disease Markers, Vol. 30, Nos. 2\u20133, 2011, pp. 101\u2013110.\n763. Sauler, Maor, and Mridu Gulati, \u201cNewly Recognized Occupational and Environmental Causes of C"] [11.784570693969727, 21.900676727294922, " Curve Analysis,\u201d BMC Psychiatry, Vol. 16, 2016.\n773. Sciancalepore, Roseann, and Robert W. Motta, \u201cGender Related Correlates of Posttraumatic Stress Symptoms in a World Trade Center Tragedy Sample,\u201d International Journal of Emergency Mental Health, "] [11.754335403442383, 21.86983871459961, "rs Associated With Mental Health Outcomes Among World Trade Center Disaster Evacuees,\u201d Disaster Medicine and Public Health Preparedness, Vol. 11, No. 3, 2017, pp. 326\u2013336.\n159\n784. Sherrieb, Kathleen, and Fran H. Norris, \u201cPublic Health Consequences o"] [11.80530834197998, 21.91162109375, ". Singh, A., R. Zeig-Owens, C. B. Hall, Y. Liu, L. Rabin, T. Schwartz, M. P. Webber, D. Appel, and D. J. Prezant, \u201cWorld Trade Center Exposure, Post-Traumatic Stress Disorder, and Subjective Cognitive Concerns in a Cohort of Rescue/Recovery Workers,\u201d"] [11.7752103805542, 21.902482986450195, "ggi, \u201cPotential Carcinogenic Effects of World Trade Center Dust After Intratracheal Instillation to Sprague-Dawley Rats: First Observation,\u201d American Journal of Industrial Medicine, Vol. 56, No. 2, 2013, pp. 155\u2013162.\n805. Sofka, Carla J., \u201cAssessing "] [11.777548789978027, 21.898530960083008, "e Barlev, Michael Marmor, and Marc Wilkenfeld, \u201cNeurologic Evaluations of Patients Exposed to the World Trade Center Disaster,\u201d Journal of Occupational and Environmental Medicine, Vol. 58, No. 11, 2016, pp. 1150\u2013 1154.\n816. Stecker, Mark, Jacqueline "] [11.780282020568848, 21.90201759338379, "irbrother, \u201cBehavior Problems in New York City\u2019s Children After the September 11, 2001, Terrorist Attacks,\u201d American Journal of Orthopsychiatry, Vol. 75, No. 2, 2005, pp. 190\u2013200.\n826. Stuber, Jennifer, Heidi Resnick, and Sandro Galea, \u201cGender Dispar"] [11.787513732910156, 21.90079689025879, " Allergy and Clinical Immunology, Vol. 113, No. 3, 2004, pp. 420\u2013426.\n835. Szema, Anthony M., Khalil W. Savary, Benjamin L. Ying, and Kevin Lai, \u201cPost 9/11: High Asthma Rates Among Children in Chinatown, New York,\u201d Allergy and Asthma Proceedings, Vol"] [11.781767845153809, 21.899581909179688, "ental Health Perspectives, Vol. 116, No. 10, 2008, pp. 1383\u20131390.\n845. Thorpe, Lorna E., Shervin Assari, Stephen Deppen, Sherry Glied, Nicole Lurie, Matthew P. Mauer, Vickie M. Mays, and Edward Trapido, \u201cThe Role of Epidemiology in Disaster Response "] [11.779189109802246, 21.899450302124023, "r, \u201cA Deese- Roediger-McDermott Study of Trauma Memory Among Employees of New York City Companies Affected by the September 11, 2001, Attacks,\u201d Annals of Clinical Psychiatry, Vol. 27, No. 3, 2015, pp. 165\u2013174.\n167\n856. Trout, Douglas, Ashok Nimgade, "] [11.781866073608398, 21.899477005004883, "re Science and Environmental Epidemiology, Vol. 27, No. 3, 2017, pp. 306\u2013312.\n865. van Gerwen, Maaike A. G., Stephanie Tuminello, Gregory J. Riggins, Thais B. Mendes, Michael Donovan, Emma K. T. Benn, Eric Genden, Janete M. Cerutti, and Emanuela Taio"] [11.781473159790039, 21.8994197845459, "juana Among Manhattan, New York, Residents After the September 11th Terrorist Attacks,\u201d American Journal of Epidemiology, Vol. 155, No. 11, 2002, pp. 988\u2013996.\n875. Vossbrinck, Madeline, Rachel Zeig-Owens, Charles Hall, Theresa Schwartz, William Moir,"] [11.782514572143555, 21.899696350097656, "e,\u201d Journal of Adult Development, Vol. 9, No. 4, 2002, pp. 241\u2013250.\n886. Warren, Tiffany, Shannon Lee, and Stephen Saunders, \u201cFactors Influencing Experienced Distress and Attitude Toward Trauma by Emergency Medicine Practitioners,\u201d Journal of Clinica"] [11.787039756774902, 21.89964485168457, ". 3, 2005, pp. 355\u2013374.\n896. Webber, Mayris P., Michelle S. Glaser, Jessica Weakley, Jackie Soo, Fen Ye, Rachel Zeig-Owens, Michael D. Weiden, Anna Nolan, Thomas K. Aldrich, Kerry Kelly, et al., \u201cPhysician-Diagnosed Respiratory Conditions and Mental "] [11.7872953414917, 21.90319061279297, "ger, et al., \u201cObstructive Airways Disease with Air Trapping Among Firefighters Exposed to World Trade Center Dust,\u201d Chest, Vol. 137, No. 3, 2010, pp. 566\u2013574.\n905. Weiden, Michael D., Sophia Kwon, Erin Caraher, Kenneth I. Berger, Joan Reibman, Willia"] [11.779158592224121, 21.90087890625, "m the World Trade Center Health Registry,\u201d Drug and Alcohol Dependence, Vol. 140, 2014, pp. 1\u20137.\n914. Welch, Alice E., Kimberly Caramanica Zweig, Jonathan M. McAteer, and Robert M. Brackbill, \u201cIntensity of Binge Drinking a Decade After the September "] [11.789121627807617, 21.903173446655273, "nals of Allergy, Asthma and Immunology, Vol. 126, No. 3, 2020.\n175\n924. Wisnivesky, Juan P., Susan L. Teitelbaum, Andrew C. Todd, Paolo Boffetta, Michael Crane, Laura Crowley, Rafael E. de la Hoz, Cornelia Dellenbaugh, Denise Harrison, Robin Herbert,"] [11.787693977355957, 21.902057647705078, "phen M. Friedman, and Hannah T. Jordan, \u201cProbable Posttraumatic Stress Disorder and Lower Respiratory Symptoms Among Rescue/Recovery Workers and Community Members After the 9/11 World Trade Center Attacks: A Longitudinal Mediation Analysis,\u201d Psychoso"] [11.78400993347168, 21.897624969482422, "ticulate that Settled Inside the Surrounding Buildings and Outside on the Streets of Southern New York City After the Collapse of the World Trade Center, September 11, 2001,\u201d Journal of the Air and Waste Management Association, Vol. 54, No. 5, 2004, "] [11.782825469970703, 21.89971923828125, "on/Irritants, Asthma Control, and Health-Related Quality of Life Among 9/11-Exposed Individuals with Asthma,\u201d International Journal of Environmental Research and Public Health, Vol. 16, No. 11, 2019.\n952. Yurt, Roger W., Palmer Q. Bessey, Nicole E. A"] [11.781886100769043, 21.900772094726562, "lan, et al., \u201cWorld Trade Center Disaster and Sensitization to Subsequent Life Stress: A Longitudinal Study of Disaster Responders,\u201d Preventive Medicine, Vol. 75, 2015, pp. 70\u201374.\n961. Zvolensky, Michael J., Roman Kotov, Clyde B. Schechter, Adam Gonz"] [14.979828834533691, 13.774786949157715, "her end users (child code)\n\u2013 Policymakers external to\nProgram (e.g., Congress or state governments) (child code)\n 181\n Program Documentation A Priori Codebook\n Focus Group Transcripts A Priori Codebook\n Interview Transcripts A Priori Codebo"] [14.925378799438477, 13.832144737243652, "rs, and advocacy on behalf of the Program (child code)\n\u2013 Informing Program/research planning (child code)\n\u2013 Informing individual health care decisions (child code)\n\u2013 Responding to future disasters (child code)\n\u2013 Guiding future research (child code)\n\u2013"] [11.778584480285645, 21.902271270751953, "fect Term* (\u201cWorld Trade Center\u201d OR WTC OR \u201cSeptember 11\u201d OR \u201cground zero\u201d) AND Exposure Term* (\u201cWorld Trade Center\u201d OR WTC OR \u201cSeptember 11\u201d OR \u201cground zero\u201d) AND Translation Term*\n 184\n*Terms were searched one at a time\ngovinfo\nLimit 2001\u2013present\n"] [14.909995079040527, 13.842796325683594, "lly think about the dust and everything else, cleanup, when young kids are 19, 20 years old now, that\u2019s to me I think about it constantly because I can\u2019t even imagine a juvenile rheumatoid arthritis.\nThere was general agreement across stakeholder com"] [14.917437553405762, 13.838711738586426, "ents most commonly described three criteria. They would prioritize research according to\n\u2022 what is most clinically relevant\n\u2022 who is affected\n\u2022 the \u201cfeasibility of being able to answer the question.\u201d\nOne researcher described what is meant by clinical"] [14.905844688415527, 13.852826118469238, "ntific question that\u2019s raised in the grant proposal or the contract proposal. It\u2019s about the feasibility of being able to answer the question. That\u2019s nothing new for the Federal Government or for any funding agency, but it will be of particular impor"] [14.873268127441406, 13.886492729187012, "Center Health Program Research Grantee Meeting, New York, June 2019.\nConnected Papers, homepage, undated. As of September 21, 2021: https://www.connectedpapers.com/\nCooper, Simon, Robyn Cant, Michelle Kelly, Tracy Levett-Jones, Lisa McKenna, Philippa"] [14.859016418457031, 13.906060218811035, "activity/hearings/hearing-on-examining-hr- 1786-james-zadroga-911-health-and-compensation\nHouse Committee on Energy and Commerce Democratic Staff, \u201cHearing on \u2018Examining H.R. 1786, the James Zadroga 9/11 Health and Compensation Reauthorization Act,\u2019\u201d"] [14.916653633117676, 13.829129219055176, "\u2019Brien, \u201cScoping Studies: Advancing the Methodology,\u201d Implementation Science, Vol. 5, 2010.\nLiberati, Alessandro, Douglas G. Altman, Jennifer Tetzlaff, Cynthia Mulrow, Peter C. G\u00f8tzsche, John P. A. Ioannidis, Mike Clarke, P. J. Devereaux, Jos Kleijne"] [14.90475845336914, 13.856038093566895, "1, 2020: https://www.niehs.nih.gov/research/programs/translational/resources/index.cfm\nNational Institutes of Health, \u201cCooperative Research Agreements Related to the World Trade Center Health Program (U01),\u201d PAR-12-126, March 23, 2012. As of Septembe"] [14.895660400390625, 13.870979309082031, "Categorization,\u201d ACM Computing Surveys, Vol. 34, No. 1, March 2002, pp. 1\u201347.\nSelker, Harry P., Laurel K. Leslie, June S. Wasser, Andrew G. Plaut, Ira B. Wilson, and John L. Griffith, \u201cTufts CTSI: Comparative Effectiveness Research as a Conceptual Fr"] [14.910593032836914, 13.846722602844238, "er 21, 2021: https://www.webtrends.com/\nWilczynski, Nancy L., R. Brian Haynes, John N. Lavis, Ravi Ramkissoonsingh, and Alexandra E. Arnold-Oatley, \u201cOptimal Search Strategies for Detecting Health Services Research Studies in MEDLINE,\u201d Canadian Medica"] [11.78405475616455, 21.897714614868164, "rking Group of New York City, 2011 Annual Report on 9/11 Health, New York, November 2011. As of September 20, 201: http://www.nyc.gov/html/doh/wtc/downloads/pdf/news/wtc-mwg-annual-report2011.pdf\nWTC\u2014See World Trade Center.\nYip, Jennifer, \u201cMental Hea"] [8.622601509094238, 4.0262932777404785, "Suggestions for Estimating the Effects of State Gun Policies\nCommentary on Four Methodological Problems in the Current Literature\nTERRY L. SCHELL, ROSANNA SMART, ANDREW R. MORRAL\n Sponsored by Arnold Ventures\n CORPORATION\nFor more information on this"] [8.730412483215332, 4.071606636047363, "ernative explanation is that different researchers may be using methods that are more or less appropriate to the gun policy topics they are investigating. Use of flawed or inappropriate methods can lead to incorrect conclusions, even among the most n"] [8.663691520690918, 4.005818843841553, "ve are publicly available on the project website at www.rand.org/gunpolicy.\nJustice Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being "] [8.77692699432373, 4.113707542419434, "uce Confounding .................................................15 Uncertain Control of Confounders..........................................................................................................17\n4. Ensuring That Key Model Assumptions Ar"] [8.755578994750977, 4.108136177062988, "). In this report, we discuss four common methodological problems that we observed in the gun policy literature and offer suggestions for how future research on gun policies should be conducted, reported, and evaluated.\nThis report is not intended as"] [8.763955116271973, 4.110021114349365, ". Some of these challenges are a result of the complexity of the policies being studied or limitations inherent in the available data. For example, classifying policies or laws involves trade-offs between increasing homogeneity among the policies who"] [8.83024787902832, 4.176074028015137, "or prespecified time points. If the policy effect is operationalized with multiple parameters (e.g., in hybrid models), researchers should present results as the joint effect of the multiple coefficients used to describe the effect. They should not t"] [8.86215877532959, 4.15702486038208, " biased\u2014if there are heterogeneous effects across units or time-varying policy effects.\nThe recommendation to control for confounders, however, should be balanced against the harms associated with overly complex models. Models that are more complex t"] [8.88455867767334, 4.208651542663574, "ch the treated unit on the outcome and other covariates in the pre-policy period, and the causal effect is estimated by assuming that, in the absence of treatment, the outcomes of the treated and weighted control units would have been identical.\nIn t"] [8.862374305725098, 4.177831172943115, " of independent, identically distributed residuals). Although some papers acknowledged these potential issues, they rarely provided empirical evidence to support the authors\u2019 preferred model specification. More often, papers reported several alternat"] [8.879268646240234, 4.157898902893066, "ings to represent a significance test. Moreover, blocking on the implementation year and the quality of the match, which is what has typically been done in this literature, leaves unaddressed\nxi\nseveral known sources of heteroscedasticity (e.g., matc"] [8.836921691894531, 4.144748687744141, " reviewed.\n\u2022 Recommendation 15. Some of the proliferation of alternative tests might be attributed to the curiosity of journal editors and reviewers who wish to see their own preferred specification reported and so require that it be added to article"] [8.575366973876953, 4.107635974884033, "s are needed to identify the effects of gun policies in a persuasive and replicable way. In this report, we identified four areas that we think may be most ready for these improvements and proposed some ways that these improvements might be made.\nxii"] [8.82156753540039, 4.178004264831543, "in-differences (DID) regression model, most commonly two-way fixed-effects models (i.e., including fixed effects for both the temporal and geographic units of analysis). Less\n1 Although not all guns are firearms, in this report, we follow conventiona"] [8.791956901550293, 4.07692813873291, "ression-based models to identify the effects of gun policies, synthetic control studies have become increasingly common. They also have a somewhat unique set of limitations and interpretational challenges that have not been clearly articulated in the"] [8.773283958435059, 3.982050657272339, "stard, 1997; Rosengart et al., 2005; Vernick and Hepburn, 2003) have published or shared their coding of laws, which allows for debate and improvement of the coding schemes, such coding often is not transparent and cannot be reviewed to determine acc"] [8.670604705810547, 4.072177886962891, "re being developed. These include\n\u2022 the RAND State Firearm Law Database, which, as of this writing, covers 1979 through January 2020 and includes 17 broad classes of state gun policies and many subcategories (Cherney et al., 2020)1\n\u2022 Boston Universit"] [8.849406242370605, 4.214301586151123, " used only about 20 times a year to remove firearms from someone who presented an imminent risk to themselves or others. It was not until after the Virginia Tech shooting in 2007 that the law started to be more widely used. With this pattern of uptak"] [8.868733406066895, 4.22288703918457, " there is no single effect size to report. In fact, for the linear splines used in much of the extant gun policy literature, these models assume that the policy of interest can have effects on the outcome that are extremely large in magnitude\u2014in some"] [8.850907325744629, 4.236173152923584, "hen the only effect of the policy is an immediate surge in crime following implementation within the treated units, the slope parameter will be negative, not positive.3 Standard frameworks for inferring causality from observations (e.g., Mill, 1843) "] [8.822349548339844, 4.304981708526611, "tion would be expected to become progressively more extreme after the policy is implemented\u2014the opposite of regression to the mean. In contrast, in data showing regression to the mean, a null hypothesis that the trend before a given\n 8\ndate equals th"] [8.874664306640625, 4.214725017547607, "e justified as the phase-in period of the policy\u2019s effect (e.g., as used in the preferred specifications in Donohue, 2004, and Schell, Cefalu, et al., 2020). Such splines are similar to dummy-coded variables but with a gradual rather than abrupt tran"] [8.779483795166016, 4.102950096130371, "ets these three requirements for interpreting the effects. However, in 2020, we and other researchers published a study of the effects of three gun laws that we believe does satisfy these criteria (see Schell, Cefalu, et al., 2020). In that paper, we"] [8.828702926635742, 4.212758541107178, " the model results as revealing policy effects. Although we focus this chapter on issues of confounding that are most relevant to estimating the causal effects of state firearm policies, these issues are not unique to the study of firearm policies an"] [8.705071449279785, 4.584042549133301, "2014; Ayres and Donohue, 2003; Donohue, 2003; Donohue, Aneja, and Weber, 2019; Grambsch, 2008; Kovandzic and Marvell, 2003; Kovandzic, Marvell, and Vieraitis, 2005; Lott and Mustard, 1997; Manning, 2003; Plassmann and Whitley, 2003; Rosengart et al.,"] [8.861860275268555, 4.1943817138671875, "ects of firearm policy and requires alternative approaches to those used most commonly in this literature. There are several methods that do not require parallel pre-trends in outcomes but instead assume that expected outcomes for states exposed and "] [8.809213638305664, 4.125529766082764, "resent in the outcome in the prior year. Thus, the model implies that law effects propagate forward in time even if the model does not contain an explicit effect of the law on the outcomes in those later years.\nIn general, if researchers include auto"] [8.845658302307129, 4.140625476837158, "d variable bias) in gun policy research (see, for example, Ayres and Donohue, 2009; Moody and Marvell, 2019), and many candidate confounders have been proposed as potentially important for ensuring valid estimates of a policy\u2019s effects. These candida"] [8.839301109313965, 4.173318386077881, "Determining which variables are potential confounders and which are\n2 In this context, collider refers to candidate covariates that may themselves be affected by implementation of the law and by changes in the outcome. Including colliders as covariat"] [8.863052368164062, 4.156650066375732, "r all predictors in the model. These problems are greatly exacerbated if one prunes variables based on standard levels of statistical significance (the default in many software packages) rather than on a criterion, such as cross-validated error or th"] [8.917852401733398, 4.24080753326416, " (2010)\u2014is the synthetic control method, which estimates the causal effect by comparing (1) one analytic unit (e.g., a state) that implemented a policy with (2) a weighted average of other comparison units that did not implement the policy. These wei"] [8.911599159240723, 4.239274024963379, "nt and control groups.\nHowever, in the gun policy research literature, the synthetic control studies that we examined did not attempt to balance on covariates that are thought to be associated with the treatment. Unless there are a large number of co"] [8.8982572555542, 4.246212482452393, "ng method in which treatment and control states are matched on those factors (Rubin, 1974). The Donohue, Aneja, and Weber (2019) synthetic control analyses achieved relatively good balance on the pre-implementation trends in the outcomes, but the tre"] [8.928474426269531, 4.247531890869141, " In fact, Kaul et al. (2018) showed that the optimization method used to estimate synthetic control weights results in all other covariates being ignored when all pre-treatment outcomes are included as predictors.\nResearchers using synthetic control "] [8.8352689743042, 4.18434476852417, "D, that combines features from both synthetic control and DID methods. Their approach (1) estimates unit-specific weights that define the synthetic control unit based on pre-treatment data, (2) estimates time-specific weights that define the syntheti"] [8.811219215393066, 4.140734672546387, "ss a variety of modeling approaches commonly used in gun policy evaluations to identify the approach that made the most-appropriate assumptions about the firearm mortality data. By design, that simulation study removed the possibility of selection bi"] [8.849281311035156, 4.164191246032715, "o severely underestimate the true uncertainty that two-thirds or more of effects known to have no systematic association with the outcome variable appear to be statistically significant, a share far higher than the 5 percent expected for significance"] [8.886642456054688, 4.197265148162842, "mber of states (or jurisdictions), in which case the standard clustering corrections may not yield accurate estimates of uncertainty (Conley and Taber, 2011; MacKinnon and Webb, 2017). Although a growing methodological literature has sought to derive"] [8.851492881774902, 4.168961524963379, " the pre-implementation period\n\u2022 for states with more-prevalent count outcomes (e.g., for states with higher homicide\nrates) or with dichotomous outcomes with prevalence closer to 50 percent.\nIn addition, the variance will depend on the specific year"] [8.85544204711914, 4.158848762512207, " on all these factors and still have sufficient permutations to get a useful estimate of the p value in an analysis of state-level panel data of gun violence. Without blocking on those factors, a gun law passed in a small state with a high prevalence"] [8.84815788269043, 4.1555094718933105, " two- tailed). In addition to the mathematical limit on the number of possible quantiles that can be estimated in the data, there is a broader question about the accuracy of those quantiles, given their estimation in such a small sample.\n2 Models tha"] [8.857200622558594, 4.142101764678955, "rarely used in the studies that we examined in The Science of Gun Policy. Additionally, such procedures further compromise statistical power, which might contraindicate their use in this field even if they are generally useful elsewhere. Because ther"] [8.827250480651855, 4.173608779907227, "ignificant effects may often get the direction of the effect wrong (Gelman and Carlin, 2014). These serious problems are common whenever the effects of interest are small relative to other sources of variation in the outcomes (Cohen, 1988).\nNeverthel"] [8.834299087524414, 4.166562557220459, "re generally, significance tests conducted on studies in which the effect size of interest is small relative to the standard error of the estimate provided by the available data have almost no chance of improving public policy and have a non-negligib"] [8.862480163574219, 4.137494087219238, "o discover are likely to be exaggerated in their magnitude and, in the worst cases, are almost as likely to be in the wrong direction as the right one (Gelman and Carlin, 2014). Insufficient power may be slightly less of a concern in studies that eva"] [8.831974029541016, 4.157149314880371, "licy literature that we reviewed often have substantially lower power because of even less-precise estimates of causal effects. The permutation test results from the synthetic control method studies included in our literature review correspond to an "] [8.728835105895996, 4.071093559265137, "to the lives of so many.\nFurthermore, we have not offered a comprehensive primer on estimating gun policy effects but instead focused our discussion on a few common problems that we have seen repeatedly in the gun policy research studies that we have"] [8.798417091369629, 4.05365514755249, "ven those with a good number of studies seemingly confirming their effects.\nYet these limitations of the available evidence should not be seen as an excuse for inaction by policymakers. When strong empirical evidence of the effects of policies is ava"] [8.853206634521484, 4.218791961669922, "ssion equation that takes on values of zero before the policy was implemented (as well as in states that never implemented it) and then takes on values that increase linearly over time for a given state once the policy is implemented in that state. F"] [8.890395164489746, 4.2437849044799805, "1 2000 30 10 1 2001 31 11 1\n 36\nReferences\nAbadie, Alberto, \u201cUsing Synthetic Controls: Feasibility, Data Requirements, and Methodological Aspects,\u201d Journal of Economic Literature, Vol. 59, No. 2, 2021, pp. 391\u2013425.\nAbadie, Alberto, Alexis Diamond,"] [8.849452018737793, 4.252730846405029, "vi Feller, and Jesse Rothstein, \u201cThe Augmented Synthetic Control Method,\u201d Journal of the American Statistical Association, Vol. 116, No. 536, 2021a, pp. 1789\u20131803.\n\u2014\u2014\u2014, Synthetic Controls with Staggered Adoption, Cambridge, Mass.: National Bureau of "] [8.80868148803711, 4.254513740539551, ",\u201d Causal Inference: The Remix, March 8, 2021.\nDaw, Jamie R., and Laura A. Hatfield, \u201cMatching and Regression to the Mean in Difference-in- Differences Analysis,\u201d Health Services Research, Vol. 53, No. 6, December 2018, pp. 4138\u2013 4156.\nde Chaisemarti"] [8.628000259399414, 4.317120552062988, "tational Statistics, Vol. 15, No. 3, September 2000, pp. 373\u2013390.\nGibbons, Charles E., Juan Carlos Sua\u0301rez Serrato, and Michael B. Urbancic, \u201cBroken or Fixed Effects?\u201d Journal of Econometric Methods, Vol. 8, No. 1, 2019.\nGiffords Law Center to Preven"] [8.744794845581055, 4.247753143310547, "d Kevin Lang, \u201cThe Promise and Pitfalls of Differences-in-Differences: Reflections on 16 and Pregnant and Other Applications,\u201d Journal of Business & Economic Statistics, Vol. 38, No. 3, 2020, pp. 613\u2013620.\nKaul, Ashok, Stefan Klo\u0308\u00dfner, Gregor Pfeifer,"] [8.396588325500488, 4.3350677490234375, "ess, 2003, pp. 331\u2013341.\nManski, Charles F., and John V. Pepper, \u201cHow Do Right-to-Carry Laws Affect Crime Rates? Coping with Ambiguity Using Bounded-Variation Assumptions,\u201d Review of Economics and Statistics, Vol. 100, No. 2, 2018, pp. 232\u2013244.\nMcShan"] [8.531933784484863, 4.144667625427246, "sis of Research Evidence on the Effects of Gun Policies in the United States, Santa Monica, Calif., RR-2088-RC, 2018. As of December 30, 2021:\nhttps://www.rand.org/pubs/research_reports/RR2088.html\nRiley, Richard D., Kym I. E. Snell, Joie Ensor, Dani"] [8.598929405212402, 4.221160411834717, "orporation, TL-354-LJAF, 2020. As of May 29, 2021: https://www.rand.org/pubs/tools/TL354.html\nShadish, William R., Thomas D. Cook, and Donald T. Campbell, Experimental and Quasi- Experimental Designs for Generalized Causal Inference, 2nd ed., Boston,"] [8.83504581451416, 4.234911918640137, "shington, D.C.: Brookings Institution Press, 2003, pp. 345\u2013402.\nWasserstein, Ronald L., Allen L. Schirm, and Nicole A. Lazar, \u201cMoving to a World Beyond \u2018p < 0.05,\u2019\u201d American Statistician, Vol. 73, Supp. 1, 2019, pp. 1\u201319.\n46\nWegman, Edward J., and Ia"] [0.36478304862976074, 6.087376117706299, "Spending Trajectories After Age 65\nVariation by Initial Wealth MICHAEL D. HURD, SUSANN ROHWEDDER\n Sponsored by Insight Investment\n CORPORATION\nFor more information on this publication, visit www.rand.org/t/RRA2355-1.\nAbout RAND\nThe RAND Corporation i"] [0.3651174008846283, 6.090665340423584, "iversity of Michigan Health and Retirement Study. The report presents estimates of the trajectories of spending after age 65 among single and coupled households stratified by wealth holdings observed at or closely following age 65. The estimated traj"] [0.36514994502067566, 6.084751129150391, "recognize that spending needs are not constant over the course of retirement. Furthermore, there is heterogeneity across households with respect to the evolution of spending with age. Many households may be able to anticipate the cost of their desire"] [0.3647146224975586, 6.082938194274902, "hange to help determine adequate saving rates during the working life and affordable spending levels during retirement.\nFigure S.1. Estimated Spending Trajectories for Single Households\n Percent of total spending at age 65\n100\n 90\n 80\n 70\n 60\n 50"] [0.36497601866722107, 6.082755088806152, "..............................28 Appendix F. Spending Path Parameters, Median Regressions......................................................31 Appendix G. Sensitivity of Results to Estimation Method ................................................"] [0.3647937476634979, 6.082681655883789, " Quartile............................27 Table E.1. Budget Shares of Single Households...........................................................................28 Table E.2. Budget Shares of Coupled Households........................................."] [0.36463695764541626, 6.083130359649658, " the surviving spouse: At advanced old age, the marginal utility of wealth to the surviving spouse declines because of their short life expectancy, causing the couple to consume more earlier. Furthermore, the spending path of the household will decli"] [0.36573854088783264, 6.086630344390869, "ending on some categories will decline with age, they will bring spending forward, which would steepen any decline due to mortality risk.1\nAn alternative explanation for declining budget shares is a worsening of economic resources with age, which wou"] [0.36497771739959717, 6.08835506439209, "mortality and possible cohort differences. A long-running panel is necessary because of macro shocks that could dominate over short periods. Furthermore, we use data on the detailed composition of spending to study budget shares and what those might "] [0.3644361197948456, 6.083079814910889, " categories were split to distinguish spending on goods versus spending on services. CAMS waves 2005 through 2019 queried spending in 39 categories.\n 4\nAnalytic Sample and Derivation of Initial Wealth Quartile\nWe derive our analytic sample in two st"] [0.3642522096633911, 6.082539081573486, "seholds in our analytic sample come from multiple birth cohorts, spanning birth years 1917 to 1952 (median: 1936); therefore, the year when individuals in our sample were observed near retirement (ages 65 through 69) varies. To summarize households\u2019 "] [0.3642794191837311, 6.08236026763916, " Lowest\n \u221283,791\n 4,582\n \u22123,660\n 0\n \u22124,916\n 0\n 2nd\n 5,000\n 101,812\n 34,818\n 20,362\n 3,188\n 0\n 3rd\n 104,887\n 411,600\n 214,420\n 193,443\n 68,314\n 54,978\n Highest\n 418,244\n 6,545,000\n 1,301,632\n 712,745\n 722,853\n "] [0.3641536235809326, 6.082484722137451, "ingle Households\n Age Band\nTable 2.2. Annual Household Spending\nInitial Wealth Quartile Lowest 2nd 3rd\nMeans\nHighest All\n50,698 34,687 49,276 34,520 47,976 32,824 46,293 32,956 47,912 33,578\n40,731 28,505 39,226 27,446 38,998 26,963 35,776 26,094"] [0.3644333779811859, 6.082302093505859, "0.0%\n8.0% 6.0% 4.0% 2.0% 0.0%\nUtilities\n 65-69\n70-74 75-79 80+ lowest highest\n 9\n Single Households Coupled Households\n 20.0% 18.0% 16.0% 14.0% 12.0% 10.0%\n8.0% 6.0% 4.0% 2.0% 0.0%\nGifts and donations\n 65-69\n70-74 lowest\n75-79 "] [0.3643743395805359, 6.082466125488281, ".1 shows real two-year spending changes for couples and singles, by age band, over years 2005 to 2019, or seven changes. To reduce the influence of outliers, we show medians within age-band-wave cells of the rates of change. The changes are calculate"] [0.36597341299057007, 6.082011699676514, "west quartile as reference. The three specifications differ in how age is modeled. In the columns labeled \u201cAge Bands,\u201d age is entered as categorical variables with ages 65 through 69 as reference. In the \u201cAge Continuous\u201d columns, age is entered linea"] [0.36627212166786194, 6.092051982879639, "088 0.0097\n0.0102\n 2nd 3rd Highest\nMale spouse\u2019s age 65\u201369\n70\u201374 75\u201379 80+\nMale spouse\u2019s age\u201465\nFemale spouse\u2019s age is 2+ years less than male spouse\u2019s age Constant\n0.0246 0.0185 0.0101 0.0176 0.0099 0.0183\n(Ref.) (Ref.) 0.0309* 0.0176\n\u22120.0142 "] [0.3645212650299072, 6.083536148071289, "uding age bands as controls\n Percent of spending at age 65\n 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90\n 100\n 90\n 80\n 70\n 60\n 50\n 40\n 30\n 20\n 10\n 0\nOLS estimation, linear age control\n Percent of total sp"] [0.365604043006897, 6.083918571472168, "icted spending path for households in which female spouse\u2019s age is less than two years younger than the male.\n Percent of spending at age 65\n65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 lower mid upper\n 18\nC"] [0.36543384194374084, 6.084564208984375, "d a fixed effects estimator and modeled spending as a quadratic in age. However, the fitted shape of the spending path in a quadric specification will be dominated by the large sample sizes at younger ages, thus obscuring the spending declines at old"] [0.3672904372215271, 6.09583854675293, "ctories, are based on historical rates of change. Although our choice of functional forms and explanatory variables are informed by economic reasoning, our data are not fit to a structural model based on utility maximization with explicit modeling of"] [0.3649139106273651, 6.0849609375, "g panel of the HRS, we estimated survival differentials by age, sex, marital status, and education. According to our estimates, a single female lacking a high school education has a 50 percent chance of surviving to about age 80; a married female wit"] [0.36816099286079407, 6.107114791870117, "dual trajectories would average out to the population average of \u22120.04. Separating the models requires linking together individual-level rates of change over more periods and the direct modeling of individual heterogeneity. This in turn requires a mo"] [0.36564454436302185, 6.086993217468262, "dget constraints because even those in the top quartile, who are the least constrained, exhibit a declining path. We used the variation in budget shares to support an alternative hypothesis: Worsening health associated with aging causes declining mar"] [0.36463847756385803, 6.082204818725586, "\n sizes across age bands are insufficient for robust statistical analyses.\n24\nAppendix B. CAMS Spending Categories\nThe CAMS elicits household spending in 39 categories, which we aggregated into broader categories (see Table B.1).\nTable B.1. Aggregat"] [0.36508652567863464, 6.083196640014648, "tion.\nTable C.1. Persistence of Wealth Quartile Between Ages 65 Through 69 and 70 Through 74\nWealth Wealth Quartile, Ages 70 Through 74 Quartile,\nAges 65\nThrough 69 Lowest 2nd 3rd Highest All\nLowest 20.8 5.1 1.2 0.2 27.4 2nd 6.3 13.8 5.1 1.1 26.3 3rd"] [0.36424943804740906, 6.08207893371582, "7 0.9\nDurables 0.7 0.7\nHousing 26.2 22.1\nTransportation 13.8 16.4\nHousehold\nsupplies and 4.6 3.8 services\nUtilities 16.8 16.7 Health 9.9 12.4\n0.9 1.4\n0.7 0.8 21.1 23.5 13.7 13.6\n4.8 4.1\n14.9 12.2 13.1 11.2\n7.6 11.2\n16.9 14.5 1.7 1.8\n1.0 0.7 0.7\n0.7 1"] [0.36439064145088196, 6.086981773376465, "0.0 1,936 161\nQuartile\n2nd 3rd Highest All\n18.0 18.3 16.4 17.5 1.8 1.5 1.3 1.5\n2.7 3.3 3.5 3.0\n1.4 1.4 1.4 1.5 100.0 100.0 100.0 100.0 320 401 491 1,373\n Trips and vacation\n1.7\nPersonal care 1.6\nTotal 100.0\n n 281\nSOURCE: Authors\u2019 "] [0.367512047290802, 6.104408264160156, "Single Households\n spending at t in each age band\n\u2022 median spending ratio at the population level: S med , where S med is the population median\nSt t+2\nSmed t t\n 100\n 90\n 80\n 70\n 60\n 50\n 40\n 30\n 20\n 10\n 0\n female\nmale female Low"] [0.3655506372451782, 6.096524715423584, "irement Study: Data Quality and Early Results, 1995.\nRAND Corporation, \u201cRAND HRS CAMS Data File 2019 (V1),\u201d dataset produced by the RAND Center for the Study of Aging, January 2022a.\nRAND Corporation, \u201cRAND HRS Longitudinal File 2018 (V2),\u201d dataset p"] [9.605276107788086, -1.834992527961731, "Selecting and Evaluating Case Studies of the Economic Benefits of Research and Services at the National Institute for Occupational Safety and Health\nCase Studies on Personal Dust Monitors for Coal Miners, Improved Ambulance Design, and Amputation Sur"] [12.643470764160156, 13.54572868347168, "mental Policy\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was conducted in t"] [9.552170753479004, -1.8383804559707642, "............................................................. 13 The Cost of Black Lung ......................................................................................................................... 14 Overview of NIOSH\u2019s Activities Relate"] [9.588399887084961, -1.8042012453079224, "s Findings .............................................................................................. 113 Summary of Case Study Findings ........................................................................................................ 113 "] [9.446989059448242, -1.6073298454284668, "........................................................... 70 Figure 3.10. Avoided Injuries per Year Will Increase as New Ambulances Become More\nPrevalent over Time....................................................................................."] [9.54500961303711, -1.8816633224487305, "and Productivity Losses Attributable to Individual\nCases of Fatal and Nonfatal Respiratory Disease ................................................................. 43 Table 2.9. Estimated Avoided Medical Costs and Productivity Losses for Cases of Fa"] [9.490641593933105, -1.940078616142273, "................................. 103\nTable 4.6. Incidence Rate Ratios of Poisson Regression of Total Initial Penalties with\nIncreasing Controls, 2003\u20132018 ......................................................................................... 106\n"] [9.525545120239258, -1.9084911346435547, "h three exploratory case studies. This report builds upon that work by developing a process for selecting case studies for evaluation, applying that selection process to a list of ten potential case studies, and selecting three case studies from this"] [9.416605949401855, -1.5641030073165894, "al cases avoided by age 73 or 85 and whether a 3-percent or 7-percent discount rate is used.\nIn the Improved Ambulance Design case, NIOSH\u2019s impact on ambulance design has been the result of a steady stream of partnerships with stakeholders. NIOSH has"] [10.601858139038086, 13.044549942016602, "assachusetts. The program also provided better information on the extent of amputations in Michigan and in which industries and firms amputations had occurred that were not reported in other sources.\n\u0000 While our estimates are not causal, if we assume"] [9.557899475097656, -1.8595396280288696, "ntion coal mine dust personal sampler unit chronic obstructive pulmonary disease continuous personal dust monitor\nCoal Workers\u2019 Health Surveillance Program\ncoal worker\u2019s pneumoconiosis, a.k.a. \u201cblack lung\u201d Department of Transport\nEnhanced Coal Worker"] [9.622454643249512, -1.842854380607605, "e difficult to accurately quantify the impact of activities on the underlying risk or associated outcomes. Second, benefits may not accrue until many years in the future. Third, much of NIOSH\u2019s work is done in collaboration with many government, acad"] [9.598272323608398, -1.8396682739257812, "tween them. RAND decided which case studies to pursue, although as the methodology clearly notes, NIOSH\u2019s institutional priorities were one of several important factors in determining which cases to evaluate in detail. Given the need for detailed inf"] [9.804469108581543, -2.0044972896575928, "f activities aimed at producing outputs that will help mitigate the hazard. Examples of NIOSH activities include research, surveillance, and training. These activities lead to outputs such as new information about the causes of a hazard, the identifi"] [9.596078872680664, -1.8465031385421753, "s is exposed, such as a case study that evaluates the impact of several activities aimed at reducing a certain type of injury for a certain type of worker. Alternatively, a case might group several related hazards, such as a case study that evaluates"] [9.586170196533203, -1.838426113128662, "observed an increase in prevalence of coal workers\u2019 pneumoconiosis (CWP, or \u201cblack lung\u201d) in 2005, 2006, and 2007 (and more cases in younger miners).\nOil and gas workers can be exposed to hydrocarbon gases and vapors (HGV) and oxygen (O2)-deficient a"] [9.593156814575195, -1.8131580352783203, " loss is the most common occupational disease among workers in the mining industry. Hazardous noise exposures are more prevalent in this sector than in any other major U.S. industrial sector. NIOSH studies have shown that ca. 90% of coal miners and 4"] [9.587806701660156, -1.8451205492019653, "s provided funds to start regional safety training programs for commercial fishermen, although NOAA funding ended many years ago. Today, most funding comes from the Coast Guard, NIOSH, course fees, and locally raised funds.\n 7\nMethod for Selecting"] [9.574280738830566, -1.8418852090835571, "t areas of particular interest to NIOSH. Another institutional factor might be the consideration of which case studies NIOSH can complete in-house versus which case studies are best suited for evaluation by an external independent research organizati"] [9.525049209594727, -1.736570954322815, "of nine recorded fatalities (and an unrecorded number of injuries) between January of 2010 and March of 2015. New industry standards and proposed changes to federal regulations could promote safer methods for crude oil measurement, but even the large"] [4.8322343826293945, 13.77695369720459, "eletal Diseases in Poultry Processing Plants, Reduction in Exposure to Hazardous Drugs in Health Care, and Alaska Commercial Fishing Training\u2014were deemed likely to face significant feasibility challenges, and thus appear on the right-hand side of the"] [9.518280029296875, -1.9088863134384155, "that would be selected should each evaluate different groups of workers to meet priorities over balance; hence we would need to choose between the two cases related to mining. We selected Personal Dust Monitors for Coal Miners over Mining Hearing Los"] [9.477681159973145, -1.9555275440216064, " Co., Inc. (R&P), allows miners to take corrective actions based on these measurements to reduce occupational exposure to respirable coal mine dust. NIOSH, through an informal partnership with industry, labor, and MSHA, collaborated in product develo"] [9.510353088378906, -1.919029712677002, "e coal mine dust. Finally, we provide estimates of the economic benefits of the illnesses and fatalities likely to be averted due to the adoption of CPDMs and consider NIOSH\u2019s role in contributing to these benefits.\nThe Cost of Black Lung\nThe costs t"] [9.500321388244629, -1.9240574836730957, "9), which established the Mining Enforcement and Safety Administration within the Department of the Interior. The Coal Act established a mandatory federal exposure limit for the average concentration of respirable dust in underground coal mines of 3."] [9.50968074798584, -1.9218605756759644, " exams to miners in the field and provide early detection of dust-related pulmonary disease, as well as target additional areas for prevention. Both surveillance programs are provided at no cost to miners, but participation is voluntary.\nThrough the "] [9.478672981262207, -1.950817346572876, " industry, labor, and MSHA to develop and test the\nprototype devices in laboratory and mine settings.\n2004\u20132008 NIOSH published two reports demonstrating the CPDM provided accurate readings of a miner\u2019s dust exposure and was wearable and durable duri"] [9.460153579711914, -1.971962809562683, " monitors\u2014and once the technology has been verified, to use these monitors in conjunction with other sampling methods for surveillance.\nIn response to the first report, NIOSH\u2019s Pittsburgh Research Center (PRC) initiated the development of a fixed-sit"] [9.437960624694824, -1.9919005632400513, "o Fisher Scientific conducted regional workshops in 2010 to help coal miners learn how to use the new instrument. NIOSH awarded another contract to Thermo Fisher Scientific in 2012 to revise the design and make the device lighter to carry. A modified"] [9.47189998626709, -1.9585946798324585, " CPDMs in April 2016. In August 2016, MSHA lowered the PEL for respirable coal mine dust from 2.0 mg/m3 to 1.5 mg/m3 of air for underground and surface coal mines, and from 1.0 mg/m3 to 0.5 mg/m3 for intake air at underground mines and for Part\n90 mi"] [9.472742080688477, -1.960742712020874, " furthest away when\ndownwind of the continuous miner\n\u0000 Staying out of the return air when not bolting\n\u0000 Alternating changing of dust collection bags so that\none person is not getting all of this specific unavoidable dust exposure\n\u0000 Rock dusting more "] [9.474658966064453, -1.9560127258300781, "s of NIOSH\u2019s technological contribution to reducing the risk of exposure to high concentrations of respirable coal mine dust, we compare the reduction in negative health outcomes associated with observed reductions in exposure levels and the reductio"] [9.472208023071289, -1.9588706493377686, "tion into categories that will later be used as the framework for estimating changes in exposure. Not all miners are exposed to high concentrations of respirable coal mine dust. In the regulatory analysis for the coal mine dust rule, MSHA estimated t"] [9.465418815612793, -1.965467929840088, "ile we do not have sufficiently detailed information to identify coal rank for each individual mine in MSHA\u2019s Mines dataset, we use the distribution of WLs by coal rank within each occupation from MSHA\u2019s QRA (MSHA, 2013).8 To estimate the distributio"] [9.450441360473633, -1.9826525449752808, "nce\nLow-/Med.- High-Rank\nRank Bituminous Anthracite\nMid-Recurrence\nLow-/Med.- High-Rank\nRank Bituminous Anthracite\nHigh-Recurrence\n Auger Operator\nContinuous Miner Operator\nCutting Machine Operator\nDrill Operator\nElectrician and Helper\nLaborer\nLoad"] [9.46751880645752, -1.9600943326950073, " July 2016, operator samples were collected using the CPDM, and the PEL was 2.0 mg/m3 of air (1.0 mg/m3 for Part 90 miners).\n3. From August 2016 to December 2018, operator samples were collected using the CPDM, and the PEL was 1.5 mg/m3 of air (0.5 m"] [9.459966659545898, -1.968891978263855, "ample these occupations during mine inspections. Prior to 2016, operator samples accounted for slightly more than half of all samples collected, but due to increased sampling requirements operator samples now account for more than 80 percent of all s"] [9.465842247009277, -1.9646480083465576, "3 1.009 0.913 0.886 1.168 1.614 0.939 1.223 1.288 1.315 0.475\nHigh-Recurrence\n1.527 1.126 1.270 \u2013\n\u2013 1.781 \u2013 1.341 1.497 1.444 \u2013 0.969 1.218 1.658 2.839 1.390 \u2013\n\u2013 2.660 0.708\n Auger Operator 0.645 Continuous Miner Operator 0.525 Cutting Machine Operat"] [9.421238899230957, -2.0144171714782715, "y selectively sampling on lower production shifts/days because a higher number of valid samples was required for each calendar quarter.\nTable 2.5. Number (and Percentage) of Coal Dust Samples Exceeding the PEL\n Population\nSurface workers\nUnderground "] [9.463091850280762, -1.9679551124572754, "rue for occupations that collect relatively few samples each period. For groups such as \u201cother underground workers,\u201d the distribution of measurements varies considerably over time because it reflects a different mix of job titles and tasks each perio"] [9.464690208435059, -1.9669207334518433, "were able to continually monitor the device to make decisions to continue working.\nAn alternate explanation is that the data reflect a downward bias in the operator samples prior to 2016. In practice, while equivalent in accuracy to CMDPSUs, CPDMs le"] [9.467601776123047, -1.9665447473526, "ay, this implies that sampling using CPDMs may occur for as little as two to four weeks for a designated occupation during a calendar quarter. However, the benefits of lessons learned through end-of-shift measurements and adoption of better work prac"] [9.469626426696777, -1.967380166053772, "ary to July 2016 because we use quarterly and not monthly data due to sampling limitations and because most mines delayed the adoption of CPDMs until April 2016. Therefore, we use the second and third calendar quarters of 2016 to estimate the impact "] [9.47909164428711, -1.9544366598129272, "ponse to using CPDMs (Haas and Colinet, 2018).\nThe before and after estimation is calculated as follows:\n\u0000\u0000 \u0000 \u0000\u0000 \u0000 \u0000\u0000\u0000\u0000\u0000\u0000\u0000 \u0000 \u0000\u0000\u0000\u0000\u0000\u0000\u0000 \u0000 \u0000\u0000 \u0000 \u0000\u0000 (Equation 1)\nwhere Ct is the average dust concentration at time t, \u00000 is a constant, \u0000PDM equals 1 if a sam"] [9.478307723999023, -1.9534600973129272, ".e., areas with a high number of exceedances).21 This effect is attributable to the CPDM providing both continuous real-time measurement that allows miners to move further away from the source and end-of-shift measurements that allow miners to take c"] [9.497576713562012, -1.9334497451782227, "disease per 1,000 miners. Based on these models, we estimate impacts for five major adverse health conditions:\n1. CWP category 1 (CWP 1+): Based on the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconio"] [9.472709655761719, -1.9591246843338013, " NMRD.\nFirst, we estimate the number of excess cases of morbidity and mortality due to respiratory disease over a 45-year job tenure, from age 20 to 65, under baseline mining conditions compared with the probability of death without occupational expo"] [9.496848106384277, -1.9337892532348633, " equivalent to a 5.4 percent reduction in exposure to respirable coal mine dust. We also present a sensitivity analysis showing the effect of using a relatively higher estimate of a 9.2 percent reduction, which is between the 5.4 and 13.0 percent est"] [9.517186164855957, -1.9147909879684448, " and new workers entering the workforce.26 The benefits of using a single probability distribution are twofold: it avoids the need to make additional assumptions about workforce replacement and disease latency and progression, and estimates a smooth,"] [9.53445053100586, -1.909550666809082, "nek, 2019). Many miners wait until near retirement age (around their late 50s) before seeking diagnosis or treatment for CWP or starting the process of qualifying for federal black lung benefits.29 Therefore, we use 20 as an approximation for years o"] [9.5303373336792, -1.9026758670806885, " is not considered to be disabling, but likely will result in a significant health impediment for coal miners. PMF and severe emphysema can both result in totally disability and inability to work. For cases of CWP 2+, PMF, and COPD, we use estimates "] [9.528935432434082, -1.9003132581710815, "r cases of CWP 1+ based on the value of lost workday injury. For cases of CWP 2+, we use an estimate of approximately $490,000 (in 2018 dollars) from the EPA\u2019s Office of Air and Radiation for avoided cases of chronic bronchitis (EPA, 2011b). For case"] [9.477791786193848, -1.9568184614181519, " attribute a specific percentage of the monetized benefits of MSHA\u2019s coal mine dust rule to NIOSH. Furthermore, it is challenging to separate the impacts of requiring the use of CPDMs and mandating a reduction in the PEL as both provisions of the rul"] [9.507601737976074, -1.9601885080337524, "e risk models described in this chapter, this larger estimated reduction results in approximately a 40-percent increase in the number of cases of fatal and nonfatal respiratory disease prevented and a corresponding 40- to 45-percent increase in monet"] [9.495587348937988, -1.9344600439071655, "eved and after 40 years approximately 95 percent of the steady state benefits will be achieved.\n 47\nmonetized benefits by approximately 25 to 45 percent. This range is relatively large because it represents the estimated monetized benefits using disc"] [9.483871459960938, -1.950125813484192, "ed) if they deactivate or disable their proximity reader to ensure they get valid dust samples using the CPDM. Current regulations require both detectors and CPDMs be worn. NIOSH is also conducting research on techniques that can be used to mitigate "] [9.457517623901367, -1.6290158033370972, "ons linked to CPDMs would have been less likely to occur. It is unlikely similar technology would have been developed without NIOSH. The technology has now been available for more than a decade and no other countries, or other manufacturers within th"] [9.391573905944824, -1.532822847366333, "ure 3.2, those individuals make up the majority of injuries. This report focuses on ambulance occupants.\n51\nFigure 3.1. The Number of Ambulance Crashes Is Slowly Increasing over Time\n \u0000\u0000\u0000\u0000\u0000\u0000 \u0000\u0000 \u0000\u0000\u0000\u0000\u0000\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\u0000\u0000\u0000\n\u0000\n "] [9.389327049255371, -1.5292226076126099, "heir jobs while wearing standard safety restraints (Larmon, LeGassick, and Schriger, 1993). This has led many to work unrestrained in the patient compartment. In serious crashes investigated by NHTSA, 84 percent of EMS providers in the patient compar"] [9.417671203613281, -1.5643742084503174, ": A Survey on Ambulance Patient Compartment Safety,\u201d Journal of Emergency Medical Services, Vol. 32, No. 3, 2007, pp. 86\u201390.\nCurrent, R. S., P. H. Moore, J. D. Green, J. R. Yannaccone, G. R. Whitman, and L. A. Sicher, \u201cCrash Testing of Ambulance Chas"] [9.394708633422852, -1.534191370010376, "uctural Integrity Test to Support SAE J3027 Compliant Litter Systems\u201d\nNIOSH, Improving EMS Worker Safety in the Patient Compartment, Washington, D.C.: Department of Homeland Security, 2017.\nReichard, Audrey A., Suzanne M. Marsh, Theresa R. Tonozzi, S"] [9.403984069824219, -1.5445812940597534, "stry-standard 30 mph crash test setting. The researchers performed frontal, side, rear, and rollover crash tests. The resulting data allowed researchers to reconstruct and publish the \u201ccrash pulse\u201d for each crash type. The published crash pulses now "] [9.414344787597656, -1.560110092163086, "ted, manufacturers would provide new, stronger prototype components as test assets. This iterative process allowed the test procedures to be tested and refined while also providing manufacturers with the opportunity to\n41 For more information, see NI"] [9.407036781311035, -1.5525529384613037, ".S. Army Tank Automotive Research, Development and Engineering Center\n 42 Assessment based on an interview with Jim Green of NIOSH on June 21, 2019.\n43 Assessment based on an interview with an equipment manufacturer on April 10, 2019.\n44 Assessme"] [9.391702651977539, -1.5327132940292358, "ated there were 240,800 full-time employed EMTs and paramedics (NIOSH, 2019b). In addition to EMS workers, members of the general public ride in the patient compartment as patients or when accompanying a patient.\nAn alternative way to think about the"] [9.39190673828125, -1.539440393447876, " truck chassis and Type III is mounted on a van chassis. Type II ambulances do not have a box-shaped patient compartment, but instead use a van chassis with a raised roof.\n 59\nseveral data sources to reach reasonable assumptions on these issues. Howe"] [9.396403312683105, -1.5402649641036987, "on is included in the estimate of 22.9 million trips, and if the average air ambulances transport just as many patients per day as the average ground ambulance, then\n22.4 million of the trips are ground transportation ambulances. This is a conservati"] [9.389545440673828, -1.530428409576416, "t there were approximately 36.1 million (22.4 million + 13.7 million) ambulance trips in 2016.\nStep 3: Estimate the Current Rate of Injuries and Fatalities in the Patient Compartment\nWe use data from NASS-GES and FARS to measure the current rates of "] [9.387965202331543, -1.5289462804794312, "om 2002 to 2015.54 An estimated additional 291 front seat ambulance passengers were injured and an average of 1.1 killed per year from 2002 to 2015. Patient compartments accounted for an estimated 332 injuries and an average of 5.8 fatalities per yea"] [9.38667106628418, -1.5270072221755981, " Injuries are indeed more severe when the ambulance is traveling faster, although high-speed crashes are rare. Some crashes occur when the ambulance is at a complete stop and is struck by another vehicle.\n65\nWe estimated urban and nonurban injury rat"] [9.39596176147461, -1.537033200263977, "whether the road on which the crash occurred is urban or rural. We categorize crashes that occur on urban roads as attributed to \u201curban\u201d areas, and crashes that occur on rural roads as attributed to \u201cnonurban\u201d areas. These allocations are imperfect a"] [9.384580612182617, -1.524616003036499, "ering all the redesign elements in aggregate. The alternative restraints were more successful than traditional lap belts in preventing injuries, but in some cases testing dummies still contacted other interior elements of the ambulance during crash s"] [9.379443168640137, -1.5188462734222412, "es in replacement rates are caused by differences in usage rates; urban ambulances accumulate miles far faster than rural vehicles due to more frequent usage. Based on the date SAE standards were issued and the fact that redesigned ambulances are now"] [9.384557723999023, -1.5232007503509521, "\nSerious Injury\nFatal Injury\nInjured, Unknown Severity\nAlternative Distribution 3:\nSeat Belt Literature (Non\u0000Urban)\n84.6%\n8.6%\n4.3%\n1.4%\n0.5%\n0.6%\nAlternative Distribution 3:\nSeat Belt Literature (Urban)\n84.8%\n8.7%\n4.3%\n1.5%\n0.1%\n0.6%\nAlternative Dis"] [9.375160217285156, -1.5152655839920044, "mbulances reduce the number of injuries in each severity category by a fixed percentage. The standards introduced by NIOSH, as well as the design changes made by the manufacturers NIOSH partnered with, made a wide variety of changes to improve the sa"] [9.37209415435791, -1.4943057298660278, "than 10-percent reduction in fatalities to over 80-percent reduction in fatalities. We base our assumption for fatality risk on two more recent studies. NHTSA (2000) found seat belts reduce fatalities in light trucks by 60 percent, with uncertainty r"] [9.380881309509277, -1.518993616104126, " not have sufficient data to differentiate between patients and workers in modeling reductions in injury associated with new restraint designs. As such, we make the following simplifying assumption: We assume that 35 percent of patient compartment oc"] [9.431870460510254, -1.577394723892212, "eets updates and population growth, and the third where benefits increase due to population growth only.\n 73\nFigure 3.10. Avoided Injuries per Year Will Increase as New Ambulances Become More Prevalent over Time\n Number of avoided injuries predicted"] [9.396696090698242, -1.5288105010986328, " 2049\n 2050\nAlternate Distribution 1\nAlternate Distribution 2\nAlternate Distribution 3\nConsistent with Figure 3.9, if redesign results in the patient"] [9.425811767578125, -1.5741276741027832, ".6 million to $10.1 million per year in avoided direct costs by 2020, and $8.0 million to $14.9 million by 2036. For comparison to the case presented in Chapter 2, these result in an annualized value of $4.3 million to $8.0 million from 2017 to 2050 "] [9.48975658416748, -1.64646315574646, "SH research, rather than re-creating the same research themselves. Indeed, some of the industry partners NIOSH worked with are encouraging Canada to adopt the same SAE standards, as common global standards can help companies streamline manufacturing "] [10.60155963897705, 13.045241355895996, "ers, and includes acute, obvious injuries such as amputations.68\n66 Over 90 percent of amputations in Michigan in recent years are finger or partial finger amputations, although amputations may involve other extremities including hands, arms, toes, f"] [10.60021686553955, 13.046892166137695, "ent of the problem. Further, it is difficult to measure progress on reducing work-related amputations if accurate, stable estimates of the current number do not exist (Rosenman, 2013).\nThe Burden of Work-Related Amputations\nMost work-related amputati"] [10.600398063659668, 13.047089576721191, "ogram does not receive any other outside funding.73 The surveillance program specifically began reviewing medical records for patients treated for amputations and referring cases meeting designated criteria to MIOSHA. Beginning with data received in "] [10.600351333618164, 13.047737121582031, "lted in 1,566 violations cited and $652,755 in penalties assessed.77\n75 See MSU, undated-a, for the yearly reports for the amputation surveillance program. From 2006 to September 2008, the industries were based on Standard Industrial Classification ("] [10.60105037689209, 13.046608924865723, "iffer slightly from their study. For example, between 2006 and 2012, our data record 233 inspections based on referrals with total initial violations of 1,971 and total initial penalties of $804,840. It is not clear why these differences exist but so"] [10.601205825805664, 13.046319961547852, "in 2003\u20132009 and 42 in 2011\u20132018, showing that the process is becoming more efficient over time. A shorter time between amputation and inspection in recent years provided an opportunity for quicker remediation.\n 82\nBetter Targeting of Inspections\nThe"] [10.601058006286621, 13.046738624572754, " phone March 28, 2019; interview with Adrian Rocskay of the General Industry Safety and Health Division of MIOSHA, conducted via phone April 29, 2019. See also Berkowitz, 2018.\n80 Interview with Doug Kalinowski conducted via phone on June 6, 2019.\n81"] [10.601325988769531, 13.045247077941895, " than most other injuries . . . Furthermore,\n82 NIOSH supports 26 states to do some kind of state-based surveillance program (Rosenman interview). See also Davis et al., 2014, and Friedman et al., 2013.\n83 Although the Massachusetts program has used "] [10.600955963134766, 13.046318054199219, "86 See also Michaels, 2016. Although the Michigan surveillance program is not mentioned in the documentation\nto the new rule, influence of the Michigan and Massachusetts programs on the federal regulation was noted by\nDr. David Michaels in his interv"] [10.601187705993652, 13.04549789428711, "e BLS data we see the number and rates of amputations decrease through time both in Michigan and in the rest of the United States. Amputations decreased substantially in Michigan from the 2003\u20132006 period (average 390/year) to the 2008\u20132017 period (a"] [10.601299285888672, 13.04537296295166, " surveillance program did not exist (i.e., we do not know the counterfactual), we cannot claim that the program caused inspections to find\n87\nmore violations and penalties than they otherwise would have. However, we find that the surveillance inspect"] [10.603175163269043, 13.046282768249512, "the employer belongs to (six digits); the type and scope of the inspection; whether the employer is privately owned; information on related activities; whether it was an inspection for health or for safety; count of serious, willful, repeat, other, a"] [10.603221893310547, 13.04627513885498, " Note that in the data inspections are referred to as \u201cplanned\u201d while in the manual they are called \u201cprogrammed.\u201d94 Planned inspections make up\n73 percent of the observations in the Michigan data, followed by complaint at 14 percent, referral at 4 pe"] [10.601975440979004, 13.044966697692871, "tions and 44 percent partial inspections.\n94 The reason for the difference in terminology is not clear.\n95 Although we have generally used the word \u201cinjury\u201d to describe the event that results in an amputation, the OSHA data use the word \u201caccident.\u201d\n "] [10.60672664642334, 13.04163932800293, "t Current Penalty Other Current Penalty Unclass Current Penalty Total Current Penalty Total FTA Amount\nSerious Initial Violations Willful Initial Violations Repeat Initial Violations Other Initial Violations Unclass Initial Violations Total Initial V"] [10.609119415283203, 13.031789779663086, "8 0\n3,075.81 0 4,194.43 0 3,130.26 0\n197.16 0\n124.60 0 6,901.08 0 1,749.94 0 2,228.84 0 1,999.27 0\n201.19 0\n681.78 0 4,083.52 0 877.44 0\nMichigan surveillance program.\n2,100 4,409.03 134,310 900 1,629.17 21,150\n00.000\n0 368.58 40,080 0 98.09 4,500 00"] [10.60219955444336, 13.045186042785645, "nzero observations and observations with violation counts less than 30.\n 97\nFigure 4.4. Distribution of the IHS of Total Initial Penalty Size from Surveillance Program Referrals and All Other Inspections in Michigan\nSOURCE: Author analysis based on "] [10.60009765625, 13.041291236877441, "se are good outcomes for the purposes of the current study. We believe that MIOSHA inspectors are not incentivized to inflate these numbers, and their pay and prestige within the agency are not based on them. Assuming variation in hazardous condition"] [10.603232383728027, 13.0428466796875, "with the highest number of hazardous conditions, thus leading to a more effective use of resources. Thus, if (1) violations and unsafe conditions that could lead to injuries exist and are unevenly distributed across worksites, (2) MIOSHA inspectors r"] [10.608503341674805, 13.03742790222168, "is present. Log-linear models also cannot incorporate observations with zeros in the outcome variable. Both Poisson and negative binomial regression analyses are commonly used to model count data and to deal with the problem of zero-valued dependent "] [10.603116035461426, 13.048551559448242, "2, but MIOSHA still had high-priority industries in its strategic plan. Regressions using priority industries based on the 2014\u20132018 Strategic Plan produced an estimate of 1.60 for the Michigan surveillance program. Using an indicator for being in a "] [10.603358268737793, 13.042518615722656, "trol) N\n(1) (2)\n2.50*** 2.75*** (0.01) (0.02)\nNo No No No No No 2.50 2.50 86,136 86,136\n(3) (4)\n2.07*** 2.90*** (0.03) (0.07)\nYes Yes No Yes No No\n2.50 2.50 86,136 86,136\n(5) (6)\n2.45*** (0.03)\n2.37*** 0.00 (0.05) (0.00)\nYes Yes Yes Yes No Yes 2.50 2"] [10.60114574432373, 13.045385360717773, "ccident Type = Unprog Rel Type = Prog Related Type = Follow-up Type = Prog Other Type = Monitoring Type = Other\nType = Un Prog Other Type = Variance\nType = Fat/Cat\nSafety Inspection\n(1)\n3.24*** (0.38)\n(2)\n2.68*** (0.33)\n2.21*** (0.15)\n1.54*** (0.06)\n"] [10.60179328918457, 13.045516967773438, "ploited a cutoff of OSHA\u2019s Site-Specific Targeting plan to estimate the effects of inspections with a fuzzy regression discontinuity using panel data on 61,702 unique establishments between 1996 and 2011. The authors reported that inspections decreas"] [10.602777481079102, 13.044083595275879, " the mean) compared with the 24 surveillance inspections that were performed. Viewed through this lens, the program \u201csaved\u201d 14 (72) inspections per year along with their associated costs and still found the same number of violations. Calculating simi"] [10.6021089553833, 13.044168472290039, "uld have led to no reductions in injuries, then the 24 additional surveillance inspections per year would lead to $9.72 million dollars of saved costs and lost earnings per year of the program. To the extent\nthat the very act of conducting an inspect"] [10.601666450500488, 13.045204162597656, "e geography or over many years to have enough statistical power to see the effects of the program on amputations.\n 110\nThere is a further value in the information provided by the Michigan surveillance program. Although it is well known that the BLS S"] [10.601876258850098, 13.042998313903809, "federal rule change. Documenting and detailing exactly how the Michigan program influenced the Massachusetts surveillance program and how important the public comments from the Massachusetts Department of Health were on the creation of the federal la"] [9.585186958312988, -1.843606948852539, "se studies, and RAND traced the elements of these case studies from the input hazard to the potential changes in health outcomes for workers and other affected individuals. In parallel, RAND identified attributes of cases studies that NIOSH might use"] [9.435942649841309, -1.58917236328125, "nts, both by working directly with manufacturers and by collaborating with standard-setting organizations. NIOSH continues to play a pivotal role in these partnerships, and many of the design changes may not have happened without NIOSH\u2019s involvement."] [9.617916107177734, -1.816443681716919, "t resources utilized for these inspections would have been used to conduct inspections similar to the average inspection measured in our data had the program not existed, then we can provide some rough numbers of the effects of the program on these p"] [9.60155963897705, -1.840132713317871, "ting Evidence on Cancer Risk Among Firefighters found NIOSH research was associated with an annualized value of $71 million in 2016 dollars in avoided medical costs and productivity losses, and approximately $1 billion per year in VSL estimates for a"] [9.480489730834961, -1.9509994983673096, "be subtracted from the baseline levels in Tables A.1\u2013A.5 to calculate the impact of CPDMs on the excess risk of respiratory disease due to coal mine dust (measured per 1,000 workers).\n 108 Due to the relative complexity of the exposure risk models, "] [9.474058151245117, -1.9582080841064453, "ever, we note that the additional excess risk may be significantly higher for workers smoking two packs a day as opposed to workers smoking less than half a pack per day, for example.\n119\nTable A.1. Estimated Excess Risk of CWP by Age 73 After 45 Yea"] [9.4432954788208, -1.9910173416137695, "112.2\n143.1 98.3\n122.6 83.5\n117.2 79.7 180.3 125.8 306.4 225.7 128.1 87.4\n194.1 136.2\n211.2 149.3 218.3 154.8\n49.5 32.7\nCWP 1+\n310.3 207.6\n243.4\n\u2013 \u2013\n378.7 \u2013\n261.3\n302.2 288.3\n\u2013\n170.7\n230.2 345.5 633.8 274.1\n\u2013\n\u2013 597.4\n114.6\nCWP 2+\n279.6 170.0\n206.4\n\u2013 "] [9.434784889221191, -2.007786273956299, " Operator Longwall Jacksetter Longwall Tailgate Operator Mechanic and Helper\nMobile Bridge Operator\nRoof Bolter\nScoop Car Operator\nSection Foreman\nShuttle Car Operator Uni-Hauler Operator\nUtility Man\nAll Other Underground Jobs Part 90 Miners\nRank Bit"] [9.462393760681152, -1.9720126390457153, "n and Helper\nLaborer\nLoading Machine Operator\nLongwall Headgate Operator\nLongwall Jacksetter\nLongwall T ailgate Operator\nMechanic and Helper\nMobile Bridge Operator\nRoof Bolter\nScoop Car Operator\nSection Foreman\nShuttle Car Operator\nUni-Hauler Operato"] [9.434728622436523, -1.998702883720398, "e A.8. Estimated Excess Risk of COPD by Age 73 After 45 Years of Occupational Exposure at Reduced Exposure Levels (per 1,000 Workers)\n Occupation\nLow-Recurrence\nMid-Recurrence\nHigh-Recurrence\n Auger Operator 35.1 Continuous Miner Operator 28.0 Cuttin"] [9.43201732635498, -2.002349615097046, " Uni-Hauler Operator\nUtility Man\nAll Other Underground Jobs Part 90 Miners\nLow-/Med.- High-Rank\nRank Bituminous Anthracite Rank\nBituminous Anthracite\nRank\n21.8 15.5 17.7 \u2013\n\u2013 26.0 \u2013 18.8 21.3 20.5 \u2013 13.2 16.9 24.0 45.8 19.6 \u2013 \u2013 42.2 9.5\nBituminous Ant"] [9.507789611816406, -1.9014227390289307, "6 99.9%\n37 100.0%\n38 100.0%\n39 100.0%\n40 100.0%\n41 100.0%\n42 100.0%\n43 100.0%\n44 100.0%\n45 100.0%\n46 100.0%\n47 100.0%\n48 100.0%\n49 100.0%\n50 100.0%\n51 100.0%\n52 100.0%\n53 100.0%\n54 100.0%\n55 100.0%\n56 100.0%\n57 100.0%\n58 100.0%\n59 100.0%\n60 100.0%\n61"] [9.536096572875977, -1.8774093389511108, "Blackburn, M. L., \u201cThe Relative Performance of Poisson and Negative Binomial Regression Estimators,\u201d Oxford Bulletin of Economics and Statistics, Vol. 77, No. 4, 2014, pp. 605\u2013616.\nBlackley, David J., Cara N. Halldin, and A. Scott Laney, \u201cContinued I"] [9.555695533752441, -1.7345069646835327, "lic Health Referrals to OSHA,\u201d September 2011. As of July 15, 2019:\nhttp://www.cste2.org/webpdfs/occupational/OSHAreferral922011.pdf\nCromartie, John, and Dennis Vilorio, \u201cRural Population Trends,\u201d Amber Waves, February 15, 2019. As of July 24, 2019: "] [11.426514625549316, 18.06827735900879, "ria/transport_ria_final-csapr_2011-06.pdf\nEPA\u2014See Environmental Protection Agency.\nFederal Transit Administration, \u201c2001 Table 24: Number of Injuries\u2013Collisions and Non- Collisions,\u201d webpage, 2001. As of November 5, 2019: https://www.transit.dot.gov/"] [9.596160888671875, -1.7384157180786133, "fects of Publicizing Violations of Workplace Safety and Health Laws,\u201d August 30, 2019. As of November 5, 2019: https://drive.google.com/file/d/1HcKpGXZuFWNNLa1YTl0A4Hte1BiJabT-/view\nKica, Joanna, and Kenneth D. Rosenman, \u201cMultisource Surveillance Sys"] [9.508392333984375, -1.9017256498336792, "hn Wood, David J. Blackley, and David N. Weissman, \u201cCoal Workers\u2019 Pneumoconiosis\u2014Attributable Years of Potential Life Lost to Life Expectancy and Potential Life Lost Before Age 65 Years\u2014United States, 1999\u20132016,\u201d Morbidity and Mortality Weekly Report"] [9.515250205993652, -1.8865069150924683, "e Operators\u2019 Dust Control Plans and Compliance Sampling for Respirable Dust,\u201d Federal Register, Vol. 68, No. 44, March 6, 2003, pp. 10784\u201310884.\n\u2014\u2014\u2014, \u201cLowering Miners\u2019 Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors"] [9.540881156921387, -1.706622838973999, "ght Trucks, Publication No. DOT HS 809 199, Washington, D.C.: NHTSA, 2000.\n\u2014\u2014\u2014, \u201cThe National Highway Traffic Safety Administration and Ground Ambulance Crashes,\u201d presentation, April 2014. As of November 5, 2019: https://www.ems.gov/pdf/GroundAmbulan"] [9.559944152832031, -1.7578836679458618, "ault.html\n\u2014\u2014\u2014, Enhanced Coal Workers\u2019 Health Surveillance Program, Publication Number 2019-112, Washington, D.C.: Department of Health and Human Services, October 2018c.\n\u2014\u2014\u2014, \u201cThe Work-Related Injury Statistics Query System,\u201d webpage, last updated Se"] [9.49836540222168, -1.675426959991455, " Paul Moore, and Roger Levine, \u201cSafety in Numbers: A Survey on Ambulance Patient Compartment Safety,\u201d Journal of Emergency Medical Services, Vol. 32, No. 3, 2007, pp. 86\u201390.\nReynolds, Laura, Cara N. Halldin, A. Scott Laney, and David J. Blackley, \u201cCo"] [11.497929573059082, 17.97974395751953, "s, \u201cImpact of Differential Injury Reporting on the Estimation of the Total Number of Work-Related Amputations,\u201d American Journal of Industrial Medicine, Vol. 57, 2014, pp. 1144\u20131148.\nUnited States Census Bureau, \u201cStatistics of U.S. Businesses (SUSB),"] [12.418963432312012, 12.331299781799316, " CORPORATION\nBENJAMIN M. MILLER, DEBRA KNOPMAN, LIISA ECOLA, BRIAN PHILLIPS, MOON KIM, NATHANIEL EDENFIELD, DANIEL SCHWAM, DIOGO PROSDOCIMI\nU.S. Airport\nInfrastructure Funding\nand Financing\nIssues and Policy Options Pursuant to Section 122 of the 20"] [12.42623519897461, 12.307918548583984, "endations on the actions needed to upgrade the national aviation infrastructure system to meet the grow- ing and shifting demands of the 21st century.\u201d RAND, a nonprofit and nonpartisan policy research organization, was selected by the FAA through a "] [12.40483283996582, 12.340084075927734, "logy, and commu- nity organizations and institutions that affect well-being. For more information, email chep@ rand.org.\nContents\n Preface........................................................................................................... iii "] [12.426681518554688, 12.324301719665527, "r Trends in Airline and Airport Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Summary of Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [12.435931205749512, 12.324671745300293, "PTER FIVE\nFederal Role in Airport Infrastructure Funding: Airport Improvement Program. . . . . . . . . . . . . . . Airport and Airway Trust Fund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [12.442874908447266, 12.312820434570312, "ng Sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Summary of Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............................................."] [12.429525375366211, 12.315533638000488, "an Index for Three Airline Industry Metrics, 1974\u20132018 . . . . . . . . . .\n2.3. Herfindahl-Hirschman Index According to Enplanements at Large- and Medium-Hub Airports, 2018 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [12.45357894897461, 12.303030014038086, ". . . . . . . . . . . . .\n4.8. Trends in Commercial Service Airport Expenses, 2009\u20132017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n4.9. Commercial Service Airport Expenses, by Airport Size, 2009\u20132017 . . . . . . . . . . . . . . . . . "] [12.553301811218262, 12.21769905090332, " . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n6.4. PFC Collections, by Year, 1992\u20132018. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n6.5. Billions of Dollars of PFC Proje"] [12.382473945617676, 12.355938911437988, ", and Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134\n8.6. Airports with the Most Hours of OPSNET Delays in 2018 . . . . . . . . . . ."] [12.422446250915527, 12.327098846435547, ". . . . . . . . . . . . . . . .\n4.3. Funding Sources for Average Rural and Urban Commercial Service Airports, 2017 . . .\n4.4. Expenses for Average Rural and Urban Commercial Service Airports,\n2017 (millions of dollars) . . . . . . . . . . . . . . . ."] [12.426225662231445, 12.324981689453125, "tion (FAA) Reauthorization Act of 2018 directed the FAA to contract with an independent research organization to address questions and provide recommendations related to infrastructure funding and financing at commercial service airports. These airpo"] [12.428546905517578, 12.324281692504883, "s an important determinant in an airport\u2019s funding preferences. Depending on the \u201ccolor of money,\u201d airports also are required to line up approvals from the appropriate combina- tion of federal regulators, local and state governments, and airlines bef"] [12.444479942321777, 12.31186294555664, "ts over local land-use policy and public priorities.\nFinding 3: There Are Known Areas in Which Infrastructure Investment Is Needed\nAirport runways are generally in good repair. This reflects the priority given to airside infrastructure\u2014i.e., infrastr"] [12.572338104248047, 12.202818870544434, "orts that choose to participate in the federally authorized passenger facility charge (PFC) program. With reference to the color of money in Finding 1, airlines cannot veto FAA-approved PFC-funded projects. The cap on PFCs has been set at $4.50 per p"] [12.525179862976074, 12.255840301513672, "small to support airport construction of any conse- quence. Airports, however, are permitted to defer their annual entitlements over several years to accumulate sufficient funds to undertake a project.\nFinding 6: The Airport and Airway Trust Fund Has"] [12.571301460266113, 12.208173751831055, " by outside observers, including the FAA. The FAA has effective enforcement options available for discouraging the second form of revenue diversion, but the FAA\u2019s existing enforcement mechanisms are largely unable to prevent grandfathered airports fr"] [12.611346244812012, 12.16626262664795, " 100 percent of AIP primary entitlements for medium- and large-hub airports\nthat choose to raise their PFC above $4.50.\nWe are not aware of compelling evidence or data justifying a particular level for a new cap. Any number could be chosen, but we no"] [12.581626892089844, 12.196672439575195, "ace demands on infrastructure.\nNot all airports will choose to seek an immediate or longer-term PFC increase. To increase transparency regarding the intentions of airports in maintaining cash reserves beyond those required by bond rating agencies, we"] [12.542978286743164, 12.238699913024902, "ct funds to current high-priority projects at spe- cific airports.\nWe recommend that Congress remove the triggered primary entitlement increase that occurs when Congress appropriates at least at $3.2 billion to the AIP. Those airports not vol- untari"] [12.54062557220459, 12.248098373413086, " as determined by the FAA.\nCongress Should Include Ancillary Fees in the Domestic Passenger Ticket Tax\nAncillary fees are charges for airline-provided services or products that some airlines sell sepa- rately from tickets, such as checked baggage, ad"] [12.53756046295166, 12.237664222717285, " airports, cities, and routes are served by only one or two airlines. Lack of competition among airlines at a given airport can result in higher costs for travelers. In practice, PFC proj- ects provide airports with a means of accommodating new entra"] [12.444089889526367, 12.313529968261719, "rastructure, air traffic control towers, and other air traffic facilities, and there is a need for an assessment of their current capacity, functionality, and physical condition. An up-to-date inventory and assessment of infrastructure conditions wou"] [12.558111190795898, 12.214385986328125, "tus, regional and local economic conditions, and other factors.\nAs noted in (c)(1), 20 airports account for 96 percent of delays measured by the FAA\u2019s OPSNET. These airports create delays for passengers that propagate throughout the NAS.\nSeparately, "] [12.509547233581543, 12.265233039855957, "als, while AIP grants are generally focused\non airside infrastructure. Expanding airports\u2019 revenue bases to include the taxing of nonairport local businesses and residents\nis unattractive to local governments and would increase the cost of local good"] [12.430463790893555, 12.324503898620605, "ter Two\nChapter Five\nChapter Eight\n Table S.3\u2014Continued\nSubsection of\nSection 122 Issue\nLarge-Hub Airports\n(d)(1) Analyze the current and\nfuture capacity constraints\nof large-hub airports\n(d)(2) Quantify large- hub airports\u2019\ninfrastructure requirem"] [12.416905403137207, 12.332905769348145, "be available over this five-year period.\nChapter in Report\nChapter Eight\nChapter Two\nChapter Eight\nChapter Five\nChapter Five\nSummary xxv\n Acknowledgments\n As a part of Section 122 of the FAA Reauthorization Act of 2018, the RAND research team was "] [12.411314010620117, 12.336248397827148, "hone interviews. These include, in alpha- betical order, representatives from Airlines for America, Airports Council International\u2013North America, Airports Council International\u2013World, Cincinnati/Northern Kentucky International Airport, Frasca & Assoc"] [12.423074722290039, 12.325263977050781, "n Statistics\nCAB Civil Aeronautics Board\nCATS Certification Activity Tracking System\nCFC customer facility charge\nCFR Code of Federal Regulations\nCLT Charlotte Douglas International Airport\nCPI Consumer Price Index\nDB1B Airline Origin and Destination"] [12.433572769165039, 12.321582794189453, "ncluded in the price of an airline ticket that is now sold separately, such as checked baggage, advance seat assignments, and priority boarding.\nAircraft that are operational, airworthy, and based at an airport for a majority of the year.\nAn arrangem"] [12.412070274353027, 12.343354225158691, "service airports and to provide improved general aviation access to the overall community. These may be publicly or privately owned.\nAn agreement between an airport and airlines in which signatory airlines agree to cover an airport\u2019s operating expens"] [12.430785179138184, 12.321972846984863, "adding fees or taxes that increase fares, subsidizing overly ambitious local airport expansion plans, supporting plans that might open the way toward more competition, or enabling jurisdictions to divert airport-generated revenue for nonaviation publ"] [12.491740226745605, 12.275603294372559, "ggests congressional interest in this study is closely tied to under- standing impacts of potential changes in the PFC program on airports, airlines, and passengers before commencing further legislative action. In Chapter Six of this report, we discu"] [12.429959297180176, 12.321381568908691, "aircraft, and role within the national airport system.\nTable 1.1 presents the various airport categories and subcategories, along with their defi- nitions and relevant statistics. The FAA aggregates airports as either commercial service air- ports or"] [12.430339813232422, 12.322335243225098, "cluding runways, taxiways, aprons, and aircraft gates and the land adjacent to these facilities required by current FAA standards\u201d (FAA Order 5100.38D, 2019). Landside refers to \u201c[t]he portion of an airport that provides the facilities necessary for "] [12.418898582458496, 12.33133316040039, "n links connecting from outside the airport to the airport, enabling passengers to access the airport\u2019s services. This exclusion can be problematic for funding and finance at some airports and jurisdictions, as will be discussed further in Chapter Th"] [12.409578323364258, 12.339298248291016, "ted in the latest edition of the American Society of Civil Engineers (ASCE) Infrastructure Report Card, which states,\nThe FAA\u2019s set performance goal is that no less than 93% of runways at NPIAS airports are in excellent, good or fair condition. In 20"] [12.498825073242188, 12.270456314086914, " of airport opera- tions, including aeronautical and non-aeronautical expenditures and revenue, federal and state grants, and other sources of capital.\nIn Chapters Five and Six, we take a closer look at two important funding mechanisms administered b"] [12.49242115020752, 12.271669387817383, "e last increase in 2000 to the year of enactment of this Act\n(c)(7) Impact to passengers and airports of indexing the PFC for inflation\n(c)(8) How long airports are constrained with current PFC collections\n(c)(9) Impact of PFCs on promoting competiti"] [12.139309883117676, -5.067380905151367, "ot off the ground in the 1910s when the U.S. Post Office began encouraging mail delivery via air.1 The main legislation regulating commercial flight passed in 1938 and was patterned on trucking regulation, which in turn had grown from concerns rooted"] [12.425087928771973, 12.322916984558105, "irlines that ceased to operate (Goetz and Vowles, 2009). Since 2008, another six major airlines have been acquired by other airlines:\n\u2022 Midwest, acquired by Republic Airlines, 2009\n\u2022 Northwest, acquired by Delta Air Lines, 2009\n\u2022 Continental, acquire"] [12.440106391906738, 12.3154878616333, "n, Pan Am, Northwest, TWA, and USAir, all of which have merged with other airlines or ceased operating as of 2018. The \u201cLCCs\u201d category includes AirTran, Alaska, ATA, Hawaiian, JetBlue, Midway, Sun Country, Vanguard, and Virgin America. The \u201cULCCs\u201d ca"] [12.448197364807129, 12.304278373718262, "rated markets have higher HHI. The Department of Justice considers a market or industry HHI of 1,500 to 2,500 to be moderately concentrated and anything above 2,500 to be highly concentrated (U.S. Department of Justice, 2018). The HHI is a widely acc"] [12.432721138000488, 12.318214416503906, "ta do not include ASM or revenue passenger miles, so we could not recalculate the HHI for ASM and rev- enue passenger miles to include operating carriers as part of the marketing carriers.\n Figure 2.2\nHerfindahl-Hirschman Index for Three Airline Indu"] [12.423822402954102, 12.324353218078613, "rcent of its enplanements were for Alaska Air and 11 percent were under its own name in 2018.\n 14 U.S. Airport Infrastructure Funding and Financing\nTable 2.1\nProportion of Enplanements, by Airline Category, 2018\nCarrier Type\nPercentage of Enplanement"] [12.419550895690918, 12.329009056091309, "i-hub markets are less concentrated, meaning that passengers in those markets have a greater choice of ticketing carriers to choose from. Three of the four most highly concentrated airports (Midway, Hobby, and Love) are in multi-hub markets. The\n11 A"] [12.422599792480469, 12.319527626037598, "ts,12 accounting for direct flights as well as flights with one or two layovers. We looked at round-trip itineraries between two markets, and each market pair is included twice, once with one city being the origin and a second time with that city as "] [12.439663887023926, 12.308575630187988, "fees are exempted from reporting (GAO, 2014a). Bag fee collections increased substantially beginning in 2008, when they grew by almost 150 percent (BTS, 2019e).\nHistorical Context and Trends in Air Travel 17\n 1,501\u20132,500 2,501\u20135,000 5,001\u20137,500 7,501"] [12.438577651977539, 12.306501388549805, "ncillary fees.\nFigure 2.7\nTotal U.S. Enplanements and Enplanements per Capita, 1990\u20132018\n800 4\n700\n600 3\n500\nEnplanements (millions) 400 2 Enplanements per capita 300\n200 1\n100\n00 1990 1995 2000 2005 2010 2015 2018\nYear\nSOURCE: BTS, 2019b.\n\u2022 changes "] [12.420541763305664, 12.328063011169434, "aft as a way to compete more on price than quality. LCCs continue to seek out airports that enable quick turnaround times at gates, since using aircraft efficiently continues to be an important element of their business model (Graham, 2013).\nAs the d"] [12.424137115478516, 12.32420825958252, "ndicator. The evidence shows that, as enplanements have risen over the past three decades, the number of operations rose at a slower pace and has declined over the past 15 years.\nForecasting airport trends too far into the future is risky because ind"] [12.389766693115234, 12.366691589355469, "ports in the United States are publicly owned, and our focus in this chapter is on commercial service airports. Among large- and medium-hub airports, almost all are owned by cities, counties, or independent authorities established by a city or county"] [12.498154640197754, 12.272406578063965, "pter Six.\nNot all revenues, however, can be used to cover all expenses. The color of money matters. Revenue use is governed by a system of statutory-based \u201cgrant assurances,\u201d which are admin- istered by the FAA and restrict airports\u2019 abilities to rai"] [12.446099281311035, 12.311469078063965, "s choose to use an individual airport (for example, in either an origin- destination or hub mode) can affect the finances of the airport, its access to certain types of revenue sources, and its leverage in negotiations with incumbent airlines and new"] [12.46853256225586, 12.29512882232666, " simply refer to these as agreements. Although not every airport signs such agreements with its incumbent air- lines, the large majority do (Faulhaber et al., 2010). Agreements are discussed in more detail later in this chapter.\nThe Business of Airpo"] [12.455477714538574, 12.302342414855957, "hod\nLandside: shared, with residual protection\nHybrid compensatory\nAirfield: any method\nTerminal: any method\nLandside: shared, without residual protection\nCompensatory\nAirfield: any method\nTerminal: compensatory\nLandside: kept by airport\n "] [12.451447486877441, 12.309946060180664, "capital projects.\n8 Comparable data on medium hubs were not provided.\n9 Wu notes that his categorizations differ slightly from the FAA; however, he also notes that \u201cthere are no consistent defi-\nnitions of the types of rate methodologies\u201d (Wu, 2015a,"] [12.414883613586426, 12.341336250305176, "takeholders and to obtain FAA approval, but they do not require airline approval. These issues are discussed in greater detail in Chap- ter Six.\nGate Control and New Market Entrants\nOne common point of contention between airports and airlines is the "] [12.427556037902832, 12.32404899597168, "irline uses an airport as a hub does not mean it has a majority of passengers and operations at that airport; an airport might serve as a hub for more than one airline.16\nAnother issue is that hub airports might have a higher proportion of passengers"] [12.435571670532227, 12.321279525756836, "ultiple hub airlines. All but one of the large-hub airports serve as a hub or focus city for at least one airline. Specifics are shown in Table 3.2.\nMarket Size and Demand\nLarger airports with high demand should be in a better position to negotiate w"] [12.448338508605957, 12.310707092285156, "revenues and expenditures to the FAA using its CATS database, which contains a standard categorization of revenues and other funding sources as well as individual items in each category. CATS distinguishes between two types of operating revenues: aer"] [12.499382972717285, 12.274336814880371, "l contributions by airport sponsors and others,18 as well as federal and state grant programs and the PFC program. Generally, these non-operating revenues might not be used for operating expenses of the air- port, and as a result, are especially impo"] [12.516244888305664, 12.256656646728516, " were consolidated into the AIP in the Airport and Airway Improvement Act of 1982 (AAIA). See FAA, 2017c.\n20 The appropriation limitation also includes four other funding categories: Small Community Fund, Administrative Expenses, Airport Technology R"] [12.445998191833496, 12.31597900390625, " debt activities, which occur primarily through the municipal bond market. Bond proceeds are inflows of capital. Repayment of borrowed capital and interest payments associated with the debt incurred, col- lectively called debt service, is counted as "] [12.465415000915527, 12.296875953674316, " be made only with certain types of funds. The following section on federal regulations touches on some of these restric- tions, and the results of these and revenue-specific restrictions are shown in Tables 3.5 and 3.6 at the end of that section.\nFe"] [12.528017044067383, 12.252889633178711, "ot exceed the costs allocated to that user or user group under a cost allocation method- ology adopted by the airport proprietor that is consistent with this guidance\u201d (FAA, 2013, Sec- tion 3.1). This policy allows for fees to vary between signatory "] [12.545218467712402, 12.235811233520508, " an airport, the airport must use those revenues for airport purposes (FAA Order 5190.6B, 2009, Chap- ter 3). Although airports can raise revenue by selling airport property, the FAA must approve any sales. Approval requires that the airport establis"] [12.542943954467773, 12.238910675048828, "u and the Texarkana Airport Authority have expired (FAA, 2018c). San Diego\u2019s grandfathering authority was eliminated when the airport was transferred to a new and independent authority. The cap was set independently for each airport and increases ann"] [12.536649703979492, 12.239639282226562, "n an existing expressway to make the project eligible (Gos- ling, Wei, and Freeman, 2012). The project was not approved by the FAA until after a seven- year legal case clarified the interpretation of \u201cexclusive use\u201d (Karaskiewicz, 2018).36 In a more "] [12.49150276184082, 12.277173042297363, "ting, and administrative costs\n\u2022 Airside development and planning\n\u2022 Select projects in non\u2013revenue- generating areas\n\u2022 All AIP eligible projects\n\u2022 Projects in revenue- generating areas, with certain limitations\n\u2022 Debt service\n\u2022 Capital expenditures\n\u2022"] [12.507622718811035, 12.264935493469238, "g\nAIP PFC\nBonds\nPrivate Investment\n Operating\n SOURCES: Operating (aeronautical and non-aeronautical) and non-operating funds: FAA Order "] [12.483636856079102, 12.282489776611328, "be approved by the FAA before airports can receive AIP grants or PFC approvals (FAA Order 5100.38D, 2019, Appendix W).\nAIP grant assurances\u2014conditions that airport sponsors must meet as a condition for having accepted past AIP grants\u2014also include sev"] [12.433475494384766, 12.319585800170898, "te the minimum usage of slots at Level 3 airports. At DCA and LGA, which serve primarily domestic flights, slots are distributed to carriers on a rolling basis, largely based on the number of slots a car- rier has historically owned and operated. At "] [12.424786567687988, 12.332279205322266, "necessary restriction.42 Because no clear verdict has been reached, the perimeter rules remain in place at the time of this writing.\nEnvironmental, Noise, Safety, and Security Regulations\nAirports are subject to many federal regulations in four areas"] [12.425943374633789, 12.328828811645508, "regard to safety regulations, commercial service airports must maintain a current FAA-approved Airport Certification Manual to show that current and planned infrastructure meet safety requirements under 14 CFR Part 139. These requirements are mainly "] [12.419119834899902, 12.337575912475586, "rcial service airports would not be sold to private investors (Poole, 2018).46\n43 The pilot program allows for up to ten airports to be privatized, and applications have been staggered over several years.\n44 Stewart International Airport in Newburgh,"] [12.430150985717773, 12.326709747314453, "ope\u2019s 500 airports that are fully public fell from 78 percent to 59 percent between 2010 and 2016. Mixed- ownership airports, which encompass various types of public-private partnerships, have dou- bled over the same period, from 13 percent to 25 per"] [12.440397262573242, 12.314682006835938, "However, airport planning cycles are much longer, with many long-term master plans looking out 20 years or more. Changes to the physical infrastructure at airports tend to require many years to plan, permit, and build. Airports are also subject to a "] [12.410118103027344, 12.348054885864258, " airports are governed by FAA regulations and adhere to the terms of use-and-lease agreements with airlines, other stakeholders (shown in Figure 3.2) can affect an airport\u2019s abil- ity to embark on major capital projects or change its operations. Such"] [12.432954788208008, 12.320581436157227, "d businesses\nFIxed-base operators, concession holders, ground transport, janitorial, and other service providers\nThe Business of Airports 47\n Airlines\nTransportation Security Administration (TSA)\n SOURCES: RAND design with Noun Pro"] [12.434569358825684, 12.319891929626465, "rport size. Although the FAA has allowed a limited number of airports to pursue privatization, this option has not proven as popular in the United States as it has in other countries.\nThe FAA imposes some specific restrictions on airports and their r"] [12.433070182800293, 12.321428298950195, "nt) was from aeronau- tical operating revenue, $10.1 billion (35.1 percent) was from non-aeronautical operating rev- enue, and $1.4 billion (4.9 percent) was from non-operating revenue, as shown in Figure 4.1.\n1 Airports report data to CATS aggregate"] [12.403369903564453, 12.353202819824219, "rom all other types of debt. To avoid double-counting the interest, we have subtracted non-operating expenses from debt service. Because we cannot subtract only the long-term bond debt, the value we report as debt service might undercount the princip"] [12.429490089416504, 12.326674461364746, "aeronautical operating\nNon-operating PFC\nAIP and other grants\nBond proceeds\nTotal 27,015\nSOURCE: CATS (FAA, undated c).\nLarge-Hub Medium-Hub Small-Hub Non-Hub\nPrimary Primary Primary Primary Nonprimary Total\nSource (30 Airports) (31 Airports) (72 Air"] [12.43153190612793, 12.319587707519531, "imary Primary Primary Primary Nonprimary Total Category Source (30 Airports) (31 Airports) (72 Airports) (194 Airports) (76 Airports) (403 Airports)\n Operating Expense 9,377\nNon-operating Expense 2,725\nCapital Expense 8,749 expenditures\nPrincipal Deb"] [12.431267738342285, 12.319170951843262, "Figure 4.5\nProportion of Expenses for Rural and Urban Commercial Service Airports, 2017\n Percentage\n100 90\n 80\n 70\n 60\n 50\n 40\n 30\n 20\n 10\n0\n SOURCE: CATS (FAA, undated c).\nRural\nUrban\nTrends in Funding and Expenses from 2009 to 2017\nIdea"] [12.437346458435059, 12.318612098693848, ".0%\n4.7%\n11.7% 10.4%\n2012 2013\n23.224 24.603 40.8% 40.7% 33.9% 33.5%\n3.4% 4.7%\n11.9% 11.4% 10.0% 9.8%\n Figure 4.7\nCommercial Service Airport Revenue, by Airport Size, 2009\u20132017\n Billions of dollars (nominal)\nBillions of dollars (nominal)\nYear\nNon"] [12.439220428466797, 12.314384460449219, "l revenue increased, whereas the proportions of other sources decreased.\nTrends in Expenses, by Airport Size\nAs shown in Figure 4.8 and Table 4.6, operating expenses were the largest category of expenses from 2009 to 2017 and have shown consistent gr"] [12.4041109085083, 12.349115371704102, "ds for urban airports and rural airports have developed differently over time. As shown in Figure 4.10, the two largest sources of revenue, aeronautical and non-aeronautical operating revenues, have been steadily increasing for urban airports. Rural "] [12.446319580078125, 12.313405990600586, " (nominal)\nBillions of dollars (nominal)\nBillions of dollars (nominal)\n10 8 6 4 2\nLarge-hub primary airports\n2.5 2.0 1.5 1.0 0.5\nMedium-hub primary airports\n2.0 1.6 1.2 0.8 0.4\nSmall-hub primary airports\n 2.0 1.6 1.2 0.8 0.4\nBillions of dollars "] [12.516363143920898, 12.256647109985352, "rating revenues across airports of all sizes steadily increased. However, the rate of increase declines with the size of the air- port. Also, the proportion of AIP and other grants compared with other sources of revenue decreased during this period f"] [12.516097068786621, 12.261394500732422, "nding for the AIP and for FAA programs more generally. It was established by the Airport and Airway Development Act of 1970 (P.L. 91-258) and sub- sequently reactivated by the Airport and Airway Improvement Act of 1982 (Pub. L. 97-248).1 Appendix E i"] [12.49746036529541, 12.273722648620605, " general aviation jet fuel surtax on fractional ownership\nRate for Calendar Year 2019\n7.5% of fare\n$4.20 (indexed annually to CPI)\n$18.60 (indexed annually to CPI)\n$9.30 (indexed annually to CPI)\n7.5% of fare\n6.25% of amount paid for the transportati"] [12.496550559997559, 12.276482582092285, "tional Airport that was shared with us, the median large-hub airport was responsible for about $14 of AATF excise tax contributions for each $1 in AIP grants received over the period from FY 2009 to FY 2016, the median medium hub was responsible for "] [12.496915817260742, 12.283997535705566, "et fuel could substitute for diesel fuel when facing a lower tax rate, depriving the High- way Trust Fund of revenue. The 2005 Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (Pub. L. 109-59) equalized the tax rat"] [12.517889022827148, 12.26109790802002, "Airport and Airway Trust Fund Revenues and Outlays, FYs 1999\u20132018\n 16\n 15\n 14\n 13\n 12\n 11\n 10\n9\n8\n7\n6\n1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018\nFiscal year\nSOURCE: OMB, 20"] [12.518929481506348, 12.260100364685059, "n trust fund revenues over expenditures can be seen as an offset in federal deficit computations. In some cases, however, the balance may be seen as having been spent on non-aviation programs or purposes. Because the balance is invested in short-term"] [12.505206108093262, 12.271110534667969, "lion at the end of FY 2024 and $47.7 bil- lion at the end of FY 2029 (JCT, 2019, Table 2). Figure 5.6 plots the projections for the uncom- mitted balance along with the projections for AATF revenues (including interest, because inter- est earnings co"] [12.50291633605957, 12.27369499206543, "rs intervened; the uncommitted balance ended up being about $5.7 billion at the end of FY 2016 (Tang and Elias, 2017, p. 8). Five years later, in 2011, the CBO projected that the cash balance (which includes amounts that have been obligated but not y"] [12.50925064086914, 12.266643524169922, " of the FAA budget but also be designed to guard against the possibility of draining down the balance, should revenues fail to materialize. As GAO, 2012a, p. 22, notes,\nAccording to an industry expert, the effects of certain exogenous events\u2014events c"] [12.490970611572266, 12.278119087219238, " origins in the years after World War II, when policymakers established the Federal-Aid Airport Program in the Federal Airport Act of 1946 (Pub. L. 79-377) to support building airfields, terminals, and access roads. This funding came from the General"] [12.49799919128418, 12.27503490447998, "ng, developing an environ- mental management system, and developing a plan for recycling and minimizing the generation of airport solid waste (49 U.S.C. \u00a7 47102).\n\u2022 Airport development: a wide-ranging term that includes (but is not limited to) con- s"] [12.52484130859375, 12.25284194946289, "tly, the FAA Reauthorization Act of 2018 (Pub. L. 115-254) authorized annual AIP spending of $3.35 billion from FY 2019 to FY 2023. However, Congress also imposes a separate, sometimes lower limitation on obliga- tions that can be made in a particula"] [12.510683059692383, 12.264433860778809, " limitation to less than $3 billion in tandem with other changes to both the AIP and the PFC program.9 This proposal, which was not adopted by Congress, would have raised\nFigure 5.7\nAirport Improvement Program Funding Authorized and Airport Improveme"] [12.514394760131836, 12.262319564819336, "more money through the PFC program than they forgo in AIP grants.\nThe overwhelming majority of AIP dollars support airside infrastructure, consistent with the NPR system, which prioritizes these projects as part and parcel of prioritizing safety. In "] [12.52227783203125, 12.256011962890625, "rded at the airport in calendar year 2017 is used. Table 5.2 lists the fund- ing amounts per passenger, depending on the number of enplanements. The table lists the amounts specified in statute that are apportioned when the AIP obligation limitation "] [12.52399730682373, 12.257396697998047, "s received funding through the cargo enti- tlement program, with Memphis International receiving the most funding ($16.9 million) because it accounted for about 15 percent of total landed weight among eligible airports (FAA, undated a). In general, t"] [12.541587829589844, 12.236126899719238, "ing as the \u201cprotected entitlements\u201d category in Figure 5.8.\nSmall Airport Fund\nThe Small Airport Fund receives 87.5 percent of forgone primary entitlements at large- and medium-hub airports that impose a PFC, as described above. The amounts are reapp"] [12.522924423217773, 12.25442886352539, ") are added to the discretionary pot and are not subject to set-asides, with the exception that at least half of these funds are to go to airports other than large and medium hubs.\nState Block Grant Program\nThe State Block Grant Program provides stat"] [12.515120506286621, 12.259849548339844, "r- ances that reflect federal priorities incorporated into statute over time.15 Details are provided in Appendix G.\nDistribution of Airport Improvement Program Grants by Airport Size\nFigure 5.9 shows the distribution of the dollars of AIP grants over"] [12.561453819274902, 12.21500015258789, "smaller airports, and airports outside metropolitan areas in particular, received priority consideration for $1 billion in supplemental AIP funds appropriated in the Consolidated Appropriations Act, 2018 (Pub. L. 115-141). No supplemental discretiona"] [12.552343368530273, 12.226945877075195, "rom passengers. Passengers pay a flight segment fee that is indexed to the CPI, along with a ticket tax of 7.5 percent of the fare. Other excise taxes are based on inter- national travel, cargo, and fuel use.\nUnder current law, the authorized amount "] [12.58504581451416, 12.191237449645996, " be increased above $4.50, the amount it has been since April 2001, when the cap increase included in the 2000 FAA reauthorization took effect.\nIn this chapter, we begin by providing background on the PFC program, a description of eligibility criteri"] [12.559627532958984, 12.213910102844238, "time of the PFC program\u2019s creation shine a light on one of the motivating factors for the PFC: promoting competition. GAO, 1990, pp. 2\u20133, states,\nA PFC gives airports a source of revenue for financing airport expansion projects indepen- dent of airli"] [12.545426368713379, 12.226821899414062, "irports forgo 50 percent of their AIP primary entitlements if they impose a PFC of $3 or less, and they forgo 75 percent of these AIP funds if they impose a PFC of more than $3.\nAfter receiving a PFC application from an airport, the FAA first reviews"] [12.54305648803711, 12.228924751281738, "e eligible at hub airports, but concession areas, such as food courts, are not).\n\u2022 PFC revenues can be leveraged to incur debt, and airports can use PFCs to pay principal and interest on this debt. In most cases, bonds backed by PFC revenues must be "] [12.57243537902832, 12.201789855957031, "n to destination, including stops or layovers along the way.\nTable 6.1\nPFCs by Airport Category\nAirport Category\nLarge hub\nMedium hub\nSmall hub\nNon-hub primary\nNonprimary commercial service\nTotal 506\nFederal Role in Airport Infrastructure Funding: Pa"] [12.589486122131348, 12.185174942016602, "19f. Boise charged a PFC from 1994 to 2015, while Greenville has never charged a PFC. See Day, 2019, and Greenville-Spartanburg Airport Commission, 2019.\n 90 U.S. Airport Infrastructure Funding and Financing\nFigure 6.2\nPercentage of All Hub Airports "] [12.555166244506836, 12.218504905700684, "s not double apportionment amounts.\n Percentage charging a PFC\nPercentage charging $4.50 PFC\n Percentage of hub airports\n Federal Role in Airport Infrastructure Funding: Passenger Facility Charge Program 91\nFigure 6.3\nPFC Collections Versus AIP Gr"] [12.543085098266602, 12.230232238769531, "ual PFC projects are approved at non-hub primary airports, more than 75 percent of the dollars are for projects at large-hub airports. Figure 6.5 displays the distribution of PFC dollars by airport hub size over the duration of the PFC program (throu"] [12.580070495605469, 12.193830490112305, "6 percent at large hubs to 95 percent at nonprimary airports.\nInflation and the Purchasing Power of the PFC over Time\nPrices rise over time because of inflation. Therefore, the amount of infrastructure that can be purchased with each dollar declines "] [12.588075637817383, 12.188582420349121, " three construction- related inflation indexes, which used construction materials, average hourly wages, and the price of asphalt, respectively. Using these indexes, a PFC of $4.50 in the year 2000 would purchase $2.72 of construction materials, $2.6"] [12.587370872497559, 12.186964988708496, "at construction cost inflation varies across several major U.S. cities. This source also finds that airport terminal construction costs vary between certain major U.S. cities and by type of terminal being built (Turner & Townsend, 2019, pp. 98\u2013103). "] [12.5779447555542, 12.195786476135254, "c.19 The only way to fund additional projects (other than those already approved) using a PFC would be by using revenues received after 2030 or, in the case of the small number of airports collecting a PFC at less than the maximum rate of $4.50, by s"] [12.574378967285156, 12.198272705078125, "port reaches its authorized PFC collection amount prior to the anticipated PFC expiration date (i.e., if enplanements are higher than expected at the time of PFC approval), the authorization to collect would lapse unless the airport submits an additi"] [12.579660415649414, 12.196867942810059, "jects without borrowing until 2023 at all but one large-hub airport, with the existing $4.50 cap (again, with the exception of the one that does not charge a $4.50 PFC).\nIt is important to note that our analysis is unable to incorporate projects that"] [12.581518173217773, 12.189387321472168, "o collect essentially the maximum potential PFC revenue in future years as well.\nFor the 2020s, we estimate that 86 percent of large-hub PFC revenues are tied up, while about $4.2 billion could be earned over that period to fund as-yet-unapproved pro"] [12.556428909301758, 12.216208457946777, "nd charts in this chapter can inform the discussion surround- ing the adequacy of the existing maximum allowable PFC, there are limitations to this analy- sis. In addition to an inability to account for projects in early planning stages, this analysi"] [12.550675392150879, 12.2190580368042, "ices to deter the entry of competitors. Although this strategy reduces profits in the short term, it enables the incumbent to charge prices that are higher than competitive market rates in the future, once the threat of competition is gone. In some c"] [12.570306777954102, 12.202136993408203, "hat potentially enhance competition provide the baseline data for this analysis.\nInterviews with stakeholders yielded differing points of view on whether airlines some- times press airports to use up their PFC funds on projects not related to competi"] [12.601385116577148, 12.172914505004883, "etition-Enhancing PFC Projects in Four Markets\nDetroit, MI\n00 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019\nPittsburgh, PA\n1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019\nYear Atlanta, GA\n1995\n1997\n1999\n2001\n2003\n2"] [12.61040210723877, 12.165996551513672, " could build up to a larger aggregate effect. Relatively rapid increases or decreases in competition at airports are usually associated with consolidation and changes in airline hubbing decisions. For example, the steep decline in the HHI in Pittsbur"] [12.640652656555176, 12.13697624206543, " cap means more potential PFC revenues avail- able to be used for infrastructure projects, greater potential for airport-level variation in PFC levels, and larger possible impacts on passengers.\nPolicymaker Decisions\nThe effects of raising the PFC ca"] [12.61296558380127, 12.164424896240234, "um hubs) or eliminating AIP eligibility entirely for these airports (entitlement or discretionary), that would affect airports differently than PFC cap increases that do not alter AIP eligibility standards. For example, airports might increase their "] [12.610690116882324, 12.166781425476074, "ently does not cap the levels at which airports may set their airport improvement fees, which are broadly similar to the U.S. PFC. In Canada, though, these charges are typically limited to\nFederal Role in Airport Infrastructure Funding: Passenger Fac"] [12.60044002532959, 12.177092552185059, "in terms of a decrease in demand for travel. Passengers with connections also would be hit harder by a PFC increase than travelers with nonstop flights, since the charge is imposed on each leg of a two-flight trip. These larger effects on connecting "] [12.601816177368164, 12.17374324798584, "the country\u2019s airports\u201d (Whitman Insight Strategies, 2019). As with all surveys, the way in which the same questions are framed and anchored can have a large effect on the response.\nAnother possibility is that a higher PFC cap could allow airports to"] [12.60358715057373, 12.176937103271484, "ects on nonstop and connecting pas- sengers, with connecting passengers paying multiple PFCs, but it is important for modeling the demand response. Specifically, applying a demand elasticity of \u22120.8 (the baseline value used by GAO, 2014c)36 means tha"] [12.606147766113281, 12.1715726852417, " to substitute other forms of travel). We use demand elasticities that do not distinguish between these categories for this analysis for two reasons. First, the elasticity estimates from InterVISTAS Consulting Inc., 2007, and those included in the GA"] [12.578363418579102, 12.19594669342041, "n nominal dollars and adjusted for inflation using the CPI. A combination of factors contributed to this growth over time: an increase in airports charging a PFC, an increase in the share charging at $4.50, and an increase in enplanements at these ai"] [12.517024040222168, 12.251705169677734, "so might use a cap increase to pay down existing debt faster, and thus reduce their interest costs. Specifi- cally, we estimate that raising the PFC cap by $1 would increase potential PFC revenue avail- able to hub airports over the next five years ("] [12.437895774841309, 12.34788703918457, ". Note that nearly all airports are operating in the municipal (tax-exempt) bond market, although there are a few exceptions of airports using taxable bonds instead.\nBond Issuers\nThe issuer of an airport bond depends on the oversight structure of the"] [12.466264724731445, 12.2984037399292, "t infrastructure projects, GARBs are issued with maturity dates in increments of 10, 20, and 30 years.\nSimilar to the usage of the proceeds, the covenants of the GARBs specify the sources of revenue that can be used for repayment of the debt.1 Revenu"] [12.470523834228516, 12.357558250427246, "onds are issued by airport operators for projects that require less consultation from the airlines. For either single- or double-barrel bonds, airports must track the components of the bond proceeds to the specific projects that have been approved fo"] [12.44054126739502, 12.323713302612305, " operators\u2019 balance sheets because they are the issuers of the bonds.\n 116 U.S. Airport Infrastructure Funding and Financing\nSuch facilities include rental car centers, terminals, and other leased infrastructure outside the normal fee structures of a"] [12.433914184570312, 12.329936981201172, "y AAA-grade corporate bonds and tax-exempt bonds of comparable grade from 2006 to 2016 is 0.65 percentage points (Maguire and Hughes, 2018). Even though tax-exempt bonds offer lower interest rates than taxable bonds, they can be attractive to many in"] [12.420553207397461, 12.341202735900879, "nplanements compared with the amount of indebtedness, the ratio of annual revenue gen- erated to total indebtedness, and the quality of the airlines that operate in the airport. Other factors include the issuing airport\u2019s debt structure and its infra"] [12.451997756958008, 12.346916198730469, "y to borrow helps an airport pay for projects whose costs exceed what the airport could pay for with a single year\u2019s revenue. Throughout this report, we do not consider bond proceeds to be revenue because this would double-count revenue (today\u2019s bond"] [12.439098358154297, 12.325203895568848, "d to the two airports when reporting its financials to the FAA. Therefore, the bond proceeds and debt services in this report exclude such airports.\n Figure 7.1\nBond Proceeds and Revenue, by Airport Size, 2009\u20132017\n Billions of dollars\nBillions "] [12.429632186889648, 12.332379341125488, "vice airports and is likely to remain so, barring changes in the tax code or major market disruptions. Airports that participate in the municipal bond market are considered by the rating agencies to offer investment-grade opportunities with a low ris"] [12.415910720825195, 12.335785865783691, "air transportation services at affordable fares and reasonable levels of qual- ity to travelers, businesses, and aviators that are anticipated to use these services in the future. As complements or alternatives to supply-side measures, demand-side ma"] [12.427854537963867, 12.321369171142578, "ssengers in 2018 as in 1990. For comparison, the U.S. popula- tion grew by only 30 percent over this same period. The FAA\u2019s TAF suggests this growth will continue. Medium-, small-, and non-hub airports are all expected to see enplanements grow by 20\u2013"] [12.405922889709473, 12.33953857421875, "ng toward use of larger planes to meet demand without a comparable increase in operations, and this trend is anticipated to continue. However, the relatively mild growth in the number of operations does not necessar- ily translate to diminished infra"] [12.414590835571289, 12.335112571716309, " trying to optimize in response to their own expectations of the future. Under these circumstances, forecasting demand many years into the future at an individual airport is challenging.\nThere are two main sources of demand forecasts for airport plan"] [12.391817092895508, 12.350268363952637, "essing Future Demand and Capacity Constraints 127\n Historical\n Forecast\n Baseline\nOptimistic scenario Pessimistic scenario\n 4\n3\n 2020 2025 2030 2035\n2040 2045\nFiscal year\n Historical\n Forecast\n Baseline\nOptimistic scenario Pessimistic scena"] [12.412092208862305, 12.335102081298828, "capacity constraints, forecast aircraft fleet mixes, and capacity profiles of individual airports. The FACT reports thus give insight into the evolution of airside capacity constraints as well as the inputs determining these constraints over time.\nTh"] [12.3873291015625, 12.35641860961914, "ped because of lack of evidence (McLaughlin and Sasso, 2017).\nThe changes in projected airside capacity constraints over the past two decades contain lessons for the future of airside capacity planning. For one, external factors, such as demand for a"] [12.4276704788208, 12.322630882263184, "y, deter- mine when it will become constrained, and identify projects to expand.5 We emphasize that this analysis is specific to the airport in question and is not collected on a systemwide basis. Without systemwide, empirical data on landside infras"] [12.385881423950195, 12.35857105255127, "structure needs, as well as the revenue that pays for those investments, can change quickly. Flexibility of funding sources is of paramount concern to airports because they want and need the agility to alter plans if conditions suddenly change.\nImpac"] [12.344659805297852, 12.387012481689453, " delay data by cause, from June 2003 to the present, for most nonstop commercial flights, as submitted by reporting carriers.7 As shown in Figure 8.5, there are five categories of delay causes within the ASQP database: air carrier, extreme weather, n"] [12.357287406921387, 12.378914833068848, "ntify the party best able to reduce the delay. Because late-arriving aircraft delays occur when a previous flight delayed the aircraft, causing the current flight to be delayed, the party best suited to reduce the delay depends on the cause of the in"] [12.360804557800293, 12.376687049865723, "ort individually.10\nNational Aviation System (OPSNET) Delays\nNAS delays, as described above, are delays for which the FAA, airport operators, and state or local governments are in the best position to take corrective action to prevent or mitigate the"] [12.371387481689453, 12.365309715270996, "er challenges, however. San Francisco, for instance, must often deal with low ceilings because of the frequent presence of fog, whereas Denver might face snowy conditions more frequently. There are several airports where weather is not the pre- domin"] [12.381166458129883, 12.355325698852539, "sing Future Demand and Capacity Constraints 137\n Ten-Year Trend\nGrand Total\n365,230\n310,331\n267,972\n265,947\n151,627\n150,947\n125,885\n83,352\n57,186\n42,363\n33,878\n30,130\n29,848\n29,647\n28,382\n26,849\n25,511\n25,010\n22,328\n15,592\n86,"] [12.382781982421875, 12.3537015914917, "0.1\n2016\n 3.4\n 5.7\n 3.8\n 1.2\n 1.7\n 1.5\n 1.0\n 1.0\n 0.3\n 0.8\n0.9\n 0.5\n 0.6\n 0.6\n 0.5\n 0.5\n 0.6\n 0.2\n 0.2\n 0.5\n 0.01\n 0.1\n2015\n 2.7\n 4.9\n 2.5\n 1.9\n 2.3\n 1.4\n 1.0\n 1.1\n 0.5\n 0.8\n0.9\n 0.5\n 0.5\n 0.3\n 0.5\n 0.3\n 0.4\n 0.3\n 0.4\n 0.3\n 0.01\n 0.1\n2014\n 4.1\n 4.8\n "] [12.338193893432617, 12.395492553710938, " at least at those airports able to expand, can reduce the probability that volume delays will occur when airlines schedule many flights at the same time, but it is unlikely to eliminate all congestion at peak times. Likewise, improved infra- structu"] [12.352910995483398, 12.381048202514648, "LGA\u2013ORD\nBad weather causes a 12-minute delay. Arrives 12 minutes late.\nFlight 2, ORD\u2013LGA\nFlight leaves 12 minutes late but is able to make up 2 minutes in the air. Arrives 10 minutes late.\nFlight 3, LGA\u2013ORD\nFlight leaves 10 minutes late but is able t"] [12.354804039001465, 12.380718231201172, ".12 Consequently, this measure of total NAS delay cannot be attributed to an individual airport. As an example of how total delay is calculated, Table 8.4 provides the top 13 O&D pairs that produce the most total NAS delay. These 13 O&D pairs represe"] [12.355141639709473, 12.386202812194824, "r Most NAS Delays\n100\n90\n 2,621 pairs (41%) make up 90% of NAS delay 1,426 pairs (22%) make up 75% of NAS delay\n572 pairs (9%) make up 50% of NAS delay 142 pairs (2.2%) make up 25% of NAS delay\n13 pairs (<1%) make up 5% of NAS delay\n Cumul"] [12.399672508239746, 12.351463317871094, "ebt service an airport\u2019s reserves should be able to cover; this metric is commonly referred to as \u201cdays of cash on hand.\u201d The recommended amount varies depending on whether the airport or airline bears the risk of paying costs if revenues fall short."] [12.413548469543457, 12.33689022064209, "e metric for measuring the airport\u2019s current financial status. Large- and medium- hub airports have seen their days of cash on hand slowly increase in recent years, although as noted above, these airports might also be saving for additional infrastru"] [12.393465995788574, 12.347625732421875, " depreciation) + Debt Service (excluding coverage)\nTable 8.6 shows that a holistic view of airports with the most OPSNET delays per opera- tion in 2018 reveals variation and nuance in airports\u2019 status. For example CLT has relatively normal delays per"] [12.394124984741211, 12.347984313964844, "/A\nN/A\n0.87914864\nN/A\n1.60533197\n0.70224447\n2.26166683\nN/A\n1.52525321\n1.22924694\n1.99380368\n2.17973263\nN/A\n2.87975066\n1.63250881\n2.29556382\nN/A\nN/A\n2.52490346\n1.56405689\n2.73352892\nTrend 2009\u20132017\nDSCR 2009\nN/A\nN/A\n1.1573963\nN/A\n1.804785722\n0.0717375"] [12.372149467468262, 12.372482299804688, "in effects of exter- nal factors (e.g., economic conditions and airline decisions) make airport planning difficult. This is one reason why airports find flexibility in funding desirable.\nCapacity constraints can manifest themselves in several ways th"] [12.440325736999512, 12.311896324157715, "sure that there is coherence in its overall strategy, either with the vision above or an alternative vision, and a willingness to adapt federal programs and resources to align with that overall strategy.\nWe begin this chapter by presenting our findin"] [12.429618835449219, 12.32363224029541, " on the \u201ccolor of money,\u201d airports might be required to line up approvals from the appropriate combination of federal regulators, local governments, state governments, and airlines before making investments in airport infrastructure. Decisions made b"] [12.424018859863281, 12.327232360839844, "ated excellent, good, or fair. This reflects the priority given to airside infrastructure in federal grants provided under the AIP and the effectiveness of funding from all sources to meet airside needs. However, terminals and control towers are wide"] [12.595108032226562, 12.179045677185059, "e cap on PFCs has been set at $4.50 per passenger since the 2000 FAA Reautho-\nKey Findings and Recommendations 151\n152 U.S. Airport Infrastructure Funding and Financing\nrization Act. Since that time, the purchasing power of a dollar of PFC revenues h"] [12.529820442199707, 12.248085975646973, "thorized exclusively for use by commercial service airports, nor do GA airports have sufficient passenger volume to support such a user fee. Instead, GA and nonprimary commercial service airports rely on AIP funding, which is redistributive by design"] [12.541553497314453, 12.23916244506836, "ue diversion practices in 1982. Airports operated by these air- port sponsors are legally allowed to divert airport operating revenue, up to a statutory limit. The second form encompasses revenue diversion by any other airport sponsor, which most fre"] [12.474002838134766, 12.288987159729004, "o of complementary changes to the PFC program, the AIP, the AATF, and to policies and procedures regarding revenue diversion, as indicated in Figure 9.1. The interrelated nature of these funding programs and policies makes it important to consider\nFi"] [12.586956024169922, 12.188413619995117, "create delays for passengers that propagate throughout the NAS.\nSeparately, the average inflation-adjusted domestic ticket price fell from $630 in 1993 to $432 in 2018. Competition and market conditions are the primary determinants of ticket prices. "] [12.52662181854248, 12.242829322814941, "unattractive to local governments and would increase the cost of local goods and services unrelated to air travel. Privatization is possible but rarely pursued; the Airport Investment Partnership Program, established in 1997, allows airports to explo"] [12.450745582580566, 12.306044578552246, "e-hub airports\n(d)(2) Quantify large- hub airports\u2019\ninfrastructure requirements, including terminal, landside,\nand airside infrastructure\n(d)(3) Quantify the percentage\ngrowth in infrastructure requirements\nof the large- hub airports relative to othe"] [12.560516357421875, 12.216344833374023, "8 U.S. Airport Infrastructure Funding and Financing\nthese recommendations as a whole rather than in isolation. Taken together, these changes have the potential to help airports of all sizes maintain safe, efficient, and sustainable operations.\nThe vi"] [12.604011535644531, 12.174156188964844, " operations will likely lead to increased infrastructure requirements.\nUnder current policy, larger airports are generally able to raise funds for critical projects and are meeting their debt obligations. Some airports, such as CLT, appear to be fina"] [12.58985710144043, 12.187263488769531, "ary entitlements entirely. The largest airports, with more than about 26 million enplanements, would be more than made whole by the ability to keep collecting at the higher PFC level after forgoing their primary entitlements.\nOption C: Increase the C"] [12.60819149017334, 12.169609069824219, "ise their PFC above $4.50, indexed to inflation, should forgo their AIP primary entitlements dollar-for-dollar for each dollar of PFCs they collect, up to 100 percent of these entitlements. Instead, that money could more efficiently achieve the redis"] [12.594623565673828, 12.182840347290039, "not be allowed to charge layover passengers a PFC of less than 50 per- cent of the origin PFC. This would prevent airports from lowering their layover PFC to $0 to attract layover traffic and only charge origin passengers for infrastructure use.\nKey "] [12.542908668518066, 12.23946475982666, "ver time, but the timing and magnitude of annual grants would be better aligned with the timing and magnitude of needs. Airports could compete to receive more funds in the form of larger grants from the pool of discretionary funding, when needed, but"] [12.560036659240723, 12.232426643371582, "elps fund the AATF. This policy favors airlines that separate ancillary fees from their base ticket price over those that do not. Airlines should be free to separate ancillary fees if they wish, but the Domestic Passenger Ticket Tax should not incent"] [12.517792701721191, 12.257220268249512, "provide conclusive evidence as to whether individual PFC projects have had an effect on competition. Facilities funded with PFCs may not be leased on an exclusive- use basis, and that policy element of the PFC program might support competition. In pr"] [12.518451690673828, 12.251100540161133, "ric planes using the same infrastructure untaxed. A comparable situation applies to the gas tax supporting the Highway Trust Fund. To ensure stability and equity of funding, Congress should authorize the FAA to conduct a study that considers transiti"] [12.419217109680176, 12.33345890045166, "AIP funding over time, but the timing and magnitude of annual grants\nKey Findings and Recommendations 165\n166 U.S. Airport Infrastructure Funding and Financing\nwould be better aligned with the timing and magnitude of needs. Second, although airport r"] [12.443991661071777, 12.305595397949219, "ploads/2017/01/Aviation-Final.pdf\nASCE\u2014See American Society of Civil Engineers.\nBeckman, Howard, \u201cAbility of Local Jurisdictions to Regulate Airport Noise,\u201d webpage, August 2, 2012. As of June 26, 2019:\nhttp://www.airportnoiselaw.org/abate.html\nBelko"] [12.436064720153809, 12.314573287963867, "s-t-100-and-t-100f-traffic-reporting\n\u2014\u2014\u2014, \u201cRural Airports,\u201d webpage, December 18, 2018. As of May 1, 2019: https://www.bts.gov/modes/aviation/rural-airports\n\u2014\u2014\u2014, \u201cOn-Time Performance: Flight Delays at a Glance,\u201d 2019a. As of October 18, 2019: https:/"] [12.432177543640137, 12.3187837600708, "Subpart C, Collection, Handling, I, Part 158, Subpart C, Section 158.53,\nI, Part 158, Subpart D, Reporting, Code of Federal Regulations, Title 49, Part 1542, Airport Security, October 1, 2018.\nCoogan, Matthew A., MarketSense Consulting LLC, and Jacob"] [12.460821151733398, 12.297324180603027, "eparing Attachments for PFC Application Form: Section 6 of FAA Form 5500-1,\u201d undated e. As of November 22, 2019: https://www.faa.gov/airports/resources/forms/media/pfc_5500_1_instruct_attach_0810.pdf\n\u2014\u2014\u2014, \u201cThe Operations Network (OPSNET),\u201d database, "] [12.476387977600098, 12.280998229980469, "9, 2019:\nhttps://www.faa.gov/data_research/aviation/taf/media/taf_summary_fy_2018-2045.pdf\n\u2014\u2014\u2014, \u201cGrandfathered Airports,\u201d fact sheet, May 1, 2018c. As of September 9, 2019: https://cats.airports.faa.gov/GrandfatheredAirports.pdf\n\u2014\u2014\u2014, \u201cFY 2018-2020 Ai"] [12.470787048339844, 12.281540870666504, "cular 150/5070-6B, Change 2, Change 2 to Airport Master Plans, Washington, D.C.: Federal Aviation Administration, January 27, 2015. As of October 10, 2019: https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC_150_5070-6B_with_chg_1&2.pdf\nFe"] [12.432780265808105, 12.317214012145996, "hority, Airport Revenue Bonds, Series 2009, Bozeman, Mont., October 7, 2009. As of November 22, 2019:\nhttps://emma.msrb.org/EP332996-EP37912-EP659937.pdf\nGAO\u2014See Government Accountability Office.\nGentry, Jennifer, Kent Duffy, and William J. Swedish, "] [12.436762809753418, 12.3112154006958, "anged Little in Recent Years, but Stakeholders Voice Concerns About Competition, Washington, D.C., GAO 14-515, June 2014a. As of June 25, 2019:\nhttps://w w w.gao.gov/products/GAO-14-515\n\u2014\u2014\u2014, Airport Privatization: Limited Interest Despite FAA\u2019s Pilot"] [12.429261207580566, 12.31963062286377, "dicators, Washington, D.C.: Transportation Research Board, ACRP Report 19A, 2011.\nH.R. 1265\u2014See Investing in America: Rebuilding America\u2019s Airport Infrastructure Act, 2017. H.R. 3791\u2014See Investing in America: Rebuilding America\u2019s Airport Infrastructu"] [12.429228782653809, 12.321261405944824, "D.C.: Transportation Research Board, ACRP Legal Research Digest 35, September 2018.\nKasper, Daniel M., and Darin Lee, An Assessment of Competition and Consumer Choice in Today\u2019s U.S. Airline Industry, presentation prepared for Airlines for America, J"] [12.437605857849121, 12.312853813171387, "://web.mit.edu/airlinedata/www/Aircraft&Related.html\nMathews, J. Scott, \u201cA Counterpoint Assessment of Vancouver International Airport as a Gateway to North America,\u201d Thunderbird International Business Review, Vol. 41, No. 3, May/June 1999, pp. 265\u201327"] [12.446270942687988, 12.307161331176758, ", D.C.: National Academies Press, 2007. As of November 11, 2019: https://www.nap.edu/catalog/14041/innovative-finance-and-alternative-sources-of-revenue-for-airports\nNunes, Ashley, \u201cIs Trump\u2019s Plan to Privatize Air-Traffic Control a Good Idea?\u201d The A"] [12.441102027893066, 12.309943199157715, "/default/files/2018-05/ Final%20Official%20Statement%20-%202010%20PFC%20bonds.pdf\nPublic Law 79-377, Federal Airport Act of 1946, May 13, 1946.\nPublic Law 91-258, Airport and Airway Development Act of 1970, May 21, 1970.\nPublic Law 93-44, Airport Dev"] [12.453758239746094, 12.298121452331543, "Chana R., \u201cAirport Munis,\u201d Forbes, June 9, 2003. As of August 5, 2019: h t t p s : / / w w w . f o r b e s . c o m / f o r b e s / 2 0 0 3 / 0 6 0 9 / 1 3 4 . h t m l # 6 9 d c 7 b 6 0 4 15 7\nSFO\u2014See San Francisco International Airport.\nSharkey, Joe,"] [12.441707611083984, 12.30689525604248, ".pdf\nUnited Airlines, Inc. v. The Port Authority of New York and New Jersey \u2013 Complaint and Exhibits A to NN (16-14-13), FAA-2015-0026, posted January 8, 2015. As of June 25, 2019: https://www.regulations.gov/document?D=FAA-2015-0026-0001\nU.S. Code, "] [12.415633201599121, 12.335700035095215, "gister_notices/media/pfc_69fr6366.pdf\nReferences 179\n180 U.S. Airport Infrastructure Funding and Financing\n\u2014\u2014\u2014, \u201cRevisions to Passenger Facility Charge Rule for Compensation to Air Carriers,\u201d Final Rule, Federal Register, Vol. 69, No. 53, March 18, 2"] [12.433289527893066, 12.31922435760498, "inance/articles/airport-rate-methodology\n\u2014\u2014\u2014, \u201cUnited States Airport Rates and Charges Regulations,\u201d webpage, March 15, 2015b. As of June 25, 2019:\nhttps://www.dwuconsulting.com/airport-finance/articles/airport-rate-regulation\n\u2014\u2014\u2014, \u201cAir Ticket Taxes "] [12.426175117492676, 12.32492446899414, " CORPORATION\nBENJAMIN M. MILLER, DEBRA KNOPMAN, LIISA ECOLA, BRIAN PHILLIPS, MOON KIM, NATHANIEL EDENFIELD, DANIEL SCHWAM, DIOGO PROSDOCIMI\nU.S. Airport\nInfrastructure Funding\nand Financing\nIssues and Policy Options Pursuant to Section 122 of the 2"] [12.419242858886719, 12.326345443725586, "s related concerns, and to \u201cmake recommendations on the actions needed to upgrade the national aviation infrastructure system to meet the growing and shifting demands of the 21st century.\u201d RAND, a nonprofit and nonpartisan policy research organizatio"] [12.389833450317383, 12.368315696716309, "ynamics, transportation, energy, and climate and the environment, as well as other policy concerns that are influenced by the natural and built environment, technology, and commu- nity organizations and institutions that affect well-being. For more i"] [12.428065299987793, 12.322516441345215, "ane Downey, Vice President of Government Relations, Global Business Travel Associa- tion\n\u2022 Bryant Francis, Director of Aviation at the Port of Oakland\n\u2022 Trish Gilbert, Executive Vice President of the National Air Traffic Controllers Association\n\u2022 Ada"] [12.422528266906738, 12.330842018127441, "ank Camm and Lauri Rohn, for their timely and constructive reviews of our work throughout the study period as part of the RAND quality assurance process. We thank John Strong for wearing a second hat as an exter- nal reviewer in addition to being a m"] [12.466552734375, 12.289430618286133, "ions regarding which entities must approve the spending. As a consequence, airport operators consider more than whether sufficient dollars are available to fund an infrastructure project. They also carefully consider whether and how much funding can "] [12.432591438293457, 12.31875991821289, "000 annual enplanements\nNonprimary commercial service\n At least 2,500 and no more than 10,000\n0.10\n126\nNoncommercial service: Less than 2,500 annual enplanements\nGeneral aviation\n Less than 2,500\n0.05\n378,858\n 2,549\nReliever\n Designated to relieve co"] [12.575075149536133, 12.195751190185547, "n the Passenger Facility Charge Would Reduce Airports\u2019 Borrowing Costs but Likely Would Increase Ticket Prices\nAirports will need to make significant investments in the coming years to sustain existing capacity and services and to accommodate growth "] [12.53176498413086, 12.246932029724121, "y generate in excise tax revenues to the Airport and Airway Trust Fund (AATF), which funds the AIP and many other FAA programs. Airports must be included in the NPIAS to be eligible to receive AIP funds.\nThere are two general types of AIP grants: ent"] [12.5404052734375, 12.240083694458008, "e or local governments diverting revenue from aviation fuel taxes to nonaviation purposes.\nThe argument for grandfathering was that accounting and spending practices at these air- ports made a clean separation of revenue between airport and nonairpor"] [12.626709938049316, 12.151354789733887, "policy options in Chapter Nine: (1) index the current cap to inflation, (2) increase the flexibility of airport revenue but do not increase cumulative revenue other than indexing the cap to inflation, (3) raise but do not remove the PFC cap and index"] [12.664020538330078, 12.115450859069824, "m airlines and other stakeholders when requesting a PFC increase.\nTo ensure that airports have sufficient and stable sources of revenue commensurate with present and future capital needs, the PFC cap should be indexed to inflation, regardless of whet"] [12.554182052612305, 12.22556209564209, "their own capital needs do not impose costs on other airports in the process. Origin passengers represent the majority of passengers at most airports, with the notable exception of three large hubs, and layover passengers could still be charged PFCs "] [12.502196311950684, 12.27772045135498, "d to ensure excise tax revenues are spent on aviation system priorities. In practice, the enforcement mechanism is weak and is regularly ignored by Congress. Under excise tax levels set in current law, a large uncommitted bal- ance is projected to ma"] [12.540657997131348, 12.240256309509277, "authority to withhold other USDOT grants from airport sponsors (as opposed to withholding FAA grants from airport management) that remain out of compliance with revenue diversion rules. This withholding rarely occurs, but the FAA should pursue this p"] [12.48994255065918, 12.280450820922852, " Fuel Taxes Will Eventually Be Needed\nFuel taxes are not the largest portion of AATF revenue. Nonetheless, progress on developing and deploying electric planes could eventually lead to declines in fuel-based tax revenues while leaving the electric pl"] [12.472319602966309, 12.291232109069824, "propriate infrastructure investments.\nAirports of all sizes draw on multiple sources of funding. Larger airports tend to generate most of their revenues from their operations and take advantage of the municipal bond market. In contrast, smaller airpo"] [12.512340545654297, 12.26102066040039, "ions to fund terminal construction projects\nResources eligible for use toward noise reduction and emission reduction projects\nGap between the cost of projects eligible for the AIP and the annual federal funding provided\nImpact of regulatory requireme"] [12.449546813964844, 12.309305191040039, "e. Markets with fewer passengers are likely to be served by fewer airlines.\nSome airlines have separated ancillary fees, such as fees for baggage and reserved seats, from their base fares. Ancillary fees that have been separated from base fares are e"] [12.485353469848633, 12.282306671142578, "by 17 percent, small hubs by 10 percent, and non-hubs by\n6 percent. This growth will likely lead to increased infrastructure requirements, but local circumstances will determine whether changes are required and, if so, their associated costs.\nIn tota"] [12.441414833068848, 12.31056022644043, "serve at least 2,500 passenger boardings (enplanements) per year and that receive scheduled passenger service, handle 99.9 percent of those enplanements. These airports provide the physical infrastructure\u2014runways, terminals, gates, and other faciliti"] [15.794466972351074, 9.71764087677002, " Research Report\nSTEPHANIE BROOKS HOLLIDAY, NICHOLAS M. PACE, NEIL GOWENSMITH, IRA PACKER, DANIEL MURRIE, ALICIA VIRANI, BING HAN, SARAH B. HUNTER\nEstimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release in"] [15.715341567993164, 9.698152542114258, "tate Hospitals FIST felony incompetent to stand trial\nLASD Los Angeles County Sheriff Department MIST misdemeanor incompetent to stand trial ODR Office of Diversion and Reentry\nSMI serious mental illness\nThis increase in the mental health population "] [15.742323875427246, 9.773357391357422, "o provide these services, and may save costs without compromising public safety.\n 2\n Box 1. Current ODR Diversion Programs\n\u2022 Supportive housing program for individuals experiencing homelessness (i.e., ODR Housing program): Initiated in August 2016, t"] [15.72406005859375, 9.676996231079102, " incarceration, with a particular focus on the population with mental illness. In August 2018, the BOS directed a study of the existing jail mental health population to determine who may be eligible for diversion programs (which resulted in this repo"] [15.711453437805176, 9.662684440612793, "th providers. On August 5, 2019,\nDHS, DMH, and the Department of Public Health delivered a report to the County Chief Executive Office outlining the need for services to be developed along a continuum of care, with significant options for unlocked co"] [15.691022872924805, 9.657625198364258, "cal eligibility for diversion. We started this phase by holding discussions with ODR clinicians to better understand ODR programs and processes, including the factors they consider when determining if they will put someone forward as a candidate for "] [15.699616432189941, 9.663237571716309, "chart review of a stratified random sample of individuals from the jail mental health population to identify an estimate of the number\nof individuals that are potentially divertible. LASD provided a data set that included all individuals in\nits jail "] [15.691722869873047, 9.652612686157227, " coded the charts, they flagged any charts that were especially challenging or inconclusive. All flagged charts were reviewed by another clinician to make a final determination.27\nAfter completion of the clinical review, the legal and clinical decisi"] [15.689258575439453, 9.652862548828125, "n by gender. A larger percentage of women were determined to be appropriate candidates for diversion than men.\nAdditional analyses by race/ethnicity are reported in Appendix D.\nTABLE 2\nAppropriateness for Diversion of the Jail Mental Health Populatio"] [15.68593692779541, 9.649837493896484, " she could have been diverted at some point during pretrial proceedings or at the time the court\u2019s judgment was rendered. That said, it is also worthwhile to consider effective community-based treatment options that can be provided along the entire c"] [15.739027976989746, 9.71839427947998, "al needs\nover competency services.31 Bexar County in Texas provides police officers with a dedicated short-term treatment facility for individuals with mental illness who have minor charges; outcomes are promising in that numbers of diversions have i"] [15.690841674804688, 9.658317565917969, " receive individualized consideration, the number of cases\nin any given \u201cmental health\u201d courtroom should be\n Even with increased diversion, however, there\nwill continue to be a large number of individuals with mental health needs who remain in jail\u2014 "] [15.692724227905273, 9.644590377807617, "all number of courtrooms that are currently in play. Legal stakeholders in other courts may have differing views regarding the factors that shape legal suitability and clinical eligibility. If it is assumed\nthat the judges assigned to courtrooms curr"] [15.695686340332031, 9.65526294708252, "ed, if relevant) during our review period. But we acknowledge that any review of this sort\u2014just like any clinical diagnosis in jail\u2014cannot infallibly distinguish all symptoms of mental illness from all effects of substances.\nFifth, it is important to"] [15.692115783691406, 9.6680908203125, " real-time\n 11\nway to track outcomes.39 Therefore, this might also include new data-collection infrastructure or efforts. An increased capacity for ongoing data collection is particularly important because there are numerous systemic changes and evol"] [15.688051223754883, 9.655075073242188, "subset would decline to participate in a diversion program.\nFinally, although ODR is responsible for developing diversionary programming, there are other local and state agencies that have a stake and\na role in providing solutions. Therefore, future "] [15.688509941101074, 9.656002044677734, "including information from the jail medical record\nas well as information regarding use of public mental health services in Los Angeles County. Based on both the legal and clinical review, they then made a determination about each person\u2019s overall po"] [15.67894172668457, 9.626252174377441, "issue; those considered potentially appropriate are those in which there are certain charges or statuses that raise some question of suitability but the issue is not one that appears to be an obvious bar for diversion. All cases categorized as approp"] [15.681913375854492, 9.63444995880127, "(DDES) online system, which was one of several sources used in the ODR preliminary study. Because we were not granted access to DDES, we relied on ODR to use the system on our behalf and to provide us with current charge and recent conviction informa"] [15.61877155303955, 9.498058319091797, "priate\n NOTES: All other cases were considered appropriate for purposes of our review. PC = California Penal Code; HS = California Health and Safety Code. a There is no specific penal code associated with this criterion.\n 15\nAppendix C. Clinical Crit"] [15.652154922485352, 9.53145980834961, "er\nUnspecified schizophrenia spectrum and other psychotic disorder\nBipolar I disorder\nCurrent/most recent episode manic\nCurrent/most recent episode depressed\nF31.31 F31.32 F31.4 F31.5 F31.75 F31.76\nIntellectual disability\nSchizophrenia\nMild F31.11 Mo"] [7.698696136474609, 4.507229328155518, "anor Charges and Recent Felony Convictions Rated as Not Appropriate for Diversion\nCite Description\n PC 32\nPC 182.5\nPC 186.28 PC 187\nPC 187(a)\nPC 187(a)(1) PC 189\nPC 190.05 PC 192(a)\nPC 192(b)\nPC 207(b)\nPC 209(b)\nPC 209(b)(1) PC 209.5\nPC 209.5(a) P"] [7.689189910888672, 4.5999603271484375, "omy of minor under eighteen\nSodomy\u2014victim under 18\nSodomy\u2014victim under 16, defendant over 21 Sodomy\u2014victim under 14, defendant 10 years older Oral copulation\u2014victim under 18\nOral copulation\u2014victim under 16\nOral copulation\u2014victim under 14\nLewd act on "] [7.724452018737793, 4.597231864929199, "g minor to assist in distribution of obscene matter; posing or modeling involving sexual conduct Brandishing a firearm\n 22\n Cite\nPC 417(b)\nPC 417(c)\nPC 417.3\nPC 417.4\nPC 647.6(a)(1) PC 647.6\nPC 653f(b)\nPC 664/187(a) PC 664/187(a)(1) PC 664/187\nPC "] [7.776411056518555, 4.438451290130615, "dwelling, vehicle, or aircraft\nDischarging firearm from vehicle with GBI or death\nExplosion or attempt to explode destructive device with intent to murder\nCarrying a loaded firearm with intent to commit felony\nAllowing another to discharge firearm fr"] [7.624754905700684, 4.3362274169921875, "ony conviction, stolen firearm or by gang member\nDelivering concealable firearm to person within any of the classes prohibited by California Penal Code 12021 or 12021.1\nDelivering concealable firearm to person within any of the classes prohibited by "] [15.720633506774902, 9.668146133422852, "gram Countywide to Safely Divert More Individuals with Serious Clinical Needs, 2019.\n18 Motion by Supervisors Sheila Kuehl and Mark Ridley-Thomas: Expanding Countywide Diversion for Justice Involved Adults, 2019; Garcia, 2019.\n19 LAC + USC Restorativ"] [5.8600969314575195, 3.950509548187256, "oups by two sex levels). However, this study\u2019s sampling frame contained 29 strata because the remaining three strata had no individuals. In each stratum, a simple random sample was drawn where the sample size was proportional to\nthe size of the strat"] [15.765860557556152, 9.722784042358398, " Mental Health Treatment Center (Item No. 25, Agenda of February 12, 2019), August 7, 2019. As of November 8, 2019: http://file.lacounty.gov/SDSInter/bos/supdocs/139802.pdf\nCowell, Alexander J., Arnie Aldridge, Nahama Broner, and Jesse M. Hinde, A Co"] [15.755338668823242, 9.841679573059082, ". As of December 4, 2019: https://www.rand.org/pubs/research_reports/RR1754.html\nHunter, Sarah B., and Adam Scherling, Los Angeles County Office of Diversion and Reentry\u2019s Supportive Housing Program: A Study of Participants\u2019 Housing Stability and New"] [15.729928016662598, 9.706847190856934, "de to Safely Divert More Individuals with Serious Clinical Needs, May 14, 2019. As of November 8, 2019: http://file.lacounty.gov/SDSInter/bos/supdocs/135516.pdf\nMotion by Supervisors Hilda L. Solis and Sheila Kuehl: Cancellation of Design-Build Contr"] [13.929522514343262, 4.287179946899414, "dated. As of November 12, 2019: https://ctsi.ucla.edu/patients-community/pages/whole-person- care\nWarren, Janet I., Daniel C. Murrie, William Stejskal, Lori\nH. Colwell, James Morris, Preeti Chauhan, and Park Dietz, \u201cOpinion Formation in Evaluating th"] [13.874741554260254, 4.595544815063477, "ND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout\nthe world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the pub"] [11.380224227905273, 10.676151275634766, " Evaluation of the SB 1041 Reforms to California\u2019s CalWORKs Welfare-to-Work Program\nUpdated Findings Regarding Policy Implementation and Outcomes\nRAND AUTHORS Lois M. Davis, Lynn A. Karoly, Dionne Barnes-Proby, Beverly A. Weidmer, Praise O. Iyiewuare"] [11.331635475158691, 10.712841987609863, "on. Following a competitive bidding process, the California Department of Social Services (CDSS) awarded the evaluation contract to the RAND Corporation, in partnership with the American Institutes for Research (AIR).\nAs described in the evaluation b"] [11.380355834960938, 10.68085765838623, " California\u2019s CalWORKs Welfare-to-Work Program: Findings Regarding the Initial Policy Implementation and Outcomes, by RAND authors Lois M. Davis, Lynn A. Karoly, Robert Bozick, Diana Catherine Lavery, Dionne Barnes-Proby, Beverly A. Weidmer, Praise I"] [11.33756160736084, 10.711930274963379, "...............................................................................................................................xiii Summary .............................................................................................................."] [11.330890655517578, 10.714649200439453, "1.................................................................... 66 Early Engagement Activities.................................................................................................... 69 Counties\u2019 Views Regarding Impact of SB 1041 on"] [11.351134300231934, 10.705504417419434, "................................. 177 Outcomes One Year After Entry ............................................................................................ 180 Discussion .........................................................................."] [11.528190612792969, 10.546781539916992, "by Race/Ethnicity: 2016...................................................................................................... 156 Figure 6.3. Percentage of CalWORKs WTW Clients in the Transitional\nGroup and Post\u2013SB 1041 Group: Status Cross-Sections i"] [11.50979232788086, 10.563318252563477, "........................................ 170\nFigure 6.14. Percentage of CalWORKs WTW Clients Who Were Employed for\nat Least One Quarter in the Subsequent Three Years After Entry: Tracked Entry\nCohorts 2007, 2009, 2011, 2013..........................."] [11.398100852966309, 10.660754203796387, ".............................................................. 209 Figure A.2. Assessment of WTW Clients\u2019 Barriers and Needs (Pre\u2013AB 74) ............................ 210 Figure A.3. California OCAT (Post\u2013AB 74)........................................"] [11.299674034118652, 10.774017333984375, "57 Table 4.7. How Long It Currently Takes a CalWORKs Participant to Start to Receive\nthe Services to Which He or She Was Referred (All Counties) ........................................... 58 Table 4.8. In the Last Year, Have More CalWORKs Clients Do"] [11.190011978149414, 10.86409854888916, "ll Counties and by County Caseload Size) ......................... 74\nTable 4.23. Write-In Responses Regarding Services Offered to Children Through\nCounties\u2019 FS Programs (By County Caseload Size)......................................................."] [11.365323066711426, 10.701929092407227, "TW Entry Cohorts) ............................ 185 Table 8.1. Summary of Key Findings......................................................................................... 192 Table A.1. Comparison of CalWORKs Welfare-to-Work 24-Month Time-Clock\nA"] [11.252741813659668, 10.827545166015625, "........... 282\nTable D.10. Percentage of CalWORKs Clients in a County Who Have Used Their\nFull 24-Month Time Clock and . . . (All Counties and by County Caseload Size) ........... 283\nTable D.11. Supervisors\u2019 Assessment of How Well WTW Caseworkers\nU"] [11.536581993103027, 10.540704727172852, " of Months Counted on the 48-Month Time-on-Aid\nClock and Counted on the 24-Month Time Clock Two Years After Entry:\nTracked Entry Cohorts 2007, 2009, 2011, 2013, 2014....................................................... 297\nTable E.5.b. Average Numb"] [11.494983673095703, 10.575345039367676, "............................................ 303\nTable E.13. CalWORKs WTW Client Status Among Those with the Short-Term WTW Exemption for Young Children in December 2012: February 2013, February 2014, February 2015, February 2016....................."] [11.459634780883789, 10.603353500366211, "ime exemption from WTW requirements to care for a child from birth to age 23 months, replacing the prior temporary young child exemption\u2014 which excused one adult per family from WTW work participation requirements while caring for one child below the"] [11.348785400390625, 10.707649230957031, "links to a set of outputs and finally an array of desired impacts on child and family well-being. The evaluation framework serves to illustrate that whether the reforms achieve their intended effect will depend on a number of factors. First, as part "] [11.367509841918945, 10.679959297180176, "pproached the policy and process changes adopted under SB 1041, and the opportunities for addressing any challenges encountered to date.\nIn addition, this report includes analyses based on several other sources of data that contribute to other study "] [11.302633285522461, 10.7482328414917, "d that the core components of SB 1041 had been implemented as of mid-2016, although issues remained with the execution of some components, particularly the WTW 24-month time clock. From the perspective of the CDSS staff and other state stakeholders w"] [11.236588478088379, 10.785273551940918, "ies to which he or she had been assigned or scheduled. In terms of receiving services, more than 90 percent of counties reported that it takes WTW clients less than one month to receive child care, transportation, and domestic abuse services. Still, "] [11.110150337219238, 10.789734840393066, " has required counties to revamp their business processes and, in some cases, develop or strengthen partnerships with service providers. It has also extended the time needed to complete a WTW plan. The time required to administer the OCAT, the sensit"] [11.20333194732666, 10.849493026733398, "y services and to serve a smaller share of eligible families (73 percent versus 84 percent for large counties). State- and county-level stakeholders largely viewed the FS program as a success because of the flexibility it offers to address the unique"] [11.210126876831055, 10.838652610778809, "he part of the community colleges following budget cuts in the wake of the Great Recession, a growing economy making work more attractive than further education, the expectation on the part of recipients that pursuing a degree would likely extend bey"] [11.480623245239258, 10.593034744262695, "ticipant Indicators in the Post\u2013SB 1041 Period\nAs with the first evaluation report, the status and tracking study components covered in this second report are based on the analysis of state administrative data covering the CalWORKs WTW population. Th"] [11.541826248168945, 10.533784866333008, " WTW clients meeting federal work participation requirements, causing their 24-month time clock not to advance; and WTW clients with exemptions or sanctions that caused both clocks to stop.\n\u2022 Comparing the rate of ever receiving an exemption before a"] [11.59070873260498, 10.484975814819336, "ORKs WTW in the post\u2013SB 1041 period relative to the pre\u2013SB 1041 period. A larger percentage of the February 2014 entry cohort was employed for at least one quarter in the cohort\u2019s first two years after entry compared with the February 2007 entry coho"] [11.543387413024902, 10.530179023742676, " covering the period from the first quarter of 2007 through the first quarter of 2016, were employed in a multicohort interrupted time series design that aims to isolate changes in outcomes that can be associated with SB 1041. Outcomes are measured f"] [11.473578453063965, 10.608255386352539, "erly earnings among new CalWORKs WTW clients two years after enrollment was no different than predicted.\nAlthough these analyses are based on the early cohorts to experience SB 1041 and during a period when implementation was still underway, the find"] [11.229694366455078, 10.78915786743164, "en these issues, we will continue to focus on this aspect of implementation of SB 1041 in the final round of qualitative and quantitative data collection and analysis.\nThe degree of take-up of the 24 months of WTW services and how the flexibility is "] [11.345559120178223, 10.706457138061523, "he legislation, such as connecting CalWORKs clients to needed services. In our final round of data collection, we will be particularly interested in novel approaches that counties have taken that may prove to be useful models for other counties and h"] [11.285648345947266, 10.746277809143066, "nk the several individuals who served as key points of contact for and greatly facilitated our second wave of data collection in the six focal counties. These individuals include Sadaf Pirzada, program specialist for Alameda County; Roselinda Torres "] [11.36164665222168, 10.682530403137207, " Number\nCPI Consumer Price Index\nCWD county welfare department\nCWDA County Welfare Directors Association\nDHHS U.S. Department of Health and Human Services\nEDD Employment Development Department\nESE Expanded Subsidized Employment\nFS Family Stabilizatio"] [11.34865951538086, 10.70548152923584, " identified situation or crisis that would interfere with participation in WTW activities and services; and (3) the Expanded Subsidized Employment (ESE) program, which added funds for CWDs to expand the number of subsidized employment placements for "] [11.331483840942383, 10.70651626586914, "tus study and a WTW client tracking study to examine point-in-time and dynamic indicators for the CalWORKs WTW population both before and after the SB 1041 changes; a county welfare operations impact study to assess the consequences of SB 1041 for va"] [11.4351167678833, 10.621809005737305, "ystems that were not yet available for analysis but will be examined in the final study report.) We also employ the state administrative data, now with an additional year of data relative to the first report (through 2016), to update our assessment o"] [11.430821418762207, 10.637721061706543, "ths to 48 months as of 2011), exemptions from work requirements for adults with a young child in the assistance unit3 (with a more generous allowance as of 2009), and the financial incentives to work (made less generous in 2011).\nSB 1041 Policy Chang"] [11.434381484985352, 10.637737274169922, "B 1041 time-clock structure.\n\u2022 Those in the program prior to January 1, 2013, with fewer than 24 months accumulated are subject to the 24-month CalWORKs WTW time clock, followed by the CalWORKs federal standards until the 48-month lifetime limit is r"] [11.366593360900879, 10.684761047363281, "vices component if they were no longer eligible for the young child exemption.\n\u2022 Other provisions. SB 1041 included a number of other changes, including (1) restoring the earned income disregard (the income excluded when calculating the benefit level"] [11.353826522827148, 10.701752662658691, "rough the implementation stage in the second column, to the outputs from the policy change, and finally to the desired impacts on child and family well-being. The top row indicates the sequence of activities, starting with the passage of SB 1041, con"] [11.32109260559082, 10.723889350891113, "ertaken to satisfy SB 1041; to examine the understanding of the reforms from the perspective of CalWORKs clients, caseworkers, and other county welfare office staff; and to identify any other factors that may affect SB 1041 implementation and its imp"] [11.352180480957031, 10.69417953491211, "ot constant. To address this challenge, as discussed in Karoly et al. (2015), the evaluation components concerned with measuring the impact of the legislation use relevant analytic and statistical techniques to control for such confounding factors. T"] [11.327956199645996, 10.71596908569336, "WTW clients?\nHas SB 1041 helped remove barriers to WTW clients\u2019 employment?\nHas SB 1041 affected WTW clients\u2019 transitions at the 25-month mark?\nHas SB 1041 accelerated WTW clients\u2019 paths to self-sufficiency?\nHas SB 1041 affected California\u2019s TANF ann"] [11.263936996459961, 10.773447036743164, " of the OCAT, which had a longer development phase, lagged relative to these other components. A majority of the counties indicated they had formed new or enhanced partnerships with community-based service providers as they implemented SB 1041.\n\u2022 The"] [11.50887393951416, 10.562183380126953, "verage, a 10-percent increase over the March 2013 cross-section.\n\u2022 The descriptive analysis for the tracking study, which followed pre\u2013 and post\u2013\nSB 1041 cohorts up to two years after CalWORKs entry, showed small to moderate increases in the prevalen"] [11.33045482635498, 10.714801788330078, "s. Most relevant for this second evaluation report are the following results from the telephone interviews:\n\u2022 At the time of the survey, about half of the sample was currently enrolled in the CalWORKs program. Employment issues was the most common re"] [11.344477653503418, 10.70969295501709, "he Child Supplement surveys and assessments include the following:\n\u2022 Twenty-five percent of parents reported that their children were in parental care only (as opposed to Head Start, other centers, relative care, or non-relative home care). Among tho"] [11.382894515991211, 10.668428421020508, "tive data to address questions specific to the status and tracking studies. Although deeper analysis will occur in the final report when county-level administrative data can also be examined, the state data cover key indicators for CalWORKs WTW clien"] [11.355140686035156, 10.693958282470703, "ducted using state administrative data.\nIn the remainder of this chapter, we discuss each of the data components and corresponding methods in turn, with additional technical details provided in Appendix B and Appendix C. The processes for collecting "] [11.277519226074219, 10.750441551208496, "ferrals to, coordination of, and use of supportive services \u2022 Coordination and communication with community colleges \u2022 Status of implementation of AB 74 early engagement\n\u2022 Impact of SB 1041 on CalWORKs WTW clients\n\u2022 Successes, challenges, and next st"] [11.268136024475098, 10.762393951416016, "examined responses to individual questions across the set of state-level key informant interviews. This allowed us to identify key themes that emerged from the interviews and where there were similarities or differences in views regarding the goals o"] [11.270404815673828, 10.765411376953125, "he 2016 ACS questionnaire to minimize measurement error. The final questionnaire contains the following sections (see Appendix B):\n\u2022 Barriers to the Implementation of SB 1041 Reforms and Related Mandates in Your County\n\u2022 Implementation and Effect of "] [11.248783111572266, 10.776394844055176, "y percent of counties completed the survey within the scheduled four-week time frame. We provided additional time for several counties and then closed the survey on July 12, 2016. All 58 counties participated, resulting in a 100-percent response rate"] [11.243558883666992, 10.811884880065918, "ate, degree of urbanicity, demographic makeup of the population, measures of socioeconomic status, and the state of the economy. Counties were also selected such that, together, they would capture a sizable share of the CalWORKs caseload.\n22\nFigure 2"] [11.250123977661133, 10.80700397491455, "meda Fresno\nSan Francisco Central Bay Area, Valley East Bay (south)\nLarge Medium central metro metro 99.6 89.2\n1,594,569 972,297 4.1 2.5\n32.6 30.6 11.1 4.7 27.9 9.8 22.7 51.9\n5.6 3.0\n13.1 26.4 42.8 19.7\n20.5 31.0\n$77,214 $43,423 12.5 27.7\n5.9 11.6\n16"] [11.262574195861816, 10.767777442932129, "iew Topics\n\u2022 Informant\u2019s perception of how implementation of SB 1041 is going\n\u2022 Implementation and perspective on OCAT\n\u2022 Current processes for calculating clients\u2019 WTW 24-month time clock \u2022 Views on the work participation rate\n\u2022 Clients\u2019 engagement i"] [11.239952087402344, 10.775794982910156, "\nWTW clients\n a Includes directors of CalWORKs, WTW, and FS, ESE, OCAT, and child care programs.\nb Includes mental health providers, domestic violence services, alcohol and drug programs, educational providers and vocational training provi"] [11.20300579071045, 10.790542602539062, "cts their work and experience with CalWORKs WTW clients. Specifically, the caseworker focus group protocol covered the following topics (see Appendix B):\n\u2022 OCAT implementation\n\u2022 conducting appraisals using OCAT\n\u2022 the OCAT appraisal summary\n\u2022 views on"] [11.299981117248535, 10.721256256103516, " 22 15 17 25 25 23 38 21 30 17 68\n110 28\n Each caseworker focus group session followed a written protocol, and the sessions ran approximately 90 minutes. A researcher with experience in conducting focus groups facilitated the caseworker focus "] [11.256690979003906, 10.762151718139648, "ews was drawn from a subset of the CalWORKs clients from the 2013 and 2014 cohorts who participated in CalSES and who reported that they had received assistance from the CalWORKs program to further their education or participate in a training program"] [11.196331977844238, 10.7857666015625, "discussions with clients in 2015, we anticipated that we may find some differences by language in their experiences with referrals to and accessing of educational services. We were unable to sample based on language for the OCAT appraisal group since"] [11.339807510375977, 10.701537132263184, "ntion. This approach allowed for a systematic process of categorizing the data through reduction, organization, and connection. The method supports exploration and the discovery of categorical relationships derived directly from the data and encourag"] [11.416146278381348, 10.644532203674316, "her system\u2014LEADER [Los Angeles Eligiblity, Automated Determination, Evaluation and Reporting] Replacement System [LRS]\u2014is for Los Angeles County.) These data will add such information as participants\u2019 use of services, enrollment in education programs"] [11.507286071777344, 10.567943572998047, "tural workers, and the informal sector (i.e., individuals working for cash). Estimates suggest that unemployment insurance administrative data underreport self-reported employment among welfare leavers by 10 to 20 percent (Isaacs and Lyon, 2000). Oth"] [11.528642654418945, 10.54410171508789, " identified these sanctioned participants in the exception file as having exception reason codes 200, 201, 202, 203, 204, or 205, and no record in the program participation file within the same month.\n10 CalWORKs WTW clients are members of cases. A C"] [11.49198055267334, 10.578725814819336, "ntry includes 891,047 WTW clients.\nThe impact analysis of two-year outcomes includes 28 cohorts of clients who were first-time CalWORKs WTW clients from January 2007 through December 2014. The cohorts are defined the same as in the analysis of one-ye"] [11.51020622253418, 10.5609130859375, " associated with SB 1041. This analysis assesses the association between SB 1041 and CalWORKs WTW clients\u2019 employment, CalWORKs WTW status, and other measures of economic status. We assess these associations by comparing the outcomes of individuals w"] [11.51640510559082, 10.555255889892578, "s the cohort that entered in the fourth quarter of 2014 and the last entry cohort for whom we could observe two-year outcomes was the cohort that entered in the fourth quarter of 2013.\nWe conducted analyses on three sets of outcomes, measured one yea"] [11.27827262878418, 10.764106750488281, "ure); (2) state-level stakeholders external to CDSS (e.g., welfare advocates, representatives from community college groups, legislative staff) acknowledged the hard work of all parties, but they continued to highlight the challenges that county work"] [11.295483589172363, 10.75419807434082, "d the release of guidance to explain the methodology for the 20-percent target for extensions beyond the 24-month time clock (CDSS, 2015b).\nThree of the state stakeholders interviewed\u2014staff not employed by CDSS\u2014offered a somewhat more mixed picture o"] [11.094522476196289, 10.83983039855957, "te-level respondents reported that the OCAT had been implemented by the counties, training had been being provided on the system, and the long-term plan was to integrate it with the Statewide Automated Welfare System (SAWS). A CDSS administrator high"] [11.262166976928711, 10.795520782470703, "pathways. Echoing a theme identified in our 2015 study, community college representatives were concerned that they had not observed an uptick in referrals in this area. State respondents suggested a variety of factors may be contributing to this pict"] [11.277689933776855, 10.79080581665039, "mployment is growing, it\u2019s growing slowly. But it is really an avenue that we continue to push counties on.\nFS. Designed to provide intensive case management and services to high-need clients (and their children, if needed), the FS program was charac"] [11.27882194519043, 10.773529052734375, "ounty findings). One CDSS administrator, reflecting on the state\u2019s recent success in meeting WPR, hoped that, with time, concerns at the county level in this area would slowly alleviate. However, another CDSS administrator emphasized that counties ma"] [11.234546661376953, 10.828704833984375, "small and medium-sized counties. In terms of the complexity of SB 1041 reforms, 72 percent of counties reported it was a moderate to major hindrance to implementation in the last year (mid-2015 to mid-2016); large counties were more likely to report "] [11.347742080688477, 10.719551086425781, "on). Overall, 77 percent of counties\u2019 supervisors reported that WTW caseworkers understood moderately well to very well how to determine a client\u2019s 24- month time clock. Yet, supervisors in 72 percent of counties reported that they were only somewhat"] [11.194396018981934, 10.86391544342041, "the 24-month time clock far lower, with only one-third assessing that clients understood the process moderately to very well.\n\u2022 What have been counties\u2019 experiences with the ESE program in the last year? Similar to the 2015 ACS results, 45 counties ("] [11.118847846984863, 10.834349632263184, "rcent of eligible families over the same period. For those counties with FS programs, 89 percent reported that the FS program was doing moderately well to very well in helping to stabilize families in crisis and in helping to address clients\u2019 barrier"] [11.270642280578613, 10.772964477539062, ".\n\u2022 What are counties\u2019 assessments of the effects of SB 1041 on key outcomes, and how well are SB 1041 reforms and related mandates working at the county level? Between\n41 percent and 65 percent of counties estimated that the implementation of SB 104"] [11.218873023986816, 10.85442066192627, "back on their information needs and suggestions for improving SB 1041. Appendix D presents additional survey results regarding the provision of and capacity to provide services related to employment, education and training, and supportive services.\nF"] [11.168463706970215, 10.92128849029541, "ation (All Counties and by County Caseload Size)\nGroup and Indicator\nAll counties\nNumber\nPercentage distribution\nSmall counties\nNumber\nPercentage distribution\nMedium-sized counties Number\nPercentage distribution\nLarge counties\nNumber\nPercentage distr"] [11.205384254455566, 10.873053550720215, "e\njob opportunities for CalWORKs clients educational opportunities for CalWORKs\nNumber of Responding Counties in Total\n58\n58\nCounty Rated Issue as a Moderate or Major Hindrance\nAll Small Medium Large Counties Counties Counties Counties\n34 15136 59% 7"] [11.168984413146973, 10.914786338806152, "unty size.\n53\n19 7 11 3 5\n12% 55% 15% 28%\nIn addition, similar to the 2015 ACS results, 41 percent of counties reported that competition with other state and federal mandates (e.g., Medi-Cal expansion) was a hindrance to implementation. Small and med"] [11.1950044631958, 10.898858070373535, "abuse service providers, many counties indicated that this was not needed including 40 percent of small counties, 65 percent of medium-sized counties, and 50 percent of large counties; and (3) with respect to developing new or enhanced partnerships w"] [11.216870307922363, 10.8763427734375, "for clients to begin engaging in job skills training, on-the-job training, subsidized employment, or community service. Although the results by county are not shown here, Table D.3 in Appendix D presents the detailed results for Table 4.5. Table D.3 "] [11.240801811218262, 10.833388328552246, "ities. Although the results by county are not shown here, Table D.4 in Appendix D presents the detailed results for Table 4.6. Table D.4 indicates that, for GED preparation, community college/postsecondary education, and other types of education, lar"] [11.190041542053223, 10.918015480041504, "istribution\nDomestic abuse\nNumber\nPercentage distribution\nTranslation\nNumber\nPercentage distribution\nHousing assistance Number\nPercentage distribution\nOther services\nNumber\nPercentage distribution\nMore Than Two\nMonths Total\n1 58 2% 100%\n1 58 2% 100%\n"] [11.248937606811523, 10.847315788269043, "s (20 counties), and 5,000 or more for large counties (18 counties). Counties were instructed to mark one answer per row. Percentages are calculated using the number of counties responding to the question as the denominator. Appendix D provides resul"] [11.309708595275879, 10.75973129272461, " calculation of the 24-month time clock.\n60\n Table 4.9. Who Is Responsible for Calculating How Much Time CalWORKs Clients Have Left on Their WTW 24-Month Time Clock (All Counties and by County Caseload Size)\n A Special Group of Staff Have "] [11.319796562194824, 10.80712604522705, "ppendix D presents the detailed results for Table 4.11. Table D.7 indicates\nTable 4.11. Of the Counties That Provided Additional Training on How to Calculate the 24-Month Time Clock, Type of Training Provided in the Last Year (All Counties)\n Type "] [11.291633605957031, 10.790693283081055, "l Counties)\n 24-Month Time Clock Activity\nAccurately explain the 24-month time clock to CalWORKs clients\nNumber\nPercentage distribution\nAccurately calculate CalWORKs clients\u2019 24- month time clock\nNumber\nPercentage distribution\nAccurately reconcil"] [11.327079772949219, 10.738875389099121, "degree of confidence they had that staff could carry out the different activities associated with the 24-month time clock. In Table 4.13, we focus more narrowly on the caseworkers who are often the initial staff to do the determinations of the 24-mon"] [11.289215087890625, 10.832765579223633, "centage distribution\nNot at All Well\n1 2%\nSlightly Moderately Well Well\n12 34 21% 58%\nVery Not Well Applicable\nTotal\n 0 5 32 0% 9% 56%\n0 8 35 0% 14% 60%\n3 4 30 5% 7% 52%\n11 0 58 19% 0% 100%\n20 0 57 35% 0% 100%\n15 0 58 26% 0% 100%\n21 0 58 36% 0"] [11.225769996643066, 10.856221199035645, "add up to 100 or may exceed 100 because of rounding.\nUnderstanding of Other Components of SB 1041\nSupervisors were asked to assess the understanding of other components of SB 1041 for both caseworkers and CalWORKs clients. In the tables that follow, "] [11.228940963745117, 10.863591194152832, " 4,999 for medium-sized counties (20 counties), and 5,000 or more for large counties (18 counties). Counties were instructed to mark one answer on the Likert scale per policy change. Percentages are calculated using the number of counties responding "] [11.235677719116211, 10.874211311340332, "lock. Only 40 percent of supervisors rated CalWORKs clients\u2019 understanding of the change to CalWORKs federal participation standards after the 24-month time clock has been exhausted as moderately well to very well. Also, only 60 percent of supervisor"] [11.182612419128418, 10.902542114257812, "o, but No, Planning\nYes Opted Out to Join Total\n457658 78% 12% 10% 100%\nGroup and Indicator\nAll counties\nNumber\nPercentage distribution\nSmall counties\nNumber\nPercentage distribution\nMedium-sized counties Number\nPercentage distribution\nLarge counties\n"] [11.195443153381348, 10.895037651062012, "m as doing moderately well than were small counties on all of the categories listed in Table 4.17, except for the category of keeping clients from returning to CalWORKs. Fifty percent of large counties rated the ESE program as doing only slightly wel"] [11.16592025756836, 10.89409351348877, "e counties\n(18 counties). Counties were instructed to mark one answer per row. Percentages are calculated using the number of counties responding to the question as the denominator.\nFamily Stabilization Program\nOverall, 57 of the 58 counties (98 perc"] [11.176459312438965, 10.878482818603516, "all counties, 39 percent reassigned caseworkers to the FS program,\n28 percent hired additional caseworkers, and 17 percent created a new unit to manage the FS program (Table 4.22). Forty-four percent of counties reported expanding the services offere"] [11.183433532714844, 10.865528106689453, "m to handle the more complex cases where children are at greater risk for entering the child welfare system; and revising program policy and service delivery in the area of temporary shelter and subsidies under the housing support component to serve "] [11.1973876953125, 10.85395336151123, "t camp or other after school/summer youth programs, as well as extended mental health meetings and support groups and services in ten domains of their lives.\n\u2022 Mental health counseling.\n\u2022 Mental health counseling and behavioral health services.\n\u2022 Men"] [11.185624122619629, 10.86121654510498, "th a housing resource center to provide homeless and imminent risk housing services directly to FS families. The housing specialists and case managers attend FS meetings to discuss the housing needs and progress of FS customers. Domestic violence and"] [11.144012451171875, 10.899045944213867, "ing to stabilize families in crisis and in helping to address clients\u2019 barriers to self-sufficiency. With respect to addressing housing issues, 75 percent of counties rated the FS program as doing\n76\n moderately well to very well with respec"] [11.155362129211426, 10.86697006225586, " of intensive case management. Small counties indicated that intensive case management was essential to\n\u2022 helping families in need\n\u2022 assisting customers in stopping their WTW 24-month time clock and looking at the\nwhole family addressing the removal "] [11.114935874938965, 10.836821556091309, "gram was, in their view, helping program participants create the conditions needed to successfully engage in the WTW program; only one county disagreed with the statement, and three counties did not answer this question.\nOnline CalWORKs Appraisal Too"] [11.114056587219238, 10.844491958618164, " in completing the OCAT.\nTable 4.26 summarizes counties\u2019 responses with respect to how the OCAT has affected the different issues listed. The two areas for which counties reported that the OCAT has had a positive effect were with respect to identifyi"] [11.11082649230957, 10.85294246673584, "cent of counties reported that it had increased the number of referrals, whereas 43 percent of counties reported no effect (results not shown). Counties were also asked to explain how, if at all, the OCAT has changed the referral process in their cou"] [11.101104736328125, 10.919015884399414, "the OCAT in the client\u2019s preferred language\nNumber\nPercentage distribution\nSOURCE: Authors\u2019 analysis of 2016 ACS data.\nNeither\nVery Somewhat Dissatisfied Somewhat Very\nDissatisfied Dissatisfied or Satisfied Satisfied Satisfied Total\n8 31 9 7 3 58\n "] [11.202211380004883, 10.880411148071289, "nties (20 counties), and 5,000 or more for large counties (18 counties). Counties were instructed to mark one rating for each type of need listed. Percentages are calculated using the number of counties responding to the question as the denominator. "] [11.189840316772461, 10.895864486694336, "Enrollment in GED programs Number\nPercent\nWorse Worse\n17 2% 12%\n05 0% 9%\nSame Better\n28 20 48% 35%\n24 28 41% 48%\nMuch Somewhat Aboutthe Somewhat\nMuch Not\nBetter Applicable Total\n2 058 3% 0% 100%\n1 058 2% 0% 100%\n 03418\n0% 5% 73% 14% 5% 2% 100%"] [11.192374229431152, 10.871481895446777, "c abuse assistance, housing assistance) Number\nPercentage distribution\nProvision of mental health and/or substance abuse counseling or treatment\nNumber\nPercentage distribution\nCoordination with community colleges Number\nPercentage distribution\nCoordi"] [11.270315170288086, 10.783097267150879, "ell, and 81 percent rated the implementation of the FS program in the last year as working moderately well to very well (Table 4.30).\nTwo areas that counties flagged as working less well were tracking WTW participation of CalWORKs clients and improvi"] [11.334959030151367, 10.730891227722168, " the 24-month time clock, FS, and OCAT.\n\u2022 Remove the WTW 24-month time clock. The time clock is time intensive, and time would be better spent focusing on client outcomes.\n88\n Table 4.31\u2014Continued\nMedium-Sized Counties\n\u2022 24-month time clock. Post\u2013"] [11.354011535644531, 10.714181900024414, " remove-from-aid process.*\n\u2022 It would be helpful to have all of the 24-month time clock mandates, tables, forms, and other materials consolidated into one resource booklet.*\n\u2022 More information on the automation and tracking of WTW 24-month time clock"] [11.305937767028809, 10.750627517700195, "urces and energy toward the six-month period for those families who really need additional time and attention. The 24-month time clock impacts our ability to meet WPR, since the state and federal regulations do not align.\n\u2022 To provide our clients wit"] [11.312853813171387, 10.742840766906738, "aging the difficulties associated with the 24-month time clock and provide our workers with more time to focus on WTW engagement.\n90\n Table 4.32\u2014Continued Medium-Sized Counties\n\u2022 Improve the WTW 2 so that it is less confusing to a client. For "] [11.157078742980957, 10.819345474243164, "mplement until the consortia have effectively created tracking tools in the software programs. It\u2019s very cumbersome to track FS and Housing Stability Plan (HSP) separately because our consortium has no tracking mechanisms in the system. HSP 14 and FS"] [11.219895362854004, 10.840738296508789, "ently, the counties have NO WAY to track and see if the customers\u2019 needs were met by the CalWORKs Employment Services case managers. Additionally, 183 learning needs screenings; 344 emotional and mental health concerns identified; 56 customers with p"] [11.272616386413574, 10.772263526916504, "hat stop, exempt, and/or extend the 24-month time clock render the policy somewhat ineffectual and certainly inefficient in terms of resources and workload, including time and resources dedicated to continuous policy development, training/retraining,"] [11.18358039855957, 10.805917739868164, " to meet the state\u2019s WPR affected implementation of SB 1041, if at all? As they did as of 2015, most focal county staff continued to express significant concerns\n Chapter Five Methods\n\u2022 Based on analysis of qualitative data collected for six focal c"] [11.24013614654541, 10.81188678741455, "nt, for example, reported that she did not want her young daughter to hear that she had been depressed. Another client stated that she did not want her eight-year old son to hear her talking about the abuse she had suffered from his father. In genera"] [11.322690963745117, 10.734037399291992, "iscussion regarding interviewee results about the WPR, including calculation of weekly participation hours, consequences of not meeting the federal WPR, perceived impact of SB 1041 on the WPR, and the tension perceived by interviewees about meeting W"] [11.340069770812988, 10.725848197937012, "he six focal counties and a completely manual process in the last county. Although the automated system ticks the 24-month time clock automatically after the initial input of information, the individual managing the clock is still responsible for ent"] [11.376432418823242, 10.691588401794434, " 24-month time clock was first implemented, CDSS released multiple directives for calculating and managing the clock (e.g., CDSS, 2012c). On-site trainings occurred in counties to reinforce the instructions relayed through these directives and to cla"] [11.414666175842285, 10.654973983764648, "lients of the months unticked from their WTW 24-month time clocks, and if appropriate, engage them in WTW activities (CDSS, 2015i).\nApplication of Extenders to the WTW 24-Month Time Clock\nIn January 2015, CDSS released further guidance on extensions "] [11.341553688049316, 10.728347778320312, "ers received on the 24-month time clock happened during the induction period. Updated trainings on the 24-month time clock were delivered by staff development and through briefings.\nCaseworkers\u2019 Understanding and Perceptions of the WTW 24-month Time "] [11.369152069091797, 10.699557304382324, "rvisors had to develop some guidelines, and they were not formal. Individual supervisors have a grasp on teaching their staff. When you go to another unit, it\u2019s hit or miss. Some supervisors don\u2019t have a good grasp on [the WTW 24-month time clock], s"] [11.347347259521484, 10.719223022460938, "it to a customer.\u201d\nFurthermore, respondents noted that several factors hindered caseworkers from providing clients with a comprehensive explanation of the WTW 24-month time clock. First, the complexity of and inconsistent instructions regarding the W"] [11.34956169128418, 10.719183921813965, "h long plan. One county leader said,\n[Clients] want to know, \u201cHow many hours do I have to do?\u201d They want concrete things. Nothing with this clock is really concrete . . . I think we try to explain the options, but I just think sometimes clients have "] [11.341907501220703, 10.726003646850586, "late the clock, and caseworkers do not have always access to the data they could use to correctly calculate the clock according to their county\u2019s standards. This further complicated management of the WTW 24-month time clock. One caseworker noted, \u201cWe"] [11.359951972961426, 10.74236011505127, " the [federal requirements] . . .\n104\nIf the feds say, \u2018This is what you have to do,\u2019 and we were on board and aligned with that at the state level, I think that we could really . . . be able to hone in on what we do to align with the feds and be abl"] [11.307246208190918, 10.771140098571777, "TW Requirements (for 24 Months)\n20 non-core 30 non-core 35 non-core No\n The weekly work participation hours required for the WTW program are aligned with federal requirements; however, the methodology for calculating participation hours diffe"] [11.305452346801758, 10.757169723510742, "nistrator from another county explained, \u201cBest practice is to get the client to meet WPR from the get go, because in doing so, you\u2019re acclimating them to the most \u2018difficult\u2019 requirement. The 24-month time clock is then icing on the cake. If they get"] [11.259249687194824, 10.80893325805664, "using their 24-month time clock.\n 107\nown activities. As one respondent explained, \u201cI think our clients feel like they have that flexibility [to choose their activities]; they have more options now than they used to and I don\u2019t know that WPR goes aga"] [11.26979923248291, 10.789582252502441, "Ks federal WPR. One county administrator shared that the state was facing a potential sanction for not meeting the state WPR, adding, \u201cAnd that\u2019s the biggest conflict that we\u2019re feeling. We can\u2019t afford not to do the WPR, so it\u2019s a balancing act righ"] [11.2714204788208, 10.790656089782715, "In this county, caseworkers explained that, at the policy level, the approach was \u201cno longer work first\u201d and that \u201cengagement has been emphasized over WPR.\u201d Yet, in that same focus group, caseworkers noted that while the county\u2019s policy focused on cl"] [11.148102760314941, 10.836341857910156, "d similar thoughts, noting, \u201cThere [are] also cases where the customer is meeting WPR week after week, but they aren\u2019t really trying to get off aid. They have the numbers, so WPR looks good, but they aren\u2019t reaching self-sufficiency. It\u2019s a Catch-22."] [11.097415924072266, 10.835918426513672, " Demographics General Information, Household Composition, Finances/Benefits, Client Index Numbera, Assistance Unit Case Numberb, First Name,\nLast Name, Date of Birth, Gender\n Employment Current Activities, Reasons for Not Working, Job History, Wo"] [11.088606834411621, 10.845105171203613, "ient. Most clients complete the orientation and OCAT in one day. However, one county indicated that the orientation\u2014a one-on-one or group review of the WTW program\u2014and associated requirements are lengthy procedures (e.g., clients complete various for"] [11.065131187438965, 10.84469223022461, "ion from these conversations to answer the questions in the OCAT. This helps save time and makes the interaction more conversational. Specifically, one worker said, \u201cI don\u2019t ask the questions verbatim. I tell the customer, tell me if you have concern"] [11.042309761047363, 10.880249977111816, "\u201cI do the main questions\u2014I don\u2019t go in depth unless it\u2019s really necessary. I can get most done in 30 minutes\u2014I tell them I\u2019ll call them back if I have any further questions. . . . I don\u2019t do every detail\u2014just enough to have it complete.\u201d\nAt the time "] [11.06882095336914, 10.852447509765625, "y, there were mixed views on the impact of the OCAT on caseloads. Administrators indicated that the caseload had remained stable or declined, while caseworkers lamented that their caseloads are double the maximum allowed. One worker said, \u201cWe fall be"] [11.059814453125, 10.847736358642578, "ok, just in case they had no- shows. If they had [a no-show], they would just get another customer then and just continue moving along. But with the OCAT, it is so lengthy that they can\u2019t do that, so when the folks don\u2019t appear, that messes their rou"] [11.104472160339355, 10.83906364440918, "m the primary data system to enter into OCAT, and after the OCAT is complete, they enter data from the OCAT into the primary data system. An administrator in one county commented, \u201cThe worker has to input information into two separate systems (which "] [11.030550003051758, 10.806291580200195, "nterview is problematic. One county administrator said, \u201cMany times, our clients bring their children, even though the letter says not to bring them. It can be difficult to administer the OCAT with kids in the room because of the kinds of questions a"] [11.037436485290527, 10.865240097045898, "ne, you could see all their information.\u201d Another major concern involved the process of transferring cases between caseworkers. Two county administrators explained,\nAnother major problem is that there isn\u2019t a system in the computer to transfer the in"] [11.086774826049805, 10.845624923706055, "15 percent of people who were referred to Job Club were not appropriate. Now with OCAT, we\u2019re seeing a lot less of that. We\u2019re getting a lot less referrals for Job Club. OCAT really opens up an opportunity to ask questions that we never would have as"] [11.101434707641602, 10.837746620178223, "ining emotionally for [the workers], because they were really getting in deep with our families, which is great, we want that because we want to be able to identify the issues up front so we can guide our families into the right path, or at least off"] [11.078078269958496, 10.838889122009277, "t cover all of the needs identified. A lot of the questions are intimidating for clients and even for us workers.\u201d\nIn addition to emphasizing that the OCAT questions would be best asked by clinical professionals, caseworkers commented that they belie"] [11.086078643798828, 10.832415580749512, "nother worker from the same county said, \u201cI\u2019ve condensed the questions \u2018Do you have any DV [domestic violence], MH [mental health], or substance abuse issues?\u2019\u201d Workers in the other two counties made very similar comments. Administrators from two of "] [11.081080436706543, 10.84677505493164, "praisal as well as how it is used to make referrals.\nPerceived Strengths and Weaknesses of the OCAT Appraisal Summary\nAcross the focal counties, administrators were generally supportive of the OCAT appraisal summary, describing it as a comprehensive "] [11.08032512664795, 10.844242095947266, "or example, in one county, the WTW plan is created before an OCAT appraisal is completed with the client and revised only rarely following the OCAT. Caseworkers in another county explained that the WTW activities are designed based on caseworker judg"] [11.067981719970703, 10.836015701293945, "\nWelfare Staff and Caseworker Suggestions for Improving the OCAT\nAdministrators and caseworkers offered the following recommendations for improving the OCAT tool:\n1. Make OCAT available in other languages in addition to English.\n2. Enhance the report"] [11.1660737991333, 10.80766487121582, ", others reported that they had not been notified or had simply been told they would have to come back to meet with another caseworker. Some clients reported that they were not surprised that the appraisal took as long as it did \u201cbecause everything t"] [11.129722595214844, 10.780120849609375, "formation on domestic violence could be used against them in child custody cases or could be reported to the Department of Children\u2019s Services. Clients were also asked whether it had been difficult to talk about these topics with the caseworker. Whil"] [11.130269050598145, 10.796431541442871, " doing the appraisal.\nFinally, clients were asked whether they had felt any pressure to complete the appraisal or to answer any questions in order to receive the benefits. While clients did not state that they had been pressured, most reported that t"] [11.18996810913086, 10.841047286987305, "et an appointment at a convenient time or that the counseling provider they had been referred to was in a clinic that was\n128\nrun down or that was located in an area they considered unsafe. Some of the clients also reported that they had been referre"] [11.197137832641602, 10.847892761230469, "eported that implementation of the FS program has proceeded smoothly. Some challenges were identified:\n23 The program can provide a range of services, such as mental health treatment for families, domestic violence or substance abuse counseling, and "] [11.207444190979004, 10.853312492370605, "m participation to ensure that clients have the necessary skills to succeed in the placement. Further eligibility criteria noted by county leadership include completion of Job Club, a specified amount of time left on WTW aid, and satisfactory experie"] [11.21055793762207, 10.849177360534668, "m participants and (2) sending qualified re\u0301sume\u0301s of ESE\n131\nparticipants out to employers. Once a match is made and the employer is interested in a potential candidate, the employer reaches out to the participant (either directly or through the wor"] [11.203851699829102, 10.860333442687988, "rge and disparate; things are very spread out . . . there are many pockets that are difficult to reach, and this makes implementation challenging.\n132\nParticipants are supposed to receive an ESE placement within a specified time frame. In one county,"] [11.212212562561035, 10.845602035522461, "that over there.\u201d Caseworkers in four of the six focal counties mentioned inadequate transportation as a barrier to participant readiness for the ESE program. Lack of participant motivation also impeded readiness to work and posed a challenge to the "] [11.238180160522461, 10.850689888000488, "the program, any breakdown in communication can lead to delays and poor outcomes for clients.\n\u2022 Increase diversity of employment opportunities. Respondents in three of the six focal counties also recommended increasing the diversity of employment opp"] [11.188328742980957, 10.818561553955078, " payment while they waited to get approved.\n\u2022 Other clients reported that getting help with transportation expenses was very helpful but that reimbursements for cash expenses were sometimes delayed.\nIn addition, clients interviewed had a number of co"] [11.208165168762207, 10.812149047851562, "tional education or training, or other services. For example:\n\u2022 One client reported that she had applied for child care assistance but that she had had to find an eligible provider and then submit paperwork in order for that provider to get paid. It "] [11.231913566589355, 10.825748443603516, "chool at the moment (e.g., one client reported that his girlfriend was going to school, and, that once she finished, it would be his turn to do so; while another reported that she did not have child care during evening hours, which is when some of th"] [11.243950843811035, 10.80894947052002, "lenges. According to leaders in three of the focal counties, community college opportunities are available in each county, however, these programs can be difficult to access for a variety of reasons, including limited class availability and transport"] [11.236661911010742, 10.81899642944336, "clients. Community college staff stated in both 2015 and 2016 that the flexibility under SB 1041 is helpful for clients who wished to pursue their education. As one community college representative explained, \u201cStudents can dedicate more time to their"] [11.24362564086914, 10.808570861816406, " in an educational program at some point while they were enrolled in CalWORKs. About half of the clients that were new to the CalWORKs program reported either being enrolled in an educational program or being interested in continuing their education."] [11.237258911132812, 10.819055557250977, " for clients, noting that, \u201cStudents can dedicate more time to their schooling and not have to be burdened with the 20 hours of work a week on top of that.\u201d At the same time, some community college staff voiced concern that only clients who specifica"] [11.282831192016602, 10.770166397094727, "es that can limit access to child care services. Staff from three of the six counties indicated that communication with CalWORKs clients in regard to child care could be improved, particularly when they are at risk of losing their child care slots be"] [11.136591911315918, 10.849839210510254, "h limited client ability to access supportive services and secure and maintain employment. Staff from counties that include rural areas were more likely to share this concern, although one of the urban focal counties emphasized that approving and fac"] [11.110152244567871, 10.863859176635742, "unties did staff report a strong domestic violence service system, with on-site clinicians that are equipped to work quickly with clients. Staff described their services as a \u201crobust domestic violence program that assists our WTW population,\u201d includi"] [11.123191833496094, 10.835679054260254, "the OCAT and the FS program has resulted in increased communication with external service providers, with more focus on tracking clients\u2019 progress.\n144\nLearning Disability Services\nIf clients screen positive for a learning disability, they are referr"] [11.25663948059082, 10.782585144042969, " high school diploma to start with. So we are creating these very long-term plans at this point which is pushing for them to get work experience far into the future beyond the time limits of the CalWORKs program, so that has also been a concern of th"] [11.250526428222656, 10.786846160888672, "hanges so that counties can build on the programs in place. Staff in two counties reported that they struggled with the way in which SB 1041 was rolled out to the counties (a theme that also emerged in our 2015 site visits). The administrator in one "] [11.181195259094238, 10.83870792388916, "g and doing all that stuff, could better be used in focusing on the families and providing one-on-one services with them.\u201d A caseworker from a different county said, \u201cWe spend so much time on these things that we forget why they are here. We don\u2019t ha"] [11.105669975280762, 10.864964485168457, "he WPR.\u201d An employment service provider from the same county also emphasized the importance of supporting the clients, stating, \u201c[T]hey [the workers] need to let them [the clients] know that they believe in them and that they can make a difference . "] [11.330503463745117, 10.74417781829834, "ve easily said, \u201cI would rather do the CalWORKs side of the clock, not the feds, I don\u2019t want to do any core hours.\u201d So our WPR would be zero, conceivably. And you can\u2019t fault the counties for that, because we\u2019re just doing what you kind of gave us a"] [11.299670219421387, 10.738479614257812, "so much. . . . When people have a place to live that\u2019s stable and affordable, the rest can fall into line.\u201d\nImprove referral processes and coordination with service providers. Some service providers reported little to no increases in the number of re"] [11.521529197692871, 10.55182933807373, "tus, and\nearnings) might be associated with the passage\nof SB 1041, rather than other factors, such as the changing economy. We continue to consider\n Chapter Six Methods\n\u2022 We analyze state administrative data from WDTIP, MEDS, and EDD wage data.\n\u2022 A"] [11.522747993469238, 10.55178165435791, "TW clients were exempt from participating in WTW requirements? The percentage of clients who received at least one exemption during their first two years in the CalWORKs WTW program increased slightly from the February 2007 entry cohort to the Februa"] [11.530359268188477, 10.544215202331543, "employed in February 2016 than in February 2013 (26 percent in 2013 and 34 percent in 2016).\n\u2022 How much did WTW clients who were employed earn? For the February 2016 cross- section, employed clients earned about $2,533 per quarter on average, a 17-pe"] [11.51451587677002, 10.559667587280273, " 6.1 identifies which of the two studies (the status study, the tracking study, or both) addressed each research question. In general, the status study addressed questions about WTW clients at a point in time, and the tracking study addressed pattern"] [11.51996898651123, 10.553528785705566, " 2015 2016 0 Year\nUnemployment rate (percent)\n CalWORKs WTW clients (left axis)\nUnemployment rate (right axis)\nSB 1041\n SOURCES: WDTIP, 2006 to 2016; EDD unemployment data.\nNOTES: CalWORKs WTW client status is measured in February "] [11.541740417480469, 10.535656929016113, "lients declined by 20 percent. (See the last four periods in Figure 6.1.) The 2013 status cross-section had 338,565 clients, compared with 337,388 for the 2014 status cross-section, 308,926 for the 2015 status cross-section, and 272,013 for the 2016 "] [11.444952964782715, 10.62834358215332, "n exhausted, clients are subject to the stricter work requirements of the CalWORKs federal standards, which are similar, but not identical, to TANF requirements. If, however, the client meets the more stringent CalWORKs federal requirements, months o"] [11.474603652954102, 10.602814674377441, "most months counted on the 48-month time-on-aid clock (nearly 13 out of 36 months counted on average).\nIn addition, we examined how many months were counted on the WTW 24-month time clock for the 2013 and 2014 entry cohorts (the post\u2013SB 1041 cohorts)"] [11.503865242004395, 10.571495056152344, "of ticks on the 24-month time clock for the 2013 and 2014 entry cohorts are presented in Figures E.1 and E.2 in Appendix E.\n 160\nFigure 6.6. Average Number of Months as a CalWORKs WTW Client, Counted on the 48-Month Time-on-Aid Clock, and Counted on "] [11.545974731445312, 10.530275344848633, " transitional group had at least one of the WTW 24-month time clock exemptions in 2013, which increased to 12 percent in 2014, and 14 percent in 2015 and 2016; less than 1 percent of the post\u2013SB 1041 group had this type of exemption in 2013, which in"] [11.511198043823242, 10.567706108093262, "ry cohorts yielded similar findings as with status cross- sectional snapshots and adds a pre-policy trend. For each tracked entry cohort, the percentage of\n163\nclients who received at least one exemption within two years was substantially greater tha"] [11.531525611877441, 10.543701171875, "nts Were No Longer CalWORKs WTW Clients One, Two, and Three Years After Entry?\nThis section describes clients\u2019 exits from the CalWORKs WTW program. Leaving the CalWORKs WTW program is a fluid concept because clients may leave the program for a period"] [11.540071487426758, 10.534767150878906, "ployment and earnings. This section offers an initial examination of employment patterns because only about three years had elapsed since the policy change at the time of the analysis in this report.34\nBy several measures, CalWORKs WTW clients increa"] [11.536208152770996, 10.538384437561035, "Status Cross-Sections and Transitional and Post\u2013SB 1041 Groups in February 2013, February 2014, February 2015, February 2016\n Status cohort\n2013\n2014\n2015\n2016\n26 26 28\n30 30 29\n33 33 33\n33\n34\n33\n0 20 40 60 80 100\nPercentage of clients\nAll cl"] [11.543068885803223, 10.532580375671387, "ly employed during their third year after entering CalWORKs WTW compared with their second year, with the exception of the February 2007 entry cohort. Among the February 2007 entry cohort, a little more than 22 percent were continuously employed duri"] [11.525104522705078, 10.548270225524902, "ffect.37 We isolated the group of clients\n37 Clients with the short-term WTW exemption for young children refers to those who were exempt pursuant to AB X4 4 and were subject to reengagement (see Appendix A for further discussion). This short-term ex"] [11.52130126953125, 10.55233383178711, "rticipation in the Cal-Learn program. It also included a small number of exceptions such as penalty, good cause, extender, and repayment. The category \u201cnot a CalWORKs WTW client\u201d was measured as a client not present in the WDTIP data system in Februa"] [11.522577285766602, 10.549849510192871, " families that are potentially eligible for the TANF program in California (i.e., potentially eligible for CalWORKs WTW) to similar families in other states. That analysis is not updated in this report but will be updated in our final report for this"] [11.5239839553833, 10.548391342163086, "ORKs WTW client (+1.9 percentage points). When disaggregated into mutually exclusive categories, the percentage who were employed-only was significantly lower (\u20132.1 percentage points), while the percentage who were both a CalWORKs WTW client and empl"] [11.528837203979492, 10.54277229309082, "d, WTW Client\n Employed, Not WTW Client\n Entry Quarter 0\n New Clients Enter CalWORKs WTW\n Two Years After Entry Quarter 8\n Not Employed, Not WTW Client\n Not Employed, WTW Client\n Employed, WTW Client\n WTW\nClient Employed\n Employed, Not WTW Client"] [11.52929401397705, 10.543669700622559, "2. Percentage of CalWORKs WTW Entrants Who Are CalWORKs WTW Clients One Year After Entry, Percentage Employed One Year After Entry, and Average County Unemployment Rate One Year After Entry\n75\n50\nPercentage\n25\n0\nQ1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3"] [11.537382125854492, 10.5357027053833, "f CalWORKs WTW Entrants Who Were Employed One Year After Entry\n50\n45\nPercentage\n35\n30\nQ1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4\n2007 2008 2009 2010 2011 2012 2013 2014\nEntry cohort\n+ 1.9*\n SB 1041\n Post\u2013SB 1041, with SB 1041\nP"] [11.581302642822266, 10.493354797363281, "mployment rates and client characteristics, we see that the rates of those in CalWORKs WTW only one year after entry (and not employed) as well as the rates of those neither in CalWORKs WTW nor employed one year after entry were each about 1 percenta"] [11.551251411437988, 10.519351959228516, "er employed nor a CalWORKs WTW client one year after entry, which is 0.9 percentage points lower than we would have expected.\nOne Year After Enrollment, Was the Level of Earnings Different for Cohorts of CalWORKs WTW Clients Who Enrolled After SB 104"] [11.586362838745117, 10.488525390625, " and 2014 CalWORKs WTW Entry Cohorts)\n 2013 Cohorts\n2014 Cohorts Estimated\nEstimated Impact for 2013 Different from 2014?\nu\u0308 u\u0308\nu\u0308\n Status One Year After Entry\nEmployed\nWTW Client\nNeither\nWTW client only Employed and WTW client Employed only\nQu"] [11.560729026794434, 10.513813018798828, "entage\n35\n 40\nPost\u2013SB 1041, with SB 1041\n+ 1.9*\n Pre\u2013SB 1041\nSB 1041\n Post\u2013SB 1041, without SB 1041 30\nQ1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4\n2007 2008 2009 2010 2011 2012 2013\nEntry cohort\n "] [11.553008079528809, 10.521585464477539, "ith SB 1041\n 2,500\n2,000\nReal quarterly earnings ($)\n Change associated with SB 1041\n 1,973\n\u201318\n1,954\n 1,500\n1,000\n500\n0\n Without SB 1041\nWith SB 1041\nSOURCE: Authors\u2019 analysis of 2010\u20132014 WDTIP files, EDD employment and earnings files, and EDD "] [11.33887767791748, 10.708303451538086, "e expect many of the clients who would benefit from the flexibility introduced with SB 1041 to have used it as intended\u2014to increase their human capital and address barriers that would then put them on a more stable employment trajectory. We will also"] [11.25307559967041, 10.793949127197266, " of June 2016\nFrom the perspective of state-level stakeholders, all of the components of SB 1041 and the complementary Early Engagement activities were in place as of mid-2016, training had been provided, and data systems had been automated to the ex"] [11.196041107177734, 10.824509620666504, "g barriers to self-sufficiency and needed services.\n\u2022 A majority of counties in the 2016 ACS indicated that it currently takes less than one month for a CalWORKs WTW client to begin participation in employment and/or job training and education. More "] [11.293312072753906, 10.758895874023438, "ate-level stakeholders viewed the ESE program as an underused mechanism, but use is\nexpected to grow with its consolidation with the AB 98 Subsidized Employment program.\n\u2022 One challenge with the ESE program was getting employers to participate. Anoth"] [11.533589363098145, 10.54170036315918, "lients who received at least one exemption during their first two years in the CalWORKs WTW program increased slightly from the February 2007 entry cohort to the February 2014 entry cohort (from 44 percent to 46 percent). There was a similar increase"] [11.518414497375488, 10.554316520690918, "oss-section.\n\u2022 Among the WTW clients who had the short-term WTW exemption for young children in December 2012, 16 percent still had this exemption in February 2014 and almost none had it in February 2015 and February 2016. Sixty-five percent of this "] [11.545247077941895, 10.53066349029541, "he WTW 24-month time clock. After three years, clients who started in the CalWORKs WTW program in February 2013 had used, on average, about 11 months of the 48-month time limit and about two months of the WTW 24-month time clock.\n\u2022 The percentage of "] [11.516274452209473, 10.55793571472168, "t still had this exemption in February 2014 and almost none still had it in February 2015 and February 2016. Sixty-five percent of this group were not clients in the CalWORKs WTW program in February 2016.\nThird, with respect to impact on clients, the"] [11.27267837524414, 10.767935752868652, "y obtaining a solid understanding of the WTW 24-month time clock and how it applies to them. And caseworkers continue to struggle with understanding how to calculate clients\u2019 24-month time clocks and how to explain and prepare CalWORKs clients for th"] [11.290884017944336, 10.748302459716797, " expected to increase the counties\u2019 use of subsidized employment as a tool for increasing work participation. The extent to which this occurs will be of interest in our final round of data collection. Greater use of the program may require that count"] [11.401860237121582, 10.66649055480957, "e started later and other features in the law were scheduled to be phased in over time.\nOverview of New WTW Services and WTW 24-Month Time Clock\nUnder SB 1041, the lifetime limit for CalWORKs receipt remained at 48 months (the time limit adopted in 2"] [11.400175094604492, 10.672992706298828, "anuary 1, 2013, have a 24- month period to engage in more-flexible WTW activities. However, those already enrolled in CalWORKs as of 2013 with more than 24 months of cumulative aid will likely reach their 48- month lifetime limit before exhausting th"] [11.381710052490234, 10.693872451782227, "ant difference between the clocks is the approved activities and the distinction between core and non-core activities. SB 1041 eliminated the WTW core and non- core hourly requirements, with the CalWORKs WTW 24-month time clock activities being more "] [11.366474151611328, 10.70975112915039, "\n\u2022 \u2022 \u2022 \u2022 \u2022\n\u2022\n\u2022 \u2022\n\u2022 \u2022\nFederal Work Activities\nCore Activities\nUnsubsidized employment \u2022 Self-employment\nSubsidized private or public sector\n\u2022 Grant-based on-the-job training\n\u2022 Work study\nWork experience\nCommunity service\nVocational education (12-month"] [11.437856674194336, 10.695069313049316, ", WTW exemption, in the process of developing a WTW plan, good cause, domestic abuse waiver, etc.) (CDSS, 2012a; CDSS, 2012c). In general, the 48-month time-on-aid clock continues to tick each month while the nonexempt participant remains eligible fo"] [11.3867769241333, 10.685846328735352, "estimated for July 2015 through December 2015.\nTransitioning to the Post\u201324-Month Time Clock Process\nCaseworkers are to initiate the transition to the post\u201324-month time clock process when clients are nearing the end of the 24-month time clock. After"] [11.41787338256836, 10.660947799682617, "on of unticking a clock takes place in a manual system that communicates with the automatic system to send time-clock information to the state and federal welfare programs. As mentioned earlier, the 24-month time clock is unticked if a caseworker fin"] [11.177528381347656, 10.810492515563965, "ior to cuts in 2011 in response to the Great Recession.\n\u2022 Supports for pregnant and parenting teens. The Cal-Learn program, after a suspension of case management services, was reinstated and allowed to resume its specialized case management and suppo"] [11.174653053283691, 10.82268238067627, "nsuccessful in finding employment (Figure A.1). This is consistent with a \u201cwork-first\u201d approach, where job-search activities are required immediately upon receipt of assistance\u2014typically for four weeks\u2014and followed by a more thorough assessment of sk"] [11.259620666503906, 10.801475524902344, "e eligible for FS. Additionally, at least one adult in the family must not yet have exhausted his or her 24-month time clock and his or her 48-month cash-aid time clock to participate. If a client is granted good cause while in the FS program, partic"] [11.231819152832031, 10.82710075378418, "ment in a particular field (CDSS, 2013c). Through ESE, the county and the employer share responsibility for the participant\u2019s wages during the job-placement period. The system used to divide responsibility for wages between the two parties varies amo"] [11.27544116973877, 10.798460006713867, " requirements by getting a caseload reduction credit, based on the extent to which the caseload has declined relative to 2005 for reasons other than eligibility changes (Schott and Pavetti, 2013; Brown and Derr, 2015).53 If a state program is unable "] [11.272204399108887, 10.756095886230469, "ews with CalWORKs WTW clients.\nState-Level Key Informants\nThe state-level key informant interviews were conducted with individuals from the following agencies and organizations:\n\u2022 CDSS\n\u2022 CWDA\n\u2022 Legislative Analyst\u2019s Office\n\u2022 legislative staff\n\u2022 Offic"] [11.26197624206543, 10.7807035446167, "ask: How has your role \u2013 and/or your organization\u2019s role changed with regard to the implementation of SB 1041 since we (or another member of the evaluation team) spoke with you in spring 2015?] What is your role \u2013 and your organization\u2019s role \u2013 in re"] [11.100552558898926, 10.834576606750488, "el?\nb. In the last year, what trainings have been offered to counties to prepare for OCAT implementation and to support caseworkers in the process?\ni. How effective do you believe the OCAT trainings have been? [Probe for examples of how the OCAT trai"] [11.247368812561035, 10.820266723632812, "ams and the community colleges, in providing education services to CalWORKs participants?\na. What are some of the factors that facilitate collaboration at the state level between the state welfare program and California Community College Chancellor\u2019s"] [11.235733985900879, 10.802006721496582, "ble for 48 months, and in 24 of those months there are different,\nin some cases reduced, participation standards?\niii. That after the 24-month time clock is exhausted, that there is a change to the\nCalWORKs federal participation standards?\n11. Implem"] [11.3158597946167, 10.720027923583984, ", mental health services). The 2016 survey will ask about implementation activities that took place between the completion of the 2015 ACS (i.e., July 2015) and today. As you may know, the RAND Corporation and American Institutes for Research (AIR) a"] [11.253530502319336, 10.790356636047363, " clicking the \u201csave and exit\u201d button. Please complete all sections before \u201csubmitting\u201d the survey at the end of Section VII.\nTo review definitions related to the SB 1041 reforms, please see the last three pages of the survey. We encourage you to prin"] [11.303460121154785, 10.762802124023438, "ces for CalWORKs participants\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n k) Availability of line staff (e.g., caseworkers, employment services specialists) who work with and/or counsel WTW participants\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n m) Explaining the complexity"] [11.319512367248535, 10.743711471557617, " or reconcile participants\u2019 24-month time clock status on a monthly basis.\nr WTW caseworkers calculate participants\u2019 24-month time clock on a monthly basis for their caseload.\nr Other\nIf you selected \u201cOther,\u201d please go to Question 5a. If not, please "] [11.300902366638184, 10.759805679321289, " time clock\nd) Effectively counsel CalWORKs participants on the flexibility of the 24-month time clock\nNot At All Somewhat Very Confident Confident Confident\n\u00a6\u00a6\u00a6\n\u00a6\u00a6\u00a6\n c) Accurately reconcile discrepancies between your consortium\u2019s database and your "] [11.108183860778809, 10.832982063293457, "_ If your WTW caseworkers have questions about the use of OCAT, what resources do they have\navailable to them? (Check all that apply.)\nr Support from an administrator or supervisor\nr Support from a content expert within your county social services de"] [11.130627632141113, 10.82662582397461, "ed\n\u00a6 \u00a6\n\u00a6 \u00a6\n c) Ability to save partially completed appraisals conducted using the OCAT\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n e) Ability of caseworkers to administer the OCAT in the participant\u2019s preferred language\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n Overall, how satisf"] [11.223794937133789, 10.834521293640137, "ibe any new and/or enhanced partnerships you established in the last year for the ESE Program.\n______________________________________________________________________________ ____________________________________________________________________________"] [11.21082878112793, 10.842475891113281, " \u00a6\n \u00a6\n Transportation services (e.g., bus, Metro Rail)\nSubstance abuse Translation services Other services\n\u00a6\u00a6\u00a6\n\u00a6 \u00a6 \u00a6 \u00a6 \u00a6 \u00a6 \u00a6 \u00a6 \u00a6\n e) Mental health\n \u00a6\n \u00a6\n \u00a6\n g) Domestic abuse\n \u00a6\n \u00a6\n \u00a6\n i) Housing assistance\n \u00a6\n \u00a6\n \u00a6\n Comp"] [11.189831733703613, 10.861380577087402, "dcare\nr Lack of interest/motivation\nr Other personal problems/issues\nPlease briefly describe \u201cOther\u201d from Question 39. ______________________________________________________________________________\n____________________________________________________"] [11.198797225952148, 10.861449241638184, "services \u00a6 \u00a6\nPlease describe what services you added or expanded as part of the FS Program in the last year (since July 2015).\n______________________________________________________________________________ ____________________________________________"] [11.284866333007812, 10.770817756652832, " Stabilization Programs. Please continue to the next section.\n To return to a page in this section, please click \u201cBack.\"\nTo continue to the next section, please click \u201cNext.\u201d\nTo exit the survey and return at a later time, please click \"Save and Exi"] [11.247318267822266, 10.805039405822754, " You have reached the end of Section VI: Questions for Supervisors About Line Staff and CalWORKs Participants. Please continue to the next section.\n To return to a page in this section, please click \u201cBack.\"\nTo continue to the next section, plea"] [11.263187408447266, 10.773073196411133, "\u00a6\u00a6\n c) Provision of services (e.g., child care, domestic abuse assistance, housing assistance)\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n e) Coordination with community colleges\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n \u00a6\n g) Coordination with other county agencies to provide serv"] [11.387282371520996, 10.669605255126953, "f SB 1041 Reforms\nIn this survey, we will be asking you about SB 1041 policy reforms to the CalWORKs Program that were implemented January 1, 2013. What we mean by SB 1041 reforms is the following:\n\u2022 Changes to the Welfare-to-Work (WTW) time clock o "] [11.375953674316406, 10.676013946533203, "good cause for lack of services. SB 1041 replaced these exemptions with a once-in-a-lifetime exemption for young children.\n\u00a7 Counties had until January 1, 2015, to reengage these exempt individuals.\n\u2022 Earned income deduction\no Effective October 1, 20"] [11.277043342590332, 10.746481895446777, "ime clock with flexibility in welfare-to-work requirements; lowered the minimum hourly participation requirement for single parents; allowed recipients one lifetime exemption whereby one adult per family is excused from WTW activities if they are car"] [11.13322925567627, 10.821555137634277, "ew Questions\nFirst we\u2019d like to ask you a few background questions and ask about the overall status of SB 1041\u2019s reforms implementation. (~5 minutes)\n2. Role. Let\u2019s start with your role within the county welfare department. What is your job title or "] [11.053406715393066, 10.845389366149902, "er caseloads?\n6. We understand that the OCAT is currently available in English only. How\nare the service needs and barriers to self-sufficiency assessed for non- English speaking clients?\na. For these clients, how does the appraisal process differ fr"] [11.312917709350586, 10.749903678894043, "ond to the amount of time it takes to\ncomplete the OCAT?\nc. What concerns, if any, do they have about doing the OCAT\ninterview?\nd. How have clients responded to sensitive questions (e.g., about\nsubstance use, domestic abuse, mental health issues)?\ne."] [11.255012512207031, 10.786535263061523, "ot had CalWORKs participants transition to the post 24- month time clock, when do you anticipate that will occur?\n6. WPR: One topic that emerged from our interviews last year was the work participation rate (WPR) and counties\u2019 efforts to meet WPR.\na."] [11.20256519317627, 10.848973274230957, "ss supportive services (e.g., tuition assistance, money for books, transportation and child care assistance) to allow them to enroll and fully participate in education programs? What, if any, barriers exist to limit or prevent access to these service"] [11.205300331115723, 10.849197387695312, "ty social services department?\n6. Do you interact with WTW caseworkers? If so, in what ways?\n7. What types of supports does the CalWORKs Program provide students?\na. In your view, how knowledgeable are students about what services and supports they a"] [11.224114418029785, 10.849353790283203, "xpand the number of subsidized employment slots available to CalWORKs clients.\na. Expanded Subsidized Employment (ESE) Program\nii. Has your county developed an Expanded Subsidized Employment program\n[Note: Interviewer should review the county-specifi"] [11.258280754089355, 10.76679801940918, "nt or organization?\na. By the county social services department?\nb. Self-referral?\nc. What information, if any, is needed by your department or organization from the county\nsocial services department when a referral is made?\nd. Do you interact with W"] [11.22422981262207, 10.711912155151367, "n education and training activities; and 5) the Family Stabilization and Expanded Subsidized Employment programs. The information you share with us today will help inform our understanding of the implementation and impact of SB 1041 reforms.\nREVIEW O"] [11.214136123657227, 10.77273941040039, "e note that you may not be helped directly by participating in this study. However, others may be helped by what is learned from this research. The results of this focus group will help the RAND/AIR research team develop recommendations to the CDSS r"] [11.091580390930176, 10.836377143859863, "in your office?\nb. As a result of using the OCAT, have there been any organizational changes in the\noffice, or a redefining of staff roles?\nc. What type of training and guidance were provided to prepare you to implement the\nOCAT?\ni. Was it adequate \u2013"] [11.32178783416748, 10.782846450805664, "tion, domestic abuse services]\nd. To what extent do you feel the referral process is working effectively in your county?\ne. In your experience, have there been any significant changes in the type and number\nof referrals \u2013 meaning have there been any "] [11.235794067382812, 10.754858016967773, "ng adequate - \u2013 did it provide clear guidance on what activities necessitate \u201cticking\u201d or \u201cunticking\u201d the 24-month time clock ?\ne. How well do you think CalWORKs participants understand the 24-month time clock [Probe: increased flexibility; reduced p"] [11.247264862060547, 10.838990211486816, "ticipants with the education programs that they need or want to enroll in?\ni. Since implementation of SB 1041, are more clients participating in educational programs now as part of the welfare to work program? Why or why not? [Probe for barriers or f"] [11.261530876159668, 10.763651847839355, "gram is working effectively in your county?\nd. What, if any, are the barriers or challenges to implementing the ESE program? (probe:\ninsufficient number or type of employers, inadequate/insufficient participant work experience or interest, delays in "] [11.261335372924805, 10.75526237487793, "or are eligible to receive in the future.\nD. I am going to ask you several questions about the types of services or assistance you have received from the CalWORKs Program.\nE. We\u2019re interested in your opinions and whatever you have to say is fine with"] [11.2371826171875, 10.798345565795898, " When did you enroll in the CalWORKs Program?\n2. What services are you currently receiving under the CalWORKs Program?\na. Which ones did you find most helpful and why?\nb. Which ones did you find least helpful and why?\nc. Are there any services that y"] [11.20669937133789, 10.77500057220459, "l and emotional health and about your exposure to domestic violence or any issues you have experienced related to drug or alcohol use.\na. What did you think about the questions that you were asked?\nb. Did any of the questions make you uncomfortable? "] [11.433363914489746, 10.618315696716309, " would like to interview you again in about 3 months to see how things are going and to talk to you again about the types of benefits or services you have received or have tried to get from the CalWORKs program during those 3 months and any issues or"] [11.509859085083008, 10.558167457580566, " individuals in the state from 1998 to the present. CDSS receives quarterly updates from the California Department of Health Care Services and provides us with processed extract files semiannually. The extracts are in two forms: annual monthly extrac"] [11.532231330871582, 10.541260719299316, "d clients include those sanctioned because of WTW noncompliance; being a fleeing felon; violating a condition of probation or parole; being convicted of a felony for the possession, use, or distribution of a controlled substance; and being a custodia"] [11.539660453796387, 10.535353660583496, "cember 2012. \u201cFebruary 2013 status study cross-section, post-SB 1041 group\u201d is defined as individuals who were CalWORKs WTW clients during February 2013 and first started in the CalWORKs WTW program in January 2013 or February 2013.\n57 At the recomme"] [11.505311012268066, 10.5648775100708, " the first quarter of 2007 (January, February, or March 2007) and had not been clients any time between January 1998 and December 2006. \u201cImpact study cohort 2014Q4\u201d is defined as individuals who were clients in the fourth quarter of 2014 (October, No"] [11.405485153198242, 10.651789665222168, "iables in the tracking study analysis data set to a two-year span and the impact study analysis data set to the quarterly level.\nData Integrity\nStaff at AIR and Stanfield Systems assessed the integrity of the data files and variables prepared for ana"] [11.402746200561523, 10.656429290771484, "l\nData Constructs\nCaseload status Case discontinuance Applicant denials\nWTW activities, exemptions, terminations\nDemographics, sources of cash assistance, earnings, other income sources\n We expect that the final evaluation report will benefit "] [11.168609619140625, 10.923389434814453, " All counties\nSmall counties Medium-sized counties Large counties\nNumber 12 Number 2 Number 5 Number 5\n12 24 10 3 10 5 2 8 5 7 6 0\nNumber 24\nNumber 26 9 3 Number 105 5 0 Number 125 1 0\n0 58 0 20 0 20 0 18\n0 58 0 20 0 20 0 18\n0 58 0 20 0 20 0 18\n3 58"] [11.178116798400879, 10.919649124145508, "mber Number Number\nNumber Number Number Number\n26 10 4 11 3 1 9 4 2 6 3 1\n5 1 1 2 0 0 2 1 1 1 0 0\nSOURCE: Authors\u2019 analysis of 2016 ACS data.\n(20 counties), from 1,000 to 4,999 for medium-sized counties\n274\n "] [11.224793434143066, 10.924036979675293, "s to Which He or She Has Been Assigned or Scheduled (All Counties and by County Caseload Size)\n Employment/Job Training Activity\nSubsidized employment All counties\nSmall counties Medium-sized counties Large counties\nJob skills training All counti"] [11.17869758605957, 10.924474716186523, "18\n1 51 0 17 1 18 0 15\n SOURCE: Authors\u2019 analysis of 2016 ACS data.\nNOTE: Caseload size is up to 999 for small counties (20 counties), from 1,000 to 4,999 for medium-sized counties (20 counties), and 5,000 or more for large co"] [11.190200805664062, 10.910709381103516, "20 5 18\n30 58 8 20 13 20 9 18\n3 58 2 20\n0 20\n1 18\n Benefited from enrollment in community college\n All counties\nSmall counties Medium-sized counties Large counties\nNumber Number Number Number\n Successfully transitioned to e"] [11.170557975769043, 10.925320625305176, " Medium-sized counties Large counties\nNumber Number Number Number\nNumber Number Number Number\n35 11 46 9 5 14 14 4 18 12 2 14\n7 39 46 2 12 14\n2 16 18\n3 11 14\n SOURCE: Authors\u2019 analysis of 2016 ACS data.\nNOTE: Caseload size is up to 999 for small "] [11.195536613464355, 10.930318832397461, "ties\nSmall counties Medium-sized counties Large counties\nNumber Number Number Number\n0 5 32 0 2 10 0 2 12 0 1 10\n How to use the flexibility of the 24-month time clock to the CalWORKs client\u2019s advantage\n All counties\nSmall counties Medi"] [11.191784858703613, 10.879538536071777, " Supervisor\u2019s Rating of Caseworker Understanding of Other SB 1041 Changes and Related Supports\n Policy Change\nEnhanced educational flexibility All counties\nSmall counties Medium-sized counties Large counties\nNumber Number Number Number\nNot at All"] [11.1875581741333, 10.919475555419922, "3 Number 2 Number 1 Number 0\n13 30 10 0 5 10 3 0 5 9 4 0 3 11 3 0\n4 16 35 0 2 5 11 0 0 3 16 0 2 8 8 0\n Increased flexibility offered by the 24-month time clock\nAll counties\nSmall counties Medium-sized counties Large counties\nNu"] [11.144726753234863, 10.94507122039795, " Table D.14. Among Counties with an FS Program, Their Rating of How Well the FS Program Is Doing (All Counties and by County Caseload Size)\n FS Program Component\nHelping stabilize families in crisis All counties\nSmall counties Med"] [11.149872779846191, 10.933032035827637, " Number\n Ability to identify client exemptions\nAll counties\nSmall counties\nMedium-sized counties\nLarge counties\nSOURCE: Authors\u2019 analysis of 2016 ACS data.\nNOTE: Caseload size is up to 999 for small counties\n(20 counties), and 5,000 or more fo"] [11.166346549987793, 10.921520233154297, "nties (18 counties). Counties were instructed to mark one rating for each type of need listed. County-level results for Table 4.28, Q27 on the ACS.\nNeeds\nTotal\nVery Somewhat\nDissatis-\nfied fied\nSomewhat Very Satisfied Satisfied\nDissatis-\n CalW"] [11.16688060760498, 10.92997932434082, "Medium-sized counties Large counties\nNumber Number Number Number\n0 7 0 3 0 3 0 1\n291\n13 7 13 5 11 6\n Table D.18\u2014Continued\nMuch Somewhat About Somewhat Much Not\n "] [11.164831161499023, 10.928305625915527, "20 3 18\n16 58 9 20 5 20 2 18\n All counties\nSmall counties Medium-sized counties Large counties\nNumber 2 Number 2 Number 0 Number 0\nVery Well\n24 5 10 9\n19 3 7 9\n23 4 8 11\n24 3 10 11\n20 1 9 10\n13 1 5 7\n6 1 2 3\n23 1 13 9\nNot at All\n "] [11.529232025146484, 10.545701026916504, "ured in February of each year. CalWORKs WTW clients include participating, exempt, or sanctioned CalWORKs WTW clients. These clients were members of two-parent families, all other families, and TANF timed-out cases. Unemployment rate is for Californi"] [11.522425651550293, 10.55431079864502, " all other families, or TANF timed-out cases present in February 2013, 2014, 2015, and 2016. Categories may not add up to 100 percent because of rounding error.\n296\n Table E.4. Number of New CalWORKs WTW Clients: Tracked Entry Cohorts 2007, 2009,"] [11.568848609924316, 10.512142181396484, "00.0\n79,423 40.7 36,023 2.9\n27,647 13.0 143,432 100.0 40,858 41.4 19,571 3.0\n19,636 13.7 128,581 100.0 38,565 27.2 16,452 0.4\n8,011 0.1\nPercentage\n2014 2015 2016\n100.0 100.0 100.0\n31.7 29.5 29.2 11.1 12.6 13.2\n14.3 13.1 10.2 100.0 100.0 100.0 30.7 27"] [11.531818389892578, 10.54514217376709, "ions stop the WTW 24-month time clock, the 48-month time-on-aid clock, or both. For the tracking study, the presence of exemptions and sanctions were measured for 36 months including the entry month. For example, for the 2013 cohort, we counted month"] [11.542076110839844, 10.531943321228027, "337,388\n2015\n308,926\n101,995 193,703 64,322 115,223 37,673\n2016\n272,013\n90,825 143,432 48,857 128,581 41,968\n89,085 321,401 84,319 17,164\n99,876 253,683 75,385 83,705 4,766 24,491\n301\n Table E.10. Average Real Quarterly E"] [11.536347389221191, 10.536722183227539, " February 2013, February 2014, February 2015, February 2016\n Group and Indicator\nClients with short-term WTW exemption for young children in December 2012\nNew WTW exemption for young children Short-term young children exemption\nSanction 139\n"] [11.554656028747559, 10.517277717590332, "mployed only or also a CalWORKs WTW client\n\u2022 CalWORKs WTW client: CalWORKs WTW client only or also employed\n\u2022 employed only (and not a CalWORKs WTW client)\n\u2022 both employed and a CalWORKs WTW client\n 305\n\u2022 CalWORKs WTW client only (and not employed)\n\u2022"] [11.564375877380371, 10.509493827819824, "6 39.9 39.8 38.3 36.8 34.6 36.9 36.4 35.1 33.8\nNot Employed nor WTW Client\n23.6 23.2 22.7 23.4 25.9 24.5 23.8 26.1 27.7 26.9 24.4 26.0 24.7 24.7 24.2 24.6 26.3 26.0 26.4 27.9 28.1 26.9 27.3 27.3\nReal Quarterly Earnings ($)\n$1,407.35 $1,397.75 $1,398."] [11.560808181762695, 10.513289451599121, "3 34.3 32.8 33.5 32.2 33.4 32.3 32.4 32.4\nReal Quarterly Earnings ($)\n$1,405.31 $1,455.58 $1,639.61 $1,609.06 $1,549.56 $1,594.65 $1,662.67 $1,694.14 $1,584.23 $1,673.50 $1,736.73 $1,912.95 $1,832.76 $1,902.88 $1,957.81 $2,127.62\nEntry Cohort\n "] [11.403040885925293, 10.649775505065918, ". Karoly, Anamarie Auger, Beverly A. Weidmer, Ashley N. Muchow, and Italo A. Gutierrez, A Descriptive Profile of CalWORKs Recipients and Their Families: Initial Findings from the California Socioeconomic Survey, Santa Monica, Calif.: RAND Corporation"] [11.400840759277344, 10.651121139526367, "nfo/acl/2013/13-01.pdf\n\u2014\u2014\u2014, Pathways to Success: Overview of CalWORKs Change, Sacramento, Calif.: CalWORKs Employment and Eligibility Branch, 2013a.\n\u2014\u2014\u2014, \u201cCalifornia Work Opportunity and Responsibility to Kids (CalWORKs) Program: Release of Third Set"] [11.394221305847168, 10.66327953338623, "lity to Kids (CalWORKs) Program: Additional Guidance and Forms Regarding Welfare-to-Work (WTW) 24-Month Time Clock Extensions, and Release of Related Welfare Data Tracking Implementation Project (WDTIP) Tracking Recipients Across California (TRAC) Im"] [11.369059562683105, 10.680440902709961, ".3, Sacramento, Calif., January 2016a.\n\u2014\u2014\u2014, \u201cCalifornia Work Opportunity and Responsibility to Kids (CalWORKs) Assembly Bill (AB) 98 Subsidized Employment and Expanded Subsidized Employment (ESE) Program Changes,\u201d All County Letter (ACL) No. 16-95, S"] [11.38794994354248, 10.66407585144043, "ports/RR919.html\n315\nLegislative Analyst\u2019s Office, \u201cThe 2012\u201313 Budget: The Governor\u2019s CalWORKs and Child Care Proposals,\u201d webpage, February 22, 2012. As of June 16, 2016: http://www.lao.ca.gov/analysis/2012/ss/calworks-child-care-022212.aspx\nO*NET R"] [11.350530624389648, 10.694893836975098, "tives and if there are any unintended consequences. This second evaluation report extends the analyses in the initial evaluation report through updated findings from the process study based on the second wave of the All-County Survey and qualitative "] [16.225812911987305, 2.9541268348693848, " EXECUTIVE SUMMARY\nLocal jurisdictions, faced with caseloads of increasing com- plexity and cost, have adopted alternative approaches to crimi- nal case processing\u2014including new technologies\u2014that have the potential to reduce backlog and improve ju"] [16.21894645690918, 2.948911190032959, "ogy in some capacity should be developed.\n\u2022 Model configurations that can be used to help purchasers make intelligent buying decisions should be developed.\n\u2022 Research is needed to better understand the effect of telepresence technology on defendants\u2019"] [16.21499252319336, 2.964846134185791, "nefiel\n9th Circuit Court, Florida\nRobin Davis\nICF International\nJonathan P. Hein\nDarke County, Ohio, Common Pleas Court\nJohn W. Johnson\nMiami-Dade Corrections and Rehabilitation\nCasey Kennedy\nTexas Office of Court Administration\nFredric Lederer\nCente"] [16.215063095092773, 2.950925350189209, "t appearances via video. According to the National Center for State Courts\u2019 (NCSC\u2019s) State Court Organization data set, which was last updated in\nJune 2017, state-level offices of courts oversee the use of video- conferencing in 35 states and the Dis"] [16.224401473999023, 2.9533493518829346, "; Devoe and Frattaroli, 2009).1 In Crawford v. Washington, the Supreme Court further clarified that it is a violation of the defendant\u2019s Sixth Amendment rights under the confrontation clause to be denied the opportunity to confront or challenge\nan ad"] [16.23271369934082, 2.9533865451812744, " individuals to appear in court remotely, telepresence eliminates the need to trans- port defendants and offenders from correctional facilities to courthouses, reducing potential threats to the safety\nof court personnel, corrections staff, victims, w"] [16.230072021484375, 2.9535603523254395, "nd child abuse, to testify against the defendant without expe- riencing the revictimization and trauma of being physically present with their offender (Garvin et al., 2011; Kenniston, 2015).\nAlthough telepresence technology might offer courts valu- a"] [16.21878433227539, 2.9515113830566406, "s for the constitutional rights of court parties. More-serious technical issues could delay or disrupt court proceedings (Devoe and Frattaroli, 2009).\n\u2022 data storage and security: Securely storing the large quantities of video and audio data generate"] [16.231998443603516, 2.9467363357543945, "elays and challenges created by technical issues and the potential violation of the defendant\u2019s legal and constitu- tional rights. Ultimately, the participants identified 24 specific research and development needs related to the use of telepres- ence"] [16.233837127685547, 2.952803611755371, "nsiveness when speaking (Landstro\u0308m and Granhag, 2010; Landstro\u0308m, 2008; Landstro\u0308m, Ask, and Sommar, 2015). Telepresence technology has the potential to negatively affect each of these elements. Although no known studies have confirmed this directly"] [16.220523834228516, 2.948591709136963, "s appearing remotely might be in a room where other people are talking or where other background noises are present. One panel member described an instance in which videoconferenc- ing equipment was installed in the loud boiler room of a jail, making"] [16.22824478149414, 2.9501636028289795, "her the technical setup of the equipment has as much of an impact as the tech- nology itself on a judge\u2019s determination during a bail hearing. Panel members also noted that research on the impact of social media platforms on communication suggests th"] [16.23027992248535, 2.954756736755371, " games that require remote communication might be more comfortable with the technology and view the court proceedings as something like a game. A lack of appreciation for the seriousness of the proceed- ing, coupled with the feeling of being removed "] [16.221935272216797, 2.963545322418213, "found satisfac- tion among patients, but not among providers, and suggested that although defendants might largely be satisfied with the quality of representation in proceedings involving telepresence technology, the defense attorneys could find the "] [16.235261917114258, 2.9536869525909424, "fendant appears in person. Therefore, the use or availability of telepres- ence technology might encourage victims or other witnesses to participate in the proceedings. Telepresence technology might be especially beneficial in cases where physically "] [16.256500244140625, 2.9121034145355225, "ce technology if the equipment setup is so complicated that \u201cthe bench looks like a cockpit.\u201d\nThe panel members discussed the benefits of using telepres- ence technology to enable judges to sign warrants electronically after hours, including over the"] [16.229867935180664, 2.9513938426971436, "eedings through a regular conference\ncall. More research is needed to understand the implications of these backup options. Although it might appear that allowing the proceedings to be conducted via conference call speeds up proceedings, saves money, "] [16.21755599975586, 2.9469335079193115, " and case outcomes, several areas were identified as priority research and development needs. The panel identified and later ranked needs related to understand- ing the impact of telepresence technology on court proceedings. These needs include conce"] [16.232885360717773, 2.945823907852173, "the way in which telepresence technology is installed or operated can affect perceptions of credibility and case outcomes. Technical stan- dards and training on proper setup and use could help insure against these negative consequences.\nAccording to "] [16.22927474975586, 2.9492011070251465, "in mind that are easy to install in a variety of settings, including court and correctional facilities. Moreover, participants argued that telepresence vendors should automate system updates and provide ongoing technical support to promote the system"] [16.231075286865234, 2.948455572128296, "chnological devices and equipment to enable telepresence technology to be incorpo- rated.\nParticipants also touched on the importance of the back- ground for remote court appearances. Lighting and other environmental conditions of the remote court pa"] [16.215730667114258, 2.945613384246826, "ested that research should be conducted to identify best practices for videoconferencing audio setups and to determine which materials or other equipment could be used in the setup to minimize background noise and produce high-quality audio. The pane"] [16.211505889892578, 2.948892116546631, " concern that multimedia court records would allow appellate courts\nto overturn lower court rulings more easily and make assess- ments about credibility and other factors that could usurp the function of the trial court. As a result, trial and appell"] [16.230375289916992, 2.9479386806488037, "lling telepresence technology equip- ment can be high, efficiencies could be realized by ensuring that telepresence systems are designed to enable multiple func- tions.\nHowever, panel members pointed out that court purchasers often neither are aware "] [16.2298526763916, 2.9480412006378174, "earch into options for improving network connectivity.\n Proprietary equipment and software that cannot be translated across devices might limit the ways in which telepresence technology can be used in court.\nPotential Expansions of Telepresence Techn"] [16.23740577697754, 2.9503417015075684, " as the best option for areas with less tech- nological bandwidth but that seek to use telepresence technol- ogy. Improving wireless coverage is less expensive and more feasible than adding more bandwidth or using satellites. A judge, attorney, or ot"] [16.261287689208984, 2.9583888053894043, " courts might consider implementing some of these capabilities for use in certain legal proceedings. If everyone participated through telepresence technology, any bias or nega- tive consequences would be eliminated because the defendant or other key "] [16.258886337280273, 2.92344331741333, " a related concern about the potential impact a fully virtual courtroom could have on behaviors and interactions. As mentioned earlier, communicat- ing behind a screen might change how an individual engages with others. It remains an open question wh"] [14.836663246154785, 1.8305730819702148, "thing to the objective and 9 indicated that meeting the need could result in a 20-percent or greater improvement in performance).\n2. how practical it would be to meet the need (while meeting some needs might require only minor adaptation, meeting oth"] [16.22132110595703, 2.9456558227539062, "rchasers; (7) conducting research into the effect of telepresence technology on defen- dants\u2019 experiences with the court process and perceptions of procedural justice; (8) developing standards on video quality and image size; (9) conducting research "] [16.23700523376465, 2.941804885864258, "arch to identify best prac- tices and minimum standards for audio setup.\n\u2022 Conduct research to assess the impact of telepresence technology on the expe- riences of witnesses and victims.\n\u2022 Identify the technical issues that impact the effectiveness o"] [16.224658966064453, 2.94027042388916, " practices for useful Yes performance indicators and the kinds\nof data that should be collected\nfrom these systems to inform the\nindicators.\n\u2022 Conduct research to assess the Yes impact of telepresence technology\non the experiences of witnesses and\nvi"] [16.23295021057129, 2.945559024810791, "ccess to and sharing of telepres- ence feeds.\nNeed Received a High- Importance\nScore Corresponding (Yes/No) Category\nYes Measuring outcomes\nNo Measuring outcomes\nYes Technical standards and training\nYes Technical standards and training\nNo Measuring o"] [16.238996505737305, 2.94160532951355, " remote interactions on court\noutcomes. One panel member referred to telepresence technol- ogy as being \u201cguilty until proven innocent.\u201d In other words, without rigorous efforts to assess the impact of telepresence technology on such outcomes as bail "] [14.91557788848877, 2.109917640686035, " of the workshop\u2019s focus areas.\nIn advance of the workshop, participants were provided an opportunity to identify the issues and topics that they felt would be important to discuss during the workshop. Using a comprehensive literature review and inpu"] [14.839286804199219, 1.8340734243392944, "d be met and broadly implemented successfully. That is, they could assign the need\u2019s chance of success between 10 percent (i.e., a rating of 1) and 90 percent (i.e., a rating of 9). This dimension was intended to include not only technical concerns ("] [14.803759574890137, 1.8020082712173462, "version 3.5. We chose this algorithm to minimize within-cluster variance when deter- mining the breaks between tiers. The choice of three tiers is arbitrary but was done in part to remain consistent across the set of technology workshops we have cond"] [14.782297134399414, 1.696960210800171, "o indicate whether each problem and need pairing should be voted up or down on the list. An example of this form is provided in Table A.2.\nWe then tallied the participants\u2019 third-round responses\nand applied those votes to produce a final list of prio"] [14.779119491577148, 1.6928385496139526, "suffer when some or all of the\nparticipants are remote (judge, court reporter, prosecutor, defendant, etc.).\nNeed: Conduct research on the impacts on decisionmaking, communication, and 3 perceptions of satisfaction with the process when one or more p"] [14.773310661315918, 1.7055670022964478, " output from this process became the final ranking of the panel\u2019s prioritized results.\nFigure A.3. How a Need\u2019s Increase in Expected Value Might Result in Its Movement Across Tier Boundaries\nHigher score\nTier 1 score range\n1\n27\n 1\n1\n 2\n Fig"] [16.20197105407715, 2.955606698989868, " 45, No. 1, 2014.\nConcurrent Technologies Corporation and CONSAD Research Corporation, Evaluation of Video Conferencing Demonstration Projects: Final Report, Johnstown, Pa.: Pennsylvania Commission on Crime and Delinquency, 2000.\nCookingham, Lisa M.,"] [13.939416885375977, 3.690253496170044, "lywood, John S., Dulani Woods, Andrew Lauland, Sean E. Goodison, Thomas J. Wilson, and Brian A. Jackson, Using Future Broadband Communications Technologies to Strengthen Law Enforcement, Santa Monica, Calif.: RAND Corporation, RR-1462- NIJ, 2016. As "] [16.153432846069336, 2.960085391998291, " Journal, Vol. 90, No. 4, 2015, pp. 1683\u20131705.\nMacCabe, Jena, \u201cCan You Hear Me Now?: Interpreters for California Civil Cases,\u201d Loyola of Los Angeles Law Review, Vol. 49, 2016,\npp. 685\u2013704.\nMaryland Administrative Office of the Courts, Evaluation of t"] [16.214677810668945, 2.951392412185669, "cial Media its Impact with Positive and Negative Aspects,\u201d International Journal of Computer Applications Technology and Research, Vol. 5, No. 2, 2016, pp. 71\u201375.\nStrickland, S., R. Schauffler, R. LaFountain, and K. Holt, eds., \u201cState Court Organizat"] [13.924877166748047, 4.1803388595581055, "er by training and a research public health analyst in the Applied Justice Division at RTI International. She has provided training and technical assistance to research partners evaluating innovative prosecutorial strategies and conducted original sc"] [13.918503761291504, 4.1691975593566895, "ention. Planty has led several projects for the U.S. Department of Justice and plays a key role in several ongoing studies related to school safety, incident-based crime statistics, identity theft, and sexual assault. Before joining RTI in 2017, Plan"] [13.866904258728027, 4.538262367248535, "ement by NIJ or the RAND Corporation.\n This publication was made possible by Award Number 2013-MU-CX-K003, awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions o"] [18.952497482299805, 7.630707263946533, " CORPORATION\nSTEPHANIE BROOKS HOLLIDAY, JIRKA TAYLOR, PRISCILLIA HUNT, IFEANYI EDOCHIE, SARAH B. HUNTER\nEvaluation of a Trauma-Informed Program for Juvenile Justice- Involved Youth\nThe Pilot Program at Lookout Mountain Youth Services Center\n For more"] [18.97475242614746, 7.612160682678223, "d social and economic well-being of populations and communities throughout the world. The program focuses on such topics as access to justice, policing, corrections, drug policy, and court system reform, as well as other policy concerns pertaining to"] [18.97511863708496, 7.612967014312744, "am. To better understand the nature of the pilot program, we com- pleted a series of related procedures. We conducted key informant discussions, reviewed relevant documents, and conducted a site visit to observe the facility. To understand barriers a"] [18.979660034179688, 7.615165710449219, " or proportion of youth who earned a diploma or GED during the evaluation period.\nStaff Program Outcomes\nData indicated that staff absences were common. During the pilot period, staff members on both units missed approximately three days of work per "] [18.972978591918945, 7.614723205566406, " across DYS facilities. Therefore, while the program holds promise, we offer the fol- lowing recommendations to Colorado DYS for the ongoing implementation of the program:\nviii\nEvaluation of a Trauma-Informed Program for Juvenile Justice-Involved You"] [18.980728149414062, 7.6144819259643555, "............................................................................................. 1 Colorado DYS Pilot Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [18.968643188476562, 7.630098819732666, "........................................ 53 ix\nFigures and Tables\n Figures\n1.1. The Colorado Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [17.111669540405273, 7.946569919586182, "t CI confidence interval\nDYS Division of Youth Services FTE full-time equivalent\nGEE generalized estimating equation\nHB House Bill\nLMYSC Lookout Mountain Youth Services Center MYSI Missouri Youth Service Institute\nOR odds ratio\nPREA Prison Rape Elimi"] [18.93364143371582, 7.624588489532471, "First, certain symptoms of mental health diagnoses can manifest as problem behav- iors such as anger, irritability, and aggression (Underwood and Washington, 2016). Similarly, youth with a history of complex trauma may be at greater risk of exhibitin"] [18.970857620239258, 7.612483978271484, "mbers. In the report, staff members noted that they lacked training to appropriately de-escalate behavioral incidents. Together, as indi- cated in the report, these practices represented a significant barrier to effective rehabilitation.\nIn recogniti"] [18.973962783813477, 7.612307071685791, "aff.\nbehavioral health needs (Ryan and Mitchell, 2011). Together with HB 17-1329, this Strategic Plan shaped the design and implementation of the trauma-informed pilot program at Lookout Mountain Youth Services Center (LMYSC).\nColorado DYS Pilot Prog"] [18.98270034790039, 7.607851505279541, "program is described in more detail in subsequent chapters.\nPresent Evaluation\nIn addition to establishing the pilot program, HB 17-1329 required that the program be evalu- ated to assess its effectiveness during its first year of implementation. The"] [18.97569465637207, 7.611936092376709, "SI submitted to DYS for the training contract, the Colorado DYS Policy on Reporting Critical Incidents (CDHS, 2017a), the Colorado DYS Strategic Plan (CDHS, 2017b), and the MYSI Assessment of the Colorado Division of Youth Corrections (MYSI, 2017).\nF"] [18.97730827331543, 7.612593650817871, "selecting a comparison group from a different facil- ity may have introduced more variability with respect to these factors. Each unit at LMYSC is made up of multiple pods. The pilot unit was smaller than other units with regard to the number of pods"] [18.963720321655273, 7.617681980133057, "event the youth from being in a prone position; as well as the use of transport restraints. Levels of physi- cal responses were recorded using categories established by Colorado DYS. Level One refers to an \u201cescort hold,\u201d in which a staff member holds"] [18.974946975708008, 7.613674163818359, "eyes or skin). \u201cUnauthorized/Incidental\u201d incidents reflect fights that are not the result of an intentional act of aggression.\nMethod 7\n8 Evaluation of a Trauma-Informed Program for Juvenile Justice-Involved Youth\nInjuries. We received information as"] [18.990007400512695, 7.609992504119873, "nary conversations with represen- tatives of DYS and LMYSC. These discussions revolved around two principal topics: (1) data collected by the DYS that could be made available to the research team; and (2) reflections of DYS and LMYSC representatives "] [18.979839324951172, 7.613332271575928, " the youth and staff in the pilot and comparison groups. For youth, this included age, race/ ethnicity, and committing offense; for staff, this included role at the facility. We also examined whether there were differences in the mean length of time "] [18.976518630981445, 7.61264705657959, "mparison of costs over time, and (4) unit costs (to the extent possible and analytically meaningful). Note that in the main text, we focus on summarizing the results of this analysis and provide more detailed results in Appendix C.\nCHAPTER THREE\nEval"] [18.9766788482666, 7.61194372177124, "perience and supervise the direct care staff.\nAt the beginning of the pilot program, the intention was that YSS staff would be specifi- cally assigned to the pilot program; however, based on our key informant discussions, this became more difficult t"] [18.976905822753906, 7.611234188079834, "nt, the training included ten modules and incorporated didactic elements and practical applications (e.g., case vignettes). The\nMissouri Model training incorporates elements of existing models of leadership and group pro- cess (e.g., Tuckman Model of"] [18.976449966430664, 7.611424922943115, "ram model differed from implementation.\nFeatures of Programming Across LMYSC\nYouth involved in the pilot program participated in many of the same activities as youth in other areas of the facility. In this section, we describe the core features of pr"] [18.977344512939453, 7.611392021179199, "two individual and one family session, but if the family is unable to participate, it can be three individual sessions. In addition, youth receive at least one group therapy session per week. These treatment groups are determined based on the individ"] [18.975894927978516, 7.6123247146606445, "o reported that he encourages staff to display youth achievements and artwork, and to incorporate aspects of the treatment philosophy (e.g., charts with different emotions, community standards). In addition, youth in the pilot program were given acce"] [18.976728439331055, 7.612020969390869, "s prior to parole, and continue providing this service for 90 days after parole in the family\u2019s own community. The goal of this component is to help understand and address any issues that the family has and connect them with resources that they may n"] [18.976062774658203, 7.610878944396973, "articipate in regular behavioral health services, consistent with the broader LMYSC community\n\u2022 All LMYSC staff are provided with training in the Sanctuary Model; pilot staff received additional intensive training in the months leading up to pilot im"] [18.975278854370117, 7.609463691711426, " columns summarize the outcomes expected from the program. In the short term, the pilot program is expected to decrease negative behavioral incidents, reduce use of restraints and seclusion as behavior management techniques, decrease injuries, decrea"] [18.976394653320312, 7.613952159881592, "mber acknowledged that eliminating seclusion is beneficial, in that seclusion can be traumatizing. However, this staff member described the value of \u201ccontain- ment\u201d in more extreme situations (e.g., \u201ccausing physical harm every day\u201d), noting that thi"] [18.9722900390625, 7.615522861480713, "ff members feeling unsafe.\n20 Evaluation of a Trauma-Informed Program for Juvenile Justice-Involved Youth\nIn turn, being short-staffed has resulted in multiple challenges to implementation. First, inter- viewees described how one foundational tenet o"] [18.975236892700195, 7.613562107086182, "he jail system. Here, it\u2019s a little different. If you attack a staff, we\u2019ll do what we have to do, use community restoring techniques.\u201d When asked if these techniques were effective, the staff member said, \u201cWith certain youth. Then certain youth care"] [18.974193572998047, 7.613766193389893, "ereas some found it helpful and engaging, those with more of a background in trauma-informed care found it less useful. The latter group suggested there could be ways to dive deeper into the content and spend more time discussing application of the i"] [18.962249755859375, 7.637209892272949, " on youth who resided on the pilot or comparison units during the evaluation period. This included youth who were on these units at the beginning of the evaluation period, as well as youth who entered these units during the year of implementation. Th"] [18.95637321472168, 7.637156009674072, "nts and Level Two physical responses were most common. Of note, the maximum number of physical responses with mechanical restraints or Level Two physical responses for a given youth in any month was seven incidents. On both units, most outcomes were "] [18.959379196166992, 7.633627891540527, "Juvenile Justice-Involved Youth\nTable 3.4\nProportion of Youth Experiencing Each Outcome by Unit\n Outcomes\nWithout mechanical restraint With mechanical restraint Side hold\nTransport restraint\nLevel One Level Two Critical\nSeclusion < 4 hours Seclusion "] [18.974199295043945, 7.619929790496826, ")\n40.20 (26.64) 22.0% (9)\np-value\np = 0.86 p = 0.49\n Within the subset of youth who had not yet earned their degree (n = 41 pilot youth, n = 31 comparison youth), we examined the mean number of credits earned during the pilot year. We also examined"] [18.98045539855957, 7.616750240325928, "nt difference in the proportion\nTable 3.7\nStaff Absences and Turnover by Unit\n Outcome\nTotal absences (days) Absences per month (days) Staff left facility\nPilot\nM (SD) or % (n)\n17.4 (27.14) 2.68 (2.81) 31.10% (14)\nComparison M (SD) or % (n)\n15.38 (17"] [18.991430282592773, 7.591710567474365, "d (2) costs associated with the running of the facility of which the pilot is a part, but which are not specific to the pilot. We discuss these two types of costs in turn below to arrive at a composite measure of the pilot\u2019s running costs. Thus, this"] [18.970033645629883, 7.618109703063965, "is share of facility-wide costs to the pilot.\n1 Please note that the setup of the pilot also likely required staff time from personnel not explicitly dedicated to the pilot, such as participation in training or oversight and management by the facilit"] [18.96710968017578, 7.624937534332275, "90 $290 $417 Total $436,323\n CHAPTER FOUR\nConclusion\nThis report has documented the first year of implementation of the trauma-informed pilot program at LMYSC. In this section, we summarize the findings, discuss how the pilot pro- gram fits with the"] [18.97700309753418, 7.6129326820373535, "need for behavioral management techniques that staff members can use to address these situations. In addition, though use of mechanical restraints was less common in the pilot program, it was still used with 45 percent of youth at least once during t"] [18.979198455810547, 7.612909317016602, "ning or the pilot program philosophy when interacting with youth on those other units. Therefore, nonpilot units also had exposure to certain aspects of trauma-informed care. This may have contributed to the lack of significant differences between th"] [18.97123146057129, 7.618381023406982, "s a substantial difference between the staff working in the pilot and nonpilot areas (i.e., where more senior or specialist-skilled individuals are recruited for the pilot).\nConsiderations Related to Fit with Colorado DYS\nFrom a theoretical and empir"] [18.97857093811035, 7.6122260093688965, "part because certain restrictions had to be put in place across the facility and in part because staff were pulled from the pilot to cover other units. To some extent, placing limits on the programming of the pilot program may be inevitable when ther"] [18.979562759399414, 7.611501216888428, "program. We did not interview staff of the comparison unit for this evaluation, but doing so would provide additional information about what practices and challenges were unique to the pilot versus experienced facility-wide.\nRegarding the evaluation,"] [18.974002838134766, 7.615287780761719, " the cost analysis, data provided by DYS include only information on costs directly incurred by DYS and do not include other notable cost categories, including rent/ mortgage, utilities, insurance, and workers\u2019 compensation. As such, the costs of the"] [18.97650718688965, 7.613167762756348, "all staff\u2014including new program staff\u2014would ensure that staff members are operating from a shared understanding of the program. It may not be feasible for MYSI staff to provide this type of training to all new staff members, especially given current "] [18.973155975341797, 7.615084648132324, "t recom- mendation) may also reduce absences and turnover.\n4. Explore staff concerns regarding safety and the effectiveness of the program in more depth.\nStaff reported that in recent months they had felt unsafe at the facility\u2014and some staff noted t"] [18.975666046142578, 7.616041660308838, "ral health staff\nConclusion 37\n38 Evaluation of a Trauma-Informed Program for Juvenile Justice-Involved Youth\nrun groups that only include pilot program youth. Staff members also had suggestions of addi- tional groups or activities that would be bene"] [18.935705184936523, 7.639151096343994, "as the Colorado DYS Strategic Plan specifically identifies the promotion of \u201cprosocial, safe, and nonviolent interactions\u201d as a goal, and the pilot program aims to \u201cpromote building trust and healthy relationships between youths and staff and to allo"] [18.96307945251465, 7.632481575012207, "1000 10071000010\nComparison\nPilot\n00000000000 00000000000\n3314835561000\nPilot\n446914414400\nComparison\n00000000000 00000000111\n01001003211 00201000020\n10013112903 10402100043\n00000000000 00000000000\nComparison\nPilot\n00110000000 00000000000\n "] [18.97950553894043, 7.614924430847168, "94)* 0.60 (0.21, 1.71) 0.40 (0.15, 1.07)\u2020\n1.62 (0.47, 5.52)\n0.63 (0.25, 1.56) 2.87 (0.71, 11.61) 1.37 (0.51, 3.68)\n6.00 (0.53, 68.40) 2.31 (0.38, 14.24)\n1.84 (0.70, 4.81)\n(not reported due to inflated confidence intervals)\n Physical response\n Seclu"] [18.981969833374023, 7.624057769775391, ". We understand that the team is a key part of this pilot program. How is your working\nrelationship with your colleagues? [probes] How is your working relationship with lead- ers? [probes]\nSection E: Barriers and Challenges to Implementation (All Sta"] [18.983671188354492, 7.6278791427612305, "clude annual leave payments and sick leave payments. Negative values represent reversals of earlier payments. The total costs from July 2018 to June 2019 were $83,655, or on average $6,971 per month. Of these, the prorated amount attributable to the "] [17.1159725189209, 7.966616153717041, "at would be added to an already existing pod.\nReferences\n Abram, Karen M., Linda A. Teplin, Devon R. Charles, Sandra L. Longworth, Gary M. McClelland, and Mina K. Dulcan, \u201cPosttraumatic Stress Disorder and Trauma in Youth in Juvenile Detention,\u201d Arch"] [17.040937423706055, 7.926052570343018, "ry, \u201cFostering Implementation of Health Services Research Findings into Practice: A Consolidated Framework for Advancing Implementation Science,\u201d Implementation Science, Vol. 4, Article 50, 2009, pp. 1\u201315.\nDeLisi, Matt, Andy Hochstetler, Gloria Jones"] [17.124225616455078, 7.986224174499512, "hol Use Disorders in Primary Care. Santa Monica, Calif.: RAND Corporation, RR-2049- NIDA, 2017. As of September 30, 2019:\nhttps://www.rand.org/pubs/research_reports/RR2049.html\nIBM Corporation, IBM SPSS Statistics, version 21, 2012.\nKen Blanchard Com"] [16.979862213134766, 7.943071365356445, "velopmental Sequence in Small Groups,\u201d Psychological Bulletin, Vol. 63, No. 6, 1965, pp. 384\u2013399.\nUnderwood, Lee A., and Aryssa Washington, \u201cMental Illness and Juvenile Offenders,\u201d International Journal of Environmental Research and Public Health, Vo"] [12.199738502502441, 19.454395294189453, " SOCIAL AND ECONOMIC WELL-BEING\nThe Frequency and\nEconomic Impact of\nMusculoskeletal Disorders\nfor California Firefighters\nTrends and Outcomes over the Past Decade Michael Dworsky, Seth A. Seabury, Nicholas Broten\nPrepared for the Commission on Healt"] [11.367276191711426, 17.5760498046875, ". ICJ is dedicated to improving the civil justice system by supplying policymakers and the public with rigorous and nonpartisan research. Its studies identify trends in litigation and inform policy choices concerning liability, compensation, regulati"] [12.217477798461914, 19.51566505432129, "eletal Disorder?.......................................................................................................6 Injury Compensation for Public Safety Employees in California ............................................................ 7 Exis"] [12.028932571411133, 19.221139907836914, ".............................................................................................................. 60 Summary Statistics ....................................................................................................................."] [11.890530586242676, 19.358781814575195, "...................... 52 Figure 7.1. Number of Chiropractic Visits in Three Years of Medical Care, All Workers\u2019\nCompensation Information System Injuries with One or More Chiropractic Visit.............. 80 Figure 7.2. Number of Occupational Therapy "] [12.099863052368164, 19.176876068115234, "................................................................ 43 Table 4.5. Relative Earnings by Injury Year and Occupation, Musculoskeletal Injuries\nwith Permanent Disability........................................................................"] [11.903925895690918, 19.28983497619629, " with Indemnity Benefits Receiving Any Capped\nServices, by Injury Type, Service Type, and Occupation..................................................... 78\nTable 7.2. Average Visits Injured Workers with Indemnity Benefits Receiving Any\nCapped Servic"] [12.178513526916504, 19.40487289428711, "upation .......................................................................................................................... 105\nTable B.2. Sensitivity Analysis of Earnings Loss Estimates Accounting for Potential Misreporting of Labor Code \u00a7485"] [12.199475288391113, 19.47527503967285, "ters than for workers in similar occupations. MSDs in older firefighters (aged 55 or above at injury) had earnings and employment losses comparable to private-sector workers, however. The report also examined the effect of medical reforms enacted in "] [12.197025299072266, 19.44672966003418, "among firefighters with MSDs.\n\uf0b7 Estimate the effects of disability rating reforms enacted in SB 863.\n\uf0b7 Assess the effect of caps on chiropractic, occupational therapy, and physical\nmedicine visits.\nWe analyzed administrative data from the California "] [12.241640090942383, 19.494705200195312, "es are high compared to other workers. Between 2005 and 2017, the firefighter injury rate ranges from just under 200 per 1,000 workers to more than 250 per 1,000. Injury rates for police officers are similar though slightly lower, while the overall r"] [12.225508689880371, 19.411590576171875, "f Musculoskeletal Disorders for Firefighters Remain Less Severe than for Workers in Similar Occupations\nWe also examined postinjury earnings and employment for firefighters, using methods developed in previous RAND studies to compare injured worker o"] [12.186375617980957, 19.342676162719727, "milar impairment severity to police and other comparison occupations with the same type of rating. Firefighters had slightly higher final ratings than comparable occupations prior to SB 863, however. Firefighters have relatively high occupational adj"] [12.211459159851074, 19.523712158203125, "mented under SB 863.\nFirefighters with Musculoskeletal Disorders Rarely Receive Treatment or Permanent Disability Benefits for Post-Traumatic Stress Disorder or Other Psychiatric Conditions\nWe examined diagnosis codes on medical services and prescrip"] [12.141926765441895, 19.43442153930664, "s on patterns of care or worker outcomes, so the Commission on Health and Safety and Workers\u2019 Compensation requested that we study this issue. We ask what\nxv\nproportion of workers with and without MSDs have sufficiently high utilization of the capped"] [12.296314239501953, 19.983922958374023, "pensation system. Data from the workers\u2019 compensation system also cannot speak to the incidence of PTSD or mental distress among workers who do not file claims for a workplace injury. The potential for stigma suggests a need to go beyond claims data "] [12.2094087600708, 19.477693557739258, "te sector (Bureau of Labor Statistics, undated). In California, the risks of firefighting have become even more salient in the past few years, with the record wildfires and resulting deaths that have occurred.\nThe health risks facing firefighters go "] [11.826142311096191, 18.329742431640625, "eform in 2012 with California Senate Bill (SB) 863. This bill was passed in response to the fact that employer costs and premiums were rising even though the earlier 2004 reforms had led to a dramatic cut in permanent partial disability (PPD) benefit"] [12.201118469238281, 19.47572135925293, "delays in medical treatment. However, while these reforms have the potential to improve worker outcomes and contain costs, their implications for California firefighters with MSDs should be relatively minor.\n 2\nworkers appeared to be particularly har"] [12.188061714172363, 19.461719512939453, "e PTSD and other psychological injury reporting.\n7. Empirically assess what percentage of MSD claims are ultimately determined compensable under workers\u2019 compensation.\n8. Of MSDs determined compensable, assess how many are subject to causal apportion"] [12.128130912780762, 19.276445388793945, "urces and methods to the relevant chapters, and additional details on sample construction are presented in Appendix A.\nChapter 3 uses only occupation descriptions, worker demographics, and injury characteristics from the First Report of Injury (FROI)"] [12.1973237991333, 19.452083587646484, "l factors relevant to public safety employees, particularly regarding disability compensation that could affect our findings. We then discuss previous work and offer a few descriptive statistics using national data to describe the overall MSD risk fo"] [12.165858268737793, 19.357995986938477, "lassification of Diseases (ICD), specifically ICD-9-CM diagnosis codes contained in the medical billing data. The ICD-9 codes have the advantage of providing more precise clinical detail about the nature of injury and an individual\u2019s physical conditi"] [11.720882415771484, 18.263290405273438, "nclude full coverage of medical costs and partial coverage of lost wages. Indemnity benefits vary depending on whether the injury is permanent or temporary, as well as according to such other factors as the type of injury and/or the worker\u2019s age or o"] [12.29411792755127, 19.269594192504883, "ear. As noted above, these workers are routinely asked to put their lives at risk to protect the public, and we might be concerned that workers would be less willing to take on these risks if they knew it would lead to significant future economic har"] [12.339669227600098, 19.157407760620117, "hus, comparing workers eligible for LC \u00a74850 compensation to other workers could make it look as if injured firefighters and other safety employees were actively working after an injury even if they were out of work due to temporary disability. This "] [12.225854873657227, 19.47926902770996, "ing moral hazard\u201c while workers increasing their risk taking and experiencing more injuries is referred to as \u201crisk bearing moral hazard\u201c (Butler and Worrall, 1991). Both are theoretically feasible, but generally speaking the former is considered to "] [12.229222297668457, 19.49047088623047, " is a growing concern in California. Using data from the Department of the Interior from 2003 to 2007, Britton et al. (2013) identified slips or falls as the most common type of nonfatal injury, followed by injuries involving equipment or machinery. "] [11.804280281066895, 19.04103660583496, "se is made up of information on individual workers\u2019 compensation claims submitted to DIR from claims administrators using the Electronic Data Interchange (EDI) formats developed by the International Association of Industrial Accident Boards and Commi"] [11.849204063415527, 19.062284469604492, ", such as maximum medical improvement, end date of temporary total disability payments, date and receipt of permanent partial disability payments, return to work (if applicable), and claim closure.\nIn theory, combining data from FROI and SROI should "] [12.443924903869629, 19.67017936706543, "a semiannual survey of approximately 200,000 nonfarm establishments, for a total of about 1.2 million establishments over a three-year survey frame, which BLS uses to provide annual estimates. Because of the nature of the survey, the data exclude far"] [12.237144470214844, 19.439144134521484, "or on a scale of 1 to 5, with 5 indicating the factor is more relevant. As we discuss below, we use these data on job demands to select private- sector occupations similar to firefighting for inclusion in a comparison group.\nMethods\nWe had to choose "] [12.481293678283691, 19.69826889038086, "d classification system, unlike the occupation description. Submission of class codes to WCIS is optional for self-insured employers, however, so class codes are not present in all FROI records, with differentially low rates of reporting among public"] [12.35971736907959, 19.625375747680664, "active firefighters identified by our current approach.\nComparing Job Demands for Firefighters and Workers in Other Occupations\nAs with the 2010 RAND firefighter study, our analysis compares injury frequency and outcomes for firefighters to a selecti"] [12.384291648864746, 19.68433952331543, " less relevant each factor is for a firefighter compared to someone in a randomly selected occupation, according to whether the difference is positive or negative, respectively. Even though the precise ordering should be taken as suggestive since the"] [12.402048110961914, 19.704832077026367, " -0.51\n3.11 -0.54\n3.04 1.07\n3.1 0.46\n3.84 0.34\n3.24 0.3\n3.84 0.25\n4.19 0.07\n1.93 -0.12\n Spend time using your hands to handle, control, or feel objects or tools\nSpend time making repetitive motions Indoors, environmentally controlled Spen"] [12.400469779968262, 19.6787052154541, "ghters based on\njob characteristics.\nTable 3.2. Firefighters Compared to Similar Occupations\n0.0\n5.3\n7.9\n9.5\n10.6\n Occupation Title\nStatistical Distance\n Municipal firefighters\nMunicipal firefighting and prevention supervisors Fire investigators F"] [12.26589298248291, 19.531723022460938, "s and attendants, except emergency medical technicians Refrigeration mechanics and installers Septic tank servicers and sewer pipe cleaners Millwrights Commercial pilots Occupational health and safety technicians\n 25.3\n 22\nis unlikely to y"] [12.276254653930664, 19.497344970703125, ", the general patterns are the same even with additional years.\nMillwrights; Occupational Health and Safety Technicians; and Police Identification and Records Officers. We did not identify the excluded occupations in the WCIS data, so we are unable t"] [12.228455543518066, 19.456134796142578, "or firefighters. For firefighters, MSDs account for 47.3 percent of all injuries, compared to 38 percent for police officers, 42.5 percent for other public-sector workers, 37.2 percent for workers in the private-sector comparison group, and 41.8 perc"] [12.227568626403809, 19.456560134887695, "kely (54.6 percent) than the statewide average to be female.\nTable 3.5. Demographics of Injured Workers with Musculoskeletal Disorder Claims, by Occupation\n Active Active Rest of Public Firefighters Police Sector\nRest of Private Sector\n40.4 13.9%\n2"] [12.264884948730469, 19.493833541870117, "tiple body parts.\nFigure 3.3. Injuries by Occupation and Body Part\n 0.0% 20.0% Firefighters\nPolice Officers\nOther Public-Sector Workers\nPrivate Sector Comparison Group\nOther Workers\nHead, Face or Neck Upper Extremities\n40.0%\n60.0% 80.0%\n100.0% 120."] [12.245169639587402, 19.489526748657227, " missing data on injury cause.\nWCIS also includes some information on the cause of injury, which we compare for MSDs versus other injuries across occupations in Table 3.6. Specifically, we report the share of all injuries reported to WCIS that fall i"] [12.290763854980469, 19.230419158935547, "ot specifically referring to job security or injury compensation, as we expect that job security and injury compensation are similar between firefighters, police officers, and other public employees. While definitively studying the factors that drive"] [12.501883506774902, 18.344301223754883, "gain experience or find better jobs, in which case earnings losses would be greater than the observed drop in earnings from before an injury to after an\n 32\ninjury. On the other hand, noninjured workers might experience declines in earnings over time"] [12.500448226928711, 18.351964950561523, "settings with extremely high job security, such as state and local government or unionized manufacturing, such an assumption could well be a reasonable approximation in the absence of better data.\nHowever, this is not a justifiable assumption for the"] [12.45236873626709, 18.425090789794922, "Control Group\nA key departure from previous RAND research on earnings losses is the use of medical-only injuries as an alternative control group. A limitation of our typical methodology is that the individual characteristics available for uninjured c"] [12.33519458770752, 18.42974281311035, "e UI program must report the wage and salary earnings of every employee to EDD on a quarterly basis. EDD stores these data in the Base Wage File. Both workers\u2019 compensation and UI are nearly universal in California, so the wage and salary earnings of"] [12.262491226196289, 19.34300422668457, "3 Match rates were very similar across occupational categories: summing across all injuries and injury years available, between 57.5 and 61.5 percent of the sample used in Chapter 3 was successfully matched to EDD wage data with matched controls.\n36\n"] [12.300232887268066, 19.230636596679688, "ed in Appendix A.\n5 The BLS OES program reports an average hourly wage of $35.51 for firefighters and an annual mean wage of $48.12 for police. See Bureau of Labor Statistics (2017a) for police and Bureau of Labor Statistics (2017b) for firefighters."] [12.42381477355957, 18.481109619140625, "laims is 92 percent, as against 82 percent for police, 87 percent for other public-sector workers, and 79 percent for similar private- sector workers.8 The differences in control worker earnings dynamics illustrated by Figure 4.1 are thus in line wit"] [12.245781898498535, 19.369422912597656, "y in earnings noted above. Similar recoveries in relative earnings are apparent for other occupations as well, but relative earnings in the second year after injury are sharply lower for all other occupations studied here: 88 percent for police, 85 p"] [12.272978782653809, 19.306224822998047, "ounced in nonmusculoskeletal cases. However, relative at-injury employment remains sharply higher for firefighters (90 percent) than for other comparable occupations (83 percent for police, 85 percent for other public-sector workers, and 76 percent f"] [12.264791488647461, 19.22681427001953, "phics and to provide a comparison to results obtained using uninjured control workers, we also present unadjusted relative earnings based on medical-only controls, as well as estimates based on uninjured control workers. Table 4.3 focuses on earnings"] [12.201035499572754, 19.2801513671875, "rred between 2005\u20132007 and 2010\u20132012 and that a similar deterioration in outcomes was evident in the other occupations as well. Comparing\n43\nworkers injured just before SB 863 took effect (2010\u20132012 injury years) to those injured just after SB 863 to"] [12.286388397216797, 18.937015533447266, "ectories up to three years postinjury for injured and control workers in each occupation; figures plotting these trajectories are shown in Appendix B. We do not find evidence of a sharp decline in the third postinjury year for firefighters when compa"] [12.228785514831543, 19.575912475585938, "uggested by Boone et al. (2011). We would expect this mechanism to be less relevant for firefighters given the high levels of job security (including high postinjury job retention); we cannot rule out that the severe pressure and sharp cuts in state "] [12.273600578308105, 20.06232261657715, "viewed 37 studies and found that there were associations between work factors and common mental health conditions but concluded that the causal relationship between work and mental disorders remained unclear due to methodological limitations in the e"] [12.272393226623535, 20.199569702148438, "sychiatric Association\u2019s Diagnostic and Statistical Manual of Mental Disorders (5th ed.) for more details (APA, 2013).\n3 Hoge et al. (2004) surveyed veterans returning from Iraq and Afghanistan and found that fewer than half of those experiencing PTS"] [12.21667194366455, 19.639938354492188, "consequences of comorbid psychiatric conditions is referred to as sample 4 in Appendix A.\n6 We conducted this analysis only on claims with dates of service.\n7 The ICD-9 code for PTSD is 309.81. Our measure of psychiatric disorders includes all ICD-9 "] [12.227503776550293, 19.512489318847656, " and police with MSD claims in comparison to other public-sector workers and similar private-sector workers. On nonmusculoskeletal disorder claims, psychiatric disorder rates for firefighters and police are closer to those observed among comparable p"] [12.213554382324219, 19.503787994384766, "s had relative earnings of 90 percent over the two years after injury, versus relative earnings of 71 percent for firefighters who also had psychiatric comorbidities. Consistent with the estimates in Chapter 4, relative earnings for workers in other "] [12.205653190612793, 19.513225555419922, "ychiatric comorbidities are associated with worse labor market outcomes compared to MSDs without such comorbidities. This finding was anticipated given previous evidence on earnings losses for workers with permanent disability due to psychiatric impa"] [11.948555946350098, 18.47332000732422, "ornia and the changes implemented under SB 863. This discussion draws heavily on Chapter 5 of Dworsky et al. (2016). Readers seeking further details may wish to consult that report.\nThe level of permanent disability (PD) benefits provided to an injur"] [11.947400093078613, 18.477100372314453, "er, the larger the magnitude of the adjustment. Again assuming a 10-percent rating after occupational adjustment, a 21-year-old worker would have the rating reduced to 8 percent and a 62-year-old worker would be increased to 13 percent. The age- adju"] [11.906447410583496, 18.423198699951172, "ed to calculate permanent partial disability. Second, SB 863 made several modifications to the Permanent Disability Rating Schedule. We briefly discuss these changes here, with an emphasis on the potential impacts on firefighters with MSDs.2\nOne majo"] [11.952513694763184, 18.453310012817383, "lic safety workers who are unable to return to work.\n 57\nbelow the statewide average weekly wage, the majority of all injured workers were receiving the maximum weekly PD benefit before SB 863. The workers examined in this report\u2014particularly firefig"] [12.016939163208008, 18.518569946289062, "t. Like the add-on elimination, the bump-up / bump-down elimination was expected to have limited effect because the implementing language in SB 899 was interpreted by the courts to mean a substantial fraction of PPD benefits are paid out before the b"] [12.132057189941406, 18.641122817993164, " a back injury. The injury in the Guzman case was carpal tunnel syndrome. 59\n Data\nWe rely on disability ratings performed by the state DEU. DEU performs three types of ratings, known as consult, summary, and formal ratings. The characteristics of ca"] [12.137283325195312, 18.60107421875, "with PD, and it is therefore unclear whether DEU can be treated as representative of the full population of workers with PD. As discussed above, cases with different types of ratings (summary, consult, or formal) reach DEU through distinct pathways t"] [12.14638614654541, 18.7578067779541, "is of trends. Sample sizes by occupation and period (pre- vs. post- SB 863) are presented below.\nTable 6.3 shows summary statistics on DEU ratings for workers in one of the occupations of interest in this study with MSDs. Panel A reports summary stat"] [12.205154418945312, 19.369916915893555, "Impairments and Disability Ratings for Firefighters and Other Workers\nBefore comparing ratings and benefits across occupations, we examine the distribution- specific impairments rated in MSD for firefighters and other occupations. We grouped impairme"] [12.184950828552246, 19.272247314453125, " 6.4. Body Part of Highest-Rated Permanent Impairment by Occupation, Constant-Maturity Musculoskeletal Disorder Cases\n Body Part\nKnee\nLumbar spine\nShoulder\nCervical spine\nAnkle\nHip\nElbow\nArm neuropathy\nHypertensive cardiovascular disease Other\nActive"] [12.19918441772461, 19.316879272460938, "26) 13.0 13.0 (0.74) (0.40)\nOther Private-Sector\n 12.5 12.9\n Table 6.6 presents final ratings by occupation, both for the full 2005\u20132015 sample and by injury date, with injury dates grouped into cases rated under the pre\u2013SB 863 disability rating sche"] [12.196210861206055, 19.273181915283203, "results presented in Table 6.6 reflect average outcomes over the entire period when the disability rating schedule established under SB 899 was in effect, from 2005 to 2012. Since outcomes may have changed during this period, a narrower-term comparis"] [12.196209907531738, 19.31216049194336, "89)\nNOTE: Standard errors\nOther Private-Sector\n Active Public Police Sector\n11.0 10.8 (0.38) (0.18) 10.8 10.3 (0.46) (0.21) 11.2 10.9 (0.37) (0.17) 13.1 12.6 (0.40) (0.21)\n11.6 11.2 (0.20) (0.10)\nComparison Group\n10.6 (0.71) 14.2 (1.29) 12.1 (0.89) 1"] [12.181306838989258, 19.362653732299805, "n summary ratings, this appeared to reflect systemwide rating practices rather than anything particular to firefighters.\nThese findings suggest that increased apportionment among consult ratings may have offset some of the rating increases anticipate"] [12.211662292480469, 19.405780792236328, "D injuries Non-MSD injuries\nActive Active Firefighters Police\n0.6% 0.5% 4.0% 3.7%\nActive Active Firefighters Police\n0.6% 0.4% 0.0% 1.0%\nActive Active Firefighters Police\n0.0% 1.1% 7.7% 6.0%\nOther Public Sector\n1.6% 10.6%\nOther Public Sector\n1.3% 1.8%"] [12.20817756652832, 19.323822021484375, " the average statutory benefit across occupations and over time. Table 6.10 shows that there were substantial increases in statutory benefits after SB 863 took effect for both summary and consult ratings. As above, we compare 2010\u20132012 injury dates t"] [12.09259033203125, 19.405582427978516, "apportionment to nonoccupational cause. While we did not have a sufficient sample size of firefighters with consult ratings to examine differences across occupation, across all occupations the increased frequency of apportionment was concentrated amo"] [11.852511405944824, 19.349851608276367, "e targeted modes of treatment: chiropractic, OT, and PT. Although LC \u00a74604.5 specified that the cap could be waived with written authorization by the employer, the treatment caps clearly established a new and substantial barrier to receipt of care be"] [12.085799217224121, 19.371732711791992, "899 differentially reduced spending on low back injuries and that this reduction in spending led to worse labor market outcomes for injured workers. Powell and Seabury (2018), however, did not have access to data on medical claims and were not able t"] [11.830964088439941, 19.35021209716797, "that are subsequently reversed are a reasonable indication of delays and hassles encountered by injured workers.\nTo study the treatment caps, we focused on visit counts within the three varieties of capped services: chiropractic, OT, and PT. We focus"] [11.885579109191895, 19.348392486572266, "sit counts up to three years after the first service date in the workers\u2019 compensation bills.\nResults\nTable 7.1 reports the proportion of indemnity claims receiving each of the capped services at any time in the first three years of medical care. Uti"] [11.81801986694336, 19.34449005126953, "its.\nFigures 7.1, 7.2, and 7.3 depict the distribution of chiropractic, OT, and PT visit counts for workers using each service type who had 36 or fewer visits in the first three years after the first service date. The fitted curve on each histogram i"] [11.86661148071289, 19.357479095458984, "\n93.85% 0.78% 5.36%\n83.61% 1.56% 14.83%\nPrivate-Sector Comparison\n94.15% 0.68% 5.17%\n96.20% 0.90% 2.90%\n83.87% 1.69% 14.44%\n Under 24 visits Exactly 24 visits Over 24 visits\n Occupational Therapy\nUnder 24 visits Exactly 24 visits Over 24 visits\nPhysi"] [12.12132453918457, 19.419994354248047, "24 visits on pre\u2013SB 228 injuries, it is difficult to know how many workers would have received more than 24 visits in the absence of the treatment caps. It is also plausible that the major reforms implemented in 2004\u20132005 (as well as the more recent "] [12.231307029724121, 19.489097595214844, "other workers. Similar to the 2010 report, we found that firefighters are significantly more likely to be injured than workers in other occupations, and a larger share of those injuries are MSDs. Specifically, we found that nearly half (47 percent) o"] [12.173995971679688, 19.403661727905273, "ss likely to separate from their at-injury employers than other types of workers. In most occupations, employment at the at- injury employer is well below the overall employment rate, indicating that injury can lead to increased job separations or ca"] [12.187850952148438, 19.45598030090332, "ssible to credibly evaluate their impact on patient outcomes.\nThere are a number of policy implications from the findings. Perhaps most importantly, California firefighters continue to face an elevated risk of injuries, particularly MSDs. While injur"] [11.807619094848633, 19.047473907470703, "rlying results in the text.\nSample Construction and Weighting\nWe construct four separate analytic samples for analysis. For each sample, we construct weights to correct for bias due to potentially nonrandom variation in data reporting across the popu"] [12.454082489013672, 18.46584701538086, "kers in California, not just those who pass this claim administrator screen, we construct weights to match the target distribution described above. To construct these weights, we first partition our data into mutually exclusive categories defined by "] [12.17115592956543, 19.37149429321289, "\nA limitation of our reliance on DEU data is that the population of workers who are rated at DEU may not be representative of the full population of workers with PD. Furthermore, because PD may take many years to emerge after injury, even the WCIS cl"] [12.176685333251953, 19.412527084350586, "osis\n93\n734; 735\nLegg-Perthes disease; osteoporosis, spontaneous fracture, other diseases of the\n781\nSuch symptoms as leg cramps, leg pain, muscle pain, joint pain\nCarpal tunnel syndrome (CTS)\nTable A.4 reports a cross-tabulation of this definition a"] [12.078895568847656, 19.241987228393555, "valence of the specific types of diagnoses used in our diagnosis- based definition for the sample of claims that do versus do not meet the FROI-based definition. The distribution of diagnoses is very similar across columns with one exception: workers"] [12.466743469238281, 18.264881134033203, " advantage given our study\u2019s focus on trends in case mix and outcomes.\nAdditional Details on Methods for Earnings Loss Estimation (Chapter 4)\nOur primary estimation sample for analysis of earnings losses includes injuries between 2005 and 2015 matche"] [12.526008605957031, 18.15338134765625, "stimate outcomes for indemnity injuries relative to the medical-only control group. We use Poisson regression to accommodate the heavily right-skewed distribution of earnings. This regression model can be written as follows:\nyit \uf03dexp(\uf061\uf02b\uf062Indemnityi \uf02b\uf067"] [12.1146879196167, 18.63869857788086, "ional Details on Disability Evaluation Unit Data Construction (Chapter 6)\nDIR provided the RAND research team with data on DEU ratings. A member of the research team (Neuhauser) processed these data and produced a file with information on up to six r"] [12.120001792907715, 18.63064193725586, "w final rating using the formula set forth in the Permanent Disability Rating Schedule for combining multiple ratings.\nWe linked the WCIS data described in earlier chapters to DEU so that we could maintain consistency with the definitions of MSDs and"] [11.805243492126465, 19.347047805786133, "e do not believe there is evidence of changes over time in selection into DEU that would bias analysis of changes in ratings after SB 863.\nIn light of these issues, we do not attempt to reweight DEU records to obtain representative estimates for the "] [11.798453330993652, 19.347000122070312, "ess/eval; Physical therapist assess/eval; Physical therapist assess/eval; Physical therapist assess/eval; Physical therapist assess/eval; Physical therapist assess/eval; PT evaluation\nPT reevaluation\nOT evaluation\nOT reevaluation Therapeutic exercise"] [12.219449043273926, 19.38834571838379, "eiving Any Capped Services, by Injury Type, Service Type, and Occupation, Alternative Service Definition\nOther Private- Active Public Sector\n Type of Injury Firefighters\nActive Police Sector Comparison\n Chiropractic\n Non-MSD 8.7 9.5\n9.2 8.2 9.0 7.7\n8"] [12.360917091369629, 18.423908233642578, "esponds to the time limit for LC \u00a74850 benefits.\nTo evaluate the robustness of our analysis to this form of misreporting, we produced earnings loss estimates focusing solely on the second year after injury, after the expiration of LC \u00a74850 time. Thes"] [12.187726974487305, 19.30502700805664, ")\n\u20130.150*** (0.00509)\n\u20130.145*** (0.00490)\n\u20130.171*** (0.0235)\n\u20130.164*** (0.0232)\n Figure B.1. Injured and Control Worker Earnings to Three Years Postinjury, by Occupation\n 107\nAdditional Results for Disability Rating Analysis (Chapter 6)\nTable"] [12.198113441467285, 19.31368637084961, "average\n2010\u20132012 average\nActive Active Firefighters Police\n3.033 3.897*** (1.928) (0.916) 0.497 3.459*** (2.523) (1.071)\nOther Public Sector\n2.114*** (0.477) 0.0709 (0.575)\nPrivate- Sector Comparison Group\n1.519 (2.103) \u20130.490 (2.646)\n 109\n B. Dif"] [12.192096710205078, 19.33618927001953, " occupations. Particularly sharp increases were apparent for firefighters and other public-sector workers with summary ratings.\nTable B.7. Almaraz Ratings by Injury Date and Occupation, Consult Ratings\n Injury Date\n2005\u20132012\n2013\u20132015\n2005\u20132015 Chang"] [11.789355278015137, 21.88997459411621, "Berninger, Amy, Mayris P. Webber, Hillel W. Cohen, Jackson Gustave, Roy Lee, Justin K. Niles, Sydney Chiu, Rachel Zeig-Owens, Jackie Soo, Kerry Kelly, and David J. Prezant, \u201cTrends of Elevated PTSD Risk in Firefighters Exposed to the World Trade Cent"] [11.23837947845459, 18.195293426513672, "s.cdc.gov/view/cdc/39008\nDepartment of Industrial Relations, California Safety Officer Workers\u2019 Compensation Cancer Presumption\u2014Impact of AB 1035, San Francisco, Calif.: Department of Industrial Relations, 2014.\nDIR\u2014See Department of Industrial Relat"] [12.213751792907715, 19.5594539642334, "org/10.1136/OEMED-2016-104015\nHaynes, Hylton J. G., and Joseph L. Molis, United States Firefighter Injuries\u20142016, Quincy, Mass.: National Fire Protection Association, 2017.\nHoge, Charles W., Carl A. Castro, Stephen C. Messer, Dennis McGurk, Dave I. C"] [12.212776184082031, 19.52861213684082, " University of Montana, Missoula, Mont: ScholarWorks, Graduate Student Theses, Dissertations, & Professional Papers, January 2017, 11059. As of July 29, 2019: https://scholarworks.umt.edu/etd/11059\n116\nSeabury, Seth A., and Christopher F. McLaren, Th"] [12.159754753112793, 18.80067253112793, "Industrial Cancers in California\u2019s Workers\u2019 Compensation System\nEvidence on Earnings Losses and Disability Benefits\nMICHAEL DWORSKY, CAROLYN M. RUTTER\n SOCIAL AND ECONOMIC WELL-BEING\nPrepared for the California Department of Industrial Relations\nFor"] [12.2612943649292, 18.912050247192383, "orm the ongoing debate over compensation for industrial cancer in California. In this report, we provide new evidence on the following questions:\n1. What level of earnings losses is experienced by workers who file workers\u2019 compensation claims for ind"] [12.324445724487305, 19.014698028564453, "information, email justicepolicy@rand.org.\niv\nContents\nPreface............................................................................................................................................ iii Figures...................................."] [12.364669799804688, 19.0728702545166, "rnings Losses and Benefit Payments for Workers with Occupational Cancer Claims\nby Gender................................................................................................................................ 40 Earnings and Employment Change"] [12.350248336791992, 19.080732345581055, ".................................................... 31\nTable 3.4. Disability Ratings for Constant-Maturity Cancer Cases Evaluated at the State Disability Evaluation Unit, by Injury Date ..............................................................."] [12.356264114379883, 19.087934494018555, "of Injury Under Alternative Case Definitions, by Occupation ....................................................................... 62\nviii\nSummary\nCalifornia\u2019s workers\u2019 compensation system requires employers to provide medical care and disability (o"] [12.203027725219727, 18.833269119262695, "legislative attention. Much of this controversy stems from concerns about the fairness of permanent partial disability (PPD) benefits for workers with occupational cancer. Permanent disability (PD) compensation in California is based on impairment ra"] [12.36685848236084, 19.083927154541016, "ing of demographically identical workers in the same occupations and industries who filed minor, or medical-only, workers\u2019 compensation claims expected to result in minimal long-term earnings losses. We used claims data to calculate the proportion of"] [12.375395774841309, 19.066734313964844, " and detection rise with age. They are also overwhelmingly male: just 13.6 percent of workers with cancer claims in our sample were female, while 41.2 percent of workers with a non-cancer claim were female. This gender breakdown largely reflects the "] [12.379301071166992, 19.10635757446289, " different characteristics from others with workers\u2019 compensation claims, there are also important differences in demographics, benefit receipt, and claim denial rates across occupational groups (Table S.2). Lifeguards with cancer are substantially y"] [12.36928939819336, 19.086971282958984, "d workers to access compensation for occupational cancers. However, other explanations for this pattern cannot be ruled out without more detailed information on primary cancer site or stage at diagnosis; such information was not available in the clai"] [12.370959281921387, 19.084558486938477, "an half the level observed among peace officers and firefighters before the claim, their losses in dollar terms ($43,000) also exceed those for any occupation group examined in this study.\nxiv\nFigure S.1. Earnings Losses After Cancer Claims, by Occup"] [12.356406211853027, 19.081520080566406, " firefighters.\nTable S.3. Pretax Wage Replacement Rates over Five Years, by Occupation\n 5-year earnings losses (extrapolated) (Standard error)\nAverage benefit payments\nPretax wage replacement rates\nPeace Officers\n$40,826 ($5,205) $19,860 49%"] [12.395809173583984, 19.083311080932617, "im filing for public safety workers. Even for peace officers and firefighters, however, rates of full or partial denial on cancer claims are several times higher than those observed for the average workers\u2019 compensation claim. Detailed examination of"] [12.364485740661621, 19.085514068603516, "atively high (86 percent) for firefighters, but was far lower for peace officers (49 percent) and lower still for workers in other occupations (39 percent). Workers in these other occupation groups had high disability ratings and also had the highest"] [12.305333137512207, 18.997026443481445, "with cancer site and staging. Linking workers\u2019 compensation data to group health claims with a consortium of large public employers or, potentially, a retiree health care system would dramatically improve the credibility of our claims-based case asce"] [11.85102367401123, 18.411176681518555, "artial disability\nPTD permanent total disability\nSB Senate Bill\nSROI Subsequent Report of Injury\nTD temporary disability\nTTD temporary total disability\nWCIS Workers\u2019 Compensation Information System\n xxi\n1. Introduction\nAs in other states, California\u2019"] [12.29081916809082, 18.95987319946289, "e:\n1. Do the standards for determining impairment due to occupational injury or illness accurately reflect the level of impairment caused by industrial cancer?\n 1\n2. Study and compare the differences between the fifth and sixth editions of the Americ"] [11.723960876464844, 18.261302947998047, "examination of the AMA Guides and the rating process in California in relation to industrial cancer claims\u201d (DIR, 2019, pp. 4\u20135).\n 2\nthree days or that requires an inpatient hospital admission. Workers with a temporary condition will collect weekly t"] [11.851033210754395, 18.391830444335938, "its are thus infrequently used. We estimate that 1.0 percent of cancer cases receive PTD benefits without also receiving PPD benefits. This group accounts for 3.4 percent of workers with PD (i.e., those with either PPD or PTD benefits). In this repor"] [11.959712982177734, 18.470314025878906, "stantial reduction in the size of PD ratings: the adoption of the AMA Guides led to a reduction because the average rating in the AMA Guides is lower than the rating assigned to a similar impairment evaluated using the pre-2005 PDRS. Neuhauser (2007)"] [11.897397994995117, 18.386220932006836, "ept those whose impairments already had an adjustment factor of 1.4.4 Second, the maximum weekly wage used to calculate PPD benefits was raised for the first time since 2006. Workers injured between January 1, 2006, and December 31, 2012, were eligib"] [12.369588851928711, 19.08193588256836, "eases arising out of and in the course of employment, including cancer. The most likely mechanism for work to cause cancer is exposure to carcinogens in the workplace or while carrying out job duties. The National Institute of Occupational Safety and"] [12.368192672729492, 19.082687377929688, "of workers with occupational disease filed a workers\u2019 compensation claim (Biddle et al., 1998). We note that these estimates were derived from data on cases identified between 1992 and 1994 in Michigan, and so the external validity of these findings "] [12.308012008666992, 19.01987075805664, "care available to workers with cancer.\n8\n2. Data and Methods for Studying Earnings Loss and Benefits Due to Occupational Cancer\nThis chapter provides an overview of the data sources used in this study and our analytic methods. Our analysis of earning"] [11.759317398071289, 19.022918701171875, "the state Employment Development Department (EDD) to measure postinjury labor market outcomes.\nThe WCIS FROI/SROI and EDD data used in this study, which are quite complex, are described at length in Chapter 2 and Appendix A of Dworsky, Rennane, and B"] [11.796780586242676, 19.046981811523438, "e reported to claim administrator), worker demographics (i.e., age and sex), job and employer characteristics\n10\n(i.e., weekly wage, class code, and location), and information about the type of injury (nature, cause, and body part of injury). After a"] [12.177985191345215, 18.751523971557617, "d the resulting disability rating. To supplement the WCIS, we will use data on ratings from the California DEU. DEU is a state agency that performs between 60,000 and 80,000 ratings of permanent disabilities each year. The DEU data contain specific i"] [12.377388000488281, 19.113492965698242, "ultiple injuries when other occupational injuries have occurred or occupational diseases are present.\nTo address the shortcomings of our primary case definition, we conducted sensitivity analyses in which we used medical bills reported to the WCIS to"] [12.467458724975586, 19.369884490966797, " officer occupation group beyond police and sheriff\u2019s deputies. However, this initial approach led to a small, but nontrivial number of public safety workers (primarily peace officers with less common job titles, such as special agents or investigato"] [12.370369911193848, 19.133583068847656, "efighter workforce remains overwhelmingly male, and there were too few cancer claims from female lifeguards to provide informative estimates of gender differences; the other occupations group, meanwhile, had a higher proportion of female workers with"] [11.861748695373535, 19.062808990478516, "trate reliable reporting of the SROI.5 We dropped 1,283 cases due to missing data or because they were submitted by claims administrators that systematically failed to report benefit payments and other claim outcomes, leaving 4,156 cases with complet"] [12.37065315246582, 19.088104248046875, "ation was motivated by concerns about cases in the other occupations category that appeared likely to be misclassified public safety workers or were otherwise ambiguous, it is not surprising that many of the cases dropped were in the other occupation"] [12.381050109863281, 19.097326278686523, "\nAgriculture, Forestry, Fishing and Hunting (11)\nMining, Quarrying, and Oil and Gas Extraction (21)\nUtilities (22)\nConstruction (23)\nManufacturing (31\u201333)\nWholesale Trade (42)\nRetail Trade (44\u201345)\nTransportation and Warehousing (48\u201349)\nInformation (5"] [12.406007766723633, 19.083297729492188, "ensation claims other than cancer result in payment of death benefits, versus 2.8 percent of cancer claims.8\nThe above calculations include all cancer claims filed, including denied claims. Table 2.1 also makes it clear that cancer claims are subject"] [12.385022163391113, 19.093223571777344, "mographics prevented us from obtaining meaningful estimates of gender differences in postinjury outcomes for firefighters or lifeguards.\nTable 2.2. Demographics, Benefit Receipt, and Employer Characteristics of Workers\u2019 Compensation Claims, by Cancer"] [12.381187438964844, 19.09612464904785, " is unsurprising given the severity of cancer, we found major differences across occupations in the probability that claims resulted in paid death benefits. We did not observe paid death benefits for any lifeguards in our sample, while 2.4 percent of"] [12.359175682067871, 19.085744857788086, " the availability and scope of legal presumptions for cancer. Presumptions for lifeguards are limited to skin cancer, which can frequently be treated with limited side effects. It is therefore unsurprising that lifeguards with cancer claims experienc"] [12.483931541442871, 18.39922332763672, "main continuously employed, the inclusion of workers who leave employment after the quarter of injury outweighs wage growth (see Dworsky et al., 2016, for an example). Furthermore, wage growth and the risk of job loss are highly sensitive to economic"] [12.42074966430664, 18.788843154907227, "hich was also focused narrowly on injuries and labor market outcomes for firefighters and other groups of public safety workers.\nThe great advantage of using workers with medical-only injuries is that the filing of a workers\u2019 compensation claim provi"] [12.486944198608398, 18.399341583251953, "ith the same type of employer). For other occupations, we control for the two-digit NAICS code (e.g., manufacturing, utilities, construction, or health care). We include similar controls for seven categories of employer size at the time of injury, wh"] [12.107258796691895, 18.374038696289062, "r terms could be misleading. We use the Poisson regression estimates when we describe earnings losses in percentage terms.\nMethods for Calculating Pretax Wage Replacement Rates\nEstimating wage replacement rates for this study posed some additional ch"] [12.381476402282715, 19.066627502441406, "ctions in earnings in the years following a cancer claim. Employment rates for these groups of workers are reported in the second panel of the table. Compared with workers in other occupations, public safety workers have very high employment rates tw"] [12.385801315307617, 19.06991195678711, " presents these event-study estimates by plotting two lines for each occupation. The solid colored lines with markers show the actual earnings of workers with cancer claims in each of the four occupation groups.3 The light gray dashed line plotted fo"] [12.3883056640625, 19.065330505371094, "e pattern observed for lifeguards reflects the seasonality of lifeguard employment; this distinctive pattern underscores the importance for the present study of using a control group of workers with medical-only injuries whose occupations can be obse"] [12.371825218200684, 19.07264518737793, "cers and firefighters before the claim, their losses in dollar terms ($43,000) exceed those for any occupation group examined in this study.\nTable 3.2 summarizes the earnings losses depicted in Figure 3.1 by reporting the results from our regression "] [12.2290678024292, 19.143577575683594, "aluate the robustness of our estimates to reverse causation associated with claims that are filed with a substantial delay, we estimated our main regression models on a sample that excluded all claims (both cancer claims and medical-only claims) file"] [12.189675331115723, 18.858997344970703, "in substantive terms and is consistent with our expectation that SB 863 would have increased final ratings substantially. However, the sample of ratings performed at DEU was limited, and this difference was not statistically significant either.8\n7 Mo"] [12.345072746276855, 19.062828063964844, "nefit receipt and average paid amounts for those receiving benefits differ sharply between public safety workers and those in other occupations. TTD payments for those receiving TTD benefits averaged $47,197 for peace officers and $58,326 for firefig"] [12.379487991333008, 19.079317092895508, "cross occupations for the vast majority\n9 As noted above, we observed no lifeguards who received TTD benefits for cancer claims. 33\n of workers; while SB 863 raised the maximum weekly PD benefit substantially between 2012 and 2014, most workers with "] [12.34467887878418, 19.012588500976562, "6, we compare benefit payments with earnings losses in order to derive a measure of the pretax wage replacement rate provided to the average worker with a cancer claim in each\n10 Unfortunately, we did not have access to any other reliable source of d"] [12.37541675567627, 18.99814224243164, "the second year after injury for workers injured between 2005 and 2008, for whom five-year losses were directly observable. This ratio was 4.74, meaning that the dollar value of losses over five years after injury is 4.74 times the value of losses in"] [12.379369735717773, 19.0687313079834, "05), they found that less-educated cancer patients experienced more severe earnings and employment losses. Occupational differences between blue-collar and white-collar workers were also substantial.\nOther studies that did not provide longitudinal es"] [12.374289512634277, 19.071491241455078, "ts in Michigan. Bradley et al. (2007) found substantial reductions in employment at 6 months for both breast cancer patients (17-percentage-point reduction) and prostate cancer patients (10-percentage-point reduction), but that reductions in employme"] [12.374513626098633, 19.06886100769043, "table that we find persistently lower employment for all occupation groups other than lifeguards, when the U.S.-based studies on outcomes at two or more years after diagnosis generally do not find strong evidence of reduced employment. The peace offi"] [12.377143859863281, 19.079484939575195, " generous for patients who remain cancer-free, but inadequate for patients who experience recurrence or new cancers in the future. While the potential for long-term complications that lead to reduced work capacity in the future is relevant for a wide"] [12.37346076965332, 19.0689640045166, " Annual earnings\nEmployment\nNumber of cases\n2 years before injury 1 year before injury 1 year after injury\n2 years after injury\n2 years before injury 1 year before injury 1 year after injury\n2 years after injury\nMale\n$116,880 $119,724 $1"] [12.370270729064941, 19.071870803833008, "rs\n\u201310,219*** (3,029) \u20136,497 (12,823) 58,088\nLifeguards\n4,330 (3,433) \u20138,011 (6,397) 1,970\nOther\n\u201351,096*** (3,796) 20,994*** (5,372) 3,199,352\n NOTES: *** p < 0.01. Standard errors appear in parentheses.\nFor the three groups of public safety worker"] [12.398843765258789, 19.04966926574707, "for disability ratings and benefit payments conditional on benefit receipt by gender.\n43\nseem to suggest that female peace officers have, on average, slightly higher standard and final ratings compared with male peace officers. However, no gender dif"] [12.373617172241211, 19.076940536499023, "ficance of difference between male and female workers in each occupation. Significance of differences in percentage with benefits was assessed using a chi-squared test. Significance of differences in dollar amounts was assessed using a two-sample t-t"] [12.384086608886719, 19.094011306762695, "by the presumptions. Even for peace officers and firefighters, however, rates of full or partial denial on cancer claims are several times higher than those observed for the average workers\u2019 compensation claim. Detailed examination of delays in benef"] [12.375027656555176, 19.07842254638672, " likely to contain more women. For the time being, however, the small number of women who filed workers\u2019 compensation claims for cancer poses a major challenge to research on the role of gender in the workers\u2019 compensation system\u2019s treatment of cance"] [12.371210098266602, 19.019397735595703, "d with other injuries or diseases. Unfortunately, our inability to capture medical claims and diagnoses outside workers\u2019 compensation (most notably from workers\u2019 group health coverage) means that our case definitions based on medical claims are almos"] [12.407586097717285, 19.117218017578125, " to pension eligibility. However, multiple cancer screening guidelines are keyed to ages 40, 45, and 50, and these guidelines generate sharp increases in screening that are likely to translate into increased detection at exactly the same ages when pu"] [12.46323013305664, 19.28611183166504, " there were many cases with ambiguous occupation descriptions that we were unable to conclusively assign to one of our four occupational categories. When possible, we followed the approach taken in Dworsky, Seabury, and Broten (2019), which used occu"] [12.367645263671875, 19.104419708251953, " of cases\nNumber of unique occupation titles\nPercentage of Cases\nPolice officer\nDeputy sheriff\nOfficer 11.9\nPercentage of Cases\n12.98\nPercentage of Cases\n40.79\nPercentage of Cases\n1.93\n1.45\n1.45\n1.45\n1.45\n1.45\n1.45 1.45 0.97\n0.97\nPeace Officer\nFirefi"] [12.358349800109863, 19.11867904663086, " excluding benign and unspecified neoplasms (i.e., limited to ICD-9 codes 140\u2013209 and 230\u2013234) in three or more consecutive calendar quarters. This definition was chosen to select cases with a pattern of medical care over time that was very unlikely "] [12.3753023147583, 19.09453582763672, " is likely to be missing from our data, limiting our ability to definitively identify the full population of cancer cases on the basis of medical bills reported to the WCIS.\nDespite these limitations, the WCIS medical bills provide us with the best a"] [12.506231307983398, 18.218530654907227, "ver two years before injury and two years after injury to measure preinjury earnings and postinjury earnings. We assigned employment outcomes (both employment at any firm in California and employment specifically at the at-injury employer) from eight"] [12.478784561157227, 18.240007400512695, " at-injury employer)\n\u2022 firm size (full set of indicators for seven categories of firm size, with cutpoints at 10, 50, 100, 500, 1,000, and 5,000 employees)\n\u2022 injury date (full set of indicators for calendar quarter of injury, from 2005Q1 to 2015Q4). "] [12.482905387878418, 18.604841232299805, "n cannot be tested directly because we do not see what would have happened to these workers in the absence of the cancer claim, but it can be tested indirectly because we have eight quarterly observations prior to the date of injury. Specifically, we"] [12.485776901245117, 18.614120483398438, "th a cancer claim to 1 and set the weight for each worker with a medical-only claim to \ud835\udc64\ud835\udc64 = \ud835\udc5d\ud835\udc5d /1 \u2212 \ud835\udc5d\ud835\udc5d , the\npredicted odds of a cancer claim, which measures how much more likely it is that the worker was a cancer case relative to a non-cancer case. "] [12.406207084655762, 19.00878143310547, "\n\u20135,949*** (498.0)\n\u20135,503*** (651.1)\n\u20136,489*** (521.2)\n28,813,572\n0.223 0.0762 0.999\n Number of observations\n(442.2) 1,460,079\n0.153 0.0482 1\n(607.9) 493,748\n0.195 0.188 0.988\n2\n\ud835\udef8\ud835\udef8 2statistic\np-value for parallel trends\nR\n6 \u20132,184*** (414.5)\n7 8"] [12.376504898071289, 19.059045791625977, " with a substantial delay after the date of injury raises the possibility that some of these claims are filed, at least in part, in response to workers\u2019 labor market outcomes. In this case, our estimates of earnings losses could be biased due to reve"] [12.363892555236816, 19.1331844329834, "tions\n\u201311,417*** (1,512) 635,450\n NOTE: * p < 0.10, ** p < 0.05, *** p < 0.01. Standard errors appear in parentheses. \u201cNature of injury\u201d definition includes claims for which nature of injury on FROI is 74 (Cancer). \u201cMedical claims (loose)\u201d "] [12.348848342895508, 19.046255111694336, "Cancer: Findings from a Longitudinal Study of Breast and Prostate Cancer Survivors Employment and Cancer,\u201d Cancer Investigation, Vol. 25, No. 1, 2007, pp. 47\u201354.\nBureau of Labor Statistics, \u201cLabor Force Statistics from the Current Population Survey,\u201d"] [12.277807235717773, 18.9630069732666, " in T. L. Guidotti, ed., Health Risks and Fair Compensation in the Fire Service, New York, N.Y.: Springer International Publishing Switzerland, 2016,\npp. 265\u2013280.\nHauglann, Beate, Ju\u0304rate\u0307 S\u030caltyte\u0307 Benth, Sophie D. Fossa\u030a, and Alv A. Dahl, \u201cA Cohort"] [12.335043907165527, 19.036998748779297, " on the Employment of Older Workers,\u201d Health Services Research, Vol. 43, No. 1, 2008, pp. 193\u2013210.\nStuart, Elizabeth, Haiden A. Huskamp, Kenneth Duckworth, Jeffrey Simmons, Zirui Song, Michael E. Chernew, and Colleen L. Barry, \u201cUsing Propensity Score"] [11.650724411010742, 18.076522827148438, "Wage Loss Monitoring for Injured Workers in California\u2019s Workers\u2019 Compensation System\n2016\u20132017 Injury Year Findings (Third Interim Report)\nSTEPHANIE RENNANE, NICHOLAS BROTEN, MICHAEL DWORSKY\n SOCIAL AND ECONOMIC WELL-BEING\nSponsored by the Californ"] [11.363065719604492, 17.682998657226562, "er an accurate and up-to date estimate of wage loss for all injured workers in the state.\nRAND Institute for Civil Justice\nThe RAND Institute for Civil Justice (ICJ) is dedicated to improving the civil justice system by supplying policymakers and the"] [12.293999671936035, 18.047697067260742, "......................................... 8 Conceptual Framework........................................................................................................................... 12 Earnings Dynamics Through Injury for Injured and Uninjured "] [12.298672676086426, 18.015722274780273, "............................. xi Earnings Loss Trends by Claim Severity ................................................................... xii Earnings Loss Trends for Constant-Maturity Indemnity Claims..............................xiii Injured and "] [12.32911491394043, 18.026870727539062, "r After Injury:\nAll Indemnity Injuries........................................................................................................... 87 Figure A.3a. Earnings Loss by Industry for Workers with Permanent Partial Disability\nBenefits (consta"] [12.387211799621582, 18.0577335357666, "Percentage Matched by Firm Size .............................................................................. 54 Table A.3a. Balance Statistics by Injury Cohort........................................................................... 54 Table A.3b"] [12.24047565460205, 18.0135555267334, ".................................................................................. 80\nTable A.9f. Changes in Relative Earnings Compared to Overall Average, by Quartile of Pre-Injury Earnings............................................................"] [12.130776405334473, 18.19517707824707, "r before\n2015\n\u2022 comparison of earnings losses due to 2016 and 2017 injuries and earnings loss for earlier\ninjury years\n\u2022 comparison of differences in earnings loss levels and changes across subgroups of\ninjuries.\nAs noted earlier, trends in earnings "] [12.317461967468262, 18.092283248901367, "d control workers to estimate wage loss one and two years after injury.\nKey Findings\nUsing this methodology, we estimated earnings losses, relative employment, and post-injury employment at the same firm as prior to the injury for workers injured in "] [12.243864059448242, 17.944244384765625, "econd full year after injury (1\u20134 quarters after quarter of injury).\nRelative Earnings Increased in Los Angeles but Declined in the Bay Area\nWe estimate that relative earnings in the first year after injury increased in Los Angeles by 2.1 percentage "] [11.760904312133789, 18.140405654907227, "y, given long reporting lags, but show large declines in relative earnings during the Great Recession and modest improvements beginning in 2014.\nFollowing this report, RAND will produce a final policy report that will provide a more\n sustained analys"] [11.6054105758667, 18.0938720703125, "tcomes\u2014leading to more substantial earnings losses\u2014also make it more difficult and costly for the workers\u2019 compensation system to meet its objective of providing adequate disability benefits to workers.\nThe overall objective of this project is to pro"] [11.672934532165527, 18.228185653686523, "d injury or illness is defined as one that prevents a worker from doing his or her usual work for more than three days or that requires an inpatient hospital admission.4 Workers with a temporary condition will collect weekly temporary total disabilit"] [11.858576774597168, 18.286376953125, " filed by workers who have already retired or separated from their employer for reasons unrelated to their injuries. This may be particularly likely for occupational disease claims, which have a longer claim filing window than injury claims. In other"] [11.857232093811035, 18.352933883666992, "e similar to those observed for workers injured in 2010\u20132012 (Dworsky, Rennane, and Broten, 2018a, 2018b), consistent with this assumption. Although the findings in this report suggest that outcomes for injured workers have begun to improve for injur"] [11.845911026000977, 18.3250789642334, "ers (ASCs) and payment for spinal hardware.\nPPD benefits also increased sharply because of changes to the disability rating formula and increases in the weekly maximum benefit. In addition to these changes, a $120 million Return to Work Fund was esta"] [11.990392684936523, 18.199342727661133, " and affect care during the first two years after injury for the 2016 and 2017 injured workers at the focus of this report and potentially have an indirect effect on labor market outcomes. However, the potential impacts may be limited in the first fe"] [11.983001708984375, 18.1408634185791, "jury and increase the risk of poor labor market outcomes. At the same time, increased labor demand due to economic growth means that employers may be more motivated to accommodate workers after an injury, or that workers who end up leaving a job afte"] [11.754480361938477, 19.00345802307129, "on to our methods should reference that study.\nData for Wage Loss Monitoring\nWe make use of several administrative data sources for this project, all of which have been used for prior RAND studies (e.g., Peterson et al., 1998; Reville et al., 2005; D"] [11.809989929199219, 19.039228439331055, "that captures all market segments (including self-insured and public-sector employers). Given the absence of any more reliable benchmark, this study will follow Dworsky et al. (2016) in treating FROI reported to the WCIS as a representative sample of"] [12.047688484191895, 18.245372772216797, "ng report.9 Additionally, this report provides an opportunity to update the data for injuries occurring in 2014 and 2015 now that more time has elapsed since the date of injury.\nAlso because of the longer follow-up period in this report, we present r"] [12.307292938232422, 18.442014694213867, "n the Base Wage File. The Base Wage File represents the most accurate and comprehensive source of data on quarterly wage and salary earnings in California. The industries covered by UI are virtually identical to the industries covered by workers\u2019 com"] [12.488898277282715, 18.339065551757812, "ceptual Framework\nWe define earnings loss due to a workplace injury as the difference between what a worker earns following an injury and what he or she would have earned had he or she not been injured. We refer to the counterfactual amount that a wo"] [12.509188652038574, 18.31641387939453, "es data to tell us how each injured worker\u2019s earnings would have evolved over time. A major\n12\nadvantage of our method is that the data on the matched controls can capture subtle differences between workers in the dynamics of potential earnings, incl"] [12.566184043884277, 18.35263442993164, "to non-employment are highest in agriculture, ranging over the year from 10.9 percent to 27.7 percent.\nOverall, the share of all separations that lead to a period of non-employment for the worker is higher during recessions and lower during periods o"] [12.504180908203125, 18.33934211730957, "pool to workers who were employed at the same firm as the injured worker during the quarter of injury. To further limit the donor pool, we discarded potential controls whose annual earnings are not close to those of the injured worker. Specifically, "] [12.514028549194336, 18.322782516479492, " before the quarter of injury and the eighth quarter after injury.13\nFinally, we selected control workers for injured workers with complete records on key FROI variables and valid EDD wage histories. As shown in Table 2.1, we successfully matched abo"] [12.481807708740234, 18.291059494018555, "clines before and after the date of injury are driven by the fact that we are sampling workers at a point when 100 percent of both injured and control workers are employed: The lower employment rate (and, as a result, earnings) before and after the p"] [12.520472526550293, 18.29851722717285, "or to the four-quarter match window provides an indirect evaluation of our matching methodology. Figure 2.1 illustrates clearly that injured and control worker earnings are extremely close over the year before the match window (pre-injury quarters \u20138"] [12.323087692260742, 18.066728591918945, " we primarily emphasize trends in earnings losses. However, it is useful to see how total employment and at-injury employment evolve for both injured and control workers in order to interpret the relative measures that we focus on in our presentation"] [12.389777183532715, 18.207975387573242, "rnings loss a useful tool for monitoring changes in worker outcomes.\nHowever, a serious drawback of focusing on overall trends is that the relatively limited earnings losses experienced by the majority of medical-only cases can make it difficult to d"] [12.465590476989746, 18.24285316467285, "rnings is the difference between injured and control worker real earnings over the first (for 2016 and 2017 injuries) or second (for 2016 injuries only) year following the quarter of injury, adjusted by the difference between injured and control work"] [12.453744888305664, 18.22607421875, "he year before the injury, and that the control workers\u2019 average earnings in the second post-injury year are $36,200. Because the injured worker earned $200 less than his or her control workers prior to the injury, counterfactual earnings are adjuste"] [12.361995697021484, 18.07330322265625, "economic recovery [2013\u20132015], and the 2016 and 2017 injury cohorts). Details of our regression specifications are presented in the appendix. We ran these regressions on first-year post-injury outcomes, including the 2016 and 2017 injury cohorts, and"] [12.33043098449707, 18.014989852905273, "ups experience changes that are different from the overall average. For instance, if relative earnings for manufacturing workers injured in 2014\u20132015 were four percentage points less than the systemwide average, these estimates would tell us whether "] [12.340118408203125, 17.993980407714844, "y year 96% Relative employment\nFirst post-injury year 100% Second post-injury year 102% Relative at-injury employment\nFirst post-injury year 91% Second post-injury year 86%\nRecession Pre\u2013SB 863\nPost\u2013SB 863\nPre- Recovery,\n 2008\u20132009 2010\u20132012 2013"] [12.323354721069336, 17.989229202270508, "ured in 2016 and 2017 relative to prior cohorts, with a mean of $706 (compared to a mean pre-injury weekly wage ranging between $656 and $675 for prior cohorts) and a median of $540, increasing from $499 for the 2013\u20132015 injury cohorts. Given that t"] [12.33320140838623, 17.9489688873291, "y Area, 20 percent in the Inland Empire, and another 24 percent in Los Angeles (a two-percentage-point decline from the 2013\u2013 2015 injury cohorts). Eleven percent of injured workers lived in the Central Valley, and the remainder were spread fairly ev"] [12.345507621765137, 17.970666885375977, "d 77 to 78 percent between 2008 and 2012. Still, the share with at least one year of job tenure is higher than the 70 percent observed in the 2005\u20132007 injury cohorts.\n30\nTable 3.3. Industry, Firm Size, and Job Tenure by Year of Injury Year of Injury"] [12.346210479736328, 17.9864501953125, " the second post-injury year also increased from 88 for the 2013\u20132015 injury cohorts to 89 percent for 2016 injuries. Relative at-injury employment during the first post-injury year also increased by one percentage point relative to 2013\u20132015, to 79 "] [12.327548027038574, 18.049169540405273, "ins a constant-maturity sample of claims where the worker received PPD benefits within 36 months of injury.\nTable 3.5 shows the results on relative earnings, total employment, and at-injury employment for the constant-maturity PPD sample. Relative ea"] [12.356161117553711, 18.037015914916992, "loyment also remained stable for the overall 2016 and 2017 injury cohorts but increased by two percentage points, to 87 percent, in the first post-injury year for workers with indemnity payments from the 2016 and 2017 injury cohorts, and one percenta"] [12.261480331420898, 18.086647033691406, "ensation system, as well as trends estimated separately for medical-only and indemnity claims, and some preliminary analyses of outcomes for workers with permanent disability payments through 2015.\nIn this chapter, we estimate trends in earnings loss"] [12.317113876342773, 18.012353897094727, "ups of workers, or whether certain industries, regions, or other populations have had experiences that deviate from the statewide average trend.\nThe analysis presented here is descriptive and is not intended to test hypotheses about what mechanisms e"] [12.317059516906738, 17.990646362304688, " year after injury, relative earnings declined by 1.9 percentage points for workers in retail who were injured in 2016. None of the other subgroups experienced statistically significant changes in relative earnings during the second year after injury"] [12.358827590942383, 18.04676055908203, "ngs than the statewide average in larger firms. However, relative earnings in firms with over 5,000 employees declined by 1.6 percentage points for workers with permanent disability injured between 2013 and 2015. On the other hand, relative earnings "] [12.307003021240234, 18.036222457885742, "e quartiles had relative earnings ranging between 50 and 60 percent, approximately a 30-percentage-point difference. Relative earnings for workers with PPD in the lowest wage quartile began to improve, increasing by four percentage points for workers"] [12.33377742767334, 18.009803771972656, "in relative earnings during the first year after injury for workers with injuries of a specific nature in 2016 and 2017. We did not detect any statistically significant breaks in the relative earnings during the first year after injury for any of the"] [12.251463890075684, 17.92853355407715, "ve earnings. Two exceptions to this general rule are the fact that workers from North State\u2013Shasta had significantly lower earnings relative to the average worker over the entire time frame, and workers in San Diego had significantly higher earnings "] [12.259788513183594, 17.93340492248535, ": Relative earnings increased by an average of 3.8 percentage points during the first year after injury for workers injured in 2016 and 2017, and by 2.7 percentage points during the second year after injury for workers injured in 2016. Relative earni"] [12.318185806274414, 18.004405975341797, "ty payments did increase for injured workers in 2016 and 2017. Relative earnings in the first year after injury increased by one percentage point, to 78 percent, for injured workers in 2016 and 2017 and increased by one percentage point, to 82 percen"] [12.433597564697266, 18.229232788085938, "ings increased by 3.8 percentage points for injured workers in 2013\u20132015, compared with prior cohorts. Because of the long follow-up period required to analyze outcomes for permanent disability, we caution that these outcomes are preliminary and will"] [12.55692195892334, 18.342121124267578, " matched to an injured worker, an average of all matched control characteristics was used.\nTo identify the combination of parameters that produces the best match for the full population of injured workers, we tested 12 variations of the match on subs"] [12.577712059020996, 18.335329055786133, "tead. Finally, we also present the elementwise absolute imbalance, which sums the absolute value of the difference in quarterly earnings between injured and control. Formally, these are\ndefined as follows, with \ud835\udc56\ud835\udc56 indexing injured workers and \ud835\udc61\ud835\udc61\ninju"] [12.553685188293457, 18.379989624023438, "ies\n\u20130.54% 0.04% 21.70% 20.86%\n26.16% 25.24%\n2010\u20132012 Injuries\n\u20130.16% 18.73%\n22.67%\n2013\u20132015 Injuries\n\u20130.59% 19.07%\n22.97%\n 54\nTable A.3c. Overall Imbalance\n Time Period\nMatch window\n(1\u20134Q before injury) Second pre-injury year (5\u20138Q "] [12.527216911315918, 18.402841567993164, " administrator weight, is 1.311, and its maximum value is 42.60. A summary of the sample construction and weighting scheme is shown in Table A.4.\n55\n % female Average age Weekly wage Self-insured\nAll FROI in WCIS 0.42 40.45 706.16 0.33\nGood Clai"] [12.419258117675781, 18.084386825561523, " injury date. The primary\nlevel of relative earnings from the level in the preceding time period. For example, \ud835\udefd\ud835\udefdY: captures\nand workers injured in 2005\u20132007, while \ud835\udefd\ud835\udefdFY captures the seasonally adjusted difference in\nthe seasonally adjusted differenc"] [12.402338981628418, 17.947010040283203, "es are compared with 2013\u20132015 injuries. The group-specific trend break coefficients capture whether the difference in relative earnings between each group and the statewide average changed relative to the previous time period. For example, \ud835\udefd\ud835\udefdx,Fs fo"] [12.461315155029297, 17.85597801208496, "ody parts Benefit Receipt PPD\nTTD\nAny indemnity\n2005\u20132007 2008\u20132009 Injuries Injuries\n39% 41% 42.04 42.80\n805.29 781.95\n686.63 659.73 33% 31%\n18% 19% 7% 6% 12% 12% 2% 2% 18% 19% 27% 26%\n2% 2%\n3% 2% 5% 5% 7% 7%\n87% 87% 6% 6% 40% 41% 9% 8%\n18% 18% 22% "] [12.631711959838867, 17.77525520324707, "uries includes injuries through 2017. Sample for two-year indemnity injuries includes injuries through 2016.\n 61\nTable A.8a. Permanent Differences in Relative Earnings by Firm Size Category\n One Year Post-Injury\nTwo Years Post-Injury\n Firm S"] [12.707412719726562, 17.733373641967773, "0000]**\n0.0989 (0.0055) [0.0000]**\n\u20130.0433\n(0.0042) [0.0000]**\n\u20130.1104\n(0.0036) [0.0000]**\n\u20130.0542\n(0.0031) [0.0000]**\n0.1421 (0.0017) [0.0000]**\n\u20130.1454\n(0.0051) [0.0000]**\n\u20130.0679\n(0.0056) [0.0000]**\n\u20130.1364\nbrackets. The p-values presented above a"] [12.701942443847656, 17.742504119873047, ") [0.1990]\n 64\nTable A.8d. Permanent Differences in Relative Earnings by Nature of Injury\n One Year Post-Injury\nTwo Years Post-Injury\n Nature of Injury\nCumulative\nMultiple\nOther\nSpecific\nIndemnity b/se/p \u20130.1118 (0.0026) [0.0000]**\n\u20130.033 (0"] [12.655624389648438, 17.756088256835938, "017. Sample for two-year indemnity injuries includes injuries through 2016.\n 66\nTable A.8f. Permanent Differences in Relative Earnings by Quartile of Pre-injury Earnings\n One Year Post-Injury\nTwo Years Post-Injury\n Quartile of Earnings\n1st p"] [12.707138061523438, 17.73259735107422, "0]**\nIndemnity b/se/p 0.0237 (0.0015) [0.0000]**\n0.0034 (0.0012) [0.0080]**\n\u20130.0954\n(0.0038) [0.0000]**\n\u20130.2 (0.0059) [0.0000]**\nPPD (CM) (2005\u20132015) b/se/p\n0.0127 (0.0028) [0.0001]**\n0.0127 (0.0027) [0.0000]**\n\u20130.0713\n(0.0054) [0.0000]**\n\u20130.1616\n(0."] [12.702566146850586, 17.73748779296875, "0.0094) [0.2165] \u20130.0018 (0.0073) [0.8076] \u20130.0043 (0.0036) [0.2301] \u20130.0291 (0.0274) [0.2943] \u20130.0015 (0.0071)\n 69\nOne Year Post-Injury\nTwo Years Post-Injury\n Trend Break*(Subgroup)\nIndemnity b/se/p [0.7293]\nPPD (CM) (2005\u20132015) b/se/p"] [12.713492393493652, 17.731952667236328, "[0.5902] \u20130.0011 (0.0043) [0.8082] 0.0178 (0.0073) [0.0185] 0.0122 (0.0095) [0.2050] \u20130.0161 (0.0083) [0.0599] \u20130.0126\n(0.0107) [0.2438] 0.0067 (0.0135) [0.6200] 0.0157\n(0.0123) [0.2085]\nPPD (CM) (2005\u20132015)\nb/se/p\n0.0091\n(0.0251) [0.7205] 0.0269 (0."] [12.67992115020752, 17.745948791503906, "244 (0.0049) [0.0000]** \u20130.0126 (0.0047) [0.0103]\nPPD (CM) (2005\u20132015)\nb/se/p\n0.0681 (0.0187) [0.0007]** 0.0134 (0.0140) [0.3438] \u20130.0263 (0.0127) [0.0441] \u20130.0096 (0.0097) [0.3281] \u20130.0024 (0.0075) [0.7461] \u20130.0067 (0.0032) [0.0415] 0.0218 (0.0106) "] [12.690587043762207, 17.74176597595215, "pared to Overall Average by Region\nOne Year Post-Injury\nTwo Years Post-Injury\n Trend Break*(Subgroup)\n2008*Bay Area 2008*Central Coast 2008*Central Valley 2008*Eastern Sierra 2008*Inland Empire 2008*Los Angeles 2008*N. Sac Valley 2008*North"] [12.6986665725708, 17.73396873474121, "]\nPPD (CM) (2005\u20132015) b/se/p [0.3631]\n0.0017 (0.0205) [0.9327]\n0.0181 (0.0192) [0.3499]\n0.0175 (0.0097) [0.0769] \u20130.0011 (0.0107) [0.9191] \u20130.0039 (0.0044) [0.3899]\n\u20130.001 (0.0092) [0.9185]\n0.0307 (0.0061) [0.0000]**\n0.001 (0.0153) [0.9471] \u20130.0026 "] [12.708587646484375, 17.72882843017578, "77]\n0.0313 (0.0220) [0.1611]\n\u20130.0003 (0.0021) [0.8947]\n\u20130.0092 (0.0098) [0.3550]\n\u20130.0503 (0.0224) [0.0301]\n0.0055 (0.0221) [0.8049]\n0.007 (0.0021) [0.0015]**\n0.0091 (0.0084) [0.2860]\n\u20130.0336 (0.0168) [0.0521]\n\u20130.0372 (0.0209) [0.0832]\n0.002 (0.0012) "] [12.711958885192871, 17.731786727905273, "[0.6006] 0.0047 (0.0031) [0.1400] 0.0075 (0.0026) [0.0061] \u20130.0096 (0.0273) [0.7250] \u20130.0106 (0.0133) [0.4274] 0.0005 (0.0145) [0.9751] 0.0014 (0.0147) [0.9217] 0.008 (0.0032) [0.0154]\nPPD (CM) (2005\u20132015) b/se/p \u20130.0059 (0.0263) [0.8229]\n0.0023 (0.0"] [12.706442832946777, 17.742658615112305, "0.0523] \u20130.0123 (0.0154) [0.4280]\n0.0173 (0.0063) [0.0092]\n\u20130.003 (0.0039) [0.4495]\n 2013*Multiple \u20130.0124 (0.0030)\n2013*Neck\n2013*Trunk 2013*Upper extremities 2016*Ears/hearing 2016*Eyes\n2016*Face\n2016*Head 2016*Lower extremities\n[0.0002]** \u20130.0"] [12.717337608337402, 17.726131439208984, " Trend Break*(Subgroup)\n2013*1st pre-injury wage quartile 2013*2nd pre-injury wage quartile 2013*3rd pre-injury wage quartile 2013*4th pre-injury wage quartile 2016*1st pre-injury wage quartile 2016*2nd pre-injury wage quartile 2016*3rd pre-i"] [12.673016548156738, 17.738637924194336, "ded in the analysis as a base period, so no coefficients are reported for these injury dates. The p-values presented above are unadjusted. ** indicates Holm-adjusted statistical significance based on a benchmark of \u03b1 = 0.05. PPD (CM) indicates injuri"] [12.491056442260742, 17.855060577392578, "Subgroup)\n2016*Southern California, cumulative\nIndemnity b/se/p 0.0381 (0.0089) [0.0001]**\nPPD (CM) (2005\u20132015) b/se/p\n NOTE: Table shows linear regression coefficients, standard errors in parentheses, and unadjusted p-values in brackets. 2005\u201320"] [12.306994438171387, 18.045948028564453, "e A.3d. Earnings Loss by Job Tenure at Injury for Workers with Permanent Partial Disability Benefits (constant maturity sample), 2005\u20132015 Injuries\n SOURCE: 2005\u20132015 matched WCIS-EDD data.\nNOTE: Relative earnings defined as ratio of injured worker e"] [11.197593688964844, 18.161903381347656, " for Workplace Safety,\u201d Journal of Health Economics, Vol. 30, No. 4, 2011, pp. 764\u2013 773.\nBrooks, Ward, Study of Geographical Differences in California Workers\u2019 Compensation Claim Costs, Oakland, Calif.: Workers\u2019 Compensation Insurance Rating Bureau o"] [11.229050636291504, 18.161497116088867, " Its Second Century, Kalamazoo, Mich.: W. E. Upjohn Institute for Employment Research, 2017.\nHyatt, Henry R., and James R. Spletzer, \u201cThe Shifting Job Tenure Distribution,\u201d Labour Economics, Vol. 41, 2016, pp. 363\u2013377. doi:10.1016/j.labeco.2016.05.00"] [5.782861232757568, 2.262216091156006, " CORPORATION\nLYNN A. KAROLY\nAssessing the\nCosts and Benefits\nof LifeSet\nThe Youth Villages Program Model for Transition-Age Youth\n For more information on this publication, visit www.rand.org/t/RR2839\n Library of Congress Cataloging-in-Publication "] [12.650152206420898, 13.576275825500488, "as well as those interested more generally in the costs and benefits of programs serving young adults transitioning out of the foster care system.\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improv"] [5.780622959136963, 2.2651278972625732, "............. 15 Housing Stability ...................................................................................................................... 15 Economic Well-Being.........................................................................."] [5.785033702850342, 2.2662718296051025, "es\nTable S.1. Summary of the Estimated Cost and Benefits of LifeSet per Participant Under Alternative Assumptions, 2015 Dollars .................................................................................. x Table 2.1. Summary of Estimated Impac"] [5.783413410186768, 2.264052629470825, "i.e., a randomized control trial [RCT]), for a cohort of participants in Tennessee who enrolled in the program between October 2010 and October 2012, with findings reported one year and two years after randomization. Based largely on survey data, the"] [5.785216808319092, 2.2655653953552246, "his summary, we highlight key findings and discuss the implications of the analysis for understanding the economic returns from LifeSet.\nKey Findings\nThe BCA of LifeSet presented in this report produced the following key findings (see Table S.1):\n\u2022 L"] [5.78511381149292, 2.2654805183410645, "per Participant Under Alternative Assumptions, 2015 Dollars\n More Conservative\nSummary Result Estimate\n Base-Case Estimate\n Less Conservative Estimate\n Present-value cost net of control group services Present-value of outcomes and deadweig"] [5.783797264099121, 2.264622449874878, "economic values of the outcomes that could be included in the analysis. In just over one-half of the simulations, present-value net benefits exceeded zero, indicating a positive economic return.\n\u2022 If all outcomes could be valued, the estimated net be"] [5.783140182495117, 2.2627580165863037, "he evidence regarding the program\u2019s economic benefits, in particular. These include the following:\nxi\n\u2022 Collect comprehensive information about the cost of program implementation for both the services provided to LifeSet participants and the \u201cbusines"] [5.786574363708496, 2.2651867866516113, "benefit-cost analysis\nC control\nCPI Consumer Price Index\nCPS Current Population Survey GED general equivalency diploma NSC National Student Clearinghouse RCT randomized control trial\nSNAP Supplemental Nutrition Assistance Program SSI Supplemental Sec"] [5.787984371185303, 2.2658488750457764, "ured additional outcomes in three of the six domains: education and training, employment and earnings, and criminal involvement.\n1 A growing body of research documents the challenges and adverse outcomes faced by youth transitioning to adulthood from"] [5.787116527557373, 2.2644686698913574, "gh School\nDiploma/General Equivalency Diploma\n\u0000 Post-Secondary Education Plans\n\u0000 Employment Skills\nCommunity Partnerships\n\u0000 Community\nCollaboration\n\u0000 Accessing Support\n\u0000 Customer\nSatisfaction\nTeam/Staff Development\n\u0000 Career/Leadership Opportunities\n\u0000"] [5.785192489624023, 2.2644224166870117, " the evaluation represent either benefits or costs, depending on the sign of the impact coefficient, as well as whether the perspective is that of the public sector (i.e., taxpayers), the participants themselves, or the rest of society. In performing"] [5.787598133087158, 2.2665927410125732, "measured, Chapter 3 presents the approach taken in this study to value the outcomes examined in the impact evaluation. The resulting estimates of benefits and costs are presented in Chapter 4. Conclusions and implications of the findings are the subj"] [5.782420635223389, 2.26460599899292, "vices offered by the LifeSet staff. The frequency and duration of services utilized were close to expected levels, participation rates on the part of young adults were high, and participants were highly engaged in services.\n3 This chapter provides a "] [5.79999303817749, 2.275283098220825, "ng stability and economic well-being, health and safety, social support, and criminal involvement.\nTable 2.1 provides a summary of the findings in the form of a stoplight chart, with each row summarizing the impacts for a given outcome measure at thr"] [5.813154697418213, 2.2835521697998047, " safety, continued\n Binge drinking in past month\n 0\n Used illegal drugs\n \u2013\n Condom use during last sexual encounter\n +\n Was robbed or assaulted\n 0\n Partner violence\n \u2013\n Social support\n Score on social support scale\n "] [5.791136264801025, 2.2689638137817383, "nefits), depending on the viewpoint of the decisionmaker. In such cases, the cell is shaded in a red and green pattern and viewed as indeterminant when judging whether the impact is advantageous or not.\nFinally, Table 2.1 also indicates statistical s"] [5.78927755355835, 2.2669217586517334, "cally significant only for the mental health problems scale, the indicator of not receiving health care when needed, and the indicator of experiencing partner violence.\n9\n\u2022 Criminal involvement. The category of criminal involvement shows mixed findin"] [5.7871785163879395, 2.265272378921509, "had a higher incidence of having a high school diploma and enrollment in vocational training, but the estimates of postsecondary enrollment showed a lower incidence by the end of two years for LifeSet participants relative to the control group (see T"] [5.797433376312256, 2.2732818126678467, "ved SSI*\nYear 1\n Received SNAP*\nYear 1\n Received WIC*\nYear 1\n Received public housing/rental assistance*\nYear 1\n Received Families First (TANF)*\nYear 1\n 12\n Outcome\nImpacts in MDRC Evaluation\nSource for Shadow Price\n H"] [5.800068378448486, 2.270399570465088, "Set participants from their observed higher rate of high school attainment as of the first year. We focus on receipt of a high school diploma and assume no benefit from attaining a GED.5 To estimate the lifetime earnings gain of a recipient of a high"] [5.792426109313965, 2.2684664726257324, " regular diploma, after accounting for the selectivity of who receives which type of diploma and other biases introduced by the available data. The CPS, our source of estimated lifetime earnings, does not differentiate between those who completed a h"] [5.785764694213867, 2.264472007751465, "ther, the projected earnings gains are based on the impacts for educational attainment, discussed earlier.\nHousing Stability\nThe MDRC evaluation reported the impact of LifeSet, in the first year, on a housing stability scale composed of four indicato"] [5.80470085144043, 2.284283399581909, " of the transfer benefit as it would apply for a single adult (or family with one adult and one dependent child, in the case of WIC and TANF) in Tennessee as of 2015 (see Table 3.2). Because the evaluation measured any use of the benefit program duri"] [5.786125183105469, 2.2647039890289307, "t for housing, which is an estimated average value of the housing benefit that varies by local rental rates and family income.\nHealth\nThe MDRC evaluation assessed various measures of health status, health care utilization, and health insurance covera"] [5.790493965148926, 2.2674150466918945, "rime costs associated with the effect on being robbed or assaulted (victimization increased by a very small amount) and the effect on intimate partner violence (victimization decreased by a statistically significant amount) (see Table B.6). In both c"] [5.760613918304443, 2.2413036823272705, "self-reported crime, with only one statistically significant reduction in the incidence of criminal behavior\u2014for receiving cash or goods in exchange for sex (see Table B.8). Although the incidence of arrests was lower (but statistically insignificant"] [5.780385971069336, 2.2635531425476074, "alysis for LifeSet\nIn this chapter, we present the results of our BCA, drawing on the cost and impact estimates summarized in Chapter 2 and employing the approach to valuing outcomes reviewed in Chapter 3. Given the uncertainties in both cost and the"] [5.786526679992676, 2.2653861045837402, "et per Participant Under Alternative Assumptions, 2015 Dollars\n More Conservative Summary Result Estimate\n Base-Case Estimate\n Less Conservative Estimate\n Present-value cost 8,763 8,357 7,951\nLifeSet cost\nOffset for service utilization by"] [5.785153388977051, 2.2656502723693848, "group had higher rates of enrollment in postsecondary education, the projected future benefits from this source of impact are negative and almost offset the high school productivity gains.\nAmong the observed outcomes, the largest contributor to posit"] [5.784580230712891, 2.2658655643463135, "is less than 1 (0.42), indicating that costs exceed benefits.\nAccounting for Uncertainty in the Included Impacts\nThe base-case estimates rest on assumptions about the economic values of the outcomes affected by LifeSet, as well as the value of the re"] [5.786341667175293, 2.267540454864502, "ing insecurity, reduced economic insecurity, and greater social support; improvements in mental health and reduced substance misuse; reduced costs associated with having a handgun; and greater adherence to safer sex practices. If these outcomes could"] [5.784665584564209, 2.2646524906158447, " the short-term impacts were sustained.\nEven with these sources of uncertain net benefits or costs, under the more conservative assumptions, the addition of the currently unmeasured benefits could be sufficient to generate positive net benefits overa"] [5.7864203453063965, 2.26692795753479, "ojected to the future, beyond the point of last follow-up. Because the impact estimates were not always favorable for the treatment group, the impacts of LifeSet were associated with both positive benefits and negative benefits (or costs). Given unce"] [5.788637638092041, 2.2719852924346924, "rease in taxes required to pay for LifeSet, net of any increase or decrease in taxes based on the program impacts. A more conservative estimate produces a deadweight cost of about $4,400 per participant, while a less conservative estimate has no such"] [5.78412389755249, 2.2647204399108887, "use the magnitude of the impacts on the outcomes that are not valued\n28\nwas typically small and statistically insignificant, these omitted sources of potential benefits are not likely to generate net benefits that are substantially larger than those "] [5.7845330238342285, 2.264596700668335, "feSet is funded partially through private funders, more funding may be specifically dedicated toward tangible goods and\n29\nfinancial support around housing, clothing, and basic necessities. In other areas, staff may\nhave access to limited wraparound "] [5.784621238708496, 2.264803409576416, "uld experience even better outcomes from participating in LifeSet than those realized for the Tennessee participants. This would occur if the program model were effective at serving youth with even greater challenges. (Program effects could be smalle"] [5.788759708404541, 2.268035411834717, "gs and private benefits.\n\u2022 Capture the associated magnitude (or quantity) of the impacts to go beyond simply measuring the incidence of any given outcome. For example, for homelessness, measure the number of nights and type of homelessness for each e"] [5.785760879516602, 2.2660889625549316, " in December 2018 (WSIPP, 2018a). Before we review the BCA findings, we discuss the following BCA components: program cost, program impacts, and valuation of program impacts and other assumptions.\nWSIPP Estimate of LifeSet Program Cost in Washington "] [5.810284614562988, 2.2857818603515625, "erall effect on net benefits from this omission is unclear.\nEven for the year 1 findings, the WSIPP model does not account for all of the outcomes measured in the MDRC evaluation. In particular, as shown in Table A.1, the WSIPP model accounts for jus"] [5.800685405731201, 2.2730259895324707, "adult\nYear 1\n Score on familial closeness scale*\nYear 1\n Biological family member would offer place to stay*\nFriends would offer place to stay*\nYear 1\n Year 1\n Criminal involvement\n Criminal behavior scale\n Got in gang fight or as"] [5.801748275756836, 2.2748069763183594, "pendent organization, and used the gold-standard design, an RCT. Thus, the WSIPP-adjusted effect sizes are the same as the unadjusted effect sizes.\nThe WSIPP model also allows for effect sizes to change over time, based on either a longitudinal follo"] [5.801769256591797, 2.2753429412841797, "dology produces a somewhat higher effect size of 0.104. And the effect is assumed to persist. Had the result for arrests been used instead, the impact would have been negative (a favorable outcome), with an effect size of \u20130.040, as reported by MDRC."] [5.789428234100342, 2.2682838439941406, " assumption in the WSIPP model is the inclusion of a parameter to capture the efficiency cost of raising taxes to pay for government transfers and other benefits, known as deadweight loss. In effect, every dollar of public revenue required to pay for"] [5.801209449768066, 2.2770605087280273, "s\n0\n\u20132,017 0\n2 26 0 \u20132,044 0 \u20132,017\n0\n\u20135,328 0\n0 12 9 \u201387 \u20134,962 \u20135,328\n\u20139,963\n\u20133,063 5,033\n3 66 9 \u20133,211 \u20134,962 \u201313,026\nTable A.3. WSIPP Model BCA Results\n0 \u20139,963\n3,466 816 3,461 1,572\n1 0 4 24 0 0 0 \u2013780 0 0\n3,466 \u20139,147\n Summary Result\n By St"] [5.807144641876221, 2.283526659011841, ". One- and Two-Year Impact Estimates: Employment and Earnings\n Control Impact Effect\nOutcome Source Group (T \u2013 C) Size p-value\n Earnings from formal work\u2014year 1, year 2\nEarnings\u2014year 1 ($) 12-mo. survey 3,488 611 0.12 0.043\n Earnings\u2014year"] [5.805612564086914, 2.2808640003204346, "* (%) 12-mo. survey 6.9 2.0 0.08 0.230\n Received SNAP* (%) 12-mo. survey 51.4 6.1 0.12 0.036\n Received WIC* (%) 12-mo. survey 16.2 0.8 0.02 0.710\n Received public housing/rental assistance* 12-mo. survey 7.1 1.6 0.06 0.337 (%)\n Received Families Firs"] [5.755148410797119, 2.232232093811035, " times a week to almost every day 54.2 \u20131.6 \u20130.03\n Score on familial closeness scale (range: 12-mo. survey 7.9 0.1 0.01 0.801 0\u201318)*\n Biological family member would offer 12-mo. survey 0.497 respondent a place to stay if needed* (%)\nNot at all likel"] [5.78863000869751, 2.2672367095947266, "t the cost of delivering the LifeSet program was $11,841 per participant in 2015 dollars (see Table C.1). These costs consist of staff salaries and benefits, Youth Villages overhead, travel, operations and maintenance, and direct support to youth.\nTa"] [5.826273441314697, 2.3025336265563965, "ager (%) 12-mo. survey\nMore than once per week 21.9 8.2\n Once per week 38.5 12.1\nMore than once per month 4.6 6.2\n About once per month 6.7 10.4\n Less than once per month 2.5 6.5\n Did not have a case manager 25.7 56.5\n Received help preparing for "] [5.791889667510986, 2.2710845470428467, "ants, we assume that those sessions were also one hour, on average. Thus, we estimate about 15 hours of contact with a case manager for control group members.\nHourly Cost for Case Worker Contact\nThe final step is to estimate the cost per hour of cont"] [5.7892069816589355, 2.268122434616089, "n the estimate of program services used by the control group. (One exception was the estimated earning effect, in which the smaller estimate was taken from the two-year impact based on the administrative survey and the larger estimate was taken from "] [5.789228439331055, 2.2679550647735596, "r and upper bounds used in the more and less conservative assumptions\n(Chapter 3)\n Administrative cost rate for transfer programs Uniform Range of 10% to 20%\n Deadweight-loss parameter Triangle Minimum of 0, midpoint of 0.25, maximum of 0.50\n N"] [15.539274215698242, 6.500128746032715, ", John Eric Humphries, and Nicholas Mader, \u201cThe GED,\u201d in Eric A. Hanushek, Stephen J. Machin, and Ludger Woessmann, eds., Handbook of the Economics of Education, Vol. 3, Amsterdam: North-Holland, 2011, pp. 423\u2013484.\nHeckman, James J., and Paul A. LaFo"] [5.784895896911621, 2.264645576477051, "of Two Interventions,\u201d Journal of Studies on Alcohol, Vol. 63, No. 2, 2002, pp. 219\u2013228.\nSteurle, Eugene, and Leigh M. Jackson, eds., Advancing the Power of Economic Evidence for Making Informed Investments in Children, Youth, and Families, Washingto"] [9.428431510925293, 10.467313766479492, " CORPORATION\nMALCOLM V. WILLIAMS, LAURIE T. MARTIN, JESSICA SOUSA\nEarly Learnings from\nthe Hospital Community Cooperative of the American Hospital Association\nHealth is increasingly understood to be shaped by more than individual genetics, clinical "] [9.437740325927734, 10.4800443649292, "rganizations together to collectively address key SDOH in their communities and pro- mote health equity. The effort builds on the AHA\u2019s #123forEquity Pledge to Act Campaign (American Hospital Association, undated-a), which has chal- lenged hospitals "] [9.437657356262207, 10.480353355407715, "on, this report should be of use to foundations or other funding agencies that might support similar partnered approaches to improve health inequity in their communities.\nApproach\nWe collected data from each of the ten teams at two points in time\u2014in "] [9.425620079040527, 10.461301803588867, "dress SDOH.\nTeams provided examples of how their capac-\nity to address SDOH had expanded. These included increases in executive leadership support and funding for addressing SDOH and health equity; identifica- tion of new partners and a strengthening"] [9.425132751464844, 10.462849617004395, "ed at least one partner. But at baseline, only two teams felt that they had \u201cthe right types of partners to address health equity\u201d; the other eight felt they had \u201csome of the right partners.\u201d At the end of the first year, eight teams felt that they h"] [9.439008712768555, 10.48129653930664, "ess encampment within its community during the HCC project period. Although this effort was independent of the HCC project, the team was able to quickly mobilize in support of its community partners to support housing placement for seven individuals "] [9.437287330627441, 10.485870361328125, "sing policy change (data not shown), others were poised to take advantage of policy win- dows and opportunities for alignment.\nTeams Appreciated the Flexibility of HCC Funding and Protected Time to Work on Projects\nEach team received $10,000 and valu"] [9.440518379211426, 10.477213859558105, "ised to take advantage of opportunities when they arose.\n 7\nLessons Learned\nThis inaugural cohort generated some helpful lessons learned for hospitals and health systems looking to develop partnered approaches to addressing SDOH and health equity in"] [9.437397956848145, 10.480469703674316, "H. Second, because this pilot involved only ten sites, these results may not be representative of what other hospital or health system partnerships could achieve in the same period. Further compounding this issue of generalizability is that teams cam"] [9.440463066101074, 10.484957695007324, "partners:\n\u2022 CHRISTUS St. Vincent\n\u2022 Grady Health System\n\u2022 Holy Name Medical Center\n\u2022 Hurley Children\u2019s Hospital\n\u2022 MultiCare Health System\n\u2022 Parkland Health and Hospital System\n\u2022 Sharp HealthCare\n\u2022 Truman Medical Center Behavioral Health \u2022 University o"] [12.657007217407227, 13.581744194030762, "8 during which teams worked with technical assistance providers to define and refine their projects. RAND researchers collected data at two time points: January 2019 (baseline, allowing time for teams to finalize projects) and October 2019 (follow-up"] [14.943359375, 3.146245241165161, " INTRODUCTION\n CHALLENGES FOR THE U.S. JUSTICE SYSTEM\n RESULTS\nWe identified the following four categories of chal- lenges that come from changes in society as a whole:\n\u2022 shifts in the amount and nature of crime\n\u2022 changing needs of contact popula"] [14.332587242126465, 3.310185194015503, "local criminal justice agencies and fostering the adoption of new technologies, policies, and\n2\npractices that can improve agencies\u2019 performance. To advance that mission, NIJ sponsored the Priority Crimi- nal Justice Needs Initiative,\na five-year coo"] [14.621865272521973, 3.083862781524658, "ities Workshop\nJune 2016: Law Enforcement Advisory Panel Mid 2016: Corrections Futures Interview Panel\nFebruary 2017: Potential Impact of Electronic Media Use on the Right to a Fair Trial Workshop\nMarch 2017: Workforce Issues in Corrections Workshop\n"] [14.865325927734375, 3.1740076541900635, "m change. The issues and problems in many of these areas of concern have been the focus of other research. To link the results of this effort to that broader foundation of scholarship, we provide examples of such studies throughout. In the remainder "] [15.182769775390625, 3.184657096862793, "ond to crimes where the perpetrators might be thousands of miles away and might have entered their jurisdiction only virtually. Cybercrimes also create challenges for court practitioners in both maintaining the expertise in technology needed to under"] [14.907286643981934, 3.251085042953491, "ed the need for model policies\nand procedures that are specific to such new types of crime as \u201cSWATing,\u201d or calling the police from a falsified telephone number to trigger a law enforcement tactical response to another address. The law enforcement an"] [15.620942115783691, 4.7274088859558105, "h response, courts wrestle with the right approach for individuals whose offending might be driven by a treatable illness, and corrections agencies have become the nation\u2019s de facto primary institutions for mental health care delivery (Al-Rousan et a"] [14.764883041381836, 3.1818785667419434, "ed that research and measures also are\nThe needs of the multilingual populations served by criminal\njustice agencies were the source of a very specific technology requirement across the three sectors: technology for real-time language translation.\nne"] [14.537595748901367, 3.129197359085083, " agencies deploying technologies that might have the potential for misuse or abuse.\nfore, for the viability of such strategies as community policing, which rely on collaborative approaches to solve problems (Slocum, 2018; Murphy, Madon, and Cherney, "] [14.451851844787598, 3.1239676475524902, "tage and other law enforcement surveillance data. Clear guidelines were felt to be needed to distinguish between data that should be published to improve transparency and fight crime and data that, if released, could be readily exploited by criminals"] [14.502579689025879, 3.158689260482788, "g police use of force and the disparate impacts on communities of such strategies as order- maintenance policing (Tyler, Jackson, and Mentovich, 2015).\nIt also was mentioned in our discussion with respect to future technology-focused public safety st"] [14.7317476272583, 3.093388795852661, " court proceedings, such as alternative dispute resolution, restorative justice, arbitration and mediation, and diversion- ary programs. Law enforcement also prioritized the need for research and measures to assess the effectiveness of different\n "] [14.942790031433105, 3.164156913757324, "st successful.\n\u2022 Develop better tools to sort cases and match them with the process that is most likely to get to an outcome efficiently and effectively (e.g., negotiation, trial, diversion, specialty court), including collecting data to inform the a"] [15.003578186035156, 3.2814531326293945, "e services (Bureau of Justice Statistics, undated).\nDecentralization has significant consequences for criminal justice innovation. This atomization can be a boon to innova-\nInformation sharing and contractual mechanisms were recommended as options fo"] [14.617841720581055, 3.005059242248535, "rity of proposed solutions for this issue focused on procurement policies and contractual requirements,\n Practitioners across all sectors of the justice system complained that their agencies are drowning in a flood of data.\nwhich could be potentiall"] [14.431763648986816, 3.046488046646118, " across the country, among different levels of government, or even international. Even within single geographic jurisdictions, the justice system requires information sharing to work effectively. For example, there is a need for data to be shared bet"] [14.987762451171875, 3.294271945953369, ". Among the types of tools mentioned were mobile devices that securely deliver inmate information and body-worn comput- ers to improve the effectiveness and efficiency of community corrections. Agencies also highlighted the need for procedural and te"] [15.134295463562012, 3.3941497802734375, "reconstituting community correc-\n tions operations in a locally disruptive event that might affect both staff and supervisees.\nCommon Innovation Needs and Opportunities\nSolutions to enduring issues raised largely by corrections\nand law enforcement pa"] [15.643587112426758, 3.946633815765381, "imes argued that raising standards for recruitment\u2014for example, requiring post\u2013high school education for public safety officers\u2014would be valuable in making the justice system more effective, they also pointed out that recruitment difficulties led to "] [15.07614803314209, 3.3787472248077393, " on improving equipment to better protect criminal justice staff, including making changes to personal equipment and disseminating effective practices for selecting and carrying gear. Participants also described the need for novel tools to allow offi"] [15.032600402832031, 3.2507357597351074, "oncerns about rates of criminal\nrecidivism. Most criminal justice offenders are released back into their communities at some point, and the rate at which they fall back into crime calls into question the capability of current efforts to promote behav"] [15.016562461853027, 3.1651785373687744, "tive.\n\u2022 Hold more interagency exercises to build relationships between agencies and bolster preparedness for large- scale incidents, where success depends on using common resources effectively.\n\u2022 Address shortfalls in the ability to notify individual"] [14.97365951538086, 3.2383739948272705, "Opportunities\nAlthough many participants argued that the justice system requires more resources or different funding streams and that leaders should better advocate for those needs, a wide variety of cross-sector needs focused on how justice agencies"] [14.407463073730469, 3.3022592067718506, " and viable solutions can be quite different for agencies that are responsible for geographically dispersed and sparsely populated rural areas than for those that are responsible for densely populated urban jurisdictions.\nNotes\n1 The Initiative was a"] [14.903068542480469, 3.1096291542053223, "anges that could be made using existing technology and business practices that possibly could improve performance in the relatively near term.\nAlthough the inputs from our large group of workshop participants over the course of the project provided a"] [13.905308723449707, 3.600975275039673, "-Tech-Brings-New- Issues-to-Public-Safety-Agencies.html\nCollom, Lindsey, \u201cWhen Police Officers Use Social Media, Their Departments See Risks,\u201d Arizona Republic, April 17, 2012.\nCummings, Scott, and Deborah Rhode, \u201cAccess to Justice: Looking Back, Thi"] [13.972457885742188, 3.7552950382232666, "kson, Annie Brothers, Mark Barrett, Dulani Woods, and Michael J. D. Vermeer, A Database of Criminal Justice Needs for Innovation: Requirements for Developers and Funders\u2014User Guide, Santa Monica, Calif.: RAND Corporation, TL-352-NIJ, 2020. As of Marc"] [14.188444137573242, 3.6406872272491455, "orithmic Management,\u201d Big Data and Society, 2018, pp. 1\u201316.\nLink, Nathan W., \u201cCriminal Justice Debt During the Prisoner Reintegration Process: Who Has It and How Much?\u201d Criminal Justice and Behavior, Vol. 46, No. 1, 2019, pp. 154\u2013172.\nLofstrom, Magnu"] [13.966569900512695, 3.988377809524536, "\nRAND Corporation, \u201cPriority Criminal Justice Needs Initiative,\u201d webpage, undated. As of February 1, 2020: https://www.rand.org/well-being/justice-policy/projects/priority- criminal-justice-needs.html\nRobbins, Ira P., \u201cLessons from Hurricane Katrina:"] [15.598587989807129, 4.73151159286499, "on Team Model of Police Response to Mental Health Crises: A Primer for Mental Health Practitioners,\u201d Best Practices in Mental Health,\nVol. 8, No. 2, 2012, pp. 71\u201379.\nWood, Emily F., Monica K. Miller, and Tatyana Kaplan, \u201cSpecialty Courts: Time for a "] [13.915023803710938, 4.211830139160156, "unen, Andrew Lauland, Kristin Leuschner, Jocelyn Lofstrom, Mauri Jun Matsuda, Heather McCracken, Rosa Meza, Paul Ng, Cordaye Ogletree, Rachel Ostrow, Bryce Pardo, Catherine Plummer, Laura Poole, Carter Price, Rajeev Ramchand, Adrian Salas, Jessica Sa"] [13.917498588562012, 4.182918071746826, " on science and technology policy, criminal justice, national security, and emerging technologies and innovation. His recent research involves the policy, procedure, and technology needs of criminal justice agencies, development planning and program "] [13.918110847473145, 4.157321453094482, "the RAND Corporation. Her research focuses on national security, performance measure development, program evaluation, emerging technologies, public health systems, and workforce training. She received her master\u2019s degree in public health.\n About This"] [13.863866806030273, 4.6031317710876465, " prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.\nRAND\u2019s publications do not necessarily reflect the opinions of its research clients and sponsors. R\u00ae is a registered trademark.\n CORPORATION\nRR-4242-NIJ\n"] [16.059236526489258, 9.920320510864258, "Breaking Barriers: A Rapid Rehousing and Employment Pilot Program for Adults on Probation in Los Angeles County\nEvaluation Report\nSARAH B. HUNTER, ADAM SCHERLING, MELISSA FELICIAN, SANGITA M. BAXI, MATTHEW CEFALU\n SOCIAL AND ECONOMIC WELL-BEING\nSpon"] [13.937215805053711, 4.283514499664307, " recommendations regarding future programming and research. This report should be of interest to state and county governments serving populations on felony probation and other organizations serving criminal justice\u2013involved populations.\nRAND Social a"] [16.102148056030273, 9.974579811096191, ".................................................................................................... 14 Chapter 4. Findings ....................................................................................................................... 19 Key"] [16.16879653930664, 9.98058032989502, "............................................................................... 58 Figure B.3. Survival Plot of Days Housed by Age ....................................................................... 59 Figure B.4. Survival Plot of Days Housed by "] [16.095516204833984, 9.915400505065918, "...... 50 Table B.3. Number of Days Employed ......................................................................................... 51 Table B.4. Hours per Week While Employed........................................................................"] [16.041118621826172, 9.880213737487793, "g options in Los Angeles\n\u2022 logistical barriers from the geographic spread of the county\n\u2022 caution among landlords and property managers regarding the temporary subsidy model\nand serving the criminal justice\u2013involved population\n\u2022 staffing concerns fro"] [16.109249114990234, 9.91877555847168, "ogram (i.e., whether participation in the program had an effect on recidivism, housing stability, employment, or income).\nAlthough this evaluation cannot make strong conclusions about the effects the program might have had on the outcomes of interest"] [16.12132453918457, 9.934874534606934, "ome point\n- Fifty-five (24 percent) had a job at program entry, 52 (23 percent) started without a job and gained employment, and 20 (9 percent) started with a job and lost employment.\n- The average wage rate among those employed was $12 per hour, the"] [16.075942993164062, 9.887883186340332, " example, most participants did not achieve great gains in employment and associated income during the two-year program period. More information might be helpful in determining how to achieve these goals. There are many possible barriers to employmen"] [16.080814361572266, 9.902995109558105, " stakeholders moving forward. Our data suggest, and our interactions with stakeholders confirm, that many participants will not be able to support the full rental amount at the end of the 24-month subsidy period, particularly as rents in Los Angeles "] [16.057388305664062, 9.927470207214355, "sing obtainment, employment, recidivism) suggest that there are important participant and program factors to consider when scaling up such a program, in that the program as initially designed was associated with more progress in terms of job attainme"] [16.08898162841797, 9.91263484954834, "nt that put them at risk of reoffending and returning to jail or prison (Bradley et al., 2001; Petersilia, 2001; Petersilia, 2005; Gideon and Sung, 2011). Many of the individuals face difficulties accessing housing because probation conditions may re"] [15.882421493530273, 10.04481315612793, "rs initiative. More specifically, the Los Angeles County Probation Department\u2014in collaboration with the Los Angeles County Department of Health Services (DHS), the Corporation for Supportive Housing (CSH), the Conrad N. Hilton\n 1\nFoundation, and two "] [15.727415084838867, 10.290644645690918, "hat rapid rehousing may be effective in helping families and individuals exit homeless shelters more quickly and reduces returns to shelters (Cunningham, Gillespie, and Anderson, 2015). However, it does not solve the housing affordability problem, wi"] [15.642765045166016, 10.317355155944824, "a sense of hope for the future and a way back to self-sufficiency (Shaheen and Rio, 2007; Marrone, 2005). Contrary to prevalent stereotypes, research has shown that people experiencing homelessness do want to work, including those who have disabiliti"] [16.037250518798828, 9.943222999572754, "nificant effects on recidivism (Miller and Ngugi, 2009). One recent evaluation of a small pilot project\u2014entitled Jail in Reach, a program to rapidly rehouse individuals who were newly released from a county jail or prison in the state of Texas with a"] [16.062042236328125, 9.891864776611328, "e Breaking Barriers pilot program. We conducted a formative study during the first year of program implementation and a summative evaluation three years after the program was launched. The primary research questions were the following:\n1. How does th"] [16.069978713989258, 9.888934135437012, "ations.\nThe primary goals of the Breaking Barriers pilot program were to (1) reduce recidivism, (2) improve participants\u2019 housing stability, and (3) improve employment incomes sufficiently for individuals to take over their own rental payments by the"] [16.068376541137695, 9.893184661865234, "reed that a referral was appropriate for Breaking Barriers, they were offered an opportunity to enroll in the program.\nIf an individual was determined ineligible, they were often referred to a more suitable program that could better meet their needs."] [16.066242218017578, 9.880125999450684, "rs, starts immediately and is followed by coordination of the employment and housing services, which we describe in more detail in the following sections.\n8\nFigure 2.1. Breaking Barriers Program Logic Model\n INPUTS\n\u2022 Funding: Hilton Foundation ($2"] [16.05804443359375, 9.88680648803711, " \u2022 duration of housing subsidies\nIncome and employment outputs (BC, Chrysalis):\n\u2022 % of eligible participants applied for benefits (i.e., TANF, General Relief, SNAP)\n\u2022 frequency of engagement with BB program services (i.e., housing stabilization, case"] [16.018217086791992, 9.88774299621582, ". The case manager, in collaboration with the participant, develops an individualized case management service plan that identifies short- and long-term goals. The case manager supports the participant through the housing search and move-in process an"] [16.052854537963867, 9.889511108398438, "cipants to prepare them for interviews and help them search for, apply for, and access jobs on a part-time or full-time basis. Some participants also benefited from employment with Chrysalis\u2019 in-house contracting and temp agencies on a short-term bas"] [16.064321517944336, 9.879752159118652, "ing their full rental amount over time. If a participant\u2019s contribution to rent exceeded their total unit rent, then the participant graduated from the program.\n13\nChapter 3. Evaluation Design\nThe evaluation was conducted in two stages. During the fi"] [16.06995964050293, 9.883221626281738, "aunch of the program. The 19 interviewees all played key roles in program design or implementation. For example, participants included direct service staff, such as case managers, employment specialists, housing coordinators, housing specialists, and"] [16.081768035888672, 9.865915298461914, "rt.\nWe did not focus on or attempt to assess fidelity to the Housing First model during this qualitative assessment. No standardized scales were used to rank or rate interviewees\u2019 agreement with concepts and ideas about aspects of implementation, and"] [16.15019416809082, 9.814083099365234, "ng change in program outcomes in the less rigorous design options (i.e., intervention group\u2013only designs). Stakeholders concluded that it was not feasible to implement a randomized controlled trial because there were not enough resources to screen mo"] [16.058542251586914, 9.887642860412598, "rcation of roles and responsibilities across functions. All interviewees expressed very clearly where their roles began and ended, and clearly articulated the roles of other program staff. No overlapping roles or duplication of effort was found. Even"] [16.065147399902344, 9.875150680541992, "noted that the program was individualized to the client, making it tailored to the specific needs of program participants. For example, case managers meet clients close to where they work or live, and participants who are parents receive additional r"] [16.023263931274414, 9.878039360046387, "ards (for public transportation use) to alleviate transportation barriers, and employed several clients directly through Chrysalis Works, an internal service company, to give them an opportunity to start building an employment history.\n 20\n Facilit"] [16.06618881225586, 9.884562492370605, "ew terrain around housing clients with criminal histories, often working harder to find housing in locations that clients think would be safer for them based on their personal history or that clients have indicated as their preference. Case managers "] [16.084476470947266, 9.879494667053223, "ored differently to better engage them in the program.\n22\nTable 4.2. Stakeholder-Reported Program Challenges Challenges to Implementation\nExternal to the program but central to program design\nHousing market and high and rising rents in Los Angeles: A"] [16.046964645385742, 9.864912986755371, "sing coordinators. The increase in clients brought several logistical and time management challenges. With such a client-oriented program tailored to meet the clients where they are living and work with them toward specific goals (which are developed"] [16.067609786987305, 9.89449405670166, "s the housing affordability crisis and size of Los Angeles County. When these results were shared with stakeholders in response to a more-recent review of the study findings, the stakeholders reported ways in which they addressed many of the cited ch"] [16.113481521606445, 9.934432029724121, "lthough individuals could receive up to a 24- month rental subsidy that started sometime after program enrollment, by using the two-year program period, we balanced inclusion of participants who had adequate opportunity to receive the different progr"] [16.25373077392578, 9.873054504394531, " 61 (18 percent of those referred) did not attend an eligibility meeting. Of those who attended an eligibility meeting, 54 (16 percent of those referred) were not enrolled or were enrolled after November 2016 and thus were excluded from the analysis "] [16.106239318847656, 9.983546257019043, "or child support.\n\u2022 Only 1 percent were reported as veterans.\nDuring the six months prior to program entry, participants reported residing in a variety of different settings. The following is a breakdown of places in which participants reported resid"] [16.10249137878418, 9.979948043823242, "using or residential substance use treatment, or whereabouts were unknown at exit, or participant had died); or (3) recidivism exit (i.e., exited program because of incarceration). Using these criteria, 11 participants (27 percent) were classified as"] [16.188600540161133, 9.927064895629883, ".7% 8.3% 12.9% 19.1%\nIn Unstable, Unknown, or\nIncarcerated Neutral Housing\n16.7% 18.9%\n14.1% 23.5% 18.2% 16.1%\n16.1% 17.9% 18.3% 21.7%\n14.3% 21.8% 20.6% 14.3% 22.2% 22.2% 18.2% 0.0%\n0.0% 33.3%\n8.3% 16.7% 20.7% 13.8%\n18.0% 22.1%\n9.6% 19.2% 18.2% 18.2%"] [16.21422004699707, 9.910992622375488, "evel appeared to be related, such that individuals with a higher education at program entry were more likely to obtain employment during the two-year program period, but this result was not statistically significant after correcting for multiple test"] [16.220321655273438, 9.914702415466309, "r of the program (i.e., months 1\u20136) and this number rose to more than 46 percent in the second half of the first year, then increased to 51.9 percent in the first part of the second year, and up to 58 percent in the last quarter of the program period"] [16.123111724853516, 9.966594696044922, " days) compared with men (166\ndays).\n\u2022 Individuals who were Hispanic were more likely to have a permanent-tenure position\n(on average 75 percent) compared with black participants or individuals of other races/ethnicities (49 percent).\n35\nNo other ass"] [16.118396759033203, 9.95224380493164, " had information about the client\u2019s portion of income being applied to rent, their rental subsidy amount, and total rent. At housing exit or the end of our evaluation period (whichever came first), we had access to the same data as at housing move-in"] [16.129335403442383, 9.961593627929688, "loyment insurance\n2.0% 0.8% 0.0% 46.0% 46.5% 42.9% 39.9% 39.5% 57.1% 2.7% 3.1% 0.0% 0.7% 0.8% 0.0%\n1.4% 1.6% 0.0% 4.1% 3.1% 0.0% 0.7% 0.8% 7.1%\n8.8% 9.3% 7.1% 2.7% 3.1% 0.0%\n5.9% 29.4% 47.1% 5.9% 5.9%\n0.0% 5.9% 0.0%\n5.9% 5.9%\nNOTE: TANF = Temporary A"] [16.162555694580078, 9.951870918273926, " Move-In Median\nAt Two-Year Mark or Program Exit\n Rental Exit Status Information\nStably housed at exit\nClient portion\nBC subsidy\nTotal rent Incarcerated at exit\nClient portion BC subsidy Total rent\nn Mean 19 $108.27\n19 $899.49 19 $1,006.06\n25 "] [16.163421630859375, 9.930063247680664, " findings, if all participants were black, then 14.1 percent would have received a felony conviction; if all the participants were white, then the model estimates that 38.2 percent of them would have received a felony conviction.\nNext, we explored ti"] [16.147018432617188, 9.926949501037598, "quarter of participants started the program without a job and ended the program employed; less than 10 percent started off employed and ended up without employment. The majority of participants were not employed at program entry or at program exit or"] [16.10736846923828, 9.927215576171875, " under probation or parole in California have two-year felony reconviction rates of around 22 percent (Bird, Goss, and Nguyen, 2019) with rates varying depending on whether an individual was initially sentenced to prison (25 percent), jail (28 percen"] [16.05807876586914, 9.872509956359863, "on gathering, program planners may want to tailor the program based on what they learn. For instance, this might entail enhancing the employment support arm of the program or developing more-specific program participant eligibility criteria. One exam"] [16.077049255371094, 9.892266273498535, "age of these opportunities and potentially expanding the opportunities available for participants to gain a better compensated skill set are necessary.\nStudy Limitations\nSeveral limitations to this evaluation should be noted. Regarding the formative "] [16.055837631225586, 9.875969886779785, "o understand the objectives of the Breaking Barriers program, the way the program is being implemented and any challenges faced to date in implementing the program.\nToday we want to talk about the Breaking Barriers Program from your point of view. I "] [16.056440353393555, 9.879229545593262, "m thinking of things like your organization\u2019s mission, the clients you serve, and range of services the agency provides generally (not just to Breaking Barriers).\n3. What services does your agency provide to Breaking Barriers and what is your specifi"] [16.23446273803711, 9.943442344665527, "aining Employment Among Those Unemployed at Program Entry\nTable B.1 shows the model of employment status on the last day (at program exit or at two years) among clients unemployed on first day (n =166): 173 were unemployed on the first day and six pa"] [16.24887466430664, 9.935275077819824, "less than a high school diploma/unknown, AB 109 supervision status, and in the program for months 0\u20136.\n50\nTable B.3. Number of Days Employed\n (Intercept)\nAge\nFemale\nRace/ethnicity\u2013Hispanic\nRace/ethnicity\u2013white\nRace/ethnicity\u2013other\nEducatio"] [16.284893035888672, 9.980960845947266, "\nEducation\u2013postsecondary, some college, bachelor\u2019s or higher\nEducation\u2013high school diploma Supervision status\u2013ATC Program months 7\u201312 Program months 13\u201318 Program months 19\u201324\nEstimate Std. Error\n14.717 1.990 -0.061 0.045 0.061 0.863 -0.580 0.870 -1."] [16.254140853881836, 9.96493148803711, "0.358 -0.903 -0.012 1.600 1.225\nPr(>|t|)\n0.028 0.909 0.881 0.001a 0.028 0.155 0.305\n0.721 0.368 0.991 0.111 0.222\n Race/ethnicity\u2013Hispanic\nRace/ethnicity\u2013white\nRace/ethnicity\u2013other\nEducation\u2013postsecondary, some college, bachelor\u2019s or higher\nEduc"] [16.262012481689453, 9.92141056060791, "hnicity\u2013other\nEducation\u2013postsecondary, some college, bachelor\u2019s or higher\nEducation\u2013high school diploma Supervision status\u2013ATC\nCoef Exp(coef)\n-0.026 0.974 0.254 1.289 0.263 1.301 0.249 1.282 -0.589 0.555 -0.709 0.492\n0.234 1.264 -0.058 0.944\nSe(coef)"] [16.25026512145996, 9.927084922790527, " 0.440 0.544\nz Value 0.171\n-2.252 -0.807 1.329 2.233 1.681 -0.802 0.179 -0.277\nPr(>|z|)\n0.865 0.024 0.420 0.184 0.026 0.093 0.422 0.858 0.782\n Race/ethnicity\u2013Hispanic\nRace/ethnicity\u2013white\nRace/ethnicity\u2013other\nEducation\u2013postsecondary, some college"] [15.786355018615723, 10.228330612182617, "ncisco, Calif.: Public Policy Institute of California, 2019. As of October 27, 2019: https://www.ppic.org/wp-content/uploads/recidivism-of-felony-offenders-in-california.pdf\nBradley, Katharine H., R. B. Michael Oliver, Noel C. Richardson, and Elspeth"] [15.772806167602539, 10.257580757141113, ": Housing Decisions Among Families Exiting Shelter,\u201d Housing Policy Debate, Vol. 24, No. 2, 2014, pp. 364\u2013386.\nFlynn, Kathleen Nye, \u201cPutting Teeth into AB 109: Why California\u2019s Historic Public Safety Realignment Act Should Require Reentry Programming"] [15.75679874420166, 10.268465995788574, "ychiatric Rehabilitation, Vol. 8, No. 1, 2005, pp. 13\u201335.\nMiller, Marna, and Irene Ngugi, Impacts of Housing Supports: Persons with Mental Illness and Ex-Offenders, Olympia, Wash.: Washington State Institute for Public Policy, Document No. 09-11-1901"] [8.625720024108887, 4.045413494110107, " SECOND EDITION\nThe\nScience\nof Gun\nPolicy\nA Critical Synthesis of Research Evidence\non the Effects of Gun Policies in the United States\nRosanna Smart, Andrew R. Morral, Sierra Smucker, Samantha Cherney, Terry L. Schell, Samuel Peterson, Sangeeta C. A"] [8.597091674804688, 4.076287746429443, "es; and the first edition of this report, which synthesized the available scientific data on the effects of 13 types of firearm policies on a variety of outcomes related to gun ownership. This second edition builds on that 2018 report, adding five ne"] [8.2296781539917, 4.321372032165527, "........................................................ xxxi Abbreviations..................................................................................... xxxiii\nPART A\nIntroduction and Methods. . . . . . . . . . . . . . . . . . . . . . . . . ."] [7.996466636657715, 4.277312278747559, "nd Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Effects on Mass Shootings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [8.06613826751709, 4.296239852905273, "....... 109\nCHAPTER SEVEN\nExtreme Risk Protection Orders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 State Implementation of Extreme Risk Protection Orders . . . ."] [8.082757949829102, 4.255815505981445, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Outcomes Without Studies Examining the Effects of Licensing and Permitting\nRequirements .................................................................................. 163 ChapterNineRe"] [8.041781425476074, 4.226560592651367, ".. 196\nCHAPTER THIRTEEN\nFirearm Sales Reporting, Recording, and Registration Requirements. . . . . . . . . . . . . . . . . . 197 State Implementation of Firearm Sales Reporting, Recording, and Registration\nRequirements................................"] [8.1812744140625, 4.338245391845703, "ndguns....................................................................................... 229 ChapterFifteenReferences........................................................................ 230\nPART D\nEvidence for the Effects of Policies Regulat"] [8.160968780517578, 4.32070779800415, "ealed-CarryLaws............................................................................ 277 StateImplementationofConcealed-CarryLaws................................................ 279 EffectsonSuicide............................................."] [8.014697074890137, 4.405547142028809, " 336 Why Don\u2019t We Know More? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 ChapterTwenty-OneReferences.................................................."] [8.022157669067383, 4.2108659744262695, "iolentCrime............................................................. 137\n8.3. Incidence Rate Ratios Associated with the Effect of Background\nChecks on Mass Shootings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [8.074739456176758, 5.097479820251465, "ios Associated with the Effect of Stand-Your-Ground\nLaws on Violent Crime. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244\n16.3. Incidence Rate Ratios Associated with t"] [8.633286476135254, 4.066010475158691, "Studies Meeting Inclusion Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33\n2.4. SupersededStudies ......................................................................35\n2.5. Include"] [8.592260360717773, 4.073369979858398, "o support claims about the effects of various policies.\nMethodology\nWe used Royal Society of Medicine guidelines for conducting systematic reviews of a scientific literature (Khan et al., 2003). We focused on the empirical literature assessing the ef"] [8.7175931930542, 4.0673723220825195, "lass of policies being considered; presents and rates the avail- able evidence; and describes what conclusions, if any, can be drawn about the policy\u2019s effects on outcomes.\nIn many cases, we were unable to identify any research that met our criteria "] [8.69948673248291, 4.069265365600586, "same direction, and contradictory evidence was\nnot found in other studies with equivalent or stronger methods.\n5. Supportive evidence. This designation was made when at least three studies not compromised by serious methodological weaknesses found su"] [8.10659408569336, 4.33894681930542, "\n I\n Child-Access Prevention Laws\n e\u0302L\n e\u0302M\n e\u0302S\n I\n I\n I\n e\u0302L\n I\n Stand-Your-Ground Laws\n I\nI\n e\u0301M\n e\u0301S\n I\n I\n Bans on Low-Quality Handguns\n I\n I\n I\n I\n Bans on the Sale of Assault Weapons and High"] [8.01437759399414, 4.304880142211914, "es\nNOTE: I = inconclusive; L = limited; M = moderate; S = supportive. When we identified no studies meeting eligibility criteria, cells are blank.e\u0301= the policy We concluded that there is limited evidence that licensing and permitting requirements de"] [8.111787796020508, 4.285064697265625, "ale of Assault Weapons and High-Capacity Magazines\n Firearm Sales Reporting, Recording, and Registration Requirements\n Lost or Stolen Firearm Reporting Requirements\n Firearm Safety Training Requirements\n Waiting Periods\n Licensing and "] [7.914064407348633, 4.368479251861572, "ides among youth and limited evidence that the laws reduce total (i.e., firearm and nonfirearm) suicides among youth. In addition, there is limited evidence that these laws may reduce unintentional firearm injuries and deaths among adults. There is s"] [7.945265293121338, 4.2994704246521, "they reduce total suicides and firearm homicides.\n\u2022 Recommendation 5. States without waiting-period laws should consider adopting them as a strategy for reducing suicides and homicides.\nConclusion 6. There is limited evidence that licensing and permi"] [8.571735382080078, 4.0874834060668945, " an important new federal initiative that, if sus- tained in future budgets, could make enormous contributions to knowledge about how to prevent gun-related injuries and deaths.\nSummary xxv\nxxvi The Science of Gun Policy: A Critical Synthesis of Rese"] [8.504135131835938, 4.134194374084473, "l victimization estimates. The current goal of gen-\nerating such estimates for 22 states is a reasonable compromise between cost and the public\u2019s need for more-detailed information. However, the bureau should con- tinue to expand its development of m"] [8.520792961120605, 4.118262767791748, "ce of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nduce more readily detectable effects on public safety, health, and industry outcomes. The United States has a large stock of privately owned guns in circu"] [8.501033782958984, 4.161099910736084, " Regina Kunz, Jos Kleijnen, and Gerd Antes, \u201cFive Steps to Conducting a Systematic Review,\u201d Journal of the Royal Society of Medicine, Vol. 96, No. 3, 2003, pp. 118\u2013121.\nNational Research Council, Firearms and Violence: A Critical Review, Washington, "] [8.478687286376953, 4.128871917724609, "der\nERPO extreme risk protection order\nFBI Federal Bureau of Investigation\nFFL federal firearms licensee\nIRR incidence rate ratio\nK\u201312 kindergarten through grade 12\nN/A not applicable\nNIBRS National Incident-Based Reporting System\nNICS National Insta"] [8.618444442749023, 4.054927825927734, "ferences.html).\n 3\n4 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nEntrenched disagreements on gun policy are not surprising, given the number and variety of contested and contradictory studi"] [8.609678268432617, 4.065941333770752, "lence of gun ownership has an effect on crime or suicide, problems in the measurement of defensive gun use, and what we can learn from Australia\u2019s experience banning some semiautomatic weapons. Those essays remain available on the project website. Th"] [8.338227272033691, 4.16969633102417, "ales and transfers\n6. background checks\n7. licensing and permitting requirements\n8. waiting periods\n9. firearm safety training requirements\n10. lost or stolen firearm reporting requirements\n11. firearm sales reporting, recording, and registration req"] [8.33299446105957, 4.2248969078063965, "occurs is not known. Thus, for laws that increase or decrease firearm suicides, the effects on total suicides are likely smaller and harder to detect but are fundamentally of greater interest for public policy. For this reason, we examine the effects"] [8.303598403930664, 4.228024959564209, ", and murder or nonnegligent manslaughter. The last category excludes deaths caused by suicide, negligence, or accident, as well as justifiable homicides (such as the killing of a felon by a peace officer in the line of duty) (FBI, 2016e).\nGun polici"] [8.354323387145996, 4.21043062210083, "gency departments for assault; of these, 60,470 (3.8 percent) were firearm-related (CDC, 2017c).6\nUnintentional Injuries and Deaths\nLike official statistics on suicide, those on unintentional injuries and deaths in the United States are compiled by t"] [8.36861801147461, 4.259217739105225, "See Campbell and Nass, 2019.\nIntroduction 9\n 10 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nOften, the attention of researchers, the public, and policymakers is focused on mass shooting inc"] [8.434992790222168, 4.199455738067627, "es with available NVDRS data (Conner et al., 2019). Several years ago, the FBI announced plans to begin a new data collection effort designed to track all incidents in which law enforcement seriously injure or kill citizens (Kindy, 2015), but results"] [8.453235626220703, 4.173545837402344, "in using data on justifiable homicides to understand how specific firearm policies (e.g., stand-your-ground laws) influence defensive gun use because the policies themselves change what is classified as justifiable. The literature on defensive gun us"] [8.575390815734863, 4.081994533538818, "had active licenses to sell firearms in the United States. Just more than 47 percent of these licenses were held by dealers or pawnbrokers, 41 percent were held by collectors,8 about 10 per- cent were held by manufacturers of ammunition or firearms, "] [8.312762260437012, 4.261879920959473, "de Reports,\u201d American Journal of Public Health, Vol. 106, No. 5, May 2016, pp. 922\u2013927.\nBarber, Catherine, and David Hemenway, \u201cToo Many or Too Few Unintentional Firearm Deaths in Official US Mortality Data?\u201d Accident Analysis and Prevention, Vol. 43"] [8.39233112335205, 4.223932266235352, "r, Clayton E., \u201cWhy the FBI\u2019s Justifiable Homicide Statistics Are a Misleading Measure of Defensive Gun Use,\u201d University of Florida Journal of Law and Public Policy, Vol. 27, 2016, pp. 505\u2013514.\nDuwe, Grant, \u201cThe Patterns and Prevalence of Mass Public"] [8.330039024353027, 4.251132011413574, " M., \u201cOn the Sources of Ordinary Science Knowledge and Extraordinary Science Ignorance,\u201d in Kathleen Hall Jamieson, Dan Kahan, and Dietram A. Scheufele, eds., Oxford Handbook of the Science of Science Communication, Oxford, UK: Oxford University Pres"] [8.37822437286377, 4.236038684844971, "creation and Tourism, Lansing, Mich.: Michigan Land Resource Project, Public Sector Consultants, 2001.\nNiforatos, Joshua D., Alexander R. Zheutlin, and Richard M. Pescatore, \u201cPublic Interest in Gun Control in the USA,\u201d Injury Prevention, Vol. 25, Sup"] [8.605831146240234, 4.056595802307129, " National Survey of Fishing, Hunting, and Wildlife-Associated Recreation, Washington, D.C., FHW/16-NAT, April 2018.\nWorld Health Organization, Preventing Suicide: A Global Imperative, Geneva, 2014.\nIntroduction 17\nCHAPTER TWO\nMethods\n In this second "] [8.6141939163208, 4.049216270446777, "luding the White House and other U.S. government organizations, advocacy organizations focused on gun policy (such as the National Rifle Association and the Brady Campaign to Prevent Gun Violence), academic organizations focused on gun policy or gun "] [8.620944023132324, 4.011054515838623, "di- tional policies, programs, or strategies that had been noted by advocacy groups, had been implemented by states, or had garnered media or legislative attention since we assembled the original list. From this updated list, each member of our resea"] [8.682321548461914, 4.048093318939209, ", Papachristos, and Hureau, 2014; Braga and Weisburd, 2012; Braga, Weisburd, and Turchan, 2018). Accordingly, we offer no conclusions on the efficacy of such approaches. However, we recognize the potential importance of these other interventions and "] [8.670931816101074, 4.046010494232178, "ference Service\nSocial Science Abstracts\nEconLit\nBusiness Source Complete\nWorldCat Scopus\nLawReviews (LexisNexis)\nDetails\nNational Library of Medicine\u2019s database of medical literature. Not used for gun industry or hunting searches.\nJournal articles, "] [8.570723533630371, 4.087504863739014, " outcomes included the following:\n\u2022 gun OR guns OR firearm* OR handgun* OR shotgun* OR rifle* OR longgun* OR machinegun* OR \u201cmachine gun*\u201d OR pistol* OR \u201cautomatic weapon\u201d OR \u201cassault weapon\u201d OR \u201csemi-automatic weapon*\u201d OR \u201cautomatic weapons\u201d OR \u201cass"] [8.803266525268555, 3.9917116165161133, "al step, the next steps in the study review process used stan- dardized review criteria to identify all studies with evidence for policy effects meeting minimum evidence standards. Table 2.2 describes our inclusion and exclusion criteria for the titl"] [8.744515419006348, 4.082747459411621, "rm policy, or include quantita- tive analyses. In addition, we excluded studies if they were commentaries or conceptual discussions, systematic reviews or meta-analyses, case studies, dissertations, confer- ence abstracts, legal statutes or congressi"] [8.741893768310547, 4.073286056518555, "nerally requires three types of evidence (Mill, 1843):\n\u2022 The cause and effect regularly co-occur (i.e., association).\n\u2022 The cause occurs before the effect (i.e., precedence).\n\u2022 Alternative explanations for the association have been ruled out (i.e., e"] [8.792366027832031, 4.112669467926025, "imates, standard errors, confidence intervals). One reviewer extracted data of interest from each study and entered them into the standardized form. A second reviewer independently extracted information on estimated effects and checked all other fiel"] [8.771788597106934, 4.079983711242676, "existing literature may have low power, poorly calibrated standard errors and Type 1 error rates, and other problems. Nevertheless, the criteria that we selected for evaluating individual studies represent threats to validity that we could evaluate o"] [8.727751731872559, 4.076359748840332, "of available studies as a whole to make a determina- tion about the level of evidence supporting the effect of the policy on each outcome.\nMethods 29\n30 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun P"] [8.771161079406738, 4.078004360198975, "the estimates are not necessarily identical, they are not independent and thus cannot be combined as a single estimate.\nWhile the selection of p < 0.20 as the criterion for rating evidence as suggestive is arbitrary, this threshold corresponds to eff"] [8.673477172851562, 4.077386379241943, "tinct data sets reflects the fact that many gun policy studies use identical or overlapping data sets (e.g., state homi- cide rates over several years). Chance associations in these data sets are likely to be identified by all who analyze them. There"] [8.607420921325684, 4.157115936279297, "011)\n3 Aneja, Donohue, and Zhang (2011)\n4 Aneja, Donohue, and Zhang (2014)\n5 Anestis and Anestis (2015)\n6 Ayres and Donohue (1999)\n7 Ayres and Donohue (2002)\n8 Ayres and Donohue (2003a)\n9 Ayres and Donohue (2003b)\n10 Ayres and Donohue (2009a)\n11 Ayre"] [8.592822074890137, 4.158802509307861, "l. (2015)\n107 Sen and Panjamapirom (2012)\n108 Shi and Lee (2018)\n109 Siegel et al. (2017b)\n110 Steidley and Kosla (2018)\n111 Strnad (2007)\n112 Swanson et al. (2013)\n113 Swanson et al. (2016)\n114 Vigdor and Mercy (2003)\n115 Vigdor and Mercy (2006)\n116"] [8.383501052856445, 4.317742824554443, "fficer- Involved Shootings\n Mass Shootings\n 79\n 46, 57, 79\n 16, 79\n 72, 79\n 16\n 16, 44, 46\n Unintentional Injuries and Deaths\n 43\n Violent Crime\n 86, 102, 106\n 107, 112, 113\n 28, 100, "] [8.826826095581055, 4.182374000549316, "come of interest was determined. We then used the base rate to transform the regression esti- mate, \u03b2, to an IRR using the following formula:\nIRR = (average base rate+\u03b2). average base rate\nHowever, if the linear model used a logged dependent variable"] [8.59022331237793, 4.16729211807251, "thodological rigor. These limitations in the existing literature led us to pursue a more qualitative evaluation of the conclusions that available studies can support. As more research or relevant databases become available, meta-analyses may become f"] [8.387063026428223, 4.322972297668457, "and Daniel S. Nagin, \u201cDo Right-to-Carry Laws Deter Violent Crime?\u201d Journal of Legal Studies, Vol. 27, No. 1, 1998, pp. 209\u2013219.\nBlau, Benjamin M., Devon H. Gorry, and Chip Wade, \u201cGuns, Laws, and Public Shootings in the United States,\u201d Applied Economi"] [8.29302978515625, 4.312121868133545, "in Permit-to- Purchase Handgun Laws in Connecticut and Missouri on Suicide Rates,\u201d Preventive Medicine, Vol. 79, 2015, pp. 43\u201349.\nCrifasi, Cassandra K., Keshia M. Pollack, and Daniel W. Webster, \u201cEffects of State-Level Policy Changes on Homicide and "] [8.384628295898438, 4.3450541496276855, "European Economic Review, Vol. 81, 2016, pp. 32\u201367.\nDuwe, Grant, Tomislav Kovandzic, and Carlisle E. Moody, \u201cThe Impact of Right-to-Carry Concealed Firearm Laws on Mass Public Shootings,\u201d Homicide Studies, Vol. 6, No. 4, 2002, pp. 271\u2013296.\nEdwards, G"] [8.334614753723145, 4.2356462478637695, "rrok, \u201cUsing Placebo Laws to Test \u2018More Guns, Less Crime,\u2019\u201d Advances in Economic Analysis and Policy, Vol. 4, No. 1, 2004.\nHempstead, Katherine, and Antonio Rodri\u0301guez Andre\u0301s, Gun Control and Suicide: The Impact of State Firearm Regulations, 1995\u201320"] [8.323847770690918, 4.346024036407471, "un Violence 1994\u20132003, Washington, D.C.: National Institute of Justice, 2004.\nKoper, Christopher S., and Jeffrey A. Roth, \u201cThe Impact of the 1994 Federal Assault Weapon Ban on Gun Violence Outcomes: An Assessment of Multiple Outcome Measures and Some"] [8.421097755432129, 4.290160179138184, "2, June 2003, pp. 185\u2013198.\n\u2014\u2014\u2014, \u201cAbortion and Crime: Unwanted Children and Out-of-Wedlock Births,\u201d Economic Inquiry, Vol. 45, No. 2, 2007, pp. 304\u2013324.\nLuca, Michael, Deepak Malhotra, and Christopher Poliquin, The Impact of Mass Shootings on Gun Poli"] [8.441882133483887, 4.203737735748291, "ds 45\n46 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nMorral, Andrew R., Terry L. Schell, and Margaret Tankard, The Magnitude and Sources of Disagreement Among Gun Policy Experts, Santa Moni"] [8.309746742248535, 4.2906975746154785, "Handgun Laws on Crime: Beyond the Dummy Variables,\u201d International Review of Law and Economics, Vol. 23, No. 2, 2003, pp. 199\u2013216.\nRudolph, K. E., E. A. Stuart, J. S. Vernick, and D. W. Webster, \u201cAssociation Between Connecticut\u2019s Permit-to-Purchase Ha"] [8.079544067382812, 4.275758266448975, "4.\nWebster, D., C. K. Crifasi, and J. S. Vernick, \u201cEffects of the Repeal of Missouri\u2019s Handgun Purchaser Licensing Law on Homicides,\u201d Journal of Urban Health, Vol. 91, No. 2, 2014, pp. 293\u2013302.\nWebster, Daniel W., and Marc Starnes, \u201cReexamining the A"] [7.720798492431641, 4.611335277557373, "ons (e.g., age 18 is the minimum legal age for handgun possession at the federal level). Other policies establish mechanisms for the removal of firearms from individuals who are prohibited possessors or expand firearm prohibitions to apply to individ"] [7.729409694671631, 4.604490280151367, "d 22\u201327; 8.4 percent for those aged 28\u201333) (calculated using data from the Centers for Disease Control and Prevention [CDC], 2019a). In theory, therefore, stricter age limits on purchasing or possessing a firearm could reduce the incidence of defensi"] [7.774677753448486, 4.621810436248779, "e retail sources.\nHowever, the effectiveness of minimum age laws is likely to be tempered by the ease with which many youth can obtain firearms from sources other than legal retail- ers. For example, an analysis of data from the National Fatality Rev"] [7.708008289337158, 4.636480808258057, "equently used than long guns in firearm suicides and violent crime, so, in theory, raising the mini- mum age for such weapons could decrease violence without impacting lawful activi- ties, such as hunting (Tritch, 2014). More-restrictive minimum age "] [7.726592540740967, 4.599644660949707, "m age requirements that exceed the federal minimum for handgun possession.3 Several states also have minimums that are higher than the federal law for long gun purchase and possession.\nEight states and the District of Columbia restrict all handgun sa"] [7.715597152709961, 4.623339653015137, "e District of Columbia restrict long gun possession to those aged 21 or older.8 The minimum age for possession of a long gun in Alaska, Minnesota, and New York is 16,9 and it is 14 in Montana.10\nEffects on Suicide\nResearch Synthesis Findings\nWe ident"] [7.714855670928955, 4.6048431396484375, "un possession that were in place prior to the 1994 federal minimum age restriction, (2) state laws prohibiting juvenile handgun possession enacted the same year as the 1994 federal minimum age restriction, and (3) the federal ban on juvenile handgun "] [7.71175479888916, 4.618946075439453, "empirical model but focusing on suicides by males and the 1995 to 2004 period after the federal minimum age law, Andre\u0301s and Hempstead (2011)\nassessed how state bans on the purchase of firearms by minors affected suicide rates in four age groups (15\u2013"] [7.697803974151611, 4.630131244659424, "ne that raised its minimum age for posses- sion did so the same year it implemented a minimum purchase law, making the effects of these laws confounded. Moreover, the statistical model had an unfavorable ratio of covariates to observations (less than"] [7.7356343269348145, 4.615756988525391, " passage of the background check law. Conversely, an effect size of more than 1.00 indicates that the law appears to increase the outcome by a factor equivalent to the effect size value. When the CIs do not include the value of 1.00, the estimated ef"] [7.7150726318359375, 4.615061283111572, "s by minors were associated with significantly lower rates of suicide among males aged 15\u201344.\nConsidering these findings and an assessment of the relative strengths of these studies, we find inconclusive evi- dence for how minimum age requirements fo"] [7.69413948059082, 4.631784439086914, "8 to 1999. Using fixed-effects models that controlled for national trends, average state effects, a lag of the dependent variable, and state-specific linear trends, the author jointly exam- ined the effects of (1) state laws prohibiting juvenile hand"] [7.712571620941162, 4.609293460845947, " the study period; in addition, every state but one that raised its minimum age for possession did so the same year it implemented a minimum purchase age law, making the effects of these laws confounded. Moreover, the statistical model had an unfavor"] [7.696390151977539, 4.634617328643799, " these results, and in consid- eration of the relative strengths of these studies, we find inconclusive evidence for how minimum age requirements for pur- chasing a firearm affect total and firearm homicides.\nMinimum age requirements for possessing a"] [7.693017959594727, 4.635412216186523, "3.\nFigure 3.3\nIncidence Rate Ratios Associated with the Effect of Minimum Age Requirements on Unintentional Injuries and Deaths\nNOTE: IRR values marked with blue squares indicate that methodological concerns are discussed in the text. See Appendix B "] [7.686431884765625, 4.645875453948975, "e.g., on how these policies were coded), it is clear that the analysis used a linear model to pre- dict a rare dichotomous outcome. Therefore, model assumptions were likely violated, making model estimates and CIs unreliable.\nFigure 3.4 displays the "] [8.091702461242676, 4.455223083496094, "web/ncipc/mortrate.html\nDuda, M. D., and K. C. Young, Factors Related to Hunting and Fishing Participation in the United States, Harrisonburg, Va.: Responsive Management, report for the U.S. Fish and Wildlife Service, Grant # 14-48-0009-92-1252, 1993"] [8.125788688659668, 4.403290271759033, "vior, Vol. 4, No. 1, 1999, pp. 59\u201375.\nOffice of Juvenile Justice and Delinquency Prevention, OJJDP Statistical Briefing Book, Washington, D.C.: U.S. Department of Justice, May 25, 2016.\nPuzzanchera, C., G. Chamberlin, and W. Kang, \u201cEasy Access to the"] [7.807309627532959, 4.299423694610596, " Young People in California: Descriptive Epidemiology and Gun Ownership,\u201d Journal of Adolescent Health, Vol. 43, No. 6, 2008, pp. 619\u2013622.\nMinimum Age Requirements 71\nCHAPTER FOUR\nProhibitions Associated with Mental Illness\n Federal law prohibits the"] [7.844851016998291, 4.176984786987305, "The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nEpidemiological evidence suggests that a diagnosis of mental illness alone has little relation to risk of interpersonal violence (Swanson et al.,"] [7.823531150817871, 4.197139263153076, "s than perpetrators of violence (Desmarais et al., 2014). One study of persons with severe mental illness (in treatment at mental health agencies in Chicago) found that their annual exposure to violent crime victimization was more than four times hig"] [7.816747188568115, 4.188330173492432, "suggests that some of these suicides might have been prevented if this population had been prohibited from obtaining a firearm.\nTo assess the effects of expanded mental health\u2013related prohibitions, the ideal data would distinguish outcomes between th"] [7.835873603820801, 4.2236409187316895, "or example, Alabama prohibits \u201canyone of unsound mind\u201d from owning, possessing, or controlling a fire- arm. Arkansas prohibits those adjudicated as \u201cmentally ill,\u201d and Illinois\u2019 law applies to anyone adjudicated to have a \u201cmental disability.\u201d See Ala"] [7.837932109832764, 4.18243408203125, "ealth\u2013related prohibitions on suicide. Examining state-level data from 1995 to 2004, Andre\u0301s and Hempstead (2011) assessed how men\u2019s suicide rates were related to different categories of firearm restrictions, including prohibitions for persons with a"] [7.838809013366699, 4.059807777404785, "r regression models included state-level time-varying covariates, state-level suicide rates in 1990, and fixed effects for year and census subregion. Sen and Panjamapirom (2012) found that, compared with back- ground checks that investigate only crim"] [7.850172519683838, 4.096753120422363, "associated with mental illness can reduce total suicides and firearm suicides. A third study reported finding no effect of expanded NICS reporting for mental illness\u2013related prohibitions on suicide but did not provide detailed results.\nConsidering th"] [7.83502721786499, 4.081454753875732, "13) obtained data from 2002 to 2009 for individuals in Connecti- cut who had been hospitalized for schizophrenia, bipolar disorder, or major depressive disorder. The authors estimated changes in violent crime arrests for individuals with at least one"] [7.840433120727539, 4.164143085479736, "sed in the text. See Appendix B for details.\nProhibitions Associated with Mental Illness 81\n Conclusions\nWe identified two qualifying studies that estimated how laws prohibiting gun purchases by those with a mental illness affect violent crime or ho"] [8.262130737304688, 4.187375068664551, "y Support Fund, \u201cMass Shootings in the United States: 2009\u20132017,\u201d December 6, 2018. As of May 15, 2019: http://everytownresearch.org/reports/mass-shootings-analysis/\nFederal Bureau of Investigation, \u201cFederal Denials: Reasons Why the NICS Section Deni"] [7.848820209503174, 4.178459167480469, "., and A. Panjamapirom, \u201cState Background Checks for Gun Purchase and Firearm Deaths:\nAn Exploratory Study,\u201d Preventive Medicine, Vol. 55, No. 4, 2012, pp. 346\u2013350.\nSubstance Abuse and Mental Health Services Administration, Results from the 2017 Nati"] [7.651023864746094, 4.308387279510498, "ciety more broadly. In 1994, Congress enacted the Violent Crime Control and Law Enforcement Act (Pub. L. 103-322), making it illegal to pos- sess or receive a firearm while subject to a nontemporary restraining order protecting an intimate partner or"] [7.653542518615723, 4.300945281982422, "idents are killed by their unmarried partner. In 2008, the pro- portion of intimate partner homicides committed by a spouse (46.7 percent) was nearly equal to the proportion committed by a boyfriend or girlfriend (48.6 percent) (Cooper and Smith, 201"] [7.705085277557373, 4.302717685699463, "e to keep guns illegally.\nDomestic violence\u2013related firearm laws may also affect suicide rates. Research suggests that intimate partner homicides in which firearms are the primary weapon are more likely to result in the suicide of the perpetrator tha"] [7.65933895111084, 4.303694725036621, "ith firearms (Hemenway et al., 2019a).\nAlternatively, the process or threat of removing a firearm may increase tensions in a domestic violence situation, which may increase the risk of violence to the victim, officers responding to the situation, and"] [7.683351993560791, 4.348138809204102, "rth Dakota, Ohio, Oregon, Pennsyl-\n Prohibitions Associated with Domestic Violence 89\npossession when an order is issued ex parte.3 Twenty-eight states have expanded the applicability of the DVRO firearm prohibition beyond the definition in federal l"] [7.696534156799316, 4.351129055023193, " 30-7-16; N.Y. Crim. Proc. Law \u00a7 530.11; N.C. Gen. Stat. \u00a7 50B-1(b); N.D. Cent. Code \u00a7 14-07.1-01.4; Ore. Rev. Stat. \u00a7135.230; 23 Pa. Cons. Stat. Ann. \u00a7 6102(a); R.I. Gen. Laws \u00a7 15-15-1(10); S.D. Codified Laws \u00a7 25-10-3.1(2); Tenn. Code Ann. \u00a7 36-3-"] [7.661088943481445, 4.306225776672363, "aler, he or she should be unable to complete the purchase. At least one state\u2019s laws require notifying the person who filed the restraining order or was the victim of the misdemeanor crime of domestic violence that the abuser attempted to purchase a "] [7.711580753326416, 4.2657647132873535, "cioeconomic and demo- graphic variables, and hunting licenses per capita, the authors found that prohibitions related to domestic violence conviction were associated with significantly lower rates of suicide among men aged 45\u201364; the estimated relati"] [7.66747522354126, 4.30427360534668, " violence have\n uncertain\neffects on total and firearm suicides.\nEvidence for this relationship is\ninconclusive.\n Prohibitions Associated with Domestic Violence 93\nEffects on Violent Crime\nResearch Synthesis Findings\nWe identified six qualifying stud"] [7.655501365661621, 4.319756507873535, "sian (2016) examined the 1996 Lautenberg Amendment, federal legislation that extended prohibited-possessor status to those convicted of misdemeanor domestic violence offenses and that stipulated a mechanism for requiring that they surrender all firea"] [7.638662338256836, 4.307688236236572, " of misdemeanor crimes of domestic violence; (3) prohibitions against persons convicted of misdemeanor stalking; and (4) laws designating some stalking crimes as felonies, which could serve to prohibit firearm purchase and possession for domestic vio"] [7.674186706542969, 4.28079891204834, " for year and census subregion fixed effects, baseline state suicide rates, and numerous state-level time-varying covariates, the authors found that checks on restraining orders were associated with significantly reduced rates of total and firearm ho"] [7.710529327392578, 4.273636817932129, "\nEvidence for this relationship is\nmoderate.\n 98 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nstantially similar data sets with largely overlapping time periods. One additional study used a "] [7.693699836730957, 4.289120674133301, "es (Zeoli et al., 2018). Considering these results, we find that there is inconclusive evidence for how state firearm prohibitions associated with stalking convictions influence firearm-related intimate partner homicides, and there is limited evi- de"] [7.848863124847412, 4.295773506164551, "ez, Carolina, Rachel P. Kurland, Emily F. Rothman, Megan Bair-Merritt, Eric Fleegler, Ziming Xuan, Sandro Galea, Craig S. Ross, Bindu Kalesan, Kristin A. Goss, and Michael Siegel, \u201cState Intimate Partner Violence\u2013Related Firearm Laws and Intimate Par"] [7.892604827880859, 4.304795265197754, "cides?\u201d Journal of Policy Analysis and Management, Vol. 35, No. 1, Winter 2016, pp. 67\u201393.\nSaltzman, Linda E., James A. Mercy, Patrick W. O\u2019Carroll, Mark L. Rosenberg, and Philip H. Rhodes, \u201cWeapon Involvement and Injury Outcomes in Family and Intima"] [7.652254104614258, 4.341032981872559, "icies, Alcohol Taxes and Police Staffing Levels on Intimate Partner Homicide in Large U.S. Cities,\u201d Injury Prevention, Vol. 16, No. 2, 2010, pp. 90\u201395.\nCHAPTER SIX\nSurrender of Firearms by Prohibited Possessors\n Federal law bans the sale of firearms "] [7.692185878753662, 4.306710720062256, "s stipulate roles for judicial officers or law enforcement to ensure that firearms are surrendered or confiscated. In addition, 29 states require the surrender of firearms pursuant to domestic violence restraining orders, to last for the duration of "] [7.65359354019165, 4.327674388885498, "800. Upon a showing by clear and convincing evidence that a party has used, displayed, or threatened to use a firearm or other dangerous weapon in a felony or is ineligible to pos- sess a firearm under \u00a7 9.41.040, the court shall require that the par"] [7.642101287841797, 4.343337535858154, " restraining orders or those convicted of misdemeanors. Among the policies they examined were state laws allow- ing police to confiscate firearms from a domestic violence incident (they simultaneously examined state laws that allow police to make war"] [7.658512592315674, 4.300646781921387, "equirements for firearm relinquishment. Using data from 1991 to 2015 and negative binomial regression models with controls for the lagged inti- mate partner homicide rate, national trends, and region fixed effects, the authors found that the effects "] [7.654101371765137, 4.282289028167725, "omicides and firearm intimate partner homicides to be uncer-\ntain. Additional analyses by Vigdor and\nMercy (2006) that focused on other\ntypes of violent crime found signifi-\ncant effects of confiscation laws indicat-\ning that they increase assaults, "] [7.437053680419922, 4.290658950805664, "vels on Intimate Partner Homicide in Large U.S. Cities,\u201d Injury Prevention, Vol. 16, No. 2, 2010, pp. 90\u201395.\nCHAPTER SEVEN\nExtreme Risk Protection Orders\n Extreme risk protection order (ERPO) laws, sometimes known as gun violence restraining order or"] [7.422550678253174, 4.286876201629639, "le individuals to petition for an ERPO in emergency cases without waiting to provide notice of a hearing to the respondent. Like ex parte orders related to domestic violence (see Chapter Five), these laws are designed for situations in which the wait"] [7.427519798278809, 4.286031723022461, "their behavior rather than relying on specific criminal or mental health histories, then ERPO laws could decrease suicides and homicides among this population over and above the suicides and homicides prevented by existing prohibited purchaser laws ("] [7.415937423706055, 4.287095069885254, "ition for an ERPO to law enforcement officers. However, some laws extend that right to family members and medical professionals. In general, by expanding the ability to request an ERPO to family members and others with knowledge of the high-risk indi"] [7.440438747406006, 4.286654472351074, "l event. How- ever, applying information on suicide case fatality rates by method and assuming a counterfactual pre-intervention probability of using a gun in a suicide attempt that was informed by the relationship between state-level gun ownership a"] [7.445359706878662, 4.279648303985596, "7-2510.04.\n3 California, Colorado, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, Oregon, and Washington. See Calif. Penal Code \u00a7 18150; Colo. Rev. Stat. \u00a7 13-14.5-104; Del. Code Ann. Tit. 10, \u00a7 7701, 7704 (family and hous"] [7.461786270141602, 4.285738945007324, " date in 1999 and the second of which is stated to correspond with enhanced enforcement of the law following the Virginia Tech mass shooting in 2007.\nBased on the 1999 enactment date of Connecticut\u2019s ERPO law, the analyses showed small and uncertain "] [7.432157039642334, 4.274782180786133, "res indicate that methodological concerns are discussed in the text. See Appendix B for details.\nConclusions\nOne study that examined the effects of ERPOs on suicide rates generated mixed find- ings. Specifically, Kivisto and Phalen (2018) found a sug"] [8.22094440460205, 4.25071907043457, "irsch, Charles M. Belden, Michael A. Norko, Allison G. Robertson, Linda K. Frisman, Hsiu-Ju Lin, Marvin S. Swartz, and George F. Parker, \u201cCriminal Justice and Suicide Outcomes with Indiana\u2019s Risk-Based Gun Seizure Law,\u201d Journal of the American Academ"] [7.982597827911377, 4.211298942565918, "ew, eight operate by establishing restrictions or requirements on the sales and transfers of firearms in legal markets. Each policy is reviewed in the subsequent chap- ters in Part C, as follows:\n\u2022 background checks (Chapter Eight)\n\u2022 licensing and pe"] [7.9254631996154785, 4.1743550300598145, "y individuals who already own a fire-\n1 The Bureau of Alcohol, Tobacco, and Firearms (2002, p. A-3) defined crime gun as \u201cany firearm that is ille- gally possessed, used in a crime, or suspected to have been used in a crime. An abandoned firearm may "] [7.831691265106201, 4.089111328125, "disqualifi- cations for high-risk individuals and whether these disqualifications correctly target individuals who present greater danger to themselves or others. As of December 2018, the Federal Bureau of Investigation (FBI)\u2019s National Instant Crimi"] [7.860306262969971, 4.160187721252441, "ome cases (e.g., restraining orders), an individual may be only temporarily prohibited from possessing a firearm, and, in the case of crime outcomes, details on the criminal offender can be known only if the perpetrator is known. (See the discussion "] [7.91942834854126, 4.202926158905029, "\u00a7 202.254; N.M. Stat. Ann. 1978, \u00a7 30-7-7.1; N.Y. Gen. Bus. Law \u00a7\u00a7 897, 898; Ore. Rev. Stat. \u00a7 166.435; R.I. Gen. Laws \u00a7 11-47-35; 13 Vt. Stat. Ann. \u00a7 4019; Wash. Rev. Code Ann. \u00a7 9.41.113; D.C. Code Ann. \u00a7\u00a7 7-2502.01, 7-2502.03.\n3 Calif. Penal Code "] [7.895033836364746, 4.0505290031433105, "itation of the Ludwig and Cook (2000) study is that it had an unfavorable ratio of estimated parameters to observations (less than one to six), meaning it could have mis- leading parameter estimates and confidence intervals (CIs) due to model overfit"] [7.867957592010498, 4.058351516723633, "esis of Research Evidence on the Effects of U.S. Gun Policies\nlower firearm suicide and total suicide rates. Sen and Panjamapirom\u2019s estimates sug- gest the post-policy firearm suicide rate to be 96 percent of the expected rate had this policy not bee"] [7.865612983703613, 4.059185981750488, "es likely are not reliable.\nFinally, Kagawa et al. (2018) used synthetic control methods to estimate how suicide rates were affected by the 1998 repeals of comprehensive background check laws in both Indiana and Tennessee. For each state separately, "] [7.857541561126709, 4.055854320526123, " in many states when the Brady Act was implemented. The second study, Sen and Panjamapirom (2012), examined components of background checks, finding significant effects indicating that checks on mental illness and checks on fugitive status reduce tot"] [7.857149124145508, 4.043776988983154, " on the Effects of U.S. Gun Policies\nEffects on Violent Crime\nResearch Synthesis Findings\nOf studies that examined the relationship between background checks and violent crime, we identified 14 that met our inclusion criteria.13 Ludwig and Cook (2000"] [7.845473766326904, 4.044134616851807, "ividuals with a felony arrest and did not provide evidence for background checks per se.\n14 Ludwig and Cook (2000) also tested the effects of background checks specifically (separate from waiting periods, which were also imposed by the Brady Act) by "] [7.848971366882324, 4.053371429443359, "ffects of the types of background checks conducted by states on homicides. They noted that the supply of state and local records to the NICS is voluntary and that substantial variation exists in state laws regarding the categories of records included"] [7.8358330726623535, 4.079153060913086, " ratio of estimated parameters to observa- tions (less than one to ten), meaning the estimated effects and significance values may be inaccurate because of model overfitting. Examining a shorter time frame (1979 to 1998) and using negative binomial m"] [7.858725547790527, 4.042957782745361, "mes as involv- ing firearms (Swanson et al., 2016).\nSince the first edition of this report, four more studies provide mixed evidence for the effect of background checks on violent crime, although the studies adopt different policy definitions or clas"] [7.873578071594238, 4.075078010559082, "eal of the background check law. The authors found uncertain effects for both policies on firearm homicide rates, while the estimate from Indiana showed that the repeal was associated with a significant increase in nonfirearm homi- cide rates. Althou"] [7.840527057647705, 4.032416343688965, "ing evidence on the effects of background checks, or some component of background checks, on violent crime. Six of these studies provided an overall effect of either dealer background checks or private-seller background checks on total homicide rates"] [7.862104892730713, 4.042652606964111, "ects on violent crime and total homicides.\nEvidence for this relationship is\nBackground Checks 139\n Background checks have\nuncertain\ninconclusive.\n decrease\nfirearm homicides.\nPrivate-seller background checks have\nuncertain\neffects on firearm"] [7.950466632843018, 4.124605655670166, "aws and the probability of at least one mass shooting event occurring (see Figure 8.3). However, assessing the effects of gun policies on mass shoot- ings was not the primary focus of the study, and the authors intended the estimates to serve solely "] [7.872623920440674, 4.060521125793457, "ion over the study period), and because the models did not control for other potential differences across states, the authors\u2019 estimates most likely reflect differences between states that have the laws and states that do not rather than differ- ence"] [7.8448076248168945, 4.038365840911865, "characteristics and potential proxy indicators of gun trafficking (e.g., the number of Bureau of Alcohol, Tobacco, Firearms and Explosives [ATF] gun traces linked back to a given FFL) and (2) dealer dropout rates during a period of reforms to the fed"] [8.329808235168457, 4.29582405090332, "rujillo-Baute, \u201cHow Do US State Firearms Laws Affect Firearms Manufacturing Location? An Empirical Investigation, 1986\u20132010,\u201d Journal of Economic Geography, Vol. 17, No. 4, 2017, pp. 753\u2013790.\nBuchanan, Larry, Josh Keller, Richard A. Oppel, Jr., and D"] [8.101299285888672, 4.134023666381836, "lia, Jon S. Vernick, Daniel Webster, Cassandra Crifasi, Kara E. Rudolph, Magdalena Cerda\u0301, Aaron Shev, and Garen J. Wintemute, \u201cRepeal of Comprehensive Background Check Policies and Firearm Homicide and Suicide,\u201d Epidemiology, Vol. 29, No. 4, 2018, p"] [7.92037296295166, 4.177368640899658, "\u201d Preventive Medicine, Vol. 55, No. 4, 2012, pp. 346\u2013350.\nSwanson, Jeffrey W., Michele M. Easter, Allison G. Robertson, Marvin S. Swartz, Kelly Alanis- Hirsch, Daniel Moseley, Charles Dion, and John Petrila, \u201cGun Violence, Mental Illness, and Laws Th"] [7.986944675445557, 4.283416271209717, "a firearm, and the policies could facilitate firearm removal from owners who become ineligible. Requiring permits to purchase ammunition makes it more difficult for prohibited possessors to use their illicit firearms. Where no such checks occur, proh"] [8.009427070617676, 4.323285102844238, "arm. Azrael et al. (2017) found that, on average, gun owners had close to five firearms each, and a large majority (62 percent) purchased their most recent weapon from a licensed gun dealer. For those who already own guns, licensing and permitting re"] [7.984408378601074, 4.237574100494385, " crime through dis- rupting illegal firearm trafficking, causal inference could be strengthened by exam- ining crime gun trace data and changes in homicide rates.2 Specifically, if permit-to- purchase laws restrict trafficking operations from in-stat"] [7.90979528427124, 4.314228534698486, "strict of Columbia have implemented licensing or permitting regimes for all firearms,9 and seven states have done so for handguns.10 Michigan\u2019s law has a broad exemption for individuals who purchase handguns from licensed dealers following a backgrou"] [7.991991996765137, 4.376065254211426, "\u00a7 2C:58-3.\n16 R.I. Gen. Laws \u00a7 11-47-35.\n17 Hawaii Rev. Stat. \u00a7 134-2; N.J. Stat. Ann. \u00a7 2C:58-3; N.C. Gen. Stat. \u00a7 14-403 (handguns only).\n18 Connecticut, Illinois, Massachusetts, New Jersey, and the District of Columbia. See Conn. Gen. Stat.\n\u00a7\u00a7 29-"] [7.953995227813721, 4.285163402557373, "percentage change in total suicide and firearm suicide in Connecticut before and after the state established a permit-to-purchase law in 1995, as well as before and after the repeal of Missouri\u2019s permit-to-purchase law in 2007. This approach enabled "] [7.925442695617676, 4.280263423919678, ". Therefore, the estimates reported in Crifasi et al. (2015) may not be reliable indicators of the direction or magnitude of the true effects of permit-to-purchase laws on suicide.\nFinally, a 2017 study of waiting periods and background checks includ"] [7.933847427368164, 4.299917697906494, "s were associated with significantly reduced rates of total and firearm suicides for adults aged 21 or older.\nConsidering these studies, we find limited evidence that licensing and permitting requirements decrease total suicides and firearm suicides "] [7.993612766265869, 4.300989151000977, " law in this study, it is not possible to conclude that the changes were a result of the permit-to-purchase por- tion of the law as opposed to other factors influencing homicides in the state around the same time.\nCrifasi, Pollack, and Webster (2016)"] [7.958400726318359, 4.2705206871032715, "). Both studies that examined total homicide rates\u2014either among adults aged 21 or older or among intimate partners\u2014found uncertain effects of the laws. The same two studies also found uncertain effects for firearm-specific homicides among the populat"] [7.980981826782227, 4.283955097198486, "0.85, 1.39] 0.95 [0.62, 1.12] 0.60 [0.22, 0.98] 1.01 [0.90, 1.12]\n1.04 [0.85, 1.28] 1.06 [0.83, 1.37]\n0.45 [0.10, 2.08]\n0.20 [0.02, 1.90] 1.67 [0.18, 15.18]\n0.86 [0.82, 0.90] 1.04 [0.97, 1.13]\n1.17 [1.12, 1.22] 1.28 [1.22, 1.34] 0.96 [0.87, 1.05]\n1.2"] [7.976702690124512, 4.29130744934082, " yielded two studies that met our inclusion criteria and examined the effects of licensing and permitting requirements on mass shootings in the United States.20 Using a two-way fixed-effects linear probability model, Luca, Malhotra, and Poliquin (201"] [7.993774890899658, 4.310966491699219, "tes (i.e., population size and aggregated personal income). The authors found uncertain effects of permit-to- purchase regimes on the likelihood of a public shooting event. Although their esti- mates of the effect of permit requirements for firearm o"] [7.9499993324279785, 4.280005931854248, " examined how a policy index that captured the stringency of state laws regarding comprehensive background checks and permit-to-purchase requirements related to variation in the number of firearm manufacturing plants in a state and the number of back"] [8.321435928344727, 4.269649028778076, "\nBraga, Anthony A., Garen J. Wintemute, Glenn L. Pierce, Philip J. Cook, and Greg Ridgeway, \u201cInterpreting the Empirical Evidence on Illegal Gun Market Dynamics,\u201d Journal of Urban Health, Vol. 89, No. 5, 2012, pp. 779\u2013793.\nBrauer, Jurgen, Daniel Monto"] [7.749129772186279, 3.9731369018554688, "ell, Terry L., Beth Ann Griffin, and Andrew R. Morral, Evaluating Methods to Estimate the Effect of State Laws on Firearm Deaths: A Simulation Study, Santa Monica, Calif.: RAND Corporation, RR-2685-RC, 2018. As of October 1, 2019: https://www.rand.or"] [7.70283842086792, 3.9216737747192383, " self-harm, giving angry or distraught buyers time to \u201ccool off\u201d or gain perspective. While it is plausible that this cooling-off period could reduce impul- sive interpersonal gun violence, some evidence exists for the potential effects of this mecha"] [7.811837196350098, 4.051218032836914, "crime (Webster and Wintemute, 2015; Braga et al., 2012).2 However, a series of provisions attached to Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) appropriations (com- monly known as the Tiahrt Amendments) has denied most researchers acc"] [7.7077507972717285, 3.9365885257720947, " present elevated risk of violence. As discussed in Chapter Eight, the major- ity of prohibited possessors who perpetrate gun violence acquire their firearms from social acquaintances or the black market; thus, a large portion of violent gun crime is"] [7.684587478637695, 3.9118363857269287, " such policy heterogeneity will depend on the extent to which different types of firearms are substitutes and the marginal effect of requiring an additional day or days of delay before transfer can occur. State waiting-period laws applying to only a "] [7.708450794219971, 3.9238638877868652, "rates before and after the implementation of the Brady Act in 1994, which initially imposed waiting periods and background checks for purchases from licensed firearm dealers. When the Brady Act was implemented, 18 states and the District of Columbia "] [7.691632270812988, 3.9168622493743896, "des and with suggestive negative effects on total suicides, and longer waiting periods (one week or more) showed some evidence of larger effects.8 Although the authors\u2019 preferred model with quadratic state-specific trends had poten- tial issues with "] [7.704274654388428, 3.9230117797851562, "a decline in firearm suicide induced by the waiting-period law might have reduced suicide attempts by other lethal means.\n Figure 10.1\nIncidence Rate Ratios Associated with the Effect of Waiting Periods on Suicide\nNOTE: IRR values marked with blue sq"] [7.687110900878906, 3.9047019481658936, " of the true causal effects of the laws.\nWe identified five studies that specifically examined the effect of waiting periods on violent crime. Mustard (2001) evaluated how waiting-period and shall-issue laws (see Chapter Eighteen) affect felonious de"] [7.689583778381348, 3.9080259799957275, "uicides as a proxy for state-level firearm prevalence, and other state-level factors. The authors found that waiting periods were associated with a suggestive negative effect on homicides. Using data over a longer time frame (1990 to 2013), linear mo"] [7.686642646789551, 3.91292142868042, "ds 177\n Evidence for this relationship is\nmoderate.\n Firearm homicides. We identified five qualifying studies that examined the effects of waiting periods on firearm homicide rates, but we discount the evidence provided by one (Ludwig and Cook, 2"] [7.6788554191589355, 3.9081456661224365, "se laws may be poor indicators of their true effects. In addition, the model did not adjust for clustered standard errors. Together, these shortcomings suggest that the model results may not accurately describe the true effects of waiting periods.\nUs"] [7.677031993865967, 3.912700653076172, " waiting-period law\nincreasing the incidence of mass shoot-\nings. However, estimates in the same\nmodel also showed a suggestive effect\nof waiting-period length on decreasing\nthe incidence of mass shootings, which\ncomplicates interpretation of the ove"] [7.67680549621582, 3.9068965911865234, ". Because Glaeser and Glendon (1998) separately estimated the effects of waiting periods for those with and without a prior arrest history, we do not include effect sizes for this study in the figure.\nFigure 10.4\nIncidence Rate Ratios Associated with"] [8.286524772644043, 4.23550271987915, "mphis, Tennessee, Washington, D.C.: U.S. Department of the Treasury, July 2002.\nCook, P. J., and Jens Ludwig, \u201cThe Effect of the Brady Act on Gun Violence,\u201d in B. Harcourt, ed., Guns, Crime, and Punishment in America, New York: New York University Pr"] [8.289587020874023, 4.261102199554443, "he United States: The Importance of Attending to Method in Understanding Population-Level Disparities in the Burden of Suicide,\u201d Annual Review of Public Health, Vol. 33, 2012, pp. 393\u2013408.\nMiller, M., D. Hemenway, and D. Azrael, \u201cFirearms and Suicide"] [8.085522651672363, 4.3839006423950195, "r before being permitted to operate one. However, detrac- tors of the laws suggest that such regulations create unwarranted costs and barriers to firearm ownership and that such ownership should not be made conditional on train- ing (Cole, 2014).\nFir"] [8.061266899108887, 4.399338245391846, "ining (in which 80 percent of training courses covered proper gun storage) were significantly more likely to store their fire- arms loaded and unlocked compared with gun owners who had not received formal training; however, the most common source of "] [8.106945991516113, 4.362652778625488, "orage practices might be more likely to change the behavior of gun owners than are noncredible messengers who promote safe storage.\nMore research is needed to understand the relationship between safety training and changes in firearm owners\u2019 safety b"] [8.153351783752441, 4.474908351898193, "e sort of firearm train- ing, either in a formal course or through some other setting, such as through military service. This includes jurisdictions with \u201cmay-issue\u201d9 or \u201cshall-issue\u201d concealed-carry laws.10 See Chapter Eighteen for further informati"] [8.104063987731934, 4.409356117248535, "v. Stat. \u00a7 237.110(4)(i); Mich. Comp. Laws Ann. 28.425b; Minn. Stat. \u00a7 624.714, Subd. 2; Mont. Code Ann. 45-8-321(3); Neb. Rev. Stat. \u00a7 69-2429(6); Nev. Rev. Stat. 202.3657(3)(c); N.M. Stat. Ann. 1978, \u00a7 29-19-4A(10); N.C. Gen. Stat. Ann. \u00a7 14-415.12"] [8.102334976196289, 4.370115756988525, "mponent effect of these\nlaws. Considering the methodologi-\ncal concerns with this single study, we\nfind inconclusive evidence for the effect of firearm safety training requirements on total homicides.\nFirearm safety training requirements have\n uncer"] [8.11646556854248, 4.311335563659668, "ovide standard errors, test statistics, or exact p-values, so we do not interpret this evidence for this review.\nFirearm Safety Training Requirements 191\n 192 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S."] [8.0556001663208, 4.208322048187256, " There is no federal law requiring individuals to report lost or stolen firearms.\nIn 2018, federally licensed firearm dealers reported 14,738 firearms (includ- ing pistols, rifles, shotguns, revolvers, and machine guns) as lost or stolen from their p"] [8.039358139038086, 4.186556816101074, "able to prohibited possessors or to individuals seeking to obtain firearms for criminal purposes. Thus, to estimate how requirements for reporting lost or stolen firearms affect such outcomes as violent crime, we might first examine to what extent su"] [7.999717712402344, 4.214659214019775, ".4\nOutcomes Without Studies Examining the Effects of Lost or Stolen Firearm Reporting Requirements\nWe did not identify any research that met our inclusion criteria and examined the relationship between required reporting of lost or stolen firearms an"] [7.996395587921143, 4.199344158172607, "ence, undated-e).\nThere is also no federal firearm registration system, which we define as a record- keeping system controlled by a government agency that both stores the names of current owners of each firearm of a specific class and requires that t"] [7.981147289276123, 4.204038143157959, "rohibited pos- sessors. For instance, California, which has a firearm registration system, passed Proposition 63 in 2016. The law, among other things, requires courts to search Cali- fornia\u2019s centralized records of firearm sales and transfers wheneve"] [7.968996047973633, 4.317010402679443, "umbia, all private sales are completed through dealers, who maintain records of all sales.7 Furthermore, seven states require licensed dealers to maintain records of handgun sales,8 and three states require private sellers to do so.9\nSome states have"] [7.9792375564575195, 4.216733932495117, "nt agency. Four of these states require records of all sales to be transmitted, includ- ing those by licensed dealers and private sellers.11 Similarly, the District of Columbia\u2019s registration requirement gives law enforcement access to all sales reco"] [8.026430130004883, 4.280370712280273, "2p(a)\n(1), 53-202q; Hawaii Rev. Stat. Ann. \u00a7\u00a7 134-3(a), (b), 134-4; Md. Code Ann., Crim. Law \u00a7 4-303; N.J. Stat. Ann. \u00a7\u00a7 2C:39-5f, 2C:58-12; N.Y. Penal Law \u00a7\u00a7 265.00(22)(e)-(f), 265.00(23), 400.00(10), (16-a), 400.02.\n Firearm Sales Reporting, Record"] [8.079241752624512, 4.280201435089111, "ts of U.S. Gun Policies\nies for firearm prevalence. Models showed a large and significant negative relation- ship between registration laws and NICS background checks for firearm purchases. However, insufficient information was provided in the paper "] [8.268776893615723, 4.419483661651611, "ational Rifle Association, Institute for Legislative Action, \u201cNew Zealand Experience Further Proves Registration Facilitates Confiscations,\u201d July 8, 2019b.\nSteidley, Trent, and Martin T. Kosla, \u201cToward a Status Anxiety Theory of Macro-Level Firearm D"] [8.247259140014648, 4.43510627746582, " as semiautomatic firearms that have at least two of a designated list of features (27 C.F.R. 478.11). In contrast, fully automatic weapons (i.e., machine guns) can produce continuous fire by a single trigger function without manual reloading, and th"] [8.273517608642578, 4.43230676651001, "percent) involved an assault weapon or high- capacity magazine, resulting in 155 percent more injuries and 47 percent more fatali- ties compared with other incidents (Everytown for Gun Safety Support Fund, 2017b). In a 2018 update to the same analysi"] [8.230341911315918, 4.427492141723633, "nerating market effects for ancillary gun companies that produce or sell certain replacement parts, accessories, or specialized magazines and precision barrels used primarily for sport shooting.\nOverall, the effects of these policies will depend larg"] [8.246477127075195, 4.433925628662109, "tate law and to be therefore banned.4 For exam- ple, the law states that a \u201csemiautomatic, centerfire rifle that has the capacity to accept a detachable magazine\u201d is an assault weapon if it also contains any of the following fea- tures: \u201c(A) a pistol"] [8.242695808410645, 4.414859294891357, " high-capacity magazines for pistols.14 The rest ban high- capacity magazines for all firearms,15 although there are differences in definition here too. California, Connecticut, Hawaii, Maryland, Massachusetts, New Jersey, New York, and the District "] [8.212301254272461, 4.449263095855713, "ed how bans on high-capacity maga- zines affect firearm homicide rates (Moody and Marvell, 2018b). Using a log-linear model with two-way fixed effects, the authors used a hybrid policy specification to esti- mate the joint effect of law passage on th"] [8.304336547851562, 4.414403438568115, "e of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nEffects on Mass Shootings\nResearch Synthesis Findings\nWe identified four studies that met our inclusion criteria and estimated the effects of state or fede"] [8.276106834411621, 4.478522777557373, "hether a mass shooting occurred in a given state-year. In con- trast to Gius (2015c), Luca, Malhotra, and Poliquin (2016) did not control for the\n18 The author found a large and statistically significant association between implementation of the fede"] [8.333834648132324, 4.392183780670166, "sal effect estimates.\nFinally, Gius (2018) employed a model similar to that of Gius (2015c) to evalu- ate whether federal or state assault weapon bans influence school shooting fatalities or injuries, controlling for background check laws, state-leve"] [8.282472610473633, 4.446548938751221, " bans have\nuncertain\neffects on\nmass shootings.\n Evidence for this relationship is\ninconclusive.\n Bans on the Sale of Assault Weapons and High-Capacity Magazines 215\nGorry, and Wade (2016) found that the bans significantly reduced the annual inc"] [8.29480266571045, 4.404730319976807, "t sizes of interest, so we do not present them in a figure.\n216 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nConclusions\nOne study provided some evidence that\nsecondary-market prices of assa"] [8.3428955078125, 4.264766693115234, "onomics and Statistics, Vol. 93, No. 1, 2011,\npp. 113\u2013125.\nCox, D. R., and E. J. Snell, Analysis of Binary Data, 2nd ed., New York: Chapman and Hall, 1989.\nEverytown for Gun Safety Support Fund, \u201cMass Shootings in the United States: 2009\u20132016,\u201d April"] [8.232148170471191, 4.436081409454346, "Markets and Gun Violence 1994\u20132003, Washington, D.C.: National Institute of Justice, 2004.\nKoper, Christopher S., and Jeffrey A. Roth, \u201cThe Impact of the 1994 Federal Assault Weapon Ban on Gun Violence Outcomes: An Assessment of Multiple Outcome Meas"] [8.158461570739746, 4.453430652618408, "turers are exempt from the federal restrictions.\nSince 1968, several state laws have aimed to extend or clarify design and safety requirements on all guns in circulation in the United States, not just imported guns. Specifically, lawmakers have targe"] [8.15467357635498, 4.470946311950684, "nnect mechanism, which prevents a semiautomatic pistol with a detachable magazine from firing when there is no magazine in the pistol. Finally, some states create a roster of approved handguns that satisfy the state\u2019s safety and design standards. In "] [8.135157585144043, 4.4936113357543945, "s of inexpen- sive handguns were more likely than purchasers of other handguns to be charged with new crimes after handgun purchase.\nThese studies suggest that small and inexpensive handguns are disproportion- ately preferred by those engaged in crim"] [8.172119140625, 4.477353572845459, "s, or hunting and recreation. Although handguns are commonly used in suicides (Hanlon et al., 2019) and individuals who die by suicide are more likely than the general population to have purchased a hand- gun in the previous three years (Grassel et a"] [8.186238288879395, 4.451742172241211, "s filed a class-action suit alleging that the guns can fire without being triggered (Cohn, 2018). The case ultimately was settled.\n The specifics of which weapons or weapon features are prohibited by a particu- lar ban may be key to understanding the"] [8.15541934967041, 4.42655611038208, "Ann. \u00a7 624.712; 9 N.Y. CRR 482.6.\n6 Calif. Penal Code \u00a7 32015; Md. Code, Pub. Safety, \u00a7 5-404; Mass. Gen. Laws Ch. 140 \u00a7 1313/4; 24 D.C. MR \u00a7 2323.\n7 Calif. Ann. Penal Code \u00a7\u00a7 31910, 16900; Mass. Gen. Laws Ch. 140, \u00a7 123; 9 N.Y. CRR 482.5.\nBans on Lo"] [8.191816329956055, 4.433516502380371, "with the low-quality handgun bans examined in Rosengart et al. (2005).\n8 Calif. Penal Code \u00a7 31910.\n9 Hawaii and the District of Columbia. See Hawaii Rev. Stat. \u00a7 134-15(a); D.C. Code Ann. \u00a7 7-2505.04(b).\n Figure 15.1\nIncidence Rate Ratios Associated"] [8.180365562438965, 4.455743312835693, " than five observations per estimated parameter, there is a substantial likelihood that the model was overfit. Thus, in keeping with our review methodology, we discount the results of this study.\nRosengart et al. (2005) used data from 1979 to 1998 to"] [8.193731307983398, 4.4579315185546875, "n the number of states that changed the bans during the study time frame, but it is likely that only one state (California) changed its low-quality handgun law over this period. Thus, the effect of these laws may not have been well identified, and th"] [8.173741340637207, 4.475668907165527, "ct fire- arm homicides.\nEffects on the Gun Industry\nResearch Synthesis Findings\nWe identified one study that met our inclusion criteria and assessed how bans on low-quality handguns affect gun industry outcomes. Using a first-differences model, Webst"] [8.345087051391602, 4.284758567810059, ".\nCook, Philip J., \u201cThe Saturday Night Special: An Assessment of Alternative Definitions from a Policy Perspective,\u201d Journal of Criminal Law and Criminology, Vol. 72, No. 4, 1981, pp. 1735\u20131745.\nFunk, T. Markus, \u201cGun Control and Economic Discriminati"] [8.214153289794922, 4.327502727508545, "of October 1, 2019: https://www.rand.org/pubs/research_reports/RR2685.html\nVernick, Jon S., Daniel W. Webster, and Lisa M. Hepburn, \u201cEffects of Maryland\u2019s Law Banning Saturday Night Special Handguns on Crime Guns,\u201d Injury Prevention, Vol. 5, No. 4, 1"] [8.086234092712402, 5.082766532897949, "ations individuals who own guns can use and carry their firearms. Of the 18 policy classes included in this review, five operate by affecting the behaviors of gun owners. Each is reviewed in the subsequent chapters in Part D, as follows:\n\u2022 stand-your"] [8.071894645690918, 5.117340087890625, "l documented, but several data sources do exist (Kleck, 2018; Hemenway and Solnick, 2015b; National Research Council, 2004; see also RAND Corporation, 2018, Chapter Twenty-Three). Ideally, analyses of the effects of stand-your-ground laws on defensiv"] [8.04106330871582, 4.9864091873168945, "assed similar laws.3 Eight states have expanded castle doctrine to\n1 Standard castle doctrine states that a person in his or her own home does not have a duty to retreat prior to using force, including deadly force, in self-defense.\n2 Fla. Stat. Ann."] [8.032370567321777, 4.921562194824219, "n. \u00a7 200.120(2); N.H. Rev. Stat. Ann. \u00a7 627:4(III); N.C. Gen. Stat. Ann. \u00a7 14-51.3; Okla. Stat. Ann. Tit. 21 \u00a7 1289.25(D); 18 Pa. Cons. Stat. Ann. \u00a7 505(b)(2.3); S.C. Ann. Code \u00a7 16-11-440(C); S.D. Laws \u00a7 22-18-4; Tenn. Ann. Code \u00a7 39-11-611(b); Tex."] [7.880980491638184, 4.641770839691162, "diate family\n10 For example, Ala. Code \u00a7 13-A-3-23 (kidnapping; assault; burglary; robbery; forcible rape; forcible sodomy; \u201cusing or about to use physical force against an owner, employee, or other person authorized to be on business property when t"] [8.072093963623047, 5.111195087432861, "and Wisconsin. See Ia. Code Ann. \u00a7 704.1; Kan. Stat. Ann. \u00a7\u00a7 21-5222, 5223, 5230; Tenn. Ann. Code \u00a7 39-11-611; Wisc. Stat. Ann. \u00a7 939.48.\n13 W. Va. Ann. Code \u00a7 55-7-22.\n14 N.D. Ann. Code \u00a7 12.1-05-07.\n member.15 In Wisconsin, the law applies in an in"] [8.074202537536621, 5.11223030090332, " as a proxy for firearm ownership (Wallace, 2014). However, without simultane- ously examining firearm or total suicide rates, this outcome is difficult to interpret as providing a causal effect of stand-your-ground laws, so the study did not meet ou"] [8.076089859008789, 5.114745140075684, "m 2000 to 2010 to estimate the laws\u2019 effects on homicide rates. The authors defined stand-your-ground laws using a binary variable equal to one for polices that \u201cremove the duty to retreat in some place outside the home\u201d (Cheng and Hoekstra, 2013, p."] [8.07993221282959, 5.097986221313477, "and castle doctrine to apply outside the home\u2014we do not count this study as part of the evidence base for the effects of stand-your-ground laws.\nStand-Your-Ground Laws 241\n 242 The Science of Gun Policy: A Critical Synthesis of Research Evidence on t"] [8.074932098388672, 5.118607997894287, "sib, Kostandini, and Jordan (2018) estimated the effects of stand-your- ground laws on per capita rates of total firearm-related deaths, excluding deaths by suicide.22 Based on mortality data from 1999 to 2013, and using a state and year fixed- effec"] [8.073601722717285, 5.116652488708496, "4 states that passed a stand-your-ground law between 2005 and 2007, the authors used the synthetic control method approach to generate a weighted combination of control states (i.e., a \u201csynthetic control\u201d) that approximated the pre-law firearm homici"] [8.072129249572754, 5.118592262268066, "13) found that these\nlaws significantly increase homicide\nStand-Your-Ground Laws 245\n rates, but they have uncertain effects on robbery, aggravated assault, and bur- glary rates. McClellan and Tekin (2017) also found significant increases in total"] [8.081025123596191, 5.100434303283691, "thors found that stand-your-ground laws were associated with a statisti- cally significant decline in the likelihood of a public shooting incident. However, their use of a linear model to predict a dichotomous (and rare) outcome likely violated model"] [8.074385643005371, 5.118340492248535, "nt for changes in policing and incarceration rates, and contemporaneous crime rates. Using negative binomial regression models, they found stand-your-ground laws to be associated with increases in justifiable homicide, ranging from an uncertain 28-pe"] [8.069609642028809, 5.122525691986084, "gical reasons. Given the methodological quality of these studies, we consider these findings inconclusive evidence for the effect of stand-your-ground laws on defensive gun use.\nEffects on the Gun Industry\nResearch Synthesis Findings\nOne study (Walla"] [8.118453979492188, 5.012565612792969, "Nelson, Linear Probability, Logit, and Probit Models, Beverly Hills, Calif.: Sage Publications, 1984.\nBlau, Benjamin M., Devon H. Gorry, and Chip Wade, \u201cGuns, Laws, and Public Shootings in the United States,\u201d Applied Economics, Vol. 48, No. 49, 2016,"] [7.9763593673706055, 4.595427989959717, "ip?\u201d Justice Policy Journal, Vol. 11, No. 2, Fall 2014.\nWebster, D., C. K. Crifasi, and J. S. Vernick, \u201cEffects of the Repeal of Missouri\u2019s Handgun Purchaser Licensing Law on Homicides,\u201d Journal of Urban Health, Vol. 91, No. 2, 2014, pp. 293\u2013302.\nCHA"] [7.891017436981201, 4.687350273132324, "Policies\nnationwide, two-thirds of which involved a firearm (Office of Juvenile Justice and Delinquency Prevention, 2016). Young adults between ages 18 and 21 have among the highest rates of violent offending of any age group (Loeber and Stallings, 2"] [7.8909382820129395, 4.751043319702148, "Azrael and Miller, 2016).\nIn the absence of strong causal models, however, alternative explanations remain plausible. If, for instance, those most determined to kill themselves leave a weapon unsecured so that it will be available for use when they a"] [7.890439510345459, 4.758365631103516, " understood by gun owners to account for the apparent effects of these laws. If a person is unaware of a law, it is difficult to associate her or his behavior with that law. It may be, however, that knowledge of the law is not the key driver of impro"] [7.845764636993408, 4.666425704956055, "states imposing criminal liability for negligent storage allow for exceptions or defenses.8 The most common is when the gun has been stored in a locked\n3 Mass. Gen. Laws Ch. 140, \u00a7 131L.\n4 California, Minnesota, New York, and the District of Columbia"] [7.850014686584473, 4.679474830627441, "N.C. Gen. Stat. Ann. \u00a7 14-315.1; R.I. Gen. Laws Ann. \u00a7 11-47-60.1; Tex. Penal Code Ann. \u00a7 46.13.\n11 Calif. Penal Code \u00a7 25105; Conn. Gen. Stat. Ann. \u00a7 29-37i; Hawaii Rev. Stat. \u00a7 134-10.5; N.H. Rev. Stat. Ann. \u00a7 650-C:1; R.I. Gen. Laws Ann. \u00a7 11-47-6"] [7.84343147277832, 4.718878269195557, "6 are also exceptions.\nIn addition to the main distinctions among the CAP laws already discussed, another difference is how they define minors. In the majority of states, it is an offense to provide a firearm to an individual under age 18.27 In Texas"] [7.886125564575195, 4.757151126861572, "ligent storage a felony. In four such jurisdictions, these factors bump the crime from a misdemeanor to a felony,33 and in the other four, there is no misdemeanor offense, only these felonies.34 Texas makes clear that regardless of what additional fa"] [7.876070976257324, 4.755343437194824, "idence on the Effects of U.S. Gun Policies\n10.8-percent reduction in firearm suicides; in addition, they found uncertain effects on nonfirearm suicides. In this age group, the post-policy firearm suicide rate was 89 per- cent of the rate expected wit"] [7.883020877838135, 4.751962661743164, " likely the result of suicide attempts. Therefore, DeSimone, Markowitz, and Xu (2013) should be understood to evaluate the effects of CAP laws on nonfatal firearm injuries resulting from a combination of suicide attempts and self-inflicted uninten-\n3"] [7.889598846435547, 4.750951290130615, "ility models weighted by state population and adjusting for a large set of state-level time- varying covariates, state fixed effects, national trends, and state-specific linear trends, the authors found that the estimated associations between CAP law"] [7.890880107879639, 4.745833396911621, "rearm suicides\namong those aged 19 or younger. Using\ndata on hospitalizations for self-inflicted\nfirearm injuries, DeSimone, Markowitz,\nand Xu (2013) found significant effects\nsuggesting that CAP laws reduce such\ninjuries among those aged 17 or young"] [7.884581089019775, 4.761966228485107, "data. The authors examined information in 11 states between 1988 and 2003 and employed fixed effects for state and year in their statistical models (along with other state- and hospital-level covariates). They found that CAP laws based on negligent s"] [7.8897857666015625, 4.758749008178711, "th the CAP laws examined in these studies.\nFigure 17.2\nIncidence Rate Ratios Associated with the Effect of Child-Access Prevention Laws on Violent Crime\nNOTE: IRR values marked with blue squares indicate that methodological concerns are discussed in "] [7.886037349700928, 4.757742881774902, "ntional fire- arm deaths among those aged 14 or younger. In addition, they showed that this effect was not consistent across all states that have CAP laws. Significant reductions in such deaths were observed in states with felony CAP laws, and in sta"] [7.877745151519775, 4.753025531768799, "ge alone or on either negligent storage or reckless provision had uncertain effects on unintentional firearm injuries in children aged 18 or younger in the 11 states that were part of the NIS, but they did find a statistically significant effect of t"] [7.8911309242248535, 4.747739791870117, "ied no significant methodological concerns. See Appendix B for details.\nChild-Access Prevention Laws 267\n 268 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nConclusions\nWe identified six "] [7.924571990966797, 4.722050189971924, "li- ties, injuries, and the incidence of multiple-victim public shootings, which the author defined as events unrelated to other criminal activity in which two or more people were killed or wounded in a public location. The analysis covered 1977 to 1"] [7.894988059997559, 4.743607044219971, "fying study of\nthe effect of CAP laws on mass shoot-\nings and one qualifying study of the\neffect of CAP laws on school shoot-\nings. Lott (2003) found uncertain\neffects for these laws on mass shooting\ncasualties and mass shooting incidents,\nand Anders"] [7.953558921813965, 4.717583656311035, " was likely overfit. We therefore excluded those results from our synthesis.\n272 The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of U.S. Gun Policies\nOutcomes Without Studies Examining the Effects of Child-Access P"] [8.27381420135498, 4.2993597984313965, "nfatal Injury Reports, 2000\u20132017,\u201d WISQARS database, Atlanta, Ga., January 18, 2019b. As of July 26, 2019:\nhttps://webappa.cdc.gov/sasweb/ncipc/nfirates.html\nConner, Andrew, Deborah Azrael, and Matthew Miller, \u201cSuicide Case-Fatality Rates in the Unit"] [8.146040916442871, 4.409717082977295, " New Mexico Juveniles\u2019 Possession of Firearms, Albuquerque, N.M.: New Mexico Criminal Justice Statistical Analysis Center, Working Paper 27, 1998.\nLoeber, R., and R. Stallings, \u201cModeling the Impact of Interventions on Local Indicators of Offending, V"] [8.535358428955078, 4.643646240234375, " Ownership in Veterans Entering Residential PTSD Treatment: Associations with Suicide Ideation, Attempts, and Combat Exposure,\u201d Psychiatry Research, Vol. 229, No. 1\u20132, 2015, pp. 220\u2013224.\nSpicer, R. S., and T. R. Miller, \u201cSuicide Acts in 8 States: Inc"] [8.524155616760254, 4.651505470275879, "t about which laws are most likely to do so. Permitless-carry and shall-issue laws that make it easier for citizens to carry concealed weapons could increase the number of people carrying guns. The increased prevalence of concealed weapons could lead"] [8.55006217956543, 4.650468826293945, "cealed-carry permits related to changes in various types of violent crime (Kovandzic and Marvell, 2003). The authors analyzed data from 58 Florida counties spanning 1980\u20132000, providing coverage of the period before and after the passage of Florida\u2019s"] [8.234149932861328, 4.621625900268555, "h Dakota, Oklahoma, South Dakota, Vermont, West Virginia, and Wyoming. See Alaska Stat. \u00a7 11.61.220; Ariz. Rev. Stat. \u00a7 13-3112; Ark. App. 488 (via case law: Taff v. State, 2018); Ida. Code Ann. \u00a7 18-3302 (applies only out- side cities); Kan. Stat. A"] [8.584247589111328, 4.658480167388916, "e laws (USA Carry, 2017).\nEffects on Suicide\nResearch Synthesis Findings\nWe identified three studies that met our inclusion criteria and examined the effect of concealed-carry laws on suicide; no studies examined the effects of permitless-carry laws "] [8.582782745361328, 4.648416996002197, "cide rates. However, relative to laws that prohibited concealed carry,5 both may-issue and shall-issue laws were associated with significant increases in nonfirearm suicide rates.\nFigure 18.1 displays the incidence rate ratios (IRRs) and CIs associat"] [8.611294746398926, 4.598357677459717, "Two important reviews of the scientific literature on gun policy effects\u2014one by the National Research Council (NRC), a part of the National Academy of Sciences (NRC, 2004), and one by the Community Preventive Services Task Force, established by the U"] [8.62801742553711, 4.668210983276367, "ted in Table 18.1, the NRC (2004) panel, with one member dissenting, concluded:\nSome studies find that right-to-carry laws reduce violent crime, others find that the effects are negligible, and still others find that such laws increase violent crime."] [8.646280288696289, 4.666731357574463, "a sets used by Lott (1998b, 2000) and by Plassmann and Whitley (2003), and Plassmann subsequently acknowledged these errors to the NRC (NRC, 2004, p. 136). Correction of these errors elimi- nated many of the significant effects reported by Plassmann "] [8.6541748046875, 4.67650032043457, "esearch Evidence on the Effects of U.S. Gun Policies\nnot comparable with later data, according to the National Archive of Criminal Jus- tice Data (undated). Nevertheless, several analyses have continued to use county-level crime data to evaluate law "] [8.672659873962402, 4.687114715576172, "dy et al. (2014) suggested that shall-issue laws significantly reduced the trends in rape and murder rates. They found no significant association between shall-issue laws and either assault or robbery. The fact that their model predicted a given outc"] [8.64704418182373, 4.6724700927734375, "rrections for serial correlation in the data used, without which incorrect claims of statistical significance would be expected to proliferate (Schell, Griffin, and Morral, 2018; Aneja, Donohue, and Zhang, 2014; Helland and Tabarrok, 2004).\nState-Lev"] [8.676039695739746, 4.680805683135986, "e (see Figure 18.3). However, as with Lott (2000), the authors did not statistically adjust for serial correlation in the panel data, and the model\u2019s ratio of estimated parameters to observations was less than one to ten, mean- ing the model may have"] [8.643189430236816, 4.673551082611084, "lly significant might not be after correcting these analyses (Schell, Griffin, and Morral, 2018; Aneja, Donohue, and Zhang, 2014; Helland and Tabarrok, 2004).\nDeSimone, Markowitz, and Xu (2013) evaluated the effects of child-access pre- vention laws "] [8.68465518951416, 4.688808441162109, "hall-issue states. Relative to states with shall-issue laws, states with more-restrictive firearm-carry policies had rates of firearm homicide that were 11 percent higher (see Figure 18.3). However, this model did not statistically adjust for the kno"] [8.679919242858887, 4.684589385986328, "ounty-level analyses, that their specification improved model fit over that of Aneja, Donohue, and Zhang (2014). They also found that the individual states\u2019 trends were jointly significant, which they took as evidence supporting the need for their in"] [8.692605018615723, 4.628279209136963, " designed to estimate the distribution of treatment effects under the assumption that laws have no real effect. They concluded that, after the seventh year post-implementation, states with shall- issue laws had significantly elevated rates of violent"] [8.654401779174805, 4.672765731811523, "ars of data for six states after 1998, because the CDC began suppressing homicide counts below ten in that year. Nevertheless, the authors report similar results from sensitivity analyses using a different data source, the Supplementary Homicide Repo"] [8.635656356811523, 4.6800456047058105, "stard, 2001; Crifasi, Pollack, and Webster, 2016). Mustard (2001) preferred a spline model, estimating the change in trends before versus after implementation of shall-issue laws for the outcome of felonious police deaths per capita or per full-time "] [8.677733421325684, 4.690601348876953, "ncreases in crime com- pared with decreases. However, this study had an unfavorable ratio of model covariates to observations (less than one to ten), meaning the model may have been overfit, and thus its estimates and CIs may be unreliable indicators"] [8.66395378112793, 4.686612129211426, "on violent crime and murder rates. Analyzing data over a partially overlapping period, from 1976 to 1998, and using a Poisson model that controlled for state and year fixed effects, state-specific linear trends, and time-varying state covari- ates, L"] [8.616097450256348, 4.619085311889648, "del comparison techniques, Strnad (2007) reanalyzed models of the effects of shall- issue laws from Donohue (2004). In contrast to the approach of Donohue (2004) and many others, Strnad (2007) did not assess the evidence for or against shall-issue la"] [8.616581916809082, 4.607001781463623, "orting dummy-coded law effects published since the NRC (2004) review of gun policy effects. For a summary of effects reported for all studies discussed in this chapter, see Appendix B. IRR values marked with green circles indicate that we identified "] [8.651896476745605, 4.684941291809082, "study that included four more years of data found uncertain effects of the law in seven of eight evaluated years, with a single significant negative effect in the seventh year (Moody and Marvell, 2018a). La Valle and Glover (2012) found that shall-is"] [8.646276473999023, 4.704158782958984, " which included data after 2000, found largely uncertain effects of shall-issue laws on robberies (Moody and Marvell, 2018a; Moody et al., 2014; Kendall and Tamura, 2010; Helland and Tabarrok, 2004; Plassmann and Whitley, 2003). Therefore, we conclud"] [8.629778861999512, 4.676876544952393, " it could be argued that these two\nstudies of the effect of these laws on all\nviolent crimes should not suffice to sug-\ngest that there is more than inconclusive\nevidence for such an effect. However, because analyses on all violent crimes may have gr"] [8.625359535217285, 4.6720404624938965, "e law, unintentional firearm injuries among those aged 18 or older were more than twice as frequent as would be expected without the law, which would be extraordinary if true. However, the estimated effects of shall-issue laws in this study were base"] [8.559700012207031, 4.626875400543213, "e other four studies adopted slightly different definitions for mass shooting. Lott (2003) examined multiple-victim public shootings, which the author defined as events unrelated to other criminal activity in which two or more people were killed or w"] [8.575611114501953, 4.642007827758789, "be poor indicators of their true effects.\nExamining a partially overlapping but later period (1989\u20132014), Luca, Malhotra, and Poliquin (2016) used a linear probability model to estimate the impact of shall- issue concealed-carry laws on a binary indi"] [8.592281341552734, 4.658538341522217, "ce, the authors found that concealed- carry laws had an uncertain relationship with the number of school shooting victims (see Figure 18.5). Given the relatively rare nature of this outcome, these analyses may have been underpowered to detect an effe"] [8.581564903259277, 4.6511921882629395, "Guns & Ammo magazine as a proxy for gun ownership. This study identified uncertain effects of these laws on gun ownership.\nShall-issue concealed-carry laws have\n uncertain\neffects on\nmass shootings.\nEvidence for this relationship is\ninconclusive.\n 30"] [8.576461791992188, 4.656351566314697, "\nuncertain effect of shall-issue concealed-\ncarry laws on gun ownership proxy out-\ncomes. One study found that allowing\npermitless carry in Arizona was cor-\nrelated with significant increases in\nNICS background checks relative to the\nnational trend. "] [8.407251358032227, 4.348101615905762, "n M., Devon H. Gorry, and Chip Wade, \u201cGuns, Laws, and Public Shootings in the United States,\u201d Applied Economics, Vol. 48, No. 49, 2016, pp. 4732\u20134746.\nBronars, Stephen G., and John R. Lott, Jr., \u201cCriminal Deterrence, Geographic Spillovers, and the Ri"] [8.388692855834961, 4.340567588806152, " Change,\u201d Statistics in Medicine, Vol. 27, No. 24, 2008, pp. 5005\u20135025.\nGinwalla, Rashna, Peter Rhee, Randall Friese, Donald J. Green, Lynn Gries, Bellal Joseph, Narong Kulvatunyou, Dafney Lubin, Terence O\u2019Keeffe, Gary Vercruysse, Julie Wynne, and An"] [8.399658203125, 4.346022605895996, "012, pp. 580\u2013601.\nLoftin, Colin, David McDowall, and Matthew D. Fetzer, \u201cA Comparison of SHR and Vital Statistics Homicide Estimates for U.S. Cities,\u201d Journal of Contemporary Criminal Justice, Vol. 24, No. 1, 2008, pp. 4\u201317.\nLott, John R., Jr., \u201cThe "] [8.399218559265137, 4.364871501922607, "ematic Measurement Error with State-Level Crime Data: Evidence from the \u2018More Guns Less Crime\u2019 Debate,\u201d Journal of Research in Crime and Delinquency, Vol. 42, No. 2, May 2005, pp. 187\u2013210.\nMoody, Carlisle E., \u201cTesting for the Effects of Concealed Wea"] [8.329681396484375, 4.2996673583984375, "nal Justice, Vol. 25, No. 1, 2009, pp. 67\u201388.\nRosengart, M., P. Cummings, A. Nathens, P. Heagerty, R. Maier, and F. Rivara, \u201cAn Evaluation of State Firearm Regulations and Homicide and Suicide Death Rates,\u201d Injury Prevention, Vol. 11, No. 2, 2005, pp"] [8.328523635864258, 4.588964462280273, "aws prohibit the possession of firearms in federal facilities, other than federal court facilities, except for hunting or other lawful purposes (18 U.S.C. 930). Similarly, firearms are prohibited on property belonging to the U.S. Department of Vetera"] [8.287267684936523, 4.489310264587402, "rences in how mass shootings are defined\u2014the latter study restricts analysis to mass public shootings\u2014there also appears to be some disagreement about how gun-free zones are classified.\nTo evaluate the effects of gun-free zones, the ideal data would "] [8.262885093688965, 4.611923694610596, "83.1; Wash. Rev. Code Ann. \u00a7 9.41.300; W. Va. Code \u00a7 61-7-11a; Wisc. Stat. Ann. \u00a7 175.60; Wyo. Stat. \u00a7 6-5-209.\n3 For example, Colorado\u2019s restriction concerns carrying concealed weapons into public buildings guarded by security personnel (Colo. Rev. "] [8.305549621582031, 4.60792875289917, " Mis- souri, prohibit concealed carry but allow open carry. These laws also have caveats, which, like Kentucky, relate to trying to keep the firearm regulations restricted to alcohol-centric restaurants or areas of restaurants (Miss. Code Ann. \u00a7 45-9"] [8.325742721557617, 4.542750358581543, "blic Shootings Keep Occurring in Gun-Free Zones: 94% of Attacks Since 1950,\u201d June 15, 2018a.\nEverytown for Gun Safety Support Fund, \u201cMass Shootings in the United States: 2009\u20132016,\u201d April 11, 2017b. As of May 3, 2017: http://everytownresearch.org/rep"] [8.337615013122559, 4.577810287475586, "(q)(3)(B)(ii), (iii)). State and local laws and school district policies often further restrict whether law enforcement officers, properly licensed teachers, or others may carry firearms at primary and secondary schools.\nThose who argue in favor of a"] [8.350014686584473, 4.597726821899414, "ince the intro- duction of federal regulations related to guns on school property, rates of students car- rying weapons in general and to school have decreased. In 1993, 22 percent of students in grades 9\u201312 carried a weapon, such as a gun or knife, "] [8.338945388793945, 4.586155414581299, "ch an experiment would be the low base rate of gun violence experienced by schools in the United States. Thus, it may be difficult to detect the effects of these policies unless many schools were included in the experiment over what might be several "] [8.354015350341797, 4.61723518371582, " of trustees of the school district or governing body of a charter school may appoint one marshal for every 200 students or for each building of the campus, subject to various other rules.3 In distressed rural counties in Tennessee, schools may imple"] [8.320959091186523, 4.533714294433594, " on School Safety, Washington, D.C.: U.S. Department of Education, U.S. Department of Justice, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security, December 18, 2018.\nFowler, Katherine A., Linda L. Dahlberg, Tadesse"] [8.60276985168457, 4.078216075897217, "in the United States. In this report, we have attempted to pro- vide a rigorous and balanced assessment of what current scientific knowledge can tell the public and policymakers about the true effects of many gun policies that are frequently discusse"] [8.72832202911377, 4.056792259216309, " knowable do not supersede questions of individual rights or Second Amendment rights. Both should be central considerations in policymaking.\nFacts have never dictated policy, but they can inform it. The relevance of research to inform gun policy has "] [8.631383895874023, 4.084183216094971, "- ods. Our finding of supportive evidence of an effect is limited to cases for which at least three studies not compromised by serious methodological weaknesses found suggestive or significant effects in the same direction, and the effect was found i"] [8.159842491149902, 4.343437671661377, "ws\n e\u0302L\n e\u0302M\n e\u0302S\n I\n I\n I\n e\u0302L\n I\n Stand-Your-Ground Laws\n I\nI\n e\u0301M\n e\u0301S\n I\n I\n Bans on Low-Quality Handguns\n I\n I\n I\n I\n Bans on the Sale of Assault Weapons and High-Capacity Magazines\n I\n"] [7.972999572753906, 4.330459117889404, "conclusive; L = limited; M = moderate; S = supportive. When we identified no studies meeting eligibility criteria, cells are blank.e\u0301= the policy We concluded that there is limited evidence that licensing and permitting requirements decrease total su"] [7.990834712982178, 4.42820930480957, "rm Sales Reporting, Recording, and Registration Requirements\n Lost or Stolen Firearm Reporting Requirements\n Firearm Safety Training Requirements\n Waiting Periods\n Licensing and Permitting Requirements\n Background Checks\n Extreme Risk"] [7.938178062438965, 4.787667751312256, "background checks or waiting periods), or they are designed to affect a relatively small proportion of gun owners (e.g., prohibitions that target the mentally ill or domestic violence offenders). Thus, the other laws generally concern either the smal"] [8.0768461227417, 5.094651222229004, "are effects too large to be explained by justifiable homicides. Consider, for instance, that there were a combined 2,201 firearm homi- cides in 2017 in Florida and Texas, two states with stand-your-ground laws (Centers for Disease Control and Prevent"] [7.838009357452393, 4.264880657196045, "-a). In this context, the fact that there is now moderate evidence that domestic violence restrain- ing orders and their associated prohibitions against gun ownership reduce total and firearm-related intimate partner homicides is noteworthy.\n\u2022 Recomm"] [7.830002307891846, 4.134309768676758, "a; Owens, Horrocks, and House, 2002; Sakinofsky, 2000). We also found limited evidence that permit-to-purchase requirements, which often include a waiting period as part of the permitting process, reduce total and fire- arm suicides among adults.\nCon"] [8.541260719299316, 4.645824909210205, "es involve sharing data on all prohibited possessors with NICS.\nConclusion 8. There is limited evidence that shall-issue, or right-to-carry, laws increase violent crime rates.\nThere has been more research on shall-issue laws than on all the other pol"] [8.381569862365723, 4.205401420593262, "render laws; extreme risk protection orders, or \u201cred-flag\u201d laws; firearm safety training requirements; firearm sales reporting, record- ing, and registration requirements; bans on low-quality handguns; and permitless- carry laws.\nWhy Don\u2019t We Know Mo"] [8.574677467346191, 4.101715564727783, " an elevated risk of firearm homicide for members of the household. This finding was viewed by some as a one-sided attempt to manipu- late the gun policy debate.\nIn an effort led by the National Rifle Association (Cagle and Martinez, 2004), a suffici"] [8.530904769897461, 4.119350433349609, "for decisions about firearms and violence, the federal government needs to support a systematic program of data collection and research that specifically addresses that issue\u201d (p. 3). The federal government\u2019s support for research on gun violence prev"] [8.485318183898926, 4.159950256347656, "he lack of research in this area stems, to some extent, from difficulties defining and measuring legal defensive gun use. In some\u2014perhaps most\u2014such cases, guns may contribute to an individual\u2019s self-defense by deterring crimes that would otherwise oc"] [8.415600776672363, 4.144293785095215, "data on gun ownership and availability and on guns in legal and illegal markets severely limits the quality of existing research.\nThere are no regularly collected data that describe gun ownership or use at the state level since the CDC suspended its "] [8.537572860717773, 4.157314300537109, "lishes aggregate statistics on its gun tracing program, but case-level details about the crimes that the guns were involved in, how they were acquired, and other key details are omit- ted from these reports. Although some researchers have been able t"] [12.976312637329102, 4.176159381866455, "ited States than has been available through the FBI\u2019s Uniform Crime Reporting Program. Whereas the FBI system collects summary or aggregate statistics on serious violent and property crimes reported to law enforcement agencies, NIBRS was designed to "] [8.466362953186035, 4.159002304077148, "2017b). BJS is planning to expand the survey panel in order to generate reliable esti- mates for 22 states that account for 79 percent of the U.S. population. In addition, the bureau has published model-based state estimates for some types of crime o"] [8.492316246032715, 4.146329879760742, " help develop a data infrastructure for nonfatal firearm injury surveillance is not unprecedented. In 1994, the CDC provided funding for seven states to develop, implement, and evaluate systems; New York City and Cali- fornia also invested in firearm"] [8.730742454528809, 4.086963653564453, "in many discoveries of effects that reject the null hypothesis that the policy had no effect when, in fact, under proper inferential procedures, the discoveries would be consistent with the law having no effect (or a small effect in the opposite dire"] [8.613683700561523, 4.07908296585083, "information on laws not yet incorporated into the database. With such help, we hope to make the database a resource beneficial to all analysts.\n\u2022 Recommendation 16. Researchers, reviewers, academics, and science reporters should expect new analyses o"] [8.349376678466797, 4.244017124176025, ", Vol. 177, No. 1, 2016, pp. 124\u2013126.\nAzrael, Deborah, Lisa Hepburn, David Hemenway, and Matthew Miller, \u201cThe Stock and Flow of U.S. Firearms: Results from the 2015 National Firearms Survey,\u201d Russell Sage Foundation Journal of the Social Sciences, Vo"] [8.305792808532715, 4.241460800170898, " Notes from Four Decades in the Trenches,\u201d Crime and Justice, Vol. 42, No. 1, 2013, pp. 19\u201373.\nCook, Philip J., and Anthony A. Braga, \u201cComprehensive Firearms Tracing: Strategic and Investigative Uses of New Data on Firearms Markets,\u201d Arizona Law Revi"] [8.472323417663574, 4.15731954574585, "kets and Gun Violence 1994\u20132003, Washington, D.C.: National Institute of Justice, 2004.\nLewiecki, E. M., and S. A. Miller, \u201cSuicide, Guns, and Public Policy,\u201d American Journal of Public Health, Vol. 103, No. 1, 2013, pp. 27\u201331.\nSummary and Conclusion"] [8.316069602966309, 4.244080066680908, " Surveillance,\u201d American Journal of Preventive Medicine, Vol. 15, No. 3, Supp. 1, 1998, pp. 113\u2013119.\nSchell, Terry L., Beth Ann Griffin, and Andrew R. Morral, Evaluating Methods to Estimate the Effect of State Laws on Firearm Deaths: A Simulation Stu"] [8.490693092346191, 4.10510778427124, "which we define as a recordkeeping system controlled by a government agency that (1) stores the names of current owners of each firearm of a specific class and (2) requires that these records are updated after a firearm is transferred to a new owner."] [8.595884323120117, 4.061818599700928, "yntheses of the 13 original gun policies as separate chapters in relatively random order. For this updated edition, we reorganized the chapters to group together policies that are related to each other based on the mechanism by which they are designe"] [8.302964210510254, 4.2435221672058105, "usion in our review and our assessment of their methodological quality were appropriate. This reassessment led to several changes.\nIn this updated edition, we excluded two of the studies assessed in our original review: Duggan, Hjalmarsson, and Jacob"] [8.15145206451416, 4.160863876342773, "he study did not have strictly longitudinal hospital-level data, this was not an adequate reason for us to fully lessen our confidence in these findings. Thus, in our updated review, this study\u2019s estimates of the effect of child-access prevention law"] [7.929407119750977, 4.3111138343811035, "violent crime:\n\u2013 original: limited evidence for decreasing violent crime and total homicides\n\u2013 revised: inconclusive evidence for the effect on violent crime and total homi-\ncides\nChanges from the First Edition of This Report 361\n362 The Science of G"] [7.937597751617432, 4.317929744720459, " manufacturers or retailers, and firearm purchases\n\u2022 firearm sales reporting, recording, and registration requirements: inconclusive evidence for the effect on firearm purchases\n\u2022 child-access prevention laws: inconclusive evidence for the effect on "] [7.937767028808594, 4.347793102264404, "vidence for total and firearm suicides\n3 Inconclusive evidence for total and firearm suicides\n1 Inconclusive evidence for total and firearm suicides\n0 No studies\n1 Inconclusive evidence for total and firearm suicides\n4 Inconclusive evidence for total"] [7.879079818725586, 4.3144378662109375, "ides, robberies, assaults, and rapes\n3 Limited evidence for decreasing violent crime; inconclusive evidence for total and firearm homicides\n6 Inconclusive evidence for total homicides, firearm homicides, robberies, assaults, and rapes; moderate evide"] [7.923337459564209, 4.3210649490356445, " Moderate evidence for increasing total homicides; supportive evidence for increasing firearm homicides; inconclusive evidence for robberies and assaults\n4 Limited evidence for decreasing assaults; inconclusive evidence for violent crime, firearm hom"] [8.036938667297363, 4.327398300170898, " on the Effects of U.S. Gun Policies\nTable A.4\nChanges to the Number of Studies and Conclusions, Mass Shootings\n Policy\nMinimum age requirements\nProhibitions associated with mental illness\nNo. of Studies\n1\n0\nOriginal Review\nConclusion\nPurchasing: "] [8.169540405273438, 4.32096529006958, " Policy\nChild-access prevention laws\nConcealed-carry laws\nGun-free zones\nLaws allowing armed staff in K\u201312 schools\nNo. of Studies\n0\n0\n0\nN/A\nOriginal Review\nConclusion\nNo studies\nNo studies\nNo studies\nN/A\nUpdated Review\nNo. of\nStudies Conclusion\n0 N"] [8.383975982666016, 4.327144622802734, "n Economic Journal, Vol. 80, No. 1, 2013, pp. 5\u201325.\nDuggan, Mark, \u201cMore Guns, More Crime,\u201d Journal of Political Economy, Vol. 109, No. 5, 2001, pp. 1086\u20131114.\nDuggan, Mark, Randi Hjalmarsson, and Brian A. Jacob, \u201cThe Short-Term and Localized Effect o"] [8.631377220153809, 4.039549350738525, "s is provided in Chapter Two. The data used to construct these figures, as well as the full data extraction file with infor- mation from each study, is provided in an online appendix to this report, available at w w w.rand.org/t/R R 2088-1.\n377\n RR-"] [13.19300651550293, 0.3784061372280121, " EXECUTIVE SUMMARY\n Although alcohol-related impaired driving continues to be the primary cause of fatal automobile accidents (National Center for Statistics and Analysis, 2019), drug-impaired driving has emerged as a grow- ing threat to public saf"] [13.196179389953613, 0.38819822669029236, "f implementation.\n\u2022 The costs, risks, and benefits of alternative phlebotomy approaches (e.g., officer training, contracts) should be identified.\n\u2022 Detailed data should be collected on the effectiveness of field sobriety tests when used for actual dr"] [13.193687438964844, 0.3939175307750702, "and court- room presentation.\n\u2022 Laboratory-based toxico- logical screening provides\na more-powerful means\nof drug detection, but its utility can be diminished by delays in acquiring samples, limited labora- tory resources leading to backlogs, and ins"] [13.190292358398438, 0.37683427333831787, "PANTS\nJoe Abrusci\nInternational Association of Chiefs of Police\nKristen Burke\nCalifornia Department of Justice Bureau of Forensic Services\nKevin Deichsel\nColorado District Attorneys\u2019 Council\nScott Flynn\nFullerton Police Department\nSte\u0301phane Fontaine\n"] [13.189497947692871, 0.37964245676994324, " al., 2017). As states across the nation legalize medicinal and recreational cannabis use, cannabis is becom- ing more-readily available and the need to prevent and deter cannabis-impaired driving is becoming increasingly urgent. Recent studies sugge"] [13.198208808898926, 0.36718350648880005, "s.\nequip law enforcement to perform certain observational field tests, which can produce evidence supporting a finding of drug-related impairment: the SFST,5 the Advanced Roadside Impaired Driving Enforcement (ARIDE) test,6 and DRE certi- fication.7 "] [13.195085525512695, 0.3648693263530731, "prosecution of a DUID case difficult and can\nsometimes lead to an incorrect interpretation of results.\nof potential impairment. Other states have decided not to establish such numerical thresholds and instead have adopted zero-tolerance DUID laws, in"] [13.20120620727539, 0.3786921203136444, "y included two panelists from Canada who could offer a perspective on how\nlaw enforcement officers, forensic toxicologists, and prosecutors have been responding to the challenge of drug-impaired driv- ing in light of Canada\u2019s legalization of recreati"] [13.19359302520752, 0.38075241446495056, " categorized as primarily related to law enforcement\n\u2022 three were categorized as primarily related to forensic toxicology\n\u2022 eight were categorized as primarily related to prosecution\n\u2022 ten were categorized as cross-sector.\nTop-tier needs touched on i"] [13.195921897888184, 0.3828771412372589, "t- ing some drug impairment, not just alcohol-related impairment (Porath-Waller and Beirness, 2014). The participants therefore discussed how practitioners can keep a focus on detecting and proving impairment while avoiding unnecessary complica- tion"] [13.19631290435791, 0.37958598136901855, "data on the effectiveness of field sobriety tests when used for actual DUID cases for use in additional research.\n\u2022 Develop and validate training to boost the confidence of officers when testifying (e.g., \u201ccops and court\u201d training).\n\u2022 Identify the ga"] [13.195833206176758, 0.3783750832080841, "rotocol\u2014can create challenges in the prosecution of the case. The ARIDE training was created to offer more-advanced training to officers who were not able to go through the DRE program, but one participant said that there has been a recent rise in no"] [13.20035171508789, 0.3692742586135864, "ld encounter two challenges: (1) the amount\nof travel time required for the DRE to arrive at the specified location and (2) the amount of time it might take for the DRE to administer and document the 12-step protocol to collect evidence of potential "] [13.190787315368652, 0.40179574489593506, "sting law enforce- ment phlebotomy training programs needed to be expanded.14 Others noted that roadside phlebotomy could introduce poten- tial liability and evidentiary challenges. Ultimately, participants considered alternative phlebotomy approache"] [13.19184684753418, 0.3800981044769287, " identity of the impairing drug(s) is not clear; such equipment is versatile and sensitive enough to accurately test for a wide variety of drugs. This type of equip- ment can be very expensive, however, and therefore might be out of financial reach f"] [13.193967819213867, 0.38182541728019714, "hich ultimately\nwould enhance a prosecutor\u2019s ability to bring forward the stron- gest DUID case.\nThe evidence in DUID cases can be complex and hard to cogently present in court in a persuasive manner. Although the participants stated that the observa"] [13.195490837097168, 0.37973877787590027, "tablished, and observations made during prearrest screen- ing (NHTSA, 2015). The documentation of these observations, both before and during contact with the suspect, is critical for providing both evidence of impairment and the legal basis for initi"] [13.196252822875977, 0.37045928835868835, "at with drugs (unlike with alcohol), there generally is not a simple dose response that can associate\na chemical test with a degree of impairment. In other words, \u201cthere is no magic number that could be used\u201d to determine\na level of impairment from a"] [13.193960189819336, 0.37238815426826477, "re various types of chemical tests from a driver suspected of driving while impaired without first obtaining a search warrant, as long as the suspect does not revoke this implied consent by refus-\ning to submit to the chemical test at the time of the"] [13.194103240966797, 0.3676358461380005, "ing incidence of drug-impaired driving.\nCONCLUSION\nDrug-impaired driving persists as a major public safety threat. Preventing and deterring instances of drug-impaired driving require law enforcement officers, forensic toxicologists, and prosecutors t"] [14.944009780883789, 2.165679693222046, "veloped the research agenda that structured the topics presented in the main report. The descriptions in this appendix are adapted from those in previ- ous Priority Criminal Justice Needs Initiative publications and reflect adjustments to the needs i"] [14.890338897705078, 2.0351736545562744, "f Workshop Functions and Objectives\nTests That Establish Impairment: Observational Field Tests\nTests That Establish Impairment: Chemical Tests\nRole of Technology in Improving Impaired Driving Tests\nReview Key Benefits and Challenges Identified During"] [14.829534530639648, 1.8164914846420288, " need\u2019s chance of success between 10 percent (i.e., a rating of 1) and 90 percent (i.e., a rating of 9). This dimension was intended to include not only technical con- cerns (i.e., whether the need would be hard to meet) but also the effect of factor"] [14.781113624572754, 1.7118933200836182, "as standard protocols are followed.\n32%\neach problem and need pairing should be voted up or down on the list. An example of this form is provided in Table A.2.\nWe then tallied the participants\u2019 third-round responses and applied those votes to produce"] [13.33105754852295, 0.45273545384407043, "s of DUID field sobriety tests\nwhen used for actual DUID cases and use\nthose data to conduct additional research.\n 5% 5%\n5% 5%\n0% 123456789\nNOTE: Percentages on each question did not always sum to 100 percent due to rounding and variation in the nu"] [13.365310668945312, 0.46722593903541565, "have limitations that juries are unaware of (which helps to set unrealistic expectations).\nNeed: Develop best practices to maximize the benefits and address the limits of video evidence (with respect to driving under the influence).\n2\n2\n3\n3\n Issue: "] [13.204134941101074, 0.3919624984264374, "with ARIDE and DRE training in many jurisdictions.\nField sobriety tests are effective as long as standard protocols are followed.\nToxicology labs are not doing an adequate job with respect to the scope and sensitivity of DUID testing.\nThere are not e"] [13.198810577392578, 0.3751632571220398, "technologies to find agencies that are willing and able to field test.\nIt is difficult for officers to document and connect what they saw that is related to impairment prior to actually conducting a field sobriety test.\nRoadside oral fluid testing co"] [13.200271606445312, 0.3616560399532318, "e prioritized needs and other results from the discussion reflect the views of the invited experts, and these results do not necessarily reflect the views of researchers from the RAND Corporation, RTI International, or NIJ.\n3 Polydrug use refers to i"] [13.191286087036133, 0.3742513060569763, "hat might indicate impairment from different types of drugs.\n7 The International Association of Chiefs of Police and the NHTSA created the DRE certification to rigorously prepare law enforcement officers to collect evidence of potential drug-induced "] [13.193611145019531, 0.372391015291214, "field, Matthew C. Farrelly, Scott P. Novak, and Gary A. Zarkin, \u201cAssociation Between Self-Reports of Being High and Perceptions About the Safety of Drugged and Drunk Driving,\u201d Health Education Research, Vol. 31, No. 4, 2016, pp. 535\u2013541.\nArnold, Lind"] [13.203207015991211, 0.3456011116504669, "d Traffic Fatality Investigations, Willow Grove, Pa.: Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2016.\n21\n22\nGarner, Bryan A., ed., Black\u2019s Law Dictionary, 8th ed., St. Paul, Minn.: West Publishing Co"] [13.194600105285645, 0.3720594048500061, "Vol. 114, No. 5, 2019, pp. 847\u2013856.\nLogan, Barry, Sherri L. Kacinko, and Douglas J. Beirness, An Evaluation of Data from Drivers Arrested for Driving Under the Influence in Relation to Per se Limits for Cannabis, Washington, D.C.: AAA Foundation for "] [13.930852890014648, 4.223840236663818, "cipation and assistance of the workshop attendees, who are listed in the body of this report. The experiences they shared and the suggestions they put forth form the basis of the recommendations presented in this report. We would like to acknowledge "] [13.920305252075195, 4.176973342895508, "ues.\nDuren Banks is the Division Vice President for Applied Justice Research at RTI International, overseeing research and evaluation projects related to all components of the criminal justice system and community safety. She conducts research on man"] [13.885443687438965, 4.223387241363525, "system, researchers, and lawmakers.\nOther RAND research reports from the Priority Criminal Justice Needs Initiative that might be of interest are\n\u2022 Sean E. Goodison, Michael J. D. Vermeer, Jeremy D. Barnum, Dulani Woods, and Brian A. Jackson, Law Enf"] [0.9086353182792664, -0.32454749941825867, " EXECUTIVE SUMMARY\n SELECTED PRIORITY NEEDS\n RESULTS\nImplementing public education and TFA prevention efforts\n\u2022 Basic primary education should be developed for kids and parents about consent and about the risks and consequences of sharing informa"] [0.9095715284347534, -0.3239733576774597, "nstances of TFA difficult to investigate and adjudicate. Digital anonym-\nity, the ability to collect digital evidence, and the involvement of such technology-related entities as internet providers and social media platforms all present significant ch"] [0.9104296565055847, -0.32398781180381775, "ere ranked by participants according to whether they were high (Tier 1), medium (Tier 2), or lower (Tier 3) priority (see the technical appendix for more details on the method- ology used to prioritize the needs). Twenty-one of the identified strateg"] [0.9092299938201904, -0.32425668835639954, "rtance of efforts to mitigate the significant, irreparable, and persistent harm experienced by TFA victims. Participants called for research to evaluate the extent to which exist-\ning remedies mitigate harm, tools for early detection of TFA, and meth"] [0.9101197719573975, -0.32374003529548645, "sexual favors, or other things of value and threaten to harm or embarrass victims if they fail to comply (Clark, 2016).\n\u2022 nonconsensual pornography: the distribution of nude or sexually explicit images or videos of an individual without their consent"] [0.9128603339195251, -0.32195326685905457, "t they have been victimized or know who to contact for help.\nThe Prevalence of Technology-Facilitated Abuse\nTFA is on the rise. Estimates suggest that between 18 percent and 37 percent of adult Americans have experienced severe online harassment, inc"] [0.9107307195663452, -0.3231414258480072, "d engage in self-harm at alarmingly high rates (Bates, 2017; International Centre for Missing and Exploited Children, 2018; U.S. Department of Justice, 2016). A 2015 Federal Bureau\nof Investigation analysis of 43 sextortion cases found that in\n28 per"] [0.9098426699638367, -0.3238116502761841, "f experts representing local, state, and federal law enforcement; legal professionals; researchers; and experts from victim services and advocacy organizations. Many of the experts invited to attend the work- shop have made significant contributions "] [0.8950054049491882, -0.33344680070877075, "ted\nthe need for better tools to help individuals detect TFA as it is happening and respond. There was a general perception that the seriousness of TFA and its impact on victims were underap- preciated, both within the criminal justice system and out"] [0.9094463586807251, -0.32404854893684387, " (i.e., loss) of swatting and doxing.\nThere is a lack of education and resources about consent and about the risks and consequences of sharing information online.\nIt is unclear how to get relevant stakeholders and the public to care about identifying"] [0.9092699289321899, -0.32412189245224, " irreparable, and persistent harm to the victim.\nThere is resistance and reluctance among victims to come forward.\nLegal remedies and penalties for TFA are inadequate for addressing the harms (e.g., forfeiture, sex offender registry, misdemeanor vers"] [0.9109363555908203, -0.3231494128704071, "ly respond to such behaviors.\nParticipants were intent on ensuring that the term used would adequately capture the variety of behaviors and motiva- tions associated with TFA. Participants agreed that character- izations of TFA must be broad enough to"] [0.9097675085067749, -0.3239653408527374, "s a high-priority need. Participants proposed the implementation of school-based internet safety programs and public service announcements (PSAs) that would educate students and their parents about the consequences\nof sharing information online, the "] [0.9092959761619568, -0.324180006980896, " enforcement is not aware of the relevant statutes and does not understand the consequences of TFA for victims, reports will not be taken, investigations will not be conducted, and cases will not make their way to prosecutors.\nmany states have passed"] [0.9090169072151184, -0.3244493305683136, "sulted\nin the nonconsensual public dissemination of explicit photos of several celebrities. In every instance, individuals were unsuc- cessful in halting the sharing and posting of their photos on\nthe internet, with one exception: a gymnast who publi"] [0.9078365564346313, -0.32509663701057434, ", and training to help address the many challenges in bringing TFA offenders to justice. Although the identified needs often were specific to dif- ferent stages of the justice system\u2014investigation, prosecution, or sentencing\u2014one recommendation that s"] [0.9087053537368774, -0.3244699239730835, "ditation standards for first responders would ensure that it is implemented consistently nationwide. One participant\nParticipants noted that another major challenge for law enforcement agencies in addressing TFA cases is not having the training or re"] [0.9089035391807556, -0.3244054615497589, "orce the offender to take down any content pertaining to the victim.\nMitigating Harm and Empowering Victims\nAccording to participants, the window for getting unwanted material deleted from the internet in TFA cases is often quite small: \u201cIf it\u2019s not "] [0.9092764854431152, -0.3242243826389313, "revalence of TFA and the associated harms, for instance, as a supplement to the National Crime Victimization Survey, would bring attention to the number of victims affected and the extent of the impact.\nParticipants noted that, often, a victim\u2019s prim"] [0.9087756276130676, -0.3244641125202179, " interactions and allow the storage and sharing of content\nhas given rise to new modes and methods of perpetrating harassment, abuse, and other criminal behavior. Social media platforms, gaming forums, content-sharing websites, and other digital spac"] [14.928101539611816, 2.1056084632873535, "op Activities\nWe recruited panel members by identifying knowledgeable individuals through existing professional and social networks (e.g., LinkedIn) and by reviewing literature published on the topic. We then extended invitations to those individuals"] [14.851693153381348, 1.8984408378601074, " Criminal Justice Needs Initiative workshops (see, for example, Jackson et al., 2015; Jackson et al., 2016, and refer- ences therein). The needs were prioritized using a variation of the Delphi Method, a technique developed at RAND to elicit expert o"] [14.8134183883667, 1.7924153804779053, " inspection of the histogram), the participants were asked to discuss or explain their votes at one end of the spectrum or the other. If a second round of discus- sion occurred, participants were given an opportunity to adjust their ratings on the sa"] [14.788424491882324, 1.7078359127044678, "of prioritization, we implemented a method equivalent to the one we used in previ- ous work (Hollywood et al., 2016). Specifically, if every panel member voted \u201cup\u201d for a need that was at the bottom of the list, then the collective effect of those vo"] [14.790987968444824, 1.6827154159545898, "licymaking focus, the second-tier\n0%\nTable A.2. Example of the Delphi Round 3 Voting Form\nQuestion\nTier Vote Up\nVote Down\nTier 3\n1 1\n1\n17\n Tier 1\nTier 2\n Issue: Law enforcement might not prioritize TFA cases.\nNeed: Develop training materials for la"] [14.780805587768555, 1.6902217864990234, "Across Tier Boundaries\n Higher score\nTier 1 score range\n 2\n Tier 2 score range\n22\n2\n 2\nscore 3333\n Tier 3 range\n Lower score\nNOTE: Each example need\u2019s original tier is shown by a circle with a solid border (the two needs starting in Tier 2 an"] [0.9085941314697266, -0.3247723877429962, "are insufficient staff members trained to identify, gather, and process digital evidence.a\nThere is resistance and reluctance among victims to come forward.a\nCriminal justice practitioners are overwhelmed\nby the amount of unstructured data and potent"] [0.9086647033691406, -0.32454714179039, "and coordination between people working in the TFA space.\nExisting legal and other conceptions do not capture the full scope of TFA.a\nThere is resistance and reluctance among victims to come forward.a\nThere are limited resources for managing TFA case"] [0.9093643426895142, -0.3241160809993744, ".\n\u2022 Implement an \u201cinternet panic button\u201d for users.\nTFA can cause significant, irreparable, and \u2022 Reevaluate platform responsibility for TFA. persistent harm to the victim.a\nMedia and social media reporting of swatting, \u2022 Develop media and social med"] [14.020395278930664, 3.674794912338257, "on on the survey, see Bureau of Justice Statistics, undated.\n2 We have documented law enforcement challenges and needs related to digital evidence and anonymizing tools in several prior reports. For more information, see Goodison, Davis, and Jackson,"] [13.973795890808105, 3.8063771724700928, "entre for Missing and Exploited Children, Studies in Child Protection: Sexual Extortion and Nonconsensual Pornography, Alexandria, Va., 2018. As of November 8, 2019: https://www.icmec.org/studies-in-child-protection-sexual-extortion- and-non-consensu"] [13.96945858001709, 4.123092174530029, ". 30\u201354.\nRAND Corporation, \u201cDelphi Method,\u201d webpage, undated-a. As of May 7, 2020:\nhttp://www.rand.org/topics/delphi-method.html\nRAND Corporation, \u201cPriority Criminal Justice Needs Initiative,\u201d webpage, undated-b. As of May 7, 2020: www.rand.org/well-"] [13.939407348632812, 4.1808366775512695, " other policy concerns pertaining to public safety and criminal and civil justice. For more information, email justicepolicy@ rand.org.\n23\n24\nAbout the Authors\nAmanda R. Witwer is a research analyst in the Division for Applied Justice Research at RTI"] [13.932038307189941, 4.044392108917236, " of Denver, is carrying out a research effort to assess and prioritize technology and related needs across the criminal justice community. This research effort, called the Priority Criminal Justice Needs Initiative, is a component of the Criminal Jus"] [13.852832794189453, 4.618472576141357, "altered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html. For "] [-2.7045438289642334, 14.476304054260254, " CORPORATION\nMELISSA L. FINUCANE, AARON CLARK-GINSBERG, ANDREW M. PARKER,\nALEJANDRO U. BECERRA-ORNELAS, NOREEN CLANCY, RAJEEV RAMCHAND, TIM SLACK, VANESSA PARKS, LYNSAY AYER, AMANDA F. EDELMAN, ELIZABETH L. PETRUN SAYERS, SHANTHI NATARAJ, CRAIG A. "] [12.65722942352295, 13.57927417755127, "es; private-sector companies involved in reducing risk; and scientists and donors (federal and private) responsible for distributing resources that support research in this field.\nCommunity Health and Environmental Policy Program\nRAND Social and Econ"] [-2.6918046474456787, 14.4686918258667, "......3 Overview of This Report...........................................................................................................................5\n2. Conceptual Framework of Community Resilience and Vulnerability to Environmental Disasters ."] [-2.6999127864837646, 14.473421096801758, "............................35\nRecommendation 5: Deepen and Communicate the Evidence Base for Building Community Resilience..............................................................................................................................."] [-2.697197675704956, 14.472655296325684, "ale of the disaster motivated diverse stakeholders to examine the human dimensions of the spill and how communities\u2019 resilience to similar threats could be improved. This examination is needed because, as long as humans depend on extracting oil and g"] [-2.6940338611602783, 14.469993591308594, "vidence of distress associated with the DWH disaster and a variety of factors that affected the nature and severity of people\u2019s experiences. Key findings from the research are shown in Table S.1.\nTable S.1. Key Research Findings\nMental Health Distres"] [-2.5654382705688477, 14.424546241760254, "literature review and workshop discussions, several themes emerged regarding ways to reduce the stress of large oil spills and build resilience to catastrophic events. These multifaceted themes formed the basis of several key recommendations, as show"] [-2.6424834728240967, 14.452320098876953, " private sector, scientists\nGovernment (all levels), private sector\nTable S.2. Summary of Recommendations\nStakeholders with Primary Role\n x\n Recommendation\n\u2022 Deepen the evidence base for building community resilience.\no Partner with communities t"] [-2.705381393432617, 14.476339340209961, " spill should serve as turning points, after which society evaluates how to improve community efforts to prepare for, respond to, recover from, and prevent such catastrophes. Ten years after the DWH oil spill, it is time to assess the recommendations"] [-2.6780712604522705, 14.464487075805664, "ermore, implications of those findings have yet to be distilled into recommendations for specific stakeholder groups.\nReport Goal and Aims\nIn this report, researchers synthesize existing research to determine the opportunities and challenges facing s"] [-2.7079453468322754, 14.476058959960938, "h, economic, and community functioning. Initial results of the literature review were presented to representatives of nongovernment organizations, academic researchers, and community leaders who attended a workshop in New Orleans on February 8, 2019."] [-2.7037453651428223, 14.473713874816895, ".9 From those funds, about $12 billion was paid to individuals, companies, and local governments for losses caused by damages to the Gulf\u2019s ecosystem. The compensation system implemented by BP was one of the largest in U.S. history, but the company w"] [-2.201601028442383, 14.260298728942871, "and built environments. A combination of community capacities and chronic stressors (working independently or through interaction) strongly influences the recovery (or dysfunction) trajectories of individuals and communities over time.\n 1 Patel et a"] [-2.6734845638275146, 14.463218688964844, "e collaboratively to make decisions and act according to the outcome of those decisions.\nThe result of a shock is usually a mix of recovery and dysfunction\u2014for example, a community\u2019s economy might recover quickly, but its members might continue to st"] [-2.706310510635376, 14.475566864013672, "phic characteristics are important drivers of negative mental health symptoms.\nHigherlevelsofsocialcapital\u2014particularlysocialsupport,senseofcommunity,and perceived resiliency\u2014have a protective impact against spill-related stress in most cases, except"] [-2.705686092376709, 14.475032806396484, "; Grattan et al., 2011; Morris et al., 2013; Osofsky, Hansel, et al., 2015; Rung et al., 2016; Ramchand et al., 2019; Kwok, Mcgrath, et al., 2017; Gaston et al., 2017.\n2 Buttke, Vagi, Bayleyegn, et al., 2012; Buttke, Vagi, Schnall, et al., 2012; Cher"] [-2.700383186340332, 14.472939491271973, " in the Gulf Coast Region\n Total Louisiana\nTexas (reference) Mississippi Alabama\nFlorida\nSex\n7 Fan et al., 2015.\n8 Rung et al., 2016.\n9 Ramchand et al., 2019.\nDepression Screen (% SE)\n16.2 (1.5) 18.1 (2.4) 12.0 (2.1) 20.3 (2.9)a 13.4 (2.4) 19."] [-2.709423303604126, 14.476836204528809, "edictor of anxiety and depression was reported income loss related to the oil spill.15 A study of residents in coastal Alabama and Florida found that, compared with people with stable incomes, people reporting spill-related income loss had statistica"] [-2.746119499206543, 14.509610176086426, "tudy highlighted commercial fishers as particularly at risk for depression symptoms, consistent with the stress of losing multiple types of resources (e.g., job security, social networks, money, boat, self-esteem); these detrimental impacts were not "] [-2.693418025970459, 14.471048355102539, "igion is not very salient.36 In this case, we speculate that the distribution of social resources was uneven across religious and nonreligious individuals. These studies hint at important mechanisms that could contribute to the vulnerability of some "] [-2.7242531776428223, 14.483149528503418, "he Gulf Coast region. In the long term, high proportions of households reported negative financial experiences associated with the oil spill. The nature of the economic impacts of the DWH oil spill have been documented in about ten papers and reports"] [-2.7181549072265625, 14.480134963989258, "ver a seven-year period.8 In contrast to the predictive approach, more-recent analysis, based on observed data of Gulf blue crab fishing and analyzed using a quasiexperimental difference-in-differences approach, suggested that there were substantial "] [-2.7259745597839355, 14.48926067352295, "ugh many deep-water rigs in the Gulf of Mexico were not producing during the moratorium, drilling contractors, rig operators, and well servicing firms mostly retained their highly skilled employees, at least initially. Although oil production stopped"] [-2.704735040664673, 14.474373817443848, "those operating in the post- spill period.\nLimitations\nThere are several methodological limitations associated with the studies cited here. First, it can be difficult to identify the causal impact of the oil spill on economic outcomes. Although both "] [-2.6824471950531006, 14.466118812561035, "lude community-based participatory methods, random sampling, qualitative and quantitative analyses, and a focus on immediate and longer-term impacts in various coastal locations. A challenge in interpreting the findings relates to the many potential "] [-2.7052199840545654, 14.475021362304688, "ill itself. Analyses showed that being part of the compensation process was one of the strongest contributors to intrusive stress among coastal residents.\nResearch on the compensation process following the DWH oil spill suggests that the process for "] [-2.6931753158569336, 14.471975326538086, "tal impact of economic exposure on mental health symptoms, such as depression, could be explained almost entirely by economic exposure\u2019s detrimental impact on social resources (e.g., counting on family or friends for everyday favors).13\nThe community"] [-2.567683696746826, 14.426739692687988, "onclusions about community distress that can be drawn from the findings reported above. Perhaps the most fundamental challenge is deciding what is meant by community. Individuals and households can possess a sense of community through attachment to p"] [-2.541476011276245, 14.406427383422852, "holders with a Role in Addressing Each Recommendation\nNon-\nFederal State Local governmental Private\nGovernment Government Government Organizations Sector Scientists\n 1. Focus on the needs of people and their communities.\n \u2022 Addr"] [-2.5999600887298584, 14.438311576843262, "h participatory research approaches\n(e.g., partner with local organizations to design surveys and collect information)\nu\u0308u\u0308u\u0308\n \u2022 Use prospective research designs, collect baseline data, and broaden the definition of exposure (e.g., incl"] [-2.5164148807525635, 14.4061279296875, " evaluation.\nEnsure Ongoing Local Support\nIn the medium to long term, support resources need to be sustained to address the chronic stress that individuals report experiencing and to strengthen various capacities in communities. Specifically, resourc"] [-2.4669718742370605, 14.392906188964844, " the social systems in which disasters are managed. Although physical and natural scientists play a critical role in providing important technical information and insights, government is primarily responsible for leading response efforts, and public "] [-2.5791585445404053, 14.433089256286621, "f the physically contaminated zone, affecting social and economic systems more broadly. Designing recovery efforts in a way that maintains and improves the well-being of impacted communities can help groups with few livelihood alternatives (e.g., fis"] [-2.430952548980713, 14.378233909606934, "n particular needs to establish strong, sustained local partnerships in advance of a crisis event so that local context is well understood and trusted relationships can be\n10 Ritchie, Gill, and Long, 2018.\n11 Mayer, Running, and Bergstrand, 2015.\n12 "] [-2.5116188526153564, 14.41315746307373, "ders with a primary role in helping leverage diverse skills to build systems-level capacity are federal government agencies (e.g., the U.S. Department of\n15 Browne, 2015; Bankoff and Hilhorst, 2009; Hewitt, 2012.\n16 Lesen et al., 2019; Wilkinson, 201"] [-2.614197254180908, 14.438553810119629, " across different types of decisionmakers.24\n21 Finucane et al., 2019.\n22 Nicholls, Picou, and McCord, 2017.\n23 Kwok, Engel, et al., 2017; Oliver-Smith, 2012; Oliver-Smith et al., 2017; Knowles, 2014; Morse, 2008; Ryder, 2017; Osofsky et al., 2012.\n2"] [-2.575068473815918, 14.424694061279297, "P Deepwater Horizon Oil Spill and Offshore Drilling, 2011. 27 Chaplin, Twigg, and Lovell, 2019.\n28 Osofsky et al., 2012.\n29 Cutter, Boruff, and Shirley, 2003.\n30 Osofsky et al., 2012.\n 36\nImprove Adaptive Capacity Through Preparedness and Diversifica"] [-2.5929436683654785, 14.434517860412598, ", 2000; Gallopi\u0301n, 2006.\n32 United Nations Office for Disaster Risk Reduction, undated; Federal Emergency Management Agency, 2018. 33 Cruz and Suarez-Paba, 2019.\n 37\nonly 1 percent of oil spill studies conducted between 1968 and 2015.34 Furthermore, "] [-2.6015095710754395, 14.43832778930664, "ly accessible terms and phrases. The authors argue that with these processes in place, community members can be\n34 Murphy et al., 2016.\n35 Cutter, Boruff, and Shirley, 2003. 36 Wall, McNie, and Garfin, 2017. 37 Lesen et al., 2019.\n38 Lesen et al., 20"] [-2.6655361652374268, 14.460185050964355, "h groups could be minimized.46 Access issues can be particularly salient for marginalized and vulnerable populations. Participation in the generation or consumption of research studies may be inhibited by linguistic and cultural differences. Collecti"] [-2.7017288208007812, 14.471073150634766, "ethods used to develop this report that necessarily limit the conclusions that can be made. First, papers in preparation or other work still in progress are not included and new evidence or insights may emerge in the near future that alter our unders"] [-2.707998037338257, 14.4747896194458, " of academic and grey literature. We searched \u201cDeepwater Horizon\u201d in Web of Science (returning 1,534 documents) and in PubMed (returning 783 documents). We reviewed other databases from websites, including research and policy organizations (e.g., Lou"] [14.93455982208252, 2.0753982067108154, "elicited feedback on our results through a facilitated conversation with workshop participants focused on the following topics:\n\u2022 If you wanted someone to take away just one thing from this work, what would that be?\n\u2022 What strikes you as really impor"] [12.842308044433594, 13.962580680847168, "Patient questionnaires Probabilistic telephone survey\nPurposive sampling, in-person survey\nProbabilistic telephone survey\nCluster sampling, in- person household surveys\nCluster sampling, in- person household surveys\nIn-person survey\nRepresentative te"] [-2.6987764835357666, 14.469681739807129, "ontinental United States\nTX, LA, MS, AL, FL\nLA, MS, AL, Fl\nFL\nFL\nFL\n Authors (Date)\nNadeau et al. (2014)\nSumaila et al. (2012)\nU.S. Department of Commerce (2010)\nWhitehead et al. (2018)\nAustin et al. (2014) Cope et al. (2013)\nCope et al. (2016) C"] [-2.7034945487976074, 14.474555969238281, "trics.\n3. Losses in recreational activities were between 600 and 700 million dollars.\nTop Three Gaps in Knowledge\n1. Why were certain sectors more resilient than others?\n2. How did the effects of the spill differ across individual fishers/businesses?"] [-2.7106616497039795, 14.481257438659668, "er Horizon Oil Spill and Offshore Oil Drilling Moratorium, Cambridge, Mass.: National Bureau of Economic Research, 2014.\nAlvarez, Sergio, Sherry L. Larkin, John C. Whitehead, and Tim Haab, \u201cA Revealed Preference Approach to Valuing Non-Market Recreat"] [-2.703920602798462, 14.476749420166016, "onse\n52\n(CASPER) One Year Following the Gulf Coast Oil Spill: Alabama and Mississippi, 2011,\u201d Prehospital and Disaster Medicine, Vol. 27, No. 6, 2012b, pp. 496\u2013502.\nCarney, Diana, Sustainable Rural Livelihoods: What Contribution Can We Make? London: "] [-2.7056336402893066, 14.476662635803223, ": Evidence from Critical Infrastructure Cybersecurity Standards,\u201d Science and Public Policy, Vol. 46, No. 3, 2018.\nCope, Michael R., Tim Slack, Troy C. Blanchard, and Matthew R. Lee, \u201cDoes Time Heal All Wounds? Community Attachment, Natural Resource "] [-2.1890270709991455, 14.278868675231934, "Population Survey,\u201d Journal of Behavioral Health Services and Research, Vol. 42, No. 1, 2015, pp. 23\u201341.\nFederal Emergency Management Agency, A Whole Community Approach to Emergency Management: Principles, Themes, and Pathways for Action, Washington,"] [-2.730330228805542, 14.499462127685547, "gical Disaster and Chronic Community Stress,\u201d Society and Natural Resources, Vol. 11, No. 8, 1998, pp. 795\u2013815.\nGill, Duane A., Steven Picou, and Liesel Ashley Ritchie, \u201cThe Exxon Valdez and BP Oil Spills: A Comparison of Initial Social and Psycholog"] [-2.71150279045105, 14.480302810668945, "ngineering, Vol. 3, No. 4, 2015, pp. 1260\u20131271.\nHarville, Emily W., Arti Shankar, Christine Dunkel Schetter, and Maureen Lichtveld, \u201cCumulative Effects of the Gulf Oil Spill and Other Disasters on Mental Health Among Reproductive-Aged Women: The Gulf"] [-2.7091989517211914, 14.479846000671387, "lue to the State of Florida,\u201d Journal of Agricultural and Applied Economics, Vol. 45, 2013, pp. 389\u2013399.\nLawther, Peter M., \u201cCommunity Involvement in Post Disaster Re\u2010Construction\u2013Case Study of the British Red Cross Maldives Recovery Program,\u201d Intern"] [-2.7098772525787354, 14.478599548339844, "ical Responses and Resilience of People and Communities Impacted by the Deepwater Horizon Oil Spill,\u201d Transactions of the American Clinical and Climatological Association, Vol. 124, 2013, p. 191\u2013201.\nMorse, Reilly, Environmental Justice Through the E"] [-2.71052885055542, 14.479804039001465, "egrated Research on Disaster Risk, 2016.\n\u2014\u2014\u2014, \u201cThe Social Construction of Disaster Risk: Seeking Root Causes,\u201d International Journal of Disaster Risk Reduction, Vol. 22, 2017, pp. 469\u2013474.\nOsofsky, Hari M., Kate Baxter-Kauf, Bradley Hammer, Ann Maila"] [-2.7167835235595703, 14.48305606842041, " No. 2, 2019.\nPatel, Megha M., Leia Y. Saltzman, Regardt J. Ferreira, and Amy E. Lesen, \u201cResilience: Examining the Impacts of the Deepwater Horizon Oil Spill on the Gulf Coast Vietnamese American Community,\u201d Social Sciences, Vol. 7, No. 10, 2018, p. "] [-2.714003086090088, 14.480820655822754, " Deepwater Horizon Oil Spill in the WaTCH Study,\u201d Environmental Health Perspectives, Vol. 124, No. 9, 2016, pp. 1429\u2013 1435.\nRung, Ariane L., Symielle Gaston, William T. Robinson, Edward J. Trapido, and Edward S. Peters, \u201cUntangling the Disaster-Depre"] [-2.7142772674560547, 14.48139762878418, "esearch, Vol. 146, 2016, pp. 108\u2013115.\nStrelitz, Jean, Lawrence S. Engel, Richard K. Kwok, Aubrey K. Miller, Aaron Blair, and Dale P. Sandler, \u201cDeepwater Horizon Oil Spill Exposures and Nonfatal Myocardial Infarction in the GuLF STUDY,\u201d Environmental "] [-2.7120704650878906, 14.479588508605957, "esearch, Vol. 19, No. 10, 2016, pp. 1220\u20131230.\nWhitehead, John C., Tim Haab, Sherry L. Larkin, John B. Loomis, Sergio Alvarez, and Andrew Ropicki, \u201cEstimating Lost Recreational Use Values of Visitors to Northwest Florida due to the Deepwater Horizon "] [15.879366874694824, 10.498746871948242, "Health Service Utilization and Costs at the Outset of a Permanent Supportive Housing Program\nBaseline Evaluation Report\nRYAN K. MCBAIN, SARAH B. HUNTER, ADAM SCHERLING, ALINA I. PALIMARU, MATTHEW CEFALU, WILLIAM MCCONNELL, PRIYA BATRA\n SOCIAL AND EC"] [12.649535179138184, 13.57446575164795, "nd costs evolve over the course of the program, relative to a cohort of individuals experiencing homelessness who are not enrolled in the program over the same time frame. This report should be of interest to public and private health care organizati"] [15.888070106506348, 10.495797157287598, "............3 Study Setting.............................................................................................................................................3 Recruitment and Enrollment......................................................"] [15.92844009399414, 10.563603401184082, "tcomes in certain populations, such as individuals with HIV/AIDS.\nThe Affordable Care Act (ACA) expanded the eligibility requirements for Medicaid, allowing a large number of adults who experience homelessness to become Medicaid-eligible. Also, a rec"] [15.885591506958008, 10.51648998260498, "naged care plan was successful in identifying and enrolling a cohort of high-need beneficiaries into its PSH program. The 164 individuals enrolled to date exhibited multimorbid physical and behavioral health conditions and significant health service "] [15.858057022094727, 10.486035346984863, "ong-term unemployment (Slesnick, Zhang, and Yilmazer, 2018). Sustained multimorbidity creates long-term competing challenges that may persist even after an individual secures housing (Schick et al., 2019; Henwood et al., 2018).\nThe Value of Permanent"] [15.918055534362793, 10.561258316040039, "ged care plan serving more than 1 million members in inland Southern California. The health plan has established an algorithm to identify high utilizers of their health system who are dealing with chronic housing insecurity, and the plan sought to en"] [15.91154670715332, 10.534584999084473, " for help with activities of daily living; (3) at least six months of active eligibility for plan benefits in the member\u2019s lifetime; (4) at least seven inpatient days in an acute care facility in the past 12 months; (5) self-reported homelessness, th"] [15.949950218200684, 10.584563255310059, "vice charge for an event (typically a medical service provided) at a specified location for a set of diagnoses on a given date.\nWe conducted a series of descriptive analyses to summarize participant characteristics in the 12 months prior to PSH enrol"] [15.938750267028809, 10.631442070007324, " Demographic Characteristic\nBehavioral health conditions Mental health conditions Substance use disorders\nSample (n) Percentage 91 55%\n72 44%\n50 30%\n NOTE: Behavioral health conditions comprise both mental health conditions and substance use d"] [15.988879203796387, 10.60303020477295, "492 $1,753\n$2,452 $15,834 $7,323\n$998 $4,905\n$70,447\nAmount\nPer Patient Event\n$2,910 $2,094 $1,583\n$396 $232\n$280 $98\n$195 $1,750 $3,715\n$178 $142\n$683\n NOTES: Patient visits to psychiatric facilities are underrepresented; these services are p"] [16.004560470581055, 10.635013580322266, "ervice utilization and associated costs in the year prior to program enrollment. The most frequent locations of service utilization (Table 3.2) were represented by ambulance services (2,866 patient events), inpatient general hospital care (2,125 pati"] [15.935457229614258, 10.554661750793457, "the managed care plan has been successful in identifying and enrolling a cohort of high-need beneficiaries into its PSH program. The 164 individuals enrolled to date exhibited multimorbid physical and behavioral health conditions and significant heal"] [15.919528007507324, 10.52780818939209, "the subsequent 12 months of enrollment.\nLastly, with regard to demographic characteristics of participants, it appears that recruitment efforts to date have captured a relatively diverse group of individuals with respect to race/ethnicity, with rough"] [15.843725204467773, 10.463371276855469, "x physical and behavioral health needs of the population served by this program, including high utilization of emergency services and hospitalizations that\n13\nresult in significant health expenditures. The data also demonstrate the ability of the hea"] [15.743124961853027, 10.343314170837402, "No. 2, 2018, pp. 415\u2013418.\nHogan, James, Scattered-Site Housing: Characteristics and Consequences, Seattle, Wash.: U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Septempber 1996. As of June 1, 2020: https:"] [15.7243070602417, 10.29345417022705, "d Quality of Life of Individuals in Permanent Supportive Housing Who Were Formerly Chronically Homeless,\u201d American Journal of Public Health, Vol. 109, No. 2, 2019, pp. 313\u2013319.\nSlesnick, Natasha, Jing Zhang, and Tansel Yilmazer, \u201cEmployment and Other"] [12.686134338378906, 13.671090126037598, "Exploring the Impact\nof COVID-19 on Social Services for Vulnerable Populations in Los Angeles\nLessons Learned from Community Providers\nSTEPHANIE BROOKS HOLLIDAY, SARAH B. HUNTER, ALEX R. DOPP, MARGARET CHAMBERLIN, MARTIN Y. IGUCHI\n SOCIAL AND ECONOM"] [17.861736297607422, 3.944643020629883, "rs and income from operations.\n iii\nContents\nPreface ........................................................................................................................................... iii Figures ............................................."] [17.84580421447754, 3.94883394241333, "..................................7 Figure 3.2. Equity Concerns and Vulnerable Populations ............................................................12\n v\nTables\nTable 4.1. Summary of Facilitators, Barriers, and Proposed Solutions ................."] [17.788728713989258, 4.029540061950684, " Heilbrun at Drexel University and Nicole Eberhart at the RAND Corporation.\n viii\nAbbreviations\nCFIR Consolidated Framework for Implementation Research\nCOVID-19 coronavirus disease 2019\nIHME Institute for Health Metrics and Evaluation (University of "] [17.85325050354004, 3.9478743076324463, "interview guide that covered the following topics:\n\u2022 sources of information guiding organizations\u2019 pandemic response plans\n\u2022 changes made in response to COVID-19 regarding services, communication, policies,\nprocedures, or some combination thereof\n\u2022 b"] [17.85275650024414, 3.9564321041107178, "ontrol and Prevention, the World Health Organization), state and local public health agencies, the University of Washington\u2019s Institute for Health Metrics and Evaluation (IHME)\u2019s COVID-19 infection projections (IHME, 2020), personal connections with "] [17.8582820892334, 3.9403064250946045, ").\nWe also learned of ways in which programs and organizations have adjusted the focus of their services. Organizations have emphasized getting individuals into housing and supporting maintenance of housing. There has been a shift to providing food a"] [17.858097076416016, 3.935900926589966, ", talked about quickly mobilizing a crisis-management team who would meet regularly (e.g., weekly) and disseminate guidance. In some cases, these teams included infectious disease experts, who were seen as particularly valuable to guiding the organiz"] [17.865524291992188, 3.919571876525879, " from their clients placed signs on their doors with information about available services and any key guidance that might be needed. Providers also expanded the types of services provided, as described previously (e.g., providing food and other goods"] [17.85101890563965, 3.9427378177642822, "one interviewee highlighted:\nPre-COVID, our [space was] a place of respite. That was such a loss for [our clients]. Losing the libraries and parks. Safe spaces, those have really diminished.\nInner Setting\nInterviewees discussed the importance of proa"] [17.851123809814453, 3.949404716491699, "bed how staff are working to provide quality services to clients while balancing the impact of the pandemic on their own health and well-being. Some interviewees described the importance of additional professional supports (e.g., increased supervisio"] [17.859466552734375, 3.9401192665100098, "intments, COVID-related service requests, and additional documentation of supports offered to clients.\n\u2022 Client status and symptoms: This includes tracking client responses and needs over time, including mental health needs, medical issues, substance"] [17.861005783081055, 3.942193031311035, "ces could also lead to an exacerbation of existing mental health and substance use disorders. Fourth, interviewees cited barriers to determining what is accurate information about COVID-19. For example, one interviewee noted that in certain homeless "] [17.853084564208984, 3.9444217681884766, "s and involved with the criminal justice system\u2014during the early stages of the COVID-19 pandemic. Our goal was to understand the ways in which organizations have adapted their services and ultimately identify early lessons learned and innovative solu"] [17.85015106201172, 3.9448368549346924, "erns.\nRecommendations\nThough certain services are beginning to reopen in Los Angeles County, it is clear that COVID-19 will continue to influence the way services are provided\u2014especially to vulnerable populations\u2014for the foreseeable future. The chang"] [17.851320266723633, 3.9434385299682617, "use technology (e.g., older individuals, those recently released from long periods of incarceration).\n4. Focus on equity issues because the pandemic is creating disproportionate impacts that will likely widen over time. There are concrete steps that "] [17.85734748840332, 3.936675786972046, "sly described, COVID-19 has placed great burdens on staff of provider organizations, increasing their potential support needs. Support for staff might include making sure that organizations are aware of resources that are available to providers on th"] [17.851577758789062, 3.9438793659210205, "identification and other benefits offices be considered essential services\n\u2022 Temporarily waive inspection and identification requirements\n Access to benefits (B)\nSome offices closed or reduced access\n\u2022 Provide support for organizations to engage "] [17.79768943786621, 4.052585124969482, "mic.\n18\nReferences\nDamschroder, Laura J., David C. Aron, Rosalind E. Keith, Susan A. Kirsh, Jeffery A. Alexander, and Julie C. Lowery, \u201cFostering Implementation of Health Services Research Findings into Practice: A Consolidated Framework for Advancin"] [17.924100875854492, 3.953671455383301, "y Today to Accelerate the Curve on Access and Quality Tomorrow,\u201d JMIR Mental Health, Vol. 7, No. 3, March 2020.\nUniversity of Wisconsin Department of Psychiatry, \u201cSupport for Healthcare Providers,\u201d webpage, undated. As of July 30, 2020: https://www.p"] [15.385537147521973, 10.42432975769043, " The Law Enforcement Response to Homelessness\nIdentifying High-Priority Needs to Improve Law Enforcement\nStrategies for Addressing Homelessness\nSean E. Goodison, Jeremy D. Barnum, Michael J. D. Vermeer, Dulani Woods, Siara I. Sitar, Brian A. Jackson\n"] [15.382811546325684, 10.424524307250977, "ficer health and wellness.\nPartnerships and collaboration with service providers and communities\n\u2022 Research should be conducted to identify the poten- tial waste, costs, and benefits associated with siloed service provision.\n\u2022 A promising practices g"] [15.385091781616211, 10.424095153808594, "f affordable housing are broadly considered the key variables at play, homelessness can manifest differently across the country. For example, some areas have more challenges with unsheltered homelessness, particularly in locales with\na mild climate, "] [15.493090629577637, 10.397391319274902, "olutions to fill gaps or needs left unaddressed by existing responses, and evaluate whether new approaches achieve intended outcomes.\n Although poverty and the lack\nof affordable housing are broadly considered the key vari- ables at play, homelessn"] [15.533552169799805, 10.40839958190918, "y one-fifth (19 percent) were considered chronically homeless,\nmeaning a person \u201cwith a disability who has been continu- ously homeless for 1 year or more or has experienced at least four episodes of homelessness in the last 3 years\u201d (Henry et al., 2"] [15.399864196777344, 10.418559074401855, "disorder, have a previous criminal history and/ or history of incarceration, have low income, and have weak social connections and/or family support are more at risk for becoming homeless than individuals without those risk factors (National Academie"] [15.603880882263184, 10.352035522460938, "nt guidance. Three recent works\u2014a meta-analysis of homelessness intervention programs (Munthe-Kaas, Berg, and Blaasv\u00e6r, 2018), a report on the state of homelessness in America (Council of Economic Advisers, 2019), and a 2018 report by the National Ac"] [15.614262580871582, 10.360291481018066, "ess, 2016). Finally, Munthe-Kaas, Berg, and Blaasv\u00e6r recommend that worldwide interventions should be considered, which have been an area of development since the meta-analysis was conducted (see, for example, Goering et al., 2014; and Jacups, Rogers"] [15.582517623901367, 10.427163124084473, " larger impact on risk factors for homelessness, such as substance use and mental health disorders, than other approaches and suggests that it is more expensive than other alternatives. The NASEM report notes that PSH is important in increasing the a"] [15.382416725158691, 10.422317504882812, " NIJ and other stakeholders to discover and implement novel law enforcement responses to homelessness. The meeting was held on February 5 and 6, 2020, in Washington, D.C., at the NIJ offices within the Office of Justice Programs headquarters. The wor"] [15.374468803405762, 10.424283981323242, "needs. After the workshop, these needs were assessed and grouped into the following four broad operational categories (which are related to the four topical themes of the workshop):\n\u2022 Promising law enforcement practices and policy needs are related t"] [15.379166603088379, 10.425141334533691, " fourth need called for an evaluation of the benefits of innovative law enforcement approaches to mitigating justice problems that could contrib- ute to homelessness. Examples of such innovative strategies mentioned by the participants include warran"] [15.377339363098145, 10.424766540527344, "he data that are collected and share it appropriately with all relevant partners might produce database products that are actionable for only some users, leading others to abandon the data products when determining how to best fulfill roles and serve"] [15.381278991699219, 10.424962043762207, "ts in wasted resources and ineffective responses.\nLaw enforcement has limited choices to respond to frequent, minor incidents related to homelessness.a\nThe general public often has a flawed perspective about what law enforcement can and cannot do to "] [15.381399154663086, 10.423017501831055, " clinic or institutional only, or do not allow individuals to bring their property or pets with them).a\nThere are high-frequency utilizers who have a significant impact on law enforcement and other public services.\nThere is a lack of recognition of t"] [15.406508445739746, 10.422218322753906, "ants, references to other literature sources have been included where appropriate to provide more detail and support for the assertions and opinions discussed by the participants during the workshop (for example, where a participant might have mentio"] [15.461230278015137, 10.40187931060791, "tor influencing home- lessness is the unavailability of affordable housing options. The cost of housing is affected by numerous factors that can vary by jurisdiction, such as housing regulations, population growth, residential demand within neighborh"] [15.408113479614258, 10.407703399658203, "ble to community members (e.g., number of arrests), and communities see law enforcement responses as more immedi- ate because police are a phone call away from being on site for a wide variety of public concerns. However, experts discussed the oversi"] [15.391473770141602, 10.422818183898926, "lthough the challenge of homelessness might vary widely across jurisdictions, law enforcement has daily experience\nwith issues that are highly related to homelessness; specifically, mental health crises, substance use disorders, and criminal victimiz"] [15.395026206970215, 10.420886039733887, "EH with useful social services\u2014particularly for people expe- riencing unsheltered homelessness\u2014is that some are \u201cresistant\u201d to services that are offered to them (they consistently choose\nto decline services or opt not to engage with available service"] [15.393325805664062, 10.421854019165039, "bstances can negatively affect the mental and physical well-being of PEH. Experts also agreed that the inter- sectionality of these and other issues, such as trauma history, with homelessness requires further examination.\nThere is a higher likelihood"] [15.385758399963379, 10.424653053283691, "ses of homelessness, police are constantly under pressure from business leaders and members of the community to \u201cfix\u201d homelessness.\nenvironment or to have their belongings stored, and making services available to establish an environment of trust. Pa"] [15.387699127197266, 10.423550605773926, "ciently to promote public safety.\nThe law enforcement participants on the panel also highlighted efforts to reduce barriers to housing, employment, and other resources, such as warrant-clearing events or forgiving indi- viduals\u2019 fines and fees. Some "] [15.380285263061523, 10.420282363891602, "to be accessible to all persons, regard- less of ability. There is also uncertainty in the law regarding people living in recreational vehicles and campers and whether they could be considered homeless and part of an encamp- ment. Recreational vehicl"] [15.382012367248535, 10.422924041748047, " criticism\nin many cases if the community expects a rapid response to any problem. Unaddressed criticism can then generate public dissatisfaction about the way the problem is being addressed\nor the ways in which PEH are being treated. A key area for "] [15.3882417678833, 10.424189567565918, "lt to collect valid and reliable data on individuals experiencing unsheltered homelessness, given the characteristics of the population and the brief nature of their contact with government officials.\nBetter data would enable front-end analysis to be"] [15.383408546447754, 10.424236297607422, "noncriminal police encounters with PEH are recorded. Therefore, it can be difficult for agencies to determine what percentage of their workload involves this population. Track- ing these interactions, what actions officers take, and what the resultin"] [15.396142959594727, 10.417895317077637, "(e.g., psychiatrists, nurses, and other medical professionals), community leaders, and those with lived experience.\nlaw enforcement agencies often are skeptical of participating\nin research studies without having a voice in the design and implementat"] [15.385951042175293, 10.421772956848145, "enda to support police responses to PEH. These needs include finding ways to better define the nature and scope of homelessness to assess the needs of these communities. The needs also involve develop- ing a better understanding of related issues, su"] [14.935189247131348, 2.101346969604492, "se individuals and provided a brief description of the workshop\u2019s focus areas. Ten of the ini- tial 25 declined participation, although four of the ten people\nwho declined provided an alternate potential attendee from their organization who we subseq"] [14.866759300231934, 1.9606678485870361, "ators had the potential to influence the questions they posed to the group and how they phrased those questions. This also could introduce bias that could influence the findings.\nTo develop and prioritize a list of technology and policy issues that a"] [14.812565803527832, 1.8012714385986328, "oner workloads, other staffing concerns, and societal concerns.\nAfter the participants rated the needs displayed on a particular slide (i.e., for either importance or probability of success), we displayed a histogram-style summary of participant resp"] [14.789661407470703, 1.7573148012161255, "ve to the others. To collect these assessments, we printed the entire tiered list and distributed it to the participants. This step allowed the participants to see all of the ranked needs collected across the day-and-a-half work- shop, providing a to"] [14.769244194030762, 1.668990135192871, "ach need.\nFigure A.2. Example Slide for Rating the Probability of Success of a Need\n 6b. What is the probability of success?\nIssue: Most U.S. responses to homelessness are \u201csiloed\u201d into, for example, law enforcement, service provision, and individua"] [14.773259162902832, 1.6868970394134521, "actices with respect to assembling \u201chome plans\u201d for people who are preparing for release from a correctional system.\n NOTE: Shaded cells indicate that up or down votes were not possible (e.g., Tier 1 is the top tier, so it was impossible to upvote "] [14.776834487915039, 1.6853059530258179, "\u2019s new tier after the third-round score adjustment is shown by the connected circle with a dotted border.\n Tier 1 Tier 2 Tier 3\nRound 2\n Round 3\n 8\n6\nNumber of needs\n4\n2\n0\n40 50 60\n40 50 60\n Expected value score\nTier 2 score range\n22\n"] [15.379055976867676, 10.419702529907227, "best practices where agen- cies can make effective connections with services.\n\u2022 Conduct evaluations of the existing diversion and deflec- tion programs (i.e., alternatives to the justice system) that some agencies and jurisdictions are implementing.\n"] [15.381780624389648, 10.42149543762207, "ce and impact of this problem.\n\u2022 Conduct research to identify the gaps, costs, risks, and benefits of various levels of behavioral health services.\n\u2022 Conduct research to identify the most-important types of data and identify approaches and tools for "] [15.375029563903809, 10.421611785888672, "s is not able to consider the full range of public expenditures.\nPEH often have frequent contacts with the elements of the justice system (law enforcement, courts, and corrections) and, as a result, affect required resources.\nHomelessness often resul"] [15.387480735778809, 10.421103477478027, " public officials to find \u201cboard and lodging\u201d for PEH in New York State (Callahan v. Carey, 1979). A more recent example holds to the entire U.S. Ninth Circuit, Martin v. City of Boise, where individuals could not be criminally penalized for sleeping"] [15.54786491394043, 10.349689483642578, "al review boards to ensure human sub- ject protection, the latter challenge of denying benefit might be easier to address in practice. If the social service benefit (to include not only outcomes but also potential costs and unintended consequences)\ni"] [15.72387981414795, 10.269000053405762, "/RR3064.html\nHeilbrun, Kirk, David DeMatteo, Kento Yasuhara, Stephanie Brooks-Holliday, Sanjay Shah, Christopher King, Anne Bingham DiCarlo, Danielle Hamilton, and Casey LaDuke, \u201cCommunity- Based Alternatives for Justice-Involved Individuals with Sev"] [15.628877639770508, 10.33416748046875, "ner, Karen Destorel Brown, Mary Cunningham, and Noah Sawyer, Rethinking Local Affordable Housing Strategies: Lessons from 70 Years of Policy and Practice, Washington, D.C.: Brookings Institution Center on Urban and Metropolitan Policy and the Urban I"] [15.603421211242676, 10.349135398864746, " 2020.\nShelton, Katherine H., Pamela J. Taylor, Adrian Bonner, and Marianne van den Bree, \u201cRisk Factors for Homelessness: Evidence from a Population-Based Study,\u201d Psychiatric Services, Vol. 60, No. 4, 2009, pp. 465\u2013472.\nShinn, Marybeth, Ending Homele"] [13.920363426208496, 4.214150905609131, "ona State University. Finally, we are thankful for the contributions of the anonymous reviewers from the U.S. Department of Justice.\nThe RAND Justice Policy Program\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks "] [13.927698135375977, 4.120006084442139, "n criminal justice, homeland security, and terrorism preparedness. His areas of examination have included safety management in large-scale emergency response operations, the equip- ment and technology needs of criminal justice agencies and emergency "] [13.856534004211426, 4.606245517730713, "those of the author(s) and do not necessarily reflect those of the Depart- ment of Justice, the RAND Corporation, or the organizations represented by any of the workshop participants.\nLimited Print and Electronic Distribution Rights\nThis document and"] [17.423614501953125, 12.953668594360352, " Risk and Needs Assessments\nin Prisons\nIdentifying High-Priority Needs for Using Evidence- Based Practices\nJoe Russo, Michael J. D. Vermeer, Dulani Woods, and Brian A. Jackson\nDespite a slight decline in the prison population in 2017 and 2018, signif"] [17.422252655029297, 12.957135200500488, " A consumer guide should be developed to assist agen- cies in determining which questions to ask when consid- ering acquiring and implementing a new RNA tool.\n\u2022 A research organization (e.g., the National Academy of Sciences, National Institute of Ju"] [17.42399024963379, 12.954971313476562, "dation, resources needed to administer the assessment, information technology implications) before investing in an RNA tool.\nDelivering effective interventions or programming to address\nthe criminogenic needs of inmates as identified by RNA tools acc"] [15.624541282653809, 4.189676761627197, "t Bucklen\nPennsylvania Department of Corrections\nAnne Cummins\nFederal Bureau of Prisons, Minnesota\nGrant Duwe\nMinnesota Department of Corrections\nMichelle Gantt\nFederal Bureau of Prisons, New York\nZachary Hamilton\nWashington State University\nKyle Jac"] [17.4240665435791, 12.955023765563965, "em have not translated into sustained behavioral change, and efforts to rehabilitate inmates have been generally ineffective.\n 4\n Prison systems are highly complex organizations, and change can be difficult.\npredict recidivism with approximately 70-p"] [17.42400550842285, 12.954781532287598, "gislative initiatives at the state and federal levels are driving the use of RNA tools in correctional agencies. These initiatives often are part of larger, comprehensive reform packages that are designed to reduce prison populations and recidivism. "] [17.42466926574707, 12.95592975616455, "ke it challenging to sustain EBP initiatives. For example,\nthe average tenure for a state corrections agency executive is\nless than four years (Innes, 2015). In the BOP, wardens are frequently transferred between institutions by design. Although exec"] [17.4492130279541, 12.946858406066895, "essary program- ming might not be available in every institution, or they could lead to long waiting lists for individuals who need specific programming. Furthermore, some inmates might be released before they receive important programming, because t"] [17.4262752532959, 12.953255653381348, "ly lower the effectiveness of the tool in that setting. Agencies need to ensure that staff are qualified to administer the assessment and that they receive initial and follow-up training on the tool. Quality assurance methods also can help maintain i"] [17.424110412597656, 12.954743385314941, "f the First Step Act. Ultimately, a group of 15 experts was convened (see the Participants box for a full list of names and affiliations).\nThe participants were brought together for a two-day workshop. During the morning of the first day, project sta"] [17.42399787902832, 12.953535079956055, "ization exercise.\nRESULTS\nOver the course of the two-day workshop, participants identi- fied a total of 50 needs related to the use and effective deploy- ment of RNA tools in prison. The needs were organized\ninto four major themes: organizational iss"] [17.424022674560547, 12.95604419708252, "ted that security and treatment objectives are complementary in nature rather than competing interests. Effective programming can- not take place in an institution that is not safe and secure. It is also true that the proper application of RNA tools,"] [17.424793243408203, 12.952784538269043, "ons so that there is a better understanding of what works and why.\n\u2022 Develop infrastructure for ongoing support for research to produce the evidence around new programs.\n\u2022 Develop criteria (e.g., minimum qualifications) for curricu- lum facilitators."] [17.42416000366211, 12.953948974609375, "nifest in many ways (e.g., decreased capacity to administer assessments or deliver meaningful interventions), but one high-priority need focused on the difficulties that agencies face in simply maintaining situational awareness with respect to EBPs. "] [17.421802520751953, 12.957783699035645, " and objective criteria by which to measure performance, such as various cost measures, data ownership and management considerations, and training or recertifica- tion specifications. Agencies would benefit from independent evaluation, which might yi"] [17.42451286315918, 12.953746795654297, " every two to five years, while others indicate that the frequency of revalidation depends more on\nthe type of assessment instrument used and how it was devel- oped (Casey et al., 2014). The participants noted that agencies would benefit from indepen"] [17.42015838623047, 12.956015586853027, "ology system infrastructure. The participants noted that this issue will become more important in the future as tools are expected to become increasingly automated.\nAdministration of Assessments\nThe participants identified three high-priority needs t"] [17.424715042114258, 12.947088241577148, "- sors. Some staff members lack the qualifications and training necessary to work with inmates during the assessment process, and agencies might not adequately allocate time for staff to complete assessments or access relevant, collateral information"] [16.738861083984375, 7.647599220275879, "service delivery requirements, resources, or other constraints, prisons might use nonthera- peutic staff to deliver programming. One participant referred to this as cognitive-behavioral intervention versus treatment or therapy. Both cognitive-behavio"] [17.424575805664062, 12.954618453979492, "cipants stressed the importance of process evaluations; it is not enough to know\nwhether a program is effective, but it is critical to understand why a program is effective so that it can be replicated.\nFinally, the participants discussed the concept"] [17.424400329589844, 12.9530029296875, "elity.\nResearch has demonstrated that validated tools based on RNR principles can correctly predict recidivism risk (Des- marais and Singh, 2013). Moreover, research has shown that employing demonstrated, effective correctional practices and programm"] [15.017580032348633, 2.1700711250305176, "eeds. Through this process, we developed the research agenda that structured the topics presented in the main report. The descriptions in this appendix are adapted from those in previous publications of the Priority Criminal Justice Needs Initiative "] [14.918837547302246, 2.0950748920440674, " to make the group as represen- tative as possible of different disciplines, perspectives, and geo- graphic regions, the final output of the workshop likely will be significantly influenced by the specific group of experts invited to participate. It "] [14.842907905578613, 1.8283559083938599, ", the ResponseCard RF LCD from Turning Tech- nologies). Each participant was asked to individually score each problem or opportunity and its associated needs using a 1\u20139 scale for two dimensions: importance and probability of suc- cess.\nFor the impor"] [14.812065124511719, 1.7872411012649536, "to three tiers using a hierarchical clustering algorithm. The algorithm we used was the \u201cward.D\u201d spherical algorithm from the \u201cstats\u201d library in the R statistical package, version 3.5. We chose this algorithm to minimize within-cluster variance when "] [14.789922714233398, 1.7172356843948364, "d values\u2014we also set a threshold that at least 25 percent of the workshop participants must have voted on that need (and then rounded to the nearest full par- ticipant). For this workshop, there were 15 participants, so for any votes to have an effec"] [14.783746719360352, 1.703887701034546, "tices on how to sequence and prioritize the order in which each item should\nbe addressed.\n36%\n14%\n29%\n7%\n14%\n17\n 0% 0% 0% 0% 123456789\nNOTE: Percentages on each question did not always sum to\n100 percent because of rounding and variation in th"] [17.419700622558594, 12.950864791870117, " the 50 identified needs,\n\u2022 11 were related to organizational issues (two of which were high priority)\n\u2022 16 were related to the selection and implementation of RNA tools (four of which were high priority)\n\u2022 nine were related to the administration of "] [17.425029754638672, 12.955036163330078, "fidelity.\nNeed Tier\n\u2022 Develop training and guidebooks for leadership on the state of knowledge about RNA principles and how EBPs can enhance institutional security.\n\u2022 Develop a mechanism for the regular dissemination of useful information in digestib"] [17.42162322998047, 12.956743240356445, " might not be sufficiently complete.\nThe aggregate results from RNA tools can be used to assess whether an agency\u2019s programming is sufficiently meeting the needs of its population.\nIt is difficult to understand whether needs assessments are appropria"] [17.423463821411133, 12.95456600189209, " the \u201cbig picture\u201d with respect to the needs of an individual.\nAllowing staff or committee overrides of the evidence-based risk assessment can result in less desirable outcomes.\nMany programs are advertised to address the same need, but it is unclear"] [17.42344093322754, 12.954538345336914, "orrec- tional and rehabilitative objectives.\n\u2022 Identify the costs and benefits of employing special groups of staff (e.g., change champions) to manage change initiatives.\n Administration of assessments\nProgramming\nOrganizational issues\n2\n2\n3\n "] [17.424312591552734, 12.955159187316895, " Selection and implementation of RNA tools\nAdministration of assessments\nProgramming\n3\n3\n3\n a Each unique pairing of a problem or opportunity with a potential solution is counted as a separate need. This need is associated with thre"] [13.959035873413086, 3.964324951171875, "truments and Methods of Assessment,\u201d Criminal Justice and Behavior, Vol. 36, No. 6, 2009, pp. 567\u2013590.\nCarson, E. Ann, Prisoners in 2018, Washington, D.C.: Bureau of Justice Statistics, NCJ 253516, April 2020.\nCasey, Pamela M., Jennifer K. Elek, Roge"] [13.987679481506348, 3.865340232849121, "n A., Duren Banks, John S. Hollywood, Dulani\nWoods, Amanda Royal, Patrick W. Woodson, and Nicole J. Johnson, Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs for Improving Court Operations and Outcom"] [13.883601188659668, 4.086070537567139, "nstructing the Risk-Need-Responsivity Model: A Theoretical Elaboration and Evaluation,\u201d Aggression and Violent Behavior, Vol. 12, No. 2, March 2007, pp. 208\u2013228.\nYang, Min, Stephen C. P. Wong, Jeremy Coid, \u201cThe Efficacy of Violence Prediction: A Meta"] [13.919587135314941, 4.176106929779053, "re, Maryland. He holds an M.S. in agricultural economics (applied economics).\nBrian A. Jackson is a senior physical scientist at the RAND Corporation. His research focuses on criminal justice, homeland security, and terrorism preparedness. His areas "] [13.858598709106445, 4.60931921005249, "ion are those of the author(s) and do not necessarily reflect those of the Depart- ment of Justice, the RAND Corporation, or the organizations represented by any of the workshop participants.\nLimited Print and Electronic Distribution Rights\nThis docu"] [22.24149513244629, 7.288995265960693, " CORPORATION\nLYNN A. KAROLY, STEPHANIE J. WALSH\nEstimating the\nCost of Quality\nEarly Childhood Care and Education\nin Oklahoma\n Sponsored by the Oklahoma Partnership for School Readiness Foundation\nFor more information on this publication, visit www."] [22.240880966186523, 7.286771774291992, "d expenditures for the most recently completed fiscal year. The information supported estimation of the per-child cost of care by child age, setting, and quality rating. Although not intended to provide a representative sample, the data collected fro"] [22.272071838378906, 7.257046222686768, "........................................................................................................... xxii Abbreviations ..........................................................................................................................."] [22.26244354248047, 7.257868766784668, "........84 Appendix D. Additional Documentation of Model-Based Estimates .........................................133 References ........................................................................................................................."] [22.257951736450195, 7.2568678855896, " Centers by Reaching\nfor the Stars Rating and Selected Child Age Group..............................................................40 Table 3.4. Estimated Percentage of Per-Child Cost Recovered in Sampled Centers\nUsing Child Care Subsidy Program Rei"] [22.258989334106445, 7.276568412780762, "7 Table D.5. Assumed Unit Prices for FCCH Cost Model by\nReaching for the Stars Rating (2019 Dollars) ....................................................................138\nviii\nSummary\nThe affordability of licensed early childhood education and care"] [22.2497501373291, 7.2778239250183105, "to understand their program structure and the associated expenditures for the most recently completed fiscal year (typically 2018); second, drawing on the findings from these illustrative providers, we developed a cost model that was used to examine "] [22.25347900390625, 7.269725799560547, "tart programs is expected to differ from other ECCE programs given the more comprehensive set of services required; and the latter because the study timeline could not accommodate the more-lengthy human subjects research review process required for i"] [22.245601654052734, 7.284493923187256, " the three types of providers in our sample (centers, large FCCHs, and FCCHs), as well as generating estimates of per-child expenditures and the degree of variation by provider type and other characteristics.\nProgram Features of the Illustrative Prov"] [22.245756149291992, 7.277563095092773, ".\n\u2022 Licensed ECCE providers do not routinely have well-organized financial records, according to our illustrative providers. Although some of the large centers and a few of the FCCHs kept precise records\u2014some of which were maintained by bookkeepers o"] [22.258609771728516, 7.254392147064209, "n the attendance rate falls below 80 percent (so that the full subsidy, which is based on attendance rather than enrollment, would not be received). The reimbursement rates more than covered estimate costs for Two Star providers but undercompensated "] [22.24982452392578, 7.269138336181641, "riking. When a small FCCH with a total capacity of seven children maintains a group size of only six children, its costs increase 14 to 18 percent, and the amount by which the state subsidy covers its costs is reduced by 10 to 15 percent. For centers"] [22.25667381286621, 7.266258239746094, "are a few exceptions, mostly for Two Star programs and the older age groups, where the reimbursement rates are estimated to exceed the provider cost estimate by 10 percent or more (green shaded cells). The remaining few cases have reimbursement rates"] [22.255355834960938, 7.261830806732178, "ming 80% attendance with full enrollment\nTwo Star\nEstimated per-child cost ($)a Per child year\nPer child day\nEstimated percentage of cost recovered using the subsidy reimbursement rate (%)\nAssuming 100% attendance with full enrollment Assuming 90% at"] [22.255428314208984, 7.271306991577148, "r, unique considerations for the FCCH provider include how to properly treat their housing costs as a business expense and their own compensation through a salary or retained earnings. Access to expert financial advice periodically or on an ongoing b"] [22.252058029174805, 7.275320053100586, ", is a key source of cost variation to recognize, although any age groups with the same teacher-child ratio requirement could have similar reimbursement rates. Quality rating tiers are another potential key cost driver, especially if they incorporate"] [22.248943328857422, 7.277166366577148, "from our analyses and findings.\nRecommendation 1. Use cost information collected directly from providers and/or through cost modeling to reconsider the current Child Care Subsidy program reimbursement schedule. The validity of any reimbursement syste"] [22.254133224487305, 7.274033069610596, " federal rather than state monies. This requires a better understanding of why some ECCE providers do not apply for the program. In some cases, this may be a provider choice. But understanding and addressing any barriers to take-up would ensure a mor"] [22.253849029541016, 7.283019542694092, " family child care home\nGED General Educational Development\nFTE full-time equivalent\nIDEA Individuals with Disabilities Act\nIEP Individualized Education Plan\nLEA local education agency\nNAC National Accreditation Commission for Early Care and Educatio"] [22.29634666442871, 7.23582124710083, "oviding high-quality ECCE programs. Information on the resources that providers require to deliver quality ECCE can then inform issues about affordability on the part of families, as well as the public sector\u2019s role in promoting quality and subsidizi"] [22.250720977783203, 7.287021160125732, "stand the cost of ECCE in Oklahoma in various types of licensed settings. Following prior studies (e.g., Karoly and Gomez, 2019), we adopted a two-pronged approach: (1) collecting program and expenditure data from a sample of licensed providers, purp"] [22.302051544189453, 7.259334087371826, "cost model was developed to assess how changes in any one cost driver affect the estimated cost per child, while holding all other program features constant. Key cost drivers that were examined include the teacher-child ratio, teacher qualifications "] [22.26439666748047, 7.277639865875244, " they reported their annual expenditures, compared with center-based programs, which tend to have a dedicated bookkeeper or accountant on staff or under contract. Fourth, providers vary in the start and end month of their annual fiscal year, which me"] [22.2514705657959, 7.274899005889893, " earlier, our analysis focused on private licensed center- and home-based ECCE providers purposively sampled across the range of the quality ratings produced by the state\u2019s QRIS, Reaching for the Stars. In this section, we provide relevant context fo"] [22.24513816833496, 7.281627655029297, "lots. Many providers choose to serve fewer children than their license allows. We differentiate between licensed capacity versus desired enrolled, where the latter captures how many children a provider seeks to serve, which may be less than their lic"] [22.245803833007812, 7.282138347625732, "achers may be enrolled in high school.) Directors are also required to have some additional postsecondary coursework, credentials, or certificates. In other states, it is most common for center directors and master teachers to at least have a Child D"] [22.250364303588867, 7.276857852935791, "Excellence in Child Care program also covers up to 90 percent of the cost of college tuition and books for qualifying staff (e.g., those in One Star Plus programs with at least 10 percent of enrolled child receiving state child care subsidies).\nReach"] [22.250398635864258, 7.272701263427734, "d master teacher\nqualifications\nSame as licensing\nSame as licensing\nSame as licensing\n\u2022 Added administration \u2022 PD follows ELG\n\u2022 Improved learning\nenvironment\n\u2022 Added family engagement \u2022 Increased master teacher\nqualifications\nBirth to 11 months 1:4 1"] [22.252840042114258, 7.267012596130371, "each higher tiers in Reaching for the Stars, the reimbursement rates associated with the Oklahoma Child Care Subsidy program increase with each rating level. The Child Care Subsidy program assists low-income working families (those with income up to "] [22.25867462158203, 7.255866527557373, " monthsa\nThree Star\nDaily rate\nBirth to 12 months 13 to 24 months 25 to 48 months 49 to 72 months\nBlended rate\n49 to 72 monthsa\na Traditional rate and extended\nSOURCE: OKDHS, 2020.\nNOTE: Blended rates and rates for 73 months to 13 years are also incr"] [22.270286560058594, 7.274785995483398, " group size, teacher-child ratio), and other features associated with program quality (e.g., staff education and compensation, quality rating). Much of the literature has centered on cost analyses of preschool programs for three- and four-year-olds i"] [22.28553581237793, 7.294707775115967, "e staff, the salary scale and generosity of the fringe benefit package, the teacher-child ratio in the classrooms, and program intensity (e.g., part- versus full-day programs, academic-year versus calendar-year programs). ECCE teachers in public-scho"] [22.26729393005371, 7.272899627685547, " estimated at $35,354 per child on an annual basis, toddler care at $28,203 per child, and preschool-age care at $13,655 per child. These estimates are based on program features consistent with an earlier NASEM report that recommended bachelor\u2019s-leve"] [22.256385803222656, 7.281131267547607, "ECCE cost survey was to collect information on program structure and expenditures for 30 licensed center- and home-based ECCE programs located across Oklahoma serving infants, toddlers, and preschool-age children. As we discuss next, this process req"] [22.246374130249023, 7.2805280685424805, "roviders were selected purposively to ensure variation along key dimensions that would be expected to affect provider per-child costs, namely:\n\u2022 provider type (three categories) defined as for-profit centers, not-for-profit centers, and FCCHs of any "] [22.206825256347656, 7.320041179656982, "al program information, staffing levels and benefits, sources of revenue, and annual expenditures. Separate versions of the instrument were used for center- and home-based providers. Most importantly, program features and expenditures were collected "] [22.24150276184082, 7.285498142242432, "licensed ECCE center- and home- based providers in Oklahoma. Replicating the same approach for selecting another sample may also produce different values for these statistics. For this reason, we do not report such statistics in the section that foll"] [22.244401931762695, 7.279970169067383, "ban 52310 Large rural 5218 Rural 3227\n Licensed Provider Type\n Characteristic Centers Large FCCHs FCCHs\nReaching for the Stars rating (number) One Star and One Star Plus\nTwo Star\nThree Star\n1 1 9 4 3 1\n9 5\nYes 4116\nAccredited (number) "] [22.234649658203125, 7.287794589996338, "oms or groups (number) 1\n2\n3to4 5to6\n7 or more\nAges of children served (number) Children aged birth to 11 months Children aged 12 to 36 months Children aged 3 to 5 years Children aged 6 or more years\nHas waiting list (number)\nHas waiting list for spe"] [22.250165939331055, 7.271745204925537, "ther expensive fringe benefits, such as retirement, health, or dental benefits. Overall, FCCHs, especially the smaller ones, offer fewer benefits compared with centers. Although we did not collect salary or wage data for all center and FCCH staff in "] [22.21921157836914, 7.3048200607299805, " 0 10 6 6 25 0 0 0 4 2 15 2 1 6\n0 5 5 6 6 25\nSpeech screening\nSpeech services\nDevelopmental assessment\nMeals 13 Counseling 0 Referrals 9\nTransportation to and/or from program\nNo services other than meals Total providers (number)\nSources of revenue. F"] [22.246492385864258, 7.280394554138184, "Hs\nTotal\nLicensed Provider Type\n 11 \u2013 \u2013 11 18 \u2013 \u2013 18 15 \u2013 \u2013 15 18 \u2013 \u2013 18 11 \u2013 \u2013 11\n5 \u2013 \u2013 5\n\u2013 10 7 17 78 10 7 95 13 6 6 25\n25\nTotal\n Characteristics that vary across classrooms, stratified by age group (see Table 2.9), include desired "] [22.25153350830078, 7.273738861083984, " age group is consistent with the licensing requirements in both centers and FCCHs. Yet many center-based providers operate with teacher-child ratios lower than the licensing ceiling (i.e., fewer children per teacher than required), which may result "] [22.249019622802734, 7.273997783660889, "less relevant. At FCCHs, children are served in mixed age groups in one or more groups or rooms and expenditures per child are not likely to vary in the same way by child age or room compared with center-based programs. Thus, for FCCHs, all expenditu"] [22.259218215942383, 7.274367809295654, "s.\n 28\nundated). 22 In the remainder of this section, we highlight key assumptions and the alternative scenarios considered. Additional details about the cost modeling approach is provided in Appendix D.\nAssumptions for Cost Model\nThe cost analysis m"] [22.24922752380371, 7.270484447479248, "tors, that would allow more flexibility in the quantities and prices included in the model and more readily facilitate sensitivity analyses across many scenarios.\n23 Again, for the cost model, we did not consider classrooms serving school-age childre"] [22.251333236694336, 7.268409252166748, " classroom Staff Classroom expenditures per child\nSame as One Star/ One Star Plus\nSame as One Star/ One Star Plus\n50th percentile of OK preschool teachers\u2019 salaries 50th percentile of OK child care salaries Same as One Star/ One Star Plus\n5%\n "] [22.252912521362305, 7.267735958099365, "assumption is different than prior tiers.\n 31\nmaintaining accreditation (Three Star).25 A similar pattern of expenditures is assumed for small and large FCCHs, although the accreditation costs are assumed to be lower based on NAFCC fees.\nThe other ke"] [22.253170013427734, 7.268577575683594, "er enrollment, across NAEYC, NAC, and NECPA. When totaled across fees at enrollment, verification, and annual reporting, the total fees range from $2,000 to $2,200 for centers with up to 50 children, with NAEYC in the middle at $2,120. For centers wi"] [22.25279426574707, 7.267734050750732, " top tier) and that Three Star large centers employ a full-time associate director (compared with a half- time associate director at the baseline top tier, see Appendix D, Table D.1).\n\u2022 Geographic cost differences. Our baseline model assumes state-le"] [22.2506160736084, 7.266561508178711, "inistrative staff and shared resources). We repeat the same analyses for home-based care costs, although we do not attempt to generate cost estimates by child age group, given the mixed-age structure in the groups of children served in typical home-b"] [22.2504940032959, 7.269123554229736, "ce (e.g., facility rent or mortgage, utilities, maintenance), and transportation (when provided). Expenditures on staff PD is a low cost per child, sometimes with no such expenditures, while exceptional centers had annual expenditures of several thou"] [22.249967575073242, 7.269973278045654, "respectively, the sum of the cost components is not expected to add to the total because the minimum or maximum values for a given cost component are not necessarily for the same provider with the overall minimum or maximum total cost.\n\u2022 Cost per chi"] [22.25911521911621, 7.25629186630249, "aid for by the program. Variation is also evident for other cost components in Table 3.2, but the magnitudes of the differences are smaller.\nThe small number of centers in our sample limits our ability to make robust comparisons across providers base"] [22.25591468811035, 7.259997367858887, "mates.\nOverall, for the centers in our sample, the estimates indicate that less than full cost would be recovered on average in rooms serving children from birth to 11 months (infants). For infants, this finding holds across the range of per-child co"] [22.257081985473633, 7.26047945022583, "ed on the range for the estimated per-child cost. The minimum and maximum are reversed for the estimated percentage of cover recovered. In other words, the minimum per-child cost estimate will have the maximum percentage of cost recovered. For the ma"] [22.2785587310791, 7.231100559234619, "6\n13 13 19.28 35.43\n186.8 87.4 168.1 78.7 149.4 69.9\n11 11 16.86 37.29\n152.5 80.2 137.3 72.2 122.0 64.2\n15 15 16.95 26.76\n175.8 96.4 158.2 86.8 140.7 77.1\n 41\n8 8 8\nwere received. Even with these caveats, the data do illust"] [22.26292610168457, 7.2631916999816895, "n sampled providers that served that age group ($6,900) and is well under the\n30 The estimates in Table 3.5 are not necessarily comparable with other estimates of per-child ECCE costs, largely because of different assumptions about the ingredients pr"] [22.245681762695312, 7.270183086395264, "5,012 4,483 96 86 19.28 17.24\n89.2 98.6 80.3 88.7 71.4 78.9\n Table 3.5. Model-Based Baseline Per-Child Cost Estimates for Centers (Continued)\n Birth to 11 12 to 23\nIndicator Months Months 2 Years 3 Year"] [22.2526798248291, 7.258194923400879, "m materials 1.3 Food 7.6 Transportation 0.0 Space 23.1 Administration 1.6 Total 100.0\nThree Star\nEstimated per-child cost ($)a\nPer child year 16,698 Per child week 321 Per child day 64.22\nEstimated percentage of cost recovered using Child\nCare Subsid"] [22.261661529541016, 7.249150276184082, "4,663\n5,267\nOne Star One Star Plus\nTwo Star Three Star\n-4,000\nTitle\n-147 -661\n0\n4,000 8,000 12,000 Annual per-child cost (2019 $)\n16,000 20,000\n4,420\n4,810\n5,928\n9,226\nReimbursement Unrecovered cost\n 6,552\n2,674\n NOTES: The amount of costs recove"] [22.286720275878906, 7.23091983795166, "e Star and One Star Plus, with an increment of about $200 to $400 dollars per child, depending on the age group, relative to a One Star rating. The next increment from One Star Plus to Two Star is about $1,600 for infants, declining to about $600 for"] [22.26237678527832, 7.250110149383545, "or four- year-olds. Assuming 100 percent attendance, the Two Star reimbursement rate would seem to consistently over-reimburse providers for two-year-olds and older (especially three-year-olds), based on our cost estimates. However, knowing that, in "] [22.262561798095703, 7.248032569885254, "mple, under-enrollment\u2014enrolling fewer children than actual or desired capacity\u2014 would be expected to raise per child cost (see scenario C1 in Table 3.6). The C1 scenario shows that under-enrolling by about 10 percent of desired capacity (1 to 3 chil"] [22.24835205078125, 7.271976470947266, "ance with full enrollment Assuming 80% attendance with full enrollment\nC4. Higher cost areas\nEstimated per-child cost ($)a Per child year\nPer child day\nChange in per-child cost from baseline (%)\nEstimated percentage of cost recovered using Child Care"] [22.248600006103516, 7.2727251052856445, "indicators regarding the owner/operator\u2019s compensation and treatment of housing cost.\nWe begin by noting that there is considerable variation across the 12 home-based sites in the per-child cost indicators, both within and between the two size catego"] [22.253679275512695, 7.266294002532959, "r the averages, the sum of the cost components may not add to the total\nbecause of rounding. For the minimums and maximums, the sum of the cost components is not expected to add to the total because the minimum or maximum values for a given cost comp"] [22.253313064575195, 7.268521308898926, " a portion of their housing costs (e.g., rent or mortgage, utilities) as a business expense, based on the portion of annual hours that the home was used for business (both operating hours and other hours spent cleaning, preparing meals, and so on) an"] [22.248899459838867, 7.269017696380615, "nual per-child space costs and for classrooms serving two-year-olds and three-year-olds, they can operate with larger ratios (1:8 and 1:12, respectively), which lowers their per-child classroom personnel costs. Nevertheless, these potential cost savi"] [22.255489349365234, 7.263553142547607, "mated percentage of cost recovered using Child Care Subsidy program reimbursement rate (%)\nAssuming 100% attendance at observed enrollment Assuming 90% attendance at observed enrollment Assuming 80% attendance at observed enrollment\nTotal number of l"] [22.251440048217773, 7.265458106994629, "n and operate with a 1:7 ratio (see Table 2.10). However, because they are assumed to have space to serve up to 12 children, their per-child space costs are higher than the small FCCHs operating with a lower square footage for the same enrollment of "] [22.248395919799805, 7.270720481872559, "3\n79.3 82.7 71.4 74.4 63.5 66.2\n7,177 138\n27.60\n8,524 164\n32.78\n5,314 102\n20.44\n86.0 77.4 68.8\n5,568 107\n21.42\n6,731 129\n25.89\n10,691 206\n41.12\n3,175 3,363\n4,359 6,036 0 36 71 94\n50 80 160 200 1,000 1,000 1,000 1,000 0000\n3,175 3,363 4,359 7,544 0 36"] [22.277225494384766, 7.240393161773682, " resource use in other cost categories, and cost-of-living differences across communities. We explore several of these other sources of variation and the implication for per-child costs in the next section.\nCost Variation Associated with Key Cost Dri"] [22.216167449951172, 7.301929473876953, "rly 100 percent of the per-child cost under the baseline Child Care Subsidy program reimbursements, the same large FCCH with under-enrollment would recover about 85 percent of its cost.\n\u2022 If there are cost components that do not vary by region, cost "] [22.247644424438477, 7.28316593170166, "ntage of cost recovered (%)\n85.5 91.7 73.5 76.6\nAssuming 100% attendance with full enrollment\nAssuming 80% attendance with full enrollment\n58.8 61.3\n68.4 73.4 NOTES: Costs are estimated in 2019 dollars. For more details on the alternative scenarios, "] [22.240222930908203, 7.289170742034912, "services provided to families, and sources of revenue, among other features. In part, this diversity may not be surprising, as we intentionally sampled providers to obtain variation across provider type, Reaching for the Stars rating tier, for-profit"] [22.228715896606445, 7.246147155761719, "ng to collect information on ECCE provider annual expenditures, many smaller centers and FCCH providers did not have clear financial statements that carefully differentiated revenues from expenses in well- structured cost categories. For FCCHs, docum"] [22.24831199645996, 7.2667741775512695, "nt for the FCCHs, where lower-cost providers typically had their costs full covered, even with less than 100 percent attendance, but higher-cost providers would see less than full reimbursement. The reimbursement rates more than covered costs for Two"] [22.252321243286133, 7.272816181182861, "p between quality and per-child cost reflect the quality features accounted for in Reaching for the Stars, specifically those that have implications for program cost. The relationship between quality tiers and per-child cost could change if a differe"] [22.2537899017334, 7.272431373596191, " on other factors, such as local area wages and whether tiered child care subsidies will cover the higher compensation costs or whether families can afford to pay higher fees or tuition. The fact that we did not see higher- rated providers with highe"] [22.2491512298584, 7.27748441696167, "able business model and the required financial literacy.\nECCE Providers and Their Revenue\nAlthough our primary focus has been on the cost side of ECCE program operations, the information we collected from the sample of illustrative providers also poi"] [22.260547637939453, 7.24749755859375, " age and rating tier. The cost estimates and the reimbursement rates are followed by the percentage change in dollar amounts moving across age groups within a given rating tier, first starting with four-year-olds and moving to younger ages (where cos"] [22.263338088989258, 7.2465362548828125, "ercentage change in cost as move to younger ages (%)\nOne Star\nOne Star Plus Two Star Three Star\nPercentage change in cost as move to older ages (%)\nOne Star\nOne Star Plus Two Star Three Star\n1:4 1:6 1:4 1:6 1:4 1:6 1:4 1:6\n39.63 29.46 41.21 30.63 47."] [22.25374984741211, 7.272559642791748, "e groups, unless there are substantial changes in other cost factors across those age groups.\nWhich Dimensions of Cost Variation to Include in a Rate Schedule\nThe illustrative provider data reveal how much per-child costs can vary across ECCE provide"] [22.253721237182617, 7.272660732269287, "r-child requirement would have the same reimbursement rates. Quality rating tiers are another potential key cost driver, especially if they incorporate increases in classrooms staff education requirements and the associated compensation in moving up "] [22.25920867919922, 7.271941184997559, " of how providers structure their programs, the types and quantities of resources used, and the costs that they face. Even small nonrepresentative samples can illustrate the range of circumstances providers experience. Cost modeling provides a more s"] [22.251970291137695, 7.27431058883667, "itation, there are specific requirements for higher staff qualifications compared with Reaching for the Stars, but these standards do not require a provider to pay higher compensation for those staff, commensurate with their higher education and trai"] [22.240686416625977, 7.2818217277526855, "s as well. For example, most small homes operate up to 12 hours per day with just the owner on site, a situation\n72\nthat may lead to stress and burnout. FCCHs reported that it was difficult to find substitutes who were adequately trained and certifie"] [22.24933624267578, 7.2733025550842285, " are under 2 years old\n\u2022 Or six children are in care and more than\nthree children are under 2 years old\nFCCH All Groups\n Mixed-Aged Groups\n Child Care Centers Large FCCH Single-Aged Groups All Groups\nFCCH All Groups\n M"] [22.249244689941406, 7.273468494415283, "operation or 30 hours per week\n\u2022 Has satisfactory work experience and a good\nunderstanding of program requirements and\npolicies\n\u2022 Is not a director or master teacher at another\nprogram that operates concurrently at any\ngiven time\n\u2022 Can be one of thre"] [22.225515365600586, 7.301962375640869, " providers that we sampled from represent 78 percent of licensed center- and home-based providers in Oklahoma.\nTable B.1. Results of the Application of Criteria for Inclusion in the Provider Cost Survey\n Number of Providers Meeting Each\nCr"] [22.22855567932129, 7.300201892852783, "\u2022 an overview and the potential benefits of the study\n\u2022 the study funder (Oklahoma Partnership for School Readiness [OPSR] through a PDG B\u2013\n5 award from the U.S. Department of Health and Human Services and the U.S.\nDepartment of Education)\n\u2022 RAND as "] [22.236289978027344, 7.291449069976807, "m information, staffing levels and benefits, sources of revenue, and annual expenditures. As noted earlier, when providers agreed to participate, they were asked a series of screening questions to verify the information we had from OKDHS and to obtai"] [22.223772048950195, 7.298221111297607, " each classroom. When centers had more than one classroom serving the same age group, the direct and indirect costs were pooled to create a center- level total expenditure for each age group.\n4. For each age group, calculate the cost per child on an "] [22.1837100982666, 7.333024501800537, "have as you go along. Please do not hesitate to reach out to Stephanie Walsh, RAND Survey Director, at swalsh@RAND.org or 412-683-2300 x 4195.\n1\nProvider ID:\nINSTRUCTIONS\nThis questionnaire consists of four sections:\nA. General Center / Program Infor"] [22.18809700012207, 7.3281474113464355, "ary\n Most recent completed fiscal year\n For-profit / not-for-profit status\n Reach for the Stars rating\n Number of classrooms\n Licensed capacity\n Accepts state child care subsidies\n Program changes during the most recent completed fiscal yea"] [22.18670082092285, 7.328430652618408, "ission for Early Care and Education Programs (NAC)\n National Association for the Education of Young Children (NAEYC)\n Accredited Professional Preschool Learning Environment\n pm\npm\nA10. Are the regular hours just "] [22.185182571411133, 7.326570987701416, "ecent completed fiscal year, what was the number of unpaid interns in this classroom? [Enter number]\n A19. In this classroom, how many children were enrolled who had an IFSP or IEP for special needs, such as a physical disability, including hearing"] [22.187349319458008, 7.332158088684082, "physical disability, including hearing or sight problems, mental disabilities, or emotional disabilities. [Enter number]\n A24. For the most recent completed fiscal year, was a floater assigned to this classroom t"] [22.188100814819336, 7.327230930328369, ",whatwasthemaximumnumberofchildrenineachage group that were on your waiting list? [Enter number in each row as relevant.]\nMaximum number of infants (0 to 12 months) on waiting list ................................. ________ Maximum number of toddlers"] [22.187143325805664, 7.329127788543701, "time\n Fully paid health insurance\n Paid health insurance for dependents\n Paid sick leave or personal leave\n Paid to attend staff meetings\n B3. What is the minimum number of hour"] [22.18498420715332, 7.337512493133545, "e reported at the center level. Use the table on the next page to record the following types of classroom-specific expenditures:\nD1. Wages and Salaries for Classroom Staff. In the most recent completed fiscal year, what was the total expenditure on w"] [22.187843322753906, 7.333880424499512, "$$ $$$$ $$$$\n$$$$ $$$$ $$$$ $$$$ $$$$\n$$$$ $$$$ $$$$ $$$$\n D3. Classroom materials and supplies\n 17\nProvider ID: _______________\n D1. Wages and salaries for classroom staff\n "] [22.18916130065918, 7.3326334953308105, ".\nD9. Sub-Contractors: What was your total expenditure on contract workers for the year (i.e., people who work for you on a more irregular basis for whom you do not pay benefits)?\nIf possible/applicable, please record expenditures for the following t"] [22.184858322143555, 7.33820104598999, "__________\n No \uf0e0GO TO D13\nD12. Which of the following is true?\na. All of our space is donated. If so, fill out this section (i and ii, or iii):\ni. Number square feet donated: AND\nii. Estimated rent per square foot: OR\nsquare feet\nrent/square foot i"] [22.189701080322266, 7.333553791046143, "ty, which might include liability, fire, theft, flood, earthquake; vehicle; accident for children, staff or others; child abuse, etc. Do not include health insurance or any insurance programs that are part of employee benefits. Enter \u201c0\u201d if there wer"] [22.196941375732422, 7.326315402984619, "t question number, if applicable.\nProvider ID: _______________\n Thank you for all your help! The information you have provided will be invaluable to our study.\n24\nRAND Corporation Oklahoma Child Care Cost Study\nFamily Child Care Homes and Large Ch"] [22.18457794189453, 7.328396320343018, " completed fiscal year.\nTopics and Respondents: This questionnaire will cover the topics listed in the table below. We also indicate potential documentation that may be useful to have on hand.\nAs indicated in the table, the owner/program director may"] [22.187395095825195, 7.3294548988342285, "nization, such as a church or community agency? [Select one response.]\nIndependent \uf0e8 GO TO A6 Sponsored \uf0e8 GO TO A5\nA5. Now I\u2019d like to ask about sponsorship of your program. By sponsorship, we mean an organization that provides governance and/or fina"] [22.18282127380371, 7.3331122398376465, "ses:\nam NA pm\nA14. How many weeks of the year is your program closed? (Enter 0 if the program is open 52 weeks a year. Please provide a copy of the program calendar with days off.)\nNumber of weeks closed:\n6\nProvider ID:\nWe would like to collect some "] [22.18332290649414, 7.3335700035095215, "-year college or university associate degree........................................... 5 Four-year college or university bachelor\u2019s degree......................................... 6 Master\u2019s degree or higher ........................................."] [22.13557243347168, 7.382839679718018, "ours these staff work in a typical week (e.g., two part-time staff combined may work 45 hours per week in a typical week).\nYes / No\n[select one response per position]\nYes No\nYes No Yes No Yes No Yes No Yes No Yes No\nIf yes, please note the:\n Nu"] [22.187414169311523, 7.334604263305664, "enue from each of the following public or private sources for your early childhood program. [Select only those that apply.]\n Public Sources\nYes No\nDon\u2019t know\n Program service fees paid by state Child Care Subsidies (i.e., OK Department of Human"] [22.183088302612305, 7.338860988616943, "t again here.\n[You may record amounts by staff category using the rows under D1. If staff are shared across rooms/groups in your program (e.g., art, music, or physical education teachers), please prorate their wages/salary based on the share of their"] [22.18413734436035, 7.3378167152404785, " other administrative staff (e.g., director, associate director, and any other administrative staff)\nb. Food preparation/service staff (e.g., cooks and other kitchen/meal service staff)\nc. Transportation services staff (e.g., bus/van drivers)\nd. Othe"] [22.194387435913086, 7.328209400177002, "ies\na. Curricula and related materials\nb. Other learning materials and room/group supplies c. Other (specify:\nD7. Staff education and training costs\na. Classroom staff\nb. Leadership and other administrative staff\nD8. Lost tuition or fees from staff d"] [22.19194221496582, 7.330666542053223, "al\nAmount Used by Child Care\nSquare feet Percent Square feet Percent\n Interior square footage Exterior square footage\n b. Please describe the payment arrangements for building costs, including the total amount paid by the business and the t"] [22.253496170043945, 7.267393589019775, " )\n$$ $ $ $ $ $ $ $ $ $ $\n$ $\n$ $\n$ $\n$ $\n$ $\n$ $\n$ $\n$ $\n$ $\n 23\nFor Section D, please use the"] [22.250904083251953, 7.267959117889404, "ongoing training and support for a curriculum covering multiple domains of children\u2019s development, assessing children\u2019s progress, engaging with families, and overseeing fiscal accountability policies and procedures found in accreditation standards, s"] [22.251066207885742, 7.268151760101318, "her occupation equal to $36,510. We use 95 percent of the 25th percentile for a One Star lead teacher.\nTable D.3. Assumed Occupational Salaries for Oklahoma Center and FCCH Cost Model Baseline by Reaching for the Stars Rating (2019 Dollars)\n One"] [22.248828887939453, 7.269800186157227, "0 percent of salary, respectively, for other fringe benefits, which might include a partial contribution toward health insurance premiums for full-time staff.\nOther Unit Prices\nTables D.4 and D.5 display the assumed cost per unit of other cost compon"] [22.24891471862793, 7.26973295211792, "rance (e.g., liability, accident) Postage\n25.00 25.00\n890.00 45.00 0.00\n12.15 1.95 1.19 2.54\n27.00 20.00 67.00 21.00 22.00\nAdvertising\nTelephone and internet\nAudit 0.00 Fees and permits 50.00 Accreditation 0.00 Miscellaneous 13.00\n1,280.00\n1,280.00 0"] [22.234418869018555, 7.289644718170166, "\n2019/\nDavis, Elizabeth, Lynn A. Karoly, Bobbie Weber, Pia Caronongan, Kathryn Tout, Patti Banghart, Sara Shaw, and Anne Partika, Market Rate Surveys and Alternative Methods of Data Collection and Analysis to Inform Subsidy Payment Rates, Washington,"] [22.186588287353516, 7.330172538757324, "ouncil, and LaRue Allen and Bridget B. Kelly, eds., Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation, Washington, D.C.: National Academies Press, 2015. As of August 1, 2020: https://www.nap.edu/catalog/19401/transfor"] [22.230789184570312, 7.294231414794922, "gov/resource/trends-family-child-care-home-licensing- requirements-and-policies-2017-research-brief-2\n141\nNational Center on Early Childhood Quality Assurance, Trends in Group Child Care Home Licensing Requirements and Policies for 2017, research bri"] [22.212888717651367, 7.31121301651001, "n Schmidt, and Tara Lynn Orlowski, 2017 Child Care Licensing Study, Minneapolis, Minn.: National Association for Regulatory Administration, 2017. As of August 1, 2020: https://nara.memberclicks.net/assets/docs/ChildCareLicensingStudies/2017CCStudy/NA"] [0.7454094886779785, 13.429561614990234, " CORPORATION\nJORDAN R. FISCHBACH, MICHAEL T. WILSON, CRAIG A. BOND, AJAY K. KOCHHAR, DAVID CATT, DEVIN TIERNEY\nManaging Heavy\nRainfall with Green\nInfrastructure\nAn Evaluation in Pittsburgh\u2019s Negley Run Watershed\n For more information on this public"] [12.640049934387207, 13.574047088623047, "le the main body of the report is more suited to technical readers.\nThis research was funded with grant support from the Henry L. Hillman Foundation, the Heinz Endowments, and 3 Rivers Wet Weather.\nCommunity Health and Environmental Policy Program\nRA"] [15.053609848022461, 5.768073081970215, ". . . . . . . . . . . . . . . . . . . . . Organization of This Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nCHAPTER TWO\nSimula"] [0.863922655582428, 13.372710227966309, "..................................................\n. 10 . 10\n. 11 . 11 . 12 . 13 . 14 . 15 . 16 . 19 . 19\n. 21 . 21 . 21\n24 . 29 44 46\nv\nvi Managing Heavy Rainfall with Green Infrastructure\nCHAPTER FOUR\nStrategies to Manage Stormwater in Negley Run. "] [0.8805733919143677, 13.3871488571167, ".................................. Comparing Benefits and Costs with Deep Uncertainty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Discussion and Limitations . . . . . . . . . . . . . . . . . . ."] [0.8097510933876038, 13.30789852142334, " . . . . . . . . . . . . . . Recent Historical Negley Run Overflow Estimates, by Year. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Selected Depth-Duration-Frequency Estimates Used in Discrete Storm Analysis. . . . . . . . Runoff by "] [0.8806391954421997, 13.389504432678223, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nxiii . xv xxi .. 4 .. 6 .. 7 .. 8 .. 9 23 . 25 27 30 . 32\n. 33 34\n. 35\n36 .39 40\n. 43\n44 48\n50 . 51 . 53\n54\n56 . 57\n. 58\nvii\nviii Managing H"] [0.8413859009742737, 13.34557819366455, ". . . . . . . . . 22\n3.2. Summary of Recent Historical Negley Run Overflow Metrics for Different Periods. . . . 28\n3.3. Summary of Recent Historical and Projected Future Negley Run Overflows . . . . . . . . . . . ..29\n3.4. Flooding Return Period from"] [0.7266141772270203, 13.434158325195312, " as stormwater flooding and other negative out- comes can disproportionately affect low-income or majority-minority neighborhoods.\nThese challenges are especially difficult to overcome in complex and interconnected urban environments. In many cities,"] [0.729539155960083, 13.440277099609375, " County Sanitary Authority (ALCOSAN) is responsible for conveying and treat- ing wastewater from 83 municipalities in the county, including the city of Pittsburgh. But ALCOSAN functions as a regional wastewater utility governed by federal, state, and"] [0.8639003038406372, 13.395132064819336, "e effectiveness of infiltration-based approaches. However, an alternate approach is to use GSI techniques as part of combined green-and-gray strategies that seek to capture and route rainfall to a centralized surface system\u2014or daylighted\nsystem, whic"] [0.8924131989479065, 13.404012680053711, "oding given future rain- fall uncertainty. We then evaluate proposals for a phased series of large-scale GSI investments centered on a new daylighted system that would capture, store, and convey a large volume of rainfall to the Allegheny River. Spec"] [0.9526649117469788, 13.450610160827637, "tional increment also includes the previously numbered increments so that the strategy builds \u201cupward\u201d from the bottom of the watershed into the surrounding neighborhoods. We also identified three options (A, B, and C) for different levels of investm"] [0.9101516008377075, 13.421181678771973, "nge strat- egy, while Strategy 9C, which represents the highest level of investment considered, is the Max Build-Out strategy.\nStudy Results\nThis study builds closely on a prior pilot-scale effort focused on climate-resilient stormwater management ac"] [0.7689317464828491, 13.290360450744629, " a range of Recent Historical rainfall patterns compared with a single Typical Year (TY). We first evaluated sewer overflows in an FWOA (no additional investment) using the same TY approach adopted for regional planning\nxviii Managing Heavy Rainfall "] [0.9545853137969971, 13.448845863342285, "ategy under present and plausible future rainfall conditions.\nKey Findings\nA new centralized daylighted system and subsequent upstream investments could sub- stantially reduce, but not eliminate, sewer overflows in Negley Run. When we evaluated each "] [1.037799596786499, 13.519576072692871, "at build on a daylighted surface collection system could yield highly cost- effective sewer-overflow reduction across a range of assumptions. As modeled, the Cen- tral Daylighting strategy is highly cost-effective for overflow reduction. We estimate "] [0.9634906649589539, 13.461791038513184, "ts in and of themselves under many plausible futures. The results suggest that the additional services provided by GSI strategies are economically desirable over a wide range of strategy and environmental assumptions.\nThe net economic value of the st"] [0.9346267580986023, 13.451617240905762, " 84\n 48\n (28) (20) (30) (21) (33) (21) (36) (23) (41) (23)\n(49) (27) (53) (29)\n(52) (24) (54) (28) (58) (31)\n(56) (24) (58) (29) (62) (32)\n64 68\n74 79\n80 82 85\n89 96\n96"] [0.845939040184021, 13.396721839904785, " in ALCOSAN\u2019s Clean Water Plan.\nGather additional data to inform flood-risk assessment for Negley Run, includ- ing combined system descriptions and flow monitoring. This analysis was limited by the data available to inform model development and calib"] [0.8227598071098328, 13.400020599365234, "peland (Pittsburgh Parks Con- servancy) but note that this effort would not have been possible without active and thoughtful engagement with the entire task force.\nMikaela Meyer (Carnegie Mellon University) helped to assemble this report, and RAND\u2019s "] [0.706650972366333, 13.422072410583496, "ross the United States are struggling to effectively manage stormwater runoff from heavy rainfall (National Academies of Sciences and Medicine, 2019). This challenge has grown over time in response to several drivers, including impervious cover from "] [0.7174304127693176, 13.440476417541504, " related to regulatory compliance, flood risk and damage, water quality,\n 1\n2 Managing Heavy Rainfall with Green Infrastructure\necosystem services, recreational opportunities, and economic development. It is also an envi- ronmental justice and equity"] [0.7516866326332092, 13.442615509033203, "ntly expanded its efforts to more holistically invest in stormwater man- agement through new infrastructure investments and a proposed stormwater fee (Pittsburgh Water and Sewer Authority, 2020). PWSA\u2019s investments are limited to its service area, ho"] [0.9220860600471497, 13.480949401855469, "n Infrastructure\nA key focus of public conversation surrounding the Pittsburgh region\u2019s stormwater challenges since 2012 has been on green infrastructure. Green stormwater infrastructure (GSI) specifi- cally uses natural elements (vegetation, soils, "] [0.8674132823944092, 13.49780559539795, " strategy. Additionally, the ALCOSAN \u201cStarting at the Source\u201d report explored areas in which gray infrastructure plans could be reduced in favor of an expansion of green infrastructure options. ALCOSAN subse- quently established the Green Revitalizat"] [0.8457016944885254, 13.378925323486328, "ual visions for how it could implement large- scale systems of GSI and restore some amount of natural surface flows in these watersheds. It also conducted preliminary analysis of potential plan benefits but was not able to explicitly simulate how suc"] [0.8720261454582214, 13.377050399780273, "f City Planning and Urban Redevelopment Authority of Pittsburgh, 2019; Pittsburgh Water and Sewer Authority, 2016).\nGeography\nNegley Run (Figure 1.2) is a large (3,300 acres) and urbanized watershed at the eastern end of the city of Pittsburgh, with "] [0.8597797155380249, 13.386924743652344, "ata Center, 2017). Homewood, Larimer, and Lincoln-Lemington-Belmar also struggle with high rates of vacant or blighted properties, with over 20 percent of homes vacant in each neighborhood (Allegheny County/ City of Pittsburgh/Western PA Regional Dat"] [0.87261962890625, 13.406085014343262, "een First Plan concepts, for instance, in 2017 a local design collaborative developed the Negley Run Implementation Plan (envirosocialcapital, evolveEA, and eDesign Dynamics, 2017; hereafter NRIP). This plan envisions a new sepa- rated surface connec"] [0.8952659368515015, 13.415265083312988, "escribes modeled strategy results for stormwater outcomes, such as reductions in sewer overflows or street flooding, while Chap- ter Six builds on this simulation modeling analysis to compare economic benefits, cobenefits, and costs from each strateg"] [0.8840922713279724, 13.423914909362793, "cor- responding approach to cost estimation and summarize the methods applied to evaluate GSI cobenefits. The chapter concludes with a brief description of the Robust Decision Making (RDM) tools applied to support a comparison of GSI strategies under"] [0.8610548377037048, 13.38055419921875, "ts provided by PWSA or obtained from other county geographic information system sources to add new spatial and modeling detail, such as dynamic estimates of groundwater and inflow and infiltration flows. Finally, they recalibrated the model using mon"] [0.753222644329071, 13.285469055175781, "en conducted additional validation steps to compare UA-NR model output to monitored flow data and prior Negley Run CSO estimates developed by ALCOSAN and PWSA. Additional detail on UA-NR model integration and validation is provided in Appendix B.\nHis"] [0.8062431812286377, 13.321880340576172, " per the methods applied in ALCOSAN\u2019s WWP (ALCOSAN, 2019e). Annual overflow event durations and frequencies (as number of events) were then calculated using these thresholds for each strategy and uncer- tainty condition selected for simulation.\nNote "] [0.8817082047462463, 13.321222305297852, " house exceeded the home\u2019s grade elevation. This conservative assumption maintains that water would only seep into the basement along the house foundation or from first floor flooding when flood waters exceed the house\u2019s grade, although it is also po"] [0.9561968445777893, 13.500931739807129, "en Infrastructure\ndiscussed here but instead introduced in Chapter Four alongside a description of the resulting strategies. Additional methodological detail is also provided in Appendix E to this report.\nEstimating Strategy Benefits and Cobenefits\nA"] [0.9949727058410645, 13.519646644592285, "emming from the mere existence of a good or service or the option to use it in the future) can be estimated using stated preference techniques.\n\u2022 Benefit (or value) transfer methods use values from previous research in a new context to value nonmarke"] [0.9549216032028198, 13.466446876525879, "e also seek to estimate the potential benefits from CSO reduction (water- quality improvement) directly in dollar terms, representing the social benefit that results from cleaner waterways. This allows us to sum water-quality benefits and other coben"] [0.9685348868370056, 13.499908447265625, "an environments. Once this estimate is obtained and extrapolated to a calendar year, average values are multiplied by the physical quantities to convert the estimates to a monetary benefit. The National Cooperative Highway Research Program provides e"] [-0.3900027573108673, 12.737829208374023, "enity values.\nRobust Decision Making\nFinally, this study builds on the RDM approach previously described in the pilot study. RDM is a general analytical method intended to help identify policies or strategies that are robust against future uncertaint"] [0.8353666663169861, 13.340044021606445, "ces a range of stormwater management challenges under present conditions, and as noted in Chapter One future climate change could exacerbate these chal- lenges. In this chapter, we explore recent rainfall trends and use simulation modeling to esti- m"] [0.7896906137466431, 13.289182662963867, "\n\u2022 Storm variability by time and location\nModel Relationships (R)\nUpdated Negley Run (UA-NR) SWMM model Downscaled climate rainfall projections Overflow analysis tools\nFlood analysis tools\nPolicy Levers and Strategies (L)\nFWOA (current system conditi"] [0.777908205986023, 13.279446601867676, "eshold, which is shown in the column header. Returning to the example, we expected approximately 8 24-hour events where at least 2.3 inches of rain fell, but over this period we observe 18 events meeting or exceeding this threshold. For the 5-year ev"] [0.8291254639625549, 13.343690872192383, "\u2014can increase surface stormwater runoff in the early stages of a heavy rainfall event (Rossman and Huber, 2016). To account for this, we evaluated discrete storms under two scenario conditions: (1) a default dry condition, where the assumption is tha"] [0.8014229536056519, 13.317422866821289, "onnector\n 2x 18\u201d connectors and vortex gates\nNorth Negley Run Blvd 66\u201d\nOverflow Weir elevation 725.02\u2019\n Flow 48\u201d split\nHighland Drive 54\u201d\nEast Washington Boulevard 96\u201d\nEast Washington Boulevard 72\u201d\n South Negley Run Blvd 85\u201d\nWest Washington Bo"] [0.8015665411949158, 13.276559829711914, "key modeling changes that might lead to these differences in Appendix B, but the most significant factors are likely to be the following:\n\u2022 This model has been rebuilt and recalibrated for the Negley Run watershed and uses SWMM functionality not incl"] [0.7758001089096069, 13.311799049377441, "oves some rainfall events to better match long-term historical statistics (see ALCOSAN, 2009, for more information).\n2007\n2011\nYear\n2003TY 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017\nNumber of overflow events\n74 80 90 1"] [0.7819386124610901, 13.298969268798828, "As the wettest year on record as of the pub- lication of this report, 2018 remains an outlier but is nevertheless important to consider in a what-if analysis to understand how the current system and proposed strategies might perform under very extrem"] [0.7620226740837097, 13.268097877502441, "rainfall represents an average across all 3 Rivers Wet Weather radar-adjusted pixels used in the UA-NR model simulation.\nIn general, these scenario comparisons reinforce similar conclusions as the pilot study. Looking at a 10- or 15-year average repr"] [0.7435821890830994, 13.237752914428711, "mic scale. Figure developed by authors.\n 6\n4\n2\nNOAA Atlas 14\nHistorical (Highland Park)\nAverage Future (2020\u20132099)\n 3.5 3.2\n1.2 1.5 1.7 2.1 2.3 2.6\n 1.3 1.0\n2.9 2.0 2.2 2.7\n1.5 1.8\n 0\n1 10 100 1,000 1 10 100 1,000 1 10 100 1,000\nReturn period ("] [0.791813850402832, 13.293517112731934, "Climate Assessment for precipitation across the Northeast (USGCRP, 2017), but here we see how this translates to a specific location in Pittsburgh. Note, however, that the range of uncertainty grows increasingly larger for the Average Future results "] [0.7938455939292908, 13.296954154968262, " Total Runoff (MGal)\n Total runoff (MGal)\n Less than 0.25\nLess than 0.25\n 0.25 - 0.5\n0.25\u20130.5\n 0.5 - 0.75\n0.5\u20130.75\n0.75 - 1.0\n0.75\u20131.0\n1.0 - 1.25\n1.0\u20131.25\n1.25 - 1.5\n1.25\u20131.5\n1.75 - 2.0\n1.75\u20132.0 GrGearteeartethrathna2n2\n"] [0.7763544321060181, 13.274614334106445, " conditions prior to the storm: with saturated soils, alternately, the peak values from a 1-hour, 10-year rainfall increase to 25 cfs (Historical rainfall scenario) or 39 cfs (Aver- age Future scenario), respectively.\nFigure 3.8 compares the 1-hour p"] [0.7865518927574158, 13.292328834533691, "e from Synthetic Rainfall Events\nFigure 3.9 shows a sampling of street flooding maps from the discrete storm analysis using this approach for four events of varying duration and intensity (Historical rainfall scenario, dry starting conditions). Gray "] [0.7466321587562561, 13.254074096679688, "feet. Results show the median Historical rainfall scenario estimate assuming default (dry) prior conditions. Rainfall volumes for each storm shown are as follows: 1-hr, 2-yr = 1.0 in; 1-hr; 10-yr = 1.5 in; 24-hr, 2-yr = 2.1 in; 24-hr, 10-yr = 3.2 in."] [0.7711988091468811, 13.275979042053223, " also evaluated a range of historical analogue storms that derive from the 3 Rivers Wet Weather historical radar-adjusted rainfall data set. The methods used to derive and adjust these storms to represent rainfall volumes from the DDF curves are desc"] [0.8011578321456909, 13.307701110839844, " people who were trapped when floodwaters rose suddenly to a peak of over 8 feet around their idled cars (Balingit, 2013). Subsequent to this event, flood gates were installed at both ends of lower Washington Boulevard (from Negley Run Boulevard to A"] [0.8092565536499023, 13.309622764587402, "quently homes might be affected by wet basements or sewer backups in Negley Run. This analysis does not include all homes in the watershed but is instead limited to the homes along the streets noted in the previous section.12 In total, we were able t"] [0.7595082521438599, 13.268232345581055, "84 6 177 51 433 18\nTotal 2,367 100 Modeled\nHomes\nNOTE: Median rainfall estimates from the Historical rainfall scenario assuming default (dry) soil moisture, applying the synthetic rainfall approach. The sum of modeled homes in the first three columns"] [0.7757474184036255, 13.301483154296875, "nsemble average (Average Future) to better illustrate the spread across climate models. Damage estimates com- bine all modes of basement flooding described above and range from approximate $450,000\n15 Results mapped by structure are omitted from this"] [0.7901901006698608, 13.300422668457031, " year\n44 Managing Heavy Rainfall with Green Infrastructure\nFigure 3.13\nExpected Annual Basement Damage for Modeled Houses from a 1- or 24-Hour Event, by Climate Scenario\nExpected annual damage (thousands of 2019 constant $)\n0\n700\n600\n500\n400\n300\n200\n"] [0.8586162328720093, 13.333279609680176, "how Negley Run results would change with broader improvements to the regional system, including treatment plant expansion of the construction of deep tunnel interceptors as called for in the CWP. Future work could integrate the UA-NR model back into "] [0.8612211346626282, 13.372577667236328, "ood-modeling capabilities were also limited by data available to inform model development, which constrained our estimates to only a subset of the watershed. A complete inventory and mapping of storm inlets, inlet invert elevations, and associated pi"] [0.9634101390838623, 13.477545738220215, " additional storage or detention performance associated with the conveyance infra- structure that may subsequently connect local interventions.\nOur methods of preliminary analysis included plan and literature reviews, design-focused participatory wor"] [0.8737677931785583, 13.400522232055664, "nt Venture) (Stantec / Tetra Tech JV, 2018)\n\u2022 Negley Run Section 219 Environmental Infrastructure Pittsburgh, Pennsylvania Design Documentation Report: Draft 35 percent Submittal (hereafter DDR) from May 2019, in partnership with PWSA (prepared by Te"] [0.914588451385498, 13.437569618225098, "nd longitudinal sections found in Appendix G of CDAR to assess the area, length, and construction methodologies of key features. In addition, CDAR included detailed costing information with quantity takeoffs and unit prices that we used for our subse"] [0.871283769607544, 13.413901329040527, "y processes (for example, the Homewood Comprehensive Plan [Homewood Community Devel- opment Collaborative, Pittsburgh Department of City Planning and Urban Redevelopment Authority of Pittsburgh, 2019]). Due to the logistical complexity of land acquis"] [0.8746910691261292, 13.409256935119629, "ed our strategy formulation. For example, the Meadow Street Microshed Concept Plan is a focused, community-based planning effort focused on a portion of the Larimer and East Liberty neighborhoods (Pittsburgh Parks Conservancy and Larimer Consensus Gr"] [0.8720152974128723, 13.41032886505127, "son and remotely connected participatory workshops at our Oak- land office with NRWTF to assess important consensus concepts, facilitate strategy develop- ment, review preliminary results, and set the agenda for subsequent research efforts. These occ"] [0.9252446889877319, 13.419517517089844, " area along Paulson Avenue east of Washington Boulevard to the USACE design, which was designated Strategy 4. These areas within the lower Negley Run watershed are dia- grammed in Figure 4.6.\nSilver Lake Retention Basin\nOne of the novel contributions"] [0.8954866528511047, 13.414408683776855, "s not a dissimilar condition from that at Panther Hollow Lake (see Figure 4.7).\nSLRB or SLRBX would have either a surface conveyance or subsurface piped infrastruc- ture connecting it down Washington Boulevard to the USACE Wetland Basin associated wi"] [0.9488832354545593, 13.439422607421875, " within the right-of-way improvements.\nStrategies to Manage Stormwater in Negley Run 57\n 2-acre water area\n 10-yr 1-hr Overflow\n72-hour Underdrain @2.8 cfs peak\n2.5-acre Panther Hollow Lake for comparison SOURCE: (R) Image with Creative Commons Attr"] [0.9847395420074463, 13.404687881469727, "\nOutfall\nRiver\n Streets\nUnderdrain Underdrain\nUSACE Wetland Basin\nOther impervious\nOverflow\nOverflow\nUnderdrain\nInfiltration + evaporation\n Silver Lake \u201cRain Barrel\u201d\n Stormwater overflow Combined drainage GSI underdrain Natural system los"] [0.9866763949394226, 13.482961654663086, "7A, which includes a version of SLRB and investment in GSI to control 25 percent of impervious cover through the Kelly Street increment, is the Midrange strategy, while Strategy 9C, which represents the highest level of investment considered, is the "] [1.0217773914337158, 13.518007278442383, "). Though we used the construction costs of individual GSI typologies of bioretention, tree pits, and so on for our own nominal estimates of neighborhood greening and conveyance units, we also bracketed the potential cost range using\nStrategies to Ma"] [1.0340460538864136, 13.530326843261719, "tage of construction cost by type of GSI, (2) percentage of construction cost by type of anticipated maintenance activity, and (3) cost per impervious acre treated.\nThe first method assumes annual maintenance costs are typically a percentage of con- "] [0.967986524105072, 13.461835861206055, "t the build- out for this system would take approximately 15 years. We used the USACE CDAR process to guide our anticipated timeline. After a five-year planning effort, CDAR projected that it would take five to six years to complete all concepts unde"] [1.003956913948059, 13.48762321472168, "3 26.4 36.2 52.5 30.1 41.4 60.3 35.6 49.3 72.1 38.0 52.7 77.2 37.6 52.1 76.3 39.1 54.4 79.7 41.5 57.8 84.8 40.6 56.4 82.8\n58.2 85.5\n61.6 90.6\n7B Kelly-SLRB-50\n7C Kelly-SLRBX-50\n8A Lincoln-SLRB-25\n8B Lincoln-SLRB-50\n8C Lincoln-SLRBX-50\n9A EastHills-SL"] [0.9323424696922302, 13.428093910217285, "ts were constrained to stay within available computing resources. We modified the UA-NR model to represent each of the 17 strategies described in Chapter Five and ran this model using both annual time series and discrete storms to consider performanc"] [0.9537439346313477, 13.446880340576172, "rategies, 2003 Typical Year Rainfall\n Strategy name\nFWOA Channel 1/2 Basins Swale/RSC Paulson Frankstown-SLRB-25 Frankstown-SLRB-50 Kedron-SLRB-25 Kedron-SLRB-50 Kelly-SLRB-25 Kelly-SLRB-50 Kelly-SLRBX-50 Lincoln-SLRB-25 Lincoln-SLRB-50 Lincoln-SLRB"] [0.9187484383583069, 13.420555114746094, "rtion of CSO reduction in other rainfall scenarios considered. Figure 5.2\nFigure 5.2\nCombined Sewer-Overflow Volume Reduction with Strategies, Recent Historical Rainfall\n Strategy name\nFWOA Channel 1/2 Basins Swale/RSC Paulson Frankstown-SLRB-25 Fra"] [0.8656220436096191, 13.365762710571289, "ly average three projected future years (2043, 2045, and 2047). This subset of years was chosen to span the range of CSO volumes observed in the FWOA analysis, with a similar overall average. For more information, see Appendix B.\n Gr"] [0.9815160632133484, 13.448281288146973, "rategies with SLRB and more substantial invest- ments in local GSI, starting with the Midrange strategy (Strategy 7A), show a jump in perfor- mance relative to strategies focused primarily on the USACE CDAR region. Overall, the mod- eled results sugg"] [0.8228011131286621, 13.356867790222168, "e discrete storm modeling results show that the system represented in the USACE CDAR report could reduce flood depths along the Washington Boulevard corridor during major rainstorms. Figure 5.6 shows an example of flood depth reduction from a 24-hour"] [0.8407635688781738, 13.349966049194336, "Median 24-hour, 10-year rainfall volume is 3.2 inches from the Cook, McGinnis, and Samaras, 2020, historical DDF estimate. Figure shows change in 1D flood depth in the modeled street channels assuming default (dry) soil moisture conditions and using "] [0.9337742924690247, 13.424766540527344, " focus on Strategies 1 through 4, representing the extent of the direct capture region identified by PWSA for the USACE CDAR effort. The UA-NR discrete storm modeling showed essentially no additional benefit in terms of street flood mitigation in the"] [0.9691781401634216, 13.464591026306152, "hapter showed a mixed picture of benefits related to sewer overflows and flooding. CSO reduction benefits are notable and con- sistent across the range of strategies and rainfall scenarios considered and compare favorably to past estimates from PWSA\u2019"] [0.9131401181221008, 13.42026424407959, " optimized for specific local site conditions.\nAs a result, additional research will be needed to follow up on these results and determine whether specific project designs could provide localized risk reduction. Because the initial high-level finding"] [0.964697539806366, 13.48188591003418, "nmotorized transportation infrastructure, benefits from the planting of trees (including urban heat island effects, carbon sequestration, and localized air pollution effects), and amenity values accru- ing to property owners as a result of increased "] [0.9590318202972412, 13.470833778381348, " Chapter Two and Appendix F. The primary driver of these benefits are the esti- mates of (new) cycling and pedestrian behavior induced by proximity to a new amenity\u2014in this case, a multipurpose recreational trail. Figure 6.1 shows single-family house"] [0.9838166832923889, 13.504728317260742, "n in Table 6.3, tree planting results in reduced air pollution, carbon sequestration, and reduced energy use (urban heat island) as a result of biological processes and canopy shade, especially with respect to \u201cgreen streets.\u201d Typically, these benefi"] [0.9851299524307251, 13.491044044494629, "\nCumulative Approximate Air Pollution, Carbon, and Heat Island Effects from New Net Tree Plantings by Strategy Increment\n($ Thousands per Year)\n Increment Strategy Net Total Trees\n1 Channel 1/2 60\n2 Basins 90\n3 Swale/RSC 90\n4 Paulson 140\n5 Franksto"] [0.9795957803726196, 13.47752571105957, "06\nNOTE: Assumes properties affected are in a\nwith scenario. The 1 percent and 2.5 percent capitalized values are converted to annual values using a 3 percent discount rate. Average home value is assumed to be $134,071. Results are identical for all "] [0.9616537690162659, 13.464452743530273, "eduction capital cost-effectiveness ($/gal.) Discounted economic benefit (2019$) Discounted life-cycle strategy cost (2019$)\nNet present value (NPV) (2019$)\n Because the hydrologic results presented in the preceding chapter did not reveal any "] [0.9816758632659912, 13.470991134643555, " for regionwide CSO mitigation as a proxy for water-quality benefits in Negley Run (cost-avoidance approach; see Chapter Two).\nTo implement this approach, we used the average cost-effectiveness ($/gal.) from the updated ALCOSAN Clean Water Plan. The "] [0.9768124222755432, 13.474268913269043, "rison Results\nCombined Sewer-Overflow Reduction Cost-Effectiveness\nWe first compare results in terms of the cost-effectiveness of these investments toward the legally mandated overflow reduction goals. Figure 6.3 summarizes the cost-effectiveness of "] [0.9425981044769287, 13.439915657043457, "ng to lower average annual rainfall and high CDAR capital costs) are still at or below $0.15/gal. This provides notable evidence to support PWSA proceeding with additional design increments for the lower portion of the watershed as part of a CSO comp"] [0.9761404991149902, 13.475128173828125, "\n8A Lincoln-SLRB-25\n8B Lincoln-SLRB-50\n8C Lincoln-SLRBX-50\n9A EastHills-SLRB-25\n9B EastHills-SLRB-50\n9C EastHills-SLRBX-50\n(100)\n(9)\n11\n37\n40\n40\n37\n40\n37\n39 NPV ($)\n32\n27\n32\n30\n24\n29\n27\n21 51\n(50)\n0\n50\n100\n150\nBenefit and cost (millions of discounted"] [0.9801183342933655, 13.476336479187012, "could be undervalued. If these\nFigure 6.5\nDiscounted Benefits and Costs by Strategy, 2013 Rainfall and Nominal Assumptions\nCosts ($)\nBenefits ($)\n (28)\n(30) (21)\n(33) (21) (36) (23) (41) (23)\n(49) (27) (53) (29) (52) (24) (54) (28) (58) (31)\n(56)"] [0.9832344055175781, 13.476653099060059, "the scenario ensemble. NPV regret starts relatively high at Strategy 1,\n8 More specifically, in each uncertain scenario, the best performing strategy among those compared is assigned a regret value of zero, and regret for each remaining strategy is m"] [1.0056999921798706, 13.511959075927734, "further investments in local GSI in Homewood. Per Figure 6.3, there might be concern that these additional increments would yield comparatively\n Green Stormwater Infrastructure Economic Benefits and Costs 91\npoor CSO cost-effectiveness, even if their"] [0.9649792313575745, 13.466936111450195, "effectiveness. Alternately, if average annual rainfall in the near future more closely resembles the 2003\u20122017 Recent Historical (41 inches) or Higher Total Rainfall (43 inches) estimates, the Max Build-Out strategy does not lead to higher than expec"] [0.9929829239845276, 13.485884666442871, "trategies considered here are generally associated with at least competitive (and, at most, desirable) economic outcomes over a fairly wide range of future environmental conditions (rainfall) and economic estimates (estimates of the benefits and cost"] [1.00066077709198, 13.481192588806152, "while the uncertainty analysis incorporated variation in the key economic param- eters related to the overall level of annualized benefits as well as environmental conditions, the specific timing of costs and benefits, as well as the discount rate, w"] [0.9870031476020813, 13.481698989868164, " residents) were not included in the analysis. To the extent that these types of outcomes would be associated with adoption of a strategy, the costs of said strategy would be understated.\n\u2022 Distributional aspects of the benefits and costs over the af"] [1.0116972923278809, 13.478530883789062, "es for which NPV is negative. Coupled with the fact that the cobenefits are likely undervalued in the analy- sis, these results suggest that the additional services provided by GSI strategies are likely not only economically desirable for an assumed "] [0.7604061961174011, 13.287656784057617, "nd assuming no additional investments in the combined sewer system. This estimate is in line with but some- what higher than prior past estimates. Our estimates are approximately 14 percent higher (986 MGY) when instead averaging model results from a"] [0.8587417602539062, 13.351417541503906, "s effort provided some value in considering potential risks from heavy rainfall in terms of street or basement flooding. The relatively low computational cost allowed us to simulate thousands of different events and com- pare across several key dimen"] [1.015839695930481, 13.498502731323242, "presented in this analysis in a simplified, standardized way using the SWMM LID module in the UA-NR model and is not optimized for specific local site conditions. As a result, additional research will be needed to follow up on these results and deter"] [0.9352642297744751, 13.422332763671875, "ars to be a robust and low-regret approach across a wide range of cost and rain- fall assumptions. When considering NPV and taking into account a broader range of coben- efits for local residents in Homewood and surrounding neighborhoods, however, st"] [0.8805745840072632, 13.386552810668945, "e projects could be designed and sited to best address local flooding issues.\nContinue to invest in distributed local GSI projects in Negley Run neighborhoods.\nThe cobenefits analysis presented here shows that GSI could provide notable benefits for r"] [0.7060561180114746, 13.44741153717041, "101\n102 Managing Heavy Rainfall with Green Infrastructure\ndrainage) modeling for key locations of interest, such as the Washington Boulevard corridor. In addition, coupled modeling building on this work could provide localized flood assessments at th"] [0.6607151031494141, 13.472308158874512, "tary Authority, ALCOSAN Clean Water Plan, 2019e. As of September 29, 2020:\nh t t p s : // w w w. a l c o s a n . o r g /d o c s /d e f a u l t- s o u r c e /c l e a n - w a t e r- p l a n - d o c u m e n t s /c w p - s e c t i o n - 4 . p d f ? s f v"] [-0.48266473412513733, 13.269140243530273, " Computer-Assisted Approach to Scenario Discovery,\u201d Technological Forecasting and Social Change, Vol. 77, No. 1, January 2010, pp. 34\u201249.\nBureau of Reclamation, \u201cChange in Discount Rate for Water Resources Planning,\u201d Washington, D.C., December 17, 20"] [0.6345056295394897, 13.455670356750488, "water Governance: The Need for a Paradigm Shift,\u201d Environmental Management, Vol. 57, No. 5, 2016, pp. 1112\u20121124.\nDonat, Markus G., Andrew L. Lowry, Lisa V. Alexander, Paul A. O\u2019Gorman, and Nicola Maher, \u201cMore Extreme Precipitation in the World\u2019s Dry "] [0.7037449479103088, 13.449381828308105, "ic Contribution to Global Occurrence of Heavy-Precipitation and High-Temperature Extremes,\u201d Nature Climate Change, Vol. 5, No. 6, June 2015, pp. 560\u2012564.\nFord, Ariam, Rebecca Mizikar, Tom Mulholland, Masoud Sayles, Rachel Bowers, and Lydia Kramer, Gr"] [0.7511420249938965, 13.433676719665527, " An Analysis of National Bicycle and Pedestrian Documentation\u2014Project Data from 2008 to 2010, Portland, Or., 2011.\nIrwin, Nicholas B., H. Allen Klaiber, and Elena G. Irwin, \u201cDo Stormwater Basins Generate Co-Benefits? Evidence from Baltimore County, M"] [0.6922277212142944, 13.442122459411621, "heory to Practice, Dordrecht, Netherlands: Springer, 2019.\nMcGarity, Arthur, Fengwei Hung, Christina Rosan, Benjamin Hobbs, Megan Heckert, and Shandor Szalay, \u201cQuantifying Benefits of Green Stormwater Infrastructure in Philadelphia,\u201d World Environmen"] [0.7017826437950134, 13.435909271240234, "ata Center: Pittsburgh ASOS, PA US Maximum Temperature,\u201d 2020c. As of July 1, 2020: https://www.ncdc.noaa.gov/cdo-web/datasets/GHCND/stations/GHCND:USW00094823/detail\n\u2014\u2014\u2014, \u201cNational Climatic Data Center: Pittsburgh ASOS, PA US Minimum Temperature,\u201d 2"] [0.7631767392158508, 13.428494453430176, "oding on Road Transport: A Depth-Disruption Function,\u201d Transportation Research Part D: Transport and Environment, Vol. 55, 2017, pp. 67\u201281.\nPrice, Elizabeth, Taylor Holladay, and Lisa Wainger, Cost Analysis of Stormwater and Agricultural Practices fo"] [0.6768240332603455, 13.448554992675781, "ation of Green Infrastructure in Buffalo: Rain Check 1.0, Buffalo, N.Y., 2018.\nUniversity Center for Social and Urban Research at University of Pittsburgh, \u201cCity of Pittsburgh Neighborhood Profiles Census 2010 Summary File 1 (SF1) Data,\u201d 2011. As of "] [0.6964978575706482, 13.445237159729004, "of Green Infrastructure,\u201d StormwateReport, December 2, 2015. As of July 1, 2020:\nhttps://stormwater.wef.org/2015/12/real-cost-green-infrastructure/\nWestern Pennsylvania Regional Data Center, \u201cAllegheny County Property Assessments,\u201d web page, undated."] [0.9598050117492676, 13.447491645812988, "timates of recreational, amenity, and other cobenefits to local residents; compare total benefits to costs; and explore potential trade-offs. Results show that a centralized system of stormwater management in Negley Run could yield cost-effective sew"] [4.706739902496338, 7.938137531280518, " CORPORATION\nMARJORY S. BLUMENTHAL, LAURA FRAADE-BLANAR, RYAN BEST, J. LUKE IRWIN\nSafe Enough\nApproaches to Assessing Acceptable Safety for Automated Vehicles\n For more information on this"] [12.648829460144043, 13.576435089111328, "am\nRAND Social and Economic Well-Being is a division of the RAND Corporation that seeks to actively improve the health and social and economic well-being of populations and communities throughout the world. This research was conducted in the Communit"] [4.752709865570068, 7.697446346282959, "...........................23\n4. Safety as a Process.....................................................................................................................26 Safety Cases as Crosscutting Presentations of Evidence for Acceptably Safe ..."] [4.73793363571167, 7.713892936706543, "..................................................................................................................83\n iv\nAppendix A. American Life Panel Survey....................................................................................86 Appe"] [4.770453929901123, 7.7613606452941895, "ble 7.1. Approaches to Assessing AV Safety............................................................................72 Table A.1. Linear Mixed Model Predicting Safety Ratings Using Safety Message Source,\nAge, and Gender ............................"] [4.730988025665283, 7.693302154541016, "re attention is being paid to processes\u2014the kinds of steps taken by developers and how these steps are implemented\u2014and what they indicate about AV safety. These processes include safety-relevant standards-setting activities, a growing emphasis on saf"] [4.7520012855529785, 7.7067484855651855, "ht serve as a transportation-system-wide goal as opposed to an AV-specific one. Thresholds can evolve.\n Approach\nMeasurement Leading measures Roadmanship Lagging measures\nProcess\nTechnical standards Government regulation Safety culture\nThresholds\nPr"] [4.848763465881348, 7.757955551147461, "f everyday products and experiences and weighs these risks. Communication is also important because, as with other technologies associated with significant risk, AV safety is a political issue and a technical one.\nMapping Agreement Among Stakeholders"] [4.848738670349121, 7.8325276374816895, "onsortium could help, including by becoming a champion for advancing roadmanship measures.\nDevelopers should forge uniform and transparent approaches to presenting evidence for meeting safety thresholds. There are differences across the sets of circu"] [4.831796169281006, 7.86122989654541, "ne Lappin, legal scholar Bryant Walker Smith, and a European technologist who preferred to remain anonymous.\nAs part of RAND\u2019s quality assurance process, Liisa Ecola and Jane Lappin provided constructive feedback that helped us sharpen our analysis a"] [4.749293327331543, 7.729823589324951, "nventional vehicle production), industry analysts, safety and consumer advocacy organizations, government officials (federal, state, and local), safety researchers, and the general public (people expected to ride in or share the road with AVs). This "] [4.824869155883789, 7.71114444732666, "ow well an AV behaves in traffic.\nAs suggested by its title, Measuring Automated Vehicle Safety: Forging a Framework describes a framework that shows measurement possible in different settings (simulation, closed courses, and public roads with and wi"] [4.773941516876221, 7.779264450073242, "ior. As one person mused to the research team before everyday activities were constrained because of the pandemic:\nWhat kinds of risk do we accept as we walk out the door, go down the street, get on a city bus, go into a store\u2014what is the existing am"] [4.177901744842529, 7.8496551513671875, " adopt new technologies, such as seat belts, side airbags, and crumple zones\u2014sometimes in response to regulatory standards and/or public pressure and sometimes voluntarily.\nFor example, Vision Zero is a global movement aimed at eliminating traffic fa"] [4.840251922607422, 7.874565124511719, " and could feature fleet ownership. 4\n Perhaps the most important context is the environment (defined by geography, terrain, weather, lighting, traffic, roadway complexity, and more) in which the AV is tested and for which it is designed: the ODD. In"] [4.795080661773682, 7.74180269241333, "ard provides a taxonomy of automated driving capabilities, ranging from level 0 (no driving automation) to level 5 (fully automated driving with no human needed).\n14 There are more than 250 million registered vehicles in the United States, a fleet wi"] [4.748108863830566, 7.700284481048584, "urces of evidence for AV safety using the RAND American Life Panel (ALP), a nationally representative sample of the U.S. population. The survey provided insight into how the general public weights different evidence types and sources relating to AV s"] [4.7379584312438965, 7.6893815994262695, "n Table 2.1, we present different ways to categorize AV safety approaches: safety as a measurement, safety as a process, and safety as a threshold.\n Table 2.1. Approaches for Assessing AV Safety\n Safety as a Measurement (Chapter 3)\nSafety as a Thre"] [4.736839771270752, 7.6803059577941895, "id and feasible. The former means that the approach must actually reflect safety (rather than, for example, driving function, public relations, or technology development). The latter means that it must be possible to generate evidence to support (or "] [4.699038982391357, 7.649840354919434, "describing the knowledge that safety measurements can yield.\nHow Measures Show Safety: Lagging and Leading Measures\nOur 2018 report, Measuring Automated Vehicle Safety: Forging a Framework, articulated two streams of measurement: leading and lagging "] [4.692897796630859, 7.6331377029418945, "this number\u201d and assess if what happened in the past will continue to happen in the future.\nAnother said:\nOn the lagging side, what you\u2019d like to see is a reduction of injurious and fatal crashes, and that will tell the final story on if it is safe o"] [4.71444845199585, 7.671430587768555, "o provide the public with critical analysis about how something is safe.\n\u2014\u2014\u2014\u2014\u2014\nThe problem with disengagements: There isn\u2019t enough context around them. You can\u2019t be sure that a disengagement for [company A] is the same as for [company B], or even for"] [4.712833404541016, 7.669732570648193, "n aspirational leading measure for AV safety.\nThe original articulation of roadmanship focused on safe roadway citizenship. During the research for this project, stakeholder comments deepened the discussion of roadmanship:\nWhen we\u2019re talking about ro"] [4.715826511383057, 7.636518478393555, "ed to avoid a potentially dangerous situation, resulting in a leading-measure event occurring.\nTable 3.1. Relationship Between Hard Braking and Appropriate ADS Action\n Danger Present\n A: appropriate reaction\n C: false negative (crash)\n Brak"] [4.703551769256592, 7.662158489227295, "aspects of roadmanship, nor does any measure cover all possible threats to safety that occur on the roadway. No one measure can be used in isolation; each measure\u2019s contribution is best voiced in harmony. As one interviewee remarked:\nSome of the conv"] [4.709933280944824, 7.7203497886657715, "envelope (or through some other means) can generate rate-based measures, such as counts per intervention per VMT. It could also contribute to implementing other measures articulated in Table 3.2.32\nAdditionally, roadmanship measures are conceived of "] [4.71453857421875, 7.709697246551514, "racteristic\n Measures of Behavior\n Measures of Time\n Measures of Safeguard Engagement\n Measures of Probability\n Measures of User Perception\n Example\n Rapid acceleration or decelerationa\n Safety critical eventsb (combination of cra"] [4.684641361236572, 7.642517566680908, " were manually validated and coded by trained data reductionists.\" Johan Engstro\u0308m, Andrew Miller, Wenyan Huang, Susan Soccolich, Sahar Ghanipoor Machiani, Arash Jahangiri, Felix Dreger, and Joost de Winter, Behavior-Based Predictive Safety Analytics"] [4.710348606109619, 7.67978572845459, "eading measures do play a role, but we need to do more research to find out what is the most correlated with the lagging measures. This is hard to do.\n\u2014\u2014\u2014\nAVs have different behaviors and different failure modes than human drivers.\n\u2014\u2014\u2014\nDo you design "] [4.708053112030029, 7.656439304351807, "erpinnings hold. It follows that the results of leading and lagging measures should agree\u2014or, as one interviewee put it, \u201cit\u2019s reasonable that fewer fatalities would also mean fewer injuries.\u201d According to another:\nEven though you\u2019re meeting leading-"] [4.720999717712402, 7.679875373840332, "ntly, Safety II reflects the AV\u2019s ability to adapt and respond to conditions, and Safety II shifts goals from the specific \u201cdon\u2019t crash\u201d to the broader \u201cdrive safely\u201d and from \u201cavoid that something goes wrong\u201d to \u201censure that everything goes right.\u201d3"] [4.7511115074157715, 7.699677467346191, " after the update, which could result in degraded safety even if the update itself improves AV performance.\nOne option could be a measure for which events occur so frequently that a day\u2019s worth of data would be informative, but such a measure would l"] [4.779216289520264, 7.724495887756348, "e last year and a half. At this point\u2014it would be great if there were consensus, but, in its absence, we would entertain different methods.\nHowever, this ad hoc approach muddies any effort to understand safety across the industry overall and the safe"] [4.7658772468566895, 7.672436714172363, "nd other stakeholders point to processes or specific sets of steps that might be used by developers to assess safety. Processes can point to what some engineers call a positive trust balance. As explained in one interview:\nThe positive trust argument"] [4.728372097015381, 7.672392845153809, "raged or even required by government and by corporate policy. Options to demonstrate AV safety through process have been growing. As discussed in a later section, demonstrating compliance with a process is a way for developers to document the steps t"] [4.873685359954834, 7.813864231109619, ") who find common cause in establishing parameters for performance and design and for mechanisms that allow interoperability or consistency in training. One interviewee explained the need as follows:\n[As a developer,] I should show what math I used a"] [4.822084903717041, 7.895175457000732, "ces in preferences for how prescriptive a standard should be\u2014also adds delay.\nSince Measuring Automated Vehicle Safety: Forging a Framework was published,50 the number and variety of AV standards have grown (Appendix C lists notable examples), as hav"] [4.797860622406006, 7.902494430541992, "y for Automated Driving Systems\u2014Design, Verification and Validation Methods,\u201d ISO/CD TR 4804, undated.\n55 Underwriters Laboratories, \u201cAbout Us,\u201d webpage, undated-a.\n56 Junko Yoshida, \u201cSafe Autonomy: UL 4600 and How It Grew,\u201d EE Times, April 2, 2020; "] [4.9407267570495605, 7.8849897384643555, " decisionmaking, industry will not know how safe is safe enough, and government will not have a tool to define what safe driving means. . . . This standard defines a technology-neutral formal model, parameterized so that the balance between safety an"] [4.9257049560546875, 7.919042587280273, "e traffic and enforcement of traffic laws. The local and state levels are where one can find commitments to Vision Zero, focusing on the traffic system and not just individual vehicles (as noted in Chapter 1). At the state level, governments control "] [4.937119007110596, 7.86474609375, "er if that happens through a sort of evolutionary process.\nEven before the advent of the AVs now being tested, the development of FMVSS has been slow; the timetable built into the U.S. rulemaking process was noted by a variety of stakeholders.69 The "] [4.770549297332764, 7.732464790344238, "ng a floor for safety. Industry executives asserted that best practice will be at least comparable to that floor. For the public, a minimum expectation can provide assurance. This floor also limits the extent to which government officials need to con"] [4.75898551940918, 7.7006120681762695, "uently pointed to a developer\u2019s safety culture as an indicator of how it approaches safety-critical processes. Safety culture might be particularly helpful when specific processes break down or become disconnected from measures (see Chapter 3).\nAV de"] [4.752627849578857, 7.716646194458008, "al standards, which could be bootstrapped by the best practices that AVSC develops.73\nInsights can be gleaned from other domains. For example, the Federal Aviation Administration established the Safety Management System, a set of processes for managi"] [4.732613563537598, 7.702889442443848, "dge of safety, including how it is handled in a variety of industries, noted that, in transportation industries with comparatively few players (such as aviation and rail), safety culture extended to a willingness to share information about problems.7"] [4.724786758422852, 7.729162216186523, " These thresholds exist along several dimensions.\n79 These issues are discussed in later sections of this chapter. See \u201cSafety as Achieving a Threshold Based on Human Driving Performance\u201d and \u201cSafety as Achieving a Threshold Based on an Absolute Safe"] [4.725390911102295, 7.741820812225342, "en they first enter commercial service but also in an ongoing manner. The former has been traditional for human-driven vehicles,83 but the latter is important for AVs given the possibility for ongoing over-the-air updates.84 With AVs, explained one i"] [4.654385566711426, 7.8799920082092285, "ited by interviewees as a basis for a safety threshold of AVs (for example, making \u201ccomparisons to human drivers is necessary, at least in the short term\u201d; \u201ccomparing to the baseline of a human driver is a good idea\u201d; and an \u201cAV needs to have the sam"] [4.673057556152344, 8.146629333496094, "han an average driver. Oddly, simple analysis shows that they are right. In terms of any crash, from fatalities to solely property\n87 Fewtrell and Bartram, 2001.\n88 Wishart et al., 2020. This option is somewhat predicated on the assumption that, as o"] [4.650406360626221, 7.9020676612854, "es were four-vehicle crashes, only 25,808,000 drivers (less than 12 percent of drivers) would have been involved in a crash.\n94 The \u201ctrick\u201d is in comparing mean with median and a population decimal rate with an individual\u2019s whole number.\n95 Insurance"] [4.6542744636535645, 7.883556365966797, "\u201d\nA few definitions of safe drivers exist. We list these here with quotations from interviewees:\n\u2022 Pick a percentage or numerical value better than average humans: \u201c10, 20, 30 percent,\u201d \u201ca degree or order of magnitude better than humans,\u201d \u201c95 percent"] [4.7091288566589355, 7.711944580078125, " comparing of methods, instead of just looking at safety. We need to have a common definition and common methods.\nClear, transparent, and universally applied definitions and methods are required, especially for leading roadmanship measures (see Chapt"] [4.713517665863037, 7.684045314788818, "ar misses and other measures of roadmanship is naturalistic data on human-driven vehicles.101 Naturalistic driving data can provide otherwise-inaccessible insights into human factors specific to driver behavior, driver characteristics, pre-crash driv"] [4.7186102867126465, 7.67478084564209, "re deeply and inextricably linked to ODDs. Regional differences exist in leading and lagging measures. Comparing on the state level, Mississippi had 23.12 crash fatalities per 100,000 people in 2017; New York had a rate of 5.03. But this rate is not "] [4.733348846435547, 7.708032608032227, "son (average, safe, or other) could be used. Consequently, because AVs develop in \u201cislands of autonomy\u201d\u2014geographically specific and narrowly defined locales\u2014 they also might be most measurable in these select islands.\nSafety as Achieving a Threshold "] [4.731628894805908, 7.720552921295166, "est might not be able to show performance to an acceptably high level.\nFinally, validity is questionable. The degree to which passing or failing a driving test reflects overall driving ability is unclear. Although a human-driving test reflects abilit"] [4.699727535247803, 7.715673923492432, "as it can possibly be could involve evidence that the AV meets all existing best practices, including a variety of technical standards and other best-practice protocols (see Chapter 4). As one interviewee stated, \u201cwith regards to outcome, [I] don\u2019t c"] [4.549273490905762, 7.768757343292236, "requirement of zero anything is conceptually fraught and might be practically infeasible.110 Accordingly, interviews with people concerned about the interpretation of a zero- death goal featured such comments as:\nThe absolute threshold should be zero"] [4.577977180480957, 7.771648406982422, " roads are right next to a sidewalk, and you may be going 40 to 45 mph. You assume those pedestrians will not enter the roadway, etc. The parameters for safe driving are making assumptions about these behaviors. For example, when following, you assum"] [4.607003211975098, 7.7868194580078125, "r words, the new technology or system must include the same risk as the old technology or system.115 The theory is that one cannot get below this level. A hybrid between a threshold rooted in the average human driver and one rooted in the absolute go"] [4.634430885314941, 7.691163063049316, "ble fatal crash risk is a risk less than 1/20 of the above (or 3 x 10\u20136 person-years). Pegasus, 2019.\n 51\nenough? Several interviewees touched on the politics of the problem, as illustrated by the following quotation:\nIndustry hype and marketing say "] [4.708963871002197, 7.707729339599609, "erformance,\u201d one of the main challenges of using leading events is that comparable human-driver data are rarely available. Using leading events in concert with absolute safety goals instead of thresholds based on human-driving behavior nullifies this"] [4.720414161682129, 7.713166236877441, "use it.\nDefinitions, by contrast, might benefit from uniformity: \u201cTo a certain extent, all need to be speaking the same language. And the language is important to not misrepresent to people what the vehicles do.\u201d Because companies will have such dive"] [4.70983362197876, 7.704578399658203, "on what is doable given the sophistication of available technology, economic pressures, and what the public will accept.a ALARP, especially, tries to elucidate a level of risk between unacceptably high and acceptably low.b The natural corollary is th"] [4.729643821716309, 7.674396514892578, "nature, somewhere in between the two\n\u2022 understand that some uncertainties must be accepted\n\u2022 expect that resources will go to addressing the highest risks.\nWith this list in mind, phrasing an approach along the same lines as ARARA and ALARP might hav"] [4.771313190460205, 7.758431434631348, "lished and/or endorsed by\nsafety culture OR\nSafety as achieving a threshold\nSafety as achieving a threshold predicated on human driving\nSafety as achieving a threshold predicated on technology\n\u2192 As safe as a safety culture can confirm OR\nAs safe as a"] [4.786369800567627, 7.776923656463623, "04.\n125 Paul Slovic, \u201cPerceptions of Risk: Reflections on the Psychometric Paradigm,\u201d in Sheldon Krimsky and Dominic Golding, eds., Social Theories of Risk, New York: Praeger, 1990, p. 121.\n 57\nPsychometric Paradigm of Risk\nThe question of \u201chow safe"] [4.774631023406982, 7.724207878112793, ".\n128 Baruch Fischhoff, Paul Slovic, Sarah Lichtenstein, Stephen Read, and Barbara Combs, \u201cHow Safe Is Safe Enough? A Psychometric Study of Attitudes Towards Technological Risks and Benefits,\u201d Policy Sciences, Vol. 9, No. 2, 1978.\n 58\nwith an activit"] [4.779771327972412, 7.696612358093262, "ty\u2014will all play large roles in the campaign to communicate to the public about AV safety. Framing messages in positive or negative language independently\n129 For example, see Slovic et al., 2004.\n130 Melissa L. Finucane, Ali Alhakami, Paul Slovic, a"] [4.787111282348633, 7.740483283996582, "commented on amusement parks: \u201cIf you go to an amusement park and get on a roller coaster, you assume that someone has checked that it is safe enough.\u201d In the case of aviation and amusement parks, it is possible that the business design (e.g., paying"] [4.8336896896362305, 7.829948425292969, "ce in the promotion of technology acceptance and adoption in areas in which negative outcomes, however rare, have the potential for severe harm. Acceptance of technology can be negatively affected by a negative reputation (of the technology or its pr"] [4.960770130157471, 7.9334588050842285, "on of compatibility (as users develop a greater understanding of the abilities of the system).\nCommunication from the Automated Technology Itself\nCommunication of the automated capability of vehicles is an important way to address perceptions of risk"] [4.97208833694458, 7.897459983825684, "without specific training on the appropriate use or capabilities of the product or system. A recent survey found that only about one-half of new car buyers were offered system-specific training for their new vehicles by the dealership.144 In the same"] [4.801609039306641, 7.624305725097656, "ng conventions for 20 ADAS in five different categories.147\nConvincing the Public\nSources of Communication\u2014ALP Survey\nCommunication about the safety of AVs comes from a multitude of sources with varying public perceptions of trust and credibility. Ty"] [4.786936283111572, 7.5846099853515625, "ormation is available from AV near-miss rates. This topic is further discussed in Appendix A.\nTo calculate the relative influence of each source, the safety messages and resulting perceived safety ratings were entered into a linear mixed model. Using"] [4.788897514343262, 7.585434913635254, "attern of similarities and differences between rank order and the regression coefficients from the implicit items (see Table 6.1). On average, participants were aware of which sources they most and least preferred. The implicit and explicit measures "] [4.808309078216553, 7.619578838348389, "Differing Sources for Messages About AV Safety\n Order of Preference\nSafety Message Source (measure)\n Regression Coefficient (implicit)\nRank Order (explicit)\n AV crash rate\nState or local government position Federal government position\nAV near-mis"] [4.844122409820557, 7.72114372253418, "promote AV acceptance in light of the constructs and models discussed in this chapter. Early adopters will likely perceive greater benefits and lower risks associated with AVs than will individuals who are less receptive to new technologies. One surv"] [4.845809459686279, 7.700061798095703, "general public, industry stakeholders must be able to communicate their measure- and process-based safety approaches to government in ways that are clear and consolidated. According to Bryant Walker Smith:\nThe public and even regulators lack the reso"] [4.716323375701904, 7.729399681091309, " humans as opposed to errors from technology. Though the magnitude varies depending on the particulars of any given study on the topic, the general trend is clear: Individuals will not accept AVs until they are safer than human drivers. This expectat"] [4.726022720336914, 7.668015003204346, "of rare events, such as crashes.\n158 Silberg, 2017.\n 71\nTable 7.1. Approaches to Assessing AV Safety Approach Takeaways\n Approach\nMeasurement \u2022 Leading measures\nRoadmanship\nLagging measures\nMeasurement provides established and easily communicated e"] [4.738348007202148, 7.6789984703063965, "t in company statements. Regardless of the source, AV communication should factor in the difficulty that people have in gauging risk accurately.\nProgress will not come from selecting the best approach\u2014there is no such thing. None of these approaches "] [4.719588756561279, 7.705161094665527, "practice. It is also, in effect, an individual\u2019s recipe for a safety case (which we discuss later).\nHow Approaches Build on Each Other\nEach of the approaches outlined in Table 7.1 builds on, supports, and contributes to the evidence used in others. I"] [4.778552055358887, 7.69536018371582, "andards\u2014but it shouldn\u2019t be part of the ultimate measurement of whether AVs are safe or not safe.\n\u2014\u2014\u2014\nThe reality is that, without metrics, where is the oversight to make sure people meet those metrics? Cars are self-certifying to what? A system that"] [4.698156356811523, 7.641017913818359, "4600) to the recognition that such broad approaches as the Federal Aviation Administration\u2019s Safety Management System, which centers on safety cases, have value in AVs. Although safety cases began as a way of organizing and documenting engineering an"] [4.691209316253662, 7.643925189971924, "admanship even if that term was not used\u2014the more general term, \u201cleading measures,\u201d effectively refers to roadmanship measures (due partially to a dearth of other options). Measurement uncertainties and the many pointers toward the need for an integr"] [4.887491226196289, 7.780433654785156, "e issue. That is why communication (discussed in the next section) is central to the question of whether AVs are acceptably safe. Developers and the AV industry depend on either facilitation or removal of barriers by government at different levels, a"] [4.856664180755615, 7.7639546394348145, " that reality has been a motivation for regulation generally, regulators inevitably lag behind industry when it comes to understanding how the relevant science or technology works, another reality that was mentioned by a wide variety of stakeholders "] [4.858222961425781, 7.720193386077881, "d for sharing information associated with adverse incidents as case studies.171 In the absence of such sharing, National Transportation Safety Board investigations appear to play that role. Stakeholders continue to differ, as documented in the team\u2019s"] [4.8488593101501465, 7.767461776733398, "2 NHTSA, \u201cNew Test Tracking Tool,\u201d webpage, undated-a.\n 80\nplatform for data contributed voluntarily by developers and by states and localities that host testing. Stakeholders interviewed for the project struggled with the idea of a third-party revie"] [4.818389892578125, 7.815152168273926, ". Anderson, Nahom M. Beyene, Pavan Katkar, and Gregory Cyril Baumann, When Autonomous Vehicles Are Hacked, Who Is Liable? Santa Monica, Calif.: RAND Corporation, RR- 2654-RC, 2019.\n174 Viscusi, 2006.\n 81\nimproved. What is communicated\u2014and how\u2014will sh"] [4.833024024963379, 7.777333736419678, "abel Consumer Research,\u201d Federal Register, Vol. 85, No. 23598, April 28, 2020b.\n Administration\u2019s New Car Assessment Program (NCAP) created the 5-Star Safety Ratings Program to provide\n consumers with information about the crash protection and roll"] [4.813277721405029, 7.7533135414123535, "e to respond better to new challenges after encountering a difficult situation than it was able to before.180 Associated assessment challenges might dwarf those of today, but meeting\n177 Viscusi, 2006.\n178 A survey by Partners for Automated Vehicle E"] [4.91082239151001, 7.86049222946167, "evelopers should collaborate with state and local leaders to bring their vehicles into communities around the country. This collaboration could include demonstrations of how AVs operate, things they can do that might improve on human perception and r"] [12.84904670715332, 13.998120307922363, "as administered online to ALP participants. The raw data will be made available online after an embargo period of one year.\nParticipants\nData were collected from 2,203 participants (ages 23\u201390 years, mean age = 58.42, standard deviation age = 13.87; "] [4.821913719177246, 7.584532260894775, "pt these as separate groups because these sources of information might not always agree with one another, and we wanted to allow for that information pattern in the structure of the survey (as we will describe). For example, in states where AV testin"] [4.778487205505371, 7.565234661102295, "b up indicates that the source mostly shows that AVs are safe; one red thumb down indicates that the source mostly shows that AVs are unsafe\udbff\udc4b and two red thumbs down indicates that the source strongly shows that AVs are unsafe.\nIn addition to the imp"] [4.790518760681152, 7.5893096923828125, "ized coefficient; b = unstandardized coefficient; t = t-value; p = p-value.\n0.25 4.46 0.22 3.99 0.16 2.99 0.16 2.98 0.10 1.84 0.06 1.08 0.05 1.02 0.03 0.55\nAs shown in Table A.1, although safety messages from all sources were positively related to pe"] [4.792904376983643, 7.584792613983154, "ge was associated with lower perceived safety of AVs, and males rated the perceived safety of AVs higher than females did.\nInterestingly, the rank ordering of preference for message sources differed compared with the ordering provided by the standard"] [4.7943949699401855, 7.583178520202637, " Table A.2. Means and Standard Deviations of Perceived Safety, by Survey Item\n Safety Message Sources Ratings Number CR NM FVR FG SLG AV ADV FF M SD\nSituation\n "] [4.797173023223877, 7.583162784576416, " state or local government official position. Positive and negative messages from these two general source categories were loosely contrasted in items 5 and 15 (Table A.2). These items were compared in a separate repeated- measure analysis of varianc"] [4.862015247344971, 7.705855369567871, "they had published that could be cited. Research team members took notes during the otherwise unrecorded conversations, and the multiple sets of notes made the records more complete.\nStakeholder Sample\nStratified expert (purposive) sampling was used,"] [4.751082897186279, 7.680569171905518, " that enriched the discussion. In broad strokes, the set can be described as including AV technology developers (10\u201313), safety researchers and advocates (4\u2013 8), AV industry and technology analysts (3\u20136), and government entities (7\u20138).\nInterview and "] [4.748109817504883, 7.7124409675598145, "gs, at one point extending to seven sublevels. Because the interviews were semistructured, the goal of interview coding was to organize the notes into a searchable format rather than for quantitative analysis.\n 187 Dedoose Version 8.3.17, web applica"] [4.752743244171143, 7.745632171630859, "ign,\u201d in Handbook of Reliability, Availability, Maintainability and Safety in Engineering Design, London: Springer, 2009.\n191 Terje Aven and Vidar Kristensen, \u201cPerspectives on Risk: Review and Discussion of the Basis for Establishing a Unified and Ho"] [4.774460315704346, 7.80949592590332, "9.\n195 William D. Schulze, \u201cEthics, Economics and the Value of Safety,\u201d in Societal Risk Assessment, Boston, Mass.:\nSpringer, 1980.\n196 Lisa A. Robinson and James K. Hammitt, \u201cBehavioral Economics and Regulatory Analysis,\u201d Risk Analysis: An\nInternati"] [4.796485900878906, 7.851388454437256, "odel (TAM), the Theory of Planned Behavior (TPB), and the Unified Theory of Acceptance and Use of Technology (UTAUT). Using a survey approach,\n99\nthey found that each of these models individually explained 71 percent or more of the variability in beh"] [4.835336208343506, 7.871854782104492, "nsion of the UTAUT model, introducing the additional factors of hedonic motivation, price value, and habit as predictors of behavioral intention and, for the habit factor, technology use.\nPerceptions of AVs\nAmong studies of technology attitudes, surv"] [4.818974018096924, 7.89293098449707, " May 2018\nUsing an online survey and interviews, the authors compared the likelihood of acceptance and use of self-driving vehicles among individuals who use ride-hailing services (such as Uber and Lyft) with those who do not use such services. The a"] [4.773174285888672, 7.7558064460754395, " Iss. C, 2019\nResearchers sought to identify age differences in AV acceptability from using a sample of residents of Tianjin, China. They found that younger respondents had more-positive attitudes and acceptance of AV compared with older respondents "] [4.706396579742432, 7.703701019287109, "o the more stable trait of personality, while safety climate is akin to the more transient state of mood.199 Because of its quantitative nature and focus on measurement, the state of research on safety climate is more developed than that of safety cu"] [4.745835781097412, 7.83816385269165, "9\nThis article provides a meta-analytic review of predictive capabilities of safety climate measures. Universal safety climate measures have more predictive power for non\u2013injury- or non\u2013accident-related adverse events, although industry-specific safe"] [4.833540916442871, 7.792099952697754, " a systems failure.\nISO, \u201cRoad Vehicles\u2014Functional Safety\u2014Part 1: Vocabulary,\u201d ISO 26262-1:2011, 2011\nThis standard focuses on the functional safety of electrical and electronic systems, particularly in the case of their malfunction or combination wi"] [4.890456199645996, 7.888094425201416, "and severity of adverse events. It clarifies regulations for aviation designed to balance risk and the severity of negative outcomes.\nAntonius A. Lambregts, \u201cFlight Envelope Protection for Automatic and Augmented Manual Control,\u201d in Proceedings of th"] [4.808737754821777, 7.830633163452148, "\u201cConsumer\u2019s Decision-Making and Risk Perceptions Regarding Foods Produced with Biotechnology,\u201d Journal of Consumer Policy, Vol. 21, 1998\nThis study showed that acceptability of genetically modified goods is influenced both by the magnitude and charac"] [4.747223854064941, 7.933751583099365, "aries/content/assets/cm/content/miscellaneous/adas-nomenclature.pdf\nAmerican National Standards Institute, \u201cProject Initiation Notification System (PINS),\u201d ANSI Standards Action, Vol. 51, No. 27, July 30, 2020. As of September 10, 2020: https://share"] [4.65672492980957, 7.944106578826904, "nd Gil Tal, \u201cUncovering Early Adopter\u2019s Perceptions and Purchase Intentions of Automated Vehicles: Insights from Early Adopters of Electric Vehicles in California,\u201d Transportation Research Part F: Traffic Psychology and Behaviour, Vol. 60, January 20"] [4.64797306060791, 8.021729469299316, "orvehiclesafety/teen_drivers/index.html\nChandraratna, Susantha, Nick Stamatiadis, and Arnold Stromberg, \u201cCrash Involvement of Drivers with Multiple Crashes,\u201d Accident Analysis & Prevention, Vol. 38, No. 3, June 2006, pp. 532\u2013541. As of August 30, 202"] [4.677931308746338, 7.973823547363281, "\u20131427.\nDedoose Version 8.3.17, web application for managing, analyzing, and presenting qualitative and mixed-method research data, Los Angeles, Calif.: SocioCultural Research Consultants, 2020. As of June 23, 2020:\nhttps://app.dedoose.com/App/?Versio"] [4.677333354949951, 7.931827545166016, "nents/\n\u2014\u2014\u2014, \u201cSafety Management System (SMS),\u201d webpage, June 21, 2019. As of August 31, 2020: https://www.faa.gov/about/initiatives/sms/\nFederal Highway Administration, Surrogate Safety Assessment Model and Validation: Final Report, McLean, Va.: U.S. "] [4.649113655090332, 7.965421199798584, " Safety Science, Vol. 46, 2008, pp. 1047\u20131066.\nHartwich, Franziska, Claudia Witzlack, Matthias Beggiato, and Josef F. Krems, \u201cThe First Impression Counts\u2014A Combined Driving Simulator and Test Track Study on the Development of Trust and Acceptance of "] [4.671562194824219, 7.9513421058654785, "f Surrogate Safety Indicators for Vulnerable Road Users: A Review of Surrogate Safety Indicators,\u201d Transportation Reviews, Vol. 38, No. 5, 2018.\nJunietz, Philipp Matthias, Microscopic and Macroscopic Risk Metrics for the Safety Validation of Automate"] [4.674894332885742, 7.985235691070557, "fety of Self-Driving Vehicles,\u201d Reliability Engineering & System Safety, Vol. 185, Iss. C, 2019, pp. 341\u2013347.\nLund, Frederick Hansen, \u201cThe Psychology of Belief: A Study of Its Emotional and Volitional Determinants,\u201d Journal of Abnormal and Social Psy"] [4.667679309844971, 8.022414207458496, "al Governors Association, 2018. As of August 30, 2020: https://www.nga.org/wp-content/uploads/2019/09/Autonomous-Vehicle-Technology.pdf\nNational Highway Traffic Safety Administration, \u201cNew Test Tracking Tool,\u201d webpage, undated- a. As of August 20, 20"] [4.648711204528809, 7.978668212890625, "ysical-systems\nNational Research Council, Software for Dependable Systems: Sufficient Evidence? Washington, D.C.: National Academies Press, 2007.\nNational Safety Council, \u201cHappy Anniversary, Road to Zero!\u201d Safety First, blog post, October 23, 2017. A"] [4.706106662750244, 7.931396007537842, "AND American Life Panel: Technical Description, Santa Monica, Calif.: RAND Corporation, RR-1651, 2017. As of September 20, 2020:\nhttps://www.rand.org/pubs/research_reports/RR1651.html\nRae, Andrew J., Acceptable Residual Risk\u2014Principles, Philosophies "] [4.684657096862793, 7.976053237915039, "Texas Cities,\u201d Transportation Research Part F: Traffic Psychology and Behaviour, Vol. 62, April 2019, pp. 66\u201377.\nShalev-Schwartz, Shai, Shaked Shammah, and Amnon Shashua, On a Formal Model of Safe and Scalable Self-Driving Cars, arxiv.org, 2017. As o"] [4.606396675109863, 8.047286033630371, " \u201cFuture of Driving,\u201d webpage, undated. As of August 30, 2020: https://www.tesla.com/autopilot\nThong, James Y. L., and Xin Xu, \u201cConsumer Acceptance and Use of Information Technology: Extending the Unified Theory of Acceptance and Use of Technology,\u201d "] [4.628620147705078, 7.96149206161499, "n.house.gov/imo/media/doc/2020.09.15%20FINAL%20737%20MAX%2 0Report%20for%20Public%20Release.pdf\nVenkatesh, Viswanath, Michael G. Morris, Gordon B. Davis, and Fred D. Davis, \u201cUser Acceptance of Information Technology: Toward a Unified View,\u201d MIS Quart"] [4.724419116973877, 7.850259304046631, "https://www.rand.org/pubs/research_reports/RR2654.html 127\nWishart, Jeffrey, Steven Como, Maria Elli, Brendan Russo, Jack Weast, Niraj Altekar, and Emmanuel James, Driving Safety Performance Assessments Metrics for ADS-Equipped Vehicles, SAE Internat"] [12.699121475219727, 13.815451622009277, "COVID-19 and the Experiences of Populations at Greater Risk\nDescription and Top-Line Summary Data\u2014Wave 1, Summer 2020\nKATHERINE GRACE CARMAN, ANITA CHANDRA, DELIA BUGLIARI, CHRISTOPHER NELSON, CAROLYN MILLER\n Sponsored by the Robert Wood Johnson Foun"] [12.681583404541016, 13.727005004882812, "rts will update these findings.\nResearchers from RAND and RWJF jointly conducted the research reported here; the report is intended for individuals and organizations interested in learning more about public attitudes about a Culture of Health and how"] [12.885147094726562, 14.1537446975708, "........... 2\nSurvey Length ...................................................................................................................................... 5 Survey Sample Selection ............................................................."] [12.907090187072754, 14.396623611450195, "................................ 14\nQ4. [w1_wellbeing1-w1_wellbeing6] Below are a number of things people might say they feel. How much of the time in the past week, did you . . .................................................................... 14\n"] [12.884305000305176, 14.444289207458496, "8 Q12. [w1_covidtest] Have you been tested for coronavirus (COVID-19) (through a nasal swab\nor blood test)? .............................................................................................................................. 19 Q13. [w1_cov"] [12.88685417175293, 14.445611953735352, "care, do you\nthink it is easier or harder for them to get the care they need than it is for those who live in\nurban areas, or is there not much of a difference? ....................................................................... 24\nQ21. [w1_pocim"] [12.878256797790527, 14.380948066711426, "pectations: Understanding What Drives Health............................................... 27\nQ29. [w1_drivers1-w1_driver4] Here is a list of some things that may affect people\u2019s health and well-being. Please rate each on a scale from 1 to 5 where 1"] [12.88741397857666, 14.19929027557373, "...................................................................................................... 31 Respondents by Education Level ....................................................................................................... 31 Respon"] [12.881644248962402, 14.452545166015625, "................................................................................... 36\nQ13. [w1_covidexp1- w1_covidexp14] Are you experiencing or have you experienced any of the following as a result of the coronavirus (COVID-19) pandemic or the resp"] [12.884844779968262, 14.447648048400879, "nd unfair treatment of some groups, such as where people get to live or who gets bank loans. This type of racism can be so embedded in the institutions and practices of society that it can still exist even if individuals don\u2019t want to discriminate. ."] [12.877907752990723, 14.437718391418457, "tions: Trade-Offs and Perspectives.......................................................... 43\nQ31. [w1_liberty] People\u2019s right to move about freely is so important that it\u2019s worth risking a substantial increase in coronavirus (COVID-19) infections "] [12.703195571899414, 13.829092979431152, "......... 46 Respondents by Urbanicity ................................................................................................................ 46\nReferences....................................................................................."] [12.847805976867676, 13.986024856567383, " are recruited via probability-based sampling methods. Both provide computers and internet connections for respondents who do not have them at the time of panel recruitment. Both compensate respondents for their participation. Both panels collect dem"] [12.713955879211426, 13.84443473815918, "sity; Trinity College; the University of Connecticut; the University of Minnesota; and the Urban Institute for their contributions to the survey design process. We also thank the survey participants, who offered their perspectives on health and well-"] [12.727912902832031, 13.867305755615234, "safety, use of community and policy supports, concerns about equity in COVID-19 response and systemic racism, and health civic engagement, as well as views of the role of government, the role of the private sector, the determinants of health, how the"] [12.719521522521973, 13.852666854858398, "vey questions, as documented in Table 1.1. The NSHA was fielded in 2015 and 2018 (Carman et al., 2016; Carman et al., 2019) to capture how people in the United States think about, value, and prioritize issues of health, well-being, and health equity."] [12.716282844543457, 13.851977348327637, " 75% of Californians Support Shelter in Place \u2018as Long as Needed,\u2019\u201d California Health Care Foundation, April 24, 2020. As of October 9, 2020: https://www.chcf.org/blog/covid-19-tracking-poll-75- californians-support-shelter-place-as-long-as-needed/\nP"] [12.854585647583008, 13.994624137878418, "bability-based sampling methods. Both provide computers and internet connections for respondents who do not already have them. Both panels collect demographic information about respondents separately and provide this information with each data set. R"] [12.848139762878418, 13.988720893859863, "0 (22%) 350 (35%) 250 (25%) 100 (10%) 80 (8%)\n NOTES: Percentages are rounded and might not\nsum to 100. Respondents could pick only one race.\n 2 For some groups in the ALP, our target sample size was limited by the total sample who had participate"] [12.884387969970703, 13.957853317260742, "ix.\n4 It was formerly known as the Knowledge Networks Panel and was administered by Knowledge Networks.\n5 Thirteen respondents were dropped from the sample by Ipsos for leaving more than half of the questions blank or completing the survey in less th"] [12.869384765625, 13.97060489654541, "urvey represents the first wave of a planned four-wave survey study. We intend to conduct wave 2 in the fall of 2020, wave 3 in the winter of 2021, and wave 4 in the spring of 2021. When future waves are collected, updated versions of this report wil"] [12.865758895874023, 13.984525680541992, "or proportions near 0 percent or 100 percent and the largest MOE for proportions near 50 percent. Because the overall sample size of our survey is large, 5,164 respondents, the MOE for the full sample ranges from 0.10 percent to 2.33 percent for prop"] [12.903460502624512, 14.165273666381836, "nt the unweighted demographic characteristics so that readers can see the original survey sample composition before we applied weighting procedures. This can aid users of the survey data, who might apply other weighting approaches in their analyses.\n"] [12.904183387756348, 14.401564598083496, "\n None or almost Some of\nAll of the time\nMissing\n 4.3 0.1\n D. Have a lot of energy\nSample none of the time time\nWave 1 15.9 50.0 SOURCE: Santa Monica Well-Being Survey.\n None or almost Some of\nAll of the time\nMissing\n 3.5 0."] [12.859391212463379, 14.464728355407715, "ecify 10.3\nRefused 0.7\nSOURCE: Census Household COVID-19 Pulse Survey, slightly modified on coronavirus term use.\n 16\nQ8. [w1_leaveui] (If NO to Q7). In the last 7 days, were you receiving pay for the time you were not working?\nSel"] [12.894372940063477, 14.42810344696045, "-19) (through a nasal swab or blood test)?\nSample Yes No Missing\nWave 1 12.3 87.4 0.3 SOURCE: Modified from COVID Impact Survey.\nQ13. [w1_covidexp1- w1_covidexp14] Are you experiencing or have you experienced any of the following as a result of the c"] [12.866632461547852, 14.473248481750488, " since coronavirus (COVID-19) started\n1.3\nMy household applied or asked for but has not received assistance from this program since coronavirus (COVID-19) started\n3.9\nNo, my household has not received nor applied for assistance from this program sinc"] [12.8857421875, 14.451712608337402, " 22\n G. Housing or renter\u2019s assistance programs\nYes, my\nMy household applied or asked for but has not received assistance from this program since coronavirus (COVID-19) started\n1.6\nNo, my household has not received nor applied for assistanc"] [12.874515533447266, 14.455419540405273, " Somewhat Sample Strongly agree agree\nWave 1 30.2 27.3 SOURCE: Developed by RWJF and RAND.\nNeither agree nor disagree\n28.4\nSomewhat disagree\n5.1\nStrongly\ndisagree Missing\n8.7 0.4\n Q22. [w1_pocimpact2] People of colo"] [12.876178741455078, 14.429847717285156, "Some of the\nMost of the time time Rarely Never Missing\n Wave 1\nSOURCE: Developed by RWJF and RAND.\n38.1 47.6 10.4 3.6 0.3\n Views, Mindset, and Expectations: Views of Government Roles\nQ26. [w1_stgovt2] How much trust do you have that"] [12.856234550476074, 14.403409004211426, "DNA)\nNo effect\nSample 1 2 3 4 5 Missing\n Very strong effect\n 28\nQ30. [w1_equalaccess] Do you agree or disagree with the following statement: It is the obligation of the government to ensure that everyone has access to healt"] [12.845470428466797, 13.992728233337402, " 15.9 SOURCE: Developed by RWJF and RAND.\nNeither agree nor disagree\n21.0\nSomewhat disagree\n12.1\nStrongly disagree\nMissing\n 31.8 0.3\n 30\nSurvey Respondent Demographics\nBoth panels collect demographic information about respondents s"] [12.886574745178223, 14.139102935791016, " last wave. The methods used for this wave were identical to those described in the main text. For the general-population results, we calculated new weights that match the distribution of characteristics in our sample as closely as possible to that o"] [12.898153305053711, 14.405965805053711, "None or almost\nMost of the time\nMissing\n4.3 .a\nAll of the time\n 48.0 32.0\na The period indicates true 0 (rather than a number that has been rounded down to 0).\nGeneral-population 15.7 wave 1\n SOURCE: Santa Monica Well-Being Survey.\n E. Feel"] [12.87625503540039, 14.450410842895508, "The period indicates true 0 (rather than a number that has been rounded down to 0).\nCOVID Impacts: Feelings of Safety\nMore than a year\n37.0\nSample\n1\u20133 months\nMissing\n.a\n General- population wave 1\n22.8 18.7\n SOURCE: Developed by RWJF an"] [12.876192092895508, 14.457459449768066, "whites.\n Somewhat Sample Strongly agree agree\nGeneral-population 33.1 26.2 wave 1\nSOURCE: Developed by RWJF and RAND.\nNeither agree nor disagree\n30.2\nSomewhat disagree\n5.0\nStrongly disagree\nMissing\n 5.6 0.0\n Q23. [w1_sysracism] Sys"] [12.8206148147583, 14.493382453918457, " General- 40.3 46.6 9.0 4.1 0.1 population\nwave 1\nSOURCE: Developed by RWJF and RAND.\na The period indicates true 0 (rather than a number that has been rounded down to 0).\n 40\nViews, Mindset, and Expectations: Views of Government Roles\nQ26. [w"] [12.877628326416016, 14.433789253234863, "about their diet, exercise, smoking, etc.\nNo effect\nSample 1 2 3 4 5 Missing\n Very strong effect\n General-population 2.7 5.3 13.3 wave 1\nSOURCE: Developed by RWJF and RAND.\nHow they were born (their genetics/DNA)\nNo effect\nSample "] [12.86336612701416, 14.465485572814941, " disagree\nMissing\n 40.6 0.1\n Q36. [w1_ racism] Racism is a major public health crisis. Select only one answer.\n Somewhat Sample Strongly agree agree\nGeneral-population 31.7 18.0 wave 1\nSOURCE: Developed by RWJF and RAND.\nNeit"] [12.736008644104004, 13.876521110534668, "5.0\nUnknown\n0.2\n Sample\nGeneral- population wave 1\nSmall to midsize or large city, 50k+\n78.7\nRural or small town, under 50k\n21.1\n 46\nReferences\nCarman, Katherine Grace, Anita Chandra, Carolyn Miller, Matthew D. Trujillo, Douglas Yeung, Sarah W"] [12.713119506835938, 13.842901229858398, "ated. As of October 9, 2020:\nhttps://www.pewresearch.org/politics/values/\n\u2014\u2014\u2014, \u201cExplore the Data,\u201d webpage, 2020. As of October 9, 2020: https://www.pewresearch.org/pathways-2020/covid_econopen/total_us_adults/us_adults/\nPlough, Alonzo, and Anita Cha"] [13.974599838256836, 0.8138951063156128, " Wearable Sensor Technology and Potential Uses Within Law Enforcement\nIdentifying High-Priority Needs to Improve Officer Safety, Health, and Wellness Using Wearable Sensor Technology\nSean E. Goodison, Jeremy D. Barnum, Michael J. D. Vermeer, Dulani W"] [13.974111557006836, 0.802740216255188, "emented.\n\u2022 A sequenced or phased approach should be devel- oped for taking validated technology to the field for scaled evaluations.\nTechnology and data measurement\n\u2022 Individual baselines should be established to account for differences among individ"] [13.97435474395752, 0.8196526765823364, "seamlessly integrate with the technology that law enforcement already carries, measures need to be valid and reliable, interpretation of the data needs to be clear, and policies need to be in place for managing and monitoring the data. WST has the po"] [13.977204322814941, 0.886522114276886, "rm personnel or staffing selections for assignments (e.g., make changes to officers\u2019 duties in response to indicators of prolonged sedentary behavior or chronic stress indicators while on duty) (Arroyo, 2019; Bedford, 2019; Cashion, 2018). Future sce"] [13.987388610839844, 0.8944807648658752, "cies that are needed to create good policy or best practices for use in law enforcement (Jackson et al., 2020).\nAlthough the sequence of events just described is consis- tent with WST to date and could accurately reflect the future WST trajectory in "] [13.978062629699707, 0.8547787666320801, "s of the workshop.\nMeasurement\nWSTs, which we refer to as wearables when we describe the commercially available mass-market devices, contain sensors worn on the body to collect biomarkers from the user. For example, wristwatches are a common form of "] [13.974364280700684, 0.841589093208313, "ed with psychological conditions, such as mental stress. The ability to collect real-time feedback from individual users on a suite of behavioral, physiological, and psychological indicators demon- strates the potential for this emerging technology t"] [13.973992347717285, 0.814688503742218, "cross platforms, have limited battery life, must be worn for extended periods of time, and are typically much bulkier and less practi- cal for everyday wear (Dunn, Runge, and Snyder, 2018). These devices also require personal calibration to produce m"] [13.97350025177002, 0.8117828965187073, "mise for WST\napplication in law enforcement and other first responder groups (Shaw et al., 2004). This program used a suite of sensors embedded in clothing fabric, chest harnesses, wrist devices, and wrist devices with chest straps to demonstrate a p"] [13.961999893188477, 0.804934024810791, "est to law enforcement agencies, technology manufacturers, the research community focused on officer health, and public policy and privacy advocates involved in the collection and use of health data. For a detailed description of the panel selection "] [13.9732666015625, 0.806212842464447, "ta.\n There are too many devices to choose from, and there is \u2022 inadequate information about their performance.\nPolicy adaptation\nWST data are sensitive, personal information and need to be \u2022 protected by strong security.a \u2022\nIt is difficult to change"] [13.973206520080566, 0.8096606135368347, "ured, and what WST metrics are most meaningful and relevant for law enforcement.a\nThere are too many devices to choose from, and there is\ninadequate information about their performance.\nPotential Solution\n\u2022 Evaluate technologies based on technology r"] [13.972773551940918, 0.8065539598464966, "lighted the goal of securing buy- in through policy protections, along with systematically decid- ing what devices to use. The rest of the needs in this category identify as opportunities (1) the apparent willingness among officers to adopt WST for p"] [13.972617149353027, 0.8076255321502686, "ield of products. Establishing baselines to account for indi- vidual variability in each officer was seen as a potential solu-\ntion to challenges with individualization. Five of the potential solutions called for evaluations and studies of the techno"] [13.974082946777344, 0.8049037456512451, "hese efforts.\nThis section provides further context from the workshop discussion on the identified needs, organized by the four need categories developed as a result of responses at the meeting (i.e., policy adoption, policy adaptation, technology an"] [13.974284172058105, 0.8086110353469849, "this issue: (1) the acceptability of WST as a tool in policing and (2) the willing- ness of officers to wear and use WST. Experts discussed how a growing number of police leaders are beginning to understand the need for agencies to support the mental"] [13.974020957946777, 0.8109660148620605, "ut also at home to capture an individual\u2019s universe of stressors and what strategies might be effective for mitigating their impact.\nPolice leaders must also find ways to ensure that officers wear and use WSTs. According to the experts, one way to do"] [13.970460891723633, 0.810321569442749, "elieved that the devices ultimately would be used against them. Agencies will need to take steps to ensure that data collected from wearable sensors are used to inform strategies that support officers\u2019 health and wellness and improve police operation"] [13.972412109375, 0.8110122084617615, "ST data like any other law enforcement\u2013sensitive data to ensure that they enjoy the same safeguards. Other experts believed that data belong to the users from whom they are collected, allowing users to make decisions about how the data are shared and"] [13.974934577941895, 0.8258574604988098, "arency to the public. For example, some experts imagined a dashboard displaying average heart rates of officers across time and space. However, other experts cau- tioned that de-identification is difficult, especially as open data become increasingly"] [13.973380088806152, 0.8324348330497742, "critical incidents through better training, conditioning, and recovery. Experts recommended that agencies help officers by providing guidance on objectively assessing their progress over time in response to different interventions as part of the coac"] [13.978635787963867, 0.8290061354637146, "ations around WST in the near term, especially as industries begin to approach police leaders to market and sell their devices. Experts believed that it would be helpful to evalu-\nate WSTs using the U.S. Department of Defense\u2019s technology readiness l"] [13.97454833984375, 0.8242467641830444, "olve a determination of the specific needs for data accuracy, reliability, and processing for each use case. Determining who will use or be assigned WST devices also will help resolve uncertainty about what form factors and data collection, shar- ing"] [13.973245620727539, 0.8061248660087585, "iform policies, tactical requirements, and data security requirements. The challenge will be to strike a bal- ance between customizing devices to the needs of a particular agency and standardizing devices for use in law enforcement more generally. If"] [13.972162246704102, 0.8030151128768921, "making but highlighted a strong need to lay the policy groundwork now given the high ceiling of potential for WST. Now is the time to plan for the potential implications of WST, while the technology is still developing\nand personal adoption is increa"] [14.973299980163574, 2.0618107318878174, "that were not included in the existing list and suggested new ones. Although the process of expert elicitation that we describe in this appendix was designed to gather unbiased, representative results from experts and practitioners in the field, we n"] [14.837018966674805, 1.82002854347229, "ension, participants were instructed that 1 was a low score and 9 was a high score. Participants were told to score a need\u2019s importance with a 1 if it would have little or no impact on the problem and with a 9 if it would reduce the impact of the pro"] [14.790306091308594, 1.7547831535339355, "orithm to minimize within-cluster variance when deter- mining the breaks between tiers. The choice of three tiers is arbitrary but was done in part to remain consistent across the set of technology workshops that we have conducted for NIJ. Also, the "] [14.785191535949707, 1.687970757484436, " A.2. Example of the Delphi Round 3 Voting Form\nQuestion\nIssue: The effectiveness of using the technology to improve officer safety and wellness is uncertain.\nNeed: Develop a sequenced or phased approach to taking validated technology to the field fo"] [14.782458305358887, 1.68242347240448, "e that there were gaps between these boundaries, so some of the modified expected values could fall in between tiers. See Figure A.3.) As with prior work, we set a higher bar for a need to move up or down two tiers (from Tier 1 to Tier 3, or vice ver"] [13.973814964294434, 0.8041901588439941, "\n\u2022 17 were related to policy adoption\n\u2022 24 were related to policy adaptation\n\u2022 13 were related to technology and data measurement \u2022 seven were related to technology and data usage.\n Tier 1 Tier 2 Tier 3\nRound 2\n Round 3\n 7.5\n Expected "] [13.97236442565918, 0.8071478009223938, "t for law enforcement.a\nThere has been a shift in how law enforcement takes care \u2022 Provide coaching, mentoring, and evidence-based pro- of its personnel, and greater attention has been paid gramming for officers to help them understand the infor- to "] [13.972705841064453, 0.8087795376777649, ", bio- metrics, and bioanalytics and how they inform selected outcomes; or do both.\nConduct validation studies of WST devices, and conduct\n23\n reliability studies as technology changes.\n\u2022 Define a set of best practices for consumer wearable\n"] [13.972100257873535, 0.8059536218643188, " a policing career, are potentially more aware of health, and might be willing to try new technology.a\nLaws and regulations are outdated when it comes to handling digital data.\nVariation in law enforcement agencies across the country highlights the d"] [13.992477416992188, 1.0281717777252197, "r data are displayed so that they are meaningful.\n a This problem or opportunity is associated with needs that fell into different tiers.\n26\nNotes\n1 We define wearability as a qualitative measure of the comfort of a worn device. We define validity"] [13.994544982910156, 1.014760136604309, " 17, 2020: https://www.ericsson.com/4a2d0e/assets/local/reports-papers/ consumerlab/reports/2016/wearable-technology-and-the-internet-of- things-ericsson-consumerlab-2016.pdf\nEvenson, Kelly R., Michelle M. Goto, and Robert D. Furberg, \u201cSystematic Rev"] [13.994190216064453, 1.1047003269195557, " of September 22, 2020:\nhttps://www.ncjrs.gov/pdffiles1/nij/grants/250382.pdf\n27\n28\nInstitute of Medicine and National Research Council, \u201cAppendix E: Technology Readiness Levels in the Department of Defense,\u201d in Technologies to Enable Autonomous Dete"] [13.99549674987793, 1.0834770202636719, "the Field,\u201d Electronic Frontier Foundation, November 4, 2015.\nMajumder, Sumit, Tapas Mondal, and M. Jamal Deen, \u201cWearable Sensors for Remote Health Monitoring,\u201d Sensors, Vol. 17, No. 1, 2017.\nMiller, Lindsay, Jessica Toliver, and Police Executive Res"] [13.995035171508789, 1.067304253578186, " Institute in Environmental Medicine and the Soldier Systems Center, Lexington, Mass.: Lincoln Laboratory, Massachusetts Institute of Technology, November 1, 2004. As of July 17, 2020: https://apps.dtic.mil/dtic/tr/fulltext/u2/a428022.pdf\nShcherbina,"] [13.919498443603516, 4.179903984069824, " would like to acknowledge the participation and assistance of the members of the workshop on wearable sensor technology and potential uses within law enforcement, who are listed in the report. This effort would not have been possible without their w"] [13.940507888793945, 4.156471252441406, "venile Justice and a research assistant at the Personality Studies Laboratory and the Regents\u2019 Center for Learning Disorders at the University of Geor- gia. Siara holds an M.S. in criminology.\nShoshana R. Shelton is a senior policy analyst at the RAN"] [13.87314510345459, 4.381099224090576, "Priority Law Enforcement Issues and Needs, Santa Monica, Calif.: RAND Corporation, RR-2930-NIJ, 2019.\nMentions of products or companies do not represent endorsement by NIJ, the RAND Corporation, or PERF.\n This publication was made possible by Award N"] [0.24999041855335236, 20.742237091064453, " THE BENEFITS AND COSTS OF DECARBONIZING COSTA RICA\u2019S ECONOMY\nInforming the implementation\nof Costa Rica\u2019s National Decarbonization Plan under uncertainty\nDavid G. Groves, James Syme, Edmundo Molina-Perez, Carlos Calvo Hernandez (RAND Corporation)\nL"] [0.2643548846244812, 20.7564754486084, "ocial development means that the same households that face the greatest economic difficulties also suffer the most from environmental crises like the pandemic. Today in Costa Rica and beyond, the priority is to stop the pandemic, alleviate its social"] [0.23709970712661743, 20.707918167114258, "mong the best internationally. This effort makes it easier for\n iii\niv The Benefits and Costs of Decarbonizing Costa Rica\u2019s Economy\npublic policies to benefit both from academic science and from the knowledge that actors in each sector bring to the t"] [0.26063597202301025, 20.749128341674805, "e RAND Corporation, the Costa Rica Climate Change Directorate, and the Inter-American Development Bank (IDB). It was funded by the Inter-American Develop- ment Bank\u2019s (IDB)\u2019s French Climate Fund (RG-T3193) and Sustainable Energy and Climate Change In"] [0.2378336638212204, 20.726221084594727, "laborated with government ministries providing technical support in the design of policies. For more informa- tion, email eperlab.eie@ucr.ac.cr.\nAbout Costa Rica\u2019s Climate Change Directorate\nThe Climate Change Directorate of Costa Rica is an office o"] [0.23803752660751343, 20.72638511657715, "......................................................................... 5\nModeling Future GHG Emissions, Benefits, and Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . How COVID-19 Might Affe"] [0.22600403428077698, 20.712127685546875, " . . . . . . . . . . . . . . . . . . . . . . .\nAPPENDIXES\nThe following appendixes are available in a separate volume at www.rand.org/t/RRA633-1:\nA. Modeling Details and Sector Benefit and Cost Factors B. Developing Socioeconomic Scenarios\nC. Transpo"] [0.21809127926826477, 20.704835891723633, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n3.9. Levelized Cost of Electricity over Time Without Decarbonization and with the Implementation o"] [0.20436224341392517, 20.689468383789062, "counted Net Benefits and 2050 GHG Emissions for All 3,003 Futures, ClassifiedbyOutcomeRisk.....................................................................\n4.4. Total GHG Emissions in 2050, by Economic Growth Scenario . . . . . . . . . . . . . . "] [0.20485152304172516, 20.691951751708984, "\n2.5. Buildings Sector National Decarbonization Plan Actions and Model\nImplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [0.2402128130197525, 20.726337432861328, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n4.7. Non-Transportation Net Benefits Vulnerabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n. 11 . 11 .12 .12"] [0.23239107429981232, 20.717443466186523, "missions means that all GHG emissions (not just CO2) do not exceed the natural sequestration from forests.\n xiii\nxiv The Benefits and Costs of Decarbonizing Costa Rica\u2019s Economy\ning health and environmental conditions through the reduction in use of"] [0.22254998981952667, 20.70741081237793, "d Lempert, 2007; Lempert, 2019), which guides the evaluation and analysis of thousands of plausible futures to explore the risks and opportunities associated with decarbonization. As part of this process, we developed and used an interactive tool to "] [0.201277494430542, 20.68377113342285, "quivalent (MtCO2e) today to almost 19 MtCO2e by 2050. Bending this trajectory downward in order to reach net- zero emissions by 2050 will require a substantial transformation in how the economy is pow- ered and how natural resources are used and pres"] [0.2092190533876419, 20.69392967224121, "ra et al., 2020).\nEfficiency gains in industry, and the economic value of recycled materials and treated wastewater, result in a small net benefit for the industry and waste sectors: $1.3 billion together. Figure S.2 shows modest net costs for the el"] [0.1767958700656891, 20.659330368041992, "nagement, also can restore many of these lost ecosystem services.\nThere is a large potential to reduce GHG emissions in the freight transport, industry, and waste sectors, and the benefits are of similar scale to the costs. For example, there are sig"] [0.2050890326499939, 20.690378189086914, "e suggestive of the plausible range of outcomes for each line of action.\nTo understand what the calculated ranges of emissions and net benefits mean to Costa Rica decarbonization efforts, we identify the conditions that lead to high emissions or low "] [0.17283223569393158, 20.658178329467773, "th of electric private and freight transport\nGrowth of hydrogen heavy freight Growth of share of non-motorized trans- port and public transport use\nDevelopment of new renewables to meet increasing demand\nHousehold energy use\nPercentage of household e"] [0.21305644512176514, 20.699230194091797, " \u20131.8\n\u20132.5, \u20132.3, \u20132.0\n\u20136.2, \u20136.0, \u20135.6\n\u201321.2, \u201318.8, \u201315.5\nBenefits ($ billion)\n32.2, 42.9, 51.6\n0.0, 0.0, 0.0\n1.4, 1.8, 2.0\n3.3, 4.2, 5.1\n3.0, 3.5, 3.8\n19.3, 25.2, 25.3\n62.6, 77.7, 84.5\nCosts ($ billion)\n6.7, 23.9, 18.9\n1.8, 0.7, 3.5\n1.9, 4.9, 4.8\n"] [0.24656270444393158, 20.73968505859375, " Rica); Felipe De Leo\u0301n and Andrea Meza Murillo (Ministry of Environment and Energy, Climate Change Directorate); and Valentina Saavedra Go\u0301mez and Adrien Vogt-Schilb (Inter-American Development Bank [IDB]). The IDB team worked under the supervision "] [0.2217591404914856, 20.706586837768555, "verall goal to stabilize the increase in global temperature at well below 2\u00b0C, and as close to 1.5\u00b0C as possible (United Nations, 2015). This ambitious goal requires reaching net-zero emissions of carbon dioxide (CO2) by 2050, and drastically reducin"] [0.22410155832767487, 20.70600700378418, "ensity of industry, agriculture,\nand livestock\n5. collecting, treating, and reusing liquid and solid waste.\nTo facilitate these changes, the NDP lays out a wide-range of policy reforms. Table 1.1 lists some of the specific actions considered in the N"] [0.22429437935352325, 20.710556030273438, " experts in policy analysis. Over time, this model can be improved to yield more-refined estimates of emissions and of the benefits and costs of decarbonization. Co-constructing data, models, and analytic approaches leads to results that are relevant"] [0.2346554547548294, 20.720386505126953, "ible futures in which the NDP will be implemented. This means evaluating thousands of different assump- tions about the drivers of emissions and decarbonization, as well as factors that describe how benefits and cost could accrue. We use methods for "] [0.2198399305343628, 20.705785751342773, "e then estimated how emissions would change under one possible approach for implementing the NDP (called \u201cwith implementation of the National Decarbonization Plan\u201d). Next, we roughly estimated the monetary benefits and costs to provide a high-level a"] [0.22995804250240326, 20.713485717773438, "y and estimate its benefits and costs. This framework combines previously developed models of transportation and energy sectors (Godi\u0301nez-Zamora et al., 2020) with new aggregated models of other sectors that do not have more detailed models available"] [0.2355545461177826, 20.711793899536133, "d emissions rates.\nWe use a general equilibrium model of the Costa Rican economy\u2014Plataforma de Mod- elacio\u0301n Econo\u0301mico-Ambiental Integrada (Integrated Economic-Environmental Modeling [IEEM])\u2014to derive three scenarios of underlying economic activity "] [0.2235102504491806, 20.706830978393555, "ng Costa Rica\u2019s Economy\nFigure 2.1\nModeling Schematic for the Costa Rica Integrated Decarbonization Pathways Model\nare a very small fraction of all the climate change reduction benefits that would accrue if all countries reduced emissions per the 1.5"] [0.26122188568115234, 20.75246238708496, " 9\n How COVID-19 Might Affect Costa Rica\u2019s Decarbonization Efforts\nThe analysis presented here was designed and developed in large part before the COVID-19 pandemic hit, in February 2019. The socioeconomic impacts of the pandemic and the decarboniz"] [0.21514791250228882, 20.701894760131836, "eflect uncertainty about future drivers and the achievement of decarbonization actions, we devel- oped a range of estimates for the model factors and created a large set of plausible futures, as described below. These futures should not be assumed to"] [0.2181493639945984, 20.705198287963867, "ergy savings\n\u2022 improved productivity from reduced congestion\n\u2022 reduced medical costs from accidents\n\u2022 reduced health impacts from pollution\n\u2022 reduced social cost of carbon emissions, which reflect country-specific climate change\nimpacts in Costa Rica"] [0.2165897935628891, 20.703176498413086, "dix A provides details and numerical values.\nTable 2.2\nTransport Sector Benefits and Costs of Decarbonization Modeled in This Study\n Benefits of Decarbonization\n\u2022 Operations and maintenance costs savings due to alternative fuel vehicles and reduced "] [0.21549688279628754, 20.69760513305664, " additional electricity is used. The OSeMOSYS-CR model estimates the required additional renewable energy sources (and associated investment costs), and the GHG emissions savings and fuel cost savings from using these sources instead of existing foss"] [0.21719962358474731, 20.703432083129883, "ctices\nIncreased use of wood and natural building materials\nModel Implementation\n\u2022 Reduced household energy use\n\u2022 Increased share of electricity use (and corresponding\ndecrease in use of fossil fuels)\nNot included in the study.\n Table 2.6\nBuild"] [0.21348035335540771, 20.694196701049805, "an Actions and Model Implementation\n Decarbonization Plan Actions\nProcess improvement to reduce energy use Electrification of processes\nProcess improvements to reduce emissions\nIncreased efficiency of use and reduction in emissions from industrial "] [0.2766071557998657, 20.65709114074707, "- tion Plan (Poli\u0301tica Nacional de Saneamiento en Aguas Residuales; PNSAR) calls for many of these same investments due to these potential benefits (AyA, 2016). We estimate the costs of collecting and processing waste for landfill disposal, compostin"] [0.1962512582540512, 20.675378799438477, "pment. Emissions associated with electricity use are captured in the electricity sector. The GHG emissions for each type of animal is based on per animal emissions rates, which are composed of separate emission factors for enteric fermentation and ma"] [0.20103229582309723, 20.682315826416016, "all other crops. Costs from the livestock sector are based on aggregate GHG emissions reductions, per academic studies. We consulted representatives from a range of stakeholders from these sectors, who are listed in Appendix D.\nThe forestry sector mo"] [0.20736125111579895, 20.69369888305664, "lay out exactly as anticipated today, and thus there is uncertainty about how emissions could evolve in the future without decarbonization. Uncertainty about model estimates of future emissions stems from (1) inaccurate or incomplete information abou"] [0.21365498006343842, 20.69658851623535, "timates were developed prior to the spread of COVID-19. Recent studies suggest, however, that the pandemic-related reductions are likely to be temporary (Forster et al., 2020). As such, any impact on long-term economic activities can be suitably refl"] [0.19173435866832733, 20.675945281982422, "try\nWaste\nAgriculture, livestock, and forestry\nDriver Uncertainties\n\u2022 Economic growth rate \u2022\nDecarbonization Uncertainties\nN/A\n \u2022 Demand for transport (linked to economic \u2022\ngrowth) transport\n\u2022 Cost of fuels \u2022 \u2022 Infrastructure costs for electrifica"] [0.20596958696842194, 20.69012451171875, " emissions, and by how much? What range of net benefits might be achieved? Second, we seek to understand what future conditions could lead Costa Rica\u2019s decar- bonization strategy to not achieve its goals. This information then informs how to implemen"] [0.2002021223306656, 20.685392379760742, "f 4.9 MtCO2e. The current elec- tricity system is nearly 100 percent renewable and has significant excess capacity. So, while emissions reductions are not directly coming from the electricity sector, the current renew- able capacity of the electricit"] [0.18579146265983582, 20.671512603759766, "bon Economic benefits\nSavings from electrification and efficiency Opportunity costs\n-Investment costs\nNet benefits\n12.9 10.1\n 7.6\n 3.6 1.7\n2030\ninvestment costs are quickly outweighed by the benefits.2 Opportunity costs include those re"] [0.19503726065158844, 20.680395126342773, " costs associated with a particular line of action do not need to translate into costs for the economic actors of that sector. The distribution of costs and benefits over con- sumers and firms depends crucially on government policy, which is not cons"] [0.18436051905155182, 20.667158126831055, "ductions in costs associated with pollution, accidents, and congestion\u2014about $11 billion. Most benefits come from reduced accidents, accomplished through reduction in the numbers of private vehicles used and distance traveled\n Public and private tr"] [0.181879460811615, 20.667680740356445, " for under the respective lines of actions.\nImplementing the NDP increases electricity consumption (Figure 3.8). In 2018, electric- ity use was about 31 petajoules (PJ) per year, and it increases to almost 140 PJ per year under baseline assumptions. "] [0.1960572898387909, 20.681570053100586, "on benefits in the residential sector result primarily from energy cost sav- ings to residential and commercial building energy customers (Figure 3.11). Costs, though dif- ficult to estimate for the commercial sector, are considerably higher for comm"] [0.19446277618408203, 20.67720603942871, "ing emissions from industrial products\u2014about $0.6 billion\u2014and increasing energy efficiency\u2014about $200 million, under baseline assump- tions. The net benefits under these baseline assumptions are $2 billion.\nFigure 3.12\nEmissions from the Industrial S"] [0.20026321709156036, 20.68303108215332, "d\u2014about $440 million in aggregate (Dixon, 2012). Similar assessments reveal another $200 million to the regional environment and groundwater benefits from reducing untreated wastewater in communities. There may be additional ecosystem benefits from i"] [0.20217089354991913, 20.681509017944336, " 2050, but would yield about $25 billion of benefits from increased agricultural and\nlivestock yields and additional forest ecosystem services.\nThe agriculture, livestock, and forestry sector collectively leads to net sequestration in Costa Rica. Agr"] [0.2028079330921173, 20.679988861083984, "increased agricultural output due to improved management ($4 billion);3 (2) increased ecosystem ser- vice benefits from not removing wet, dry, or mangrove forests ($7.2 billion), and (3) improv- ing forest management ($13.5 billion).4 According to ou"] [0.21092134714126587, 20.696308135986328, "shown in this chapter are all based on a set of baseline assumptions. There is significant uncertainty around these assumptions, so it is important to understand whether and how these uncertainties could affect the achievement of the NDP emissions ta"] [0.20359428226947784, 20.688875198364258, " Benefits and Costs of Decarbonizing Costa Rica\u2019s Economy\nFigure 4.1\nProjections of GHG Emissions Without Decarbonization (yellow) and with the Implementation of the National Decarbonization Plan (green) Across 3,003 Plausible Futures\n National De"] [0.16613268852233887, 20.650278091430664, "ssions.\n\u2022 Low Net Benefits: We consider two different thresholds, as each can provide important insight. We first set the threshold at zero net benefits and describe which factors drive the small number of cases in which net emissions are negative. T"] [0.2012605369091034, 20.685657501220703, "050 ($ billions)\nHow Uncertain Is the Success of Costa Rica\u2019s Decarbonization Plan? 43\nseveral specific techniques to sort through the large set of uncertainties and identify what is most important. There are many seemingly obvious reasons why the ND"] [0.19942672550678253, 20.683456420898438, " and High Growth economic scenarios correspond to long-term average growth of 2 percent, 3.5 percent, and 4 percent growth per year.\n44 The Benefits and Costs of Decarbonizing Costa Rica\u2019s Economy\nTable 4.1\nSector-Specific Median GHG Emissions in 205"] [0.18884320557117462, 20.672624588012695, "ysis is between 70 and 100 percent.\nHow Uncertain Is the Success of Costa Rica\u2019s Decarbonization Plan? 45\nFigure 4.5\nRange of Uncertain Factors Defining the \u201cLow Adoption of Alternative Fueled Vehicles\u201d Vulnerability\nAdoption rate of electric private"] [0.1869061440229416, 20.67043685913086, "l Vehicles with High Economic Growth\u201d Vulnerability\nEconomic growth\nLow (2%/yr) Moderate (3.5%/yr)\nCost ratio of alternative versus conventional vehicles\n37% 103%\nFuel efficiency of conventional vehicles\n50% 60%\nHigh (4%/yr)\n285%\n150%\n Vulnerab"] [0.1867806613445282, 20.670854568481445, "above 98%\nN/A\nLow adoption of electric trucks: share of electric light freight below 92%\nN/A\n Uncertainties Relevant to Transportation\nDemand for transport (linked to economic growth)\nTechnological costs\nVehicle efficiencies\nGrowth of electric "] [0.17009247839450836, 20.652278900146484, " less negative emissions) would occur under futures in which the sequestration rates of wet forests are lower than expected or\nTable 4.3\nIndustry Uncertainties and Definition of Key Emissions Vulnerability\n Industry Uncertainties\nEconomic growth Ind"] [0.1877603828907013, 20.672048568725586, "lands), emissions from converting forests to grassland or agricultural land, and sequestration rates from dry, moist, palm, and mangrove forests (primary and secondary forests) and sequestration rates from secondary wet forests. This vulnerability de"] [0.1841430813074112, 20.66970443725586, "ost of decarbonization. Fifty-two percent of the cases that display these conditions are vul- nerable, and this vulnerability describes 41 percent of the low net benefits cases. It is defined by the following conditions (Figure 4.8):\n\u2022 Low economic g"] [0.1943921148777008, 20.67966651916504, "res in which demand for light freight transportation is above 10.14 gross tonne kilometers (Gtkm; considering 12.5 percent less demand from baseline conditions).\nTogether, these two scenarios describe the key risks for achieving substantial positive "] [0.13741445541381836, 20.62104034423828, "i- mates large benefits accruing from preserving and improving the management of primary forest (about $20 billion across all forest types under baseline assumptions). Estimating eco- system services benefits is also highly imprecise. Second, uncerta"] [0.20193727314472198, 20.688539505004883, "suring sufficient decoupling and emissions reduc- tions with significant net benefits to the economy.\nIn the transport sector, our analysis suggests that Costa Rica needs to pay attention to uncertainties around both the drivers of emissions, costs, "] [0.18754889070987701, 20.673505783081055, "ansportation.\nFor the other sectors, the NDP may not achieve zero or close to zero net emissions if the industrial and livestock emissions rates are not low enough to compensate for high economic activity. Further, the success of the NDP emissions re"] [0.20786245167255402, 20.69472885131836, "ied uncertainties. Shaping actions are those that ensure particular unfavorable conditions do not occur in the first place.\nOur analysis of the transport sector further validates the importance of several principles established in the NDP. First, the"] [0.21818900108337402, 20.705364227294922, "ions reduction targets for each sector, but it should also indicate whether and when such targets should be revised. For example, the transition rate from conventional to alternative fueled vehicles could be connected to the relative cost of alternat"] [0.24857200682163239, 20.734315872192383, "en Espan\u0303ol\nModel Assumptions and Emissions Results\n11 August 2020\nFor more information, please contact:\nDavid Groves (groves@rand.org)\nFelipe de Leon (felipe@climatrader.com) Adrien Vogt-Schilb (avogtschilb@iadb.org) Jairo Quiros (jairohumberto.quir"] [0.2405150830745697, 20.724689483642578, "rtin Cicowiez, The Integrated Economic-Environmental Modeling (IEEM) Platform, IEEM Platform Technical Guides: IEEM Mathematical Statement, IDB Technical Note No. 01842, Washington, D.C.: Inter-American Development Bank, 2020.\nBanerjee, Onil, Martin "] [0.26495039463043213, 20.753541946411133, "tico, 2020, Ana\u0301lisis de costo-beneficio de la descarbonizacio\u0301n del sector transporte y la importancia del TRP, August 2020.\nElectric Power and Energy Research Laboratory, \u201cThe OSeMOSYS\u2013CR Model,\u201d GitHub, 2020. As of October 7, 2020:\nhttps://osemosy"] [-0.49149322509765625, 13.22741985321045, "e, Vol. 17, No. 1, February 2007, pp. 73\u201385.\nGroves, David G., Edmundo Molina-Perez, Evan Bloom, and Jordan R. Fischbach, \u201cRobust Decision Making (RDM): Application to Water Planning and Climate Policy,\u201d in Vincent A. W. J. Marchau, Warren E. Walker,"] [0.253113716840744, 20.737939834594727, " Alejandro, Philip Keefer, Allen Blackman, Mati\u0301as Busso, Eduardo Cavallo, Gregory Elacqua, Ana Mari\u0301a Iba\u0301n\u0303ez, Julia\u0301n Messina, Mauricio Moreira, Carlos Scartascini, Norbert Schady, and Toma\u0301s Serebrisky, Emerging from the Pandemic Tunnel with Fast"] [0.2264755368232727, 20.708560943603516, " Is Increasing or Decreasing? Washington, D.C.: World Bank, 2014.\nSaget, Catherine, Adrien Vogt-Schilb, and Trang Luu, Jobs in a Net-Zero Emissions Future in Latin America and the Caribbean, Inter-American Development Bank and International Labour Or"] [0.209043949842453, 20.693002700805664, "o-emissions public transport. Energy savings in buildings, efficiency gains in industry, and the economic value of recycled materials and treated water complete our estimates.\nRecognizing uncertainty about the future, we evaluate thousands of differe"] [4.6648268699646, 8.083168983459473, " CORPORATION\nKARLYN D. STANLEY, MICHELLE GRISE\u0301, JAMES M. ANDERSON\nAutonomous Vehicles and the Future of Auto Insurance\n For more information on this publication, visit www.rand.org/t/RRA878-1\n Library of Congress Cataloging-in-Publication Data i"] [11.37218189239502, 17.55939292907715, " in law and business, other researchers, and the public. The ICJ is part of the Justice Policy Program within the RAND Social and Economic Well-Being Division. The program focuses on such topics as access to justice, polic- ing, corrections, drug pol"] [5.344088554382324, 8.14324951171875, "orConsumers................................................................................... FleetInsurancePolicies.............................................................................. PersonalMobilityPolicies.............................."] [5.277004718780518, 8.120404243469238, "rance Policy? . . . . . . . . . . . . . How Important Is Consumer Acceptance to the Deployment of Autonomous Vehicles?. . . How Might Different Auto Insurance Frameworks Accommodate Technologies for\nAutonomous Vehicles? . . . . . . . . . . . . . . . "] [4.92987060546875, 8.044690132141113, "port, we discuss vehicles we\ncall autonomous\u2014those that operate at Level 4 or 5:\n\u2022 At Level 4, or high automation, \u201c[a]n automated driving system (ADS) on the vehicle can itself perform all driving tasks and monitor the driving environment\u2014 essential"] [5.068629741668701, 8.093957901000977, "assigned to the driver in 94 percent (\u00b12.2%) of the crashes\u201d (NHTSA, 2015, p. 1). In 2016, NHTSA stated that it was working to \u201caddress the human choices that are linked to 94 percent of serious crashes\u201d (NHTSA, 2017). It also stated that it\ncontinue"] [5.266674041748047, 8.119087219238281, "ing AVs than an analysis that focuses on driver performance would be. To be clear, this is a descriptive prediction of how courts and legal analysts are likely to apply the predominant justifications of tort law to this new technology and not a norma"] [5.295924186706543, 8.126953125, "ge automobile insurance law to see technology to automate vehicles advance. Currently, insurance is governed by states, and each state sets its own particular requirements and requires rate approval. This makes some sense in the U.S. federal system b"] [5.338670253753662, 8.14113712310791, "e sig- nificant changes to the existing U.S. automobile insurance system, or is the cur- rent insurance model flexible enough to handle vehicles that incorporate tech- nologies that permit autonomous operation at most or all times? A majority of U.S."] [5.331835746765137, 8.13637638092041, "i\nxiv Autonomous Vehicles and the Future of Auto Insurance\nSeveral experts were proponents of self-insurance by manufacturers. These experts thought that OEMs might purchase insurance companies and have them handle the insurance for their AVs. Accord"] [5.336151599884033, 8.135988235473633, "ystem of suppliers and, in some cases, make it more difficult to determine which supplier was at fault, insurers anticipated continuing to \u201chandle this like [they] handle suppliers today.\u201d\nIn the future, how might accidents between AVs and convention"] [5.308818817138672, 8.119315147399902, "king any major overhaul of the existing auto insurance framework. As one Australian expert noted, Australian regulators recognize that what they develop needs to be proportional and scalable over time. Other countries, such as the UK and Japan, are f"] [5.323005199432373, 8.13184928894043, ".\nWe conclude this report with three recommendations:\n\u2022 Insurers, manufacturers, and other stakeholders should collaborate to develop a framework for collecting and sharing data on AVs. Further research to explore methods for information-sharing betw"] [5.228789329528809, 8.110823631286621, "merican Trucking Associations, the Association of British Insurers, AXA UK, the Centre for Connected and Autonomous Vehicles, the Consumer Federation of America, Consumer Reports, Ford Motor Company, General Motors, the Insurance Bureau of Canada, IT"] [5.044182300567627, 8.101480484008789, "ion might be slow, despite the tremendous investments made by OEMs and related companies. Failure to inspire consumer confidence in AV technologies could result in market failure and the loss of the social benefits of these technologies (Anderson, Ka"] [5.274723052978516, 8.097344398498535, "wever, the introduction of AVs will likely create uncertainty regarding regulation and insurance. The challenge for policymakers is to maximize the benefits associated with AVs while reducing the uncertainty occasioned by their introduction.\nDespite "] [5.32013463973999, 8.123924255371094, "r automobile insur- ance?\n\u2022 In the future, how might accidents between AVs and conventional vehicles and between AVs and pedestrians be handled?\n\u2022 Will minor accidents and \u201cfender benders\u201d become significantly more costly due to the cost of repairing"] [5.347529888153076, 8.151962280273438, "ay that allowed for both consistency, based on a set of common questions that all participants were asked to answer, and flexibility, whereby interviews could focus on specific topics based on the particular expertise and perspective of the participa"] [5.324276924133301, 8.142951011657715, " Canada, and Australia and explain how these models may inform future reforms of the U.S. automobile insurance industry. In Chapter Five, we explore key risks associated with AVs, including software updates, the cost of sensors, cybersecurity, remote"] [5.259458541870117, 8.132901191711426, "sis is descriptive rather than normative.\n7\n8 Autonomous Vehicles and the Future of Auto Insurance\nDeterrence\nA critical justification for the tort system is its role in deterring wrongdoing. Imposing the costs of wrongful actions on the wrongdoer cr"] [5.265326976776123, 8.133482933044434, " instead of accident in part to emphasize the fact that these incidents are the result of specific decisions and not unavoidable. However, much of the legal literature predates the adoption of this term and uses the term accident. In this report, we "] [5.253633975982666, 8.12881851196289, "ng party, that party would pay the cheapest cost avoider to take whatever accident reduction methods were cost justified (Coase, 1960). For example, imagine that the most efficient way of reducing manufacturing defects in cars was under the manufactu"] [5.2555694580078125, 8.1274995803833, " injured party.\nAs was the case with deterrence (and for somewhat similar reasons), we anticipate that the increase of automation will change defendants\u2019 relative moral culpability. It is harder to view the individual driver as morally culpable for a"] [5.297224044799805, 8.152691841125488, "bly by the fleet operator, the most morally responsible entity may be the manufacturer that designed the vehicle.\nCompensation\nIn this view, tort law exists primarily to compensate the injured. The focus is not so much on deterring misconduct or achi"] [5.26324462890625, 8.12668514251709, "t an increase in vehi- cle automation will lead to a decrease in individual driver liability and an increase in vehicle manufacturer liability. But Oliver Wendell Holmes famously observed that \u201c[t]he life of the law has not been logic: it has been ex"] [5.315899848937988, 8.108625411987305, "ficant reasons to anticipate some variation of the existing legal system for some time, for reasons of both claim administration and underwriting.\nThe existing infrastructure for handling crashes is likely to resist change. This is partly due to shee"] [5.297573089599609, 8.128241539001465, "ary to underwrite efficiently. Even if humans are playing a significant role in the driving function, manufacturers may be able to more easily collect rich data on human driving behavior and the sources of risk than insurers are. Manufacturers, howev"] [5.280361175537109, 8.119669914245605, " seek subrogation from the manufacturer because automation makes the manufacturer more responsible, as dis- cussed above. In this way, the ultimate liability may be shifted onto the manufacturer despite the continuation of the existing automobile ins"] [5.308364391326904, 8.128778457641602, "ested at the OEM\u2019s feet.\n 16 Autonomous Vehicles and the Future of Auto Insurance\nthese claims. And although one hopes that increased automation will lead to fewer crashes, this transition is likely to be gradual. Insurers have considerable specializ"] [5.326840400695801, 8.142708778381348, "gated to self-insure up to higher than anticipated retentions, based on the fact that there is no data on which insurers can appropriately price liability policies.\u201d\n16 Thestate-by-stateinsurancesystemdoesposeasignificantburdentonewentrantswantingtoo"] [5.3151021003723145, 8.135882377624512, "ummarizes U.S. experts\u2019 perceptions of the likelihood of success of future U.S. insurance frameworks. Table 3.2 outlines the experts\u2019 assessments of the\n19\n20 Autonomous Vehicles and the Future of Auto Insurance\ncriteria these experts used to assess "] [15.687666893005371, 16.282535552978516, "id not view the introduction of a national no-fault insurance system for AVs as a realistic possibility. Although national no-fault schemes have been enacted in the context of injuries stemming from both vaccines and nuclear reactors, stakeholders no"] [15.734960556030273, 16.326435089111328, ". 85-256, as codified at 42 U.S.C. \u00a7 2210).3 The Price\u2013Anderson Act was intended to promote investment in nuclear energy research by imposing statutory constraints on possible catastrophic tort liability in the event of a nuclear accident (Rabin, 199"] [5.344632625579834, 8.153675079345703, "mehow enacted, the federal bureaucracy was not equipped to administer a complex statutory insurance program. One insurer characterized a national no-fault insurance system as an interesting, but ultimately premature, idea that might make\n4 Under the "] [5.341921329498291, 8.14890193939209, "ture of Auto Insurance\nsense in a fully autonomous world, noting that \u201cwe are a very long way away from [such a world] today.\u201d\nA State No-Fault Insurance Model for Autonomous Vehicles\nIn the past, state no-fault auto insurance schemes have not lived "] [5.326478481292725, 8.143701553344727, "ntroduce a no-fault insurance system.\nStakeholders expressed concerns that a state no-fault insurance model would not properly incentivize manufacturers to design and produce safe AVs. It was noted that \u201ccosts make people act better.\u201d According to on"] [5.313190460205078, 8.11803913116455, "ally quite low. But this is no longer the case in Florida.\n10 See Zuby, undated, pp. 1\u20132 (\u201cSince 1995, IIHS [the Insurance Institute for Highway Safety] has created a rigorous program of crash test ratings that have led to measureable improvements in"] [5.330094337463379, 8.136285781860352, "better positioned to collect the information necessary to underwrite efficiently. Even if humans are driving, manufacturers may be able to more easily collect rich data on human driving behav- ior and the sources of risk than insurers. Manufacturers,"] [5.3530073165893555, 8.148345947265625, "hat, under this model, fleet owners should bear responsibility for accidents caused by AVs.13 As we explained in Chapter Two, owners of fleets of AVs may be in\n11 Although many experts predicted that the fleet model would eventually become dominant, "] [5.374232292175293, 8.135819435119629, " policies yet. They also raised potential ethical issues asso- ciated with personal mobility policies, including that such policies \u201cmake the victim responsible for protecting against [the] negligence\u201d of others\u2014although it could be argued that this "] [5.32144832611084, 8.134282112121582, "turn, and the pro- fessionals will figure it out,\u201d as one expert told us. Another expert underscored that the existing insurance framework \u201cdoes not need to be blown up and replaced with something new.\u201d Rather, the \u201cexisting structure [of the insuran"] [5.354447364807129, 8.146008491516113, "us Vehicles in Auto Insurance Claim Scenarios\nWe asked stakeholders about specific types of insurance claim incidents that might occur with AVs and how they would be handled. These incidents were\n\u2022 an AV colliding with a conventional vehicle\n\u2022 an acc"] [5.347234725952148, 8.14504337310791, "he different business models of AV manufacturers will affect the extent to which subroga- tion remains a common feature of the claims process.15\nA Crash Involving an Autonomous Vehicle and a Pedestrian\nIn response to our questions about how common au"] [5.350795269012451, 8.148810386657715, "One stakeholder concluded, \u201cThe risks of property damage are the same for AVs and non-AVs.\u201d\nAt the same time, new concerns about property damage are likely to emerge as AVs become more popular. Some stakeholders told us that, in the absence of a huma"] [5.301974296569824, 8.168591499328613, "UR\nInternational Models for Insuring Autonomous Vehicles\n This chapter provides an overview of recent developments in insurance and the reg- ulation of AVs in the UK, Australia, Canada, and Japan. We selected these coun- tries because compensating th"] [5.305515766143799, 8.138837814331055, "t]he single insurance policy\u2019s intent is to align the tort process for automated vehicle claims with traditional claims involving conventional vehicles\u201d (IBC, 2018, p. 11). Of particular interest to insurance regulators in the United States is that t"] [5.349316120147705, 8.144061088562012, "driver which will pay the bulk of the claim\u201d (Butcher and Edmonds, 2018, p. 5). However, unlike in the U.S. insurance structure, in the UK framework, \u201ceven where there is no \u2018fault,\u2019 victims are assured of compensation\u201d (Butcher and Edmonds, 2018, p."] [5.286036968231201, 8.12106990814209, " However, at Levels 4 and 5, if the vehicle is driving itself at the time and the person in the driver\u2019s seat is not in the fallback position, the person is not responsible for the accident. A UK insurance expert explained,\n[I]n the UK, if you are dr"] [5.314554214477539, 8.137804985046387, "he insurance industry and the public, NTC will bring the recommendations to the Australian legislature. The focus of NTC\u2019s consultations is changes to MAII to provide for injuries that result from an accident involving an automated vehicle or AV. Eac"] [5.33418083190918, 8.145730018615723, "compulsory third-party insurance scheme. Australian courts use tests similar to those in the United States in products liability cases.\nAustralia also has the NIIS, which ensures that \u201cpeople who sustain eligible seri- ous or catastrophic, lifetime i"] [5.335766315460205, 8.143411636352539, "es caused by human error rather than product faults. If MAII schemes were to cover ADS crash inju- ries, significant redesign of MAII schemes may be required to ensure that the cost of ADS crashes is borne by those who can control the risks. These pa"] [5.315425872802734, 8.138697624206543, "automated technology. The policy \u201cwould ensure that vehicles continue to be prop- erly insured and that people injured in collisions involving automated vehicles are compensated fairly and quickly\u201d (IBC, 2018, p. 11). IBC has noted that, \u201c[u]nlike no"] [5.359416961669922, 8.164117813110352, "uded, \u201cThese rules are based on years of jurisprudence and how the courts assigned fault in cases.\u201d\nThe insurance expert indicated that, once AV technology was introduced, an injured party would have to prove that the other party caused the accident."] [5.3220977783203125, 8.14426040649414, " Bill\u201d (IBC, 2018, p. 13). The authors noted that the two other data elements provide relevant information from the vehicle\u2019s dashboard. The Canadian insurance expert we interviewed noted that IBC officials did not think that any of the data elements"] [5.157770156860352, 8.080394744873047, "o the authors, the expert provided an unofficial but helpful translation of the provisions of the legislation:\nThe \u201cautomatic operation device\u201d is to process the sensor for detecting the operat- ing state and surrounding conditions of the vehicle and"] [5.322892665863037, 8.131467819213867, "acturer of the AV.\u201d Regard- ing other anticipated changes to the automobile insurance industry, the expert com- mented, \u201cIt is an important duty to modify or introduce a new insurance system, espe- cially for AVs. Insurance could help or become an ob"] [5.324479103088379, 8.14741325378418, "ance could either help or delay the deployment of AVs, an important point for consideration by regulators and policymakers in the United States.\nTable 4.1 illustrates some of the similarities and differences of the auto insurance frameworks we have d"] [5.232181072235107, 8.08277416229248, "e of data-sharing between OEMs and insurance companies. Finally, we examined expert perspectives on the importance of consumer acceptance of AVs, in response to our research question.\n 49\n50 Autonomous Vehicles and the Future of Auto Insurance\nWill N"] [5.270242214202881, 8.135993957519531, "uding road markings and signage, and are therefore vital to the operation of the automation. Sensors can be very expensive, costing many thousands of dollars to replace or recalibrate.\nThe expensive nature of AVs\u2019 sensors has important implications f"] [5.317683219909668, 8.116920471191406, "r technology embedded in them and that, therefore, the overall cost to the industry would probably be about equal to what it is today. For example, one manufacturer interviewee explained that the \u201cdecreased frequency [of collisions] will offset the i"] [5.320465087890625, 8.11735725402832, "-sophisticated organizations,\u201d such as a fleet operator, which could face a situation in which its fleet is disabled and the operator is required to pay a ransom.\n 54 Autonomous Vehicles and the Future of Auto Insurance\npolicies would increase as net"] [5.262359142303467, 8.048210144042969, "y negligent in a crash. However, U.S. insurance experts viewed this approach as misguided and unrealistic, noting that it placed too much responsibility on consumers, especially given that \u201cconvenience out- weighs responsibility.\u201d One expert suggeste"] [5.291641712188721, 8.063338279724121, "clude any information gleaned from a vehicle following any crime where the vehicle can reveal evidence, even the driver\u2019s personal data.\n3 One insurance expert noted in comments to the authors provided April 1, 2020, that the manufacturer could make "] [5.312755584716797, 8.103093147277832, ". 6). The workshop participant concluded that \u201call stakeholders are thinking about data\u2014and everyone is guarding them\u201d (p. 6).\nAnother workshop participant explained that, \u201cfor the insurance world, data are used to resolve claims\u201d (Anderson, Kalra, S"] [5.235520839691162, 8.051970481872559, "eport concluded that\nthere was a substantial consensus that information should be shared for the greater good of developing automated vehicles. Respondents willing to share vehicle data expressed an overwhelming desire to help manufacturers and desig"] [5.1367902755737305, 8.066061973571777, "nitor the status of the vehi- cle and the two-way communication link while the autonomous test vehicle is being operated without a driver;\n(B) A description of how the manufacturer will monitor the communication link; and,\n(C) An explanation of how a"] [5.308485984802246, 8.122776985168457, " AVs; they are employees of AV manufacturers, or, perhaps, they are independent contrac- tors retained for this specific purpose. If a remote operator is an employee of an AV manufacturer, engaged in work within the scope of employment, the operator "] [5.020898818969727, 8.09725570678711, "ology can get them from point A to point B, all the resources that have been invested will be wasted. The safe deployment of these vehicles in the public is the best way to show the public that these are safe and reliable ways to get around. This is "] [5.240799903869629, 8.099666595458984, "n:\nThe level of consumer trust with fully automated self-driving vehicles, or ADS, is currently in a year-over-year decline. In the J.D. Power 2017 U.S. Tech Choice Study,SM consumers displayed more skepticism and a growing level, with more saying th"] [5.324733734130859, 8.144636154174805, "by manufacturers\n\u2022 fleet insurance policies\n\u2022 adaptation of the existing automobile insurance framework.\nFor illustrative purposes, we compared the five frameworks on the following char- acteristics: (1) the ability to accommodate the cost of new tec"] [5.305322647094727, 8.09863567352295, "ovid- ers. If manufacturers decide to establish their own auto insurance organization, it is unknown how they might handle these challenges. Consumer acceptance, however, might be enhanced if manufacturers bundled insurance with the sale of AVs, acco"] [5.335439682006836, 8.146059036254883, "hat the existing insurance framework would be able to adapt to the deployment of AVs (see Table 3.3 in Chapter Three). As one manufacturer interviewee told us, there is \u201cno reason that the current system cannot keep working.\u201d Experts noted the histor"] [5.33254861831665, 8.13650894165039, "al experts, this would allow OEMs to bundle insurance with the sale of AVs, which might provide the benefit of indicating to consumers that the OEMs considered their vehicles to be safe. One expert thought that bundling of insurance with the price of"] [5.362079620361328, 8.15672492980957, "future, how might accidents between AVs and conventional vehicles and between AVs and pedestrians be handled? A majority of stakeholders indicated that, for accidents involving AVs and conventional cars, the claims process would not change significan"] [5.311755180358887, 8.16321849822998, "o victim compensation.1 All of the countries we investigated followed an adaptive approach to incorporating AVs into auto insurance schemes. The experts we consulted indicated that the current framework for auto insurance would be flexible enough to "] [5.255290985107422, 8.057882308959961, "iven the lack of clarity about AV data-sharing and its importance to the development of AVs, federal regulators are monitoring the issue in the AV industry. If necessary, they could seek to facilitate data-sharing. Meanwhile, U.S. cities and local tr"] [5.155234336853027, 8.093391418457031, "us international experts following their interviews, as develop- ments occurred in their countries that were relevant to the subject of our study.\nThe United Kingdom\nOn October 16, 2019, the UK Law Commission and Scottish Law Commission jointly publi"] [5.334590435028076, 8.144136428833008, "ested comments on six options that offered possible avenues for people injured in accidents with AVs to receive compensation. The six options for recovery were originally outlined in the NTC discussion paper published in October 2018 (NTC, 2018) that"] [5.33425235748291, 8.14418888092041, " caused inju- ries would be complex.\nSuggestions were sought from stakeholders on design elements of the scheme. Option 5: Minimum benchmarks\nThis option creates agreed national benchmarks for the scope and coverage of ADS crash injuries. States and "] [5.186790943145752, 8.044538497924805, "the short to medium term cover for injuries should be provided by MAII schemes. The approach should be reviewed by MAII schemes when automated vehicles are a statistically sufficient portion of registered vehicles to enable assessment of their safety"] [5.20393705368042, 8.090378761291504, "g device equipped with the automatic opera- tion device shall be capable of recording the following information.\n\u2013 Time when the operation status of the Automatic operation device\nchanges.\n\u2013 Time when the handover alarm by the automatic operation dev"] [5.23187780380249, 8.101171493530273, "he provincial insurance regulators, announced that it is studying the current limitations in the insurance laws pertaining to automated vehicles. Studying the current limitations will help the regulators identify future regulatory needs. Currently, C"] [4.698606014251709, 8.043136596679688, ", 2018. As of July 20, 2020:\nhttps://www.rand.org/pubs/conf_proceedings/CF383.html\nAnderson, James M., Nidhi Kalra, Karlyn D. Stanley, Paul Sorensen, Constantine Samaras, and Tobi A. Oluwatola, Autonomous Vehicle Technology: A Guide for Policymakers,"] [4.741759777069092, 8.045454978942871, "y of Legal Issues Arising from the Deployment of Autonomous and Connected Vehicles,\u201d Michigan Telecommunications and Technology Law Review, Vol. 23, No. 2, 2017, pp. 191\u2013320.\nDreyer, Paul, Therese Jones, Kelly Klima, Jenny Oberholtzer, Aaron Strong, "] [5.151701927185059, 8.14902400970459, " Canada, Auto Insurance for Automated Vehicles: Preparing for the Future of Mobility, 2018. As of October 1, 2020:\nhttp://www.ibc.ca/on/the-future/automated-vehicles\nInsurance Information Institute, \u201cNo-Fault Insurance Fraud in New York State Is Ramp"] [4.676882266998291, 8.017065048217773, "n, \u201cAutomated Vehicles for Safety,\u201d undated a. As of February 14, 2020: https://www.nhtsa.gov/technology-innovation/automated-vehicles-safety\n\u2014\u2014\u2014, \u201cDriver Assistance Technologies,\u201d undated b. As of October 2, 2020: https://www.nhtsa.gov/equipment/dri"] [4.753281593322754, 8.062336921691895, "cal History of the Intellectual Foundations of Modern Tort Law,\u201d Journal of Legal Studies, Vol. 14, No. 3, December 1985, pp. 461\u2013527.\nRabin, Robert L., \u201cSome Thoughts on the Efficacy of a Mass Toxics Administration Compensation Scheme,\u201d Maryland Law"] [4.735726356506348, 8.106736183166504, "w Commission, Automated Vehicles: Consultation Paper 2 on Passenger Services and Public Transport, Law Commission Consultation Paper 245/Scottish Law Commission Discussion Paper 169, London, October 19, 2019. As of October 1, 2020:\nh t t p s : // w w"] [5.339585781097412, 8.135150909423828, " Justice,\u201d Georgetown Law Journal, Vol. 91, 2003, pp. 695\u2013756.\nZuby, David, Consumer Safety Information Programs at IIHS, Arlington, Va.: Insurance Institute for Highway Safety, Paper 15-0228, undated. As of November 15, 2020: https://www-esv.nhtsa.d"] [15.812881469726562, 9.989704132080078, " CORPORATION\nSARAH B. HUNTER, ADAM SCHERLING\nLos Angeles County Office of Diversion\nand Reentry's Supportive Housing Program\nA Study of Participants\u2019 Housing Stability and New Felony Convictions\nLos Angeles (LA) County is home to the largest jail sy"] [15.840949058532715, 9.92273235321045, "nclusive.\nTherefore, it is important to understand whether supportive housing is achieving its goals. The LA County program\u2019s goals are to improve housing sta- bility and reduce criminal justice involvement among individuals enrolled into the program"] [16.017574310302734, 9.988240242004395, "Y are from the Office of Diversion and Reentry (ODR) and represent participants enrolled in ODR\u2019s supportive housing program in LA County between April 2016 and April 2019.\nSTUDY ANALYSIS INDICATES that out of 187 study participants, 169 had stable h"] [15.986291885375977, 10.015475273132324, "12.5% 22.5% 2.9% 50.5% 58.2% 0.6% 78.1% 39.2%\n2.9%\n NOTE: Percentages might not sum to 100 because of rounding.\nSix Months\nOf the full group of 187 individuals, 169 people were in a permanent housing situation at six months. One individual had mo"] [15.78919506072998, 10.235276222229004, "os Angeles County Board of Supervisors, Los Angeles, Calif., July 28, 2015.\n\u2014\u2014\u2014, \u201cHomeless Initiative Quarterly Report No. 8,\u201d memorandum to the Los Angeles County Board of Supervisors, Los Angeles, Calif., February 8, 2018. As of June 24, 2019: http"] [13.842987060546875, 4.6580305099487305, "roject leader, Sarah B. Hunter, at Sarah_Hunter@rand.org.\nThe RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout\nthe world safer and more secure, healthier and more pros"] [7.337005138397217, -4.061929702758789, " SOCIAL AND ECONOMIC WELL-BEING\nForensic Familial and\nModerate Stringency\nDNA Searches\nPolicies and Practices in the United States, England, and Wales\nTepring Piquado, Carl F. Matthies, Lucy Strang, James M. Anderson\nPrepared for the National Institu"] [13.887625694274902, 4.308134078979492, "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 concerns pertaining to public safety and criminal"] [7.331191062927246, -4.056278705596924, ".S. State Laboratory Interviews....................................................................................... 7 Qualitative England and Wales Stakeholder Interviews ...................................................................... 7 3. "] [7.340793132781982, -4.064147472381592, "Matches............................................................................................................27 Policies and Procedures............................................................................................................."] [7.337862014770508, -4.056083679199219, "............................................................................................. 46 Conclusion .............................................................................................................................................."] [7.349349021911621, -4.0705180168151855, "esting has been one of the great success stories of law enforcement over the past 30 years. The United States national network of forensic DNA databases has helped law enforcement solve many crimes, often long after the investigative trail has gone c"] [7.34252405166626, -4.062112808227539, "gency matches suggestive of kinship in\ncertain circumstances.\n viii\nFinally, we conducted qualitative interviews in England and Wales. We conducted semistructured interviews with ten subject matter experts (SMEs) who are academics and practitioners w"] [7.340841770172119, -4.055586814880371, "ine), while just over a third of responding LDIS laboratories reported no immediate plans to switch from their current evidence profile interpretation method.\nWe were also interested in whether probabilistic genotyping software, CODIS 20 Short Tandem"] [7.335941314697266, -4.0544514656066895, "pulation, also have the two largest SDIS databanks.3 California has one of the nation\u2019s most proactive DNA sampling regimes, mandating DNA collection from all felony arrestees, regardless of adjudication. DNA database laws in Texas are more restricti"] [7.350014686584473, -4.070745468139648, "Wales Interviews: History and Context of Familial DNA Testing\nIn England and Wales, the practice of familial DNA searching started without a legislative framework to cover it, and an SME noted that only after the method had been employed on a number "] [7.343705177307129, -4.065077781677246, "ent policies, both have meaningfully restricted its use to situations where the public safety implications are most acute. The English and Welsh experience provides examples of polities with similar common-law backgrounds successfully but sparingly u"] [7.3449320793151855, -4.066365718841553, "rate stringency DNA testing practices and policies, conducted interviews with administrators of forensic databases in two states, and conducted interviews with subject matter experts in England and Wales.\nBackground\nLocal, State, and National DNA Tes"] [7.338663101196289, -4.058386325836182, " or mixtures) from various evidence types (e.g., blood stains, sexual assault kits, \u201ctouch DNA\u201d). As of January 1, 2017, CODIS database searches use 20 core loci (40 alleles) from the evidence and offender samples to determine a match.4 In England an"] [7.346980094909668, -4.067633628845215, "de polymorphisms (SNPs) to generate DNA profiles from variation in hundreds of known point mutations in the human genome. SNPs are used for ancestry testing, mostly by private laboratories, not by local, state, or national forensic laboratories.\nFami"] [7.365268707275391, -4.086485862731934, "e the offender DNA databases are disproportionately comprised of people of color,6 and, as a result of this disproportion, increased use of familial DNA testing may disproportionately lead to suspicion of suspects of color. This may, in turn, perpetu"] [7.322899341583252, -4.045578479766846, "nited States?\n\uf0b7 What is the typical process for familial or moderate stringency searching and partial match reporting in the United States?\n\uf0b7 How often is familial and moderate stringency search practiced in the United States?\n\uf0b7 Can the history and p"] [7.334257125854492, -4.055272579193115, "n SDIS, is essentially a local DNA database.\n2 United States Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, Census of Publicly Funded Forensic Crime Laboratories, 2014, Ann Arbor, Mich.: Inter-university Consortium f"] [7.341793537139893, -4.064516544342041, "eof). We also interviewed SMEs about implementation of the current policy. The topics discussed during the semistructured interviews were\n5 We used a convenience sample of recognized subject matter experts within the National Police Chiefs\u2019 Council. "] [7.344059467315674, -4.064777851104736, "red on the side\nof caution.4\nCalifornia was the first state to authorize intentional familial searching, and in 2010, the technique led to the identification of the \u201cGrim Sleeper,\u201d a serial killer who murdered several women in south Los Angeles over "] [7.3486175537109375, -4.069458961486816, "ps it is time for policies to permit familial DNA searching at the national level and for explicit and uniform policies for all SDIS and LDIS laboratories, at least in the most\nserious cases.\nCompared to efforts to expand the scope of DNA databases i"] [7.35192346572876, -4.069800853729248, "e arisen as to whether it should be applied to less serious offenses. Roman and colleagues investigated the impact of DNA testing on property crimes and found that offenders were five times more likely to be identified and nine times more likely to b"] [7.368904113769531, -4.088820934295654, "eased just before the change in eligibility went into effect, is not in the DNA database. A report prepared for The Urban Institute estimated a small deterrent effect (2\u20133 percent decrease) for the offenses of robbery and burglary only, but large pro"] [7.354043483734131, -4.074597358703613, " diminished expectation of privacy as a result of their conviction or arrest. This justification obviously does not apply to offenders\u2019 relatives who may be implicated in familial searches, raising ethical and constitutional concerns over what the se"] [7.358548641204834, -4.078927040100098, " that this distinction between the accidental discovery of familial matches via moderate stringency searches and deliberate efforts to conduct familial searches is illogical.\nInternational Use of Familial and Moderate Stringency Searches\nForensic DNA"] [7.309934616088867, -4.028088092803955, "lusions on the effectiveness of the database.34\nSurvey Results\nSDIS Respondent Summary\nWe received responses from nine of the 50 SDIS laboratories. None of the surveys we received were complete. Eight of the ten SDIS surveys returned were filled out "] [7.3388471603393555, -4.0534491539001465, "010 and 2018 (prorated) for state and national matches. The share of exact matches increased between 2010 and 2018. Both the absolute number and the share of moderate and partial matches decreased in 2018. A lower (and decreasing) rate of return on m"] [7.339637279510498, -4.058233737945557, " surveyed (and if validation proceeds according to schedule they are now online), while nine responding LDIS laboratories reported no immediate plans to switch from their current evidence profile interpretation method.\n 18\nFigure 3.4. LDIS Laboratori"] [7.341073989868164, -4.0604658126831055, "ndicated that they also retain forensic profiles, partials, and mixtures ineligible for SDIS and NDIS. The same fraction reported also maintaining elimination/contamination profiles from laboratory and law enforcement personnel; two LDIS labs retain "] [7.33690881729126, -4.055777072906494, "ene profiles are often partially degraded and/or contain DNA from more than one contributor)\n 22\nFigure 3.9. LDIS Laboratories: Average Number of Forensic SDIS Uploads by Category, 2010 vs. 2018\nOur research team was interested in whether probabilis"] [7.364754676818848, -4.0801215171813965, "se fortuitous partial matches performed or outsourced Y-STR testing, but only seven of the 16 responding LDIS laboratories that performed outsourced Y-STRs use familial searching (data not shown).\n 24\nFigure 3.11. Number of LDIS Laboratories Using Fo"] [7.340793609619141, -4.055332183837891, " 995/46,586 = .02;\n(.02 \u2013 .03)/.03 = \u2212.37 or \u221237% change in share of total matches.\nAs a follow-up question, LDIS laboratories were asked to comment on why they could not complete all items in this portion of the survey. Seven of eight responding LDI"] [7.336883544921875, -4.054800987243652, "ries uploading hundreds of forensic profiles every month, means that California and Texas generate numerous \u201chits\u201d every month (hundreds in the case of California), some portion of which are not exact matches. Thus, these SDIS laboratory administrato"] [7.341739654541016, -4.0620951652526855, " with the submission of joint written requests from the investigating and prosecuting agencies. The request forms describe the conditions under which the familial search will be conducted and require applicants\u2019 signatures to attest that they underst"] [7.336400985717773, -4.054501056671143, "st, the DNA technical lead, and three other SDIS laboratory personnel. In California, there are seven people on the FDS committee, including the state CODIS administrator, DNA technical lead, and other SDIS laboratory personnel, but also a Bureau of "] [7.339261531829834, -4.057745456695557, "secutors understand the significance of the prospective FDS match and the proper ways to go about confirming it. For example, a prospective FDS match is not grounds for conducting a raid on a residence the way an exact database match might be. Texas "] [7.350519180297852, -4.071146488189697, "work relating to the collection, use, and retention of biometric samples.\nVolume and Purposes of Familial DNA Testing\nAccording to the most recent figures provided by the National DNA Database Strategy Board, a total of 13 familial searches were carr"] [7.351438522338867, -4.073951244354248, "A Database and meet a number of requirements. First, a regional representative of the National Crime Agency must have seen the request and be willing to provide the resources to support the search. In addition, the law enforcement agency applying wil"] [7.359290599822998, -4.08120059967041, " hundred years of data on births, deaths, and marriages in England and Wales were gathered and used to produce a bell curve showing the probability of an individual having a child at a particular age, and, based on the predicted age of the offender, "] [7.350010395050049, -4.071135997772217, "e few investigations rely solely on a list that has not been enhanced through prioritization, there are cases where the genetic similarity between the crime scene sample and a profile in the National DNA Database is so high that investigators do not "] [7.351461887359619, -4.073126316070557, "ase:\nFor example, if there is a case from the 1980s and we think the person was in his 30s at the time, they are likely to be in their 50s or 60s now. The chances of finding a brother or sister is really quite low because very few people in the datab"] [7.359694957733154, -4.079230308532715, "usly, the relevant law enforcement agency typically covers the cost of a familial DNA search, although it may seek additional funding from another agency, such as the Home Office, which only rarely provides financial support for such a purpose (Inter"] [7.352635860443115, -4.07362699508667, "her?\u201d\nSecond, the interviewee expressed the view that the burden of becoming involved in a criminal investigation, even when one is not a suspect, is considerable and must be taken into account. According to Interviewee 1, \u201cAny involvement in a crimi"] [7.348231315612793, -4.069354057312012, "d Wales are increasingly mixed and identification more complex.\nInterviewee 3 stated that if the process does raise the risk of amplifying racial and geographic biases, it may still be a justifiable course of action; risks must be identified at the e"] [7.349375247955322, -4.070281505584717, "ll take a scientist who can identify a major profile in these and match it to the [National] DNA Database. I know from an operational point of view, the frustration of getting results we can do nothing with and the frustration of spending a lot of mo"] [7.355875492095947, -4.07631254196167, " which are kept on file, often on paper, but nobody looks across to make those links. The best we can hope for is speculative searches of the database which can give a list of names, which is often long and difficult to investigate, and it is over to"] [7.340253829956055, -4.060707092285156, "the state of familial searches and moderate stringency matches. Still, some potentially interesting insights were gleaned from the responses of participating laboratories. Maintaining detailed records on the correlations between evidence type and DNA"] [7.3487443923950195, -4.068506240844727, "ufficient quality for inclusion in SDIS.8 While we acknowledge that some law enforcement agencies use forensic DNA databases to store or conduct forensic DNA analysis outside of the\n1 \u201cAncestry Surpasses 15 Million Members in Its DNA Network, Powerin"] [7.361629009246826, -4.082212924957275, "low the example set by Texas and automatically expunge profiles for those who have not been convicted. This would also be in line with the practice in Europe, following the ruling of the European Court of Human Rights,14 which resulted in the removal"] [7.358172416687012, -4.080379486083984, "have dramatically lowered the cost of achieving a potentially worrisome level of surveillance over mass populations.\nThe use of familial DNA searching raises important privacy and surveillance concerns. Comparing an unknown DNA sample to a database o"] [7.354844570159912, -4.07639217376709, "o help law enforcement develop leads in investigations that would otherwise go unsolved. However, the acknowledgment of racial disparities and privacy issues in the administration of familial and moderate stringency searches raises concerns about the"] [7.341528415679932, -4.063183784484863, " implications of those expansions.\nTo date, Arizona, California, Colorado, Florida, Minnesota, New York, Ohio, Texas, Utah, Virginia, Wisconsin, and Wyoming are the only states that have solved cold cases using familial DNA searches. Illinois and Lou"] [7.340106010437012, -4.061028480529785, " to better appreciate the costs and benefits of this forensic DNA database application. Future research could examine whether such an expansion of the United States DNA databases would be acceptable by society and investigate how many crimes could po"] [7.355927467346191, -4.076104640960693, "rtable, relatively inexpensive DNA analysis technology may make DNA testing more common. Private-sector DNA laboratories such as Parabon NanoLabs have recently begun using SNPs to identify and investigate leads in cold cases. Already the method has b"] [7.360907077789307, -4.080898284912109, "omic Approach,\u201d Journal of Political Economy, Vol. 76, 1968, pp. 169\u2013217.\nBhati, A., Quantifying the Specific Deterrent Effects of DNA Databases, Washington, D.C.: Justice Policy Center, The Urban Institute, 2010. As of May 9, 2013: https://www.urban"] [7.355621337890625, -4.074611186981201, ". As of June 25, 2019: https://www.fbi.gov/services/laboratory/biometric-analysis/codis\n\u2014\u2014\u2014, \u201cFrequently Asked Questions on CODIS and NDIS,\u201d undated. As of June 11, 2019: https://www.fbi.gov/services/laboratory/biometric-analysis/codis/codis-and-ndis"] [7.356739044189453, -4.077535629272461, " P. Gilld, M. Kaysere, W. R. Mayrf, N. Morlingg, et al., \u201cDNA Commission of the International Society of Forensic Genetics (ISFG): An Update of the Recommendations on the Use of Y-STRs in Forensic Analysis,\u201d International Journal of Legal Medicine, V"] [7.377029895782471, -4.097189903259277, "gants\u2019 Access to DNA Database Searches to Prove Innocence,\u201d Boston College Law Review, Vol. 60, No. 2, 2019, pp. 709\u2013751.\nMiller, G., \u201cScientists Explain How Familial Testing Nabbed Alleged Serial Killer,\u201d Science Insider, July 12, 2010.\n\u201cMurders Sus"] [7.348633766174316, -4.067649841308594, "/news/a-not-so-perfect-match/\nScientific Working Group on DNA Analysis Methods Ad Hoc Committee on Partial Matches, \u201cSWGDAM Recommendations to the FBI Director on the \u2018Interim Plan for the Release of Information in the Event of a Partial Match at NDI"] [7.353911876678467, -4.067814350128174, " DNA Profiling in Support of Criminal Investigations,\u201d Journal of Law, Medicine, and Ethics, Vol. 33, No. 3, 2005, pp. 545\u2013558.\n55\n"] [7.171360492706299, -0.9196847677230835, " What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\nGregory Midgette, Steven Davenport, Jonathan P. Caulkins, Beau Kilmer\n CORPORATION\nFor more information on this publication, visit www.rand.org/t/RR3140\n Library of Congress Cataloging"] [7.16873025894165, -0.9179396033287048, "onomic well-being of populations and communities throughout the world. This research was conducted in the Social and Behavioral Policy Program within RAND Social and Economic Well- Being. The program focuses on such topics as risk factors and prevent"] [7.15283727645874, -0.9333822727203369, ". . . . . . . 41 Estimating Marijuana Users and Use Days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Marijuana Expenditures Through 2014. . . . . . . . . . . . . . . . . . . . . ."] [7.223578929901123, -0.8728376030921936, "ures by User Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n4.1. Price Per Pure Gram for Each Drug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n4.2. Average Purity fo"] [7.231571674346924, -0.8655635118484497, " Expenditure Estimates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n3.5. Cocaine Expenditures by User Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [7.191924095153809, -0.9027948379516602, "and policies, policymakers need to know what is happening in the markets for these substances: How many people are using them? How much are they using? How much money are they spending? How have these quantities changed over time? This report provide"] [7.182770729064941, -0.9093548655509949, "in the United States and at the southwest border from 2007 through 2016. Changes in the composition of heroin users, potentially involving increased use among individuals without criminal histories, have increased the uncertainty underlying these est"] [7.2257843017578125, -0.8718044757843018, "data.\nTable S.1\nChronic Drug Users, 2006\u20132016 (millions)\nDrug\nCocaine\nHeroin\nMarijuana Methamphetamine\nEstimate 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016\nAdjusted 14.2 13.5 14.6 16.2 17.6 17.7 19.2 19.5 22.2 22.1 22.8 Unadjusted 10.5 9.9"] [7.237302780151367, -0.862869143486023, " Best 384 307 203 160\nLower\u2013 261\u2013 208\u2013 138\u2013 109\u2013 Higher 550 450 297 236\n143 143\n98\u2013 98\u2013 209 209\n153 108\n105\u2013 74\u2013 224 160\n111 108 145\n76\u2013 74\u2013 99\u2013 162 158 213\nHeroin Best 2727303127303342434447\nLower\u2013 13\u2013 14\u2013 15\u2013 15\u2013 14\u2013 15\u2013 16\u2013 19\u2013 16\u2013 18\u2013 18\u2013 Higher "] [7.191335201263428, -0.9086325764656067, "pe, and a recent wastewater testing report from Australia finds that fentanyl consumption likely doubled outside of capital city jurisdictions from April 2017 to April 2018 (Australian Criminal Intel- ligence Commission, 2018). Although the utility o"] [7.188594341278076, -0.9046221971511841, ".S. Office of National Drug Control Policy (ONDCP) to generate national estimates of the total number of chronic users, total expenditures, and total consumption for four drugs: cocaine (including crack), heroin, marijuana, and methamphetamine. This "] [7.232329368591309, -0.8660870790481567, " issues as the extent to which one can trust arrestees\u2019 self-reports about their spending on illegal drugs and how to extrapolate from arrestees in just a handful of urban areas to the country as a whole, particularly for methamphetamine, whose user "] [7.253122806549072, -0.8445723652839661, "idered under this definition.1\nTo generate estimates of CDUs, we employ a model combining drug use preva- lence in ADAM with numerous other drug use indicators and building on prior work, including previous efforts to estimate CDUs for ONDCP. The cur"] [7.251873970031738, -0.8460285067558289, "test positive.\n5. Adjust this total to restrict it to adult male arrest events involving a CDU.\n6. Convert the total of adult male arrest events involving a CDU to the total of\nadult male arrestees who were CDUs (i.e., convert from events to individu"] [7.256024360656738, -0.8415619730949402, "ult male arrests in each county in the annual UCR \u201cAge, Sex, Race\u201d series. This process gener- ated annual estimates for male arrest events involving an arrestee who is projected to test positive for cocaine, opioids, or methamphetamine.5\nSteps 5\u20138: "] [7.246288776397705, -0.8510806560516357, "d 2007-13) ab criminally active CDU get arrested according Take arrests per arrestee from F2, assumes to a Poisson distribution. criminally active CDUs who get\nF3 Proportion of adult male\narrested each year\nCalculate for three groups: 4\u201310, 11\u201320, an"] [7.240356922149658, -0.8567972779273987, "en chronic and less-frequent users. ADAM data indicate daily/near-daily users (21 or more days per month) have strikingly different consumption patterns than those who use weekly or even several times a week. It is the daily/near-daily users in parti"] [7.228846073150635, -0.8697401285171509, "umber of CDUs, but rather a basic indicator of uncertainty around each year\u2019s estimate.\nResults\nCocaine\nFigure 2.1 presents the best or \u201cpoint\u201d estimates of the number of chronic cocaine users (i.e., those who used on four or more days in the previou"] [7.230888366699219, -0.8695178031921387, "ms (ICD)-10 code T40.4 \u201cpoisoning by other synthetic narcotics\u201d in the CDC Multiple Cause of Death records. T40.4 includes fentanyl and its analogs. NFLIS = National Forensic Laboratory Information System.\n6 The impact of fentanyl is felt almost enti"] [7.224104404449463, -0.8742425441741943, "ts were female and 48 per-\nTable 2.3\nChronic Cocaine Users by Frequency (millions)\n 7 Heroin is a semisynthetic opioid. For a simple typology of opioids, see CDC, 2018b.\n14 What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\nFigure 2.3\nEstimate"] [7.2264018058776855, -0.8735433220863342, " heroin overdoses and the other measures. It may be that heroin consumption has become increasingly concentrated among a small number of very heavy users who are consuming even more than historical trends would suggest. The differences may be because"] [7.225497245788574, -0.8735420107841492, "to Figure 2.1, the error band in Figure 2.5 is driven by only one source of uncertainty: the 95-percent confidence interval surrounding the predicted share of adult male arrest events involv- ing a positive drug test for methamphetamine.\nTable 2.5\nCh"] [7.231896877288818, -0.8662734627723694, "s agreement for 2016. We suggest that the most-defensible position concerning trends in methamphetamine consumption is to acknowledge that the data are insufficient to assume a reduction in users in 2016. Table 2.7 presents the composition of chronic"] [7.197353363037109, -0.8901863694190979, "nly with inflation.\nAs we will describe further in Chapter Four, prices are not constant over the 2014\u20132016 period. Therefore, our assumption that users\u2019 drug expenditures are flat over 2013\u20132016 requires that the overall market is unit elastic\u2014that,"] [7.231723308563232, -0.8652402758598328, "trapolate expenditures. In the absence of available data, we retain prior estimates used in the most recent report (Kilmer et al., 2014a), follow the same method using 2011\u20132013 ADAM surveys, then inflate average expenditures using the Consumer Price"] [7.238088130950928, -0.8587669730186462, "n Expenditures (nominal dollars)\n Year\n2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016\n21 or More Days in Past Month\n1,661 1,684 1,708 1,731 1,754 1,778 1,801 1,825 1,854 1,856 1,880\n11\u201320 Days in Past Month\n 603\n 635\n 666\n 697\n "] [7.2206339836120605, -0.8744195103645325, "eport cocaine expenditures by user type from 2006 to 2016. Daily/near-daily users account for a disproportionate share of the reduc- tion in expenditures, decreasing 63 percent over the period versus a 55 percent decrease for the less-frequent user c"] [7.224818229675293, -0.8715078830718994, "nt) (Figure 3.6 and Table 3.9).\n28 What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\nFigure 3.3\nHeroin Expenditure Estimates\n Best Higher Lower\n Heroin expenditure (billions, 2018 dollars)\n90\n80\n70\n60\n50\n40\n30\n20\n10\n0\n2006 2007\n 200"] [7.2230072021484375, -0.8745356798171997, "on\n In this chapter, we derive estimates for the pure quantities of cocaine, heroin, and meth- amphetamine consumed. Our approach is a continuation of the method described in the previous edition of this report (Kilmer et al., 2014a) and generally si"] [7.2101898193359375, -0.8862796425819397, "ding the representativeness of drug enforcement data on the market as a whole. Basing price series for referent purchases on STRIDE makes the strong implicit assumption that prices in the market, which we do not observe, gen- erally are comparable wi"] [7.222872257232666, -0.8754345178604126, "eroin, methamphet- amine, and cocaine have been reported, we cannot assess the impact of fentanyl on heroin or other drug prices due to data limitations. We discuss this challenge in Chap- ter Six.\nResults\nThis section summarizes consumption in pure "] [7.2012505531311035, -0.8948580026626587, "ne surveillance data give us serious pause. We can be confident that methamphetamine consumption is increasing, perhaps dramatically, but we cannot make any claim beyond that. As was discussed in Chapter Two, the range depicted by the \u201chigher\u201d and \u201cl"] [6.919057369232178, -1.13029944896698, "revious versions of this report is no longer the best for estimat- ing consumption and expenditure. We offer a new approach for the latter and do not produce estimates of consumption; however, we offer some ideas for addressing such estimates in Chap"] [6.867056369781494, -1.1750290393829346, "stently lower according to NSDUH data in comparison with MTF data. As in the previ- ous report (Kilmer et al., 2014a), we assume that the MTF survey can more reliably elicit honest responses from young participants because it is administered in schoo"] [6.8806538581848145, -1.1629951000213623, "porting. The total number of past-year but not past-month users was fairly stable from 2006 to 2008 but grew steadily through 2016. Trends within other user groups are similar to the infrequent-user trend but more variable; the notable exception is t"] [6.924770832061768, -1.123801827430725, "nual estimate. Just as we create both an unadjusted and an adjusted series for the numbers of users, we create two estimates for the number of use days (Table 5.2).\nFigure 5.2 shows these totals by year, broken down by user group. There has been a la"] [6.889819145202637, -1.1569559574127197, " per day, estimated separately for each past-month user group: occasional (1.68), weekly (1.92), more than weekly (1.92), and daily/near-daily users (3.87) (Kilmer et al., 2014b).\n Two longstanding issues with this method have become increasingly wor"] [6.919849872589111, -1.1289275884628296, "add grams of wax (which can be more than 75 percent THC by weight) to grams of conventional marijuana that are, on average, 20 percent THC by weight, let alone to grams of THC-infused brownies or beverages (which can have a very low THC concentration"] [6.956176280975342, -1.0971969366073608, "ith implausible reports based on their reported days of marijuana use. Effectively, it uses data from qualified buyers on spending per day of use to impute the spending of respondents whose past-month spending reports were disqualified for being susp"] [6.9445695877075195, -1.1066290140151978, "idence on the extent of underreporting of spending, so we cannot simply adjust for the underreporting of spending by multiplying by some factor derived from the literature. Instead, we take the trends found with the RASTUD-based model and adjust them"] [6.939972877502441, -1.1109927892684937, "f use has been stable despite the many changes in mari- juana potency, product variety, and legal status at the state level.\nExtending Marijuana Expenditures Through 2016\nBecause NSDUH did not include the marijuana market module in 2015 or 2016, esti"] [6.993889331817627, -1.0668718814849854, "for the daily/near-daily user group.\nMarijuana 51\n 52 What America\u2019s Users Spend on Illegal Drugs, 2006\u20132016\nFigure 5.4\nEstimated Marijuana Expenditures\n Adjusted\n Unadjusted\n Marijuana expenditure (billions, 2018 dollars)\n60\n50\n40\n30\n20\n10\n0\n2"] [6.918796539306641, -1.1314996480941772, ").\nExtrapolating from Washington State\nCaulkins et al. (2019) estimates that Washington state\u2019s 755,000 NSDUH-identified past-month users spent $1.66 billion annually on marijuana over 2015\u20132016.8 Nation-\n8\nUsing consumption estimates from a Washingt"] [6.913496017456055, -1.1379766464233398, "f products, and increased availability through state and substate policies relaxing restrictions on marijuana access and penalties on possession. Dis- cussions often focus on changes in the motive for consumption (so-called \u201cmedical\u201d marijuana versus"] [6.905975341796875, -1.1455405950546265, "ions of THC, but there was more of it. Thus, from a grower\u2019s perspec- tive, much of the THC was not being converted into saleable product.\nIn jurisdictions where marijuana businesses are state-legal, it is common to use devices of various sorts to ex"] [6.9050092697143555, -1.1419113874435425, "ket conditions.\nUsers, Dollars, and Use Days\nBefore proceeding to novel metrics, we note that two traditional measures of market size remain viable: dollar value and number of users. One can add $20 spent on brown- ies to $40 spent on dabs to get $60"] [6.886453151702881, -1.1571224927902222, "ys per month) are thought to consume two to three times as much per day of use as those using only rarely. Hence, two markets with identical numbers of days of use could differ in esti- mated quantity consumed if a greater proportion of the use days "] [6.889455795288086, -1.1542222499847412, "d between 1.3 and 1.9 grams per use day, with a best estimate close to 1.6 grams (Kilmer et al., 2013). A similar survey conducted for the Colorado Department of Revenue in 2014 led researchers to conclude that \u201cresults confirm that a preliminary est"] [6.922269344329834, -1.1296550035476685, "nges in consumption over time in a set of units that is both standardized across years and sensitive to the fact that frequent users tend to use more per day of use.\nTHC\nThe cannabis plant contains scores of cannabinoids, but two (THC and CBD) receiv"] [7.180571556091309, -0.9166420698165894, " to support THC estimates for the nation or over time. Key data sets, such as STRIDE, never reported marijuana potency the way they reported the purity of cocaine and heroin. Seizure data analyzed by the University of Mississippi did record potency, "] [7.199809551239014, -0.9018514156341553, " data taken at different times to produce a coherent estimate. That would not be the case for fentanyl post-2013.\nAnother fundamental problem with estimating fentanyl consumption from user surveys is that much of the illicit-market fentanyl appears a"] [7.19484281539917, -0.9062238931655884, "dulterating. Because heroin users tend to have tolerance to opioids, they may be less likely to die if their heroin is adulterated with fentanyl than if a cocaine user\u2019s cocaine is adulterated with fentanyl.\nYet another challenge is that fentanyl is "] [7.1943159103393555, -0.9049240350723267, " Then the national estimate of fentanyl consumption is\nTotal fentanyl consumption = \u2211drugs d \u00d7\u2211regions i \u00d7Rdi \u00d7Wdi . This estimate could be improved or extended in the following ways:\n\u2022 summing across types of fentanyls (e.g., folding in carfentanil "] [7.18350887298584, -0.9182794690132141, "AM program\u2014or some version of it\u2014so we can collect real-time drug market data, including objective (biological) consumption measures for cocaine, heroin, meth- amphetamine, and other drugs. For example, it is possible to detect fentanyl in urine spec"] [7.0682549476623535, -1.0061134099960327, "z, Lauren Renaud, and Beau Kilmer, \u201cBig Data on a Big New Market: Insights from Washington State\u2019s Legal Marijuana Market,\u201d International Journal of Drug Policy, Vol. 57, July 2018, pp. 86\u201394.\nCaulkins, Jonathan P., Steven Davenport, Anhvinh Doanvo, "] [7.0519561767578125, -1.0228209495544434, "ry Drug Problems, Vol. 31, No. 3, 2004, pp. 467\u2013540.\nGonyer, Todd E., \u201cFederal Sentencing in a Post-Chapman World: What Is a \u2018Mixture or Substance\u2019 Anyhow?\u201d University of Kansas Law Review, Vol. 46, 1998, pp. 983\u22121011.\nHorowitz, Joel L., \u201cShould the "] [7.060093879699707, -1.0145810842514038, "ps://www.rand.org/pubs/research_reports/RR3138.html\nKilmer, Beau, Susan S. Sohler Everingham, Johnathan P. Caulkins, Gregory Midgette, Rosalie Liccardo Pacula, Peter H. Reuter, Rachel M. Burns, Bing Han, and Russell Lundberg, What America\u2019s Users Spe"] [7.034780502319336, -1.035224199295044, "Drug Control Policy.\nOregon Liquor Control Commission, 2019 Recreational Marijuana Supply and Demand Legislative Report, Portland, Oreg., January 31, 2019. As of May 20, 2019: https://www.oregon.gov/olcc/marijuana/Documents/Bulletins/2019%20Supply%20"] [7.106329917907715, -0.9820793867111206, " Prospective Relation of Cannabis Potency, Dosing and Smoking Behaviour with Cannabis Dependence: An Ecological Study,\u201d Addiction, Vol. 109, No. 7, July 2014, pp. 1101\u20131109.\nReferences 75\nSubstance use and drug policy are clearly in the national spot"] [23.221759796142578, 10.058122634887695, " CORPORATION\nCaseload Standards for\nIndigent Defenders in\nMichigan\nFinal Project Report for the Michigan Indigent Defense Commission\n Nicholas M. Pace, Dulani Woods, Shamena Anwar, Roberto Guevara, Chau Pham, Karin Liu\nFor more information on this pu"] [23.17041778564453, 9.97400188446045, "al defense attorneys followed, in which the results of the earlier time study were presented to participants as evidence of current time expenditures. Informed by those results, respondents then provided their opinions as to the average amount of tim"] [23.127090454101562, 9.922895431518555, ".......................3 Approach ...................................................................................................................................................5\nPrior Work in This Area............................................"] [23.169321060180664, 9.969511032104492, "....48 Survey Design .....................................................................................................................................49 Results ....................................................................................."] [23.14936637878418, 9.94543170928955, "......................................................................................................................86 Appendix A. Comments from Participants in the Attorney Survey ..............................................88 Appendix B. Commen"] [23.15536880493164, 9.945775985717773, "pe ................................37 Time Study Participation and Case Distribution: Attorney Location ..........................38 Time Study Case Span ................................................................................................"] [23.229524612426758, 10.031050682067871, ". Case-Related Duty Hours Calculations........................................................................72 Table 5.2. Recommended Caseload Standards..............................................................................73 Table 5.3. Stat"] [23.20320701599121, 10.000921249389648, " find him or herself routinely delivering just the minimum effort necessary to avoid ethical sanctions while hoping for a quick plea deal.\nSimilar to previous studies in other states that have also addressed the question of reasonable caseloads, this"] [23.136838912963867, 9.930344581604004, "lready mentioned. Examples: extraditions, detainers, contempt proceedings.\n A survey of criminal defense attorneys in the state followed, in which the results of the earlier time study were presented to participants as evidence of current time expen"] [23.14165687561035, 9.9352445602417, "s involving indigent defense counsel, participation is most likely when the attorney is a high-volume public defender and least likely when the attorney is in private practice. Indeed, the information we collected on 4,816 cases tracked during the re"] [23.140518188476562, 9.935093879699707, "he time study that had concluded previously, and, with that information as background, respondents would give their recommendations as to the average amount of attorney time required to provide effective assistance of counsel for each case type of in"] [23.168607711791992, 9.973245620727539, " percent of the estimated 2017 Michigan population. Other regions in the state also have population proportions that are similar to the respondent group (for example, 5.1 percent of Michigan residents live in the Northern Lower Peninsula, 3.0 percent"] [23.162805557250977, 9.957528114318848, "strative staff, such as clerks, secretaries, or receptionists; investigators; paralegals or legal assistants; interns and externs; research attorneys; interpreters; social workers; mitigation specialists; and any other nonattorney staff members). Ind"] [23.200590133666992, 9.990102767944336, " and public defenders from every region in Michigan. A one-day, in-person group session with the 29 panelists was held in Lansing on September 13, 2018.\nThough the information we sought to elicit from the expert panel paralleled that of the attorney "] [23.145902633666992, 9.931736946105957, "about necessary average hours on a paper form we provided. This was done to help the panelists minimize the effects of anchoring bias by first using self-generated anchors (their own assumptions) rather than relying solely on externally provided ones"] [23.18073272705078, 9.9657564163208, "The median of the expert panel\u2019s responses, rather than the mean, was chosen as the statistic to report the group\u2019s consensus\n4 See Chapter 4.\n xviii\nestimate as to average times. The median has the advantage of not being affected by extreme values t"] [23.207128524780273, 9.999711036682129, "hours per day. A second involves what might be characterized as absence days, which we have assumed to include two weeks of vacation (ten business days), eight business days of sick leave or other personal leave, and a 12.5-day annual holiday schedul"] [23.211776733398438, 10.007349967956543, "ons\nOther adult criminal indigent defense trial court\u2013level matter\nDelphi Panel Median Recommended Minimum Hours\nMaximum Caseload Standard\n 120 15 80 23 50 37 40 46 25 74\n8 232\n7 265 3.5 530 3 619\n It is important to note that these recommended ca"] [23.23212242126465, 10.028693199157715, "ghts for types A and B would be 200 and 20, respectively (essentially just the average hours for each of the two types), while the relative case weights for the two categories would be 4.0 (200 hours for type A cases divided by the 50-hour average fo"] [23.20038604736328, 9.9947509765625, "s than full time to handling adult criminal matters? As Table S.4 suggested, attorneys who participated in the survey varied greatly as to the amount of time they typically spent each week representing adult defendants. Let us assume that the solo pr"] [23.212568283081055, 10.043783187866211, "ing the newspaper.\u201d\n xxiii\nconclusions.8 To the extent that indigent defender caseloads in this state are indeed excessive, such problems cannot be made to disappear simply through the adoption of maximum caseload standards. Far better information ab"] [23.21294403076172, 10.043378829956055, ".991(2)(b).\n xxiv\nAcknowledgments\nWe would like to express our appreciation to those indigent defense attorneys across Michigan who volunteered to participate in a time study designed to track their case-related activities. We are well aware of the s"] [23.249897003173828, 10.013396263122559, ") for assistance in determining maximum caseload standards for providers of indigent legal representation to adult defendants in the trial-level courts of the state of Michigan. A \u201cmaximum caseload standard,\u201d typically expressed in terms of the numbe"] [23.218280792236328, 10.046627044677734, "vered. A more functional set of principles can be found in the MIDC\u2019s first four standards for indigent defense delivery systems, covering such areas as the training and education of indigent defense attorneys, the initial client interview, the use o"] [23.221210479736328, 10.041129112243652, "f the conference participants formed the basis for the recommended maximum caseload standards subsequently described in this report.\nIt should be emphasized that RAND\u2019s ultimate task in this work was to deliver the final results of the September 2018"] [23.22111701965332, 10.033586502075195, "d to over the course of a year, assuming that the attorney in question represented only cases of that\n3\none type (calculating recommended maximum caseloads in instances where the attorney handles more than one type of case is accomplished through the"] [23.220394134521484, 10.035859107971191, "ty when applied to attorneys in a particular region of the state due to unpredictable variations in weather and road conditions in that area or chronic shortages in support staff availability. No single set of caseload standards can account for such "] [23.22589683532715, 10.045548439025879, " attorney per year: not more than 150; misdemeanors (excluding traffic) per attorney per year: not more than 400; juvenile court cases per attorney per year: not more than 200; Mental Health Act cases per attorney per year: not more than 200; and app"] [23.243396759033203, 10.071208953857422, "sing out of the work of the NAC court task force, can be found in National Legal Aid and Defender Association, undated.\n21 See, e.g., ABA, 2002 (\u201cNational caseload standards should in no event be exceeded,\u201d citing the numbers in NAC Standard 13.12); "] [23.18206214904785, 9.97325325012207, "cts usually involved first determining the average amount of hours being spent by indigent defenders on different types of cases using special time studies, fielding a survey in which indigent defenders within the jurisdiction being examined review t"] [23.23936653137207, 10.03612232208252, "of the NCSC approach has been employed by the ABA\u2019s Standing Committee on Legal Aid and Indigent Defendants (ABA-SCLAID) in a cluster of studies conducted over the past five years. These studies also utilize what might be characterized as a task-base"] [23.21278190612793, 10.016303062438965, "45 \u201censure the effective representation of counsel,\u201d46 \u201cperform the duty effectively,\u201d47 complete the task \u201cwith reasonable effectiveness,\u201d48 \u201cprovide reasonably effective\n31 RubinBrown and ABA-SCLAID, 2017.\n32 Postlethwaite & Netterville and ABA-SCL"] [23.188980102539062, 9.981390953063965, "defenders\u201d at start, 23 attorneys in final session\nExpert Decisions or Adjustments\n(1) Time needed to complete each task in a case within each case type; (2) percentage of cases within each case type in which each task should take place\n(1) Time need"] [23.17881965637207, 9.989287376403809, "ask across all cases\nAverage amount of time that should be spent on cases within each case type\nWhether or not additional time was needed for performing each task within each case type\nExpert Panels\nFocus group: \u201cA select group of seasoned\u201d public de"] [23.155662536621094, 9.950963020324707, "ns.\nWhen more time spent on a task within a case type was believed to be necessary, (1) revised time needed to complete task; (2) revised percentage of cases within case type in which task should take place\n Virginia\nNCSC (2010)\nStatewide "] [23.134721755981445, 9.934075355529785, "load standards setting can be quickly and inexpensively extracted from the provider\u2019s case management system (CMS). The only practical alternative when timekeeping is not routine is to conduct a costly and often disruptive special time study in which"] [23.125471115112305, 9.931386947631836, "s. But such an approach requires that the individual providing the estimates or adjustments can recall individual events in cases of a particular type with a sufficient degree of accuracy. There is also a greater burden on participants if they are as"] [23.1274471282959, 9.92180347442627, "task-based approach asks the participant to estimate the average time needed to complete each task (a companion question often included asks the participant to estimate the percentage of cases in which the task should be performed). Task-based studie"] [23.212646484375, 10.030733108520508, " noted that regardless of whether a second set of experts is utilized, the standards that arise out of this development process are typically characterized as \u201crecommended,\u201d \u201cinterim,\u201d or \u201cprovisional.\u201d It is not until some sort of policymaking body "] [23.183048248291016, 9.994412422180176, "fender offices (just eight of Michigan\u2019s 83 counties have a public defender).\nNext was the manner in which services for indigent representations are arranged. Michigan has historically been a state where indigent defense is the responsibility of indi"] [23.131776809692383, 9.930928230285645, " counsel. The JIS CMS does have a field for that purpose, but reportedly many of the Michigan trial courts with this system in place are not utilizing it. Most courts, but not all, send extracts of the information they collect to the Judicial\n55 See,"] [23.16335105895996, 9.955255508422852, "as the one we were considering) or other quantitative data collection focusing on indigent defenders operating in Michigan trial-level courts had been performed. The 2008 NLADA report (Evaluation of Trial- Level Indigent Defense Systems in Michigan) "] [23.184654235839844, 9.980003356933594, "aling with large numbers of private law firms. Based on these considerations, we felt that we would maximize the number of participants who consistently kept time throughout the entire study period if the project asked for no more than two months of "] [23.134923934936523, 9.930523872375488, " those tasks. In addition, we know from our prior work with indigent defense timekeeping that many attorneys routinely submit their time entries based on nothing more than what they recall from memory as to what they did the day or even weeks before."] [23.134281158447266, 9.928893089294434, "tiate with a prosecutor all within the same hour. A task-based approach certainly has merit, but we felt that it would be most effectively employed when detailed timekeeping had become a routine business practice for indigent defenders and highly rel"] [23.19712257385254, 10.010770797729492, " before being formally presented with the data collection results. Armed with both their original estimates and with the data collection results they subsequently received, the experts then entered into the consensus phase of the work with as much re"] [23.189634323120117, 9.98326587677002, "ifications Used in the Standards Development Explanation\n Case Type\nMurder or manslaughter CSC\nOther class A offenses Other high-severity felonies\nLow-severity felonies and \u201ctwo-year\u201d high court misdemeanors\n\u201cOne-year\u201d misdemeanors (potential senten"] [23.231847763061523, 10.05864143371582, "defense systems across the state as part of other work the commission was conducting at the time.\n25\nAs indicated previously, a time study of indigent defense attorneys was followed by an attorney survey (additional information about the time study a"] [23.171527862548828, 9.971831321716309, "ts, no longer practicing law, or no longer receiving mail at those addresses.\nInvitations for the time study went out to 1,979 attorney email addresses. We learned from the fielding of those invitations and subsequent follow-up communications that 44"] [23.167394638061523, 9.961836814880371, "ly when the attorneys who handle the bulk of the indigent caseload in the county or the court have conflicts, either ethical in nature or in regard to scheduling. Public defenders and contract counsel program attorneys are likely to have a relatively"] [23.161890029907227, 9.956765174865723, " that we had fewer relatively younger defenders participating than we might have with a different data collection period because these attorneys are more likely to take their families on vacation at this time than older (and possibly more experienced"] [23.150623321533203, 9.945301055908203, ". As originally designed, defenderData Prime is a very powerful case manager platform for defender organizations, with, for example, extensive capabilities for scheduling upcoming appearances, processing vouchers, note taking, and report production. "] [23.131196975708008, 9.92531967163086, "ving a reservoir of existing cases in the system would have been a significant time saver for participants, especially during the early weeks of the time study. Unfortunately, there are about 134 separate indigent defense systems in the state, each o"] [23.115589141845703, 9.907772064208984, "eived through independent\ninvestigation, including public data, treatment, criminal history,\nadoption, and HHS or CPS.\n\u2022 Drafting discovery and independent investigation requests and memos\nof review of information received.\n\u2022 Other active independent"] [23.166929244995117, 9.965112686157227, "e MIDC\u2019s staff reach out to the known contacts for each of the indigent defense systems in the state to announce the launch of the caseload standards data collection efforts and request that attorneys operating within those systems be encouraged to p"] [23.160015106201172, 9.954265594482422, " available in public defender offices (and, to some degree, in relatively larger private law firms), and such encouragement signals that management considers participation to be a legitimate part of one\u2019s job. Attorneys working in assigned counsel or"] [23.141250610351562, 9.931357383728027, "n the next chapter, public defenders report that they handle significantly more indigent defense cases annually than private counsel). We are not aware of any other contemporary effort to track indigent defender time expenditures in multiple location"] [23.138654708862305, 9.927032470703125, " and time frame of this study, such information was not available to us.\nAnother option would be to utilize imputation methods that closely compare the cases reported on during the time study with the far larger population of indigent defense cases i"] [23.16744613647461, 9.955667495727539, "state.\nWe used scenario 1 and 2 cases to calculate median days from appointment to disposition for cases that remained open past different time periods. In addition to calculating median days to disposition for all scenario 1 and 2 cases, we calculat"] [23.101085662841797, 9.88979721069336, "h it was active within the time study data collection period (i.e., the number of days that a participating attorney would be able to enter time information), and (2) \u201ctotal open days,\u201d which was either the actual number of days the case was active o"] [23.181926727294922, 9.97339153289795, "he world of Michigan indigent defense might be changing and for updating whatever standards are adopted at this time.\nWe then calculated mean and median hours for each of the nine study case types, using a mild form of Winsorization to address outlie"] [23.155071258544922, 9.945085525512695, "reached an agreement with the office wherein RAND would be provided with an extract of its CMS data conforming to our needs, and, in exchange, the office\u2019s employees would not have to participate in the time study, primarily to avoid asking attorneys"] [23.154653549194336, 9.944670677185059, " elsewhere (Table 2.9).\nTable 2.8. Estimated Attorney Time Expenditures for Misdemeanor Cases\n Program\nNorth Carolina public defenders Missouri public defenders Michigan\nMichigan\nBrooklyn Legal Aid Society & Brooklyn Defender Services\nNew York (fiv"] [23.153690338134766, 9.947193145751953, "ices primarily serves a single location, while the members of the private bar might have cases spread across multiple counties.\nTable 2.10. Percentage of Recorded Case-Related Time Spent, by Activity\n Activity Type\nClient communication\nDiscovery r"] [23.155122756958008, 9.950780868530273, "cated in the Upper Peninsula and the Northern Lower Peninsula, and to a random selection of 322 other attorneys in the roster who were not identified as public defenders. The decision to make a special effort to reach out to members of the indigent d"] [23.136802673339844, 9.931800842285156, "for comparison purposes. The survey concluded with a free-text field that asked the respondent to provide any comments related to caseloads, indigent defense issues in Michigan, or ways in which attorney resources affect the delivery of an adequate a"] [23.168006896972656, 9.974108695983887, "\u2014Detroit metro Southeast\u2014other Southeast Southwest\nUpper Peninsula\nWestern NOTE: N = 323.\nActivities\n A 45-hour workweek is common among survey participants, though 10 percent reported that they typically work 60 or more hours each week (Table 3.3)."] [23.177295684814453, 9.974000930786133, "dants (essentially functioning as \u201cprivate public defenders,\u201d presumably as a result of high volume contracts with local indigent defense systems), and (3) private attorneys for whom indigent defendants take up a relatively smaller part of their time"] [23.206979751586914, 10.004364967346191, "d retained) Appointed cases (all types)\nRetained cases (all types)\nNon\u2013case-related time\nPD Other\u2013Heavy\nOther\u2013Light\n 70.3 66.1 20.7 70.9 76.3 38.6\n77.9 80.8 50.7 81.1 74.4 35.7 2.3 18.1 54.2 16.6 7.5 10.1\n NOTE: N = 48 for public defenders, 90 "] [23.225568771362305, 10.024785041809082, "ght\u201d of an NAC misdemeanor is 0.375 relative to an NAC felony, using a 150-to-400 ratio, the 128 misdemeanors would count as an extra 48 felonies on top of the 179 average felonies for Michigan public defenders). The average counts for the other two "] [23.20482635498047, 9.998666763305664, "day misdemeanors\nProbation violations\nOther adult criminal indigent defense trial court\u2013level matter\nTotal\nPD Other\u2013Heavy Other\u2013Light All Attorneys\n4 5 2 3 20 10 10 10 20 15 12 15\n100 35 30 40 200 50 44 75\n200 75 50 75 200 200 50 100 150 50 25 61\n10 "] [23.16464614868164, 9.959388732910156, "eys are much more likely than others to perform their responsibilities without the aid of any support staff whatsoever (administrative staff, such as clerks, secretaries, or receptionists; investigators; paralegals or legal assistants; interns and ex"] [23.169498443603516, 9.95971965789795, " markedly in its needs, complexities, and challenges.\u201d The recommended average should be \u201cthe average of all cases of that type taken together, including those that are pled out at an early stage with only modest time expenditures, those that require"] [23.181848526000977, 9.973531723022461, "9.2 65.6 86.4 85.3 78.2\n NOTE: Depending on the case type category, Ns for all attorneys range from 103 to 170, 22 to defenders, 27 to 53 for Other\u2013Heavy attorneys, and 54 to 93 for Other\u2013Light attorneys.\nAll Attorneys\n44.7 31.9 50.4 42.5 45"] [15.224623680114746, 1.9236541986465454, "enting a client in one of the study case types), the approach was quite different. We employed the Delphi Method, a feedback consensus method first developed by RAND in the aftermath of World War II as a way to systematically coalesce expert opinions"] [23.184497833251953, 9.99635124206543, "ttend in person, so we set up a speakerphone for audio participation, and an Adobe Connect web meeting so that the panelist could see what was displayed at the session, and our Delphi tool was hosted on a website that could be accessed from anywhere."] [23.14435386657715, 10.12411117553711, "-Law, Law Offices of Walton & Scally, PC, Utica (Macomb County)\nMelissa K. Wangler, Attorney-at-Law, The Law Office of Melissa K. Wangler, PLLC, West Branch (Ogemaw County)\nChristopher B. Wickman, Attorney-at-Law, Nichols Law Firm, Lansing (Ingham Co"] [23.17401885986328, 9.959095001220703, "eir assumptions about the amount of time now spent on average for different case types and their own recommendations about necessary average hours on a paper form we provided. This was done to help the panelists minimize the effects of anchoring bias"] [23.130077362060547, 9.913261413574219, "by the mean).\nWhen the panelists had responded to all of the questions, we projected a similar graphic and statistical summary of their responses on to a screen in the meeting room. The summaries were\n78 Zipfinger, 2007.\n 66\nupdated periodically as "] [23.185548782348633, 9.972676277160645, "d deviation of 4.98 (rounded). The CoV is the standard deviation divided by the mean of the original distribution of numbers, or, in other words, 4.98 divided by 11 (0.45, rounded).\n80 See Gracht, 2012, and Kalaian and Kasmin, 2012.\n67\n As indicated "] [23.17917823791504, 9.97106647491455, "pically required an attorney to fully investigate the behavior of the alleged victim, while the 4th-degree cases often lacked that particularly difficult aspect. There appeared to be general consensus that the CSC category was overbroad, so the follo"] [23.172182083129883, 9.96318531036377, "es was that such matters, as is true for all CSC cases, require\n81 It should be kept in mind that though the panelists were providing their estimates of average (mean) attorney hours, each value entered into the Delphi application was simply a number"] [23.201801300048828, 9.994097709655762, "dard that has helped make the 40-hour workweek part of the ideal conception of the American way of life.82 But attorneys are likely to be classified as salaried professionals under FLSA and, as such, would receive no additional compensation for time "] [23.21526336669922, 10.007904052734375, "days per year\nDuty days per year\nWork hours per day\nTotal duty hours per year\nAverage reported non\u2013case-related percentage of workweek Non\u2013case-related duty hours\nANNUAL CASE-RELATED DUTY HOURS\nCalculating the Recommended Standards\n365.25 A 7 B 52.2 "] [23.18581771850586, 9.995862007141113, "he input we received from attorneys in all three data collection efforts, we attempted to have the participants step out of their current roles as indigent defenders (if indeed that was what they were primarily doing at the time) and think more broad"] [23.257902145385742, 10.060699462890625, "n a year. As suggested by the calculations above, the two values\u2014average time needed (often referred to as a case weight) and a maximum annual caseload\u2014are related to each other mathematically by whatever estimate is used for annual case-related duty"] [23.24831199645996, 10.050111770629883, "seload and to do so with enough time to deliver effective defenses. To calculate the equivalent of an annual maximum caseload in such instances, we divided those absolute case weights into 1,855.8 hours or\n111,348 minutes, depending on how they were "] [23.24188804626465, 10.044733047485352, "orado Maryland Colorado Texas\nVirginia Washington Texas\nNAC, 1973 Colorado North Carolina New Mexico Colorado Virginia\nCase Type Measure\nEffective Annual Maximum\n Felony 2\nFelonies,upto10yearsimprisonment Caseweight(28.3hrs.) 66\nStandard 64\n Felo"] [23.25656509399414, 10.056563377380371, "n.) 453 Case weight (225 min.) 495 Case weight (217 min.) 513\nCase weight (191 min.) 583 Standard 672 Case weight (147 min.) 757 Case weight (137 min.) 813\n Case weight (93 min.)\n1,197\n 78\nJurisdiction\nRhode Island Idaho Mar"] [23.24955177307129, 10.040621757507324, "20, respectively (essentially just the average hours for each of the two types), while the relative case weights for the two categories would be 4.0 (200 hours for type A cases divided by the 50-hour average for all cases) and 0.4 (20 hours for type "] [23.212121963500977, 10.000425338745117, "B, C, D) felonies (655.8 \u00f7 40-hour case weight), or three murder or manslaughter cases and\n80\nseven CSC cases ([3 \u00d7 120-hour case weight] + [7 \u00d7 40-hour case weight] = 640 expected hours).\nWhat about a situation where an attorney devotes less than fu"] [23.259546279907227, 10.005352020263672, "pical\u201d indigent defense case in Michigan.98 Thus, a one-year misdemeanor has a relative\n98 There is some evidence from both the time study and the attorney survey that at least for the participants in these two data collection exercises, 93-day misde"] [23.216636657714844, 10.008468627929688, "t say with certainty how many are currently handling a number and mix of cases that would exceed the recommended annual maximums. We\n82\nstrongly urge the MIDC, local indigent defense systems across the state, and the Michigan trial courts to work tog"] [23.204490661621094, 10.003528594970703, "ge is that, based on what we learned in the survey, Michigan attorneys do not always limit their criminal law activities to just the nine categories of cases chosen for the caseload standards development effort. Indeed, with the exception of public d"] [23.22389793395996, 10.01952075958252, " exceeds the recommended threshold.\nAs is true for any voluntary survey, however, not all participants answered all questions. Some, for example, provided information sufficient to calculate the percentage of all case-related time devoted to indigent"] [23.24751853942871, 10.049651145935059, "ast double the maximum.\nTable 5.7. Weighted and Proportionally Adjusted Caseloads of Attorney Survey Respondents Percentage of Reporting Attorneys\n Level\nDoes not exceed standard Up to 24% over standard 25% to 49% over standard 50% to 74% over s"] [23.207698822021484, 10.028071403503418, "nt defender caseloads, at both the local system level and the individual attorney level, will be needed going forward to make sure that the standards continue to accurately reflect the evolving challenges and the unique local legal cultures facing de"] [23.094385147094727, 9.881937980651855, "from Participants in the Attorney Survey\nThe comments below were submitted by defenders responding to the attorney survey. The submissions, in alphabetical order, have been lightly edited for clarity and to avoid providing individually identifiable i"] [23.101226806640625, 9.888480186462402, " in other counties, an appointed attorney is often required to be in more than one place at one time and judges should be understanding about that situation and/or not create such\n 88\n conflicts to begin with (as far as practicable); some jud"] [23.080162048339844, 9.871285438537598, "lines, and impeachment issues. Furthermore, Westlaw & Lexis allow for running background checks on potential witnesses which allows for the defense attorney to obtain impeachable information in order to do their jobs effectively. Note the prosecutor "] [23.078838348388672, 9.867037773132324, "rsonal protection orders). It also allows defense counsel access to the other public records and PPOs of potential witnesses or alleged victims\u2014that may undercut their credibility and be used to impeach them (or to engage in additional investigation)"] [23.1002197265625, 9.887598991394043, "ed to testify to impeach a witness. A defense attorney cannot conduct the investigation and later be a both a witness and defense attorney; the ethics rules don\u2019t allow it.\nPARALEGALS & INTERNS. They could be used to streamline costs if properly trai"] [23.109844207763672, 9.897357940673828, "ed by time; the time taken should be whatever is necessary to properly and thoroughly defend any client.\n11. Every case is different, of course; e.g., in the CSC 4th case I am handling now, the assistant prosecutor was able to leverage a plea out of "] [23.082706451416016, 9.870088577270508, "for child support.\n 92\n Our office has anywhere from 25\u201370 interns depending on the term. None of the interns are full-time. Many are not even half time, coming in only 1\u20132 days a week. Our office has one full-time support person. The rem"] [23.098543167114258, 9.885905265808105, "ttorneys to research and print as well as other attorneys who work and can assist, that would be helpful.\n31. In our office, all felony matters are handled by rotating judges in one central location. As a result, multiple attorneys may have worked on"] [23.105323791503906, 9.893143653869629, "how many jail visits are compensated make it difficult to represent some clients when they do not comprehend the ramifications or impact to their life. Also the time necessary for forensic evaluations delays the ability to adequately communicate to c"] [23.07788848876953, 9.86522102355957, "s a day, by the time you add it all up, YOU ARE WORKING. When smart-minded attorneys bill for a retained case, they charge by the hour for wait time.\nWhy are we broke? Hidden reasons. We run up miles on our car shockingly fast, and thus have to repla"] [23.118282318115234, 9.906477928161621, "rance.\n46. Murder cases require an extensive amount of preparation to appropriately provide effective and zealous counsel representation. At a minimum, counsel should allocate 350 hours to appropriate legal and factual investigation, in addition to p"] [23.1051082611084, 9.892522811889648, "n sharing statewide for special issues.\n52. Not enough money for investigators, research, or other things that the state get but as defense attorneys we don\u2019t.\n53. Our lack of funding inhibits our access to experts and investigators. Adding arraignme"] [23.103960037231445, 9.890961647033691, "er form it comes in such as staff, equipment, etc.\n63. The biggest problem is that there is not adequate compensation for attorneys accepting court appointments. The pay should be hourly, at least $150.00 per hour and travel time and research should "] [23.092941284179688, 9.880516052246094, "her than the public hallway outside the courtroom.\n71. This time study should be modified into two separate categories. 1. Those offices that do not have vertical representation at the time of the study and; 2. those offices that do have vertical rep"] [23.073862075805664, 9.861723899841309, "ke in simply attempting to keep in touch with their clients. While I recognize that there are finite resources related to all publicly funded projects, including the delivery of indigent defense, the issue in developing caseload projections should re"] [23.108808517456055, 9.895588874816895, "cket, and I think you guys know about it. You must because the data exists. Why can\u2019t this be talked about publicly?\n78. We are given no resources or money for experts or additional testing. Our time is sucked away sitting in a judge\u2019s courtroom aski"] [23.139751434326172, 9.928495407104492, "gard to that case type). We have edited the original comments for clarity and dropped some that appear to only have been notes intended for the sole use of the submitter.\nMurder or Manslaughter\n\u2022 I expect a great deal of discovery in these cases, as "] [23.135149002075195, 9.925567626953125, "t development.\n\u2022 Will always conduct prelim, investigation, lots of discovery, and even if it is \u201cjust a CSC\n4,\u201d there are still lifelong consequences.\n\u2022 Need to deal with experts and tons of story development.\n\u2022 Even within CSC 1, a child vs. adult "] [23.147581100463867, 9.937797546386719, "ime is meeting with client; typically less is for discovery.\n\u2022 Usually not that complicated.\n\u2022 Less discovery for most cases, easier to negotiate.\n\u2022 Based on talking to client, investigation.\n\u2022 Probably less intense discovery, client will most likely"] [23.217693328857422, 10.070962905883789, "egal_aid_indigent_defendants/ ls_sclaid_def_train_eight_guidelines.authcheckdam.pdf\n\u2014\u2014\u2014, Ten Principles of a Public Defense Delivery System, February 2002. As of September 8, 2018:\nhttps://www.americanbar.org/content/dam/aba/administrative/legal_aid_"] [23.208585739135742, 10.110694885253906, "ange, Vol. 79, No. 8, October 2012, pp. 1525\u20131536.\nHall, Daniel J., A Workload Assessment Study for the New Mexico Trial Court Judiciary, New Mexico District Attorneys\u2019 Offices, and the New Mexico Public Defender Department: Final Report, Denver, Col"] [23.207448959350586, 10.125229835510254, "54zfszmcj4flssj3ni5vgk))/mileg.aspx?page=getObject&o bjectName=mcl-780-991\nMichigan State Bar, \u201cThe Eleven Principles of a Public Defense Delivery System,\u201d 2002. As of September 9, 2018:\nhttp://sbmblog.typepad.com/files/11_priniciples2.pdf\n108\nMichig"] [23.21881675720215, 10.060972213745117, "w, John S. Hollywood, Dulani Woods, Mikhail Zaydman, and Brian A. Jackson, Visions of Law Enforcement Technology in the Period 2024\u20132034: Report of the Law Enforcement Futuring Workshop, Santa Monica, Calif.: RAND Corporation, RR- 908-NIJ, 2015. As o"] [13.093390464782715, 0.7429909706115723, "Law Enforcement Efforts to Fight the Opioid Crisis\nConvening Police Leaders, Multidisciplinary Partners,\nand Researchers to Identify Promising Practices and to\nInform a Research Agenda\nSean E. Goodison, Michael J. D. Vermeer, Jeremy D. Barnum, Dulani"] [13.0999116897583, 0.7433027029037476, "reatment promo- tion opportunities.\n\u2022 Provide same-day, low-barrier access to treatment with a medication-first model of care.\n\u2022 Provide syringe services to reduce associated harms and create treatment intervention opportunities.\n\u2022 Use syndromic surv"] [13.08466625213623, 0.727842390537262, "aw enforcement officers experience additional physical dangers, mental trauma, and stressors. Needs related to officers\u2019 mental health were seen as pressing, and participants gave high priority to strategies such as providing mental health interventi"] [13.06406021118164, 0.7197152376174927, "elated over- dose deaths in 2010. The deadliest wave of the epidemic began in 2013, with the introduction of synthetic opioids into the illicit drug supply. Today, synthetic opioids\u2014primarily fentanyl and its analogs\u2014remain the primary driver of drug"] [13.048844337463379, 0.6921315789222717, "ech given by then\u2013Attorney General Jeff Sessions), the science of addiction and treatment, law enforcement\u2013led efforts to combat opioids, key areas of cooperation among governmental and community stakeholders, law enforcement safety and wellness, and"] [13.044955253601074, 0.6900023221969604, "riety of recommendations to address opioid use, addiction, and its consequences (White- house.gov, undated; Christie et al., 2017). The report acknowl-\nedges that effective solutions to a crisis of this scope and scale will require significant invest"] [13.065272331237793, 0.7192116379737854, "ces, the amount of dopamine in the body is naturally regulated by another chemical, gamma-aminobutyric acid (GABA). However, opioids bind to the part of the nerve that reduces GABA release, resulting in a prolonged release\nof dopamine. Opioids are re"] [13.080904960632324, 0.7556862831115723, " opioid use interferes with the brain\u2019s reward system by impairing an individual\u2019s ability to experience pleasure. This compounds compulsive opioid use as individuals seek to both re-achieve the rewarding effects of drug use and relieve withdrawal sy"] [13.082351684570312, 0.7207967042922974, "ses to the crisis. The topics of interest were identified based on literature review and discussions among RAND, PERF, and NIJ experts. Each panel included a set of prepared presentations on different facets of the topic, followed by moderated discus"] [13.068819999694824, 0.7328217625617981, "icers can rapidly administer naloxone, especially in rural jurisdictions where emergency medical services might not be as readily available (Davis et\nal., 2014; Davis et al., 2015). Equipping law enforcement with naloxone can be especially important "] [13.071577072143555, 0.7439293265342712, "ner et al., 2016). Fewer studies have examined the efficacy of law enforcement serving as an entry point to treatment. One nonrandomized controlled evaluation of a LEAD program in Seattle, Wash- ington, found favorable outcomes with regard to recidiv"] [13.052104949951172, 0.768174946308136, " Drug Trafficking Areas (HIDTA) program. The goal of the initiative is to address the basic causes of drug use, rooted in positive childhood development and family influ- ences on decisionmaking. Richards noted that West Virginia has been hit especia"] [13.071049690246582, 0.7312207818031311, "viduals with OUD alive for long enough to eventually get them into treat- ment. As stated by another law enforcement expert, a naloxone deployment functions as a \u201chandshake\u201d with individuals with OUD and helps to build trust and rapport with officers"] [13.11587905883789, 0.7819850444793701, "m. Attendees argued that it is counterproductive for law enforcement to arrest individuals for possession of MAT drugs, such as buprenorphine, because individuals should not be taken off of MAT pre- or postincar- ceration. One expert explained that, "] [13.081862449645996, 0.7385598421096802, "nt these programs. For example, the Deaths Avoided with Nalox- one (DAWN) program was developed by the Ohio Department of Health for the purpose of promoting naloxone distribution among law enforcement officers and training those officers in its use "] [13.084351539611816, 0.7384549379348755, "Matthew Stefanko, Balti- more City Health Department\n\u2022 RxStat\u2014Applying the NYPD\u2019s Data-Driven Crime Fighting Principles of Compstat to Reduce Drug Over- doses and Save Lives, by Chauncey Parker, New York/ New Jersey HIDTA\n\u2022 Overdose Fatality Reviews,"] [13.08133316040039, 0.7329798936843872, " the belief that overdoses are pre- ventable through comprehensive information sharing, proac- tive responses, and strategic focus on identifiable risk. Using\na multiagency, systematic process to examine the underlying dynamics of overdose cases, it "] [13.09699821472168, 0.7494959235191345, "enerally agreed, one participant noted that an exclusive focus on a single indicator can mask other important issues that stakeholders should address. As\nan example, this participant explained that naloxone could be considered successful based solely"] [13.077648162841797, 0.7356542348861694, "However, attendees noted that information sharing can sometimes be limited by the Health Information Portability and Accountability Act (HIPAA).\nOverall, experts expressed the need to start thinking about novel ways to attack the problem as a system "] [13.08437728881836, 0.7086758613586426, " (Pagane et al., 1996; Burgess, Barnhart, and Checkoway, 1996; Herbert et al., 2006;\n 13\nRiediker, 2007). Although dermal transmission from brief\nskin contact is not likely to be a significant risk, according to the National Institute for Occupationa"] [13.084638595581055, 0.7222808003425598, ", storage, and eventual disposal. Standardized training, policies, equipment, and oversight practices are critical to safely handling these nar- cotics but, in some cases, are still lacking because of the rapid spike in opioid use since 2013. Additio"] [13.106959342956543, 0.6905982494354248, "appropriate safety and preventative measures are needed. Attendees also commended the brief, easy-to-understand, educational video that was pro- duced by BJA to provide clear and consistent information about officers\u2019 risk of accidental exposure to o"] [13.109435081481934, 0.6808980107307434, "are on the front lines in terms of assess- ing the shifts in drug use trends and their consequences. These substances are identified through samples submitted by law enforcement from drug seizures or through medicolegal death investigations (Morgan, "] [13.149995803833008, 0.6045488715171814, "ed National Forensic Science Technology Center, the Phoenix Police Department was able to conduct a validation project for a field-deployable Raman spectrometer, a device that allows\nfor the potential identification of opioids, in addition to other n"] [13.10883617401123, 0.6582382917404175, " As a result, better information sharing is required to allow laboratories to best assess which drugs are currently in communities and which permutations are caus- ing damage that necessitates greater law enforcement or public health interventions.\nT"] [13.132649421691895, 0.7624021172523499, "ad show that individuals with OUD prefer to be notified about dangerous substances and will positively adjust drug\nuse behaviors when they are given such information. Both\nlaw enforcement and public health experts stated that they\nare obligated to sh"] [14.735572814941406, 1.770390272140503, "egies they thought appropriate, split among the action categories in whatever manner they saw fit. The final contents of each card were defined as a \u201cneed,\u201d and each need is composed of both the title describing a strategy for mitigating the opioid c"] [14.655692100524902, 1.7141928672790527, "ber of votes they received, we find eight top-tier needs, 15 middle- tier needs, and 30 lower-tier needs. Of the eight top-tier needs, one was in the cooperation and data sharing category, and\nthe remaining seven were in the overdose response and tre"] [13.28752613067627, 0.8766835331916809, "heir effectiveness. Finally, three of the\n13 top-tier needs had more than 20 percent of their votes on the research, replicate, and evaluate results action category. We consider these high-priority needs to be potentially promising strategies, but th"] [13.123380661010742, 0.7595235109329224, "y Category\n Category\nOverdose response and treatment promotion\nRelated High-Priority Need\n\u2022 Broaden the use of MAT in the general population and increase accessibility. \u2022 Promote nonenforcement police outreach to connect individuals to treatment. \u2022 "] [13.129085540771484, 0.7615037560462952, "s for Immediate Implementation\nFour of the top-tier needs from the in-group clustering were identified for which more than half of their votes had been placed in the disseminate and promote broad application action category. These needs are classifie"] [13.120857238769531, 0.7543255686759949, " and effects.\u2020\nUse data from rapid analysis of seized materials to inform public health and law enforcement interventions.\u2020\n7.4\n0 10 20 30 40 50 60 70 80 90 100\nPercentage\nNOTE: All of these needs were in the first tier within their groups. Totals mi"] [13.116809844970703, 0.7496885061264038, "ness among officers about stress and trauma from the crisis. Participants also were concerned that officers who might take advantage of these interventions could experience stigma by other officers or even be penalized by reduced job duties as a resu"] [13.10318374633789, 0.7427476644515991, " that law enforcement support for the strategy would be criti- cal, because police presence might otherwise counteract the harm-reduction approach. They suggested that more education is needed around the harm-reduction approach generally and that add"] [13.102706909179688, 0.7416940927505493, "uch an early warning system could be implemented. They noted that being associated with occupational stress or trauma from policing the opioid crisis could carry stigma and result in workplace consequences. Therefore, participation in the system woul"] [13.118358612060547, 0.750903844833374, "ation innovations). This need was derived from the discussion fol- lowing the first two panels. This was the only top-tier need\nnot mentioned in the previous two sections, because approxi- mately 40 percent of votes were in the disseminate and promot"] [13.16268539428711, 0.7976329326629639, " MAT use, expand access and funding for it, and foster collaborations that can more-effectively direct indi- viduals with OUD to MAT options.\nThe next common theme among the high-priority needs and throughout the workshop discussion was the need for "] [14.714646339416504, 1.7034651041030884, "ipants used coins to vote for needs. Figure A.1 shows photos of the voting process and Figure A.2 is a mockup of one of the voting sheets.\nAt the end of the voting, the number of coins was tallied for each category and clustered overall and within ea"] [13.069499969482422, 0.7376533150672913, "ington, 2014. As of July 23, 2019: https://soc.washington.edu/research/reports/seattles-law-enforcement- assisted-diversion-program-lessons-learned-first-two-years\nBeeson, Jeff, \u201cODMAP: A Digital Tool to Track and Analyze Overdoses,\u201d webpage, May 15,"] [13.067654609680176, 0.7287430167198181, "er S. Lonczak, and Seema L. Clifasefi, \u201cSeattle\u2019s Law Enforcement Assisted Diversion (LEAD): Program Effects on Recidivism Outcomes,\u201d Evaluation and Program Planning, Vol. 64, 2017, pp. 49\u201356.\nCommunity Oriented Policing Services, \u201cOfficer Safety and"] [13.070672035217285, 0.7477039098739624, "egn, Michael E. Andrew, and John M. Violanti, \u201cHealth Disparities in Police Officers: Comparisons to the U.S. General Population,\u201d International Journal of Emergency Mental Health, Vol. 13, No. 4, 2011, pp. 211\u2013220.\nHartley, Tara A., Khachatur Sarkis"] [13.041020393371582, 0.7015560865402222, "umberg, Don Stablein, Geetha Subramaniam, and John Rotrosen, \u201cComparative Effectiveness of Extended-Release Naltrexone Versus Buprenorphine-Naloxone for Opioid Relapse Prevention (X:BOT): A Multicentre, Open-Label, Randomised Controlled Trial,\u201d The L"] [13.046659469604492, 0.701076090335846, "cription Opioids, Bethesda, Md., June 2018b. As of July 23, 2019: https://www.drugabuse.gov/publications/drugfacts/ prescription-opioids\nNational Institute of Justice, \u201cImproving the Reliability of Drug Tests Done by Officers,\u201d webpage, November 20, "] [13.064108848571777, 0.7209246158599854, "e of Death, Police, Sheriffs, and Health Agencies Must Step Up Their Response, Washington, D.C., September 2017. As of July 23, 2019: https://www.policeforum.org/assets/opioids2017.pdf\nPolice Executive Research Forum, Building and Sustaining an Offic"] [13.081374168395996, 0.7358576655387878, "https://www.justice.gov/opa/pr/attorney-general-sessions-announces- new-tool-fight-online-drug-trafficking\nU.S. Food and Drug Administration, \u201cInformation About Medication-Assisted Treatment (MAT),\u201d webpage, February 14, 2019. As of July 23, 2019: ht"] [13.917131423950195, 4.180327415466309, "rch, research methodology, program evaluation, police use of technology, and national data-collection efforts. Prior to join- ing PERF, Goodison was a law enforcement analyst and civilian researcher for the Washington, D.C., Metropolitan Police Depar"] [13.879739761352539, 4.309675216674805, "ring together practitioners and subject-matter experts to highlight promising practices and develop a prioritized research agenda for future law enforcement efforts to combat the opioid crisis. This report and the results it presents should be of int"] [9.630291938781738, -1.8413255214691162, "Research Report\nUnderstanding the Economic Benefit Associated with Research and Services at the National Institute for Occupational Safety and Health\nAn Approach and Three Case Studies\nBenjamin M. Miller, David Metz, Troy D. Smith, Jesse Lastunen, Er"] [-0.41988709568977356, 13.587982177734375, "Resilience and Environmental Policy\nThe research reported here was conducted in the RAND Infrastructure Resilience and Environmental Policy program, which performs analyses on urbanization and other stresses. This includes research on infrastructure "] [9.622285842895508, -1.8301435708999634, "........................................................................4 Limitations.................................................................................................................................................6 Structure of the R"] [9.689955711364746, -1.8366256952285767, "....................................................................................................29 Approach for Estimating the Economic Benefit of Firefighting Risk Control Measures .......................30 Steps 1 and 2: Identify the Target Pop"] [9.616466522216797, -1.8312954902648926, "y of Key Findings ......................................................................................................................61 Limitations...................................................................................................."] [9.619682312011719, -1.8180488348007202, ".................................................................... 40 Table 3.4. Estimated Annualized Benefits of Avoided Fatal and Nonfatal Cancers for\nFirefighters Due to the Adoption of Control Measures over a 60-Year Time Horizon\nUsing Willingn"] [9.641578674316406, -1.8177067041397095, "arch and in intended users. The first case study examines research to develop, test, and support implementation of engineering control measures to limit exposure to silica among road construction workers and offers an example of NIOSH\u2019s intervention "] [9.63110637664795, -1.8248697519302368, " value associated with research conducted in partnership with industry and labor to develop, test, and support implementation of engineering controls to limit road construction workers\u2019 exposure to silica dust. Based on the willingness-to-pay and VSL"] [9.622572898864746, -1.829515814781189, "illion to $11 million in new streams of annual productivity gains per year, and almost $700,000 to more than $16 million in avoided uncompensated wage losses per year.\nThere are limitations to this analysis. First, given limitations in available data"] [9.684588432312012, -1.876968502998352, "yan and P. Timothy Bushnell, who helped ensure that we had timely access to key documents and stakeholders. We also thank Philip Armour of RAND and John Mendeloff of RAND and the University of Pittsburgh for providing careful reviews of earlier draft"] [9.607409477233887, -1.8317453861236572, "nding the benefits associated with this or any agency\u2019s research activities. The first is that the benefits of research can occur many years in the future. Also, it is often difficult to determine whether NIOSH made a significant contribution to valu"] [9.599871635437012, -1.835131049156189, "oth. Throughout, we considered suggestions made by NIOSH and incorporated these into the analysis and report, where deemed appropriate. However, we alone developed the methodology and conducted the analysis, and the terms of the contract for this pro"] [9.606998443603516, -1.8290692567825317, "tion, we briefly describe these cases.\nCase Study 1: Supporting Development of Silica Controls in Asphalt Pavement Milling\nThis case study focuses on NIOSH research conducted in partnership with industry and labor to develop, test, and support implem"] [9.644301414489746, -1.8176252841949463, "eletal disorders. The case study examines research that was used to justify an expansion of Ohio\u2019s program and appears to have encouraged other states to adopt the interventions. It provides an illustration of NIOSH conducting intervention research i"] [9.635282516479492, -1.8237673044204712, "ten lacking for many key parameters of the economic benefit models we estimate. Thus, the case study chapters walk the reader through a transparent set of logical steps, marshaling quantitative estimates where possible, and providing transparent disc"] [9.632652282714844, -1.8435351848602295, "matic overall evaluation of NIOSH\u2019s research investments. Additionally, we note that the benefits of research should ideally be evaluated in the context of the cost of producing it. We initially set out to include estimates of costs as part of this p"] [9.625042915344238, -1.8330130577087402, "ries and the effectiveness of these measures in reducing workers\u2019 exposure to silica. Finally, we provide estimates of the economic benefit of the illnesses and deaths likely averted by use of these control measures and consider NIOSH\u2019s potential rol"] [9.619384765625, -1.834879755973816, " a partnership that included the National Asphalt Pavement Association (NAPA),8 NIOSH assisted the five largest asphalt paving machine manufacturers in developing prototype fume control measures for their hot-mix asphalt pavers and then independently"] [9.609047889709473, -1.8380577564239502, "pational exposure to respirable crystalline silica, proposing a new PEL of 50 \u03bcg/m3.\n2014 All major asphalt milling machine manufacturers sign letters of commitment to install dust control measures on half-lane or larger drivable milling machines by "] [9.622798919677734, -1.833147644996643, "ey disease\u201d (OSHA, 2016b, summary). In response to the NPRM, and as a result of the evidence from NIOSH\u2019s field surveys through the partnership, all manufacturers of asphalt pavement milling machines sold in the United States signed letters of commit"] [9.630436897277832, -1.8110616207122803, "kely that ventilation controls will be installed on the vast majority of cold milling machines several years before 2024.\nApproach for Estimating the Economic Benefit of Silica Control Measures\nHaving described NIOSH activities and documented their l"] [9.628483772277832, -1.8320817947387695, "ion control measures needed to reduce exposure from cold milling machines. Manufacturers would have had to independently develop these controls.\nWe note that it is likely that awareness of the risks of silica exposure during road milling would have e"] [9.586280822753906, -1.867798089981079, "very five years, is the most complete official measure of U.S. businesses and the economy.12\nStep 2: Estimate the Number of Affected Workers\nFor this analysis, we start with the entire population of road construction workers using portable or mobile "] [9.62711238861084, -1.8358588218688965, "ers\nTotal\nAffected Workers\n1,977 4,943 6,921\n NOTE: The total is not precisely the sum of the two categories because of rounding.\nStep 3: Estimate the Reduction in Exposure\nWe rely on NIOSH research and field testing to estimate baseline exposure "] [9.609591484069824, -1.8327271938323975, "he reduction in fatal and nonfatal illnesses.\nTable 2.4 summarizes the estimated number of avoided fatal and nonfatal illnesses associated with reducing exposure levels from baseline to postintervention levels, as described in step 3. For example, th"] [9.587520599365234, -1.8426493406295776, "s according to the gender and age distribution of road construction workers.18 We inflation-adjusted medical costs to 2016 dollars using BLS\u2019s Consumer Price Index for medical care.\nTo calculate average medical costs for the affected population, we t"] [9.583910942077637, -1.8512189388275146, "tic product (GDP) implicit price deflator.\nTo construct an average total lifetime cost for lung cancer fatalities, we combined medical costs and productivity losses. For each avoided fatality, we estimate total medical costs, productivity losses asso"] [9.598487854003906, -1.8406060934066772, "s. Our analysis estimates a stream of benefits over time. Benefits will phase in over several decades because health risks depend on cumulative occupational exposure over a 45-year working lifetime based on occupational tenure in road construction. A"] [9.60948371887207, -1.8125429153442383, " these benefits over 60 years on an annualized basis to estimate the total benefit attributable to NIOSH research activities.27\nSummary of Assumptions Made in Estimating Benefits\nGiven gaps in available data, we made several assumptions in estimating"] [9.60985279083252, -1.8383359909057617, "hat highway, street, and bridge construction workers using half-lane and larger cold milling machines benefit from significantly reduced exposure to respirable crystalline silica due to the adoption of ventilation control measures. With the WTP and V"] [9.64633560180664, -1.814222812652588, "ple, tend to be significantly larger than avoided medical costs because they are based on individuals\u2019 WTP for small reductions in the probability of dying, while medical costs include actual costs incurred by individuals and, in some cases, third-pa"] [9.602042198181152, -1.8248400688171387, "osure levels is roughly proportional to the reduction in estimated benefits. However, given nonlinearities in the cumulative risk models used in the analysis, this effect could be more pronounced if the differences in measurement were greater.\nThird,"] [9.627676010131836, -1.8124133348464966, "ualized basis for fatal lung cancers.29 We do not have sufficient data to monetize benefits for other fatal and nonfatal diseases on a medical cost basis. These approaches are not directly comparable; rather, policymakers can use them to answer diffe"] [9.652932167053223, -1.7830756902694702, "the link between cancer risk and firefighting and the ways in which NIOSH\u2019s efforts have built on earlier efforts in this domain. Next, we present estimates of the effectiveness of the control measures developed in response to the original studies an"] [9.655738830566406, -1.7738100290298462, "r\u201d (TriData Division, 2009, p. vi). However, there was widespread agreement among all parties on the need for more research.\nNIOSH Research and Related Activities\nIn 2010, NIOSH researchers began a multiyear study of career firefighters in Chicago, P"] [9.65329360961914, -1.7766714096069336, " about how firefighters could better protect themselves and what fire departments and equipment manufacturers could do to reduce firefighters\u2019 risk of contracting cancer. National firefighter associations developed and published guidelines and proced"] [9.652870178222656, -1.7776646614074707, "ead trade journals and gave presentations and workshops at conferences (Fent, Horn, and DeCrane, 2015; Fent, Horn, Kirk, et al., 2015; Jackson et al., 2014; Fent, Evans, Couch, et al., 2012; International Association of Fire Fighters [IAFF], 2016).38"] [9.658782958984375, -1.770628809928894, "nts: Firefighter Case Study Year Event or Activity\n2010 NIOSHbeginsthelargeststudyoffirefightersandcancerconductedtodate,includingalmost 30,000 firefighters.\nThe initial NIOSH dermal PAH exposure study for firefighters begins (resulting in a NIOSH re"] [9.681070327758789, -1.7533968687057495, "in many departments.\nAlthough many fire safety organizations have developed and promoted exposure reduction guidelines to protect their members from an increased risk of cancer, there is currently no precise, quantitative evidence on how widely these"] [9.657195091247559, -1.773032546043396, "ng and cancer is widely accepted among those in the industry and studies to date have shown an association or correlation between cancer and firefighting, it is difficult to establish direct causation. Nonetheless, for the purposes of analysis, we as"] [9.684531211853027, -1.7390248775482178, "14, and Fent, Eisenberg, Evans, et al., 2013 as a turning point in efforts to prevent cancer in firefighters. Because the NIOSH study (Daniels, Kubale, et\n42 This information is based on internal conversations with NIOSH experts in the study of cance"] [9.656435012817383, -1.7717642784118652, "ene wet decontamination by using dish soap (Fent, Alexander, et al., 2017). However, there have been no systematic attempts to estimate the overall effect. Fent, a NIOSH researcher who studies\n43 Specifically, the IAFF\u2019s website notes that the associ"] [9.65913200378418, -1.7691638469696045, " based on the implementation of the control measures compared with standard practice in the early 2000s. Specifically, we assumed that, in the early 2000s, firefighters did not regularly wear SCBA during overhaul or outside ventilation activities, di"] [9.649948120117188, -1.7830742597579956, "medical costs and productivity losses of cancer together with the total assumed number of cases reduced to provide monetized estimates of the benefit associated with the NIOSH research. As noted above, we provide estimates for six cancers that were i"] [9.633087158203125, -1.8066328763961792, "ighters are men (see NFPA, undated). We also adjusted initial-diagnosis costs by a factor of 1.2 and last-year-of-life costs by a factor of 1.5 to account for patterns of care that have been reported to be more aggressive for younger cancer patients,"] [9.618173599243164, -1.8259574174880981, "\u2019s WTP to avoid an illness. Given insufficient data on age of onset and survival probabilities, this was not feasible. Thus, for nonfatal illnesses avoided,\n48 We derived the productivity loss estimates from the average population estimates in Grosse"] [9.613210678100586, -1.8256773948669434, "90-percent effectiveness of the exposure reduction recommendations and an 85-percent adoption rate for how widely adopted the control measures are.\nWe made assumptions about job tenure, cancer latency, and the value of future benefits. Our analysis e"] [9.641645431518555, -1.792867660522461, "ity of 1.44.55 Therefore, for both approaches, we estimated that the value of future benefits would increase by approximately 2 percent annually.\nFinally, to estimate the total benefit attributable to NIOSH research activities, we calculated the net "] [9.645610809326172, -1.8004833459854126, "fighters in the main estimation, although NIOSH research on preventing cancer among firefighters also likely benefits them. We present estimates for the entire population in a sensitivity test; however, some caveats are noted in the \u201cSensitivity Anal"] [9.654396057128906, -1.7828004360198975, "Buccal and pharynx cancers Malignant mesothelioma Esophagus cancer\nCancer of the large intestine Kidney cancer\nNOTE: As in the silica case, the results are sensitive to the choice of\nestimate for valuing avoided morbidity cases. The total estimated b"] [9.641610145568848, -1.8020597696304321, "23\n5 3\n1\n5 6\n3\nSensitivity 3:\n1.2 Million Firefighters Affected\n14,074 17,807 155 209 248\n54 35\n11\n48 64\n34\n NOTE: Annualized benefits using VSL measures are $1.3\n$3.5 billion for sensitivity 3. We have rounded these numbers, so totals do no"] [9.727594375610352, -1.8313004970550537, "pter Four. Assessing and Disseminating Impacts of Ohio Safety Intervention Grants\nBenefit payments under workers\u2019 compensation programs totaled $62.3 billion nationally in 2014, with medical benefits and wage loss compensation accounting for roughly "] [9.780651092529297, -1.8467638492584229, "ant Case Study\nYear Event or Activity\n2012 BWCworkswithNIOSHtoevaluatetheeffectivenessofthegrantprogram.\nNIOSH, along with others, organizes a workshop, \u201cUse of Workers\u2019 Compensation Data for Occupational Safety and Health.\u201d\n2013 BWCquadruplesthesize"] [9.746465682983398, -1.8378976583480835, "0 percent of the employees in Ohio, not all of those who are employed in Ohio.\n 46\nNIOSH Activities in the Ohio Evaluation Study\nFrom 2009 onward, NIOSH became more heavily involved with BWC, and, in 2010, the two formalized a partnership that incl"] [9.744378089904785, -1.835278868675232, "e success of funded safety initiatives.57 Grants are available for all policyholders, regardless of premium size.\n57 Interview with an MEM official, 2017.\n 47\nTexas Mutual piloted its own grant program in 2016, awarding around $100,000 of safety gran"] [9.733384132385254, -1.8315696716308594, "safety grants issued per state insurer, along with the total sum of the awards per year since 2012.\nTable 4.3. Number of Safety Grants per State Since 2012\n FY\n2012\n2013\n2014\n2015\n2016\n2017\n2018\nOhio Safety Intervention Grants\n126 491 561 521 47"] [9.72558307647705, -1.8288953304290771, "nesses, and fatalities. We used these steps to estimate three categories of benefits associated with the safety grant programs: avoided workers\u2019 compensation costs, associated productivity gains, and avoided uncompensated wage losses. We did not acco"] [9.743589401245117, -1.838104248046875, "d with employees affected by the grants. These are also provided in Table 4.4.\nTable 4.4. Number of Covered Employees, by State and Year\n State Year\nOhio 2012 Ohio 2013 Ohio 2014 Ohio 2015 Ohio 2016 Missouri 2016 Missouri 2017 Missouri 2018 Texas"] [9.746794700622559, -1.836030125617981, "ers by 76.2 percent.65 To do this, we used statewide data on the total medical and wage replacement costs, by year, from Baldwin and McLaren, 2016, and McLaren and Baldwin, 2017, in order to capture costs that insurers incur more than 30 months after"] [9.793268203735352, -1.8325556516647339, "f total costs can be significantly higher than 30-month costs. See Wurzelbacher, Meyers, et al., 2013. 52\n FY 2000 to FY 2009 study period was $35,000.67 In other words, we assumed that average total spending per grant by BWC and the employer is half"] [9.767958641052246, -1.847260594367981, "ants might also be pursuing workplace safety in other ways.\n67 Average BWC spending per grant is between $25,000 and $27,000. Assuming that average BWC spending was constant and average employer spending was slightly higher than the match requirement"] [12.002731323242188, 18.367368698120117, "cement rate. First, we used the statutory wage replacement rate for temporary total disability to estimate the amount of uncompensated wages. If the wage replacement rate is 70 percent, we assumed that total lost wages were indemnity payments divided"] [9.72238540649414, -1.826670527458191, "ey (that BWC provided) of 147 employers that benefited from safety grants between 2009 and 2011 suggest that keeping workers healthy provides significant productivity benefits to employers, improves production quality, and reduces absenteeism. Overal"] [9.763449668884277, -1.8043017387390137, "kers\u2019 Productivity Gains\nCompensation Costs per Year\nOhio 2012\nOhio 2013\nOhio 2014\nOhio 2015\nOhio 2016\nMissouri 2016 162,930 202,509 26,335 Missouri 2017 193,331 238,246 31,338 Missouri 2018 194,950 238,246 31,687 Texas 2016 19,485 59,562 1,961 Texas"] [9.693771362304688, -1.8239761590957642, "efit of the NIOSH research was that, from 2013 to 2017, the Ohio program was larger than it otherwise would have been in our counterfactual, in which the Ohio program did not expand until 2018. Another benefit is that the Missouri and Texas programs "] [9.646041870117188, -1.810279130935669, " be inspired to create similar programs in response to the NIOSH work. More than in the other cases, the impacts of this work are still developing. Nevertheless, we find evidence that, between 2013 and 2017, NIOSH research has been associated with $4"] [9.643205642700195, -1.8107786178588867, "nificantly larger than medical costs.\nIn interpreting findings from the case studies, we must be mindful of the fact that the two approaches to economic valuation answer different types of policy questions, with averted medical costs and productivity"] [9.648526191711426, -1.8121392726898193, "ded uncompensated wage losses per year.\nThe reader should exercise care in interpreting differences among the estimated benefits. First, as noted earlier, the results include a mix of avoided medical costs and productive losses and VSL, which address"] [9.640633583068848, -1.82390558719635, "ting reductions in injuries, illnesses, and deaths to research activities. Where assumptions were necessary, we explained the logic behind them, and, where possible given the project timeline, we conducted sensitivity analyses to clearly show the rea"] [9.656780242919922, -1.7719523906707764, "orce\u2014firefighters, who engage in fire suppression, outside ventilation, and overhaul, and C/P.72 The sources and patterns of exposure are different for these two groups. There are at least four personnel in the C/P category at a typical fire\u2014includin"] [9.657434463500977, -1.7699404954910278, "who do not follow HI/HO guidelines) because they do not enter burning structures or get very close to the fire. However, they typically do not wear respiratory protection.\n 68\nTable B.2. Command and Pump Operation Personnel\u2019s Exposure to Carcinogen"] [9.657382011413574, -1.7704570293426514, "-systemic exposure than the deposition or transfer of contaminants to skin. This is the main reason we estimate less reduction in dermal exposure for firefighters than for C/P personnel when implementing the HI/HO recommendations. Although direct upt"] [9.658357620239258, -1.7703864574432373, "g to remove an accumulation of deposits from over the years. Flame retardant contamination at stations has been documented, but this is a particularly persistent type of compound. The\n70\nimportance of this exposure is hard to assess, but low-level, l"] [9.65934944152832, -1.769139289855957, "arcinogen reduction for firefighters, bringing the total to around 35 to\n45 percent. It is difficult to know whether benzene exposure is more toxic than PAH exposure. Also, given all the assumptions made above, a larger CI is prudent. Thus, a 25- to "] [9.624273300170898, -1.8330527544021606, "lman, Jay Colinet, and Gregory Chekan, In- Depth Field Evaluation: Dust-Control Technology for Asphalt Pavement Milling at South Dakota Highway 79 Resurfacing Project, Border States Paving and Industrial Builders, Contractors, Buffalo Gap, South Dako"] [9.640213012695312, -1.8229098320007324, "7, 2013. As of December 1, 2017:\nhttp://www.ohiomfg.com/grip-assets/pdf/ 2013-06-07_lb_swc_sb_op-ed_05-30-13_statewide.pdf\nBWC\u2014See Ohio Bureau of Workers\u2019 Compensation.\nCDC\u2014See Centers for Disease Control and Prevention.\nCDC WONDER\u2014See Centers for Di"] [9.659771919250488, -1.7696666717529297, "c. As of August 10, 2017:\nhttps://www.cdc.gov/niosh/nas/default.html\n\u2014\u2014\u2014, \u201cConstruction Program,\u201d last updated January 13, 2017a. As of August 10, 2017: https://www.cdc.gov/niosh/programs/const/\n\u2014\u2014\u2014, National Center for Health Statistics, Health, Uni"] [9.713457107543945, -1.717054009437561, "iels, R. D., T. L. Kubale, J. H. Yiin, M. M. Dahm, T. R. Hales, D. Baris, S. H. Zahm, J. J. Beaumont, K. M. Waters, and L. E. Pinkerton, \u201cMortality and Cancer Incidence in a Pooled Cohort of US Firefighters from San Francisco, Chicago and Philadelphi"] [9.659104347229004, -1.76646888256073, "/2010-0156-3196.pdf\nFent, Kenneth W., Judith Eisenberg, John Snawder, Deborah Sammons, Joachim D. Pleil, Matthew A. Stiegel, Charles Mueller, Gavin P. Horn, and James Dalton, \u201cSystemic Exposure to PAHs and Benzene in Firefighters Suppressing Controll"] [9.637951850891113, -1.7940845489501953, "Health Care Cost Projections for the Medicare Population: Summary of a Workshop, Appendix A: Predicting Medicare Cost Growth, Washington, D.C.: National Academies Press, 2010. As of November 30, 2017: https://www.ncbi.nlm.nih.gov/books/NBK52815/\nFSRI"] [9.640250205993652, -1.827713131904602, " Cincinnati, Ohio: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Engineering and Physical Hazards Branch R"] [9.65689754486084, -1.7802448272705078, "nes, Hylton J. G., and Gary P. Stein, U.S. Fire Department Profile: 2015, National Fire Protection Association, April 2017. As of September 28, 2017: http://www.nfpa.org/news-and-research/fire-statistics-and-reports/fire-statistics/ the-fire-service/"] [9.645467758178711, -1.7928359508514404, "7: http://monographs.iarc.fr/ENG/Monographs/vol68/index.php\n\u2014\u2014\u2014, \u201cSilica,\u201d in International Agency for Research on Cancer, IARC Monographs on Carcinogenic Risk to Humans, Vol. 68: Silica, Some Silicates, Coal Dust and Para-Aramid Fibrils, Lyon, Franc"] [9.648016929626465, -1.7881654500961304, "er, \u201cA Reference Lottery Metric for Valuing Health,\u201d Management Science, Vol. 42, No. 8, August 1996, pp. 1118\u20131130.\n\u2019t Mannetje, A., K. Steenland, M. Attfield, P. Boffetta, H. Checkoway, N. DeKlerk, and R.-S. Koskela, \u201cExposure-Response Analysis and"] [9.630102157592773, -1.8041102886199951, "ce\n\u2014\u2014\u2014, Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, Standard 1851, 2014.\n\u2014\u2014\u2014, Standard on the Rehabilitation Process for Members During Emergency Operations and Traini"] [9.720492362976074, -1.7904247045516968, "vember 30, 2017:\nhttps://www.bwc.ohio.gov/employer/forms/publications/nlbwc/ SafeHygPubs1.asp?txtCID=516630970\n\u2014\u2014\u2014, \u201cSafety Grants,\u201d undated (b). As of November 30, 2017: https://www.bwc.ohio.gov/employer/programs/safety/EmpGrants.asp\n\u2014\u2014\u2014, \u201cSafety In"] [9.636331558227539, -1.7908471822738647, "d Other Diseases, Washington, D.C.: U.S. Department of Labor, Directorate of Standards and Guidance, Occupational Safety and Health Administration, OSHA-2010-0034-0469, December 7, 2004. As of December 8, 2017: https://www.regulations.gov/document?D="] [9.625680923461914, -1.7884539365768433, "alth and Human Services (National Institute for Occupational Safety and Health) Publication 2013-147, May 2013. As of November 30, 2017:\nhttp://www.cdc.gov/niosh/docs/2013-147/\nValiante, David J., Donald P. Schill, Kenneth D. Rosenman, and Edward Soc"] [11.209478378295898, 18.16389274597168, "Alysha R. Meyers, Stephen J. Bertke, Michael P. Lampl, David C. Robins, P. Timothy Bushnell, Ibraheem S. Al-Tarawneh, D. Childress, and J. Turnes, \u201cComparison of Cost Valuation Methods for Workers Compensation Data,\u201d in David F. Utterback and Teresa "] [5.6217427253723145, 11.91184139251709, " JUSTICE, INFRASTRUCTURE, AND ENVIRONMENT\nEstimating the Global Cost of Cyber Risk\nMethodology and Examples\nPaul Dreyer, Therese Jones, Kelly Klima, Jenny Oberholtzer, Aaron Strong, Jonathan William Welburn, Zev Winkelman\nSponsored by the William and"] [13.798775672912598, 4.507528305053711, "onmaking as it relates to science and technology, and the concurrent effects that science and technology have on policy analysis and policy choices. The program covers such topics as space exploration, information and telecommunication technologies, "] [5.621338367462158, 11.912338256835938, "............................................................5 From Direct to Systemic Costs..................................................................................................................6 Projecting Future Costs ..................."] [5.618686199188232, 11.914918899536133, "bal Cost of Cyber Risk Calculator User Manual ...................... 37 Appendix B: Review of Model Assumptions ............................................................................... 41 Appendix C: Module Y2 Sector-Exposure Relationship....."] [5.612096309661865, 11.91703987121582, "eedance Probability of Costs for Each Event Type............................................. 45\n vi\nTables\nTable S.1. Summary of Case Study Results for Different Models ................................................ ix Table 3.1. Advisen Data Set "] [5.616164207458496, 11.915679931640625, "e F.2. Sector Variation Elicitation Worksheet....................................................................... 48\n vii\nSummary\nCyber incidents have been increasing in frequency and cost in recent years, with some resulting in hundreds of millio"] [5.619648456573486, 11.912897109985352, "stemic) of $799 billion to $22.5 trillion (1.1 to 32.4 percent of GDP). The purpose of the tool we have developed is to make transparent the underlying assumptions that go into these calculations of the cost of cyber risk.\n2 Dreyer, 2018.\n viii\nThes"] [5.615240573883057, 11.91477108001709, "dam Isles, for reviewing our document and Excel tool.\n x\nAbbreviations\nCGE computable general equilibrium DDoS distributed denial of service GDP gross domestic product\nIP intellectual property\nNIST National Institute of Standards and Technology\nOECD "] [5.620837211608887, 11.912374496459961, " explored cyber cost data from more than 550 sources, including journal articles, reports, and websites.3 Some of these sources focused on catastrophic loss scenarios in different economic sectors, and some focused on the global costs of cyber crime."] [5.625509262084961, 11.906180381774902, "t costs in the United States and Canada ($225 and $190 per capita) and the lowest in Brazil and India ($79 and $64 per capita). Costs were also far higher for health care ($380) and financial services ($249) than for media ($119), research ($101), an"] [5.614606857299805, 11.915596008300781, "ledges the considerable uncertainty in the frequencies and costs of cyber incidents. This methodology (1) identifies the value at risk by country and industry sector; (2) computes direct costs by considering multiple financial exposures for each indu"] [5.6154656410217285, 11.917465209960938, " this model, we first defined the following four sets:\nCountries: \ud835\udc50 \u2208 \ud835\udc36 Industry sectors: \ud835\udc56 \u2208 \ud835\udc3c Economic exposures: \ud835\udc52 \u2208 \ud835\udc38 Perils: \ud835\udc5d \u2208 \ud835\udc43\nThat is, we constructed a model with a set of countries \ud835\udc36, industry sectors \ud835\udc3c, economic exposures \ud835\udc38, and perils \ud835\udc43."] [5.614840507507324, 11.916617393493652, "untry Levels\nWe calculated direct costs to output and GDP for each sector \ud835\udc56 in country \ud835\udc50 by relating the sets (c, i, e, and p) to \ud835\udc3a), the GDP of country c.\nFirst, we define \ud835\udc64), as sector \ud835\udc56\u2019s share of GDP in country \ud835\udc50. Thus, \ud835\udc64), \u2217 \ud835\udc3a) is the value adde"] [5.606919288635254, 11.929543495178223, "t model. When a disruption takes place within a firm, the costs are not necessarily contained within the firm, and there are broader supply-chain impacts that could be realized. Our approach allows for the inclusion of upstream impacts within the sup"] [5.599081516265869, 11.939743995666504, "e input-output model is its computational tractability arising from the linearity assumption regarding production functions.19 Because the supply chain is embedded within the SAM, it is simply a matter of matrix manipulation to obtain the economic im"] [5.612775802612305, 11.919379234313965, "ion, $B in systemic costs (upstream) in banking, and so on, regardless of whether the damages were caused by a hurricane, a war, a cyber attack, or something else. Thus, when we use direct costs to inform systemic costs, we only need the direct costs"] [5.614721298217773, 11.917792320251465, "the direct output costs of cyber attacks on sector i, and \ud835\udc67),? be the entry in the ith row and jth column of (\ud835\udc3c\" \u2212 \ud835\udc34))CD. Systemic output costs in sector i (\ud835\udc60),*) arising from direct costs to output are\n\ud835\udc60),* =\n20 OECD, 2017c.\n21 Lloyd\u2019s, 2015.\n22 Llo"] [5.614147663116455, 11.91730785369873, "ted values and probability distributions of outputs.\nSets\nCountry (C)\nRecall that we defined c as a particular country within a set of countries, C. Per the Ponemon Institute reports, the countries and regions currently suffering the most cyber attac"] [5.615838527679443, 11.917074203491211, "sibly be harmed, independent of hazard type. We consider these exposures, not in their direct contribution to GDP, but as an input to production that when damaged by a cyber attack could reduce a firm\u2019s total revenue. Following the work of Jacobs, Bu"] [5.6145830154418945, 11.892952919006348, "ystemic costs can be renormalized to payments to labor and payments to capital, but the OECD data do not disaggregate these two forms of payment. Because we are not calculating loss of life in the current version, we will not be pursuing the role of "] [5.64655876159668, 11.853517532348633, " Lockheed Martin.34 The phases of the cyber kill chain include reconnaissance, weaponization, delivery, exploitation, installation, command and control, and actions on objective. Rather than explore actions throughout the kill chain, we focus on unde"] [5.650386810302734, 11.840582847595215, " Democratic National Committee attack are widely considered acts of cyber warfare, while the U.S. Office of Personnel Management hack is widely considered an example of espionage.\nWe emphasize that this approach removes the need to define the point o"] [5.61386775970459, 11.917679786682129, " income of utilities and systemic cost in net income of users\nLoss of $81 million in assets\nDirect costs to Dyn\u2019s net income and systemic costs to net income of customers\nNet income losses borne through business interruptions\nUtilities\nPublic\nTechnol"] [5.593507766723633, 11.900994300842285, "Specifically, research by Jacobs, Bulters, and van Wieren37 investigates financial sheets from approximately 50 Dutch companies and defines a relationship between financial exposures (e) and company revenue as given in Table 3.3.\nTable 3.3. Module Y1"] [5.614715576171875, 11.918426513671875, " to add transparent rigor to the analysis of potential cyber costs to the economy. While we draw inspiration from the Jacobs, Bulters, and van Wieren38 analysis using income, assets, and IP as inputs, each term is slightly ambiguous. For example, inc"] [5.614370346069336, 11.921669006347656, "squares regression for each sector. Table 3.4 displays the coefficients, number of observations, and fit for each sector-specific regression, including a regression with all sectors. The regression makes two notable limiting assumptions. First, the r"] [5.609421730041504, 11.914896965026855, "at R&D has generally weak impacts on revenue, while total assets have the strongest impact. In fact, most intervals on \ud835\udc4c),,t&u include the value 0, implying that R&D (and, therefore, IP) may, in some cases, have no impact. In comparison, \ud835\udc4c),,v*wxy z{"] [5.615833282470703, 11.914565086364746, "lthough the model allows entering peril-exposure estimates by country and industry sector, due to limitations in available data, we were unable to distinguish the exposure-peril relationship by industry sector. For the examples shown in this document"] [5.614810466766357, 11.917595863342285, "is to measure potential economic damage rather than predict the level of damage in any given year. That is, we aim to provide a high-level estimate which, while only met in the extremes, provides insight into the total risk to the economy at large pr"] [5.611052513122559, 11.913705825805664, "ail\nOil, gas, and chemicals*\nUtilities*\nOther\n NOTE: Some sectors are not included due to insufficient data.\n* Due to an insufficient amount of data on the oil, gas, and chemicals and utilities sectors, bootstrapped values for the \"other\" secto"] [5.608188629150391, 11.91470718383789, "0.0017,0.0017, 0.80)\nT(0.0023,0.0023, 0.12)\nT(0.00032,0.00032, 0.033)\nT(0.0023,0.0023,0.12)\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\nmode, and c is the maximum\n 0.26 0\n T(0.000083,0.000083, 0.0082)\nT(0.0023,0.0023,0.12)\nT(0.00013, 0.00013, 0.068)\nT(0."] [5.615129470825195, 11.914382934570312, "cost of cyber crime in the Netherlands, build on the strengths of our model to allow for an improved understanding of annual impacts. Others, such as Lloyd\u2019s business blackout, demonstrate how our model may be applied to specific extreme events. Tabl"] [5.617391586303711, 11.910107612609863, ", we ran the model for the cost of cyber crime in the Netherlands, which has been estimated to be 1.5 percent of the Netherlands GDP.41 We assumed base inputs. We found the following:\n\u2022 Model 1: Dutch Peril and Exposure Estimates. Direct GDP losses a"] [5.615594387054443, 11.916617393493652, "ution of risk. This can be achieved by adjusting the severity and scale inputs to the desired period where 1 = 100% = loss of all output for one year. For example, if the attack resulted in loss of all output for one month and then a complete recover"] [5.606488227844238, 11.916419982910156, "ervices. A potential stand-in or shortcut for this data- intensive task is to leverage previous studies on sensitivities by industry to particular inputs, such as information and communication technologies use or energy.\nSensitivity to the Choice of "] [5.612193584442139, 11.910629272460938, "lic\nTechnology and electronics Telecom\nTransportation\nUtilities\nWholesale and retail Other\nU(0.0023,0.12) T(0.0023,0.0023,0.12) B(0.06, 0.35)\nU(0.00017,0.031)\nU(0.012, 1.97)\nU(0.0017, 0.80)\nU(0.0023,0.12)\nU(0.00032, 0.033)\nU(0.0023,0.12)\n0.26\nU(0.000"] [5.612375736236572, 11.919447898864746, "sts?\nUsers will likely want to update model assumptions to investigate their research question of choice. The examples provided in the model were built with publicly available data, and there are a number of potential improvements to sets and inter-s"] [5.613563537597656, 11.91856861114502, "iven that utilities are damaged, there is likely damage both upstream (companies that used to sell parts to the sector of utilities but cannot sell as many because the demand is reduced) and downstream (lights are out and other sectors cannot functio"] [5.608455657958984, 11.917098045349121, "and Generate Sector-Category Map buttons. These buttons will generate new tables for the user to fill on the Peril-Exposure Template, Sector-Exposure Template, and Sector-Category Map worksheets, removing all data from the sheets while doing so. The "] [5.6102423667907715, 11.916069030761719, "Data Element Lists sheet is clicked, it updates both worksheets listed above. The intent is that the user would then make copies of these\n38\nworksheets as needed and populate them with point estimates and/or probability distributions for analysis. Th"] [5.612493991851807, 11.917956352233887, "termediate calculations in the GDP and systemic costs estimation. If the GDP by sector table is selected, a pie chart displaying GDP, direct costs, and systemic costs (in diagonal and horizontal hatching, respectively) for each sector is shown. The c"] [5.602741241455078, 11.950333595275879, "from specifically including cybersecurity controls, insurance, or other mitigation methods in this model. Accordingly, the model can be updated to include them but does not focus on them. To include controls or insurance, a user could alter the secto"] [5.613635063171387, 11.9111328125, " 1.00 \u20130.02\n0.05 3.62 0.00\n0.09 1.61 0.13\n0.03 0.54 0.59\n0.03 \u20131.80 0.07\n0.16 \u20130.16 0.88\n NOTE: Some sectors are not included due to insufficient data.\n9 0.99\n0.11 0.45\n0.24 0.82\n43\nR&D\n All sectors\nBanking\nBusiness and professional services Consum"] [5.673153400421143, 11.784188270568848, "ed are omitted.\n48 See Advisen (2017) for more information about the data set. 45\n Appendix E: Characterizing Attackers and Perils\nThis appendix provides a taxonomy for characterizing attackers and perils. Potential attackers are categorized by the"] [5.613755702972412, 11.91707992553711, "versary communications in conjunction with electronic warfare, disruption of adversary civilian Incident Command System\u2013 managed systems leading to physical effects\n 46\nAppendix F: Potential Expert Elicitation Format\nWe developed an expert elicitat"] [5.6247429847717285, 11.90228271484375, "panies for Data Breaches, 2010. Advisen, \u201cCyber Loss Dataset,\u201d 2017. As of January 2, 2018:\nhttps://www.advisenltd.com/data/cyber-loss-data/\nAssociation for Financial Professionals, 2015 AFP Payments Fraud and Control Survey: Report\nof Survey Results"] [5.634345531463623, 11.883794784545898, "ss-blackout20150708.pdf\nLloyd\u2019s, Counting the Cost: Cyber Exposure Decoded, 2017. As of January 4, 2018: https://www.lloyds.com/news-and-insight/risk-insight/library/technology/countingthecost\nLockheed Martin, \u201cThe Cyber Kill Chain,\u201d 2014. As of Janu"] [5.633113861083984, 11.894838333129883, "com/content/en/us/enterprise/media/security_response/whitepapers/\nISTR2016_Ransomware_and_Businesses.pdf\nThompson, I., \u201cNotPetya Ransomware Attack Cost Us $300m\u2014Shipping Giant Maersk IT\nCrippled So Badly Firm Relied on WhatsApp,\u201d The Register, August"] [13.9321928024292, 3.9682114124298096, " JUSTICE, INFRASTRUCTURE, AND ENVIRONMENT\nLaw Enforcement Cyber Center\nFinal Technical Report\nSasha Romanosky, Karlyn D. Stanley, Jirka Taylor, Zev Winkelman\nPrepared for the Bureau of Justice Assistance\nFor more information on this publication, visi"] [13.857756614685059, 4.363964080810547, "was conducted in the RAND Justice Policy Program, which spans both criminal and civil justice system issues with such topics as public safety, effective policing, police\u2013community relations, drug policy and enforcement, corrections policy, use of tec"] [13.996590614318848, 3.5190789699554443, ".............................................................................11\n4. LECC\u2019s List of Regional Capabilities Helped Link Crime Units............................................. 15 Development of Regional Capabilities List ................"] [14.007159233093262, 3.538240432739258, "............................................................... 10 Figure 3.2. LECC \u201cChiefs\u2019 Corner\u201d Page..................................................................................... 13 Figure 4.1. Search Interface of the Directory of Cybercr"] [14.008153915405273, 3.5435214042663574, ". Link crime units\n4. Prevention education\n5. Technical assistance\n6. Justice Executive Cyber Roundtable\n7. Administrative requirements\nDesign and Build Cyber Center\n1a. Development of the LECC website\n1b. Continuous efforts to improve user experienc"] [14.008713722229004, 3.5409140586853027, "nce its utility for users. The database grew to contain 1,007 entries, representing, to our knowledge, the most comprehensive resource available for this type of information.\nPrevention Education\nTo enhance cybercrime prevention, the LECC website hos"] [14.035539627075195, 3.4865407943725586, "thank our peer reviewers, Meagan Cahill at the RAND Corporation and Patrick Mays at the Office of the State\u2019s Attorney for Montgomery County, Maryland.\n ix\nAbbreviations\nBJA Bureau of Justice Assistance\nCCDE Computer Crime and Digital Evidence\nCJTFG "] [14.006003379821777, 3.5436501502990723, "en the management of the LECC transitioned to the NW3C under a different funding arrangement. Therefore, the last six months of the original grant duration were focused on ensuring a smooth transition of LECC ownership and end-of-grant reporting and "] [14.003849983215332, 3.5480759143829346, "nt a new website framework. Outsourcing the technical aspects of the website development accelerated the creation of the website, as well as its subsequent updates. Second, the project team encountered issues with the process for modifying the websit"] [14.00804615020752, 3.52506422996521, " this article helpful?\u201d The response options were initially limited to \u201cyes\u201d and \u201cno,\u201d with accompanying thumbs up or down. Subsequently, those who indicated that information was not helpful were also invited to provide additional information, althou"] [14.002471923828125, 3.542813301086426, "o made use of information available from Google Analytics regarding what content tends to be viewed by which types of users and how they access it.1 The objective of this activity was to ensure that, given the constantly growing content on the LECC w"] [14.009291648864746, 3.519688367843628, "ups for a comprehensive redesign of the LECC website landing page. The objective of this effort was to make the landing page more user-friendly and help users better navigate the LECC website and the resources available there. Building on internal di"] [13.998011589050293, 3.5700478553771973, "en a continuous growth in traffic. Figure 2.1 shows the growth in monthly sessions and page views by domestic users (i.e., traffic coming from the United States2) at the beginning of the last three semiannual reporting periods.3 It shows that between"] [13.999858856201172, 3.5499789714813232, " where visitors to the LECC website come from. Perhaps unsurprisingly, the majority of visitors came from a relatively small number of large metropolitan areas. These are summarized in Table 3.1, including a breakdown by user type based on an analysi"] [14.006524085998535, 3.5434112548828125, " frequently visited section of the website, followed by, depending on the month in question, content on cybercrime investigations (under the \u201cinvestigators\u201d tab) or information on digital evidence (under the \u201cofficers\u201d tab). The development of traini"] [14.003412246704102, 3.548129081726074, " relevant information. To identify content for this section, in 2016, the project team began working with two RSS (Rich Site Summary) aggregators\u2014Google and Primal\u2014to select items that may be of interest to the cybercrime law enforcement community. A"] [13.998355865478516, 3.5416834354400635, " and functions. The objective of the cyber alerts was to inform law enforcement personnel on issues pertaining to emerging technology and to provide guidance for investigations, where applicable. The first two NW3C cyber alerts uploaded to the LECC w"] [14.003717422485352, 3.5438358783721924, "organization\u2019s capabilities, particularly those that were not covered by the original search. Users of the website are also offered the opportunity to provide feedback (e.g., if any information displayed is incorrect) and to contribute new content. T"] [13.998407363891602, 3.5273725986480713, "(see Law Enforcement Cyber Center, undated[g]). The Report Card was intended to help police executives and their information technology departments to build and maintain robust information systems by offering a measure for an agency to evaluate its c"] [14.108500480651855, 3.3167080879211426, "ance\nThe main effort under this task was the development of an instructional document providing information on the creation of a successful cybercrime unit. The model selected for the study was the Utah Department of Public Safety (DPS), also known a"] [14.038858413696289, 3.4729104042053223, "king with the FBI, state information-sharing initiatives, and information sharing with the private sector. The information presented in the\n 20\nreport was intended as a resource for other state and local agencies that are in the process of establishi"] [14.096805572509766, 3.389251947402954, "t\u2019s working sessions. The topics identified during these preparatory calls related to challenges in the investigation and prosecution of cybercrimes. Specifically, the challenges identified were: (1) ability to recognize all levels of digital evidenc"] [14.025521278381348, 3.503110885620117, "oncerns and challenges for cyber investigation and prosecution that merit further discussion and consideration. These are summarized in Box 7.1.\nBox 7.1. Key Concerns and Challenges Identified at the Justice Executive Cyber Roundtable\n 1. The\u201cgoi"] [14.020689010620117, 3.516770601272583, "ment of the LECC website, web analytics, ownership of LECC documentation, and regular reporting requirements. The transition was completed successfully during the reference period.\n 24\n9. Conclusions and Recommendations\nWe provide these conclusions a"] [14.030458450317383, 3.503559112548828, "ment and prosecutors with cybercrime prevention, investigation, and prosecution should continue to broker the exchange of knowledge within and across law enforcement stakeholder groups. The LECC\u2019s\n 25\nexperience with its function as a clearinghouse f"] [14.048266410827637, 3.5063958168029785, "\nTable A.1. List of LECC Training and Technical Assistances (TTAs)\n Courts, judges, law\nSt. Louis, enforcement, legislators,\nIACP LEIM conference Investigations May 2017 Missouri Federal, state, local prosecutors\n Technology Technology Tec"] [14.020299911499023, 3.5066797733306885, "al justice\n Technology implementation,\nMeeting with Utah State Bureau of crime analysis;\u037e technology January\nInvestigation implementation, cybercrime 2016 Sandy, Utah Local Law enforcement\n Equipment, technology, February Washington,\nTask Team Meetin"] [14.130794525146484, 3.4898812770843506, "ciation Section on Science and Technology, Alexandria, Virginia\nTerry L. Sult\nChief of Police\nPolice Department, Hampton, Virginia\nRobert Merner\nAssistant Chief of Police\nSeattle Police Department, Seattle, Washington\n 30\nMichael Yu\nSergeant\nMontgome"] [14.047774314880371, 3.4762160778045654, " Transnational Cyber Investigations: Michael Stawasz, Brendan McHugh, and Anne Beck Tokoph\n\u2022 Panelists provide an overview of current case law and processes\nfor obtaining overseas data, and the impact on state law\nenforcement investigation and prosec"] [13.994522094726562, 3.5002315044403076, " 27, 2017:\nhttp://www.iacpcybercenter.org/news/lecc-cyber-report-card/\nLaw Enforcement Cyber Center, \u201cStrategic Partnerships,\u201d webpage, undated(g). As of December 27, 2017:\nhttp://www.iacpcybercenter.org/about-the-cyber-center/partners/\nLaw Enforceme"] [7.965721130371094, -6.981001853942871, " CORPORATION\nLooking to the Future\nof the Department of\nImmigration and Border\nProtection (DIBP)\nAssessment of the Consolidation of the Australian Customs and Border Protection Service (ACBPS) and the DIBP (2016\u20132017)\n Daniel M. Gerstein, Karen Edwa"] [7.9714508056640625, -6.968362808227539, " analysis. As such, it does not endeavour to repli- cate the previous effort, but rather commences from that starting point.\nRelevant documents and interviews with senior leaders from across the department, including the ABF, were undertaken. While d"] [7.947369575500488, -6.956296443939209, "agement areas (ECM), RAND identified shortfalls. In summary, many of the goals of integration and reform remain a work in progress. In these ECM areas, it will require continued progress and leadership attention to meet the goals set out in the origi"] [7.947596549987793, -6.954009056091309, "......................... 1 Methodology........................................................................................... 2 StudyCaveats........................................................................................... 3\nCHAPTER TWO"] [15.058467864990234, 5.770709037780762, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DIBP Integration and Reform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [7.9404072761535645, -6.956301689147949, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nANNEXES\nA. Interviews Conducted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. Interview Questions"] [7.9489641189575195, -6.959229946136475, "................................... 44\n5.1. Organisation Design Theory as Applied to U.S. Department of Defense...........61\n5.2. Assessment of DHS Progress in Addressing the Strengthening\nDHS Management Functions High-Risk Area, as of March 2016 ..."] [7.952492713928223, -6.965468883514404, "nce the publication of the previous study.\nThis initial analysis required RAND to take a deeper and longer view of the two organisations as they existed, understand how the combined organisation could incor- porate into a single entity, and assess th"] [7.9551286697387695, -6.957052707672119, "sisted in developing lasting institutions and building the foundations for the twenty-first-century border management capacity envisioned in the integration plan. Examples are in areas such as resources for internal capability growth through research"] [7.919821739196777, -6.9367876052856445, "c Findings\nFollow-On Analysis of Key Operational Metrics\nThe integrated DIBP has improved the effectiveness and efficiency of its support for the government of Australia in the customs, immigration, and border protection mission area during the perio"] [7.969404697418213, -6.950679779052734, "held dual citizenship and were subsequently released. On a positive note, the better use of intelligence was important to rapidly resolving these cases. However, the changing demographics of the detention population and officer training deficiencies "] [7.951836109161377, -6.956507682800293, "on-ABF and part of the existing workforce reportedly are disenfranchised by the per- ceived lack of opportunity.\nSpecific Findings: Lessons Learned and Looking Toward the Future\nAn institutional predisposition toward POI versus ECM reform enabled the"] [7.954793453216553, -6.967126846313477, "the department has been laudable in some areas and lacking in others. Continued efforts to mature and, in some cases, build the organisation must continue. While the POI areas have seen important growth, the ECM sides of DIBP have not seen the same o"] [7.946376323699951, -6.958738327026367, "ble future direction for concentration DIBP efforts.\nThe second phase entailed a follow-up to the original RAND study. Specifically, the follow-up effort built on the first study, which examined performance during the period 14 May 2014 to 14 May 201"] [7.924163341522217, -6.986825942993164, " from which determinations could be made about the state of working toward the goals and objec- tives of integration and reform. As an example, the DIBP Corporate Plan 2016\u20132017 provided a basis for understanding the department\u2019s broader outcomes, go"] [7.941556930541992, -6.958948612213135, "on the same data but are assessing two different issues.\nThe RAND team\u2019s assessment was designed to examine how the integrated organ- isation has been performing in the areas of operational effectiveness and efficiency, building capabilities, and cul"] [7.9446539878845215, -6.961612701416016, "indicators of the effects on culture of DIBP and personnel programs. Capability examines whether programs and processes designed to build organisational capacity have been devel- oped. Action plan for reorganisation looks at the planning done before,"] [7.948240280151367, -6.960124969482422, "back under a first assistant secre- tary and efforts have once again slowed, particularly in ECM areas where progress has lagged. With the establishment of HA, deputy secretary leadership has again been established through the creation of the Home Af"] [7.9422688484191895, -6.9585113525390625, "ng to the Future of the Department of Immigration and Border Protection\nTable 2.1\u2014Continued\n Category\nAction Plan for Integration and Reform\nMonitoring Progress\nDescription Assessment\n Specific Findings\nExamination of the reorganisation planning for "] [7.944162845611572, -6.956762313842773, " are expected later in the reorganisation.\nA total of 168 operational program performance measures were provided by the DIBP for consideration; however, either no data or insufficient data was available for 90 metrics, as the data collection methods "] [7.933459281921387, -6.978602886199951, "ictoria, 18 August 2017. As of 7 December 2017: http://newsroom.border.gov.au/releases/abf-continues-to -smash-tobacco-syndicates-in-victoria\n5 Interview with senior DIBP regional official on August 24, 2017, in telephone interview, Australia. (19)\n "] [7.9692511558532715, -6.951757431030273, "ficulties with clarity on delegations and authorities were determined to have an operational impact, introducing ambiguities into roles and obli- gations and unhelpful friction into the operations. An example is in detention and case resolutions, whe"] [7.973203182220459, -6.958446502685547, "andards and professionalise the workforce.\n6 Telephone conversation with DIBP regional official on August 24, 2017, Australia. (19)\n 12 Looking to the Future of the Department of Immigration and Border Protection\nThe area of L&D, particularly in rela"] [7.971284866333008, -6.966215133666992, "7.\n8 Interview with senior DIBP official on August 22, 2017, in Belconnen, Australian Capital Territory. (16)\n9 Interview with senior DIBP official on August 22, 2017, in Belconnen, Australian Capital Territory. (16)\n Follow-On Operational Assessment"] [7.958179473876953, -6.964100360870361, "h a senior DIBP official on August 25, 2017, in Belconnen, Australian Capital Territory. (22)\n11 Interview with senior DIBP official on August 22, 2017, in Belconnen, Australian Capital Territory. (16)\n12 Interview with senior DIBP official on August"] [7.935092449188232, -6.956358432769775, " prototypes or, at best, as the early stages of incorporation within DIBP. The Transformation Delivery Framework and Blueprint provides the documentation and platforms for tracking and building capacity. These tools had been under development, were e"] [7.943153381347656, -6.952581405639648, "lligence and investigations.22\n16 A definition of contestability from the Defence website is: \u201cContestability is a decision support function not a decision-making function. Contestability Division will contest programs and projects across the Capabil"] [7.942744255065918, -6.959148406982422, "press support for further consolidations for ECM areas. Doing so would provide opportunity for greater focus on core operational elements of the mission.\nImplementation of the Integration and Reform Elements\nAction Plan\nIn the initial study, findings"] [7.927063465118408, -6.937868595123291, "ropriately covered. Examples include international engagement and corporate records management.26 Another example is the development of a contestability function for the DIBP, which, to date, remains a recognised shortfall needing to be corrected.27\n"] [7.938409805297852, -6.948976993560791, "on and reform to the deputy secretary level was part of this effort to regain momentum.\nDuring the 2016\u20132017 period, the Transformation Delivery Framework and Blue- print was developed, which should provide a tool and forum for monitoring progress. H"] [7.940934658050537, -6.954724311828613, "d issues with span of control.\nData management and lack of metrics continues to be a source of concern. With the Transformation Delivery Framework and Blueprint now underway, these issues could be mitigated, but progress will need to be monitored clo"] [7.957714080810547, -6.960213661193848, "in those areas where progress has been the greatest and as lessons to improve upon where progress has been lagging.\nCHAPTER THREE\nFollow-On Operational Assessment: Examination of the Five Key Areas\n Introduction\nFive key areas were identified for fur"] [7.949885368347168, -6.957153797149658, "laid out as part of the integration.\nSeveral important initiatives were underway at the time of the initial RAND study. Based on a 2016 Integrated Intelligence Capability Review (Classified), 107 intelligence recommendations were identified, with man"] [7.9566802978515625, -6.964303016662598, "e efforts, a Border Intelligence Fusion Centre (BIFC) was devel- oped in June 2016 to assist with threat identification across the border continuum. The centre includes intelligence gathering and targeting functions, including those previ- ously deli"] [7.963474750518799, -6.966028213500977, "raining, educating, and developing the experience of the individual officer is accomplished; preparing focused intelligence products with the operational consumer in mind becomes commonplace; and forward- looking intelligence products are prepared. O"] [8.002376556396484, -7.001597881317139, "ation of the Five Key Areas 25\nattempting to manually analyse and correlate the inputs. Investments would be benefi- cial to support these data-heavy processes and would undoubtedly require specialised hardware, software, and analysts to operate the "] [7.962455749511719, -6.963200092315674, "ctivities Need for standardised training curricula and career paths\nLack of centralised access to intelligence information\nNo strategic intelligence function in either organisation.\n\u2022 Customs had already started to build the capacity to support a nat"] [7.979323863983154, -6.975985527038574, "nto transnational crime syndicates.\nThe Joint Organised Crime Group investigations into high-level organised crime syndicates, such as the Jomaa syndicate, represent a major investigation success that was significantly undermined by the involvement o"] [7.969536781311035, -6.955776691436768, "s and prioritisation are made on a case-by-case basis. This prioritisation then sup- ports the selection of the cases to be investigated. This process is in its early stages and is continuing to be refined. The overarching intent is to have a departm"] [8.000777244567871, -6.94813346862793, "y focused on correcting this issue was available in October 2017.16\nThe increased capability to conduct external investigations has been further strengthened by the development of human intelligence capabilities feeding investiga- tions and by combin"] [7.965883255004883, -6.964026927947998, "\n 30 Looking to the Future of the Department of Immigration and Border Protection\nTable 3.2\nInvestigations Assessment\nPre-Integration (Pre-2015)\n\u2022 Recognised shortfalls across several areas, including internal and external investigations\n\u2022 Lacked emp"] [7.976161479949951, -6.977223873138428, "amination of the Five Key Areas 31\nhigher-risk detention population. This reflects improvements in risk management and staff professionalism that had been lacking in the former organisation.\nAlso noteworthy is the development of documentation for man"] [7.989582538604736, -6.991201877593994, "contains information on the Child Protection Panel terms of reference and report. As of 12 December 2017: https://www.border.gov.au/about/reports-publications/reviews-inquiries /child-protection-panel-terms-of-reference\n24 Interview with senior DIBP "] [7.9465179443359375, -6.985574722290039, " (2)\n26 Australian Department of Immigration and Border Protection, Immigration Detention and Community Statistics Summary, 31 May 2017. As of 7 December 2017: http://www.border.gov.au/ReportsandPublications/Documents /statistics/immigration-detentio"] [7.938807964324951, -6.951513290405273, "rations (including for contract staff). Despite improvements, several officials commented on the slow pace of development and adoption of policies, the need to refine roles and responsibilities, and the importance of better managing interactions and "] [7.975146293640137, -6.974339008331299, "n not paying sufficient attention to detention operations.35\nRegional authorities expressed similar sentiments regarding accountability in the detention space. Handoffs between the DIBP and the ABF were identified as unneces- sarily hindering case re"] [7.9798970222473145, -6.97792387008667, "rough the detention capability report.\n\u2022 While in early stages, these efforts should improve the department\u2019s operational capacity across the DIBP mission space to include within the detention area.\n\u2022 Progress noted in developing guidance/documentati"] [7.985312461853027, -6.975131511688232, "consequences of lapses in integrity and anti-corruption were foundational elements of the integration and reform efforts.\nUpdates from 2016\u20132017\nCorruption and integrity issues have been a significant challenge and remain one of the highest prioritie"] [7.974804878234863, -6.971399307250977, "or leader provided an example of the progress, highlighting a recent trip to Adelaide during which the workforce expressed support for the recent arrest of one of their own, stating they were \u201cpleased that the workforce is clean,\u201d and that there is \u201c"] [7.97311544418335, -6.971437931060791, " and 2011\u20132012) consistently highlighted the importance of integrity.\n\u2022 The ACBPS Review in June 2013 highlighted the broad need for leadership and workforce reform. Specific language included such areas as \u201cleadership behaviours, responsibilities an"] [7.977657794952393, -6.943744659423828, "an overview of the findings for the pre-integration, post- integration, and reform periods. The pre-integration and post-integration sections have been taken from the earlier report.\nLearning and Development\nInitial Findings\nIn the initial planning, "] [7.97955846786499, -6.947074890136719, "ividual highlighted that corporate L&D is ade- quate, but strongly assessed that the ABF College roles must be clarified.\nThe ABF College is responsible and funded for all non-leadership and non-APS core skills\u2013related training for ABF and certain de"] [7.979964256286621, -6.949270248413086, "ard operations due to a lack of proper training and experience.53 Such skills are part of an individual\u2019s core responsibilities and, therefore, must be mastered, beginning with a firm educational foundation.\nSeveral issues serve to highlight the lack"] [7.98503303527832, -6.950334548950195, "College.\nIn some cases, the ABF College curriculum was not seen as being focused on the highest-priority areas. One senior ABF interviewee lamented that \u201cuse of force\u201d train- ing needed to be incorporated into the curriculum.58 Another commented that"] [7.9716572761535645, -6.949699878692627, "mination of the Five Key Areas 43\nRegarding the self-service online training products developed by DIBP corporate, these have been described as \u201cadequate, but not inspiring.\u201d The courses have been described as repetitive and not updated from year to "] [7.952823162078857, -6.929579734802246, "al official on August 24, 2017, Australia. (20)\n Table 3.5\nLearning and Development Assessment\nPre-Integration (Pre-2015)\n\u2022 Shortfalls had been observed throughout the documents, beginning with the earliest findings dealing with the Alvarez and Rau a"] [7.974669933319092, -6.948554515838623, "\n\u2022 Individuals characterised as non-ABF and part of the existing workforce reportedly are disenfranchised by the perceived lack of L&D opportunity.\n\u2022 Teaching methods and the use of technology have received significant criticism.\n\u2022 The Administrative"] [7.950882434844971, -6.958394527435303, "utiny as the rest of the department.\nWhile a broader study effort would be required to fully examine these issues, the perception is there and would benefit from leadership attention.\nThe Pace of Change\nSenior leaders stated that the pace of change h"] [7.954875469207764, -6.95574951171875, "ogress but also high- light that it has been uneven across the areas.\nFigure 3.1 provides a graphic depiction of the overall assessment of the five areas based on a synthesis of information provided, collected, analysed, and discussed in this report."] [7.938035011291504, -6.932174205780029, "te, leadership, and APS core skills training materials\n Limited improvement Making progress Goals achieved\n L&D I&C Inv Det Intel\n 48 Looking to the Future of the Department of Immigration and Border Protection\nthrough the DIBP Learning and Develop"] [7.9483208656311035, -6.954579830169678, "ased on analysis of data and key documents, interviews with senior staff over the course of the two study efforts, and assessments and observations made by the RAND team.\nIn this chapter, only the most substantial lessons are provided with an eye tow"] [7.959281921386719, -6.962159156799316, "uous assessment and improvement is essential for high- performing organisations.\n\u2013 Even in functions than have been assessed to have largely met the goals of inte-\ngration and reform, a process of continuous improvement must be in place to\nLessons Le"] [7.92946720123291, -6.934847354888916, "d cor- rectly or were omitted in the delegations.\n\u2013 Over the last year, attention has turned to identifying these issues and correct-\ning the shortfalls. A related issue concerns horizontal alignment across other government departments and agencies w"] [7.9393486976623535, -6.950655460357666, "des horizontal\nintegration between DIBP elements.\n\u2022 Where successes in integration and reform have been noted, understanding what\ncontributed to those successes and replicating those efforts would be prudent.\n\u2013 For example, understanding what contrib"] [7.946939945220947, -6.949563503265381, "ween offices could be problematic, as it requires synchronisation and coordination above the FAS level.\nConclusions\nThe lessons learned in this chapter demonstrate the progress made and highlight areas where improvements could be introduced. The degr"] [7.871652603149414, -6.884164810180664, "uding lessons learned resulting from these transformations: http://www.anao.gov.au/work/performance-audit /management-machinery-government-changes\n 55\n56 Looking to the Future of the Department of Immigration and Border Protection\norganisations have "] [7.9283061027526855, -6.943373203277588, "nd-to-end capability development function within the Department to maximise the efficient, effective and professional delivery of military capability\n3. Fully implement an enterprise approach to the delivery of corporate and military enabling service"] [7.928005695343018, -6.9405903816223145, "tained in the First Principles Review of Defence highlights the impor- tant cultural and workforce changes that were planned. Clearly the effort was designed to build capability, with emphasis on enterprise management issues. Regarding the action pla"] [7.928220748901367, -6.943868160247803, "gned to those commands\n\u2022 to increase attention to strategy formulation and contingency planning\n\u2022 to provide for the more efficient use of defense resources\n\u2022 to improve joint officer management policies\n\u2022 otherwise to enhance the effectiveness of mi"] [7.930507183074951, -6.944304943084717, "s, Army, Navy, Air Force, Marines) also has a transfor- mation office. These transformation efforts seek to gain effectiveness and efficiency in the operational forces and support activities.\nThe point of recounting these U.S. DoD efforts is to highl"] [7.897529125213623, -6.906604766845703, "ts?\nWhat are the activities DOD engages in that enable it to make its unique contribution to national security? What are the functions or areas in which the department must build and maintain excellence? Are there functions or tasks that are better s"] [7.940711498260498, -6.949032783508301, "eak central staff, and failing to deconflict the roles and authorities of the organisations.14\nEven today, tensions exist where roles and authorities are unclear and, in some cases, overlapping. As shortfalls have been identified, efforts to rational"] [7.931877613067627, -6.940993785858154, " and rally around.\n3. Focus on a key set of principles and priorities at the outset of the transformation. A clear set of principles and priorities serve as a frame- work to help the organisation create a new culture and drive employee behaviors.\n4. "] [7.937636375427246, -6.947198390960693, "ge. This entails involving all levels of the organisation, from the most senior leaders to the lowest levels of the organisation. It also speaks to the importance of communicating key messages throughout the organisation and gaining buy-in for change"] [7.950186729431152, -6.954494953155518, " Act of 2004 was the most significant legislation affecting the U.S. intelligence community since the National Security Act of 1947 and created the Office of the Director of National Intelligence (ODNI) in 2005.19\nThe overarching goal of the reform e"] [7.950705528259277, -6.953299522399902, "ate elements are not \u201cadequately organised and did not have resources appropriately allocated to fulfill its missions\u201d\n\u2022 Others have indicated that the Intelligence Reform Act has not gone far enough in reforming the IC and that \u201crecalcitrant ele- me"] [7.950392246246338, -6.954808712005615, "ons and surveillance at the external borders.\u201d23 To achieve this goal, FRONTEX supported security at borders and facilitated legitimate flows of people, goods, and services. Its primary mechanism was to support coordination on border management effor"] [7.942783355712891, -6.951119899749756, "arding border management, they decided against a more centralised structure with provisions such as the right to intervene. The provision was seen to be an \u201cunrealistic idea that drew objections from frontline states because it was seen as a violatio"] [7.93283224105835, -6.9410505294799805, "he GAO framework have been introduced, including effectiveness and efficiency and culture and personnel. Indications are that action plans and monitoring progress are being considered, but are seen more as national requirements and far less central t"] [7.921608924865723, -6.928645133972168, "cript\n28 GOV.UK, Single Departmental Plan 2015 to 2020.\n Lessons Learned from Other Transformation Efforts 71\nIn turning toward the reform of the Home Office, May identified five principles that should guide the reform:\nThe right institutions and str"] [7.910048961639404, -6.914605617523193, " to reducing its operating costs over the Parliament, while continuing to improve the efficiency and effectiveness of its services, including through:\n\u2022 increased use of automated data analytics to better identify risks, allowing resources to be targ"] [7.925485610961914, -6.931674480438232, "ing with SMEs by 2020\n\u2022 working in partnership with the Cabinet Office to deliver Arms Length Bodies\u2019 transformation plans, and the Infrastructure and Projects Authority on major projects and programs and prioritisation.\nSOURCE: UK Home Office websit"] [7.944080829620361, -6.959700107574463, "The timelines for change in the integration of the DIBP were overly aggressive and the speed of transition hindered taking a more measured view of the roles, missions, and functions of the elements of the newly formed department.\n\u2022 Excessive personne"] [7.9462995529174805, -6.957128524780273, "n period and resulted in a loss of momentum. Today, it hinders the DIBP from assessing progress on its path forward for developing the twenty-first-century border management capacity for Australia.\nPersonnel issues continue to serve as unnecessary so"] [7.947896480560303, -6.9531378746032715, "assets identified to become part of HA, other government and interna- tional stakeholders that currently interface with future HA elements, and interested external parties.\nAnother major concern expressed by senior officials related to the aggressive"] [7.937358379364014, -6.940792560577393, "applicable national strategies; and the assessment of capability devel- opment requirements and associated resourcing strategies.3\nThe degree to which ECM functions will be brought up to HA-level as shared services has not been fully determined. As s"] [7.906768321990967, -6.916597843170166, "nlike in the DIBP, where one of the initial goals was to build a single culture, most expressed that a single culture should not be the stated outcome, but rather it would be more important to find ways to embrace the different cultures of the organi"] [7.926496982574463, -6.924762725830078, "ty.\n\u2022 The development of HA cannot be a \u201cpick-up\u201d game. It will require first-class\nleadership and execution at all levels and important follow-through.\n\u2022 Key documents such as business plans must be developed and disseminated early in the lifecycle "] [7.940113544464111, -6.9616241455078125, "e totals have gone from approximately 1.2 million to 1.5 million per month, a 20 per cent increase. These increases translate to transactions (that is, additional work to be performed) in support of arrivals and departures. Regarding imports, the val"] [7.943557262420654, -6.9507527351379395, "blishment will require significant deconfliction between the agencies being integrated. Determining design models\u2014centralised versus decentralised, shared services for key functions, or a more limited hub and spoke for key support functions such as i"] [7.943605422973633, -6.954036712646484, "land Michael Milford\nPOSITION\nSecretary\nActing Commissioner (ABF)\nActing Deputy Secretary Policy Group (DIBP)\nActing Deputy Secretary Visa and Citizenship Services Group (DIBP)\nDeputy Commissioner Support (ABF)\nDeputy Secretary Intelligence and Capab"] [7.941299915313721, -6.9588541984558105, "ome Affairs.\nQuestions:\n1. Biographical Information a. Name?\nb. What is/was your position(s) in the government? c. How long have/did you serve?\nd. What are/were your dates of service?\n2. Pre\u00adIntegration (2014\u20132015)\na. How was your organisation functi"] [7.920169353485107, -6.964807987213135, "ersonnel and goods has increased in recent years. Each of these movements creates an increased workload and requires a decision, verification, and potentially an inspection by DIBP organisations and personnel.\nThe overseas arrivals and departures (Fi"] [7.912862300872803, -7.003047943115234, "constant (Number of Visa Cancellations), and the other is decreasing (Illegal Worker Warning Notices Issued) (see Table C.1).\nFor the border infractions related to illegal weapons and drugs, the trends are also mixed, with the number of undeclared fi"] [7.950685501098633, -6.9982452392578125, "ous and inclusive society, and advance Australia\u2019s economic interests through the effective management of the visa and citizenship programs and provision of refugee and humanitarian assistance.\nData associated with this outcome reflects little change"] [7.950547695159912, -6.97783088684082, "7\n100 Looking to the Future of the Department of Immigration and Border Protection\nTable C.2\nCategories of Border Revenue (AUS Dollars)\n Category\nDIBP\nTaxation Revenue\n2015\u20132016 2016\u20132017 2017\u20132018\n17,322,357 17,635,995 18,579,332\n17,259,053 17"] [7.943974494934082, -6.974305629730225, "tizenship Management Deputy Secretary Policy Group\nFinance Division\nMajor Capability\nDigital Transformation and Channels Strategic Policy\nCorporate Services\nTraveller Customs and Industry Policy Integrity Security and Assurance\nPeople Division\nSOURCE"] [7.9868268966674805, -6.994017124176025, "le C.3 provides detailed overviews of the gain and loss for large organisational elements.1\n1 Large was defined as those organisations larger than 100 staff over the period of analysis.\n Abbreviations\n Australian Border Force ABF Australian Customs a"] [7.975670337677002, -6.987496852874756, "ust 2017: https://www.border.gov.au/ReportsandPublications/Documents/reviews-and-inquiries/Capability -Review-Action-Plan-Web.pdf\n\u2014\u2014\u2014, DIBP Corporate Plan 2015\u20132019, Canberra: Commonwealth of Australia, 2015. As of 14 August 2017:\nhttps://w w w.borde"] [7.977879047393799, -6.982565879821777, ". As of 7 December 2017: http://www.defence.gov.au/publications/reviews/firstprinciples/Docs/FirstPrinciplesReviewB.pdf \u2014\u2014\u2014, L&D Operating Structure, Canberra, undated.\n\u2014\u2014\u2014, Leadership and APS Core Skills Learning Curriculum 2016\u20132017, Canberra, unda"] [7.976717948913574, -6.986586093902588, " Report 2013\u20132014, Canberra, 2014. As of 14 August 2017: http://www.border.gov.au/ReportsandPublications/Documents/annual-reports/DIBP_AR_2013-14 .pdf\n\u2014\u2014\u2014, DIBP Annual Report 2014\u20132015, Canberra: Commonwealth of Australia, 2015.\n\u2014\u2014\u2014, DIBP Annual Repo"] [7.9691386222839355, -6.9776611328125, "shboard 20160901, Canberra, 1 September 2016.\n\u2014\u2014\u2014, Minister\u2019s Portfolio Dashboard 20161006, Canberra, 6 October 2016.\n\u2014\u2014\u2014, Minister\u2019s Portfolio Dashboard 20161103, Canberra, 3 November 2016.\n\u2014\u2014\u2014, Minister\u2019s Portfolio Dashboard 20161201, Canberra, 1 D"] [7.975559234619141, -6.986413478851318, "ww.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs /rp/rp1718/Quick_Guides/HomeAffairs\nComrie, Neil, Inquiry into the Circumstances of the Vivian Alvarez Matter, Canberra: Commonwealth Ombudsman, September 2005. As of"] [7.977035045623779, -6.988541126251221, " Monica, Calif.: RAND Corporation, RR-1713-AUS, 2016. As of December 22, 2017: https://www.rand.org/pubs/research_reports/RR1713.html\nGOV.UK, Single Departmental Plan 2015 to 2020, 19 February 2016. As of 7 December 2017: http://www.gov.uk/government"] [7.946789264678955, -6.961740016937256, "erra, 9 June 2017.\nU.S. Government Accountability Office, Department of Homeland Security: Important Progress Made, but More Work Remains to Strengthen Acquisition Management Functions, 16 February 2017. As of\n17 January 2018:\nhttps://w w w.gao.gov/p"] [13.899043083190918, 4.104867935180664, " Addressing Emerging Trends\nto Support the Future of\nCriminal Justice\nFindings of the Criminal Justice Technology Forecasting Group\nJohn S. Hollywood, Dulani Woods, Andrew Lauland, Brian A. Jackson, Richard Silberglitt\n CORPORATION\nFor more informati"] [13.854432106018066, 4.252093315124512, "s, foundations, and the private sector.\nThis program is part of RAND Justice, Infrastructure, and Environment, a division of the RAND Corporation dedicated to improving policy- and decisionmaking in a wide range of policy domains, including civil and"] [14.182693481445312, 3.1230227947235107, "omplete Notes and Mind Map. . . . . . . . . . . . . . . . . . online only\nE. Charters for Global/Criminal Justice Technology Forecasting Group Task\nTeams on Key Information Exchanges to External Service Providers. . . . . . . . . . . . . . . online o"] [14.184761047363281, 3.134967088699341, " 41 42 46\nD.1. Emerging Themes and Constituent Trends from the Criminal Justice TechnologyForecastingGroup....................................................... onlineonly\nTables\nS.1. Themes, Trends, and Ways Ahead from the Criminal Justice Technolo"] [14.165318489074707, 3.1248059272766113, "sed bail and sentencing support; and tools to identify services needed by those on community supervision. The emergence of situational-awareness displays in improving form factors (e.g., tablets, smartphones) offers opportunities to get needed infor-"] [14.156880378723145, 3.12333345413208, "ppendix F, available online).\n\u2022 Need to define and dis- seminate the value of fusion centers\n\u2022 Lack of established business processes for operationalizing new technologies\n\u2022 Emergence of analytics and enabling big data\n\u2022 Emergence of \u2022 situational-aw"] [14.1017427444458, 3.0725719928741455, "rity, privacy, and civil-rights planning and protections into the business cases and processes recommended in Table S.1.\nThere is a need to advance from small information-sharing pilots to field-wide inte- gration of information. Group members discus"] [14.149711608886719, 3.122300148010254, "lling business cases, a lack of established processes for implementing technologies, a lack of nationwide shar- ing capabilities to get needed information, and problems with ensuring security, privacy, and civil-rights protections. These issues repre"] [14.169093132019043, 3.122514486312866, "reats, which are most likely to affect criminal-justice practice significantly in the next three to five years. The CJTFG was tasked to (1) identify major, emerg- ing social and technology trends; (2) assess the impacts that these trends could have c"] [14.174972534179688, 3.136975049972534, "ling the future of information-sharing. Panelists also discussed and rank-ordered technologies and technology issues by how much impact they would likely have on criminal justice in the next three to five years (i.e., 2015 to 2020).\nMeeting 2\u2019s break"] [14.19244384765625, 3.1099178791046143, "a and Civil Rights, 2015); and the graduated-reentry concept for reducing incarceration rates.\nOur approach to capturing the deliberations was based on the Futures Wheel concept (Glenn, 1972), which captures an initial trend, potential direct (first-"] [14.1861572265625, 3.1136887073516846, "eing addressed elsewhere\n Response A Response B\n At the end of meeting 3, we had captured 22 trends and associated impacts, potential responses, and relationships among them. Appendix D, available online, provides detailed notes from the meeting; the"] [14.167509078979492, 3.1200878620147705, " problems and oppor- tunities recognized in the individual trends\n\u2022 nonredundant, in terms of not being addressed through other major initiatives.\nMeeting 4 (2016), a conference call, was a structured review of the analyses described above and the dr"] [14.162788391113281, 3.1225717067718506, "erging from CJTFG\nEmergence of situational-awareness\ndata streams\ndata and analytics and the challenges Emergence of big of using them\nNeed to advance from small-scale to nationwide information-sharing\nprocess, security, abound but are privacy, and c"] [14.162614822387695, 3.1062023639678955, "cy, and civil-rights lines, especially for surveillance-related technologies.\nBusiness Cases and Business Processes for Technologies Are Lacking\nThis theme brings together the lack of core business cases for new technologies with the lack of core bus"] [14.185009002685547, 3.0943961143493652, "sonal data. Civil-rights protections refers to safeguards against technologies being used for discriminatory purposes.\nDiscussion and Findings 7\n 8 Addressing Emerging Trends to Support the Future of Criminal Justice\nSenate, 2012]). Panelists noted t"] [14.192124366760254, 3.083754062652588, "ices they need (e.g., Casey et al., 2014).\nPanelists noted that a smart integration of technology, data, analytics, and good, community-based practices at a pilot site could provide an example of what good policing could look like. The panel also dis"] [14.164932250976562, 3.1225578784942627, " physical burden of carrying too many devices and the cognitive burden of being overloaded with too much information, and a lack of in-house information and analytical capabilities needed to share, process, and integrate all of the data needed to pop"] [14.178681373596191, 3.1442911624908447, "evoted substantial time to cybersecurity in its meetings. On the positive side, the CJTFG heard presentations on increased federal support for cyber, including increased Federal Bureau of Investigation (FBI) support for states\u2019 cyber investigation an"] [14.167194366455078, 3.1307969093322754, " the public expects product advertising and television show levels of performance (the so-called CSI effect) resulting from new tech- nologies; expectations are often highly unrealistic.\nThis is one of the most central trends, complicating every surv"] [14.160309791564941, 3.067214012145996, "nt), combined with a major barrier (have versus have-not agencies).\nThere are needs for information integration to enable new models of criminal jus- tice across the enterprise. To maximize the potential from emerging technologies that pro- vide more"] [14.123842239379883, 3.1304571628570557, "rs discussed. Panel- ists noted a strong need to develop systems and business models that permit \u201chave\u201d agencies to share information and capabilities with have-not agencies in the same region.\nThere are needs to enable digital-evidence management on"] [14.109946250915527, 3.1729931831359863, "d terrorism\u2014and these pressures can vary enormously from day to day. In the post-Ferguson and -Baltimore environments, demands to demilita- rize and \u201cbe less violent\u201d appear persistent. Similarly, demands to be more community-centric appear persisten"] [12.988017082214355, 4.367317199707031, "ders) and desires to make law-enforcement operations transparent. The lack of settled law and case law on surveillance-related technologies is a major barrier here.\nAgencies need to further develop and disseminate less-lethal weapons. As back- ground"] [14.118237495422363, 3.092803955078125, "ld lack training, often being the best\nreal-world alternative to using deadly force. As a result, panelists agreed that new development, testing, and fielding of less-lethal devices was needed.\nOutside of device development, the CJTFG discussed that "] [14.164779663085938, 3.1214916706085205, " common policy challenges around emerging surveillance technologies.\nTechnologies to detect firearms and other weapons remotely might be emerging.\nPanelists noted pilot efforts to use millimeter-wave technology to detect weapons from stand- off dista"] [14.138954162597656, 3.1616573333740234, "value of fusion centers\nLack of established business processes for operationalizing new technologies\nLegend\nMost central trend Central trend Other trend\n Develop core business cases for key technologies, starting with exchanges to external service p"] [14.173659324645996, 3.077929735183716, "cycle\n\u2022 integrationandinteroperabilityrequirements\n\u2022 requirements for community and external expert participation\n\u2022 cyber, civil, and privacy rights protections, along with other policy provisions, building\non the IACP Technology Policy Framework (IA"] [14.188071250915527, 3.085994005203247, " unknown and often not well suited operationally to criminal-justice practice practitioners. As a few exceptions, panelists noted that they knew of agencies learning about technologies from the IACP\u2019s Police Chief magazine and the Police Executive Re"] [13.867453575134277, 3.0929062366485596, " crime-analysis capability that would use federal databases as data sources. This model would provide incentives for agencies to contribute data to these databases.\nThe group discussed leveraging new, open-source cloud and information integration too"] [14.206572532653809, 3.0524702072143555, "ness processes.\n Educate the public about how criminal-justice technologies work (or do not work) in the real world.\n Security, privacy, and civil-rights challenges\nRAND RR1987-1.7\n Recommendation 3: Integrate security, privacy, and civil- right"] [14.317320823669434, 3.0151219367980957, "sure appropriate use of new technologies.\nFor (2), panelists noted that it was not possible to create one-size-fits-all technology poli- cies because state and local laws, as well as local operating contexts, are so different. Thus, community involve"] [14.094218254089355, 3.083909273147583, "n\nThese recommendations and actions, summarized in Figure 1.8, seek to help attain informa- tion integration throughout the criminal-justice community.\nThe need to change the culture of organizations is one that is commonly presented as a major barri"] [14.124381065368652, 3.1423451900482178, "igh risks to personnel from a person (or people who might be at a location), and specify any enforcement actions needed (i.e., carry out an arrest warrant or notify a community corrections officer)\n\u2022 corrections data, especially on those under commun"] [14.155889511108398, 3.153836965560913, "l agencies; the major limitation here is that different states and localities have very different laws, policies, and traditions on whether and how such a cloud could be used, probably creating a national storage capability infeasible at this time.\nF"] [13.010893821716309, 4.343877792358398, "e to major incidents\u2014sometimes at the same time (e.g., stories on the San Bernardino shootings versus a video release of an officer-involved shooting in Chicago).\nGiven the large number of articles and data to date on evaluating various policing stra"] [14.160765647888184, 3.1222686767578125, " law enforcement and other stakeholders throughout.\nFindings on Addressing New Technologies and New Consequences\nThis final recommendation, summarized in Figure 1.10, addresses the theme of addressing new technologies and new consequences.\nDiscussion"] [14.16956615447998, 3.0957958698272705, "evelop- ments are related to information processing and analysis, but taking advantage of information- processing advances successfully is greatly hampered by a lack of capability on business cases, implementing processes, and security, privacy, and "] [14.080395698547363, 3.17561936378479, "gton (N.C.) Police\nDepartment\n\u2022 Phillip Goff, president, Center for Policing Equity, John Jay College of Criminal Justice\n\u2022 Maggie Goodrich, chief information officer, Los Angeles Police Department\n\u2022 John Hollywood, Ph.D., director, Information and G"] [14.18146800994873, 3.0966148376464844, "esources by overlaying data from warrants, probation/parole, juvenile justice, and social services.\u201d The meeting also saw special presentations on the future of BWC deployment by the LAPD (which hosted the meeting) and on preventing and responding to"] [14.189014434814453, 3.1111438274383545, "evel consensus on the likely magnitude and breadth of the potential impact on criminal justice. Key dimensions along which impacts could occur included\n\u2022 people: e.g., training, recruiting, retention\n\u2022 process: tactics, strategies, and procedures\n\u2022 o"] [14.230738639831543, 3.0593647956848145, "3, we identified 22 trends and associated impacts, potential responses, and relationships.\nFigure B.1\nThe Futures Wheel\nTechnical Appendix 35\n First-order impacts\n Trend or event\n SOURCE: Zapyon, 2009. Creative Commons Attribution 2.5 Generic licen"] [14.120451927185059, 3.158134698867798, "tly or indirectly, and thus are most centrally involved in driving impacts on criminal justice.\nResponse A Response B\nRecommendation\nCJTFG action item\n Note describing how trend is being addressed elsewhere\n Analyzing the Trends, Impacts, and Respons"] [14.190056800842285, 3.122955799102783, "riminal justice\u2013wide information integration\napplications might occur (18) \u2022 Affects the use of BWCs (21)\n\u2022 General lack of awareness of existing material on improving cybersecurity (example of 4)\n\u2022 Demand for cyber protections is an increasing press"] [14.189865112304688, 3.0960941314697266, "nd Sosic\u030c, 2016). The trends within a cluster are comparably densely related to one another and less densely connected to trends outside the clusters. Each cluster implies an underlying key theme linking them together. The six clusters, and their und"] [14.177262306213379, 3.1275794506073, " an example.\nGetting to true, field-wide integration\nLack of business cases and processes\n40 Addressing Emerging Trends to Support the Future of Criminal Justice\nIdentifying Which Themes Are Most Central\nThe size of the node for each trend in Figure "] [14.150080680847168, 3.132457733154297, " of awareness of existing training and reference material on criminal-justice tech- nologies broadly hampered adoption and use of a variety of technologies and made those technologies more vulnerable to attack.\nFigure B.4 summarizes the relationships"] [14.161432266235352, 3.1211228370666504, "ow trend is elsewhere\n Lack of core business and use cases and other\ntechnologies\nThese capture a key storyline emerging from CJTFG\nEmergence of situational-awareness\ndata streams\nNeed to advance from small-scale to nationwide information-sharing\npr"] [14.157302856445312, 3.1176071166992188, "sharing\u201d again, as one example)\n\u2013 have a basis in research evidence, if available\n\u2022 comprehensive, collectively covering all of the themes and most of the constituent trends \u2013 For the few trends not covered, the CJTFG and the RAND team identified way"] [14.051398277282715, 3.1813619136810303, "nd\nsafeguarding.\nneed for digital-evidence management on a massive scale\n\u2013 Assess whether CJIS (or another federal agency) should establish a federally sponsored\ncloud capability for video and other digital evidence.\nneed to enable fielding of BWCs\n\u2013"] [13.771819114685059, 3.1972732543945312, ". These include hot-spot policing, geospatial predic- tive policing, and crime linking. If the NIBRS data can be further combined with entity data (i.e., data about offenders, victims, vehicles and locations\u2014e.g., the data uploaded to N-DEx, LInX, or"] [13.7367582321167, 3.039323329925537, " analysis\n Crime-analysis environment\n RAND RR1987-C.1\nAnalyses with entity data\n Linking offenders to crimes\n Social-network analysis\n 1 The environment might also permit uploading data in LInX, COPLINK, or other formats yet to be determined.\nCon"] [13.777731895446777, 3.2171385288238525, "d%20files%208-22-14.ashx\nCenter for Internet Security, \u201cMS-ISAC: Multi-State Information Sharing and Analysis Center,\u201d undated. As of March 29, 2016:\nhttps://msisac.cisecurity.org/\nCity of Chicago, \u201cChicago Data Portal,\u201d undated. As of August 8, 2017"] [13.68369197845459, 3.317434310913086, "n, Brian A., and Dulani Woods, Criminal Justice Technology Taxonomy Web Tool, Santa Monica, Calif.: RAND Corporation, TL-158-NIJ, 2015. As of March 13, 2016:\nh t t p : / / w w w . r a n d . o r g / p u b s / t o o l s / T L 15 8 . h t m l\nJustice Inf"] [13.739113807678223, 3.3442747592926025, " March 30, 2016:\nhttps://www.openstreetmap.org/about\n\u201cOur Approach to Privacy,\u201d Apple.com, undated. As of March 29, 2016: http://www.apple.com/privacy/approach-to-privacy/\nPeriscope, home page, undated. As of March 29, 2016: https://www.periscope.tv/"] [16.729650497436523, -1.3172687292099, "sition and Use of License Plate Reader Data from a Commercial Service, DHS/ICE/PIA-039, March 19, 2015. As of January 5, 2017:\nh t t p s : / / w w w . d h s . g o v / s i t e s / d e f a u l t / fi l e s / p u b l i c a t i o n s / p r i v a c y - p "] [23.88144302368164, 4.543071746826172, " JUSTICE, INFRASTRUCTURE, AND ENVIRONMENT\nIs Climate Restoration an Appropriate Climate Policy Goal?\nRobert J. Lempert, Giacomo Marangoni, Klaus Keller, Jessica Duke\nPrepared for the RAND Frederick S. Pardee Center for Longer Range Global Policy and "] [-0.42076411843299866, 13.55850887298584, "s been no shortage of past attempts to think globally about the human condition or the long-range future. What has been missing, however, is a means of tying those efforts systematically and analytically to today\u2019s policy decisions. This is the gap t"] [23.880537033081055, 4.54140567779541, ".......................................... viii Acknowledgments...................................................................................................................... x Abbreviations....................................................."] [23.88174819946289, 4.5418314933776855, "4.5. Conditions Under Which Pursuing the Restore 2100 Goal Does and\nDoes Not Create a Moral Hazard ...................................................................................... 24\nFigure 4.6. Flow of Funds Between Decarbonization and Carbon "] [23.8807373046875, 4.540910720825195, "to climate change or by weakening commitment to other ambitious climate goals.\nTherefore, this report considers climate restoration through the lens of risk management. Defined broadly, risk is the effect of uncertainty on objectives. Risk management"] [23.871875762939453, 4.552441120147705, " such goals with a 2\u00b0C target to reduce the risk of overshoot and developing appropriate long-term financing mechanisms for what might become an expensive public good. In addition, the model dynamics suggest that an ambitious climate restoration goal"] [23.879913330078125, 4.544162750244141, " start of the Industrial Revolution.\nProponents envision many types of climate restoration, but one of great interest\u2014and the focus of this study\u2014seeks to return GHG concentrations to the preindustrial level of 300 ppm within ome to two generations.1"] [23.88082504272461, 4.542664051055908, " some imbued with a sense of environmental stewardship, returning the climate to its preindustrial state seems like the moral thing to do.\nOn the other hand, climate restoration presents a monumental task, the pursuit of which is not without the pote"] [23.88063621520996, 4.543211936950684, "ursuing climate restoration would avoid such moral hazard, that is, provide a net catalytic effect, under conditions in which successful DAC is at least half as likely as successful decarbonization.\nThe analysis also suggests that near-term actions t"] [23.88092041015625, 4.541757106781006, "more severely from climate change than the rich and those living in other locations\u2014along with the deep uncertainty that surrounds the scientific understanding of the consequences of any particular level of GHGs (e.g., Moss, 1995; Keller et al., 2005"] [23.880720138549805, 4.541685581207275, "cale and scope of such activity.\nClimate Restoration Technology\nVarious means exist to extract CO2 from the atmosphere. The most straightforward approaches include reforestation (i.e., growing trees) along with improved management of agricultural and"] [23.87357521057129, 4.5340118408203125, "(Air Miners, undated). 6\n prototype is selling aggregate from captured carbon\u2014reportedly at a profit3\u2014to San Francisco International Airport for terminal renovations, using calcium extracted from waste concrete.4\nDAC has different thermodynamic requi"] [23.881071090698242, 4.542491436004639, "ication with Brent Constantz, Blue Planet\u2019s chief executive officer.\n4 Other possible calcium sources include brine from desalination plants and wastewater facilities, which produce water with excess cations. Naturally occurring seawater and geologic"] [23.880027770996094, 4.542261123657227, "resumably) low-probability, high-consequence climate effects.\nthat seems\n safe for a few years may not remain safe for decades. If successful, restoration would offer\n As noted in Table 2.1\u2019s second row, even if it proves impossible to reach 300 ppm"] [23.88078498840332, 4.543177127838135, "the majority of the evidence suggests that coupling risk information with a specific plan not only elevates perceived risk but also motivates behavior change (Fischhoff and Davis, 2014). This finding is particularly clear in the public health field ("] [23.881084442138672, 4.543184757232666, " risk management under deep uncertainty (Lempert et al., 2003; Lempert et al., 2006). The study explored the consequences of pursuing a climate restoration goal over a wide range of plausible futures, including those in which DAC technology do and do"] [23.87854766845703, 4.539314270019531, "s study, we regard the near-term decision to pursue a particular climate restoration goal as the policy lever. The analysis then explores the potential positive and negative consequences of making such a choice. In particular, we consider as policy l"] [23.870845794677734, 4.5308332443237305, " 2100\n\u2022 Restore 2100 and 2\u00b0C\n Metrics (M)\n\u2022 Net present value social welfare\n\u2022 Annual cost of abatement and carbon\ncapture\n\u2022 Damages due to climate change \u2022 Maximum global temperature and\natmospheric concentration\n\u2022 Maximum annual cost of meeting cl"] [23.86963653564453, 4.530196189880371, "e, GHG concentrations, and damages due to climate change. The model also reports the maximum cost, temperature, and GHG concentration in any given year. The study used these metrics to compare the desirability of alternative pathways and the potentia"] [23.866455078125, 4.526178359985352, "future work consideration of any potential conflicts between the storage requirements of DAC and carbon capture from fossil plants.\nThe climate sensitivity and GHG abatement cost values shown in Table 3.1 spans a reasonable subset of reported estimat"] [23.879619598388672, 4.541145324707031, "hich it does seem possible or catalytic.\nConditions Under Which Climate Restoration Is Possible\nThe multiscenario analysis suggests that there are more pathways to the Restore 2100 than the Restore 2050 goal and fewer pathways to Restore 2100 than to"] [23.876750946044922, 4.537725925445557, " Low Cost Criteria. Details are shown for various dimensions. The view is filtered on Policy, Abatcost, Ccsmarketcap, Ccsmarketcost, Clim Sens, Daccost, Dacspeed and Leak. The Policy filter keeps resto2050 and resto21\nYear\n0\n0an\nd2\ndeg. The Abatcost "] [23.87736701965332, 4.5374579429626465, "odel the 2 percent GWP threshold as a constraint. Doing so would limit the information we could glean from a large set of runs, since the model would not be able to reach the climate goals in most futures.\n (% Gross World Product) Maximum annual cost"] [23.879493713378906, 4.539999485015869, " 16% of low-cost cases\nD/C = 88%/73%\nCases common to both:\n\u2022 2% of total cases\n\u2022 16% of low-cost cases\n Restore 2100 and 2\u00b0C\n Table 4.2 also provides quantitative measures of the statement that a low-cost pathway \u201cgenerally falls in\u201d a scenario"] [23.880220413208008, 4.540380954742432, " potential overshoots with little effect on the fraction of low-cost pathways, shown in Table 4.1.\n 21\nConditions Under Which Climate Restoration Is Catalytic\nProponents see climate restoration as catalytic, helping to increase the likelihood of wide"] [23.881078720092773, 4.541037082672119, "llenge. As noted by Morton (2015) and by Wagner and Weitzman (2015), many advocates focus on two less- challenging combinations: one in which climate change could cause serious damage, but the costs of reducing emissions are small; and the other in w"] [23.88031578063965, 4.541362762451172, "5. Conditions Under Which Pursuing the Restore 2100 Goal Does and Does Not Create a Moral Hazard\n Restore goal: Net effect improves outcomes\n Restore goal: Net effect\nmakes desirable scenarios less likely\n Probability of Best case DAC\n100% 75"] [23.879650115966797, 4.540897369384766, "\nFigure 4.6 thus shows the net flow of revenues from GHG mitigation to climate restoration for five pathways to the Restore 2100 goal, with different assumptions regarding abatement costs ($225 and $650/GtCO2) and the half-life of carbon sequestered "] [23.880422592163086, 4.541680812835693, "ze the deployment of technologies that make it easier\u2014and, in fact, may prove necessary\u2014to achieve less ambitious goals, such as the 2\u00b0C target. In addition, successful climate restoration could reduce risks by significantly shortening the time that "] [23.880388259887695, 4.541362285614014, "framework to help adjudicate this question, by considering a scenario in which pursuing climate restoration increases the likelihood of successful DAC while decreasing by a similar amount the likelihood of low-cost decarbonization. Applied across a r"] [23.880502700805664, 4.541094779968262, " Restore 2075 would provide a better balance than 2050 between a not-implausible and sufficiently resonant goal.\nSecond, to avoid the risk of overshoot, a climate restoration goal might best be combined with a temperature target, such as 2\u00b0C. The sim"] [23.8703556060791, 4.530129432678223, "ed scenarios. However, none of these scenarios are guaranteed. Climate restoration thus calls for a learning process. The best we can do is pursue climate restoration with a passion while embedding it in a process of testing, experimentation, correct"] [23.86880874633789, 4.528615474700928, "ext (seqdac_maxgrowth, %/yr), starting from year 2025:\nESEQDAC[t] <= (1+seqdac_maxgrowth/100)**tstep * ESEQDAC[t-1].\nAn absolute upper bound of 1 GtC holds in year 2020, which is assumed to be the initial year\nfor DAC to be able to operate at large s"] [23.868085861206055, 4.528772354125977, "apture, diffusion speed\nHalf-life of sequestered carbon\nMarket for carbon products, marginal cost Market for carbon products, market size\nDICE Parameter\nt2xco2\nPback mcostseqdac0 seqdac_maxgrowth Reshalflife mcoststor_market0 maxestor_market\n t2xc"] [-0.6823487281799316, 13.32339859008789, "um, S. Paltsev, S. Rose, P.R. Shukla, M. Tavoni, B. C. C. van der Zwaan, and D.P. van Vuuren, \u201cAssessing Transformation Pathways,\u201d in Edenhofer, O., R. Pichs-Madruga, Y. Sokona, E. Farahani, S. Kadner, K. Seyboth, A. Adler, I. Baum, S. Brunner, P. Ei"] [-0.6954187750816345, 13.318134307861328, "ation: How Much and When?\u201d Climatic Change, Vol. 88, 2008, pp. 267\u2013291.\nKnutti, R., M. A. A. Rugenstein, and G. C. Hegerl, \u201cBeyond Equilibrium Climate Sensitivity,\u201d Nature Geoscience, Vol. 10, No. 10, 2017, p. 727.\nKriegler, E., J. W. Hall, H. Held, "] [-0.6709891557693481, 13.325234413146973, "8, 2018:\nhttp://www.pnas.org/content/114/7/1518.long\n\u2014\u2014\u2014, \u201cScientific and Economic Background on DICE Models,\u201d webpage, October 2017-b. As of March 29, 2018:\nhttps://sites.google.com/site/williamdnordhaus/dice-rice\nNordhaus, W. D., and P. Sztorc, DIC"] [-0.6968405842781067, 13.313172340393066, "Global Change, Cambridge, UK: Cambridge University Press, 1997.\nWagner, G. and M. L. Weitzman, Climate Shock: The Economic Consequences of a Hotter Planet, Princeton, N. J.: Princeton University Press, 2015.\nWeitzman, M. L., \u201cGHG Targets as Insurance"] [14.922237396240234, 2.732543468475342, " CORPORATION\nStrategies to Mitigate the Impact of Electronic Communication and\nElectronic Devices on the Right to a Fair Trial\nJustin C. Dawson, Duren Banks, Michael J. D. Vermeer, Shoshana R. Shelton\nS U M M A R Y \u25a0 The proliferation of electronic"] [14.967476844787598, 2.7204840183258057, "e of Justice, the Priority Criminal Justice Needs Initiative convened a panel to identify ways that electronic communication can impact the right to a fair trial and to recommend strategies to protect witnesses from intimidation and jurors from compr"] [14.935712814331055, 2.687195062637329, "lenging the court also to transform its approach to protecting the right to a fair trial. The right to a trial by an impartial jury is pro- tected by the Sixth Amendment to the United States Constitu- tion and has been a part of the American justice "] [14.967639923095703, 2.675161361694336, "use of mobile devices and other new capabilities to do \u201coutside research\u201d during trials and (2) educate jurors on this issue\n\u2022 develop methods to monitor juror and defendant social media activity, given concerns about use of social media to influence"] [14.846138000488281, 2.7628607749938965, "me by, in part due to the difficulty of identifying and interviewing those witnesses subject to intimidation in response to specific events and/or ongoing, community-based threats. Success-\nful intimidation often occurs beyond the notice of authoriti"] [14.854336738586426, 2.744853973388672, "threats\u2014\u201c . . . it is possible the continual progression of electronic communication technologies and social media have made witness intimidation a more insidious problem than ever\u201d (panelist). The sometimes public or widely shared nature of social m"] [14.876093864440918, 2.7509453296661377, " claimed to identify more than 5,000 undercover officers, informants, and wit- nesses before it was shut down in 2007. The site posted names, pictures, statements, and the results of plea bargains where informants provided information that led to the"] [14.945162773132324, 2.6946396827697754, "ded meaning of such com- munications. This often leads to arguments of free speech, which in turn lead judges to vast differences in interpretation. Court procedures may be emerging to convey the intent of visual communications that rely on text shor"] [14.956387519836426, 2.723843812942505, "informa- tion, thereby compromising the defendant\u2019s right to a fair trial. As one panelist noted, \u201cThere is always a problem when the legislature is allowed to dictate what can and cannot go on in a courthouse. They are led by fear and often react to"] [14.946784019470215, 2.7233941555023193, "m all have at least one judicial district that has banned or set limits on the use of electronic devices in the courthouse (National Center for\nState Courts, undated). With electronic device bans in place across the country, the panel recognized that"] [14.962770462036133, 2.714371681213379, "ensus that judicial educa-\ntion and knowledge are critical to identify and prevent witness intimidation through social media and other ECD. The panel recognized that with education and understanding, the judges themselves could better control the cou"] [14.941508293151855, 2.7308478355407715, "h which technology evolves.\nStrengthen witness protection/ \u2022 Prohibitively high cost of the witness relocation programs. protection program\n\u2022 Photos of witnesses are extremely easy to locate with modern technology.\n\u2022 Witnesses, despite warnings, cont"] [14.941277503967285, 2.687883138656616, "w challenges to this old problem, just as it has with witness intimidation. Juror misconduct may take many forms (Morri- son, 2011), including but not limited to searching for additional factual information outside the courtroom and discussion of cou"] [14.946844100952148, 2.7016539573669434, "in 2014 (Marder, 2014). Together, these data on the prevalence of juror misconduct with ECD illustrate that, while it is hard to quantify definitively, juror misconduct with ECD is a significant problem in the modern court system that war- rants cons"] [14.960423469543457, 2.707502841949463, "esented. As described earlier, the jury system depends on the impartiality\nof jurors: \u201cImpartial jurors are those who are willing and able\nto consider the evidence presented at trial without preconceived opinions about the defendant\u2019s guilt or innoce"] [14.95988655090332, 2.706035852432251, " may not understand\nin an attempt to learn more about issues related to the case. The internet provides a means for jurors to instantaneously access unlimited information, conduct their own research, and communicate with people via tweets, blogs, Fac"] [14.96215534210205, 2.7066023349761963, "he scene. During deliberations, the jury asked\nthe court to define the word \u201cperverse\u201d as it had been used in the case, but the court did not respond. That evening a juror went home after recess and looked up the term, as well as the definition of in"] [14.956396102905273, 2.7026422023773193, "ions should be an option but should be used only after a juror has been adequately instructed and warned against misconduct. Still others strongly eschewed juror sanctions as generally inappropriate and ineffec- tive in most cases. Most of the paneli"] [14.956199645996094, 2.7045018672943115, "essary to determine the case and the small details about people or events we all see and incorporate into our decision- making. Efforts to wall jurors off from considering those small details\u2014\u201csmall \u2018e\u2019 evidence\u201d\u2014may, in addition to likely being impr"] [14.96716022491455, 2.7071104049682617, "re promising practices. Points of panel consensus are summarized in Table 2.\nCONCLUSION\nJudges and attorneys have long encountered and addressed witness tampering, juror misconduct, and other potential viola- tions of the right to a fair and impartia"] [14.960577011108398, 2.7033092975616455, "promising avenue to limit juror miscon- duct than concrete rules applied the same way in every circum- stance. With regard to witness or juror intimidation, the panel determined electronic device bans in the courtroom provided a temporary solution to"] [14.918574333190918, 2.706017255783081, "f judges was a key promising approach identified by the panel with regard to preventing witness intimidation and juror misconduct. Here,\na centralized repository that includes information on the latest case law and technological advances would be hel"] [14.885698318481445, 2.7961621284484863, "unity Oriented Policing Services, 2006.\nDunn, M., Jurors\u2019 and Attorneys\u2019 Use of Social Media During Voir Dire, Trials, and Deliberations, Washington D.C.: Federal Judicial Center, January 2014.\nEgley, A. J., and C. Ritz, Highlights of the 2000 Nation"] [14.861729621887207, 2.8857462406158447, "tml\nMcKay v. Federspiel, 15-1548, U.S. Court of Appeals for the Sixth Circuit, May 20, 2016. As of July 20, 2017:\nhttps://w w w.courtlistener.com/opinion/3205597/robert-mckay-v- william-federspiel/?\nMorrison, C. M., \u201cJury 2.0,\u201d Hastings Law Journal, "] [14.29449462890625, 3.627485513687134, " Association, Winter, 2013, pp. 1\u20138.\nUnited States v. Carmichael, 326 F. Supp. 2d 1303, U.S. District Court for the Middle District of Alabama, July 22, 2004.\nUnited States v. Lawson, 677 F.3d 629, 633-34, U.S. Court of Appeals for the Fourth Circuit"] [13.919629096984863, 4.144133567810059, " International. His research focuses on courts and corrections, criminal justice, and international rule of law projects. He has a law degree from Creighton University. He began his career as a trial attorney before becoming a prosecuting attorney wi"] [13.877696990966797, 4.42173433303833, "l criminal justice agencies at the federal level; private-sector technology providers; and policymakers active in the criminal justice field.\n This publication was made possible by Award Number 2013-MU-CX-K003, awarded by the National Institute of Ju"] [4.160323143005371, 7.853066921234131, " THE ROAD TO\nZER0\nA Vision for Achieving Zero Roadway Deaths by 2050\n Liisa Ecola\n Steven W. Popper\nRichard Silberglitt\nLaura Fraade-Blanar\n Prepared for\n CORPORATION\n For more information on this publication, visit www.rand.org/"] [4.27426290512085, 7.993722915649414, "ogram, which focuses primarily on the role of scientific development and technological inno- vation in human behavior, global and regional decisionmaking as it relates to science and technology, and the concurrent effects that science and technology "] [15.046626091003418, 5.764373779296875, ". . . . . . . . . . . . . . . . . . . . . . . . . Roads That \u201cForgive\u201d Mistakes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Starting Trau"] [4.173434257507324, 7.853264808654785, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BusinessCommunityandFleetOwners....................................................................\n.. 1 .. 1 .. 3 .. 6 .. 8\n. 13 . 14 . 19 . 21\n23 24 26\n27\n27 . 32 . 41\n42\n. 45 . "] [4.163197040557861, 7.848045825958252, "portion of Population . . . . . . .\nS.3. Three Approaches Working Together to Reduce Roadway Deaths to Zero .\n1.1. Increases in Deaths by Road User Type, 2011 to 2016. . . . . . . . . . . . . . . . . . . . . . . . .\n1.2. Proportion of Roadway Deaths "] [4.178780555725098, 7.848927974700928, "sed investment in emergency response, together with enhanced connectivity for faster crash notification, improved injury prediction, better communication with 911 and first responders, and more-effective emergency medical care.\nImprovements in digita"] [4.175103187561035, 7.855635643005371, "ch the same way that people changed their minds about alcohol-impaired driving in the 1980s and 1990s, drivers in 2050 feel that their communities expect them to comply with speed limits and to not drive distracted. Widespread community road-safety a"] [4.169279098510742, 7.851115703582764, "y has seen enormous improvements in safety in other areas. As of 2017, no commercial U.S. airline passenger flight has had a fatal crash since 2009, thanks in large part to a collaborative government/industry safety management system. The number of p"] [4.168491363525391, 7.8543596267700195, "rash type, the percentage of fatalities that are men ranges from 49 percent of car passenger deaths to 99 percent of large truck deaths.\n\u2022 Rural road users are disproportionately affected as well. In 2015, an estimated 19 percent of the U.S. populati"] [4.223200798034668, 7.836610317230225, "ted States has seen over the past sev- eral decades can be attributed to many factors. One is better vehicle technologies developed by automakers, better in terms of avoiding crashes and protecting those in the vehicle\u2014such tech- nologies save 27,000"] [4.179279804229736, 7.847411632537842, "ess individual and collective decisions, and a strong safety culture is an essential prerequisite.\nThe Safe System approach is integral to the Vision Zero movement that started in Sweden in the 1990s and began spreading to the United States a decade "] [4.18367862701416, 7.850407123565674, "ing crashes is the highest priority, improving post-crash response also rep- resents a significant opportunity for saving lives. Twenty percent of trauma deaths could be prevented with optimal trauma care. Improved trauma care will be essential in ad"] [4.209051132202148, 7.852095603942871, "s promise large advances in safety. ADAS\u2014such as auto- matic emergency braking, adaptive cruise control, and lane-keeping\u2014are already being intro- duced into the fleet. Each year, these technologies are offered on a greater number of new vehicles and"] [4.172850131988525, 7.845800399780273, "majority of vehicles\nInsurance markets nudge bad drivers to safer vehicles\n \u201cSafety in all policies\u201d approach spreads\n TODAY 2025\nNOTE: TZD = Toward Zero Deaths.\nRAND RR2333-S.3\n2030\n2040\n2045\n2050\nTraffic deaths\n2035\nZero\ndeaths\nThese "] [4.178531646728516, 7.83748197555542, "r with industry and other stakeholders to develop platforms and systems to collect\nand analyze data that will generate the information needed to target safety interventions.\n\u2022 Assess strategies for improving vehicle safety, including partnerships and"] [4.167944431304932, 7.8418707847595215, "onal trauma triage criteria for crash victims.\n\u2022 Collaborate with government and business on adopting the Safe System approach and\npromoting a strong safety culture.\nSafety researchers and advocates:\n\u2022 Educate policymakers at the local, state, and fe"] [4.136959075927734, 7.845627784729004, "bout a future with zero road- way deaths. Susan Crotty handled the communications and meeting logistics of the expanding RTZ Coalition. Other NSC staff who participated in the workshops included Kelly Nantel and Julian Hoffman.\nAt the U.S. Department"] [4.185784339904785, 7.863346099853516, "reviewer, Zachary Doerzaph, director of the Center for Advanced Automotive Research at the Virginia Tech Transportation Institute, and internal reviewer, Charlene Rohr, contributed many helpful comments to the final report.\nAbbreviations\n 3HF Three-H"] [4.16980504989624, 7.858656883239746, "n public roads involving any type of motor vehicle, who died within 30 days of the crash. The National Safety Council and the Centers for Disease Control and Pre- vention (CDC) also publish annual figures but use different definitions that are more i"] [4.182270526885986, 7.8787522315979, "eaths have increased because of many causes and across demographic groups. Roadway deaths occur among all road users, although some groups are at greater risk than others. About two-thirds of those killed are drivers and passengers in cars and trucks"] [4.168056488037109, 7.8570780754089355, "or teen drivers are higher than for any other age group per mile driven; teen drivers ages 16 to 19 are almost three times more likely than drivers age 20 and up to be in a fatal crash, and the risks are highest at age 16 and 17 (IIHS, 2017b).\n\u2022 Men "] [4.1412672996521, 7.863356113433838, "red or distracted. Combined with current vehicle and road\n7 Many crashes are considered to have more than one cause (e.g., a driver was both speeding and driving while intoxi- cated), so the numbers in this paragraph do not necessarily equal 100 perc"] [4.215824604034424, 7.824280261993408, "y 2050\nvictims who reach the hospital could be prevented if the victims received efficient and effective trauma care from the time of injury to acute care to rehabilitation and beyond (Berwick, Downey, and Cornett, 2016). Reaching a trauma center mor"] [4.152309894561768, 7.837446689605713, "\u2014not \u201cHow else can traffic crashes be reduced?\u201d but \u201cIs it possible to eliminate roadway deaths altogether?\u201d\nIn 1997, Sweden became the first country in the world to enact a policy called Vision Zero\u2014a formal goal, adopted by the parliament, of reduc"] [4.203585147857666, 7.858529567718506, "ty planners, traffic engineers, and vehicle designers\u2014responsible for preventing crashes. This approach, often referred to as the Safe System approach, assumes that drivers will still make mistakes but that the road system should be designed in such "] [4.163687705993652, 7.8465118408203125, "nnectedness of vehicles, infrastructure, and vulnerable road users such as pedestrians, bicyclists, motorcyclists, and highway workers may further reduce serious crashes. As these technological improvements become more and more commonplace, and traff"] [4.1914544105529785, 7.855625152587891, "dispatchers\n Data standards adopted\nADAS on majority of vehicles\n Public support for new safety programs increases\n Insurance markets nudge bad drivers to safer vehicles\n 37,000+ deaths\nWidespread use of automated enforcement\n \u201cSafety in all "] [4.1781182289123535, 7.8483123779296875, "to be forgiving so that these mistakes do not lead to fatal outcomes. The Safe System approach also involves commitment to analyze safety problems, identify changes that bring the best return on investment, and implement these improvements throughout"] [4.282900333404541, 7.893013954162598, "e older\u201422 percent are over 65, as opposed to 15 percent 35 years ago\u2014and almost 20 percent are immigrants (up from about 13 percent in 2014) (Colby and Ortman, 2015).2\nNeither are Americans less mobile, at least overall. In fact, the demand for mobi"] [4.227844715118408, 7.854537487030029, " like revolutionary technologies. These technologies include but are not limited to the following:\n\u2022 Intelligent speed adaption manages vehicle speed, taking into account the presence of people and other vehicles, the design of the road, the surround"] [4.354732990264893, 7.868253231048584, "ee the pedestrian until it would have been too late, the car brakes in time. Happily, there isn\u2019t another vehicle directly behind\u2014most cars give you a warning sound when you are following too closely. Joe texts city hall the next day to vent about th"] [4.899353504180908, 7.943282604217529, "ain benefit has been to reduce highway crashes between passing vehi- cles. Rearview cameras allow drivers to see behind them, avoiding crashes due to hitting something behind the car (tragically, sometimes a small child). Rear parking sensors tell dr"] [4.872610569000244, 7.96789026260376, "es this flow of information from the outside to inform and engage the vehicle\u2019s safety systems and warn drivers of hazards. V2X connectivity is working in tandem with automated driving systems, sharing information about vehicle speeds and directions "] [4.826420783996582, 8.157556533813477, "ight otherwise have needed assisted living arrangements or depended on younger family members to drive them around. As self-driving cars improved in their abilities to handle bad weather, they became more common in northern cities (when first introdu"] [4.83641242980957, 8.179353713989258, "eet of automated vehicles, and both require that, to qualify for these plans, members have to be able to get into and out of the car on their own. They have different and more- expensive plans for seniors who need more assistance. Emily signs Jacquel"] [4.180727005004883, 7.851086616516113, " lances to make them more crashworthy for both patients and crew members were developed based on specialized crash tests. Ambulance crew members have restraint systems that allow them to perform patient care but survive a crash.\nSo, a key reason for "] [4.2054290771484375, 7.808305740356445, "nother way cities have made progress is by continuing the work of right-sizing their major streets that was begun in the early 2000s. Cities have converted more streets from two lanes each way without turn lanes to one lane in each direction with tur"] [4.160068035125732, 7.840736389160156, "g signage designed to break on impact so that cars that collide with it are not seriously damaged. They also use more-consistent traffic control signs and markings so that drivers encounter similar uses regardless of location. Installing rumble strip"] [4.222559452056885, 7.825549125671387, "g Trauma Care Quickly and More Efficiently\nEven with all the changes in vehicles and roads, crashes still happen\u20142050 saw more than 1 million of them. Crashes are classified broadly into three types: fatal, injury, and property- damage-only (meaning,"] [4.227325916290283, 7.82366418838501, " with optimal care on scene and prioritized for access to hospitals and selective transpor- tation to trauma centers. While most crashes involve one or two passenger vehicles, standard- ized triage systems have been useful in saving lives in incident"] [4.2590742111206055, 7.837167739868164, "ene before EMS responders arrive. Telemedicine monitoring can assist those at the scene to assess the patient and use the medical devices dropped off by drone.\nFirst responders can also be on the scene more rapidly. Those arriving in ground vehicles "] [4.16332483291626, 7.854361534118652, "hemselves. As a result of increased data sharing and changes in insurance regulations, insurance premiums are also highly stratified in terms of vehicle safety technologies, offering discounts to car owners with specific safety packages. Most of this"] [4.205153942108154, 7.862246513366699, "nts.7 This type of bond brings private or philanthropic money to fund government programs\u2014generally focused on prevention\u2014and investors are repaid only if the program outcomes are achieved. Several roads with embedded sensors to aid safety have been "] [1.9854950904846191, 8.834253311157227, "itney services. Some of these changes have been led by immigrant groups who came come from countries where driving is less common and brought their habits with them. Assimilation no longer means buying a car.\nFor another, individual dependence on pri"] [4.172375202178955, 7.847598552703857, "heir car as a tool to get from point A to point B. Attitudes about car ownership and driv- ing are more focused on convenience, comfort, efficiency, and safety rather than on power or speed. People still love cars, but they value different features t"] [4.171336650848389, 7.845072269439697, "hile it didn\u2019t get the same attention as more high-profile causes of death, the mid-2010s saw something of a crisis in roadway deaths: After years of decline, they were going up. The causes were not necessarily clear: There were more miles being driv"] [4.158091068267822, 7.822844505310059, "), and City Hall, including its office of operations and the community affairs unit.2 Their mandate was for each department to incorporate safety outcomes into its own policies and share results and ideas with other depart- ments. So they attacked a "] [4.808891773223877, 7.945185661315918, "trol, but fewer than 5 percent had rear parking sensors, automatic emergency braking (AEB), or adaptive headlights.3 Some technologies were still essentially limited to luxury models. Due to a combination of consumer pressure and the desire to show a"] [4.842493534088135, 7.924559116363525, "fectly legal in one state and illegal when it crossed the state border.\nIn the late 2010s, a process to allow some exemptions from the Federal Motor Vehicle Safety Standards was developed specifically to spur AV technology while also encouraging\n3 Cu"] [4.177394390106201, 7.844961166381836, "bottom line, since crashes were the leading cause of workplace deaths. They encouraged businesses with their own fleets to upgrade to safer vehi- cles when replacements were needed, or to sign up with car-sharing services with newer fleets. Some flee"] [4.163354873657227, 7.824401378631592, " that minimized both the probability and impact of crashes. The main focus was on reducing speed in safety-critical locations, which accomplished two things at once: It reduced the chance of a crash taking place, since higher speeds mean that drivers"] [4.7651848793029785, 8.274024963378906, "ift, it obviously did not occur overnight. But the ways that experts think about traffic safety were beginning to change dramatically, and this helped to push along some of the broader changes that took place in the ensuing years.\nYears of Rapid Chan"] [4.754674911499023, 8.174450874328613, ", bike-sharing, and other modes (such as commuter ferries). The mid-sized southern city that pioneered this type of mobility service negotiated to have access to the ride-hailing and bike-sharing data as well, to help with planning efforts. What made"] [4.157984256744385, 7.860422134399414, "ing. Both public and private organizations had been in the data collection business for years, but often on clunky legacy systems that were incapable of exporting data in formats that would be accessible to other organizations. Thefts of data from la"] [4.191915988922119, 7.8428192138671875, "des- trian deaths were never the largest category of crash fatalities nationally, their sizable increase in the late 2010s, combined with the fact that they were a substantial share of city crash fatali- ties, meant that serious progress was being ma"] [4.145949840545654, 7.86649227142334, "ave been proven to be safer than turning left directly.11 Other initiatives that began spreading across states included more consistent crash reporting and data sharing between cities and states.\nMaking these infrastructure changes required additiona"] [4.602056503295898, 7.891289234161377, "ight of the improved data to better understand problems in design that could be improved upon systemically with retrofits and new design protocols. Those jurisdictions with the resources to do so began to analyze specific crashes in depth, looking fo"] [4.86435604095459, 7.981306076049805, "nds. When DADSS finally became available for commercial use, auto manufacturers voluntarily agreed to offer it on nearly all models, given their role in its development. Even so, it takes about 25 years for automotive technologies to reach 95 percent"] [4.937929153442383, 7.955364227294922, "heir market power to exert a certain amount of pressure on AV manufacturers. Around this time, the mobility services themselves also began requiring certain levels of safety in their AV purchases via a set of safety standards that they agreed upon.\nW"] [4.263148307800293, 7.831707954406738, "swering points in a crash. (Previous luxury vehicles had communications with their own services, which could then turn around and call for help if needed; the change here was in eliminating the middleman.) Seeing the potential for this technology to "] [4.217567443847656, 7.828237533569336, "es control of the bike\u2014he can\u2019t say what happened, just that it seems to have a mind of its own. It bounces off the newly installed median barrier\u2014a huge blessing, since he might have hit the car coming from the opposite direction\u2014and throws him onto"] [4.18987512588501, 7.834601402282715, "ntos, who had reviewed the ultrasound and scene photos in advance and had advised her team to expect liver lacerations\u2014 she was right, and the operating suite was already prepared. Between the immediate crash notification, the fast extrication and tr"] [4.1617350578308105, 7.840339183807373, "ll.\nPart of this was that those elected officials who had been early champions of Vision Zero policies began talking more regularly about their successes, and over time this helped to reset the baseline. Individual car crashes had seldom made the new"] [4.746586322784424, 7.934169769287109, "peeding was especially difficult, because the crackdowns on speeding in both rural and urban areas had led to something of a backlash. Social media was full of complaints that posted speeds were too low and that AVs (which were programmed to keep to "] [13.183318138122559, 0.37759238481521606, "but identifying the best common approaches was challenging given the range of constituents and the rapidly changing technologies. Once there was agreement on the protocols, adoption of the technology accelerated remarkably.\nAnother bright spot is the"] [4.85417366027832, 7.916363716125488, "e a public utility model to support delivery of services in sparsely populated areas. People with disabilities also were avid supporters and\nearly adopters, and the quality of life of many who previously had limited mobility has been enhanced immeasu"] [4.172993183135986, 7.845454692840576, "king is the availability of funding across departments. After the loosening up of funding provisions in the federal trans- portation authorization bill 30 years ago, those measures have continued to evolve to bring more authority to the states to mak"] [4.166799068450928, 7.842098236083984, "onversations between stakeholders, facilitating public-private cooperation, and supporting research.\n\u2022 Provide leadership that prioritizes achieving zero roadway fatalities by 2050.\n\u2022 Promote and support best practices that reduce roadway fatalities,"] [4.170909404754639, 7.837189674377441, "sources.\n\u2022 Incorporate Safe System principles to identify problems, allocate resources and develop\npolicies, and adjust policies as necessary to accommodate important Safe System changes,\nsuch as adjustments in speed limits.\n\u2022 Take advantage of evide"] [4.181367874145508, 7.847448825836182, "y advocate groups working together can play a key role in education and in develop- ing partnerships to bring together groups that will need to cooperate to make progress.\nThe Road to Zero 47\n48\nThe Road to Zero: A Vision for Achieving Zero Roadway D"] [4.149970531463623, 7.844796180725098, "Participate with local leaders in supporting the safety initiatives identified in the Toward\nZero Deaths National Strategy and in local Vision Zero efforts.\n\u2022 Incorporate the latest standardized crash reporting protocols and share data as possible\nwi"] [4.027779579162598, 7.854890823364258, "my versus the desirability of having more effective automatic-\nity in the driving and safety systems of vehicles)\n\u2022 developing scenarios designed to illuminate alternative courses of actions, consequences,\nand bases for policy choices\n\u2022 the desire to"] [3.9916415214538574, 7.861336708068848, "t Horizon, it too will be unable to retain its full fitness were it not to change as both goals and conditions change.3 But the second process within the 3HF concept is to view the Second Horizon as a zone of conflict that is itself transitory from t"] [3.9787402153015137, 7.868239879608154, "\u201d in the diagram above). ABP then identifies two types of responses to the potential failure of vulnerable and load- bearing assumptions. First, \u201chedging actions\u201d help ensure against negative consequences when assumptions fail. Second, \u201cshaping actio"] [4.122979640960693, 7.833856582641602, "ary Workshop: Matching Tools and Actions to Goals\nThe process began at the RTZ Coalition\u2019s December 15, 2016, meeting with about 150 partici- pants. Focus groups led by RTZ Coalition steering group members proposed actions to reduce roadway deaths in"] [4.101937294006348, 7.836477279663086, " be inte- grated into a set of broader courses of action (COAs) that could then be assessed, modified, and selected among as principal drivers along the road to zero. The results of the two breakout groups were briefed to the full group of attendees,"] [4.100624084472656, 7.834512233734131, "kshop was again organized around breakout groups. We assigned participants to specific groups to ensure multiple viewpoints in each group. We asked them to consider each of the five COAs listed above, and to focus the discussion on what must change t"] [4.071786403656006, 7.824699878692627, "sion\nBreak\nIntegrative discussion of breakout group findings\n\u2022 Areas of Consensus\n\u2022 Areas of Disagreement\n\u2022 Most Promising COAs\no Potential impact\no Trade-offs \u2022 Uncertainties\nWorking Lunch\nConcluding Session: Characterizing the Road to Zero Discussi"] [4.0733537673950195, 7.825073719024658, " situation?\n\u2022 What actions, events, trends might effect a change in these conditions?\nLunch on your own Final breakout sessions\n\u2022 Prepare summary of contrasts to present to Full Group o Technology/policy area\no Societal conditions\no Actions, events, "] [4.081968784332275, 7.814401149749756, "sign and management, users, and emer- gency medical response and trauma care.\nAdjourn Day 1\n65\n66 The Road to Zero: A Vision for Achieving Zero Roadway Deaths by 2050\n9:00\u20139:15 am 9:15\u201310:30 am\n10:30\u201310:45 am 10:45 am\u2013Noon\nNoon\u20131:00 pm 1:00\u20132:30 pm\n2"] [4.368789196014404, 7.90186071395874, "an Allison Kennedy Kristin Kingsley Rob Strassburger King Gee\nIan Grossman\nKelly Hardy\nJill Ingrassia Jennifer Ryan Judge Earl Penrod Brandon Buchanan Andrea Eales Bradley Sant Roger Wentz\nMike Cammisa Abigail Potter Marianne Karth Nathan George Erin"] [4.226413726806641, 7.8648247718811035, "enter for Injury Research KidsAndCars.org\nLyft\nMassachusetts Institute of Technology\nMothers Against Drunk Driving (MADD)\nMobileye\nMotor and Equipment Manufacturers Association Motor and Equipment Manufacturers Association Motorcycle Safety Foundatio"] [4.199001789093018, 7.868621349334717, "rauma Systems to Achieve Zero Preventable Deaths After Injury, Washington, D.C.: National Academies Press, 2016.\nBlincoe, Lawrence, Ted R. Miller, Eduard Zaloshnja, and Bruce A. Lawrence, The Economic and Societal Impact of Motor Vehicle Crashes, 201"] [4.404697895050049, 7.95212459564209, "ewar, James A., Assumption Based Planning, Oxford University Press, 2002.\nDisley, Emma, Chris Giacomantonio, Kristy Kruithof, and Megan Sim, The Payment by Results Social Impact Bond Pilot at HMP Peterborough: Final Process Evaluation Report, London:"] [4.236968517303467, 7.892910003662109, "March 9, 2018: http://www.iihs.org/iihs/topics/t/teenagers/fatalityfacts/teenagers#Population-and-mileage-rates\nJackson, Molly, \u201cVolvo\u2019s 2020 Pledge: No One Will Die in Our Cars,\u201d Christian Science Monitor, January 21, 2016.\nKahane, Charles J., Lives"] [4.176959991455078, 7.86681604385376, "16 Fatal Motor Vehicle Crashes: Overview, Washington, D.C., DOT HS 812 456, October 2017c. As of October 11, 2017:\nhttps://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812456\n\u2014\u2014\u2014, Early Estimate of Motor Vehicle Traffic Fatalities for the Firs"] [4.199443340301514, 7.876548767089844, "14. As of March 9, 2018:\nhttp://www.towardzerodeaths.org/wp-content/uploads/TZD_Strategy_12_1_2014.pdf\nTransport and Infrastructure Senior Officials\u2019 Committee (Australia), National Road Safety Strategy 2011\u2013 2020: Implementation Status Report, Canbe"] [4.15139627456665, 7.848783016204834, " THE ROAD TO\nZER0\n EXECUTIVE SUMMARY\n Liisa Ecola\n Steven W. Popper\nRichard Silberglitt\nLaura Fraade-Blanar\n Prepared for\n CORPORATION\n For more information on this publication, visit www.rand.org/t/RR2333z1\nPublished by the RAND "] [4.187654972076416, 7.866632461547852, "ed above, in addition to local, state, and federal elected officials with responsibility for traffic safety.\nThe research reported here was conducted in the RAND Science, Technology, and Policy program, which focuses primarily on the role of scientif"] [4.168262481689453, 7.874355792999268, "cars now brake automatically, warn drivers about objects\nin their blind spots, park themselves, adjust their speed, and stay in their lanes. While crashes still happen, there are many fewer of them.\nIn 2050, those crashes are less severe, in part bec"] [4.1608052253723145, 7.851423740386963, "drivers. Some cities and companies that manage a variety of mobility options through a single account\u2014\u201cmobility services\u201d\u2014have made it easy to get around without having to drive, and they have been early adopters of advanced safety technology.\nA wide"] [4.156576633453369, 7.8513898849487305, "consider- able. In 2010, it was estimated that crashes cost the U.S economy roughly $835 billion, and there were 15,000 crashes per day. Now, 40 years later, police and emergency responders can shift attention to other needs, states and insurance com"] [4.164251327514648, 7.857594013214111, "n its\ncrash death rates of 50 percent\nor more, using the Safe System\napproach. A number of U.S.\nstates and cities have also embraced this Vision Zero strategy.\nWhile it will take a generation, the success of other countries and some U.S. cities demon"] [4.19736385345459, 7.8889923095703125, "2016 than in 2011, 1,500 were pedestrians. In 2015, pedestrian deaths accounted for 15 percent of all traffic fatalities, and about three-quarters of pedestrian deaths occurred in urban areas.\n*SOURCES: Older teen/young adult crashes: Centers for Dis"] [4.153864860534668, 7.842410564422607, "Another factor involves the ways in which roads are designed and constructed to increase road safety. In more-rural areas, these include designs for roadsides that reduce the number of obstacles that cars could strike if they run off the roads, pavem"] [4.183328151702881, 7.804234981536865, "n Sweden\nin the 1990s and began spreading to the United States a decade later. Vision Zero begins with a commitment to focus on the changes necessary to eliminate roadway deaths rather than being satisfied with incremental progress, and goes on to in"] [4.140700817108154, 7.7854790687561035, "on is a powerful force for change.\nThe National Safety Council commissioned the RAND Corporation to develop a process for the RTZ Coalition to create an overall vision and strategy to reach zero deaths. The process includ- ed convening three intensiv"] [4.169826984405518, 7.84592866897583, "h change.\n2. Accelerate Advanced Technology.\nExisting and emerging technologies promise large advances in safety. ADAS\u2014such as auto- matic emergency braking, adaptive cruise con- trol, and lane-keeping\u2014are already being intro- duced into the fleet. E"] [4.16887903213501, 7.838562488555908, "support for new safety programs increases\n Insurance markets nudge bad drivers to safer vehicles\n 37,000+ deaths\n \u201cSafety in all policies\u201d approach spreads\n Deployment of advanced vehicle technologies expands\n TODAY 2025\n2030\nTraffic "] [4.159596920013428, 7.830743312835693, "rural areas.\nExplore opportunities to align safety and research and development funding with state and local needs and improve return on investment.\nPartner with industry and other stakeholders to develop platforms and systems to collect and analyze "] [4.169052600860596, 7.837011337280273, "Work with local and state governments to prioritize trauma system investments and improve trauma care.\nParticipate in forums about data and emergency communications. Adopt national trauma triage criteria for crash victims.\nCollaborate with government"] [4.198919296264648, 7.866304874420166, "utomobile Association\nJohn Bozzella and Paul Scullion, Association of Global Automakers, Inc.\nCollin Mooney and Adrienne Gildea, Commercial Vehicle Safety Alliance\nJonathan Adkins and Russ Martin, Governors Highway Safety Association\nJeffrey Paniati "] [14.625563621520996, 2.4602415561676025, " CORPORATION\nIdentifying Law Enforcement Needs for Access to Digital Evidence in Remote Data Centers\nMichael J. D. Vermeer, Dulani Woods, Brian A. Jackson\nLaw enforcement increasingly needs to have access to data residing in remote data centers, an"] [14.635956764221191, 2.3978140354156494, "pective and improving cooperation.\n\u2022 Highly ranked needs also included better investigator access to information and training on requesting remote digital evidence. Several needs recommended creating databases and portals from which practitioners cou"] [14.626900672912598, 2.433856964111328, "e in a format that is unreadable without special software, further delaying the investigative process while the officer attempts to find the information needed for the investigation. Several months have passed since the murder.\nIn another example, co"] [14.637892723083496, 2.4439001083374023, "tions of files on its cloud servers in various places, including in other countries. In this case, it unsuccessfully argued that, because portions of these files resided in other countries, it could not be compelled with a war- rant to produce the re"] [14.644124984741211, 2.497034788131714, "ategory of data\nunder discussion has a much broader scope than merely cloud services. Remotely held digital evidence, for the purposes of this report, comprises any digital information owned, used, or pertaining to an individual that is stored or mai"] [14.635013580322266, 2.4360251426696777, "riber; law enforcement; and, in some circumstances, even the provider from having concrete infor- mation on the physical location of stored information.\nThe nature of remote storage has implications for law enforcement investigations that have need o"] [14.634737968444824, 2.414687156677246, " of critical importance for digital evidence held in remote data centers.\nThe ECPA was enacted in 1986 to address issues related\nto computing technologies that were not covered under the Wiretap Act, and it remains the most relevant statute concern- "] [14.629524230957031, 2.4099044799804688, "held by an ECS for 180 days or less always require a warrant for access. According to the statute, if a record has been held in storage by an ECS for more than 180 days or if it is held by an RCS, content information may be obtained with a court orde"] [14.637288093566895, 2.396576166152954, "t Ireland case, with arguments over whether the territorial warrant authority is based on the location of the provider or the location of the data.\n5\n 6\nTable 1. Legal Process Required Under the SCA for Various Records\nContent record with RCS Warran"] [14.658984184265137, 2.4447529315948486, "ency of data requests and the accom- panying burden for all parties involved. State and local law enforcement increasingly see the need to obtain data and digital evidence held extraterritorially or by transnational companies in their investigations "] [14.645243644714355, 2.4127719402313232, "eptions for compelled disclosure of electronic records for modern technologies in the SCA are ambiguous and outdated.\nAs mentioned above, the SCA specifies different protec- tions afforded to a record based on a few defined distinc- tions. It defines"] [14.6179780960083, 2.4363162517547607, "rial action with regard to such data (Daskal, 2015; Woods, 2016).\nIn addition to struggling with new issues of data territo- riality, the law also creates distinctions that were clear at the time of its writing but have since been blurred by new tech"] [14.649601936340332, 2.5106747150421143, "ct\u2019s identity to the actions taken and the devices used. Data and devices that are distributed over geographic areas will have different time zones associated with them and put their own time stamps on the data in their logs. When the locations are n"] [14.657510757446289, 2.449237823486328, "pace, it could be challenging to uniquely attribute some data or activity to the suspect in question or prove that their data were not tampered with. Moreover, seizing the physical storage medium on which multiple users\u2014most of whom are not involved "] [14.638367652893066, 2.388631820678711, "ces local crime investigations into the realm of international affairs, as investigators must use the MLAT process to acquire extrater- ritorial data. In most cases, the MLAT process is cumbersome, placing a significant burden on both law enforcement"] [14.631494522094727, 2.3955447673797607, " comity insofar as it provides a perceived rationale for extraterritorial application of national laws both within the United States and without.6 In addition to the specter of conflicting international legal obligations on provid- ers, such extrater"] [14.634902000427246, 2.3960068225860596, " that are difficult to understand or comply with because\nof law enforcement\u2019s inexperience or ignorance of their pro- prietary service architecture. Because of the complicated way providers may use or store data, compliance is likely to involve much "] [14.626023292541504, 2.4137630462646484, "equests. Nontechnical barriers are also encountered by law enforcement when issuing requests, including\n\u2022 erratic intake of court orders and subpoenas\n\u2022 delayed or unpredictable responses\n\u2022 inaccurate, incomprehensible, or imprecise responses\n\u2022 prohi"] [14.622851371765137, 2.4003288745880127, "e\u2014may have an inherent tendency toward becom- ing adversarial rather than cooperative. Surveys show that the public is increasingly concerned with how corporations handle\n11\n 12\ntheir data (Microsoft Corporation, 2013; Rainie and Duggan, 2015) and t"] [14.63330364227295, 2.4028778076171875, " subpoena power, such that it must be limited to a single account or individual per subpoena, with any broader request requiring a court order. Cumulatively, these changes would create uniform standards that eliminate many of the ambiguities, includi"] [14.631569862365723, 2.387357711791992, "r maintained by a provider. The act also would have included reforms to the MLA process intended to better track and expedite the process, including the creation of a publicly available MLAT request form and an online docketing system for requests. I"] [14.76852035522461, 2.289996862411499, "he workshop was to bring together a diverse group of experts and practitioners to discuss issues related to digital evidence held in remote data centers for the purpose of identifying both problems and potential solutions. We provide a general descri"] [14.67562484741211, 2.354139804840088, " the results and priorities gleaned from the pre- workshop questionnaire. For each of the subjects under discus- sion, participants were asked to consider the issue with the objective of identifying any problems, opportunities, or needs in three cate"] [14.637847900390625, 2.402848482131958, "rrant), insufficient training or access to knowledge or procedure, and the need for better interagency coordination and cooperation. One law enforcement partici- pant also asserted that officers \u201cwant to know the process and will follow it, but they "] [14.63029956817627, 2.3745784759521484, " such a site could be incentivized to become a platform for information like this.\nThere was also discussion around the idea that the lack of clarity in the law may sometimes lead to an unstated assump- tion that all extant data relevant to an invest"] [14.636467933654785, 2.385707378387451, "t with requesting evidence and data.\n\u2022 Develop an online repository (i.e., a clearinghouse) for best prac- tices in making digital evidence requests.\n\u2022 Conduct research on model statutes that could improve the proce- dures for serving and responding "] [14.632832527160645, 2.3931517601013184, "er and easier. Participants expressed a desire for the modernization and standardization of privacy law and procedures and suggested legislative solutions to some of the problems. One participant spoke optimistically about leg- islation like the ICPA"] [14.64454174041748, 2.399725914001465, "e partici- pant stated that providers often fail to recognize search warrants from other states and try to require that the warrant come from an agency that is local to them.\nAnother participant suggested that some providers may intentionally obfusca"] [14.624218940734863, 2.4085984230041504, "the participants. One participant later flatly commented, \u201cthere should not be financial incentives for complying with a court order.\u201d Another noted that providers can already seek reim- bursement for compliance, but many do not because of public pre"] [14.645181655883789, 2.412020444869995, "ovider, especially given the observed lack of sufficient communica-\ntion or coordination. One participant asserted that \u201cthere is\nno way to guarantee the trustworthiness of data preserved and delivered by a service provider.\u201d Another stated the probl"] [14.662837982177734, 2.3859095573425293, "ge of information that should legiti- mately be provided in response to legal process.\nDevelop a \u201cstandard\u201d for law enforcement requests to industry for user data.\nDevelop a catalog of existing industry practices (as a means of informing investigator"] [14.641924858093262, 2.383183002471924, "ganizational architecture and the implications for U.S. and foreign jurisdiction.\n20\n Cyber investigations, cybercrime, and crimes primarily involving digital evidence can easily span the globe. Many such crimes cannot be investigated purely with loc"] [14.64206314086914, 2.3910670280456543, " particularly time consuming and what can be done to increase efficiency. A participant later sug- gested potential options: \u201cIs it review within the U.S. govern- ment? DOJ? [U.S. Department of] State? Or is it the process within the courts? Could yo"] [14.6531400680542, 2.4108896255493164, "emote government databases. Participants noted that law enforcement consistently lacks access and connectivity to other U.S. federal repositories of digital evidence, including databases for latent fingerprints and facial recognition.\nThe FBI maintai"] [14.631951332092285, 2.3907470703125, "dard that needs to be met and the process for making the request.\nForeign legal liaisons assigned to the United States on behalf of their countries often appear to be insufficiently informed about the basics of the U.S. legal system.\n\u2022 Ask relevant e"] [14.622060775756836, 2.362510919570923, " major concern for many of the attendees. It was a backdrop to many of the discus- sions, as a negative outcome that could become a problem if\n12 It should also be noted that data originating from any devices, including IoT devices, in places with a "] [14.568413734436035, 2.590803384780884, "o help and as very easy to accomplish. Participant com- ments noted that miscommunication or lack of communication\n Table 5. Needs Related to Technical Issues\nThe methodologies for acquiring evidence are constantly evolving.\nAgencies are under strai"] [14.6021728515625, 2.4304041862487793, "his, some participants were skeptical about sharing information from providers where pro- prietary data may be involved because providers would likely push back, decreasing the chance of success. Indeed, concerns about resistance from providers in si"] [14.6467866897583, 2.371889591217041, " identify which data are being retained and the appropriate point of contact to serve legal process.\nThere are a variety of app ecosystems that maintain data, but in these cases, it is much harder to identify the point of contact to serve legal proce"] [14.629677772521973, 2.3893778324127197, "number of cybercrimes cannot effectively be investigated using local resources (e.g., ransomware attacks).\nThe requests made by law enforcement are often difficult or impossible for data custodians (i.e., providers) to comply with.\nForeign legal liai"] [14.617081642150879, 2.4063215255737305, "dards for data retention.\nEven when the investigators follow the appropriate processes, they might still have difficulty obtaining the data that they requested and have the authority to obtain.\nIt is difficult to make contact with experienced investi"] [14.649210929870605, 2.4607789516448975, "it or verify that the evidence provided is, in fact, an accurate extraction of the relevant information in the providers\u2019 systems.\n\u2022 Conduct research and interviews with CJIS and FEDRAMP certifiers to explore their willingness to also examine the pro"] [14.629474639892578, 2.3845925331115723, " process. Laws made before the rise of the modern global internet present practitio- ners with ambiguity on the appropriate means of serving legal process and uncertainty on the authority to request data. Even when data reside within the United State"] [14.627789497375488, 2.3924968242645264, "ers with a common picture of what is required in serving and com- plying with legal process. It would clarify the expectations of law enforcement and providers, remove ambiguity about the appropriate process or response, and mitigate investiga- tive "] [14.92917251586914, 2.14048171043396, " knowl- edgeable individuals identified through existing professional and social networks (e.g., LinkedIn) and by reviewing literature published on the topic. At the time of the invitation, panelists were provided with a brief description of the work"] [14.850910186767578, 1.8336578607559204, "were converted into a web-based Delphi instrument (using the Qualtrics service).\nUsing the instrument, each panelist was asked to individu- ally score each issue and its associated need using a 1\u20139 scale for the following dimensions: (1) importance o"] [14.81899356842041, 1.8010681867599487, "ne questions were not presented to the respondents during the in-room session. To address this, a Delphi instrument containing the missing questions was emailed to the par- ticipants after the workshop. Approximately half of them responded, and their"] [14.593905448913574, 2.625148057937622, "ly, the algorithm that was selected was the \u201cward.D\u201d spherical algorithm from the \u201cstats\u201d library in the R statistical package, version 3.4.1. We prefer it for this purpose to minimize within-cluster variance when determining\nNumber of needs\n Tier "] [14.396748542785645, 3.104372978210449, "ence from Cloud Computing Environments,\u201d in Keyun Ruan, ed., Cybercrime and Cloud Forensics: Applications for Investigation Processes, IGI Global, 2013, pp. 156\u2013185.\nDykstra, Josiah, and Alan T. Sherman, \u201cAcquiring Forensic Evidence from Infrastructu"] [13.97994613647461, 3.873035192489624, "ole J. Johnson, Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs for Improving Court Operations and Outcomes, Santa Monica, Calif.: RAND Corporation, RR-1255-NIJ, 2016. As of December 12, 2016: http:"] [14.606611251831055, 2.5064523220062256, "archives/opa/blog-entry/file/937001/ download\nSearch.org, homepage, undated. As of March 15, 2018: http://www.search.org/\nTaylor, M., J. Haggerty, D. Gresty, and R. Hegarty, \u201cDigital Evidence in Cloud Computing Systems,\u201d Computer Law & Security Revie"] [14.082061767578125, 3.7126402854919434, "nt-surveillance-of-users.html\nZawoad, Shams, and Ragib Hasan, \u201cDigital Forensics in the Cloud,\u201d Crosstalk, September/October 2013. As of February 21, 2018: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.433.8211&r ep=rep1&type=pdf\n35\nAcknow"] [13.918517112731934, 4.181097507476807, "ute\u2019s Farming Systems Trial. He began his career as a Coast Guard officer on afloat and ashore assignments in Miami, Fla.; New London, Conn.; and Baltimore, Md.\nBrian Jackson is a senior physical scientist at the RAND Corporation. His research focuse"] [13.82679557800293, 4.642780780792236, "rporation\nwww.rand.org\nThe 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, nonparti"] [11.271842956542969, 17.890817642211914, " CORPORATION\nMedical Care Provided\nto California\u2019s Injured\nWorkers\nMonitoring System Performance Using Administrative Data\nBarbara O. Wynn, Andrew W. Mulcahy, Hangsheng Liu, Rosalie Malsberger, Edward N. Okeke\nFor more information on this publicatio"] [11.277655601501465, 17.78584861755371, "mproving policy- and decisionmaking in a wide range of policy domains, including civil and criminal justice, infrastructure protection and homeland security, transportation and energy policy, and environmental and natural resource policy.\nThis report"] [10.487698554992676, 19.00914192199707, "........................................................................................................................... 15 Results...................................................................................................................."] [10.351613998413086, 18.964195251464844, "........................................................................................................... 58 Key Findings............................................................................................................................. 5"] [10.21155834197998, 18.94666862487793, "r ....................................................................................... 71 Limitations ................................................................................................................................ 74 Key Findings."] [10.006399154663086, 18.946456909179688, ".................................................................................. 97\nKey Findings............................................................................................................................. 97 Provider Participation "] [10.319804191589355, 18.976818084716797, "....................... 117\n9. Summary of Overall Findings and Recommendations for Monitoring System\nPerformance .......................................................................................................................... 118 Recommenda"] [10.514486312866211, 19.067806243896484, "eriods After Injury, by\nInjury Year ............................................................................................................................ 43 Figure 4.8. Average Per-Claim Total Spending Within 12 Months of Injury .............."] [10.357487678527832, 19.13472557067871, "ion .......................................................................................................... 65\nFigure 5.4. Percentage of Low Back Injuries Occurring in 2007\u20132012 with Continuous\nOpioid Use for More Than 14 Days Within First 12 Mont"] [10.141797065734863, 19.035921096801758, ".1. Change in Number of Evaluations Relative to 2007, by Medical-Legal Code ........ 103 Figure 8.2. Average Number of Units per Evaluation, by Medical-Legal Code ........................ 105 Figure 8.3. Percentage of Claims by Injury Year with Medic"] [10.104280471801758, 18.98528480529785, "Internal Medicine Participation Rate by HRR, Based on Primary\nSpecialty Reported and NPPES Data.................................................................................. 140 Figure C.7. General Surgery Participation Rate by HRR, Based on Prim"] [10.551939964294434, 19.03961753845215, "djustment Factors for Post-2007 Injuries Relative to Spending for 2007 Injuries............. 25\nTable 3.9. Change in Service Year Spending Explained by Changes in Injury Mix\nHolding All Other Factors Constant ........................................."] [10.150411605834961, 19.01386070251465, "........ 94 Table 8.1. California WC Medical-Legal Codes ........................................................................ 101 Table 8.2. Medical-Legal Fee Schedule Modifiers....................................................................."] [10.586067199707031, 18.788976669311523, "................................................................. 127 Table B.1. Diagnosis Codes to Create Injury Condition ............................................................ 129 Table B.2. Service Categories and Criteria..................."] [10.51121711730957, 19.010244369506836, "rnia WC losses and expenses and three-year moving average of insured market share calculated from first report of injury (FROI) claim counts downloaded from the WCIS website as of January 11, 2017.\n xiv\nfactors and the actual changes in spending lev"] [10.53909969329834, 19.0123348236084, "1). A major driver in the spending growth was payments to individuals, which increased 139.2 percent. This expense category includes future medical expense settlement amounts, transportation costs, and\n2 The Division of Workers\u2019 Compensation (DWC) es"] [10.489053726196289, 19.06767463684082, "vices, and drugs in the first 12 months following injury. Key findings by type of service include the following:\n\u2022 Per-claim spending within 12 months of injury on both inpatient hospital stays and outpatient (hospital and ambulatory surgery center ["] [10.359443664550781, 19.16811752319336, " California\u2019s WC program. For example, the medical treatment guidelines do not recommend use of imaging within the first 28 days unless there are red flags or imaging is otherwise needed for medical management. With the exception of uncomplicated low"] [9.913830757141113, 18.972068786621094, "ce payments for similar services, and potential market power of WC medical provider networks (MPNs) as reflected in fee discounting prior to the implementation of a new resource-based relative value scale (RBRVS) fee schedule.\nProvider Participation "] [9.875105857849121, 18.974319458007812, " proportion of the allowed amount that was actually paid prior to implementation of the RBRVS. For this analysis we focused on outpatient nonfacility physician services only. Our estimates are for overall discount rates because data limitations precl"] [10.405616760253906, 18.913745880126953, "ast\u2014the NPI for the provider furnishing each service and an identifier for each MPN\u2014became mandatory with the implementation of WCIS version 2.0 for medical data effective April 6, 2016. Assuming that\nthe new reporting requirements are enforced, the "] [10.784153938293457, 18.434125900268555, "nt of Industrial Relations, and by Irina Nemirovsky in her role as the contracting officer\u2019s representative. We would also like to acknowledge the valuable assistance received from current Division of Workers\u2019 Compensation staff, including George Par"] [10.87742805480957, 18.376893997192383, "erspective\nWorkers\u2019 compensation (WC) provides medical care and indemnity (i.e., wage replacement) benefits to employees with work-related injuries and illness. It is a mandatory \u201cno-fault\u201d system in which benefits are paid by the employer without th"] [10.619664192199707, 18.956331253051758, " Sengupta,\nReno, and Burton, 2010; Sengupta, Baldwin, and Reno, 2014; Baldwin and McLaren, 2016.\nThe medical spending experience in California is characterized by three periods: (1) steep medical spending increases in the early 2000s, (2) steep decli"] [10.492877006530762, 18.916271209716797, " to injured workers.4 The data available for this study predate the implementation of the SB 863 provisions beginning in 2013. RAND is performing a separate evaluation of the impact of the SB 863 medical treatment provisions that will draw on post\u2013SB"] [10.434884071350098, 18.93281364440918, " by conducting in-depth analyses of selected issues affecting system performance. We develop additional measures related to physician participation in the WC medical care system that provide a potential baseline for assessing the impact of implementi"] [10.741632461547852, 18.97653579711914, "for adjustments between the billed charges and paid amounts.\nEven though the WCIS is the best data available, it has limitations. Not all WC claims are reported into the system, and among reported claims there is further underreporting of medical bil"] [10.459675788879395, 18.99158477783203, "ceived the payment. For example, payments for physician-dispensed pharmaceuticals, supplies, and equipment are included in the WCIRB physician payments but are not captured in our WCIS physician file; instead, our file includes only drugs that are ph"] [10.703277587890625, 18.978239059448242, "2010\n2011\n2012\n SOURCES: RAND Analysis of First Report Claims Counts (WCIRB Summary of Policy Year Statistics, various years); WCIS compensable insured claim counts (DWC, 2016b).\n8 percent higher in 2007, 15 percent higher in 2008, and 3\u20136 percent h"] [10.532600402832031, 19.000295639038086, "\n63.3\n Number of Number Year FROI New of\nof Compensable Matched Injury Claims Claims\n2007 710,893 502,478\n2008 658,207 445,992\n2009 577,608 388,826\n2010 571,313 319,795\n2011 551,971 306,900\n2012 534,873 316,199\nTotal\n2007\u2013 3,604,865 2,280,190 2012"] [10.540127754211426, 19.012744903564453, "\n11\n3. Decomposing Spending Trends Introduction\nWhile the impact of medical spending growth on employers, on insurers, and on the stability of the entire WC system is clear, the drivers of WC medical spending growth are not as well understood. This c"] [10.575852394104004, 19.02277946472168, "y reflects the mix of services provided. While prices and volumes are amenable to measurement, intensity is more difficult to quantify.1\nFinally, our framework accounts for the injury year composition of medical spending in each calendar year. In any"] [10.56081485748291, 19.00760269165039, "he duration over which medical expenses are incurred for an injury. In Chapter Four we explore utilization and cost trends that inform the causes for the residual.\nWe considered whether to include changes in injury type (medical only, temporary indem"] [10.536059379577637, 19.00269317626953, "alifornia WC spending for medical services (Table 3.1) on WCIRB annual reports on California WC losses and expenses that are released in June (WCIRB, 2008\u20132013). We found that the reported medical spending for a given year sometimes changes between t"] [10.524178504943848, 19.0108642578125, "es in the prices paid for medical care. California WC medical spending data reported in Table 3.1 are in nominal terms; they do not reflect \u201creal\u201d changes in prices over time (which account for price inflation/deflation). The main disadvantage of nom"] [10.533344268798828, 19.004335403442383, "r inflation factor\nfor pharmaceuticals by equally weighting the annual changes in the producer price index for pharmaceutical and medicine manufacturing and for pharmacies and drug stores.\nPayments to individuals include future medical expense settle"] [10.558629989624023, 18.995128631591797, " to calculate an overall price index accordingly.\n 17\nThe WCIRB claim counts are for insured claims only and are by policy year rather than injury year. The policy year may overlap calendar years (e.g., the policy may cover injuries occurring on or a"] [10.580062866210938, 19.018367767333984, "007 levels in subsequent years and overstates the proportion of the spending attributable to inflation because it does not account for the reduction in the number of WC claims in 2008 and later years.\nResidual changes in medical spending. As noted ab"] [10.533065795898438, 19.033950805664062, "dual in total medical spending, and so the results should be interpreted with caution. In the aggregate, 2012 spending was 30.2 percent higher than 2007 levels, while the expected changes in aggregate spending in each year are negligible relative to "] [10.524662017822266, 19.030858993530273, "pending for Medical Services\n2008 2009\n4,702 4,535 3 \u201314 280 130\n995 1,247 31 58 138 363\n5,697 5,782 33 44 419 493\n2010 2011 2012\n4,767 4,662 4,855 \u201356 \u2013105 \u2013105 404 348 541\n a. Actual spending b. Expected change c. Residual change\n4,419\n "] [10.563445091247559, 19.010801315307617, " WC Claims\nThis section explores trends in the incidence of new WC claims. Changes in the number of new WC claims during a calendar year are a function of changes in the number of full-time employees and the incidence rate for WC claims. The latter i"] [10.581271171569824, 19.035236358642578, "ed spending for post-2007 injury years. Before adjustment, the framework assumes that projected spending for post-2007 injuries would be the same as real spending for 2007 injuries at the same maturity level. Using the adjustment factors in Table 3.6"] [10.56418514251709, 19.03786277770996, "ed fairly stable from 2007 to 2014 (Figure 3.1). The largest category\nof injuries\u2014strains and tears\u2014increased from 29 percent in the 2007 WCIS claims data to\n34 percent in the 2012 data. The shares of other high-volume types of injuries changed less "] [10.56061840057373, 19.0394287109375, "le 3.9. Change in Service Year Holding All\nSpending Explained by Changes in Injury Mix Other Factors Constant\n Impact ($millions)\nAdjustment factor applicable to service year spending for injury years 2008 and later\n2008 2009 2010\n2.9 10.1"] [10.532417297363281, 19.05181884765625, "ding: total\nInjury year 2007 and earlier\nInjury year 2008\u20132012\nTotal spending change relative to 2007\nCost driver contribution: total\nInjury year 2007 and earlier (inflation only)\nInjury year 2008\u20132012 (inflation, claims, injury mix)\nResidual change\n"] [10.568735122680664, 19.03639030456543, ", our estimates of spending for 2007 injuries in subsequent years will be overstated and will affect our measure of changes in injury mix.\n\u2022 We were unable to reliably identify the type of claim in the WCIS medical data (medical only, temporary indem"] [10.530162811279297, 19.018461227416992, "he effect of the three cost drivers on medical service spending. For service year 2012, we estimated the following for these claims:\n- Inflation increased spending 8.8 percent relative to 2007 levels.\n- Changes in the number of new WC claims rates fo"] [10.432751655578613, 18.971399307250977, "es in the type of services and in the volume and mix of services within service categories, and to changes in payment levels for those services. We examine costs and utilization by types of injuries and payers, and in doing so provide a foundation fo"] [10.504697799682617, 18.972753524780273, "ver, we found that MPN status was not reliably reported in the WCIS data. As a proxy for MPN care, we constructed measures that examined claims by the proportion of care that was provided under contract, but found that the overall proportion of contr"] [10.44003677368164, 18.976848602294922, "en year that had an inpatient hospitalization) and produces a per-user measure that is conditional on the claimant using the relevant service one or more times.\nClaim Characteristics\nType of injury: Because overall measures across the injury years ar"] [10.022649765014648, 19.07023811340332, "ofessional codes follow the Current Procedural Terminology (CPT) code categories. For example, the medicine category (CPT codes 90291-99607) includes a broad array of services, such as different types of nonradiologic diagnostic tests, physical thera"] [10.441798210144043, 19.092491149902344, "ury, which are substantially lower than the number of total compensable claims (Table 2.4).\n34\nUtilization\nWe found that utilization measured in volume of services per injury during the first 12 months following the date of injury increased over time"] [10.470236778259277, 19.083362579345703, "0% 2007\n2008 2009\n2010\n2011 2012\nMedicine Surgery\n Drugs Laboratory/Pathology Outpatient Facility Services\nEvaluation and manag"] [10.491266250610352, 18.986473083496094, "k injuries, and 89 percent for all injuries.\n38\nType of Payer\nBetween 70 and 80 percent of claims across injury years are submitted to WCIS for insured claims\u2014the remainder is for claims from the State of California and self-insured public and privat"] [10.520649909973145, 19.07496452331543, " in regions with large numbers of WC claims\u2014the Los Angeles, Bay Area, Inland Empire, Central Valley, and San Diego regions\u2014can drive the statewide trend. Table 4.3 reports changes in average per-injury utilization in different service categories wit"] [10.472943305969238, 19.08071517944336, " Central Sierra\nValley Foothills\n \u201313 3\n 21 29\n 35 47\n 104 85\n 17 25\n 21 34\n \u20132 \u20135\n\u201333 \u20133\nInland Empire\n \u201310\n 23\n 26\n 115\n 16\n 18\n \u201311\n\u201336\nNorth Los State\u2013 Angeles Shasta\n\u201319 \u201324 17 19 20 23 88 59\n8"] [10.478598594665527, 19.0687255859375, "2.\ninjury, an increase in the number of laboratory services they received, or a change in the mix of services rather than changes in fees.\nWhen we examined laboratory/pathology services by CPT classifications, we found that seven categories of tests "] [10.483292579650879, 19.073305130004883, " fee schedule beyond the change in the OMFS conversion factor may have contributed to the increase.\nTo the extent surgical services shifted from inpatient to outpatient facility settings, we would expect to see an increase in both utilization and spe"] [10.48575496673584, 19.082218170166016, "s for surgical services were predominantly for musculoskeletal (58 percent) and spinal (12 percent) procedures. A mix of other types of procedures accounted for the remaining 30 percent of surgical procedures. Spinal procedure volume grew 19 percent "] [16.82997703552246, 20.239961624145508, "scriptions for NSAIDs during the first 12 months postinjury is higher and\nthe proportion for opioids is lower. Another RAND study found that 26 percent of outpatient prescriptions dispensed to all injured workers in 2013 were for opioids compared to "] [16.83372688293457, 20.245939254760742, " agents (213 percent), and compound drugs\n(53 percent). For reference, we estimate the inflation increase in drug prices was 11.6 percent (Table 3.4). Increases in both the average number of prescriptions and the average payment per prescription resu"] [10.523513793945312, 19.07530403137207, "rst 12 Months Postinjury by Type of Injury\n Type of Injury Category\nLow back pain\nUpper back and neck injuries\nShoulder injuries Knee injuries\nAll injuries\n2007 ($)\n2,472\n2,231 3,288 3,396 1,994\n2008 ($)\n2,609\n2,309 3,407 3,567 2,145\n2009 ($)\n2,988"] [10.542481422424316, 19.07682228088379, "injury from 2007 to 2012, the magnitude of the change varied across regions from a 21 percent increase in the North State\u2013Shasta region to a 48 percent increase in the Eastern Sierra Foothills region (Figure 4.17). Regions with high claim volume\u2014such"] [12.404573440551758, 18.14651107788086, "ths Closed 24-36 mths Closed 36-48 mths Closed 48-60 mths\n Work Outcomes\nWe used EDD data to track the proportion of injured workers who were still employed at the first eight calendar quarters after injury. The proportion of workers\u2014injured"] [10.488883972167969, 19.00505256652832, "he WCIS. Our data file was created in August 2016. While we believe that our WCIS study data are nearly complete, we may be missing some services delivered to workers injured in 2012, and claim counts for the medical data may change. The result would"] [10.553939819335938, 18.979076385498047, "higher than that for injury year 2007. This suggests an increase in the intensity of the services. Spending for inpatient services may also have been affected by the pass-through payments for spinal hardware.\n- Utilization and spending for laboratory"] [10.357926368713379, 18.926982879638672, "nical performance using administrative data (Wynn, Timbie, and Sorbero, 2011). The framework anticipates that the clinical measures address an area that affects the health of injured workers or the cost of care and for which performance is known to b"] [10.341477394104004, 19.133079528808594, ", or neck/upper back\ndiagnosis\nNumerator: Claimants in the denominator condition who did not receive either physical therapy or chiropractor services or injectable analgesic care within 60 days preceding the MRI, or an evaluation & management service"] [10.33737564086914, 19.146095275878906, " 2008\n2009 2010 2011 2012\nInjury year\n63\nback pain (42 percent versus 19 percent) and increases to a high of 51 percent in 2009 before beginning to decline slightly in subsequent years. The imaging use measure for shoulders is much lower (6 percent i"] [10.341911315917969, 19.116966247558594, " than for TENS/PENS and nearly all utilization review denials are upheld. The uphold rate for TENS is 91 percent (RAND analysis of independent medical review decisions posted on the DWC website as of February 28, 2017).\n 64\n Percentage of low back pa"] [10.352399826049805, 18.889848709106445, "rmance on the imaging and opioid measures across the subcategories of claim characteristics are difficult to explain. In addition to measuring system performance, the indicators could be used to drill down to identify any aberrant practice patterns t"] [10.273541450500488, 19.200767517089844, "eir PCP will remain with that provider. Provider \u201cchurn,\u201d when an injured worker sees multiple PCPs within the first 12 months, could be indicative of worker dissatisfaction with care or difficulty seeing a preferred provider. However, it could also "] [10.283098220825195, 19.204259872436523, "bset to services with an HCPCS code in the E&M range (99201-99215 and 99241-99245) and a type of service classified as E&M or outpatient facility service, and with a provider primary billing specialty of multispecialty group practice, family medicine"] [10.283976554870605, 19.20386505126953, "-PCP. In sum, more than four in five injured workers had an initial E&M visit in an ambulatory setting. While the ED is an expected first encounter for some severe or otherwise acute injuries, relatively few injured workers\u2014\n9 percent\u2014had an initial "] [10.297121047973633, 19.200843811035156, "jury on the right axis. Both measures increase in magnitude from 2011 to 2012, although the relative increases are small\u2014about 3 percentage points in both cases.\n71\nTable 6.1. Days from Injury to First Nonemergency E&M Visit, by Injury Year and Type "] [10.31011962890625, 19.156484603881836, "encounters in the medical data is critical to the access measure results and interpretation. The high volume of therapy and physician non-E&M visits (such as radiology) that are the first encounters in the WCIS medical data suggest that some initial "] [10.329924583435059, 18.94206428527832, "significant gaps between injury and initial care\u2014 reflect data reporting issues, the increase in cumulative trauma injuries, or potential access issues. The type of first encounter analysis also suggests that further investigation is needed of the in"] [10.120463371276855, 18.9670352935791, " proportion of active community physicians in California who treat WC patients. Our analysis mainly focused on the physician specialties that were most frequently reported in the WCIS data. Provider participation rates are one measure of the extent t"] [10.176382064819336, 19.03252601623535, "their group practice. In 2013, nationally, 139 group practices of 25 or more eligible professionals participated in these programs and reported data.\nThe SK&A office-based physician database (SK&A data) is compiled by SK&A, a health care marketing co"] [10.127964973449707, 19.013858795166016, " 9/14\nMBC\nYes\nNo\nMultiple\nYes for 90% who responded to survey\nNo No\nYes for 90% who responded to survey\n9/14\nARF\nNo\nYes\nPrimary\nPrimary but may not be current\nNo Yes\nYes 2013\n Table 7.2. Comparison of Aggregate Physician Counts Using Alternative "] [10.167658805847168, 19.004837036132812, " least one bill in WCIS. To further refine the universe of active physicians and participating physicians, we merged individual physicians in WCIS with those in NPPES based on NPIs. Less than 2 percent (1.89 percent) of WCIS individual providers did "] [10.119091033935547, 18.99789810180664, "bust to other approaches. First, because some bills were submitted by providers using a group NPI in WCIS in 2012, we included all the individual providers practicing in these groups and assumed they served WC patients. After standardizing practice l"] [10.078269004821777, 18.98863983154297, "about one-quarter of physicians participated in WC in 2012. However, participation rates vary significantly across specialties. For example, the participation rate was more than two-thirds for orthopedic surgery, general practice, occupational medici"] [10.019874572753906, 19.008867263793945, " 47.8 percent, respectively, whereas San Diego and San Mateo had the lowest participation rates, 21.8 percent and\n28.3 percent, respectively. If we assume that all the individual providers in a group that submitted a bill in 2012 served WC patients, "] [9.656923294067383, 18.990333557128906, "he payments for out-of-network services are often much higher and do not necessarily reflect market rates.\n 86\nAnalytic Approach\nData\nWe used the 2011 WCIS data (see Chapter Two for a detailed description) to estimate maxim"] [9.694059371948242, 19.007177352905273, " adjustment factor.\n 87\nfurnished on the same date for the same patient by the same physician. We excluded procedures from the market basket that do not have RVUs (e.g., are priced individually based on the physician\u2019s report) or are not covered by t"] [9.767753601074219, 18.99199676513672, "fer between RBRVS and commercial insurance; including them in the analysis would distort the average allowed amount.\n 88\nvariation in payment levels across geographic areas. Figure 7.5 shows the commercial to RBRVS payment ratios by locality. There w"] [9.715163230895996, 18.98665428161621, "ian expenditures. Of note, office visits account for the largest proportion of all\nWC physician expenditures, 40.5 percent. All other services represent less than 7 percent of physician expenditures.\n 90\nFigure 7.7. Commercial/RBRVS Payment Ratio by "] [9.667257308959961, 19.00335693359375, "tem and computed the total actual payments and total allowed amounts by multiplying the unit allowance by the number of units reported for the line item. We excluded all anesthesia service line items because we were not able to quantify the number of"] [10.041605949401855, 18.983287811279297, "owed Amount ($)\n89,011,262 43,911,191\n36,804,562\n30,884,344 18,558,117 18,582,933 16,531,729 16,926,208 14,573,607 14,533,493\nPercentage of\nTotal Paid/Allowed\nPhysician Amount Expenditure Ratio\n11.5 0.95 5.7 0.95\n4.6 0.91\n3.9 0.92 2.4 0.94 2.4 0.94 2"] [10.030387878417969, 18.981950759887695, "ts.\nWhen interpreting physician participation rates, a small universe of potential physicians could make some rates unreliable. In selecting the commonly reported specialties, we required at\n95\nleast 100 physicians in the NPPES for the specialty. But"] [9.886216163635254, 18.977346420288086, "f the state. FAIR Health data are collected from participating insurers, whose prices may not reflect the average payment of the selected basket of services in California. The payment ratios could be either over- or underestimated.\n96\nFee Discounting"] [9.933408737182617, 19.001680374145508, "rs likely underestimates participation rates.\nOur results are robust to several sensitivity analyses. The patterns of participation across specialties in the sensitivity analyses are very similar to those in the main analysis, although participation "] [10.139843940734863, 18.999277114868164, "f SB 863 reform, a new RBRVS fee schedule has been established for provider services. Our analysis could serve as background and a baseline comparison for future studies on the impact of SB 863 on fee discounting. The implementation of SB 863 has als"] [10.167928695678711, 19.036401748657227, "st medical-legal evaluations during 2007\u20132012 involved at least one work- related issue and may have also involved one or more medical necessity disputes.\nQMEs are licensed allopathic or osteopathic physicians, chiropractors, psychologists, dentists,"] [10.123339653015137, 19.02869987487793, "se modifiers and their effects. For example, the fee schedule maximum allowable amount for an evaluation performed by an AME is 25 percent higher than the allowable amount when a QME or primary treating physician performs the evaluation. The effect o"] [10.177732467651367, 19.051626205444336, "orkers who are performing medical-legal services. We found that we were unable to do so using the WCIS data because a substantial proportion of medical-legal services are billed under an organizational identification number rather than the unique NPI"] [10.144686698913574, 19.03219985961914, " of units billed for ML104 increased from 30.6 to 45.0, which represents an increase of 216 minutes or more than 3.5 hours in the average length of time reported to conduct an examination.\n104\nFigure 8.2. Average Number of Units per Evaluation, by Me"] [10.148102760314941, 19.02199935913086, "following the date of injury. Providers are most likely to bill for medical- legal services between 12 and 24 months after injury. This pattern has remained relatively constant across injury years. The percentage of claims with medical-legal codes in"] [10.188065528869629, 19.047191619873047, " multispecialty group practice or legal medicine, or use a general code such as \u201callopathic and osteopathic physician\u201d or \u201cspecialist.\u201d These taxonomies are included in the \u201cother specialty\u201d category in the figures that follow, along with unspecified"] [10.13818645477295, 19.086746215820312, "eded only by physicians in family medicine and general practice (74 percent increase) and chiropractors (72 percent increase). Orthopedic surgeons and other surgeons bill on average fewer units per medical-legal service, which accounts for their rela"] [10.116981506347656, 19.059701919555664, "gure 8.9. Average Units per Evaluation by Region, Service Years 2007 and 2012\nFigure 8.10. Average Payment per Medical-Legal Service by Region, Service Years 2007 and 2012\n 113\nOther Services\nIn addition to performing the medical-legal evaluation, p"] [10.070744514465332, 19.06389808654785, ")\nOther E&M Services\nCentral Nervous System Assessments/Tests\nNeurology and Neuromuscular Procedures\nCardiovascular Monitoring\nPulmonary Diagnostic Testing and Therapies\nLab/Pathology 2.4\nService Category\nModifier\n9.4 0.0 0.6 3.1 5.7 4.9 1.8 1.6 1.2\n"] [10.17486572265625, 19.052654266357422, "hose reported using the generalist MD/DO code. The latter assumes that the actual distribution of the medical-legal evaluations reported as \u201cgeneral practice\u201d is similar to the distribution of the reported specialties. We created unduplicated counts "] [10.165124893188477, 19.006183624267578, "were billed based on 15-minute increments and in the average number of units billed per evaluation. In addition, there is a steady increase in the percentage of claims with medical-legal codes within the first 36 months following dates of injury. The"] [10.452186584472656, 18.924894332885742, "supplementing the WCIS with external data. Because of underreporting on indemnity data, our decomposition of the spending increases was limited by not being able to identify injured workers who received temporary or permanent disability payments.\nOth"] [10.504366874694824, 18.918926239013672, "g to comply with WCIS data reporting requirements in 2011. Regulations were proposed in 2013 to implement the financial penalties but were not finalized. SB 1160 (Mendoza) amended the penalties in Labor Code section 138.6 that may be assessed against"] [10.551146507263184, 18.999004364013672, "ation)\n 120\nB. Estimated Impact of Changes in New Claims Using WCIS Counts Compared with Systemwide Estimates Derived from SOII and WCIRB Counts\nA key cost driver in our analyses decomposing spending trends is the change in the incidence of new WC"] [10.576390266418457, 19.04184913635254, "0.863\n\u2013352.7 0.855\n\u2013354.3 0.8550\n2010 2011 2012\n\u2013540.8 \u2013736.7 \u2013851.6 0.824 0.791 0.781\n\u2013522.1 \u2013654.8 \u2013728.7 0.830 0.814 0.813\n\u2013406.3 \u2013461.3 \u2013507.3 0.8675 0.8691 0.8698\n C. Detailed Explanation of Injury Mix Adjustment\nC"] [10.569388389587402, 19.04718017578125, "r-Lower Extremity StrainTear-Upper Extremity StrainTear-Trunk\nStrainTear-Multiple\nStrainTear-Other 1,175 All Other Claims 336,750 All 2007 Claims 477,060\nSOURCE: DWC (2016b).\n49.1 100.8 136.3\n27.1 1.9 659.3 974.6\n17.4 11.3 38.0 23.9 67.9 46.6 13.1 9."] [10.56003475189209, 19.041229248046875, " subsequent years that account for changes in injury mix. The adjustment factors at 12 months\u2019 maturity increase from 1.003 in 2008 to 1.010 in 2011 and 2012, indicating that changes in injury mix explain less than a 1 percent impact on spending leve"] [10.573885917663574, 19.026334762573242, "njury years.\nTo apply the adjustment factors for changes in the incidence of new claims and injury mix, we first stratified service year medical spending by injury year (Table A.6). Each cell in the table shows actual spending in that service year fo"] [10.621232032775879, 19.02566909790039, "ning some of the residual spending increase. The ultimate (or total) medical losses over the life of a claim are much higher for permanent indemnity claims and temporary disability claims than for medical-only claims. The latter may be closed with mi"] [10.115042686462402, 19.080310821533203, "of line items reported on laboratory (CPT codes 80047-89398) and radiology (CPT codes 70010-76999) bills since these are often contain \u201crule out\u201d diagnoses. We counted the number of unique diagnosis codes that were identified as one of the four condi"] [10.012228965759277, 19.12617301940918, "\nMedicine\nMedicine\nMedicine\nMedicine Laboratory/Pathology\nLevel 2 Category\nNA\nCase Management Services\nConsultations\nED Visits\nOffice Visits\nOther\nManipulative Treatment\nNeurology Physical Medicine Other\nNA\nCriteria\nOne of the following: (a) pharmacy"] [10.132209777832031, 19.069061279296875, "roupings used in the monitoring tables\nTable B.3. Specialty Taxonomy Codes to Create Provider Specialty\n Provider Specialty\nMultispecialty group practice Single-specialty group practice Anesthesiology\nOrthopedic surgery\nOther surgery\nEmergency medic"] [10.339523315429688, 19.10349464416504, "ulder injury categories and dropped the age 18\u201350 inclusion terms used in the NCQA measure. The shoulder measure includes only CT and MRI procedures, while the measures for the back injury categories also include X-rays. We defined the index date as "] [10.265629768371582, 19.107019424438477, " of injury that were billed on the same day as an included diagnosis code in Table B.4, and (2) did not have an excluded diagnosis code at any point during the 24-month period. The denominator is the count of all bills for MRIs identified for this po"] [10.088099479675293, 18.97347640991211, "A claim had PENS if the bills included CPT codes 64553, 64555, 64560, or\n 64565, or HCPCS codes L8680-L8688. For the\n134\nE0720, E0730,\nAppendix C: Sensitivity Analyses of Provider Participation Rates for WC Patients\nFigure C.1. Physician Participatio"] [11.179386138916016, 18.17742347717285, "yMeetingPresentationFROI-SROI _Final10182013-1.pdf\n\u2014\u2014\u2014, First Reports of Injury and Subsequent Reports of Injury Update, Oakland, Calif.: Department of Industrial Relations, 2016a. As of July 20, 2017: http://www.dir.ca.gov/dwc/WCIS/AdvisoryMeetingOc"] [11.17226505279541, 18.20665168762207, "Data Reporting Requirements: Administrative Penalties, Sacramento, Calif.: California State Legislature, 2011. As of February 28, 2017: https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB826\nSenate Bill 1160 (Mendoza): Wo"] [11.118898391723633, 18.189645767211914, "g Plan\u20141995: Title 10, California Code of Regulations, Section 2318.6, Effective January 1, 2015.\n\u2014\u2014\u2014, [2007\u20132012] Report on California Workers\u2019 Compensation Losses and Expenses, 2008\u20132013. As of July 7, 2017: https://www.wcirb.com/research-and-analy"] [-0.27469587326049805, 13.569894790649414, " Adapting Land Use and Water Management Plans to a Changing Climate in Miami-Dade and Broward Counties, Florida\nDavid G. Groves, Debra Knopman, Neil Berg, Craig A. Bond, James Syme, Robert J. Lempert\n CORPORATION\nFor more information on this publicat"] [-0.42962780594825745, 13.507349014282227, "ic values.\nReaders of this report may also be interested in other RAND work on this and related topics:\n\u2022 Jordan R. Fischbach, Kyle Siler-Evans, Devin Tierney, Michael T. Wilson, Lauren M. Cook, and Linnea Warren May, Robust Stormwater Management in "] [15.051652908325195, 5.769973278045654, ".................................................................................................... ix Summary........................................................................................................ xi Acknowledgments................"] [-0.08151161670684814, 13.703043937683105, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Linkage of Economic Metrics to Hydrologic Model Output. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [-0.06709036976099014, 13.730802536010742, "..................................................................................73\nAPPENDIXES\nA. Simulating Future Land Use in the Broward Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 B. S"] [-0.06576467305421829, 13.733901977539062, ". . . . . . . . . . . . . . . . .\n4.9. Projected Change in Valuation Under the Equal-Value Elevation Method for Broward............................................................................................\n4.10. Projected Valuation Change for B"] [-0.04432864487171173, 13.743236541748047, " . . . . . .\n5.12. Value of Vulnerable Assets in UMD for Low SLR and Driest Precipitation\nConditions in the Wet Season Under the Elevation Asset Distribution Method,\n2040 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [-0.08887108415365219, 13.719289779663086, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n2.2. Potential Goals and Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [-0.10228875279426575, 13.7037353515625, "hat underlies Southeast Florida and thereby reduce soil storage capacity. If not well planned and coordinated, land use and transportation decisions at the local and regional levels could exacerbate impacts of a changing climate.\nSoutheast Florida co"] [-0.06464901566505432, 13.725783348083496, " to a changing climate and increased economic growth, followed by an analysis of alternative approaches to land use that could possibly miti- gate at least some of these vulnerabilities.\nPlanning Goals and Metrics\nDiscussions with officials in Miami-"] [-0.07316151261329651, 13.726469993591309, "bly\nrunning the model in a \u201cbatch\u201d mode to simulate many plausible futures\n\u2022 modify land cover and land use assumptions for alternative scenarios.\nFigure S.1 summarizes the relationships among the physical and economic elements of an integrated syste"] [-0.0858205109834671, 13.739473342895508, "nland flood and saltwater intrusion risk in the region.\nOur interest in developing an integrated modeling framework is to use it to gain insight into the vulnerability of South Florida\u2019s built environment to a range of possible future climate conditi"] [-0.07607778161764145, 13.7291259765625, "nly a few areas currently experiencing average depths to groundwater less than 1 foot, and areas along UMD\u2019s ridge not exhibiting any vulnerability within the time frame of the analysis.1\n\u2022 In the future (i.e., 2040 time frame), changes in precipitat"] [-0.12232870608568192, 13.683329582214355, "en more extensive interactions with decisionmakers are essential ingredients to any successful long-term planning effort.\nThe approach to analysis demonstrated in this project shows promise and should be con- tinued and refined. Specifically, improve"] [-0.10299498587846756, 13.726881980895996, "e consequences for Southeast Florida, and adaptive measures will be needed to reduce the most serious of these impacts to manageable levels. With a flat topography, low-lying land, and an extensive coast- line, the region will have an increasingly di"] [-0.14072637259960175, 13.687793731689453, "ng in a constructive and organized manner to bring available resources to bear on the challenges of SLR and climate change (Southeast Florida Regional Climate Change, 2012). As one example, partner counties and cities in this effort have formally ado"] [-0.09914345294237137, 13.689942359924316, "nsequences of constraining choices for neighboring jurisdic- tions. In the absence of mathematical simulation tools of suitable spatial and temporal resolution, these potentially large externalities from disjointed decisionmaking need to be quantifie"] [-0.10417408496141434, 13.691299438476562, "ested in demonstrating an analytical framework that enables cities and counties to better manage these kinds of externalities when making their own development decisions and approving permits for individual projects.\nIntroduction 3\n4 Adapting Land Us"] [-0.08747081458568573, 13.712974548339844, "is to include economic implications of future flooding using newly developed economic projections of assets. The final analyses were then presented at Miami-Dade County offices in December 2016 and with an updated webinar presentation in May 2017. Ov"] [-0.39032167196273804, 12.738994598388672, "e on the model(s) that relate their actions to consequences, the prior prob- ability distributions for key parameters to the models, and the importance of various objectives (Lempert, Norling, et al., 2003; Walker, Haasnoot, and Kwakkel, 2013). Tradi"] [-0.41335585713386536, 12.730378150939941, "olders who have differ- ing expectations about the future nonetheless reach consensus on action. In essence, RDM helps plan for the future without first predicting it. RDM has been applied to water resource management (Groves, Lempert, et al., 2008; "] [-0.4179929792881012, 12.703344345092773, "e number of cases generated, this step may be done either through case-by-case analysis or through an automated means of identifying the most signifi- cant vulnerabilities. The outcome of the scenario discovery step is generally several scenarios tha"] [0.01591654308140278, 13.645533561706543, "ld be relevant for this project. We subsequently reworked the XLRM matrix for purposes of further discussion and refinement with our partners. The fol- lowing subsections discuss the XLRM matrix used in this analysis (Table 2.1).\nPlanning Goals and M"] [-0.08574485778808594, 13.714727401733398, "g/L) are in violation of the U.S. Environmental Protection Agency\u2019s drinking water standard (U.S. Environmental Protection Agency, 2017). Another common high-salinity threshold used in the region is 1,000 mg/L.\n\u2022 Asset values at risk to inland ground"] [-0.06665559858083725, 13.706596374511719, " SFWMD (Dessalegne et al. 2016):\n\u2022 5th percentile = driest future (63 percent of current annual rainfall)\n\u2022 25th percentile = dry future (87 percent of current annual rainfall)\n\u2022 50th percentile = average future (109 percent of current annual rainfal"] [-0.08719804137945175, 13.714239120483398, " outputs from the hydrological models.\nEach aspect of the integrated modeling framework is discussed in greater detail in the following chapters. Simulation results were used to define the climate risk by comparing the geophysical outcomes to project"] [-0.11214518547058105, 13.688735008239746, "d White (2014) simulated UMD groundwater from a baseline period of 1996\u20132010 compared with a scenario with 30 years of SLR. Hughes, Sifuentes, and White (2016) used the Broward model to exam- ine Broward groundwater changes with SLR out to 2062. Whil"] [-0.06650808453559875, 13.724884986877441, "nal water management model, such as SFWMD\u2019s Regional Simulation Model (SFWMD, 2005). Finally, alternative economic futures might be considered.\nApproach to Analysis and Decision Support 15\nCHAPTER THREE\nIntegrated Modeling Framework\nWe coupled two US"] [-0.06374961882829666, 13.692516326904297, " purposes.\n 17\n18\nAdapting Land Use and Water Management Plans to a Changing Climate\n\u2022\n\u2022 \u2022 \u2022 \u2022 \u2022 \u2022\nThe USGS models produce a range of useful outputs:\nquantification of changes in groundwater pumping and sea level on canal leakage and groundwater infl"] [-0.052241772413253784, 13.737911224365234, "s an active groundwater component. In total, 50,179 grid cells are actively simulated in each of the model\u2019s 12 vertical layers that represent the surficial aquifer. The model operates on a monthly time step and was calibrated to observed groundwater"] [-0.0749240443110466, 13.710556983947754, "and expectations) into account. As a consequence, expected damages from future environmental risks would be capitalized into fixed asset values. However, absent additional evidence or assumptions about these responses, we chose a scenario approach to"] [-0.0627288967370987, 13.737212181091309, "W source code be included for non-Windows operating systems, which would increase model usage on different platforms, particularly for easier compilations on cloud-based servers.\nLessons Learned\nWorking with any hydrological model, such as MODFLOW, i"] [-0.07953881472349167, 13.72533893585205, "\nPlausible Future Conditions Affecting Southeast Florida\u2019s Built Environment\nThe purpose of developing an integrated modeling framework was to use it to gain insight into the vulnerability of Southeast Florida\u2019s built environment to a range of possib"] [-0.06531273573637009, 13.741498947143555, "search.\n 23\n24 Adapting Land Use and Water Management Plans to a Changing Climate\nwould allow the saltwater-freshwater interface to move inland because of the reduced hydraulic pressure from the landward side. The reverse would happen under conditio"] [0.07872913777828217, 13.435233116149902, "ased on downscaling several GCMs (and in some cases, multiple realizations for a single GCM) evaluated using three greenhouse gas emission scenarios, or RCPs, from the IPCC Fifth Assessment Report (Stocker et al., 2013). Specifically, the ensemble in"] [-0.07373276352882385, 13.725504875183105, "hese economic futures are essentially alternative levels and spatial distributions of current and future property values at risk from inland flooding and SLR (although additional environmental or other random threats could be modeled). We used the ta"] [-0.06373391300439835, 13.747673988342285, "raged over the UMD and Broward Model Domains\n30\n25\n20 Monthly rainfall (inches) 15 10\n5\n0\n2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 Year\nRAND RR1932-4.3\n Driest future\nDry future\nAverage future\nWet future\nWet"] [-0.05390206724405289, 13.751432418823242, "ludes 87 current land use descriptions. Miami-Dade\u2019s 2030 CDMP (Miami-Dade County, 2017) uses an additional 25 distinct land use descriptions, and 33 Broward\u2019s 2040 Future Land Use Plan (Broward County\n2 In particular, we used the areal interpolation"] [-0.06063513830304146, 13.73582649230957, "ty. Moreover, rural development is a new category based on projected growth within the Broward categories of rural estates and rural ranches. Figure 4.5 presents the resulting maps of standardized current and future land use across the two counties.\n"] [-0.05555788800120354, 13.745465278625488, " $10 billion for the small south-central Broward region to more than $100 billion for the large and heavily populated lower UMD region. For all regions, urban assets account for the vast majority of the value.\nFuture Land Use and Distribution of Asse"] [-0.06274308264255524, 13.734984397888184, "g data from the American Community Survey [U.S. Census Bureau, undated], and current just values). These densities were used to cap development within any particular cell. See Appendix C for details.\nSecond, grid cells available for residential devel"] [-0.06339789181947708, 13.734748840332031, " units in a spatial manner. The\n7 Recall that current and future land use codes are based on the predominant land use category by area. So, for example, residential development in a cell currently classified as water and some future residential categ"] [-0.06311243772506714, 13.737879753112793, "ly lower at $4.40 million, or an increase of approxi- mately 17.6 percent. The minimum and maximum cell values were unchanged. Figure 4.9 shows the spatial pattern of the change in value for Broward County. The method distributes population and asset"] [-0.0646786168217659, 13.731515884399414, "1\nProjected Change in Valuation Under the Equal-Value Elevation Method\n $0M\n$50M\nAventura\nMiami Beach\nValuation change\n RAND RR1932-4.11\nRegion\nNorthwest Broward\nNorth- central Broward\nNortheast Broward\nFar southwest Broward\nSouthwest Broward\nSouth- "] [-0.06736990809440613, 13.731425285339355, "pulation growth (which was slightly lower, at 10.8 percent, than the 11.4 percent assumed in the other scenarios) and did not fore- cast increased industrial or commercial activity (whose values were assumed to increase at the rate of population grow"] [-0.0610116608440876, 13.753910064697266, " dry period and the wet period. We then reported the average depth to groundwater for the wet and dry seasons. These metrics serve as proxies for flooding caused by groundwater reaching the ground surface. Smaller depths indicate proximity to the lan"] [-0.06761185079813004, 13.735860824584961, "hows changes in depths to groundwater in the future during the wet season for the middle SLR scenario and average precipitation conditions for Broward. The red regions on the coast show the impact that SLR will have on changes in depth to groundwater"] [-0.05968938022851944, 13.746698379516602, "odels. To keep our base case as close to the published USGS results as possible, we maintained the USGS assumptions about future pumping. We were unable to run scenarios with varying pumping rates to explore the differ- ences between the two models w"] [-0.10576934367418289, 13.757533073425293, "nd by the perspective of a planner, Figure 5.7 enables the user to adjust the threshold. These results show the far southwest and southwest regions of Broward have the largest sensitivity in terms of areas with low depths to groundwa- ter. The variat"] [-0.07230464369058609, 13.731258392333984, "s are vulnerable, we combined the depth to groundwater with estimates of current assets and projections of future assets in the following sections.\nAsset Values at Risk\nWe next estimated the value of assets that are vulnerable to groundwater flooding"] [-0.07239516079425812, 13.733829498291016, "t, and southwest Broward all have high numbers of grid points with vulnerable assets between $1 million and $5 million. The highest concentration of high-value vulnerable assets is in the northeast and north-central Broward regions, as seen in the ma"] [-0.07080778479576111, 13.7315092086792, " precipitation future to 23.\nFigure 5.14 summarizes the vulnerability of asset values across the precipitation and SLR futures for UMD.1 The results are organized so that precipitation and SLR increase from left to right. The horizontal lines cutting"] [-0.07176773250102997, 13.733524322509766, "nstant at current levels. The yellow bars show the percentage change in vulnerable assets due to changes in asset value between now and the 2040 time frame. For these results as well, depths to groundwater are held constant at current levels. The gra"] [-0.062015220522880554, 13.737611770629883, "and Water Management Plans to a Changing Climate\nFigure 5.15\nDisaggregated Groundwater Flooding Vulnerability for the Elevation Method\nBroward (TAZ asset method/UMD: Elevation asset method)\nModel SLR\nBroward Low\nPrecipitation\nDriest Dry Avg Wet Wette"] [-0.07135830074548721, 13.73150634765625, "h SLR. The results for the elevation method (not shown) indicate more-dispersed asset-driven vulnerability for both futures.\n60 Adapting Land Use and Water Management Plans to a Changing Climate\nFigure 5.17\nDrivers of Vulnerability to Groundwater Flo"] [-0.07134012877941132, 13.733583450317383, "ment Plan\nBroward: Above 5 feet\nMiami-Dade: Above 8 feet (along ridge)\nBroward: Along 2035 long-range transportation projects Miami-Dade: Along SMART plan\nReorient development away from high-vulnerability areas\nFill is used to raise existing developm"] [-0.07410256564617157, 13.732687950134277, "ach. These coastal areas will also face risks from flooding caused by rising tides, which is not addressed in this research. These areas are strong candidates for Strategies 4 (cut and fill) and 5 (increase pumping and drainage).\nIn UMD, the future v"] [-0.0637875571846962, 13.728426933288574, "t increases the horizontal water pressure difference between the ocean and groundwater in the Biscayne Aquifer. Increased rainfall on land and infiltration into the aquifer act to freshen groundwater, raise the water table, and push the interface bac"] [-0.06465037912130356, 13.727930068969727, "levels above 1,000 mg/L. For these two futures, chloride levels in nearly all wells in the Hollywood, Dania, and Dixie well fields exceed safe drinking water standards (e.g., >250 mg/L).\nTo summarize effects across the region, Figure 6.3 depicts the "] [-0.07091990113258362, 13.729268074035645, "with projected high chloride concentrations, all are projected to have chloride levels below 1 mg/L.\nKey Findings\nSaltwater intrusion is not projected to impact groundwater wells in UMD through the 2040 time frame. However, it has the potential to im"] [-0.07672366499900818, 13.726221084594727, " on high-value coastal development but also on some inland areas. The analysis further demon- strated the importance of looking at a wide range of possible future conditions to understand the range of possible outcomes within the region.\nAs is always"] [-0.08811864256858826, 13.720791816711426, "eas of the county, providing an opportunity for adaptation to accompany future development in these areas. Vulnerability to increased groundwater flooding hazards could affect more than $2 billion of future assets; however, $900 million of these asse"] [-0.06948541104793549, 13.733450889587402, "le assets in the region in futures that are vulnerable to SLR and changing patterns of rainfall. However, because our initial analysis accounts only for private building assets, important drivers of economic risk related to economic activity generate"] [-0.038120340555906296, 13.764391899108887, "alibrated multipliers (Table A.2) to rep- resent changes in land use over time across the Broward model extent. According to Hughes, Sifuentes, and White (2016), these multipliers generally increase in time, consistent with lower groundwater levels u"] [-0.06018637865781784, 13.73613166809082, "1 percent different). This finding justified our choice to not explicitly change land use codes in the model; rather, we simply overlaid future land use patterns and future hydrological output (using historical land use codes in the model) in the ana"] [-0.04863130673766136, 13.719499588012695, "tels\nImproved agricultural\nInsurance company offices\nLeasehold interests (government-owned property leased by a nongovernmental lessee) Light manufacturing\nLumber yards, sawmills, planing mills Military\nMineral processing, phosphate processing, cemen"] [-0.0643153265118599, 13.7417631149292, "story\nSubsurface rights\nSupermarkets\nTourist attractions, permanent exhibits, other entertainment facilities, fairgrounds (privately owned)\nUtility, gas and electricity, telephone and telegraph, locally assessed railroads, water and sewer service, pi"] [-0.07093410938978195, 13.73936939239502, "ban low density Urban low density Urban medium density Urban medium density Urban low density Urban medium density Urban medium density Urban low density\n 84 Adapting Land Use and Water Management Plans to a Changing Climate\nTable B.3\u2014Continued\nBrow"] [-0.1008739024400711, 13.719432830810547, "sidential 6\u201313 DU/AC Medium-density residential 13\u201325 DU/AC\nMedium-high density residential 25\u201360 DU/AC\nOffice or residential\nPersons per Cell\n215\n430 12,888 537 644 1,504 2,792 5,370 537\nValue per Cell (2015 $)\n51,205,048 67,241,768 184,800,000 55,9"] [-0.39911171793937683, 13.519984245300293, "rporation, MG-679-CTRMP, 2007. As of April 3, 2018:\nhttps://w w w.rand.org/pubs/monographs/MG679.html\nDOR\u2014See Florida Department of Revenue.\nEngineer Regulation 1100-2-8162, Incorporating Sea Level Change in Civil Works Programs, Washington D.C.: U.S"] [-0.31484994292259216, 13.500893592834473, "rg/pubs/research_reports/RR437.html\nGroves, David G., Robert J. Lempert, Debra Knopman, and Sandra H. Berry, Preparing for an Uncertain Future Climate in the Inland Empire: Identifying Robust Water Management Strategies, Santa Monica, Calif.: RAND Co"] [-0.5254667401313782, 13.138442993164062, " Robert Lempert, Casey Brown, Adrian Fozzard, Stuart Gill, and Anku Shah, Agreeing on Robust Decisions: New Processes for Decision Making Under Deep Uncertainty, Washington, D.C.: World Bank, Policy Research Working Paper 6906, 2014. As of April 20, "] [-0.4042070209980011, 13.441679000854492, "Good Decisions Without Predictions: Robust Decision Making for Planning Under Deep Uncertainty,\u201d Santa Monica, Calif.: RAND Corporation, RB-9701, 2013. As of April 3, 2018: https://www.rand.org/pubs/research_briefs/RB9701.html\nMiami-Dade County, \u201c203"] [-0.11796680837869644, 13.7349214553833, "theast Florida, Sea Level Rise Work Group, October 2015. As of April 3, 2018:\nh t t p : / / w w w . s o u t h e a s t fl o r i d a c l i m a t e c o m p a c t . o r g / w p - c o n t e n t / u p l o a d s / 2 0 15 / 1 0 / 2 0 15 - C o m p a c t - U n"] [-0.08788743615150452, 13.721761703491211, "isks. Looking out to the 2040 time frame, the analysis linked two groundwater flow simulation models developed separately for the two counties with a simple economic model of asset values as a function of groundwater levels and the location of the sa"] [11.444099426269531, 18.054166793823242, " CORPORATION\nEvaluation of the\nReturn-to-Work Fund in\nCalifornia\u2019s Workers\u2019\nCompensation System\nPerformance to Date and Options for Modification\n Michael Dworsky, Denise D. Quigley, Stephanie Rennane, Madeline B. Doyle\nFor more information on this pu"] [11.372027397155762, 17.56978416442871, "itute for Civil Justice (ICJ) is dedicated to improving the civil justice system by supplying policymakers and the public with rigorous and nonpartisan research. Its studies identify trends in litigation and inform policy choices about liability, com"] [11.821952819824219, 18.33907699584961, "...... 1\nOrganization of the Report .................................................................................................................. 2 Chapter Two: Background and Overview of Study ..................................................."] [11.406563758850098, 18.816993713378906, ".......................................................................................... 35 Context Surrounding the RTWSP and the SJDB Voucher Issuance ................................................... 35 Legal Process............................"] [11.425768852233887, 18.810224533081055, "................................................................................... 57 Take-Up of the RTWSP Among Eligible Workers and Patterns of SJDB Voucher Issuance............... 66 Chapter Seven: Eligible Population and Program Cost Estimates ."] [11.418951988220215, 18.81818389892578, "........... 30\nFigure 3.4. Time Between RTWSP Application and RTWSP Payment for Approved Applications...................................................................................................................... 31\nFigure 3.5. Trends in SJDB "] [11.438104629516602, 18.81006622314453, "......................................................................... 69\nTable 7.1. Lower and Upper Bounds for Ultimate RTWSP-Eligible Population per Injury\nYear, with Comparison to Assumptions Made Prior to Program Inception ...................."] [11.738147735595703, 18.50602912902832, "e Quartile........................................................................................................................... 155\nTable B.15. Characteristics of Permanently Disabled Workers With Versus Without Paid\nSJDB, 2013\u20132014 Injuries .."] [11.436899185180664, 18.780141830444336, "lity to the Supplemental Job Displacement Benefit (SJDB), a voucher-based VR benefit established in 2004 that replaced California\u2019s traditional VR system. Linking the RTWSP to the SJDB leveraged an existing process for identifying workers without a q"] [11.424193382263184, 18.79970932006836, "ent among workers who received both PPD benefits and the RTWSP. These findings suggest that the RTWSP is targeted to workers who are less likely to return to work and thus may face disproportionate earnings losses. While this study did not include da"] [11.423527717590332, 18.810924530029297, ".\nLegal representation is the factor most strongly associated with take-up of the RTWSP among eligible workers. After controlling for a wide range of other factors, eligible workers with legal representation were more than 40 percentage points more l"] [11.406277656555176, 18.82554817199707, "ization incentivized by the RTWSP\u2019s design would represent a positive unintended consequence of the choice to tie RTWSP eligibility to the SJDB voucher; higher SJDB utilization was factored into cost projections used to develop the program, but the i"] [11.400546073913574, 18.83265495300293, "te physicians about their reporting responsibilities could also improve workers\u2019 access to the RTW Supplement. Efforts to educate other injured workers\u2019 advocates about the RTWSP could also increase take-up, but we note that a strategy centered on im"] [11.42619800567627, 18.80447769165039, "ly increase program take-up, it would be prudent to have a contingency plan for financing payments above $120 million in a given year. Further analysis may also help to identify leading indicators for the volume of applications.\nBetter Evidence on Ef"] [11.553596496582031, 18.67547035217285, "e data is needed to assess the RTW Supplement\u2019s full effects on employment outcomes and on benefit adequacy and equity in the context of the current PPD benefit system, the early results presented here are promising.\nxvii\nxviii\nAcknowledgments\nWe wis"] [11.754838943481445, 18.305147171020508, "lified medical examiner\nreturn to work\n xxi\nRTWSP Return-to-Work Supplement Program SB Senate Bill\nSJDB Supplemental Job Displacement Benefit SROI Subsequent Report of Injury\nSSDI Social Security Disability Insurance TAG Technical Advisory Group\nTTD "] [11.569830894470215, 18.637313842773438, "he adequacy of indemnity benefits for workers with PPD as a result of workplace injuries and illnesses. Besides modifying the disability rating process and increasing the maximum weekly benefit, SB 863 took the novel approach of creating an additiona"] [11.402266502380371, 18.815977096557617, "ornia\u2019s RTWSP as we approach the third anniversary of the program\u2019s inception. RAND researchers conducted a mixed-methods evaluation with two key objectives: (1) to evaluate the design and performance of the RTWSP and (2) to identify practices and po"] [11.69631290435791, 18.292327880859375, "nd B provide qualitative information on the stakeholder interviews and quantitative data, including data sources, methods, and supplementary results.\n3\n4\nChapter Two: Background and Overview of Study\nThis chapter provides some background information "] [11.791322708129883, 18.287025451660156, " longer, the first three days are covered retroactively.\n 5\nMost workers who file a workers\u2019 compensation claim do not experience any work absence beyond the three-day waiting period, and thus they receive only medical care. However, three in ten in"] [11.802475929260254, 18.304655075073242, " temporary disability benefits.\n4 The Workers\u2019 Compensation Insurance Rating Bureau of California (WCIRB), which develops rates for commercial insurers that serve the California market, reports that PPD benefits were 41 percent of total indemnity pay"] [11.849658012390137, 18.295581817626953, "w states use a \u201cwage loss\u201d approach to PD benefits today. One serious drawback of the wage loss approach is that tying compensation directly to post-injury earnings creates work disincentives that lead to higher disability duration, driving up system"] [11.825654029846191, 18.360136032104492, "enefits make it a natural focus for legislative efforts to control system costs: While PPD benefits in California currently account for a smaller proportion of total system costs than is the case in many other states, PPD benefits represent roughly o"] [11.931904792785645, 18.45830535888672, " disability rating system relied on a complex combination of factors to arrive at a disability rating. The pre-2005 disability rating system was marked by a reliance on functional evaluations that attempted to account for individual-level work restri"] [11.888325691223145, 18.44025421142578, " rates of lost income fell by 26 percent after the reforms (Seabury et al., 2011). Given past evidence showing that California already had questionable benefit adequacy under the old benefit levels (Peterson et al., 1997), there was concern that the "] [11.867715835571289, 18.370067596435547, "o Permanent Partial Disability Benefits in Senate Bill 863\nIn September 2012, California adopted SB 863 as an attempt to contain medical costs for injured workers while restoring some of the PPD benefits that had been reduced. The bill made many chan"] [11.851496696472168, 18.4267520904541, " 2012, about 75 percent of PD workers had earnings above the weekly maximum, while only about 15 percent of PD workers had earnings below the weekly minimum.9\n9 For the vast majority of PD workers with ratings below 70, SB 863 raised the maximum week"] [11.471612930297852, 18.753406524658203, "on observed earnings losses, providing an extra payment to workers who experienced the worst outcomes after injury. However, it is not possible to design a system that compensates workers based directly on post-injury earnings without introducing som"] [11.453498840332031, 18.764739990234375, " between the generosity of the RTW Supplement and the affordability of the RTWSP. After modeling various possible combinations of these parameters, it was determined that eligible workers who apply would receive a flat, one-time $5,000 payment (the \u201c"] [11.428829193115234, 18.792583465576172, "chase services or equipment that promotes functional and VR but that either is not covered by workers\u2019 compensation medical benefits or the SJDB or that has costs above the $6,000 cap on the SJDB.\nIn addition to its primary objective of improving the"] [11.447366714477539, 18.771717071533203, "he current program design. Other program impacts that are more amenable to study with currently available data are examined later in the report.\nThe parameters of the RTWSP were based on analysis of historical program trends and estimated earnings lo"] [11.412858009338379, 18.811038970947266, ", apply for, and receive the RTW Supplement?\n\u2022 Does the RTWSP accurately target workers \u201cwhose permanent disability benefits are\ndisproportionately low in comparison to their earnings loss\u201d?\n\u2022 Is the RTWSP vulnerable to fraud and abuse?\n\u2022 Are barrier"] [11.37848949432373, 18.82435417175293, "ances for these required reports in 2014. To further our understanding of the operation and design of the RTWSP in California, we reviewed information available online about the RTWSP and the SJDB voucher issuance processes and held focused discussio"] [11.370563507080078, 18.829883575439453, "holders were then guided through a semistructured interview regarding their experiences with the details of workers\u2019 compensation reporting, the SJDB voucher issuance, and the RTW Supplement benefit issuance process, guided by three slides that were "] [11.428343772888184, 18.830785751342773, " multiple administrative and public use data sets to provide a comprehensive picture of injured workers who have entered the workers\u2019 compensation system since 2011. around the time of the implementation of the RTWSP. These data sources include the W"] [11.402448654174805, 18.81574249267578, "ouchers in a series of descriptive statistics and then formalized this analysis in a multivariate logistic regression. We also analyzed several factors to identify behavioral responses that might influence participation. These analyses involved compa"] [11.32308578491211, 18.81072425842285, "h report or form, the recipients, the event(s) requiring completion or submission of each report or form, and relevant timelines.\nMaximum Medical Improvement and the Return to Work & Voucher Report\nWhen an injured worker is determined by their PTP to"] [11.418939590454102, 18.808263778686523, "hin 20 days\nClaims Administrator\nSign and issue SJDB Voucher\n Injured Worker + Attorney\n * Claims administrator: employer\u2019s WC insurance carrier, third-party administrator, or self-insured employer **Information and reports that are shared with"] [11.396578788757324, 18.817020416259766, " for miscellaneous expense reimbursement. As noted above, the SJDB is nontransferrable and, for injuries occurring after December 1, 2013, cannot be settled.\nApplication Process and Eligibility Criteria\nAs mentioned in Chapter Two, injured workers wh"] [11.413939476013184, 18.81265640258789, "o obtain the necessary information. Applications with complete information that meet the criteria listed above are passed to one of three approvers for approval processing.\nApproval and Payment Issuance\nWithin 60 days, DIR must review the submitted o"] [11.406075477600098, 18.82007598876953, "ions for injuries that occurred prior to 2013 (15 percent of ineligible applications). The remaining denials occurred because of other verification issues with the applications.\n26\nApplicants who resubmit an application following a denial typically d"] [11.420051574707031, 18.814105987548828, "m\nWithin 20 days of employer\u2019s failure to provide qualifying RTW offer; at most 80 days after date when RTW & Voucher Report is submitted to employer\nWithin 12 months of SJDB voucher receipt\n NOTE: DWC = Division of Workers\u2019 Compensation.\n28\nApplicat"] [11.417793273925781, 18.81981658935547, "seven days of approval. Overall, this means that 90 percent of applicants receive the RTW Supplement within three weeks of application, and 50 percent of applicants receive the RTW Supplement less than two weeks after application. This is well within"] [11.42467212677002, 18.807979583740234, "demption, we examined those who received an SJDB payment in the WCIS, meaning that the injured worker cashed in their SJDB voucher. We estimated that the average total payment value was approximately $4,600:15 Just over half (52.5 percent) of workers"] [11.404094696044922, 18.825117111206055, "esponse to the incentives created by the RTWSP or due to other provisions of the law. Figures 3.6 and 3.7 clearly indicate a sharp increase in SJDB utilization and, for a nonrepresentative convenience sample of claims, SJDB voucher issuance for injur"] [11.40609359741211, 18.781845092773438, "ders perceive the workers\u2019 compensation process to be a \u201cvery litigious process often driven by the applicant\u2019s attorney.\u201d Three stakeholders with direct experience regarding the SJDB issuance process noted that settlement prior to being declared P&S"] [11.396278381347656, 18.813114166259766, "he California Workers\u2019 Comp System and more to do with the federal ADA\u2014mostly by compliance with FEHA and the ADA.\u201d Three stakeholders also said that employers may issue the SJDB voucher in an effort to terminate an employee (i.e., to get the injured"] [11.42105770111084, 18.79827880859375, " language that the injured worker is entitled to the supplemental benefit or that an attorney can apply for the benefit on the worker\u2019s behalf. This stakeholder also claimed that settlements occur more often and claims close faster when they are part"] [11.350093841552734, 18.861604690551758, "stributed to injured workers (two stakeholders).\nEight stakeholders claimed that the RTW program is run \u201cefficiently, with low administrative burden\u201d and \u201cprovides cash\u201d and \u201csome sort of benefit to injured workers.\u201d As one stakeholder said, \u201cthe sta"] [11.393317222595215, 18.814594268798828, "tionate earnings loss, some still noted problems with the linkage. As one said, the link between the RTW Supplement and the SJDB voucher \u201cstill did not include specific consideration of the lost earnings that are disproportionately compensated by the"] [11.384797096252441, 18.827255249023438, "dicated that there is value in not permitting the RTW Supplement to be included in settlements, as this reduces transaction costs by limiting the scope for disputes.\nThese interview findings validate our understanding of the rules and regulations tha"] [11.393305778503418, 18.821020126342773, " complete the RTWSP application if they are unable to do so at home.\nNevertheless, several stakeholders mentioned concerns related to access and lack of awareness about the RTW Supplement. Five stakeholders, including attorneys and claims administrat"] [11.37086296081543, 18.825435638427734, "rk required of the PTP. In such cases, physicians provide information in the MMI Report but do not fill out or submit the RTW & Voucher Report. As a result, fewer SJDB vouchers are issued to those who would otherwise be eligible.\nOnce they receive do"] [11.342065811157227, 18.83509063720703, "nistrators for copies of the reports.\nEight stakeholders indicated that \u201cphysicians are not paid to complete and submit the RTW & Voucher Report.\u201d In turn, physician stakeholders claimed that the RTW & Voucher report is \u201ctime-consuming to complete.\u201d "] [11.383158683776855, 18.82334327697754, " area of the [workers\u2019 compensation] system where there\u2019s money involved, there\u2019s fraud involved and someone\u2019s trying to rip off the system\u201d; and the perceptions that \u201canyone with access to a computer can get the RTW Supplemental benefit.\u201d\nStakeholde"] [11.373306274414062, 18.846315383911133, "few stakeholders mentioned issues that would contribute to the underissuance of SJDB vouchers. Two stakeholders reported experiences with claims administrators \u201cnot signing the voucher or not providing proof of service\u201d (as referred to above) and cla"] [11.387114524841309, 18.822986602783203, "formation assistance officer in a district office. The program reduces transaction costs by limiting the scope for disputes and by using the SJDB voucher as a mechanism for targeting, albeit somewhat inconsistently. Two additional strengths associate"] [11.372132301330566, 18.851816177368164, " Report) and claims administrators failing to sign or issue the SJDB voucher. Some stakeholders also noted that the RTWSP does not distinctly promote return-to-work outcomes and suggested that DIR should rename the program to better align with its ob"] [11.415488243103027, 18.857465744018555, "ience sample of claims administrators, and several auxiliary datasets from public sources.\nThis wide variety of data sources is necessary to address the broad range of research questions posed in this study. In combination, these data sources allow u"] [11.766388893127441, 19.02297592163086, "rs\u2019 Compensation Information System\ntarget\ntarget\ntarget\nthe\n The WCIS is a database of workers\u2019 compensation claims maintained by the DWC within DIR. The WCIS covers essentially all workers\u2019 compensation payers in the California system, making it th"] [11.672231674194336, 18.96674346923828, "sources other than the WCIS are PD ratings, legal representation status, and issuance of SJDB vouchers.\nReliable data on receipt of benefits and other milestones in the history of the claim are necessary to define sensible comparison groups for recip"] [11.42026138305664, 18.822830200195312, "2017. Each record represents a completed online application that was submitted to the RTWSP.19 In addition to the application date and information about the injury that was reported in the RTWSP application, these data capture whether the application"] [11.431418418884277, 18.838993072509766, "SJDB voucher. While the WCIS provides information about SJDB utilization (i.e., cases in which individuals redeemed their SJDB vouchers to pay for VR services, education and training, computers, or other services and equipment covered by the SJDB), v"] [11.477469444274902, 18.864091873168945, " the population of residents in a given zip code who speak English very well and the population of residents speaking other languages, including Spanish, Chinese, Tagalog, Korean, and Vietnamese. We used these variables to identify zip codes with rel"] [11.41811752319336, 18.816818237304688, " to reach MMI, receive a voucher, and apply for the RTWSP. Our analysis of targeting focuses on differences between workers with and without the RTW Supplement, so we performed comparisons that effectively controlled for the claim maturity (i.e., the"] [11.37501335144043, 18.856290817260742, "Who is eligible, applies for, and receives the RTWSP? To analyze take-up of the RTWSP and to estimate the size of the RTWSP-eligible population, we had to identify a sample of eligible workers, meaning those in receipt of an SJDB voucher for injuries"] [11.420289993286133, 18.813812255859375, "on permanently disabled workers with 2013\u20132014 injury dates (the PPD sample described in Chapter Five) to address two broad research questions:\n1. How do RTW Supplement recipients compare to other PPD workers in terms of demographics, job characteris"] [11.420495986938477, 18.812467575073242, "661 per week in real 2017 dollars, compared with an average wage of $813 per week for other workers with PD. RTWSP claimants are also more likely to live in zip codes where fewer residents speak English well and more likely to live in zip codes with "] [11.43193244934082, 18.796222686767578, " Supplement recipients are less likely to work in self-insured firms prior to injury, which likely reflects the fact that larger firms (including public-sector employers) are both more likely to self-insure and may be more able to provide accommodati"] [11.426046371459961, 18.805875778198242, "tal TTD payment received by all other beneficiaries with indemnity payments. Thus, while supplement recipients receive much higher benefit payments than nonrecipients, the difference in total disability duration strongly suggests that these benefit p"] [11.422646522521973, 18.817913055419922, "live in zip codes with low English-language ability and low internet connection rates, are more likely to work in manufacturing or certain high-turnover industries, and are less likely to work in public administration or education. RTW Supplement rec"] [11.389724731445312, 18.822925567626953, "fferent points in time relative to receipt of other benefit types. Most workers receive the benefit within one year of ending their TTD benefits and beginning PPD payments, again consistent with overall program guidelines that workers become eligible"] [11.494482040405273, 18.749412536621094, "losses are maximized, which might seem to suggest that RTWSP recipients\u2019 ratings are too high to be consistent with optimal targeting. In fact, Dworsky et al.\u2019s estimates indicated that workers with ratings above 30 (under the anticipated SB 863 rati"] [11.41525650024414, 18.828691482543945, "he injury, by about 19 percentage points of what the workers would have earned if uninjured. The comparison reported by Reville et al. (2005) was conducted between workers with the same disability rating (under the pre-2005 PDRS), and so this evidenc"] [11.42198657989502, 18.82650375366211, "7. No RTWSP applications were submitted by workers in the voucher RTW sample who were issued vouchers in Q2 2013 or Q4 2013, yielding a take-up rate of zero in these quarters.\nWe next estimated a series of multivariate logistic regression models to c"] [11.423725128173828, 18.826091766357422, "tes for a pooled model that combines data from all participating claims administrators. We also estimated models stratified by claims administrator and did not find evidence that predictors of voucher issuance differed substantially from the overall "] [11.412187576293945, 18.83229637145996, "tential barriers to participation (e.g., language ability and internet access) were not significant factors in take-up\nCovariate with a Significant Impact on Voucher Issuance or RTWSP Take-Up\nSettled claim\nMMI date reported\nSettled claim and MMI date"] [11.414128303527832, 18.821535110473633, "re of our convenience sample, additional estimates reported in Appendix B show that similar unadjusted patterns are evident in our convenience sample as well.\nTo sum up, the behavior of workers observed in a convenience sample of SJDB voucher recipie"] [11.416410446166992, 18.819643020629883, "ration is that the RTWSP has operated during a period of steady economic expansion and falling unemployment rates; the next economic downturn might affect the size of the eligible population through changing return-to-work rates and several other cha"] [11.430971145629883, 18.816577911376953, "Relations, DIR staff estimated the take-up rate of the RTWSP using data available in house at DIR through the end of February 2017. To proxy for RTWSP eligibility, DIR used the WCIS to identify workers who had redeemed the full $6,000 value of the SJ"] [11.445669174194336, 18.796791076660156, " take-up rate. In the first three quarters of 2017, the RTWSP received applications from 12,630 unique injured workers. If applications continue at the same rate in the last quarter of the year, this suggests that 16,840 applications would be receive"] [11.515841484069824, 18.722957611083984, "estone, leading to concerns about right-censoring in the available data. However, the proportion of PPD claims with paid SJDB amounts in the WCIS remains at 5.0 percent for 2014 injuries despite the fact that 2014 claims are more likely to be subject"] [11.550008773803711, 18.70823097229004, "f PD claims with qualifying return-to-work offers reported to the insurer by 28 months after injury. Between the 2010 and 2014 injury years, this proportion ranged between 16 percent and 21 percent, a rate that would seem to imply that as many as fou"] [11.476324081420898, 18.772605895996094, "ake a somewhat conservative assumption that those without an MMI date reported would not have received a voucher, we obtain an estimate of 40.6 percent of permanently disabled workers who might potentially be eligible to receive an SJDB voucher, trig"] [11.51124382019043, 18.738319396972656, "an alternative, we estimate the total number of ultimate indemnity claims in the WCIS by applying WCIRB development factors to the number of indemnity claims observed to date. We then assume that 50 percent of indemnity claims ultimately result in PD"] [11.53481388092041, 18.715171813964844, "ta on covered employment at self-insured employers would overstate the number of indemnity claims if self-insured employers had lower indemnity claim rates than fully insured employers, which appears to be the case in the WCIS.\n43 Authors\u2019 calculatio"] [11.43496322631836, 18.803390502929688, "rsed could be up to three times as high, or $292.2 million. We stress that this level assumes that all potentially SJDB- eligible workers are issued a voucher, that the ultimate number of PPD injuries is at the higher\n44 We cannot know that all claim"] [11.390573501586914, 18.796735763549805, " required DIR to translate crucial workers\u2019 compensation forms and notices into additional languages beyond English and Spanish.\nWithout data on a cohort of injuries that has fully worked its way through the system, we instead provide descriptive evi"] [11.400635719299316, 18.81694984436035, "ensoring. For example, the maximum time to application for 2016 injuries was set to nine months to allow nine full months under observation for the last injury dates in 2016.\nHowever, Figure 7.3 also makes clear that the time needed to establish the "] [11.426904678344727, 18.806188583374023, " sustained rapid growth in SJDB payments and the number of PD workers with incurred SJDB, largely reflect SJDB receipt by workers injured before the RTWSP was established. There is no evidence indicating that the\n84\ngrowth of the RTWSP-eligible popul"] [11.429247856140137, 18.805973052978516, "ch year\u2019s assessment in order to cover the previous calendar year\u2019s RTW Supplement payments.\nIf the RTW Fund can be replenished each year by adjusting the assessment above or below $120 million annually, solvency would not appear to be a conceptually"] [11.567233085632324, 18.681962966918945, "more stable than the rate of low-severity claims. Research by Boone et al. (2011) shows that the pro-cyclicality of workers\u2019 compensation claim rates is driven less by changes in safety over the business cycle than by the fact that workers with lower"] [11.591736793518066, 18.67878532409668, " eligibility over the business cycle than changes in covered employment.\n 47 These estimates are percentages of the employment rate for uninjured workers, which is well below 100 percent. Only seven in ten workers in the uninjured control group remai"] [11.445870399475098, 18.791746139526367, "ease in SJDB voucher issuance observed so far under SB 863 would limit how much further the rate of SJDB voucher issuance could potentially increase as economic conditions change.\nGiven this discussion, we estimate that any cyclicality in the size of"] [11.41586971282959, 18.817035675048828, "data on incurred PD would be needed to answer this question.\n 89\nand payment volumes so that the department can rapidly identify the emergence of any major changes in program costs.\n90\nChapter Eight: Policy Options to Improve the RTWSP and Related Pr"] [11.41513729095459, 18.82574462890625, "Chapter Four. We did not find strong evidence that low take-up was associated with indicators of socioeconomic vulnerability, such as low wages, or hypothesized barriers to access, such as language ability, internet access, or distance from DWC field"] [11.419938087463379, 18.8360652923584, " treated as a \u201cchange in benefit status\u201d\n92\nwarranting mandatory reporting. At present, claims administrators are required to transmit an SROI to WCIS within 15 days of the initial payment of any type of indemnity benefit. However, there is currently"] [11.420530319213867, 18.830909729003906, "ly, however, then the number of workers who might change address before receiving the RTW Supplement check will tend to increase over time. This is likely a minor concern given DIR\u2019s demonstrated ability to process applications, verify recipients (an"] [11.400613784790039, 18.83196258544922, "ims administrators on SJDB voucher issuance.\nDIR would also need to think through the program integrity implications of making the RTW Supplement an automatic payment triggered by notification from the claims administrator. The current application pr"] [11.393087387084961, 18.837690353393555, "to implement automatic payment of the RTW Supplement, we strongly recommend that DIR develop a strategy for monitoring SJDB voucher issuance and verifying that SJDB vouchers are being properly issued to all workers who receive the RTW Supplement. DIR"] [11.379486083984375, 18.850013732910156, "ders felt that email and other electronic communication methods are underutilized by claims administrators. While we did not find that internet access was associated with take-up of the RTW Supplement by eligible workers, we did not have individual-l"] [11.414671897888184, 18.819944381713867, " involve raising the value of the supplement (either for all workers or for those more likely to experience disproportionate earnings losses), restricting eligibility to a smaller group of workers without successful return to work, or changing the su"] [11.478257179260254, 18.75530433654785, " the first several years of a claim are likely to result from temporary disability, and they recommended using data from the fourth full year after injury to measure long-term earnings losses. In contrast, we found that some workers who reached MMI q"] [11.37498950958252, 18.823266983032227, "DEU disability ratings did not support stakeholder concerns that workers with minimal impairment were likely to receive the RTWSP. However, we were not able to directly examine wage loss or PPD wage replacement rates for workers who received the RTW "] [11.37491512298584, 18.82777976989746, "iting. The claims administrators and physicians at the TAG meeting supported the idea of a consolidated report.\nAnother issue raised by some stakeholders was that the RTW & Voucher Form was not being completed by physicians because time spent complet"] [11.45943546295166, 18.7847900390625, "recipients, we estimate that 47 percent of workers who received a voucher for injuries in 2013\u20132014 had redeemed the voucher and received the SJDB by 2017. Voucher redemption rates were higher for lower-wage workers: We estimate a redemption rate of "] [11.431110382080078, 18.809892654418945, " SJDB use and assessing the effectiveness of the SJDB in enabling return to work.\nChanges in SJDB utilization following SB 863\u2019s enactment cannot be fully attributed to the incentive effects of the RTW Supplement without further analysis. However, wh"] [11.418635368347168, 18.82033348083496, "several benefits. First, studying how vouchers are used (e.g., for purchasing computer equipment versus retraining) will provide insight into the VR services that workers have determined to be most important in assisting their return to work. This in"] [11.415121078491211, 18.818754196166992, "hile this current effort is studying trends in post-injury outcomes for broad groups of injured workers, an evaluation of the SJDB could draw upon some of the methodological approaches and utilize similar data to analyze trends for this relatively vu"] [11.40660285949707, 18.82526206970215, "r. However, our findings suggest that a lack of awareness and/or some confusion about the program, particularly among workers who do not have legal representation, may be preventing many eligible workers from applying. While this option would achieve"] [11.58973503112793, 18.651912689208984, "provide an evidence base for future changes to the RTW Supplement and, potentially, the SJDB. Whether the SJDB is effective at helping displaced workers with PD find new employment is a question that bears directly on whether the RTW Supplement might"] [11.776692390441895, 18.40721321105957, "into California\u2019s system that resembles some of the advantages of a wage loss system while avoiding the potential for work disincentives inherent in a pure wage loss approach.\nCalifornia has experimented with such a hybrid approach in the past. For t"] [11.506967544555664, 18.66736602783203, "the RTWSP would require action by the legislature.\nIn the near term, then, DIR should focus on increasing take-up of the RTWSP and on enabling more accurate monitoring of SJDB voucher issuance. The inherent limits of California\u2019s impairment-based app"] [11.193069458007812, 18.177879333496094, " 2012. As of June\n 109\n12, 2018: https://www.dir.ca.gov/chswc/Reports/2012/CHSWC_AnnualReport2012.pdf\nCalifornia Department of Industrial Relations, Office of the Director, Return to Work Supplement Program Proposed Regulations Revised Final Statemen"] [11.26326847076416, 18.176040649414062, "of Social Insurance, Workers\u2019 Compensation: Benefits, Coverage, and\nCosts\u20142014 Data, Washington, D.C., 2016.\nNational Academy of Social Insurance, Workers\u2019 Compensation: Benefits, Coverage, and\nCosts\u20142015 Data, Washington, D.C., 2017.\nNeuhauser, Fran"] [11.257047653198242, 18.236413955688477, "rgain: Compensation for Work Injuries in the U.S., 1900\u20132016,\u201d Boston, Mass.: Northeastern University, 2017.\nState of California, \u201cSchedule for Rating Permanent Disabilities Under the Provisions of the Labor Code of the State of California,\u201d 2005.\nU."] [11.378241539001465, 18.839550018310547, "when an injured worker receives the RTW Supplement or appeals the decision). The aim of the interviews was to learn about the RTWSP and the RTW Supplement process from the different vantage points of various stakeholder groups.\nInterview guides were "] [11.427727699279785, 18.887248992919922, " insurance carriers. Transcripts were reviewed, aligned with the protocol questions, and finalized.\nWe used a variation of content analysis to develop a coding scheme for performing a qualitative description of the themes discussed by the workers\u2019 co"] [11.365254402160645, 18.832134246826172, "he discussion and asked about any final suggestions on refinement of the RTWSP or other aspects of the workers\u2019 compensation system that affect the RTWSP. When consent was provided to record the interview, transcript documents were created from the a"] [11.290863037109375, 18.90906524658203, "?\n[Pay attention to any mentions of: affordability or sustainability of the program at the state level (for DIR), injured workers getting an adequate amount from the payment to assist in RTW, equitable disbursement of benefits, transparency or ease o"] [11.335871696472168, 18.840295791625977, "hort, about right? Are there cases that you can think of for which you think this is not right?\n11. What was the thinking behind the \u201c20-day period\u201d?\na. Are these business days or calendar days?\n12. Are there specific issues that you see from your va"] [11.37059211730957, 18.833221435546875, "er?\n28. What about the motivations and incentives, in your opinion, of the employers once they have received the copies of the P&S and RTW & Voucher reports?\n29. What about the motivations and incentives, in your opinion, of the injured worker once t"] [11.365446090698242, 18.836515426635742, "r issued?\n42. Are there any modifications that you suggest?\nWork Offer\nNow, can we turn to discussing the actual offer of work?\n43. What are the official guidelines around what constitutes an \u201coffer of work\u201d? 44. How is the offer of modified or alter"] [11.380867958068848, 18.831912994384766, "rios within which the injured worker (or the IW representative) could have an offer of work from the at-injury employer and be issued an SJDB voucher?\n62. What about if the IW is working for a different employer? If that is the case, is it then OK fo"] [11.405922889709473, 18.82286262512207, "What is the main purpose for verifying California residency?\na. Is this only for tax purposes?\nb. Can you receive the benefit if the IW lives out of state?\nc. Can you gain the voucher and or the benefit if you live outside of California?\n81. Once the"] [11.411920547485352, 18.81346893310547, "n actions that take place after the appeal?\n95. Once it is determined that an IW will receive the RTW Supplemental benefit, how does this fit into the timing of the PPD benefit payment process?\n96. California has a reverse offset plan in place such t"] [11.573522567749023, 18.88673973083496, "changes have?\nF. Conclusion/Follow-Up\n108. Thinking back about all the things you\u2019ve told us today, are there any areas that we failed to cover or important questions that we should have asked?\n109. If you were going to summarize the most important p"] [11.481355667114258, 18.84817886352539, "-missing value for the DEU rating. This yielded approximately 81,000 records from the DEU that matched the WCIS.\nVoucher Data\nWe conducted some analyses based on the entire universe of records observed in the WCIS between 2011 and 2017 or some subset"] [11.539592742919922, 18.860139846801758, "ow English-language prevalence contain 26.7 percent of the population of California, so readers should interpret the low English variable used in our analysis as selecting people who live in areas in roughly the bottom quartile of English-language pr"] [11.736954689025879, 19.00353240966797, "IS data matched on date of birth, date of injury, or gender, we treated that unique match as the true linkage and discarded other linkages. We also used fuzzy matching between claim administrator claim numbers reported on the SROI and the DEU ratings"] [11.80193042755127, 19.032878875732422, "with a SROI linkage and the proportion with indemnity benefits reported (including any temporary or permanent benefits or settled amounts for temporary or permanent benefits). Very small claims administrators with fewer than 20 claims per year were e"] [11.737598419189453, 19.04560661315918, "135\nTable B.1. Comparison of Analysis Sample to Full WCIS FROI\nDemographics and Type of Coverage\n Main Sample Main Sample Distribution\nFull WCIS Unweighted Weighted (complete records)\nFROI Target\nunweighted\n 40.99 40.70 40.87 40.86 43%"] [11.79875373840332, 18.412981033325195, "ent factors allow projection of the long-term claim count from the count observed at a given maturity for an accident year.52 Table B.3 provides statewide estimates of the total claims to date and ultimate indemnity claims by year for the 2011\u20132017 i"] [11.6482572555542, 18.561594009399414, " far more obvious, with paid-to-date claim volumes dropping each year from 2011 to 2016. For an estimate of ultimate PPD claims by year, then, we assume that 50 percent of indemnity claims will eventually result in PPD, an assumption that appears to "] [11.429855346679688, 18.81136131286621, "011 injuries.\nIdentifying Workers at Risk of Receiving the RTWSP\nTo better understand which workers face a nontrivial probability of RTW Supplement receipt, we examined seven mutually exclusive categories of claims based on benefits, settlements, and"] [11.415772438049316, 18.815298080444336, " Even so, comparison to PPD recipients enables us to analyze targeting within one of the primary eligibility criteria of the program (PD). Due to the absence of information about qualifying return to work offers or SJDB voucher issuance in the WCIS, "] [11.412432670593262, 18.823802947998047, "s. Again using data from the claims administrator sample, Figure B.1 shows that RTWSP applications are typically filed soon after an individual receives the SJDB. The majority of applications are filed within the first three months after SJDB voucher"] [11.423652648925781, 18.833293914794922, "ince this population reflects the combination of employers and industries served by a nonrandom selection of claims administrators. However, a comparison of RTW Supplement recipients to all other claims in this sample shows that the same factors appe"] [11.421631813049316, 18.833755493164062, " 2,243 1,607\n 144\nAnalysis of RTWSP Take-Up\nOur primary analysis of program take-up used logistic regression to model receipt of the SJDB voucher and workers\u2019 decisions to apply to the RTWSP, if eligible. Because both of these analyses requir"] [11.42205810546875, 18.830537796020508, "criteria (which\n54 DWC regions included in the model are Los Angeles, Inland Empire, Bay Area, Central Valley, and San Diego. The Rest of State category includes the Central Coast, Eastern Sierra Foothills, North Sacramento Valley, North State\u2013Shasta"] [11.427762031555176, 18.8250675201416, " similar across claims administrators within each broadly defined market sector. Under this assumption, it should be possible to extrapolate from the logistic regression model estimated on the convenience sample to the full analysis sample. The (weig"] [11.440156936645508, 18.827558517456055, "f claims administrator at a time: By extrapolating these separate models to the full sample, we impose the assumption that there are no meaningful differences across types of claims administrators in the probability of SJDB voucher issuance after con"] [11.462309837341309, 18.8013973236084, " and the benefit listed in the row title. Proportions were weighted using inverse probability weights from a sample of claims administrators with timely and complete reporting to the SROI.\n Table B.10. Take-Up Model of Voucher Issuance Among PD Reci"] [11.470600128173828, 18.79698371887207, " RTWSP Among Voucher Recipients: Logit Coefficients and Marginal Effects\n0.160\n0.160\n Low English ability (zip code)\nLow internet connectivity (zip code) Log miles to DWC office (zip code) Legal representation\n(1)\nLogit Coefficients\n0.0520 (0.0"] [11.601646423339844, 18.66670036315918, "14 Q4 14 Q1 15 Q2 15 Q3 15 Q4 15 Average\nSJDB Any SJDB Exhaustion Paid\n55.3% 49.1% 54.7% 54.3% 70.7% 61.2% 71.2% 64.5% 71.4% 63.3% 75.9% 69.5% 81.3% 73.7% 83.9% 77.5% 85.8% 81.7% 76.4% 70.7% 80.0% 72.0% 71.9% 62.9% 72.9% 66.4%\nSJDB Voucher\n34.2% 33.3"] [11.602755546569824, 18.660110473632812, " 47.2% 39.1% 47.0%\n NOTES: WCIS, claims administrator convenience sample, injury years 2013\u20132014. WCIS proportions were weighted using inverse probability weights from a sample of claims administrators with timely and complete reporting to th"] [11.45209789276123, 18.765291213989258, " 157\nCalifornia\u2019s Return-to-Work Supplement Program (RTWSP) is a new benefit for permanently disabled workers who suffer disproportionately high earnings loss in comparison with their workers\u2019 compensation benefits. The RTWSP provides a one-time $5"] [13.851240158081055, 4.718869686126709, " CORPORATION\nLeveraging Research and Philanthropy to Reduce Crime and Violence in the Mississippi Delta\nJessica Saunders, Dionne Barnes-Proby, Samuel Peterson\nFor more information on this publication, visit www.rand.org/t/RR2457\nPublished by the RAN"] [13.846534729003906, 4.38886022567749, "surance regulation. Program research is supported by government agencies, foundations, and the private sector.\nRAND Justice, Infrastructure, and Environment (JIE) conducts research and analysis in civil and criminal justice, infrastructure developmen"] [14.121167182922363, 6.0055670738220215, "......................................................................... 13 Funding Decisions ............................................................................................................................ 16 Making Awards ............."] [14.03043270111084, 5.94474458694458, "......................................................................... 44 Limited Social Programs and Services........................................................................................... 44 Failing Schools .........................."] [14.086246490478516, 5.990507125854492, "nterventions.................................................................................................................. 90 Adapting, Implementation, and Evaluating................................................................................"] [14.071128845214844, 5.978660583496094, "olent Crime and Calls for Service by Neighborhood Within the Brickyard Community\nand in Clarksdale, Mississippi, as a Whole........................................................................ 34 3.5. Contributors of Crime ........................"] [14.099017143249512, 6.002249717712402, "ow to think through the various options for selecting and implementing community-level violence prevention and intervention.\nThe findings of this work are organized by these research questions:\n1. How are foundations funding crime and violence reduct"] [14.058415412902832, 5.973573207855225, "nd 3.5 homicides per 10,000 residents in Phillips and Coahoma Counties, respectively, while the U.S. average was 0.7 per 10,000 (CDC, 2018). Discussions of crime and violence revealed that these communities experience a great deal of violent and prop"] [13.997461318969727, 5.982038497924805, "e Table S.1). In general, programs that reduce crime and violence directly rely on strong partnerships and cooperation with law enforcement and other government entities. Approaches that might prevent crime by targeting the risk factors are more dive"] [16.8654842376709, 7.7594685554504395, " interventions that use a multistep approach to enhance protective factors and reduce risk factors in the family. These approaches have been found to be effective in a variety of settings\nProviding continuing education to incarcerated adults to reduc"] [16.85284423828125, 7.91287899017334, "tured programs that provide youth with opportunities to connect with supportive adults, develop a sense of belonging, learn positive social norms, and build skills\nAdult or peer mentors are matched with at- risk youth (mentees). Mentors and mentees m"] [14.209712982177734, 6.128408908843994, "ience literature has identified having local champions as one of the most important components of a successful crime prevention initiative. The strength of a community-coalition approach is its representation of multiple perspectives; increased commu"] [14.153058052062988, 6.049469470977783, " coordinated effort that must rely heavily on community involvement to succeed.\nAs noted by the foundation representatives, affecting levels of crime and violence is very complex and challenging because crime and violence are so interrelated with oth"] [14.084514617919922, 5.984278678894043, "swer their four research questions:\n1. How do foundations approach public safety funding?\n2. What are the specific crime problems and their causes in Phillips County and Coahoma\nCounty?\n3. What programs have worked to address those crime problems and"] [14.042399406433105, 5.9191484451293945, "g under the influence offenses (631 versus 460 per 100,000), while also having more officers per resident (3.7 versus 2.5 per 10,000), a higher overall arrest rate (4,192 versus 3,252 per 100,000), and a higher crime clearance rate (53 percent versus"] [14.090373992919922, 5.990114688873291, "ilar issues. Through this project, we will be able to explore philanthropic efforts to reduce crime, understand the specific crime challenges and opportunities in the Mississippi Delta region, link them to the extant research literature on effective "] [14.115805625915527, 6.019651889801025, ", police department\nPolice data from the Clarksdale, Mississippi, police department\nInterviews with community stakeholders, n = 15\nFocus groups with residents, number of groups = 4, number of participants = 51\nInterviews with government officials, n "] [14.152745246887207, 6.055976390838623, "ndations, which resulted in 15 interviews (36.6-percent response rate). We did not set any criteria for the interviewees. We interviewed seven program officers, five\n4\nstrategic directors/vice presidents of programs, and three executive directors. Fo"] [14.081881523132324, 5.988983631134033, "researchers have carefully defined the core concepts. After several iterations of initial and selective coding, the theory is revised, and then the researchers identify and flesh out the details of the core concepts and categories. We coded 426 excer"] [14.078385353088379, 5.987975597381592, "4-AJ-BX-0001, awarded by the Office of Justice Programs, U.S. Department of Justice, but the findings expressed in this section are those of Baldwin and do not necessarily reflect those of the Department of Justice.\n 6\nResearch Question 2: Characteri"] [14.062564849853516, 5.993931293487549, "perceived causes of crime, current solutions to crime problems and their effectiveness, and ideas for other ways to reduce crime.\nCommunity Stakeholders\nRecruitment began with an email sent by researchers to select community stakeholders (e.g., faith"] [14.064425468444824, 5.991090297698975, "ants in Coahoma County and 22 in Phillips County, spread across two focus group sessions in each location (a total of four focus groups). We provided a hot meal, dessert, and beverages at each group. In addition, each participant received a $20 incen"] [14.166521072387695, 6.099586486816406, "cy (e.g., custodial versus noncustodial sentencing, release programs, gun control, electronic monitoring) or those that address issues that were not described by interviewees and focus group members as top crime concerns (e.g., sex offending, domesti"] [14.162666320800781, 6.0697102546691895, "g to create a framework for developing a comprehensive public safety strategy. We grounded our approach in the public health and community-based intervention promotion literature and integrated it with our expertise and experience in community-based "] [14.160953521728516, 6.0644965171813965, "upport crime and violence reduction may end up in conflict with local or national policy. They may question the legitimacy of government programs and whether clients would be as responsive to such programs versus those run by local nonprofits. As one"] [14.170296669006348, 6.070683002471924, "rd to convince people that this is important and the work is important.\u201d\nSince the number of funders is limited, several interviewees noted that the need for funding outweighs their capacity, making funding decisions difficult. The limited supply of "] [14.152856826782227, 6.067161560058594, "ved as inefficient, overly political, and lacking a deep understanding of issues and legitimacy for the client base or target population. According to one project officer,\nthere is not enough funding and/or understanding of the segregated nature of c"] [14.168094635009766, 6.074129104614258, "escribed as being relatively high risk for foundations because they involve program components that can be a hard sell, such as providing monetary incentives to active gang members to not engage in criminal behavior. At least one interviewee noted th"] [14.16842269897461, 6.070004940032959, "ndations are working to build community capacity and empower locals to guide their crime- and violence- reduction strategies, ranging from focusing on youth and prevention to community violence reduction. This approach was used by small and large fou"] [14.16639518737793, 6.070184230804443, "g on basic human needs, and there\u2019s no way there\u2019s going to be quick impact; we need to be engaged longer term. No matter how much money; we\u2019re not going to see impact for three to five years; we need to make significant investments.\nWhen describing "] [14.171187400817871, 6.082603454589844, "ho are impacted by systems and policies.\nFor an eight-month period, we held symposia series with people working in the field to see where a small foundation could have an impact.\nMaking Awards\nIn addition to determining what to fund, foundations also"] [14.181968688964844, 6.085601329803467, "vide useful examples for making strategic funding decisions (see Table 2.1). One clear example is the Chicago Fund for Safe and Peaceful Communities. This fund is the administrator for the larger Partnership for Safe and Peaceful Communities, which c"] [14.199912071228027, 6.080156326293945, "0 foundations and individual donors (Partnership for Safe and Peaceful Communities, undated)\nSupporting local leaders to adopt innovative strategies for reducing the misuse and overuse of jail incarceration. Twenty sites were selected for the challen"] [14.177773475646973, 6.078597545623779, "cusing specifically in targeted communities wasn\u2019t the strategy for us. It\u2019s a capacity issue.\u201d Such coordinating activities were also seen as an effective way to be exposed to the work taking place in a new area.\nType and Length of Awards\nMany funde"] [14.183467864990234, 6.084685802459717, "ons, nonprofit organizations, and government entities. The significance of the networks cannot be overstated. As one interviewee advised, \u201cnetworking with other funders is really important, and policy makers as well. If I had to do it over again, I w"] [14.200193405151367, 6.100067138671875, "elationships that are beyond providing funding.\u201d This will take a variety of forms, depending on the setting.\n21\nAdditionally, sustaining relationships means that \u201cit is important to be transparent about abilities and challenges . . . be clear about "] [14.197123527526855, 6.093205451965332, "ics between staff and board members and how the disconnect between their roles center on questions of impact:\n22\nA lot of foundations struggle with that. We came up with our own theory of philanthropy. Who we are and what\u2019s the change we want to see?"] [14.197997093200684, 6.08868408203125, "onduct outcome evaluations. Second, it is often challenging to define a timeline for work. Third, many successes are hard to quantify.\nHaving internal and/or financial capacity to conduct impact evaluations distinguishes large foundations from their "] [14.166780471801758, 6.063046455383301, "tive nationally has been one-sided.\nWhile foundations are engaging in an ongoing struggle to understand, assess, and promote the impact of their funding, interviewees believed the work should continue focusing on long- term impact. This is evidenced "] [14.130654335021973, 6.030494689941406, "mon understanding of many interviewees that the challenges that criminally involved clients face cut across a variety of spheres, and challenges in one sphere affect their ability to make progress in another. This helps the foundation be more strateg"] [14.038671493530273, 5.956090450286865, "a region generally referred to as \u201cthe Delta\u201d (although it is not actually near the Mississippi Delta; see Figure 3.1). Both counties have small populations, with the majority of the population residing in their respective largest cities\u2014Clarksdale i"] [14.0365571975708, 5.9509501457214355, " female\nPercentage age <18 Percentage age 65+\nEducation and economic status\nPercentage high school graduates Percentage of individuals below poverty level Median household income\nSocial\nPercentage with disability (<65)\nCoahoma County\n23,809 \u20138.9% \u201322"] [14.049857139587402, 5.960062503814697, "t Helena (193.6 versus 149.5 per 10,000; Baldwin, Brown, and Jones, 2016).\nThe CDC also collects mortality data, which list cause of death assigned by the coroners, but which likely undercounts the true homicide rate. Using data from 2012\u20132016, homic"] [14.047234535217285, 5.961088180541992, "f a variety of reasons including, but not limited to, a difference in the way crimes are committed that influences the ability of the police to close a case, bias in the criminal justice system, or black residents committing crimes at a higher rate. "] [14.031022071838379, 5.975141525268555, "y criminal justice system agencies due to their declination to participate in this project. Therefore, we relied on information collected and analyzed by Julie Baldwin for her project with the Clarksdale Police Department (Baldwin, Brown, and Jones, "] [14.057982444763184, 5.967073917388916, "op). Therefore, the analyses were re-run with the exclusion of \u201cescort\u201d and a few other call types deemed inconsequential to recreate maps identifying citizen-generated problem locations. Violent crime data were then overlaid to determine locations t"] [14.050289154052734, 5.961590766906738, "percent in Coahoma County, 31 percent in Phillips County), followed by gangs (33 percent in Coahoma County, 25 percent in Phillips County). In both counties, robbery and gangs were more of a concern to government officials than community members, and"] [13.965216636657715, 5.9676055908203125, "h concentration of crime in specific places (e.g., intersections, streets) is common in criminological research (Weisburd, 2015), as a few places often account for a disproportionate amount of crime (e.g., 3 percent of street segments account for ove"] [14.049476623535156, 5.966693878173828, "vement in violent incidents.\nLike repeat offenders, there also tended to be repeat victims, and there was often a substantial degree of overlap between offenders and victims (Tewksbury and Mustaine, 2000; Thornberry and Krohn, 2003b). There were few "] [14.043946266174316, 5.961256504058838, "\nComments regarding lack of \u201cthings to do\u201d such as an absence of stores, restaurants, and movie theaters\nComments on the absence or quality of social programs\nMentions of mental health as a contributing factor to crime or describes incident(s) involv"] [14.03122329711914, 5.962238788604736, "18\u2014I lost my guidance. I never had no type of guidance and you hear about kids raising themselves and that\u2019s what\u2019s going on. I had my mom but I had to teach myself right from wrong.\nAnother respondent discussed the relationship between parenting and"] [14.045775413513184, 5.959338188171387, "ead of being out there by yourself.\u201d\n42\nFinally, while racial segregation in social settings was frequently mentioned by county representatives, few associated race with crime. Comments about racial tension and crime noted that oppression and repress"] [14.060843467712402, 5.962937831878662, "overnment system. Less than half of the interviewees in Coahoma County discussed this issue. Across the two counties, interviewees\u2019 comments related to the poor judicial or government system noted that resources for law enforcement are inadequate, wh"] [14.05461597442627, 5.965311050415039, " in Phillips County) was failing schools, which included comments on the poor education system. Interviewees cited low high school graduation rates and low standardized test scores as evidence of the poor education systems in both counties. In additi"] [14.115936279296875, 5.927114963531494, "terms of addressing crime and violence.\n46\nPhillips County Government Addressing Crime and Violence\nIn terms of approaches that directly address crime and violence, the government officials reported several different strategies being implemented by t"] [14.052616119384766, 5.959394454956055, "icers with the necessary experience to conduct investigations. According to several interviewees, the police do not consistently enforce crime, do not always respond to calls for service, and lack professionalism. The lack of proficiency within the p"] [14.065226554870605, 5.951230049133301, " There were two primary explanations for the lack of experienced officers, the first being a recent change in administration and turnover in the department because of political and disciplinary issues over the past several years (in Helena-West Helen"] [16.99582290649414, 7.912714004516602, " some cases, reinvolvement) and focus on three factors: (1) education and prosocial activities for youth, (2) parenting skills and family support, and (3) mental health and addiction services.\nIn terms of providing education and prosocial activities "] [14.091226577758789, 5.955139636993408, " build the workforce and address chronic and multigenerational poverty. However, government officials reported that when residents receive training and build desirable job skills, they often leave to pursue better opportunities elsewhere, so they und"] [14.088290214538574, 5.966367721557617, "ed of serious reform. This sentiment was fully acknowledged by both police and local government leadership, who have been focusing on making improvements through increasing officer compensation, removing officers who are not performing to standards, "] [14.062381744384766, 5.983952045440674, "trategies, and programs can be viewed as a catalog of vetted strategies that hold promise to improve community safety in the Mississippi Delta.\nBoth Coahoma County and Phillips County have recognized issues with burglary, gun violence, petty theft, r"] [14.012676239013672, 5.9406890869140625, " specific objectives, and up to five strategies were described per objective. The research team also offers implementation considerations to provide additional relevant information when considering selecting this type of approach for the Mississippi "] [13.942550659179688, 5.932373523712158, "duce crime by systematically analyzing the problems of a community, searching for effective solutions to the problems, and evaluating the impact of their efforts.\nProgram Effects\nAssociated with 50% decrease in homicide\nMixed. In Chicago, reductions "] [14.074519157409668, 5.963347911834717, "mmunity resources to offenders\n\u2022 arresting and prosecuting the violent offenders as an example of enforcement powers,\nefforts to increase police legitimacy in the community, and subsequent community involvement (these are variant features).\nOnly one "] [14.103324890136719, 5.999335765838623, " within 48 hours to provide crisis intervention, case management, counseling, and any other necessary services to the victims\u2019 families.\n\u2022 Criminal justice review: Monthly meetings by a variety of groups including, but not limited to, local police (c"] [12.525877952575684, 3.8713948726654053, "implemented in a much wider variety of contexts, with uneven results (Papachristos, 2011).\nThis model is not enforcement-focused; rather, it attempts to change community norms and offer incentives for law-abiding behavior. There are multiple program "] [12.504273414611816, 3.840121269226074, "entified, but they generally include a four-step process called the \u201cSARA\u201d (scanning, analysis, response, and assessment) model:\n58\n\u2022 Scanning: In the first step, police identify and prioritize crime and disorder programs in a jurisdiction. This is d"] [12.500582695007324, 3.774048089981079, "ge of effectiveness across the studies. There are no data on what makes some programs better than others.\nTable 4.2. Interventions by Crime Locations Summary Table\n 59\n Approach\nHot spots policing\nCrime prevention through environmental design"] [12.516363143920898, 3.6881463527679443, "oad stolen property.\n\u2022 Residents are encouraged to evaluate their property for security weaknesses and address\nany issues they uncover.\n60\n\u2022 Other components can include citizen patrols, educational programs for young people, victim support services,"] [12.481371879577637, 3.7514123916625977, " negative secondary effects, such as alienating the community.\nThe National Research Council\u2019s Committee to Review Research on Police Policy and Practices concluded that hot-spots policing has the strongest evidence base of any other effective progra"] [12.551373481750488, 3.807232141494751, "lots, shopping malls, campuses, hospitals, or various other facilities. Installation and street light components vary by setting. Increasing street lighting may include adding new lights, trimming bushes and trees to make lights more visible, and rep"] [12.514250755310059, 3.877342700958252, "oblems and develop and implement appropriate responses. Some strategies may focus on specific local problems and target specific populations. However, the disorder-policing approach focuses less on target populations and more on the areas or location"] [16.75754737854004, 7.723364353179932, "\nEstimated Cost\nNo publicly available cost information\nImplementation Considerations Treatments take place while a juvenile is incarcerated\nPrograms are widely used across the United States; established training materials and technical assistance pro"] [17.155818939208984, 8.641508102416992, "ioral model in that it stresses cognitive reframing through the control of cognitive distortions, automatic thought, and self-instructions. Cognitive treatment centers more on the cognitive part of cognitive-behavioral treatment.\n\u2022 Education treatmen"] [15.795305252075195, 6.726642608642578, "nt\u2019s life (e.g., school, community) to improve the real-world functioning of youth by changing their natural settings\u2014home, school, and neighborhood\u2014in ways that promote prosocial behavior while decreasing antisocial behavior. Treatment varies by fam"] [16.74213218688965, 7.703912258148193, "costs $1,248 and yields $24,711 per participant; post-secondary education costs $1,248 and yields $24,711 in benefits per participant; and vocational education costs $1,495 and yields $17,781 in savings per participant.\nAdults: Cognitive Behavioral T"] [16.865346908569336, 7.950501918792725, "ough curriculum-based individual or group sessions and home visiting; social cohesion through community-focused activities; and youth social development through engaging in community- based enrichment exercises and mentorship (see Table 4.4).\nApproac"] [16.899736404418945, 7.927506446838379, "mmunities for All Ages (CFAA). However, a qualitative study demonstrated improvements in community engagement and social capital\nTwo studies found that participants had lower levels of teenage pregnancy, course failure, and school suspension than stu"] [16.826364517211914, 8.02491283416748, "ent training and child skills development activities, followed by a one-hour family session with parents and children. During the family sessions, parents and children practice the skills they have learned in their individual groups, work on conflict"] [16.854930877685547, 8.028220176696777, "h the child\u2019s second birthday. Visits are conducted by a trained public health registered nurse, and 60-to-90 minute visits occur about every other week. Nurses use instruction and observation and focus on improving pregnancy outcomes, infant health "] [16.59964942932129, 7.462274074554443, "their communities (MetLife Foundation,\n71\nGenerations United, 2015). Partnerships are critical to intergenerational communities and may include representatives from local government, older adult living communities, school, business, community organiz"] [16.916181564331055, 7.932023525238037, "esion and connectedness include\n\u2022 Intentional neighboring or communities: These communities attempt to bring together neighbors from multiple generations regularly to develop relationships and provide reciprocal support and asset sharing to address i"] [16.893089294433594, 7.904541015625, "ment.5\nAdditional promising programs to consider are\n\u2022 Gang Resistance Education and Training: A school-based intervention that aims to prevent violence and criminal activity, teach young people to avoid gang membership, and develop positive relation"] [16.839683532714844, 7.943504333496094, "ian to monitor progress, as well as provide guidance and support as needed. Mentors are expected to meet with the child for at least three to five hours per week for 12 months or longer.\nBBBS provides mentoring program guidelines about screening, mat"] [16.34457015991211, 7.550016403198242, "18 months for one program. The other program observed statistically significant reductions in recidivism.\nEstimated Cost\nAverage per capita direct expenditures for Adult Workforce Investment Act program are $2,400\u2013 $2,700. Blueprints estimates cost o"] [13.862415313720703, 8.994486808776855, "The programs combine academic and technical career curricula centered on a specific theme and offer career development and work-based learning opportunities through partnership with local employers. This model seeks to enhance school engagement and p"] [13.879728317260742, 9.0027437210083, " necessary for success in postsecondary education, some Career Pathways may include bridge programs. Bridge programs may be the first phase (basic skills training) of the career pathway, as they provide industry-relevant basic education and training "] [16.025108337402344, 9.741341590881348, "(transitional) to long-term. These programs provide income in exchange for work; reduce the perceived risk or actual cost of hiring or increasing the wages of a worker; and provide work experience to disadvantaged workers. This results in societal be"] [16.631553649902344, 7.521213531494141, "his category of interventions includes a program that focuses on mobilizing communities to identify and address social development needs (see Table 4.6).\nApproach/ Program Community development\nDescription\nCollective action by communities to use reso"] [16.942039489746094, 7.897132873535156, "and culture: values and supports history, culture and diversity.\nSpecific community-building activities include gardening, group exercises, community art projects, housing development, leadership training, and supports for low-income residents (e.g.,"] [16.943395614624023, 7.925387382507324, "ophy is based broadly on the theory of self-concept. It relies on students\u2019 intrinsic motivation for developing and maintaining positive behavioral patterns. The overall program goal of promoting positive action is accomplished by teaching skills foc"] [16.846237182617188, 7.867339611053467, "ilding activities (Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance, undated-b).\n\u2022 Behavior Monitoring and Reinforcement (also known as Achievement Mentoring): This is a two-year intervention for middl"] [14.227723121643066, 6.130978584289551, "vidence of positive effects on staying in school. In addition, there is some evidence that C&C positively affects student progress in school (Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance, undated-c"] [14.16346263885498, 6.148158073425293, "ches to Community Safety, Project Safe Neighborhood, the Comprehensive Anti-Gang Initiative, as well as the Drug Market Initiative all lauded the multiagency, action-research model for tailoring each project to the local context and a specific crime "] [14.200226783752441, 6.122493267059326, "s that we recommend be considered when implementing research-based best practices. Throughout these sections, pertinent results from other sections are highlighted.\nBuilding a Coalition/Local Steering Committee\nMany experts, researchers, and federal "] [14.21375560760498, 6.132482051849365, "revention, as they recognized that a single intervention/program conducted in isolation is unlikely to solve the problem. Therefore, they spent considerable amounts of time building local relationships, collecting information about the problem, and c"] [14.215136528015137, 6.127389907836914, "ot be considered to be finalized. The work in this report should provide a good starting point for the coalition.\nHowever, this is just the beginning for planning a comprehensive approach to crime and violence prevention. The next steps involve selec"] [14.23122787475586, 6.149947643280029, " focus on strategies that are outside of the criminal justice system because they do not wish to expose the community to different policing strategies that could potentially exacerbate problems between police and the community. This is where the coal"] [14.261055946350098, 6.1804423332214355, "proved parent child bonding\n\u2022 Increase in job placement and\nretention\n\u2022 Decrease in exposure to negative peers\n\u2022 Decreased endorsement of\nantisocial behavior\n\u2022 Increase in graduation\n\u2022 Increase in exposure to prosocial peers\n\u2022 Reduced opportunity to "] [14.199137687683105, 6.118804931640625, "\nThe selection of the actual interventions will be based on a variety of factors, and the coalition should remember that one size does not necessarily fit all. The CDC recommends that coalitions consider the feasibility of each approach or combinatio"] [14.33021068572998, 6.262772560119629, "ensive plan and associated timeline for implementation and evaluation.\nAdapting, Implementation, and Evaluating\nThe next steps are beyond the scope of this chapter, but, in general terms, they involve how to tailor the approach to a specific context,"] [14.236676216125488, 6.182061195373535, "nkerhoff et al., 2012; Glasgow et al., 1999; Mertens and Wilson, 2012).\nAdditional Considerations\nRAND has conducted a study on how to ensure success when implementing an evidence- based program into practice and identified ten important components ("] [14.24543285369873, 6.142680644989014, "ence. Many of the foundations have developed strong partnerships with either research teams or professional trainers to establish their legitimacy when they go in to a new location. These partnerships enable them to demonstrate prior success and prov"] [14.252531051635742, 6.171364784240723, "lition that represents multiple viewpoints, which often will not align, is challenging, but vital to success. For example, there were conflicting views about how to solve the crime and violence problem in the Mississippi Delta, and some of them are i"] [16.95586395263672, 7.928643226623535, "liography\nAllen, J. P., and S. Philliber, \u201cWho Benefits Most from a Broadly Targeted Prevention Program? Differential Efficacy Across Populations in the Teen Outreach Program,\u201d Journal of Community Psychology, Vol. 29, No. 6, 2001, pp. 637\u2013655.\nAllen"] [16.890853881835938, 7.954873085021973, "p://www.blueprintsprograms.com/program-costs/career-academies\n\u2014\u2014\u2014, \u201cCommunities That Care,\u201d webpage, undated-c. As of May 30, 2018: http://www.blueprintsprograms.com/factsheet/communities-that-care\n\u2014\u2014\u2014, \u201cNurse-Family Partnership,\u201d webpage, undated-d."] [16.936967849731445, 7.897586345672607, "mployment Retention and Advancement Project, Washington, D.C.: Office of Planning, Research and Evaluation, Report 2012-08, 2012.\nButts, J. A., C. G. Roman, L. Bostwick, and J. R. Porter, \u201cCure Violence: A Public Health Model to Reduce Gun Violence,\u201d"] [16.93589973449707, 7.958609104156494, "ng Parents\u2019 Positive Behavior Support in Early Childhood,\u201d Child Development, Vol. 79, No. 5, 2008, pp. 1395\u20131414.\nDutta-Gupta, I., Lessons Learned from 40 Years of Subsidized Employment Programs: A Framework, Review of Models, and Recommendations fo"] [17.040687561035156, 7.938107013702393, " Who Should Receive What Services? And How Much?\u201d University of Maryland School of Public Policy and Atlantic Council, November 2013.\nHeinrich, C. J., P. R. Mueser, K. R. Troske, K.-S. Jeon, and D. C. Kahvecioglu, \u201cDo Public Employment and Training P"] [16.911880493164062, 7.932309627532959, "d with Effective Treatment,\u201d Journal of Experimental Criminology, Vol. 1, No. 4, 2005, pp. 451\u2013476.\nLewis, K. M., D. L. DuBois, N. Bavarian, A. Acock, N. Silverthorn, J. Day, P. Ji, S. Vuchinich, and B. R. Flay, \u201cEffects of Positive Action on the Emo"] [16.904518127441406, 7.923264980316162, "utions.gov/PracticeDetails.aspx?ID=57\n\u2014\u2014\u2014, \u201cCrime SOLUTIONS.gov,\u201d webpage, undated-b. As of May 30, 2018: https://www.crimesolutions.gov/\n\u2014\u2014\u2014, \u201cProgram Profile: Corrections-Based Adult Basic/Secondary Education,\u201d webpage, undated-c. As of May 30, 201"] [16.82977294921875, 8.006054878234863, "iveness of Home Visiting Programs on Child Outcomes: A Systematic Review,\u201d BMC Public Health, Vol. 13, No. 1, 2013, p. 17.\nPerkinson, L., K. Freire, and M. Stocking, Using Essential Elements to Select, Adapt, and Evaluate Violence Prevention Approach"] [16.88323211669922, 7.938847541809082, "rug Markets, Santa Monica, Calif.: RAND Corporation, RR-1001-NIJ, 2016c. As of June 11, 2018: https://www.rand.org/pubs/research_reports/RR1001.html\nSaunders, J., M. Robbins, and A. J. Ober, \u201cMoving From Efficacy to Effectiveness,\u201d Criminology and Pu"] [16.972110748291016, 7.912926197052002, "ksbury, R., and E. E. Mustaine, \u201cRoutine Activities and Vandalism: A Theoretical and Empirical Study,\u201d Journal of Crime and Justice, Vol. 23, 2000, pp. 81\u2013110.\nThornberry, T. P., and M. D. Krohn, eds., \u201cComparison of Self-Report and Official Data for"] [17.07221031188965, 7.9892096519470215, "/www.census.gov/programs-surveys/decennial-census/decade.2010.html\n108\nU.S. Department of Education, \u201cEducation, Health and Human Services, and Labor Release Joint Career Pathways Letter,\u201d webpage, April 12, 2012. As of May 30, 2018: https://www2.ed."] [13.770425796508789, 5.968323707580566, "ing: A Model for Strengthening Community in Trauma Affected Neighborhoods, San Francisco: Bridge Housing and the Health Equity Institute, 2014.\nWeisburd, D., \u201cThe Law of Crime Concentration and the Criminology of Place,\u201d Criminology, Vol. 53, No. 2, "] [13.664653778076172, 2.7419064044952393, " Using Social Media and Social Network Analysis in Law Enforcement\nCreating a Research Agenda, Including Business Cases, Protections, and Technology Needs\nJohn S. Hollywood, Michael J. D. Vermeer, Dulani Woods, Sean E. Goodison, Brian A. Jackson\nIn"] [13.658994674682617, 2.732041120529175, "work analysis; (2) technical develop- ment, starting with assessing current tools and how they might be better tailored to law enforcement; (3) law enforcement\u2013specific training on these types of analysis; and (4) creation of a help desk to help law "] [13.670049667358398, 2.737123489379883, "and social net- work analysis. Here, the initial recommendations are to develop requirements for training and assess gaps between current com- mercial- and defense-focused training and what is needed for law enforcement training. This implicitly incl"] [13.63836669921875, 2.7391860485076904, "eraction with social media and use of social media data is therefore important, given the need to police in this technological era. However, social media analysis by law enforcement does raise acute privacy, security, and civil rights needs, because "] [13.64763069152832, 2.7451114654541016, "nge of examples of the use of social media data and social network analysis for law enforcement purposes:\n\u2022 Solving a gang-related shooting by matching knowledge about feuding gang networks with motor vehicle information. Analysts used social network"] [13.638482093811035, 2.7591612339019775, "uencers and leaders in social networks (in brief, these influencers/leaders typically have higher numbers of both direct and indirect relationships). Girvan and Newman (2002) provide an example of a method for finding likely sub- groups within larger"] [13.677962303161621, 2.726010799407959, "iated analytics in law enforcement. Panel members included a range of experts, including practitioners\nof social media and social network analysis in law enforce- ment, developers of social media and social network analysis methods for law enforcemen"] [13.654361724853516, 2.7174434661865234, "lated to social media data and social network analysis that should be discussed at the workshop. In addition to providing a way for panelists to contribute to shaping the discussion during the meeting, the questionnaire also helped to define a common"] [14.764707565307617, 1.937848687171936, " or training. In our work, each need consists of\na problem/opportunity statement and a solution statement. There can be multiple solution statements\u2014and hence multiple needs\u2014for the same problem/opportunity, capturing different options or strategies "] [13.652565956115723, 2.725001096725464, "en pairs of needs if the needs addressed similar issues or proposed the same type of solution. Displaying the network revealed that the needs and their rela- tionships fell into four entirely separate groups. The similarities between the four separat"] [13.643370628356934, 2.6993157863616943, "ld all\nbe part of emergency \u201ccalls\u201d that would get into public safety access points (PSAPs). Next Generation 911 is in part intended to address this need (National Telecommunications and Information Administration, 2017). Agencies would then have the"] [13.616185188293457, 2.7351126670837402, "vered in other business cases.\nAs for cases between the extremes above, the discussion focused on how these needed to be worked out at the local level, community by community. This led to panel discussions on the need for transparency and how to enga"] [13.579801559448242, 2.801405191421509, "ng a range of social services; sanctions typically include increased contacts with law enforcement, increased investigations and prosecutions, and increased sentencing on conviction.\nThe National Network for Safe Communities (2016) pro- vides a gener"] [13.6091947555542, 2.7275688648223877, "rimes they might commit in the future but have not actually commit- ted. Similarly, analysts need to be able to differentiate between people who are high-risk because they are a high threat to the community versus those who are at high risk of becomi"] [13.672897338867188, 2.7273240089416504, "sts of persons and other entities of interest. As examples, a 2013 FBI bul- letin presented applications of identifying why two rival gangs suddenly started battling each other; identifying a previously unknown associate of an at-large suspect, which"] [13.714330673217773, 2.7602477073669434, "y than results leading to increased community engagement.\nProtections for Data Collection\nProtections for data collection relate primarily to document- ing procedures and policies, and having protections, for data searches and collections. At the bas"] [13.654752731323242, 2.7286088466644287, "cies to prevent conducting more stops based only on casual social connections that have not been confirmed to be genuine criminal connections by subsequent investigation (both manual and machine-assisted). It was noted that \u201cjust because you have 500"] [13.672588348388672, 2.7212910652160645, " stakeholders to collectively develop model procedures and policies. Specific needs here include developing policies for using commercial social media tools, conducting covert social media research, and conducting undercover social media investiga- t"] [13.669007301330566, 2.7233409881591797, "whether an older one has been superseded.\nDevelop best practices for transparency with regard to use of social media data.\nConduct a review of the efficacy and acceptability of state and local privacy councils (one example is in Oakland, California)."] [13.667695999145508, 2.7281315326690674, "ysis Chain\nConduct a forum for the existing software developers and practitioners/users to exchange information on the shortcomings of existing software.\nConduct an independent review of commercial tools and techniques for social network analysis.\nDe"] [13.71672534942627, 2.7134017944335938, "approaches for overcom- ing them, and a way ahead to conduct the studies, analyses, and educational material development needed to prepare law enforcement\u2013focused materials for social media and social net- work analysis training. As a short-term trai"] [13.662808418273926, 2.730715751647949, "can be a\nsource of knowledge on how to obtain usable information from specific sources (mobile phone companies, social media companies, etc.).\nHigh-value, high-risk\n16\n SUMMARY AND CONCLUSIONS: THE INNOVATION AGENDA FOR SOCIAL MEDIA AND SOCIAL NETWOR"] [14.18394660949707, 2.680286169052124, "urrent (com- mercial- and defense-focused) training and what is needed for law enforcement\u2013focused training. As noted, training on legal implications and protections is a short-term need that can be addressed by developing a model curriculum.\nThe fin"] [14.757698059082031, 1.8224643468856812, "ot spot analysis. Likelihood of success was bracketed as 1 equaling about a 10 percent chance of success and 9 equaling about a 90 percent chance of success.\nTo combine the two scores, we took an expected value (EV) approach, multiplying the two scor"] [14.724642753601074, 1.8947056531906128, "e whether there were any \u201clow- hanging fruit\u201d needs, defined as being in Tier 2 but having a very low risk (median likelihood of success score of 8 or higher).\nThere were no such needs in this study.\nThere are 22 priority needs. Figure A.3 shows that"] [13.664166450500488, 2.7212159633636475, "\n0\n0\n0\n0\n0\n0\n0\nHelp desk\nfor taking down feeds\n0\n0\n0\n0\n0\n0\n0\n0\n0\n0\nSOP for covert SM research\n0\n0\n0\n0\n0\n0\n0\n0\nBP for\npublic discourse of SM uses\n1\n0\n0\n0\n0\n0\n1\n0\nBP for\nmulti- stakeholder responses to risks\n1\n0\n0\n0\n0\n1\n1\n0\nPolicy assessment of privacy"] [13.691636085510254, 2.7233214378356934, "y, and judicial fairness in handling digital evidence for criminal justice and public access purposes.\nBest practices and policy guidelines are published by\na variety of organizations over the years in multiple versions, but there is no authoritative"] [13.670513153076172, 2.7155587673187256, "rmation on the efficacy of commercial tools and techniques for social network analysis.\nWhen requesting information from social media organizations or collecting it from devices, the resulting data set is often huge (data overload).\nTable B.4. Priori"] [13.657625198364258, 2.7146527767181396, "gh social network analysis practitioners to meet the demand.\nConduct research into the gaps between where the profession is now and where it should be.\nTier 2\n Often there are several needs to redact video evidence (e.g., discovery, evidence/exhibits"] [13.6834716796875, 2.7209901809692383, "able information from specific sources (mobile phone companies, social media companies, etc.).\nTier 3\nCrimes are often \u201creported\u201d by sharing text, photos, or video on social media or directly with law enforcement. In such situations, geolocation or e"] [13.650726318359375, 2.8577094078063965, "tp://www2.oaklandnet.com/government/o/CityAdministration/d/ PrivacyAdvisoryCommission/index.htm\nColdren, James, and John Markovic, \u201cUtilizing Social Network Analysis to Reduce Violent Crime,\u201d Violence Reduction Network Webinar Series, July 20, 2015.\n"] [13.906167030334473, 3.760808229446411, "search_reports/RR1462.html\nHollywood, John S., Dulani Woods, Andrew Lauland, Brian A. Jackson, and Richard Silberglitt, Addressing Emerging Trends to Support the Future of Criminal Justice: Findings of the Criminal Justice Technology Forecasting Grou"] [13.653178215026855, 2.827582597732544, " \u201913), 2013, pp. 1042\u20131049. As of April 9, 2018: https://arxiv.org/pdf/1306.6834.pdf\nPew Research Center, \u201cHow We Analyzed Twitter Social Media Networks with NodeXL,\u201d 2014. As of June 10, 2017: http://www.pewinternet.org/files/2014/02/How-we-analyzed"] [13.9676513671875, 3.8192760944366455, "ation, in partnership with the Police Executive Research Forum (PERF), RTI International, and the University of Denver, is carrying out a research effort to assess and prioritize technology and related needs across the criminal justice community. Thi"] [13.850833892822266, 4.613625526428223, "lication are those of the author(s) and do not necessarily reflect those of the Department of Justice.\nLimited Print and Electronic Distribution Rights\nThis document and trademark(s) contained herein are protected by law. This representation of RAND "] [17.404216766357422, 8.143465042114258, " CORPORATION\nLos Angeles County\nJuvenile Justice Crime\nPrevention Act\nFiscal Year 2016\u20132017 Report Terry Fain, Susan Turner, Nima Shahidinia\nFor more information on this publication, visit www.rand.org/t/RR2401\nPublished by the RAND Corporation, Sant"] [17.447494506835938, 8.17247486114502, "latively mandated evaluation of the county\u2019s JJCPA programs, including analyzing data and reporting findings to the BSCC. This report summarizes the fiscal year 2015\u20132016 findings reported to the BSCC, as well as additional program informa- tion gath"] [17.392555236816406, 8.128089904785156, "9 Report, Santa Monica, Calif.: RAND Corpora- tion, TR-832-LACPD, September 2010b\n\u2022 Terry Fain, Susan Turner, and Greg Ridgeway, Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2007\u20132008 Report, Santa Monica, Calif.: RAND Corpor"] [18.054636001586914, 9.381244659423828, "................................................................................................... ix Tables............................................................................................................ xi Summary . . . . . . . . . . ."] [18.07628631591797, 9.384181022644043, ". . . . . . . . . . . . . . . Cost Comparisons for Programs in the Enhanced Services to High-Risk/High-Need Youths\n.. 8 .. 9\n. 11 . 11 . 14\n24 38\n. 63 64 64 68\nInitiative................................................................................"] [18.05088996887207, 9.324891090393066, "...................................................\nReferences.....................................................................................................\n. 83 . 85 . 89\n90\n. 91 .93\n. 95\n97 111 115 121 123\n125 127\n. .\n. .\nFigures\n 2.1. Outco"] [18.022663116455078, 9.31049633026123, "n for Middle School Probationers,\nby Cluster, FY 2016\u20132017: Arrest, Incarceration, and Completion of Probation . . . . . . . . .\n2.17. Outcomes for School-Based Probation Supervision for Middle School Probationers, by Cluster, FY 2016\u20132017: Completio"] [18.067298889160156, 9.317041397094727, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14\n2.4. Means, Differences in Differences, Odds Ratios, and Confidence Intervals for\nOutcomes for Mental Health. . . . . . "] [18.06772804260254, 9.294684410095215, "...................................................58\n2.17. Factors Used to Match School-Based Probation Supervision for Middle School Probationers and Comparison-Group Youths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [18.05717658996582, 9.34725570678711, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n3.17. Estimated Mean Net Cost Savings for Initiatives, FY 2016\u20132017, in 2016 Dollars . . . . . .\n4.1. Results from Simple Comparisons in Programs That Used the Previous Year"] [17.971147537231445, 9.264632225036621, "l\nProbationers, FY 2016\u20132017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................... 110\nE.1. Outcomes for Multisystemic Therapy, FY 2016\u20132017 . . . . . . . . . . . . . . . . . . . ........."] [17.700439453125, 8.48046588897705, "-Need Youths, and Enhanced School- and Community-Based Services. We also present a comparison of juve- nile justice system costs for program youths in the six months before they entered the JJCPA programs and in the six months after entering the prog"] [17.701486587524414, 8.488327980041504, "f probation, (4) successful completion of restitution, (5) successful completion of community service, and (6) probation violations. Each county can also request that a program measure supplemental outcomes for locally iden- tified service needs (BSC"] [17.7352352142334, 8.593682289123535, "square test evaluates how likely it is that a difference between two groups is not due to chance alone.\n of Supervisors (BOS) contracts, and expanded programs. These funds totaled $2,926,705, so the total expenditure of JJCPA funds in FY 2016\u20132017 wa"] [17.74936866760254, 8.718215942382812, "ion rate is not a realistic expectation.6 For all the big six outcomes, the most important metric is whether program participants performed significantly better than comparison-group youths, not the absolute value of any given outcome.\nParticipants I"] [17.718772888183594, 8.786246299743652, "outh was on probation prior to program entry. This potentially tips the scale in favor of better performance on all probation-related outcomes, except probation violations, after program entry than prior to program entry. Our evaluation of JJCPA prog"] [17.699079513549805, 9.031871795654297, "ne 30, 2017. To allow a six-month eligibility period for recidivism, however, the number for whom a program reported outcomes uses a reference period of January 1, 2016, through December 31, 2016. The participants for whom a program can report outcom"] [17.648719787597656, 9.078924179077148, "year, not on trends over time. This approach is consistent with the scope of what the BSCC required in the past and what the BOS expects. From year to year, a particular big six outcome might not always be more positive for program participants, but,"] [17.675216674804688, 8.97169017791748, "rams that used contempo- raneous comparison groups were small and showed no significant differences between program and comparison-group youths.\n\u2013 SBHS-PROB participants showed more-positive outcomes for four of the big six out-\ncomes.\n\u2013 SBMS-PROB pa"] [17.787790298461914, 8.996000289916992, "valuate the quality of program implementation.\nOutcomes\nHistorical and Contemporaneous Comparison Groups and Pre\u2013Post Comparisons\nThree of the four programs that used contemporaneous comparison groups (MST, SBMS- PROB, and SNC) were quite small. MST "] [18.103473663330078, 9.604846000671387, "ent cohort performing at least as well as the previous year\u2019s cohort had. As Table S.3 indicates, the FY 2016\u20132017 cohort equaled or surpassed the FY 2015\u20132016 cohort\u2019s performance for all but one of the 34 outcomes. For the one outcome (arrests in t"] [18.20903968811035, 9.779230117797852, "sed Services initiative spent $754 per participant. Differences between initiatives in estimated mean cost\nTable S.4\nResults of Difference-in-Differences Analyses for Programs That Used the Previous Year\u2019s Cohorts as Comparison Groups\n Program Arrest"] [18.23398780822754, 9.821295738220215, "s and Initiatives\nTable S.6 shows the estimated mean baseline and follow-up costs per participant in each JJCPA program in FY 2016\u20132017, based on the budget for each program. As one might expect, mean costs differ noticeably among the three initiativ"] [18.23910140991211, 9.828104972839355, "rall juvenile justice costs for JJCPA participants were generally higher in the six months after program entry ($19,877) than in the six months prior to program entry ($11,571), primarily because of the cost associated with administering the programs"] [17.903667449951172, 9.069709777832031, "mp were markedly lower in the six months after participants entered the program, with camp costs averaging $9,681 less in the follow-up period than in the baseline period. The reduction of camp costs in the follow-up period was enough to drive the ov"] [17.682266235351562, 8.500284194946289, "eported, only 142 (12.7 percent) had supplementary outcome data. We will continue to work with Probation to increase the amount of data available for supplemental outcomes for all JJCPA programs.\nFY 2016\u20132017 was the 16th consecutive year for which p"] [17.815397262573242, 8.734307289123535, "ool At-Risk Youths SBHS-PROB School-Based Probation Supervision for High School Probationers SBMS-AR School-Based Probation Supervision for Middle School At-Risk Youths SBMS-PROB School-Based Probation Supervision for Middle School Probationers SD sc"] [17.703580856323242, 8.47766399383545, "tion Act: Fiscal Year 2016\u20132017 Report\nThe BSCC has responsibility for administering the JJCPA program.2 From 2001 through 2016, the legislation required the BSCC to submit annual reports to the California state legis- lature measuring the success of"] [17.701093673706055, 8.47877311706543, "enile Justice Coordinating Committee identified unspent funds from previous years, which were allocated to one-time uses. These were spent on a New Directions program, Los Angeles County Board of Supervi- sors (BOS) contracts, and expanded programs. "] [17.804441452026367, 8.538061141967773, "groups already being selected before the beginning of the evalu- ation. If an experimental design cannot be used, researchers often evaluate programs using quasi-experimental designs, in which they choose a comparison group to match the treatment gro"] [17.790151596069336, 8.652680397033691, "he program (for community programs) or after they are released into the community (for juvenile hall programs). In addition to the big six, the Probation Department, working with BOC (and later with CSA and the BSCC), defined supplemental outcomes sp"] [17.7469539642334, 8.729750633239746, "ion supervision, and orders to avoid gang activity. To create a comparison group, the RAND team also worked with MST and SNC personnel to identify program \u201cnear misses\u201d appropriately similar to program participants. The near misses used in comparison"] [17.77116584777832, 8.653072357177734, "00-percent completion-of-probation rate is not a realistic expectation.4 For all the big six outcomes, the most important metric is whether program par- ticipants performed significantly better than comparison-group youths did, not the absolute value"] [17.75855827331543, 8.640213966369629, " successful. For the school-based probationer programs, we used propensity- score matching to create comparison groups, starting with a large group of routine probation- ers who were not in JJCPA programs and statistically matching their characterist"] [17.717496871948242, 8.937980651855469, " baseline over the two years.7\nPrograms measure each of the big six outcomes during both baseline and follow-up peri- ods for both the current and previous years.8 If the lower bound of a 95-percent confidence interval (CI) is less than 1 and the upp"] [17.808551788330078, 8.646760940551758, "de a difference-in- differences analysis for each big six outcome measure. The odds ratio and 95-percent CIs in the tables presenting the results of our difference-in-differences analyses always refer to the interaction term year \u00d7 post.\nLimitations "] [17.718591690063477, 8.56838321685791, "ation (e.g., Brief Symptom Inventory [BSI] scores) but actually administer the evaluation only once for most participants, at the time of program entry. We report supplemental outcomes only if the youth receives both baseline and follow-up evaluation"] [17.677282333374023, 8.482230186462402, "tcomes\n\u2022 Appendix C: CBOs that contracted with Probation to provide JJCPA services in FY\n2016 \u20132017\n\u2022 Appendix D: details of outcomes for each program\n\u2022 Appendix E: details of outcomes for each program, by participant gender\n\u2022 Appendix F: details of "] [17.74561882019043, 8.774417877197266, "t can receive services from more than one initiative and from mul- tiple programs, within or across initiatives, and concurrently or consecutively. The Probation Department counts a given youth as a participant within each program from which he or sh"] [17.688573837280273, 8.857577323913574, " number for whom a program reported outcomes.\n2 The near misses used in comparison groups for MST were youths who had similar characteristics to those of program participants but who were not accepted into the program, usually because of lack of Medi"] [17.610050201416016, 8.899042129516602, "s youths with severe mental health issues; few, if any, placement options for crossover populations (e.g., youths in both juvenile justice and foster care systems); and no cost-effective family-based community treatment service. These problems were a"] [17.495620727539062, 8.868505477905273, "nce for most outcomes in this evaluation requires that each cell of a 2 \u00d7 2 table contain at least five observations. The 2 \u00d7 2 tables use the group (program and comparison) as rows and outcome (yes = 1, no = 0) as columns. Some programs (e.g., very "] [17.52477264404297, 8.86819839477539, "treatment approach as an essential requirement because of the high incidence of co-occurring disorders among the youths. Integrated systems involve collaboration that crosses multiple public agencies, including juvenile justice and mental health, to "] [17.538150787353516, 9.037391662597656, "meone\u2019s overall psycho- logical state at a given time, and a lower score in the post period simply indicates fewer (or less severe) overall symptoms. DMH gave Probation only the overall BSI score, which Probation then forwarded to RAND. DMH measured "] [17.512493133544922, 9.021041870117188, "try (47.77), a statistically significant difference. Number of administrations of the BSI appears to be related to length of stay in the hall. Those who were administered the BSI more than once had significantly longer hall stays (60.9 days) than tho"] [17.280567169189453, 8.88991928100586, "ealth\n Mean Percentage\nCurrent Year Previous Year\n Outcome Baseline\nArrest 49.28\nIncarceration 14.64\nCompletion 0.62 of probation\nCompletion 4.88 of restitution\nCompletion 0.62 of community\nservice\nProbation 8.09 violation\nFollow-Up Baseline\n39.4"] [17.337120056152344, 8.915450096130371, "MST studies has indicated that the program has small but significant outcomes on delinquency and psychopathology, substance use, family functioning, and peer relationships (van der Stouwe et al., 2014).\nUsing eight years of data from Los Angeles Coun"] [17.41208839416504, 8.935544967651367, "groups were not statistically significant for any of the big six outcome measures. Although some measures (e.g., completion of community service) showed relatively large differences between groups, smallness of samples prevented the differences from "] [17.143327713012695, 7.732758522033691, "ivism rates (Sarteschi, Vaughn, and Kim, 2011). A study on clients in Washoe County, Nevada, showed a significant decrease in days in jail and days in psychiatric hospitalization (Frailing, 2010). In a study of four mental health courts in San Franci"] [17.1638126373291, 7.766063213348389, "y founded to treat adults, the drug court model quickly expanded to include juvenile drug courts. Between 1995 and 2001, more than 140 juvenile drug courts were established (Bureau of Justice Assistance, 2003). These juvenile courts actually had a si"] [17.518245697021484, 8.975364685058594, " SNC were near misses for SNC eligibility during FY 2014\u2013 2015, FY 2015\u20132016, or FY 2016\u20132017, primarily because the program did not deem those youths\u2019 cases sufficiently serious. The two groups did not differ significantly in age, gender, or race an"] [17.56068229675293, 9.036092758178711, "as a comparison group, difference-in-differences analysis agreed with a simple com- parison of the two groups, with one exception: Although a simple comparison indicated that the FY 2016\u20132017 had higher rates of completion of community service than t"] [17.568984985351562, 8.720991134643555, "The DPOs rely on the Los Angeles Risk and Resiliency Checkup (LARRC) to assess criminogenic risk and need factors (S. Turner, Fain, and Sehgal, 2005b; S. Turner and Fain,\n 26 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 201"] [17.57989501953125, 8.882532119750977, "and church members)\n\u2022 programs that tap girls\u2019 cultural strengths rather than focusing primarily on the indi- vidual girl (e.g., building on Afrocentric perspectives of history and community relation- ships)\nCurrent JJCPA Programs and FY 2016\u20132017 Ou"] [17.565481185913086, 9.062614440917969, "pants consists of GSCOMM participants whose outcomes we reported for the previous year (FY 2015\u20132016), with the goal of them performing at least as well in the current year as in the previous year. The program selected participants who had arrests th"] [17.403121948242188, 9.114145278930664, "67 of restitution\nCompletion 0.00 of community\nservice\nProbation 0.00 violation\nFollow-Up\n2.21\n0.46 28.89\n32.26 31.03\n11.11\nOdds Ratio\n1.455 0.397 \u2014\n0.370 \u2014\n\u2014\n95% CI\n0.666\u20133.178 0.067\u20132.372 \u2014\n0.047\u20132.948 \u2014\n\u2014\n NOTE: Because the baseline for the cur"] [17.280054092407227, 9.09119701385498, "pita.\nThe HRHN program employs a social learning curriculum (SLC) in its home-based service components. It targets services not at the participant alone but at the entire family and other parts of the participant\u2019s environment. It focuses on school a"] [17.196277618408203, 8.74559497833252, "017 Outcome Measures 31\nemphasis on reducing participant youths\u2019 exposure to delinquent peers. Although MTFC does not prevent out-of-home placement, both biological and foster parents receive parental training. The program trains parents to monitor d"] [17.32855224609375, 9.109843254089355, "t research on juvenile justice service deliv- ery in the past 15 years has been largely about failures of punitive institutional models (Bennett et al., 2017).\n\u2013 creation of links with community resources and social networks. This element of case man"] [17.402658462524414, 9.150989532470703, ", as a supplemental outcome, we measured employment during the six months before entry into the community phase of the program and in the six months following entry into the community phase. For the gender-specific, home- based component, we measured"] [17.54521942138672, 9.12882137298584, "or Outcomes for High Risk/High Need\n Mean Percentage\n Current Year\nPrevious Year\n Outcome Baseline\nArrest 35.98\nIncarceration 12.37\nCompletion 1.33 of probation\nCompletion 8.64 of restitution\nCompletion 1.38 of community\nservice\nProbation 7.00 vio"] [17.37244415283203, 9.168960571289062, "echniques include exploring the positive and negative consequences of continued use, self-monitoring to recog- nize drug cravings early on and to identify high-risk situations for use, and developing strate- gies for coping with and avoiding high-ris"] [17.521230697631836, 9.179460525512695, "itive drug tests. We measured these supplemental outcomes during the six months before program entry and in the six months following program entry or at the time of program exit, whichever came first.\n36 Los Angeles County Juvenile Justice Crime Prev"] [17.569372177124023, 9.104340553283691, "dds Ratio\n0.948 1.847 1.034\n1.569 \u2014\n4.551\n95% CI\n0.517\u20131.738\n0.612\u20135.575 0.058\u201318.494\n0.550\u20134.473 \u2014\n0.874\u201323.704\n NOTE: Because the baseline for the current year was 0, we could not compute the odds ratio for\ncommunity service. \u201cDiff \u2013 Diff Percen"] [17.927204132080078, 8.845907211303711, "ods\u2019 schools\n\u2022 rate of overall crime\n\u2022 rateofjuvenilecrime\n\u2022 rate of substance abuse\n\u2022 rate of child abuse and neglect\n\u2022 number of residents living below the poverty level.\nPrograms and services included in this initiative are ACT, HB, IOW, PARKS, SB"] [18.014158248901367, 8.829489707946777, "and FY 2016\u20132017 Outcome Measures 39\nTable 2.10\nPrograms and Comparison Groups in the Enhanced School- and Community-Based Services Initiative\nProgram Comparison Group\nACT Program participants (pre\u2013post design)\nHB Program participants (pre\u2013post desig"] [18.03542709350586, 8.825343132019043, "mmon cause of truancy and that school attendance improves when truancy programs hold parents accountable for their children\u2019s school atten- dance and when intensive monitoring and counseling of truant students are provided.\nOJJDP documents several pr"] [17.985713958740234, 8.846169471740723, "e program.\nOutcomes\nFor outcome measures, we examined 6,762 ACT participants. ACT participants had signif- icantly fewer school absences\u2014a mean of 9.8 days\u2014in the 180 days after program entry than in the 180 days immediately preceding program entry, "] [17.777973175048828, 8.953502655029297, "ce delinquency and enhance family func- tioning and success by implementing case-management interventions and services that\n\u2022 address criminogenic needs and risk factors, based on a research-based risk and need instrument validated for the Los Angele"] [17.68265724182129, 9.200748443603516, " baseline to 96.4 percent in the term of program entry, but the difference was not statistically significant. No HB participants were arrested or incarcerated at either baseline or follow-up.14\nBecause all participants in the HB were at-risk youths, "] [17.677757263183594, 9.203154563903809, "\n\u2022 recognition: distribution of participants\u2019 writing to parents, schools, libraries, government officials, and the general public.\nEvidence Base for the Program\nMany juvenile detainees have reading and writing levels significantly lower than their g"] [17.696598052978516, 9.147137641906738, "e significantly lower in the follow-up period (0.0033) than in the first 30 days of the program (0.0704). Figure 2.7 shows BSCC-mandated big six out- come results. Table D.9 in Appendix D lists all additional details for all outcomes. Cluster and gen"] [17.86083984375, 8.68425178527832, " at county and city parks, schools, and CBOs. School-based DPOs refer probationers to the after- school program. The program offers these services at a time of the day when youths, especially probationers, are most likely to be without adult supervis"] [17.85988426208496, 8.728180885314941, "owson, 2009; Benson et al., 2012). Implicit in this perspective is the recognition that prevention programming must address risk factors at the appropriate develop- mental stage and as early as possible. JJCPA\u2019s PARKS program is based on the aforemen"] [17.88243865966797, 8.7095365524292, "youths on school campuses, DPOs provide a variety of services, including early probation intervention, for youths exhibiting antisocial behavior or performing poorly in school. The program is goal oriented and strives to reduce delinquency and promot"] [18.188308715820312, 9.02245807647705, " case-management interventions\n\u2022 address both risk factors and criminogenic needs\n\u2022 employevidenced-basedtreatmentintervention\n\u2022 provide prosocial adult modeling and advocacy\n\u2022 provide postprobation planning with the probationer and family by the sch"] [18.20989418029785, 9.037952423095703, "ses, we compared 2,525 SBHS-AR and 1,765 comparison-group youths. SBHS-AR participants improved school attendance (percentage of days attended) in the term after entering the program compared with the term immediately before (93.2 percent versus 85.3"] [18.201391220092773, 9.021934509277344, "ere available only for the four school-based programs and the HB program.\n Current JJCPA Programs and FY 2016\u20132017 Outcome Measures 51\nFigure 2.9\nOutcomes for School-Based Probation Supervision for High School At-Risk Youths, by Cluster, FY 2016\u2013201"] [18.217538833618164, 9.021742820739746, "hts for comparison-group youths so that their characteristics matched those of the program participants. We included only probationers with valid data on all vari- ables in creating weights for the comparison group. Because virtually every school-bas"] [18.21634292602539, 9.02365493774414, " six outcomes by cluster. Table E.5 in Appendix E shows outcomes by gender. Table F.3 in Appendix F contains more detail on big six outcomes by cluster. In this program, youths from cluster 2 had higher arrest and incarceration rates than youths in o"] [18.2226619720459, 9.022669792175293, " two SBMS-AR youths were expelled in the term before entering the program, and only one in the term after program entry. In addition, pro- gram participants had significantly lower mean barrier scores (3.7) six months after program entry than at prog"] [18.180545806884766, 9.038827896118164, "mple comparison of rates, the two cohorts did not differ significantly in arrest rates in the difference-in-differences analysis. We could not compute the odds ratio for incarceration because the follow-up for the FY 2015\u20132016 cohort was 0.\nCurrent J"] [18.190935134887695, 9.03597354888916, ".27 0.68 0.14 0.00\nDiff \u2013 Diff Percentage\n\u20130.58 \u20130.28\nOdds Ratio\n0.872 \u2014\n95% CI\n0.129\u20135.884 \u2014\n NOTE: Because there were no incarcerations in the follow-up period for the previous year, we could not compute the odds ratio for incarceration. \u201cDiff \u2013"] [18.176612854003906, 9.020431518554688, "hree comparison-group youths completed community service and only two SBMS-PROB youths had probation violations. For big six outcomes, see Figure 2.15, with details in Table D.14.\nCluster data were available for all participants in the SBMS-PROB prog"] [17.895418167114258, 9.172191619873047, "ation Supervision for Middle School Probationers, by Cluster, FY 2016\u20132017: Arrest, Incarceration, and Completion of Probation\nNOTE: A missing bar for a cluster indicates that no one in the cluster had the indicated outcome.\nbarrier scores significan"] [18.2260799407959, 9.79915714263916, "ngs.\nWe note also that, by definition, at-risk youths are likely to have virtually no preprogram juvenile justice costs. Probationers, by contrast, might have been under supervision prior to program entry and might have also incurred other juvenile j"] [18.219507217407227, 9.808457374572754, "s that could be used for one-time costs. These were spent on a New Directions program, BOS contracts, and expanded (non-JJCPA) programs. These funds totaled $2,926,705, so the total expenditure of JJCPA funds in FY 2016\u20132017 was $30,718,002.\nEstimate"] [18.375314712524414, 9.970351219177246, " allow compari- sons for program participants in the six months after entering JJCPA programs versus the prior six months.\nThe people for whom we calculated costs are the same ones we used in reporting out- comes in the previous chapter, except for t"] [18.37755012512207, 9.976080894470215, " the estimated court cost ($3,255.25) yields a total estimate of $5,616.51 per court appearance in 2016 dollars.\nProbation Costs for Routine Supervision, Camp Stays, and Hall Stays\nThe Probation Department\u2019s Budget Department provided the estimated c"] [18.284881591796875, 9.901073455810547, "m, we counted the number of arrests, the number of days in camp, the number of court appearances, the number of days in juvenile hall, the number of days in the program, and the number of days of probation supervision. For the school-based programs, "] [18.325416564941406, 9.979631423950195, " estimated costs that such a phenomenon might skew. A median that differs substantially from its corresponding mean indicates skewness, while a similar mean and median for a given cost estimate indicate that the cost is more evenly distributed among "] [18.32933235168457, 9.99021053314209, "1.07\nProgram 20.67 0.00\nSupervision 8.37 103.27\nTotal 24,392 8,483\n1,452 0 6,391 0 6,292 5,617 9,392 0\n0 0 864 1,322\n NOTE: A positive number in a difference column indicates that the cost was lower in the six months after beginning the program tha"] [18.28953742980957, 9.919949531555176, "25 SNC participants, so high costs for a small number of youths could easily skew the mean cost.\nCost Comparisons for Programs in the Enhanced Services to High-Risk/High- Need Youths Initiative\nFor this initiative, we again estimated the costs of the"] [18.316482543945312, 9.979702949523926, "entering the program than before entering. All units are days except for arrests, which are measured by the number of arrests, and court, which is measured by the number of appearances. Because of rounding, some data groups do not necessarily sum pre"] [18.326709747314453, 9.985841751098633, "d by the number of appearances. Because of rounding, some data groups do not necessarily sum precisely.\nTable 3.7\nEstimated Juvenile Justice Costs for Youth Substance Abuse Intervention\n Baseline\nMean, Median, in 2016 in 2016 Dollars Dollars\n989 0"] [18.32990074157715, 9.990836143493652, " 0 3\nFollow-Up\nDifference, in 2016 Dollars\n Juvenile Unit Cost,\nJustice in 2016\nCost Dollars Units\nMedian,\nin 2016\nDollars Units\n0 0.00 0 0.00 0 0.00 0 0.02\n0 178.48 0 0.07 0\nMean, Median,\nin 2016 in 2016\nDollars Dollars Mean\n3 0 \u20131 0 0 0 2 0 \u20131\n16"] [18.32943344116211, 9.990152359008789, "0 0\n0 0 0\nDifference, in 2016 Follow-Up Dollars\n Juvenile Unit Cost,\nJustice in 2016\nCost Dollars Units\nMedian,\nin 2016\nDollars Units\n0 0.00 0 0.00 0 0.00 0 0.00\n0 179.47 0 0.00 0\nMean, Median,\nin 2016 in 2016\nDollars Dollars Mean\n0 0 0 0 0 0 0 0 0"] [18.33004379272461, 9.98820686340332, "rest 2,121.10 Camp 895.04 Court 5,616.51\n0.00 0.00 0.00 0.00\n0.00 0.00\nJuvenile hall\nProgram Supervision Total\n848.18\n19.41 8.37\n NOTE: A positive number in a difference column indicates that the\nbeginning the program than in the six months before "] [18.330638885498047, 9.995039939880371, "ision 8.37 0.86\nAttendance Variable 0.02\nTotal 106 0\n45 0 0 0 51 0 3 0\n0.05 0.00 0.03 0.34\n163.06 1.77 7.54\n100 0 \u201355 0 0 0 0 0 176 0 \u2013125 0 290 0 \u2013287 0\n1,256 1,386 \u20131,256 \u20131,386 15 0 \u20138 0 \u2013430 \u2013316 430 316 1,546 1,271 \u20131,440 \u20131,271\n0 0 7 0\n NOTE:"] [18.236255645751953, 9.824076652526855, "ffset cost increases in juvenile hall ($81), program administration ($758), and supervision ($565). As a result, total mean costs were lower in the follow-up period ($8,384) than during the baseline period ($9,504).\nEstimated Total Cost of Programs a"] [18.240741729736328, 9.831599235534668, "ttendance, targets only at-risk youths who have virtually no involvement with the juvenile justice system.\nTen of the JJCPA programs produced average cost savings in arrests, and HB participants had no arrests in either the baseline or follow-up peri"] [18.234642028808594, 9.82453727722168, " program and the six months after entering). As one might expect, mean costs differ noticeably among the three initiatives. The Enhanced Mental Health Services ini- tiative, whose participants are almost all probationers, showed lower arrest costs, b"] [18.194236755371094, 9.749841690063477, "3 106 13,280\n3\n NOTE: A positive number in the \u201cDifference of Means, in 2016 Dollars\u201d column indicates that the mean\nwas lower in the six months after beginning the program than in the six months before beginning. A negative number indicates that th"] [17.74542808532715, 8.906908988952637, " this document.\nThis report presents outcome measures for 14 programs in the Los Angeles County JJCPA for FY 2016\u20132017. Outcomes are reported for 17,503 program youths and 17,588 comparison- group youths. The county\u2019s 14 programs are grouped into thr"] [17.602535247802734, 8.988138198852539, "on\nand successful completion of community service. There was no significant difference\nbetween the two groups in the other four big six outcome measures. Thevastmajorityofparticipantsinprogramsthatusedpre\u2013postevaluationswereat-risk youths. These prog"] [17.568618774414062, 9.009013175964355, "Mental Health Services initiative for whom Probation reported big six outcomes, the results for that program significantly influence the results for the initiative as a whole. Echoing the results for MH participants is the finding that program partic"] [17.789506912231445, 9.015795707702637, "ant differences between baseline and follow-up measurements.\nThe Enhanced School- and Community-Based Services Initiative\nTaken as a whole, participants in the Enhanced School- and Community-Based Services ini- tiative had significantly more-positive"] [17.73780632019043, 9.079305648803711, "pants had significantly lower arrest rates and higher rates of completion of probation, restitution, and community service than those of comparison-group youths. Rates of incarceration and violations of probation for the two groups did not differ sig"] [17.72981071472168, 9.118305206298828, " Justice Crime Prevention Act: Fiscal Year 2016\u20132017 Report\nDifference-in-Differences Analyses\nA difference-in-differences analysis compares the change in the current year\u2019s cohort and the change in the previous year\u2019s cohort\u2014in this case, comparing "] [17.781484603881836, 9.064237594604492, "cohorts, which, by definition, is considered a positive outcome.\nFrom year to year, a particular big six outcome might not always be more positive for program participants, but, overall, there is a consistent pattern of program participants meet- ing"] [17.7182559967041, 8.604104042053223, "our programs\u2014HRHN, MST, SBHS-PROB, and SBMS-PROB\u2014had lower total juvenile justice costs in the follow-up period than at baseline.\nSummary and Conclusions 89\n90 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2016\u20132017 Report\nFut"] [18.092756271362305, 8.92379379272461, "comparison groups, we identified youths who quali- fied for the program but whom the program did not accept because of program limitations or who were \u201cnear misses\u201d in terms of eligibility. For the two school-based probationer pro- grams (SBHS-PROB a"] [17.73462677001953, 8.591988563537598, "SCC outcomes is as follows:\n1. successful completion of probation. The Probation Department considers this the most definitive outcome measure. It captures the issues that brought the youth to Pro- bation\u2019s attention (risk, criminogenic needs, and pr"] [17.465381622314453, 9.224719047546387, "nce abuse treatment Gang intervention Gender-specific services Gender-specific services HRHN employment services\nCluster\n5\n2, 3, 4 2, 4 1, 2, 5 5\n5\n1, 5 3\n3\n1, 2, 3 1, 4 3\n3\n1, 2, 3 3\n2\n3\n4\n4 1,4 3\n1\n3 3, 5\n 95\n96\nLos Angeles County Juvenile Justice"] [17.507810592651367, 9.501204490661621, "ustice Crime Prevention Act: Fiscal Year 2016\u20132017 Report\nTable D.2\nOutcomes for Multisystemic Therapy, FY 2016\u20132017\n BSCC-\nMandated\nOutcome Number\nArrest 19\nIncarceration 7\nCompletion of 10 probation\nCompletion of 10 restitution\nCompletion 7 of co"] [17.51019859313965, 9.531246185302734, "nity\nservice\nProbation 5 violation\nBSCC Supplemental Outcome\nSelf-efficacy for girls\nProgram\nPercentage\n2.21\n0.46 28.89\n32.26 31.03\n11.11\nBaseline\nMean\n26.96\nSample Size\n861 861 45\n31 29\n45\nSample Size\n436\nNumber\n18 5 8\n9 6\n5\nComparison\nPercentage\n2."] [17.52771759033203, 9.55221939086914, "umber\n71 24 117 14\nComparison\nPercentage\n31.00 5.50 10.00\n21.10 10.34\n18.50\nFollow-Up\nMean\n38.71 11.97\nSample Size\n200 200 150\n109 116\n150\nSample Size\n62 117\n BSCC Supplemental Outcome\nPercentage of positive tests\nPercentage testing positive\nN"] [17.512378692626953, 9.527146339416504, "SCC-\nMandated\nOutcome Number\nArrest 531\nIncarceration 245\nCompletion of 196 probation\nCompletion of 170 restitution\nCompletion 119 of community\nservice\nProbation 159 violation\nBSCC Supplemental Outcome\nJuvenile hall behavioral violations\u2014 SIRs\nProgra"] [17.509349822998047, 9.531277656555176, "h score 9.42 Barrier score 7.40\nProgram\nPercentage\n3.80\n0.71\nn.a. n.a.\nn.a. n.a. n.a. n.a.\nn.a. n.a.\n Sample Size\n2,525\nComparison\nNumber Percentage\n66 3.74\nSample Size\n1,765 1,765\n 2,525\n15 0.85\n Baseline\nFollow-Up\nMean\n93.24a 4.77a 0.32a\n16.39"] [17.528507232666016, 9.528088569641113, "ion for Middle School At-Risk Youths, FY 2016\u20132017\n BSCC- Mandated Outcome\nArrest Incarceration\nCompletion of probation\nCompletion of restitution\nCompletion of community service\nProbation violation\nNumber\n13 3\nProgram\nPercentage\n1.83 0.42 n.a.\nn.a."] [17.51896858215332, 9.519880294799805, "program or when the youth exited the program, whichever came first.\na Difference is statistically significant (p < 0.05). Statistical testing is not possible if one of the measures is 0.\nAPPENDIX E\nBoard of State and Community Corrections\u2013Mandated Ou"] [17.72406578063965, 9.402063369750977, "175 23.24 55 7.30 254 33.73\n175 36.61 89 19.31\n46 6.11\nSample Size\n753 753 753\n478 461\n753\n 114 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2016\u20132017 Report\nTable E.6\nOutcomes for School-Based Probation Supervision for"] [17.820335388183594, 9.3076171875, "a.\nservice\nviolation\n 118 Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2016\u20132017 Report\n Cluster 12345\nTable F.3\n32.60\n21.03\nSample Size\nPercentage\nSample Size\nPercentage\nSample Size\nPercentage\nSample Size\nPercentage\nSam"] [17.586400985717773, 8.497907638549805, " Year 2016\u20132017 Report\nFigure H.1\nLos Angeles County Probation Department Form for Probationers\u2019 Strengths and Risks\nRevised 2/6/07\nProgram Name/Csld No.\nMinor\u2019s First Name:\nMother\u2019s First Name:\nLOS ANGLES COUNTY PROBATION DEPARTMENT\nSTRENGTHS AND RI"] [17.538606643676758, 8.44227409362793, "oor Relationship Skills\nDeviant\nAlcohol Use\nDrug Use\nLow Self-Esteem\nPrevious Placement (relatives, DCFS, etc.,) Runaway\nAccess to Firearms\nTOTAL CHECKS\nPoor Classroom Behaviors Low Commitment to Education Academic Failures\nTruancies\nConflict w/Schoo"] [17.120193481445312, 7.963927268981934, "1, updated September 17, 2004. As of February 7, 2017:\nh t t p : // w w w.w s i p p .w a . g o v / R e p o r t s / 0 4 - 0 7- 3 9 01\nBaldwin, Scott A., Sarah Christian, Arjan Berkeljon, and William R. Shadish, \u201cThe Effects of Family Therapies for Ado"] [17.053850173950195, 7.895316123962402, "uary 5, 2017: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB1998\nCampbell, Donald T., and Julian T. Stanley, \u201cExperimental and Quasi-Experimental Designs for Research,\u201d Handbook of Research on Teaching, Boston, Mass.:"] [17.314403533935547, 8.08906364440918, " Recidivism in Juveniles: A Meta-Analysis,\u201d Criminal Justice and Behavior, Vol. 28, No. 3, June 2001, pp. 367\u2013394.\nCounty of Los Angeles, 2016\u201317 Final Budget, Los Angeles, c. 2016. As of July 3, 2018: http://ceo.lacounty.gov/pdf/budget/2016-17/Final"] [17.337425231933594, 8.087117195129395, "ion, RR-1023-LACPD, 2015. As of February 7, 2017: http://www.rand.org/pubs/research_reports/RR1023.html\nFain, Terry, Susan Turner, and Mauri Matsuda, Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2014\u20132015 Report, Santa Monica"] [17.116239547729492, 7.965823650360107, " Prevention, December 1999. As of February 7, 2017: http://purl.access.gpo.gov/GPO/LPS41069\nGreene, Peters and Associates and Northwest Regional Educational Laboratory, Guiding Principles for Promising Female Programming: An Inventory of Best Practic"] [17.090103149414062, 7.950800895690918, "Heilbrun, Kirk, David DeMatteo, Ralph Fretz, Jacey Erickson, Douglas Gerardi, and Catherine Halper, \u201cCriminal Recidivism of Female Offenders: The Importance of Structured Community-Based Aftercare,\u201d Corrections Compendium, Vol. 33, No. 2, March\u2013April"] [17.093935012817383, 7.9308180809021, "atessa, Edward J., and Christopher Lowenkamp, \u201cWhat Works in Reducing Recidivism,\u201d St. Thomas Law Journal, Vol. 3, No. 3, 2006, pp. 521\u2013535. As of June 24, 2018:\nhttps://ir.stthomas.edu/ustlj/vol3/iss3/7/\nReferences 131\n132 Los Angeles County Juvenil"] [17.111326217651367, 7.878856658935547, " . g o v / A p p / P u b l i c a t i o n s / a b s t r a c t . a s p x ? I D = 15 5 2 8 2\nMitchell, Ojmarrh, David B. Wilson, Amy Eggers, and Doris L. MacKenzie, \u201cDrug Courts\u2019 Effects on Criminal Offending for Juveniles and Adults,\u201d Campbell Systemat"] [17.094690322875977, 7.936089515686035, "Relapse Prevention: A Volume in Practical Resources for the Mental Health Professional, Academic Press, 2007, pp. 293\u2013311.\nReiss, Albert J., Jr, Klaus A. Miczek, and Jeffrey A. Roth, eds., Understanding and Preventing Violence, Vol. 1, Washington, D."] [17.164703369140625, 7.976395130157471, "an, Patrick H., and Nancy Guerra, What Works in Reducing Adolescent Violence: An Empirical Review of the Field, Boulder, Colo.: Center for the Study and Prevention of Violence, Institute for Behavioral Sciences, University of Colorado, Boulder, 1994."] [17.11428451538086, 7.974483966827393, "Elizabeth Cauffman, and Thomas Grisso, \u201cMental Health Assessments in Juvenile Justice: Report on the Consensus Conference,\u201d Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 42, No. 7, July 2003, pp. 752\u2013761.\nWestermark, Pia Ky"] [15.702946662902832, 3.9638335704803467, " CORPORATION\nBuilding a High-Quality Correctional Workforce\nIdentifying Challenges and Needs\nJoe Russo, Dulani Woods, George B. Drake, Brian A. Jackson\nOn behalf of the National Institute of Justice (NIJ), the RAND Corporation manages the Priority "] [15.768707275390625, 4.059852123260498, "andards are required to ensure that training curricula are adequate, consistent, relevant, realistic, and delivered in an effective manner.\n\u2022 There is a need for standards to control excessive workloads, which can lead to both staff turnover and inad"] [15.769486427307129, 4.063689708709717, "or 34 percent of the workforce and change jobs at a rate more than three times that of nonmillen- nials (Adkins, 2016). Turnover is expensive, and it is estimated that millennial turnover alone costs the U.S. economy more than $30 billion annually. T"] [15.761616706848145, 4.030651092529297, "ool of quality candidates, the realities of corrections work (e.g., work hours, environment, com- pensation), and the strategies required to find candidates who meet the existing and future needs of the organization\n \u2022 selection: standards and proces"] [15.770264625549316, 4.055256366729736, "arding, retention, and leadership development. The panelists addressed the misconduct theme last. Misconduct is markedly different from the other themes because it is not a distinct stage of the workforce process; rather, it is a behavior that can be"] [14.855228424072266, 1.8655799627304077, ", project staff used a variant of the Delphi Method (RAND Corporation, undated), an approach in which members of the group provide rankings on the needs individually, then discuss the results as a group, and then have the opportunity to individually "] [15.768978118896484, 4.025323867797852, "lted in 64 final needs. (See Figure 2 for a breakdown of these needs by theme and Table 1 for the top-tier needs across all themes.)\nWe acknowledge that the needs identified and the priorities assigned to them are\u2014as with any subjective assessment in"] [15.764724731445312, 4.035194396972656, "pushing decisionmaking authority\n Problem or Opportunity\nAssociated Need\nThe role of corrections staff, particularly in institutions, is generally viewed to be custodial or surveillance-oriented, which limits the sector\u2019s ability to attract new talen"] [15.769807815551758, 4.044103145599365, "ent.\nThe sector lacks a coherent vision. Because agencies operate in a rapidly shifting environment, they are struggling to keep pace both in general and with respect to their workforces in particular.\nDevelop a national vision and strategy for corre"] [15.769304275512695, 4.044590950012207, "with the public. The panelists reported that, to begin to change perceptions, the sector must actively communicate with both the media and the public. For many decades, agencies have adopted a \u201cno news is good news\u201d stance with respect to the media. "] [15.771965026855469, 4.043320655822754, "panelists reported that the perpetuation of these negative stereotypes undermines the sector and its ability to recruit new talent. They therefore identified a need for the development of best practices for such stakeholders as the major professional"] [15.775893211364746, 4.070980072021484, "ed with work experience or military service (\u201cCor- rectional Officer Education and Training,\u201d 2013). Interestingly, some states have modified educational requirements based, in part, on the labor market. For example, in 1987, the Colorado Department "] [15.76724910736084, 4.080142974853516, "-based programming and recognize and leverage the potential of corrections officers as key components of the behavioral change process could be more attractive to a wider group of candidates, allowing agen- cies to enforce competency standards. The p"] [15.77690315246582, 4.072589874267578, "\u2019s family for food stamps (Mitch- ell, 2014). Similarly, new parole officers in New Jersey receive $57,000 annually, whereas their counterparts in Louisiana earn just over $30,000 (New Jersey Civil Service Commission, 2016; Rico, 2017). Compensation "] [15.768359184265137, 4.071516036987305, " agency, and geographic area and proposed the establishment of a federal minimum wage for correctional occupations that organizations can exceed, as appropriate.\nRetirement benefits are another important aspect of compensation. Historically, relative"] [15.774930953979492, 4.070441722869873, "ensation. The\nHigh school students with college aspirations (and considering eventual repayment of student loans) could be dissuaded from careers in corrections.\n11\n 12\nFigure 5. Median Base Salaries of the Lowest-Paying U.S. College Majors in 2017\n "] [15.771591186523438, 4.055501937866211, " employment.\nInfluence of Organized Labor\nOrganized labor can inadvertently impede the sector\u2019s abil- ity to recruit new talent, according to the panelists. Many employees have joined national unions or state associations to negotiate compensation, b"] [15.776751518249512, 4.0488600730896, "plications that a human-services approach and culture would have on recruitment.\nDevelop best practices for pushing decisionmaking authority down to the lowest level.\nReevaluate or create competency standards for various correctional positions.\nDevel"] [15.791451454162598, 4.060859203338623, "s stressed that agencies should consider hiring professional recruiters rather than using existing corrections staff, as is common practice. Professional recruiters have the skills and knowledge to perform the task, and they understand how to leverag"] [15.778544425964355, 4.044780254364014, " to ensure appropriate hiring decisions. The panelists discussed a variety of challenges and identified four needs that would help improve the effectiveness and efficiency of the selection process (Table 5).\nScreening Processes\nEvery organization use"] [15.773405075073242, 4.069272994995117, "tions, 2017). Although this represents great improvement, the timeline is still longer than for other occupations. Some of the challenges identified are information technology\u2013related because many agencies struggle with outdated systems. Panelists no"] [15.769405364990234, 4.048459053039551, "n process.\nTraditional selection criteria could unnecessarily eliminate interested candidates from consideration for correctional positions.\nAssociated Need\nConduct research to identify the factors that have predictive value in determining success on"] [15.775971412658691, 4.060553550720215, " the amount and qual- ity of training that correctional staff receive prior to their first assignment. This is perhaps not surprising, given that each state generally sets its own standards and each agency must operate within its unique resource cons"] [15.778932571411133, 4.055473327636719, " then quickly exit the field) and benefit the individuals involved.\nThe panelists recognized that training new staff is a signifi- cant expense. For example, the Ohio Department of Reha- bilitation and Corrections has estimated that the cost to train"] [15.77110767364502, 4.045801162719727, " will face.\nYounger generations typically value self-improvement through relevant training opportunities.\nTraditional training models are inflexible and consume resources unnecessarily.\nHigh turnover rates are a burden to correctional agencies in man"] [15.75973892211914, 4.036949157714844, "he preparation that more-realistic training could provide. For example, new corrections officers are instructed to\n 1\n 2\n 3\n (Goldstein, 2017), but are not yet applied in corrections. The panelists recommended assessments of the costs and "] [15.767427444458008, 4.0618367195129395, "ure of a correctional facility can be as important as know- ing how to do the job itself. The panelists reported that new hires need better preparation for these challenges and called on agencies to examine and improve their organizational cultures w"] [15.765481948852539, 4.046846866607666, "esources or attention to retaining staff that they do for recruitment. The most-effective recruiting efforts can bring talented individuals to the agency, and many of these\n19\n 20\nstrategies have a role in preventing turnover, but maintaining\na high-"] [15.764469146728516, 4.042721271514893, ", including self-defense training and situational awareness and personal protection technologies.\nWorkload Implications\nStaff perceptions of workload can also be a stressor that negatively affects job satisfaction and ultimately retention, according "] [15.769612312316895, 4.068110466003418, "isionmaking has on job stress in corrections. For example, Stohr, Lovrich, and Wilson (1994) found that lack of participa- tion in decisionmaking increased the stress levels of jail staff. Conversely, employee participation in decisionmaking was link"] [15.761794090270996, 4.042444705963135, "n and, therefore, retention. For example, studies have linked inadequate supervisory support (Maahs and Pratt, 2001) and dissatisfaction with supervisors (Stohr, Self, and Lovrich, 1992) with negative attitudes and turnover intention. Furthermore, co"] [15.773711204528809, 4.056845664978027, "r intention.\nAssess and validate existing standards for staffing ratios, and examine such strategies as capped caseloads to allow agencies to meet these standards.\nDevelop best practices for \u201cparticipatory councils,\u201d and evaluate the impact that thes"] [15.77071762084961, 4.048499584197998, "ight be outdated and should be reevaluated. Rather than using a fixed age, \u201cfit-for-duty\u201d assessments might be a better way to determine whether staff can continue to perform the requisite duties. This issue will become increasingly salient as the ge"] [15.77806568145752, 4.049966335296631, "when they first join the organization. This approach does have risks, however: The panelists recognized that selecting individuals for groom- ing opportunities could create tension in the workplace among those who are not selected. To combat this, st"] [15.777545928955078, 4.052774429321289, "e panelists identified the need for an assess- ment of the adequacy of training for new supervisors and the\n[Panelists suggested establishing] a national correctional academy that would provide high-quality, standardized management- level training to"] [15.772560119628906, 4.049890995025635, " that, as officers are promoted\n Table 8. Needs Identified Related to Leadership Development\nTier\nProblem or Opportunity\nCorrectional agencies do not place sufficient emphasis on leadership and management training.\nExisting resources that support lea"] [15.77837085723877, 4.04788064956665, "emy for management-level training.\nAssess the prevalence of this organizational characteristic, and develop best practices to support continuous readiness activities well before they are needed.\nInvestigate the efficacy of relatively quick and access"] [15.774565696716309, 4.044035911560059, " practices for ethics and related training, which would prepare staff to protect themselves from criminal and civil liability. Panelists also discussed the wide variation in how agencies respond to incidents of misconduct and identified the need for "] [15.77037525177002, 4.042086124420166, "hat, if introduced and implemented effectively, could enhance transparency and positively influence staff behavior. Panelists also discussed strategies to improve the detection of misconduct, if only after the fact. They identified the need to develo"] [15.753226280212402, 4.019723892211914, "er Data\n Tier\nProblem or Opportunity\nStatistics on the correctional workforce (e.g., salary data, vacancy rates, turnover rates) are stored in separate silos and are difficult to locate and perform comparative analyses on because of the lack of stan"] [15.77517032623291, 4.044492244720459, "ong with a corresponding change in the competencies sought, would help the sector recruit a broader base of new talent.\nImprove Staff Competencies\nThe corrections sector currently suffers from low levels of professionalism, according to the panelists"] [15.23990249633789, 3.170057535171509, "- ship development. Finally, the panelists noted that, although resources exist, such as the Correctional Leadership Competen- cies for the 21st Century report (Campbell et al., 2006), there is a need for publishers to review and revise these documen"] [14.846416473388672, 1.8380380868911743, "hem. Once the group had compiled and refined its list of issues and needs, the issues and needs were converted into a web-based Delphi instrument (using the Qualtrics online survey service).\nEach panelist was asked to use the instrument to individu- "] [14.782979011535645, 1.7773305177688599, " together, and the median of that product rep- resented the overall priority for that item. Then, the resulting prioritization scores were clustered using a hierarchical clus- tering algorithm. The algorithm was the \u201cward.D\u201d spherical algorithm from "] [15.712992668151855, 4.127215385437012, "ns-face-acute-staffing- shortage-fueling-violence-1496401200\nBLS\u2014See Bureau of Labor Statistics.\nBonner, Heidi S., North Carolina Department of Public Safety, Division of Adult Correction and Juvenile Justice, Adult Institutional Corrections: Recruit"] [15.731478691101074, 4.111685752868652, "orrectional Officer Education and Training: Survey Summary,\u201d Corrections Compendium, Vol. 37, No. 3, Fall 2013.\nCullen, Francis T., Bruce G. Link, Nancy T. Wolfe, and James Frank, \u201cThe Social Dimensions of Correctional Officer Stress,\u201d Justice Quarte"] [15.657678604125977, 4.175339698791504, "s, Richard Silberglitt, George B. Drake, John S. Shaffer, Mikhail Zaydman, and Brian G. Chow, Fostering Innovation in Community and Institutional Corrections, Santa Monica, Calif.: RAND Corporation, RR-820-NIJ, 2015. As of June 26, 2018: https://www."] [15.735501289367676, 4.125497341156006, "cent/95762920/\n33\n34\nMaahs, Jeff, and Travis Pratt, \u201cUncovering the Predictors of Correctional Officers\u2019 Attitudes and Behaviors: A Meta-Analysis,\u201d Corrections Management Quarterly, Vol. 5, No. 2, Spring 2001.\nMassachusetts Public Employee Retirement"] [15.724400520324707, 4.137561798095703, "tions Management Quarterly, Vol. 5, No. 2, Spring 2001, pp. 68\u201378.\nSmith, Tom W., and Jaesok Son, \u201cMeasuring Occupational Prestige on the 2012 General Social Survey,\u201d Chicago, Ill.: National Opinion Research Center at the University of Chicago, Octob"] [13.965999603271484, 4.163010597229004, "Content Analysis,\u201d Criminal Justice Studies, Vol. 26, No. 4, 2013.\nWareham, Jennifer, Brad W. Smith, and Eric G. Lambert, \u201cRates and Patterns of Law Enforcement Turnover: A Research Note,\u201d Criminal Justice Policy Review, Vol. 26, No. 4, June 1, 2015,"] [13.922089576721191, 4.179147720336914, " master\u2019s thesis was an economic analysis of organic and conventional agriculture using the Rodale Institute\u2019s Farming Systems Trial. He began his career as a Coast Guard officer on afloat and ashore assignments in Miami, Florida; New London, Connect"] [13.855365753173828, 4.612154006958008, "l use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in anoth"] [10.982681274414062, 17.79991912841797, " CORPORATION\nHow Can Workers\u2019\nCompensation Systems\nPromote Occupational\nSafety and Health?\nStakeholders Views on Policy and Research Priorities\n Michael Dworsky, Nicholas Broten\nFor more information on this publication, visit www.rand.org/t/RR2566\n P"] [11.01567554473877, 17.779489517211914, "he well-being of workers. RAND conducted a literature scan to identify published criticisms of current workers\u2019 compensation systems, focusing on the implications of workers\u2019 compensation for worker safety, health, and economic well-being. After prod"] [10.97336483001709, 17.79545783996582, "uggest a Two-Pronged Research Agenda for\nImproving Workers\u2019 Compensation Policy ........................................................................ xii Acknowledgments.............................................................................."] [10.954038619995117, 17.774627685546875, "s.............................. 18 Focus on Compliance Leads to Complexity and Distracts from Other Objectives .............. 19\n v\nData Management and Claim Tracking Problems Within Employers.................................. 19 Occupational Health "] [10.976990699768066, 17.799739837646484, ". 53 Federal Programs .................................................................................................................. 54\nAppendix C: Compendium of Critical Perspectives on Current Workers\u2019 Compensation\nPolicy ......................"] [10.976865768432617, 17.797183990478516, "ted policymakers from resolving these challenges.\nThe National Institute for Occupational Safety and Health (NIOSH) requested that RAND explore the beliefs and priorities of key workers\u2019 compensation stakeholder groups about system challenges and res"] [10.97632884979248, 17.809574127197266, "njury prevention than, in our view, some of the published critiques had.\nStakeholders identified promising policy interventions in need of rigorous evaluation and also suggested research on questions of epidemiology and system organization that could"] [10.975750923156738, 17.816312789916992, "um of critical perspectives that resulted from our literature review is included as Appendix C to this report.\nStakeholders Identified Many Shortcomings of Workers\u2019 Compensation Policy as Important Challenges to Worker Outcomes\nIn general, stakeholde"] [10.971369743347168, 17.822561264038086, "fficult to monitor. Meanwhile, workers are often unable to navigate current systems without attorney representation, while system complexity can also deter workers from filing claims in the first place. Stakeholders felt that current approaches to di"] [10.962788581848145, 17.80394744873047, " New Models and Interventions for Health Care Delivery, Injury Prevention, Dispute Resolution, and Disability Prevention\nStakeholders identified examples of promising state-level innovations for injury prevention, return to work and disability preven"] [10.970009803771973, 17.79597282409668, "practices for relatively narrow but consequential aspects of system administration, such as rules governing claim initiation, attorney fees, and so on, with the relevant expertise often concentrated in interested parties (for example, the insurance i"] [10.992199897766113, 17.827857971191406, " at several stages of this research. We also wish to thank Philip Armour at RAND and Gregory Warner at the Harvard T. H. Chan School of Public Health for their insightful and remarkably thorough work as this study\u2019s quality assurance reviewers. We al"] [10.969680786132812, 17.79146385192871, "ompensation coverage mirror debates from the origins of the system in the early twentieth century. Nonetheless, several recent governmental and journalistic accounts have focused attention on current points of disagreement and tension in the system t"] [10.979424476623535, 17.8063907623291, "kers\n\u2022 employers\n\u2022 claims administrators\n\u2022 state agency leaders\n\u2022 occupational health care providers.\nRAND convened separate conference calls with each of these groups between February and April 2018. This report provides a synthesis of these discuss"] [11.005764961242676, 17.8376407623291, "oyers, particularly because damages sought in a lawsuit could include noneconomic costs related to pain, suffering, and wrongful death.\nThe establishment of workers\u2019 compensation systems represented a compromise, or \u201cgrand bargain,\u201d that provided par"] [11.01956558227539, 17.865985870361328, "e were driven primarily by variation in state rules regarding which classes of workers could be left out of the workers\u2019 compensation system and the tradition of voluntary coverage in many states. The commission highlighted coverage gaps for low-wage"] [10.992229461669922, 17.821674346923828, "tinuing review of the statute and recommending changes to it and related policies, (3) informing employees of their rights and responsibilities under the law, (4) informing employers and carriers of their rights and responsibilities under the law, (5"] [11.00525951385498, 17.835674285888672, "equacy, and Cost Spillovers\n\u2022 Coverage remains less than universal. Observers noted that many of the coverage restrictions identified in the national commission report are still in place, such as exclusions for small employers and agricultural worker"] [11.001195907592773, 17.83342170715332, "mplexity is a drag on performance. Several observers noted that the administration of workers\u2019 compensation is often too complex, which can lead to confusion, uncertainty, a slow claims process, a focus on compliance rather than outcomes, and dispari"] [11.009965896606445, 17.84406089782715, "9,634 in Nevada (Groeger, Grabell, and Cotts, 2015).\n\u2022 Disability determination reference guides have limitations. The evidence base for impairment-rating guides is incomplete across editions of the guides, injury types, injury severity, and individu"] [11.0020751953125, 17.821279525756836, "opt-out clause was ruled unconstitutional by the Oklahoma Supreme Court because it created radically different legal treatment for otherwise similar individuals in the same class of workers (Szymendera, 2017). A more widely adopted and less radical a"] [10.968936920166016, 17.7983341217041, "o many workers\u2019 compensation policymakers and system observers. However, some stakeholder groups may be more vocal or better coordinated than others. For instance, the International Association of Industrial Accident Boards and Commissions (IAIABC) h"] [10.967093467712402, 17.800987243652344, "ng policymaking.\nOverview of Challenges Identified as Major Priorities\nDifferent stakeholder groups raised a wide range of concerns about current workers\u2019 compensation system design and performance. The distribution of concerns across stakeholder gro"] [10.967605590820312, 17.803508758544922, "actions taken by employers and claims administrators. Claim management processes refers to policies, procedures, and norms within workers\u2019 compensation systems that affect the path from injury to closing a claim. These are affected by decisions acros"] [10.987981796264648, 17.821216583251953, "have been neglected because the relevant agencies were not represented in our discussions.\nPrevention of Injury and Disability\nWorkers, health care providers, and state agency leaders generally agreed that prevention of injury and prevention of disab"] [10.980133056640625, 17.82135581970215, "me product with essentially the same production process: one factory has numerous workers\u2019 compensation claims for soft-tissue injuries, while the other typically has no compensable injuries. The union representative viewed this pattern as an illustr"] [11.00549030303955, 17.840805053710938, "ves based directly on safety records may not even be applicable to the smallest employers. Stakeholders, including both occupational health care providers and worker representatives, identified several examples of successful programs in which workers"] [10.987069129943848, 17.812641143798828, "nd orientating contract employees but that such efforts were costly and were unlikely to be pursued by smaller host employers.\nCoverage of Conditions: Work-Relatedness and Causation\nParticipants cited many examples where work-related injuries were un"] [11.003471374511719, 17.82726287841797, " it, \u201c[T]hese big employers . . . really do feel the work-related injuries are the workers\u2019 fault as opposed to unsafe conditions.\u201d Speaking about apportionment, another worker advocate viewed legislative debates as being driven by a desire to \u201cbuild"] [10.973204612731934, 17.815011978149414, " dispute resolution mechanisms were deleterious not only to system efficiency and cost control but to the health and economic outcomes of workers themselves.\nSome state agency leaders pointed out that litigation and complex disputes are concentrated "] [10.964439392089844, 17.80909538269043, "re provider. And in general, they don\u2019t have training to deal with this. . . . [T]he worker advocacy part is being done by people who don\u2019t know the system and are discouraged from really working well in the system. The system is so stacked against w"] [10.962377548217773, 17.809772491455078, "nd the fragmentation of health records between occupational and nonoccupational health care providers harmed patients.\nConfusion about privacy and information sharing may amplify the consequences of care fragmentation between group health and workers"] [10.978595733642578, 17.82170295715332, "isease management.\nClaims administrators also raised concerns about the extent to which worker health (including comorbidities and poor health behaviors, such as smoking) made injuries more difficult to treat once they occurred. Self-insured firms ha"] [10.955781936645508, 17.81711769104004, "o remove providers who are bad apples, and an adjudication process that is capable of applying the guidelines with confidence is also necessary. In the absence of such understanding, the claims management process is heavily dependent on an ecosystem "] [10.97501277923584, 17.811452865600586, "eform\nAs noted by Rick Victor, a system feature that has helped to make workers\u2019 compensation politically viable for over a century is the functioning of the political system to reach effective compromises between the interests of workers and employe"] [10.965526580810547, 17.808135986328125, "e it unconstructive to even discuss federal standards, let alone a federal role in benefit financing. Some worker advocates, however, did argue that greater federal oversight would be necessary to stop the race to the bottom. One suggestion was for t"] [11.0072660446167, 17.831106185913086, "esolution\nCost Shifting to Social Programs and X Families\nX X X X X X X X X\n X\nX\nX\n Removing Barriers to Claiming and System Navigation\nClaims administrators suggested that evidence on best practices for the rules of a workers\u2019 compensation system s"] [11.02375316619873, 17.84627342224121, "SIG matching funds is an assessment on workers\u2019 compensation premiums (Ohio Bureau of Workers\u2019 Compensation, 2017). A peer-reviewed evaluation of the SIG program by researchers from NIOSH and BWC found that participating employers experienced dramati"] [11.003544807434082, 17.83390998840332, "s. The target population consists of workers\u2019 compensation claimants with work restrictions that interfere with their regular jobs. The intervention consists of wage subsidies, funding for worksite modification or equipment purchases up to $5,000, or"] [10.994230270385742, 17.821565628051758, "nover) was cited by one state agency representative as a barrier to socially efficient levels of accommodation. One might observe a similar pattern if these businesses faced high borrowing costs or sharp liquidity constraints. It is also worth noting"] [10.965328216552734, 17.809659957885742, "t, NIOSH may be uniquely well suited among federal agencies to provide detailed guidance focused on workers\u2019 compensation and occupational health, particularly when it comes to issues of health care delivery and injury prevention.\nIncentives to Impro"] [10.969147682189941, 17.81096839904785, "vement and occupational health delivery.\nAlternative Models for Occupational Health Care Delivery and Disability Management\nThe COHE system in Washington State is recognized as a national leader in improving the quality of occupational health care an"] [10.966227531433105, 17.808208465576172, " treatment for symptomatic diseases are largely paid by workers\u2019 compensation, while group screenings are overwhelmingly financed by employers (NYS OHCN, 2017).\nUnfortunately, challenges with funding appear to have constrained NYS OHCN from realizing"] [10.973189353942871, 17.82357406616211, "overall system.\nOne suggestion from a health care provider, however, was that a promising starting point for efforts to improve coordination between occupational health care and broader health systems is the prevention of chronic pain and transition "] [10.965409278869629, 17.809900283813477, " some U.S. states, a clearer understanding of the potential consequences for and necessary modifications to workers\u2019 compensation laws will be important for state policymakers. A recent issue brief from the California Workers\u2019 Compensation Institute "] [10.9686279296875, 17.809741973876953, "tional safety and health, preventing many treating physicians from helping workers engage productively with the workers\u2019 compensation system or coordinating with employers. Nonoccupational physicians may also fail to recognize the contribution of wor"] [10.9835786819458, 17.81764793395996, "ermine the no-fault character of the workers\u2019 compensation system by shifting the burden of proof to workers.\nA potential role for NIOSH and, perhaps, other federal research sponsors would be the creation of large research data sets combining data on"] [10.992209434509277, 17.819459915161133, " suggested that the overall effects of these arrangements deserved more careful study.\nCarve-out arrangements, in which employers work with labor unions to integrate occupational and nonoccupational benefits, frequently involve alternative dispute re"] [11.021500587463379, 17.855154037475586, " not file injury claims) fare under the opt-out arrangements developed in Texas, it will be difficult to judge whether the Texas model provides net social benefits or, as suggested by workers, simply saves money for employers by reducing workers\u2019 acc"] [10.960806846618652, 17.800579071044922, " and Illinois that clarified the sharing of responsibility between agencies and host employers.6 Worker advocates indicated that right-to-know laws should not be viewed as a panacea, however, and suggested that OSHA or\n6 For additional details, see C"] [10.95531940460205, 17.8004093170166, "ons that would improve their own systems. Stakeholders generally agreed that policy evaluation, identification of system best practices, and continued investment in the basic science of epidemiology and applied or translational work on prevention cou"] [10.972748756408691, 17.81105613708496, " spillovers and long- term disability prevention\nCost spillovers and improving medical delivery/integration with occupational health care; payment reforms to incentivize functional improvement\nEmployment of people with disabilities, including stay- a"] [10.960932731628418, 17.808204650878906, "ers include philanthropic foundations with topic areas related to the social determinants of health or health systems. National research programs (e.g., the Robert Wood Johnson Foundation\u2019s Culture of Health initiative) and regional foundations (e.g."] [10.969820022583008, 17.810020446777344, "r social-scientific evidence on questions pertaining to epidemiology, system performance, and financing. Many important questions, particularly those related to causation, apportionment, and occupational disease presumptions, will generally require o"] [10.969453811645508, 17.818424224853516, "em designs from Washington will generalize to Texas becoming as contentious as arguments about whether an education program from urban India will work in rural Brazil.\n43\nEconomic theory, fortunately, provides numerous frameworks for optimal policy d"] [10.966800689697266, 17.81362533569336, "he inherent tradeoffs and contextual factors that will determine which workers\u2019 compensation policies will be best for workers in their state.\nFinally, we note that the research priorities highlighted in this report were, to some extent, circumscribe"] [10.985638618469238, 17.818614959716797, "uld also be an occasion for policy analysts to develop more detailed policy proposals. The narrowing coverage of occupational diseases and conditions with complex causation or high latency might create a need for compensation mechanisms to be finance"] [11.094795227050781, 17.999181747436523, " International Union (SEIU) Alliance for the American Temporary Workforce United Auto Workers\nWashington L&I\nCalifornia Department of Industrial Relations Michigan Workers\u2019 Compensation Agency Pennsylvania Department of Labor and Industry Oregon Work"] [11.01440715789795, 17.85028076171875, "es were covered by workers\u2019 compensation, accounting for approximately 97 percent of jobs covered by unemployment insurance and 86 percent of all jobs (McLaren and Baldwin, 2017). Since the inception of workers\u2019 compensation programs in the early twe"] [11.637714385986328, 18.206560134887695, "e laws regulating these benefits vary considerably across states, but some features are consistent across all workers\u2019 compensation systems: cash payments for lost earnings are tax-free, medical services are provided at no cost to the injured worker,"] [11.652705192565918, 18.233383178710938, "rk (depending on the state), the worker may be eligible for permanent disability payments. If the injury prevents the claimant from performing any kind of work, he or she will be eligible for permanent total disability (PTD) benefits. If the claimant"] [11.019100189208984, 17.864389419555664, "andard vary by state. Workers\u2019 compensation also interacts with Medicare as a second payer for work-related health care expenses. Some workers\u2019 compensation settlement agreements include Medicare set-asides, in which a portion of the settlement is al"] [11.005194664001465, 17.839712142944336, "aining, including general job-search training, such as a skills evaluation, resume building, or career counseling; and coordination between injured workers and other stakeholders, including potential employers and the health care system. Vocational r"] [10.993863105773926, 17.825716018676758, "on or rating bureau (Utterback, Meyers, and Wurzelbacher, 2014). Experience modification factors are determined by the firm\u2019s historical injury record relative to its industry risk classification. Experience modification rates tend to be driven more "] [11.003952980041504, 17.832027435302734, " of workers\u2019 compensation coverage is proportional to the product of injury rates and average costs. Firms that self-insure may be protected from some systemwide shocks (such as the insurance underwriting cycle) that may raise average premiums above "] [11.0022554397583, 17.774757385253906, "ons.\n55\nAppendix C: Compendium of Critical Perspectives on Current Workers\u2019 Compensation Policy\nBackground\nNIOSH has requested support from RAND to develop, with stakeholder input, a characterization of the most important possible ways to improve wor"] [10.981805801391602, 17.802766799926758, "protection against interruption of income\n3. provision of sufficient medical care and rehabilitation services\n4. encouragement of safety.\nA fifth goal that might be viewed as instrumental to promotion of these four goals was also articulated:\n5. an e"] [10.988542556762695, 17.814376831054688, "nderstanding the diversity of viewpoints about current system performance.\nOverview of Key Workers\u2019 Compensation Policy Issues\nWorkers\u2019 Compensation Strengths\n\u2022 Workers\u2019 compensation has made a strong contribution to economic growth and has promoted "] [11.053471565246582, 17.892024993896484, "ers communication between stakeholders during the return-to-work process, has been shown to reduce disability days, labor force exits, total workers\u2019 compensation costs, and entry to SSDI (Stapleton and Christian, 2016, p. 10). Washington state\u2019s Sta"] [10.996705055236816, 17.836721420288086, "option of current protocol terminology (CPT) coding methodology, consistency in medical billing processes, and adoption of formularies and treatment guidelines (IAIABC, 2016b, p. 6).\n\u2022 Increase use of alternative dispute resolution and mediation mech"] [11.002248764038086, 17.838964462280273, "ruly evidence-based and can reduce benefit adequacy (Swedlow, 2010, p. 206\u2013207; Spieler, 2016, p. 43).\n\u2022 Loss of fringe benefits and noneconomic losses can be significant but are\ngenerally not compensated (Barth, 2010, p. 19).\n\u2022 Shifting cost burdens"] [10.99057674407959, 17.837364196777344, "tem; reinstate federal tracking of changes in the workers\u2019 compensation system; establish standards that would trigger federal oversight if states fail to meet standards (DOL, 2016, p. 24).\n\u2022 Develop an online dashboard allowing stakeholders to exami"] [10.997207641601562, 17.828189849853516, "h source of information to identify the causes of past injuries and develop ways to prevent future cases. In addition to data analysis by the National Council on Compensation Insurance and the Workers Compensation Research Institute, private insurers"] [11.114519119262695, 17.95650291442871, "ime limits diminish adequacy in less visible ways (DOL, 2016, p. 22; IAIABC, 2016b, p. 3).\n\u2022 Compensation for occupational diseases is often not adequate (Spieler, 2016, p. 99).\n64\nSuggestions for Improvement\nReturn to Work\n\u2022 Strengthen antidiscrimin"] [10.975441932678223, 17.833911895751953, "oor integration with the medical system strain resources and hurt outcomes.\n\u2022 According to 2014 NASI estimates, medical benefits account for approximately half of workers\u2019 compensation (WC) costs nationally. Despite medical cost increases, the worker"] [10.990159034729004, 17.827775955200195, "ntives will provide a clear value proposition that aligns quality standards with cost- saving activities.\n\u2022 For claims payors, care systems based on accurately measured outcomes are more inherently logical and easier to protect from manipulation than"] [10.983104705810547, 17.82182502746582, "ompensation reserves are essentially adequate. Reforms in several states have been enacted. (Lipton and Ayres, 2010, p. 37)\nCoverage is provided to most employees.\nWith the exception of Texas, workers\u2019 compensation insurance coverage is mandatory for"] [11.005687713623047, 17.819849014282227, "or survivors of those disabled or killed by occupational diseases, the state systems in general are more cognizant of such diseases and prepared to compensate for them. (Barth, 2010, p. 14)\nInsurer-based prevention programs have demonstrated some suc"] [11.006328582763672, 17.837934494018555, "rs are embracing the biopsychosocial model, understanding return to work and recovery is influenced by more than just a physical injury. Occupational health research informs safety practices, medical treatment, and return to work best practices which"] [11.310998916625977, 18.009845733642578, "tc.) as more focused on compliance with little or no benefit to employers and employees. (IAIABC, 2016a, p. 2)\nThe state should ensure compliance by all parties; educate all parties; maintain equitable playing field for all. (IAIABC, 2016c, p. 3)\nVar"] [10.985286712646484, 17.826595306396484, "-percent agreement that system should reduce disputes and be less adversarial (IAIABC, 2016b, p. 1)\nThe state should ensure there is a balanced approach to resolving disputes. (IAIABC, 2016c, p. 3)\nThe state needs to provide a neutral forum for adjud"] [11.005512237548828, 17.83599853515625, ". Casual inspection of workers\u2019 compensation data reveals that cash benefits tend to be higher in cases in which attorneys are involved, and there is a natural tendency to assume that attorneys are therefore responsible for the higher benefits. Howev"] [11.035212516784668, 17.854520797729492, "s employee differently, and often there are different definitions within a state for workers\u2019 compensation, unemployment, and taxation purposes. Some felt \u201cemployee\u201d should be defined nationally but others believed it should stay a state-by-state iss"] [11.049495697021484, 17.847658157348633, " an injury occurring, employees have an incentive to report it as work related, potentially leading to overreporting.\nGiven an injury, the injured or ill person has an incentive to claim the malady is work-related. A work injury requires no out-of-po"] [11.72048568725586, 18.222579956054688, "led as a result of occupationally-caused injuries or illnesses\u2014who are most likely to turn to other social benefit programs, particularly SSDI. (DOL, 2016, pp. 15\u201316)\nMost persons familiar with workers\u2019 compensation recognize the difficulties associa"] [11.152244567871094, 17.984525680541992, "er deems the claim to be compensable . . . If the employee\u2019s claim is denied . . . her economic situation is likely to deteriorate far more rapidly than would that of a similarly-situated worker in a comparator country [Canada, Australasia, Europe], "] [10.983992576599121, 17.837892532348633, "ry\u201d rather than the welfare of injured workers and their families. (Davoli, 2016, p. 2)\nLegislative challenges in some states, including opt-out and coverage restrictions, threaten the viability of the system and adequacy of benefits.\nOpting out of w"] [11.008088111877441, 17.834497451782227, "ination against people with disabilities. In several states, these funds were closed out except for injuries or claims prior to a specified date . . . The combination of elimination of these funds and the exclusion of conditions with multiple causes "] [10.98876667022705, 17.820011138916016, "ing or temporary work agencies often are unsure about their rights\u2014to the point that new \u201cright to know\u201d laws for temporary workers have been enacted, and specifically require that a worker be told who the workers\u2019 compensation carrier is, in case th"] [10.99155044555664, 17.82184600830078, "centives to reduce premiums]. For example, \u201cbehavior-based\u201d incentive programs that reward workers for reporting no injuries or that penalize workers who do report them are commonplace in the US. Although they are typically justified as a means to re"] [10.981091499328613, 17.815858840942383, "ensive protective measures have been available and well recognized for hundreds, and in some cases thousands, of years. For example, every week one or more workers are killed in trench cave-ins despite the fact that nearly 2,500 years ago Herodotus d"] [11.050887107849121, 17.890548706054688, " particular, the percent of prime-age men who report that they are ill or disabled has grown from less than two percent in the late 1960s to about three percent in 1983 and to nearly five percent by 2003. Is it possible that workers\u2019 compensation cas"] [11.118732452392578, 17.9171142578125, "and Return to Work Committee, 2016, p. 16)\nTrust in the workplace is one of the most important predictors of return to work. (IAIABC Disability Management and Return to Work Committee, 2016, pp. 17\u2013 18)\nSome insurers may see a conflict in return to w"] [11.636677742004395, 18.22089958190918, "igation for dollars? (Steggert, 2010, p. 75)\nAny jurisdiction\u2019s ability to deliver benefits depends on the choice of disability rating system as well as the method of implementation and administration\u2014all of which flow from underlying social policy d"] [10.964326858520508, 17.829957962036133, "es that develop over time, then these diseases should be removed from the \u201cbargain\u201d and employers should, when appropriate, be liable in tort. (Spieler, 2017, p. 99)\nMedical Management\nRising medical costs and poor integration with the medical system"] [10.971869468688965, 17.85813331604004, "l payer health care system would change workers\u2019 comp into an indemnity program only . . . needs to be consideration of the consequences of delinking medical benefits and indemnity. (IAIABC, 2016b, p. 2)\nMedical cost-control efforts often use blunt t"] [10.978519439697266, 17.832761764526367, "me state programs has been undermined by a combination of complex design and/or regulatory scope issues. Additionally, some payors\u2019 have, in my opinion, missed the boat by making \u201cblack-and-white\u201d UR decisions based on strict adherence to guidelines."] [10.982346534729004, 17.818227767944336, "ts to the changing workplace, workforce, and kind of work. Employers need to make sure their workplaces are safe and have a responsibility to report injuries . . . Employees need to know what their benefits [sic] under workers\u2019 compensation. They hav"] [11.017071723937988, 17.84418487548828, "s\u2019 compensation plays in supporting economic growth. (IAIABC, 2016a, p. 1)\nThere were many who felt that the grand bargain was an \u201cillusion\u201d and that there is no single bargain. In many ways the grand bargain is really more about the \u201cspirit\u201d of empl"] [11.178638458251953, 18.11515998840332, "\u20131027. As of July 29, 2018: https://onlinelibrary.wiley.com/doi/pdf/10.1002/ajim.22112\n 90\nBLS, \u201cFrequently Asked Questions About Data on Contingent and Alternative Employment Arrangements,\u201d 2018. As of June 20, 2018: https://www.bls.gov/cps/conting"] [11.164810180664062, 18.12539291381836, "rs\nCrum, Elizabeth, \u201cWorkers\u2019 Compensation Adjudication and Administration,\u201d in R. A. Victor and L. L. Carrubba, eds., Workers\u2019 Compensation: Where Have We Come? Where Are We Going? Cambridge, Mass.: Workers\u2019 Compensation Research Institute, 2010, pp"] [11.189631462097168, 18.1328182220459, "99.\nGalizzi, Monica, Roberto Leombruni, Lia Pacelli, and Antonella Bena, \u201cInjured Workers and Their Return to Work: Beyond Individual Disability and Economic Incentives,\u201d Evidence- Based HRM: A Global Forum for Empirical Scholarship, Vol. 4, No. 1, 2"] [11.145587921142578, 18.141830444335938, "ational Conversations, 2016b. As of July 26, 2018: https://www.iaiabc.org/iaiabc/National_Conversations1.asp\n\u2014\u2014\u2014, \u201cNew Mexico Report,\u201d in IAIABC National Conversations on the Future of Workers\u2019 Compensation, National Conversations, 2016c. As of July "] [11.14833927154541, 18.140396118164062, ": Where Have We Come? Where Are We Going? Cambridge, Mass.: Workers\u2019 Compensation Research Institute, 2010, pp. 39\u201357.\nMarmot, Michael G., Stephen Stansfeld, Chandra Patel, Fiona North, Jenny Head, Ian White, Eric Brunner, Amanda Feeney, and G. Davey"] [11.160847663879395, 18.139549255371094, "docs/ssb/v35n10/v35n10p31.pdf\nNeuhauser, Frank, \u201cThe Myth of Workplace Injuries,\u201d Perspectives (IAIABC), April 2016, pp. 16\u201321.\nNew York State Occupational Health Clinics Oversight Committee, \u201cReport to the Governor and Legislature,\u201d 2012. As of July"] [11.252962112426758, 18.14757537841797, "\ndoi:10.1111/1468-0009.00202.\nSavych, Bogdan, and H. Allan Hunt, \u201cAdequacy of Workers\u2019 Compensation Income Benefits in Michigan,\u201d Cambridge, Mass.: Workers Compensation Research Institute, WC-17-20, 2017. As of July 27, 2018: https://www.wcrinet.org/"] [11.235407829284668, 18.12547492980957, "cine, Vol. 45, No. 4, 2004b, pp. 338\u2013345. http://doi.wiley.com/10.1002/ajim.10356\nSwedlow, Alex, \u201cSocial Policies of Disability Evaluation,\u201d in R. A. Victor and L. L. Carrubba, eds., Workers\u2019 Compensation: Where Have We Come? Where Are We Going? Camb"] [10.988490104675293, 17.787010192871094, "ety and Health Through Workers\u2019 Compensation Systems,\u201d Perspectives (IAIABC), July 2017, pp. 6\u201310.\n99\nWurzelbacher, Steven J., Stephen J. Bertke, Michael P. Lampl, P. Timothy Bushnell, Alysha R. Meyers, David C. Robins, and Ibraheem S. Al-Tarawneh, \u201c"] [2.9800684452056885, 16.474515914916992, " The Cost and Affordability\nof Flood Insurance in\nNew York City\nEconomic Impacts of Rising Premiums and Policy Options for One- to Four-Family Homes\nLloyd Dixon, Noreen Clancy, Benjamin M. Miller, Sue Hoegberg, Michael M. Lewis, Bruce Bender, Samara "] [2.9906363487243652, 16.506223678588867, "l level. Congress instructed the Federal Emergency Management Agency (FEMA) to develop an affordability framework in light of legislation that directs FEMA to gradually eliminate certain program subsidies and to collect additional program fees. This "] [2.94793701171875, 16.55008316040039, "xvii Abbreviations.......................................................................................xxix\nCHAPTER ONE Introduction........................................................................................... 1 Purpose of This Study "] [2.9393985271453857, 16.539836883544922, "lculations ..................................................................35\nv\nvi The Cost and Affordability of Flood Insurance in New York City\nPremiums Using the 2007 Flood Insurance Rate Map. . . . . . . . . . . . . . . . . . . . . . . . . . . "] [2.8837740421295166, 16.548757553100586, "perty Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Effect of Flood Insurance Premium Increase on Property Tax Revenue . . . . . . . . . . . . . . . . . . . . . . Effect of Flood Insurance Premium Increase on Probability of Defaul"] [2.8609585762023926, 16.544218063354492, "vey Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 B.DevelopmentoftheProjectGeodatabase......................................"] [2.7898287773132324, 16.48038101196289, " for Properties in the\nHigh-Risk Zones of the 2007 FIRM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n3.6. Premium Increases for Properties in the High-Risk Zones\nof the 2007 FIRM . . . . . . . . . . "] [2.901806592941284, 16.5738468170166, "enario B . . . . . . . . . . . . . . . . . . . . . . . . . . .......73\n4.18. Flood Insurance Premium in Premium Scenario G . . . . . . . . . . . . . . . . . . . . . . . . . . .......73\n4.19. PITI Ratio Assuming Premium Scenario G. . . . . . . . . . ."] [2.882647752761841, 16.552000045776367, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n2.5. Comparison of Reported and Actual Flood Insurance Coverage . . . . . ..\n2.6. Deductible Amounts for Flood Insurance Policies in Place as of\nJune 2016 (Percentage of Policies"] [2.882009267807007, 16.56692123413086, " Owner-Occupied\nResidences Only (2016 Dollars). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n5.3. Impact of Flood Insurance Rate Changes on Property\nTax Revenue (2016 Dollars) . . . . . ."] [3.017437219619751, 16.751373291015625, "\n6.15. Cost of Mitigation Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108\n6.16. Design 4: Mitigation Grants and Low-Interest Loans\u2014Program Outcomes with Full Participation"] [2.94130277633667, 16.505002975463867, " . . . . . . . . . . . . . . . . . . . . . . . . . . . 164\nE.4. Comparison of Flood Zone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165\nE.5. Comparison of Elevation Difference "] [2.9514129161834717, 16.525175094604492, "urance Reform Act of 2012 and the Homeowner Flood Insurance Affordability Act of 2014.\n xv\nxvi The Cost and Affordability of Flood Insurance in New York City\nFigure S.1 Study Area\n Manhattan\nBrooklyn\nQueens\nBronx\n Staten Island\nNOTE: Purple areas"] [2.8365795612335205, 16.504283905029297, "ures, meaning they were built before the first FIRM for New York City was issued in November\n2 The Rockaway Peninsula includes the Rockaway Park and Rockaway Beach communities, which are consid- ered particularly vulnerable to flooding and other nega"] [2.7446446418762207, 16.488142013549805, "e exam- ined the effect of eliminating the current pre-FIRM rate with the 2007 FIRM in place. We also projected premiums if the PFIRM were adopted. This allowed us to examine the effect of a map reflecting greater flood risk on premiums and to analyz"] [2.8020570278167725, 16.503311157226562, "idy for certain policyholders.\nxx The Cost and Affordability of Flood Insurance in New York City\ntions relative to the BFE\u2014the median premium is only $100 more when pre-FIRM rates are eliminated, as shown in the table.\nOutside the high-risk zones, th"] [2.8188586235046387, 16.543474197387695, "ercent of the households in the study area; but these potential premium increases would both increase the number of households for whom flood insurance is burden-\nsome and increase the burden on those for whom it is already burdensome. With the PFIRM"] [2.928326368331909, 16.57630729675293, "00\n xxii The Cost and Affordability of Flood Insurance in New York City\nSome study areas, such as the Rockaway Peninsula, could be particularly hard hit by increased default rates.\nTake-up of insurance is likely to increase for homes outside of "] [3.0486040115356445, 16.78021240234375, "e more modest than in other programs. We have modeled a program in which the household buys a policy with a $10,000 deductible for building losses and a $10,000 deductible for contents coverage,\nTable S.3\nFlood Insurance Affordability Program Designs"] [2.997727870941162, 16.738338470458984, " measures become considerably more attractive assuming risk- based rates based on the PFIRM. For example, the number of households eligible for a structure elevation program rises from 190 to 5,000 (not shown in table) when the\nxxiv The Cost and Affo"] [3.0077526569366455, 16.632843017578125, " with the pre- mium subsidy alone. We illustrate that this can indeed be the case, with savings up to hundreds of millions of dollars in certain multiyear scenarios, assuming risk-based rates based on the PFIRM, but only if the low-income households "] [3.019745349884033, 16.45968246459961, "ecovery helped us understand data collected by the Build It Back program. Jona- than Hayes and Rachel Rosenberg of ideas42 designed an effective final appeal that was mailed out to the property owners who we were attempting to enroll in the study. Ma"] [2.9703516960144043, 16.50255012512207, "e National Academies of Sciences, Engineering, and Medicine on behalf of the Fed- eral Insurance and Mitigation Administration (FIMA) in helping us refine the flood insurance affordability program options considered in this report. The workshops were"] [2.95112681388855, 16.488901138305664, "he flood maps in New York City to reflect increasing flood risk will likely result in higher flood insurance premiums for many households.\nA report by the RAND Corporation developed plausible scenarios for flood insurance premiums for one- to four- f"] [2.855564832687378, 16.458072662353516, " high risk of flooding according to the Preliminary Flood Insurance Rate Map (PFIRM) that was released in June 2013.2 To collect the data, we selected a stratified random sample of 2,800 of the 48,100 one- to four-family properties in the high- risk "] [3.0344631671905518, 16.379064559936523, " in the study, the property owner received a free elevation certificate (EC) valued at $800 to $1,000, a $50 gift card, and a fact sheet describing flood risk and the information contained in the EC. Having an EC can help property owners qualify for "] [2.881364345550537, 16.4816837310791, "r various scenarios. To do this, we worked with Torrent Technologies to determine rates per $100 of coverage for a wide range of structure characteristics.8 These include structure type (e.g., basement, crawlspace), flood zone, elevation relative to "] [2.9464926719665527, 16.453269958496094, "holds for which flood insurance is burdensome absent the program assessed. The advantages and disadvantages of the alternative approaches are identified and compared.\nChapter Seven provides concluding comments.\nThe main body of the report is followed"] [2.856233596801758, 16.427656173706055, "nd Silver Beach cooperatives. Breezy Point is on the Rockaway peninsula and Edgewater Park and Silver Beach are in the Bronx.\n3 A and AE zones are areas with a 1 percent or greater annual chance of flooding. AO zones are areas with a 1 percent or gre"] [2.86368989944458, 16.4449405670166, "d by property owner in the property-owner survey.\na Based on the study sample of 2,800 properties.\nb Based on all 48,100 properties in the study areas. Because all 48,100 properties are represented, confidence intervals are not necessary.\nc Based on "] [2.8186094760894775, 16.47907829284668, "omes in the study area, 18,700 are in the high-risk zones of the 2007 FIRM (bottom set of rows in Table 2.1).\nAn important indicator of flood risk is the elevation of the structure relative to the Base Flood Elevation (BFE).9 These elevation differen"] [2.9542429447174072, 16.57078742980957, " ECs for the 240 structures in the study sample with complete ECs that are in the high-risk zones of the 2007 FIRM. Data on 2007 BFE are interpolated from the 2007 FIRM. Data are weighted to reflect the 22,200 one- to four-family properties in the hi"] [3.105433225631714, 16.78921127319336, "ersons)\n1 2 3 4 5 6 7 8\n40,800\u201344,100\n4,800\u20137,600 10,300\u201314,000 5,100\u20138,000\n7,400\u201310,900 2,800\u20134,900 1,800\u20134,100\n800\u20132,600 600\u20132,200\n\u2014\n11\u201318% 24\u201333% 12\u201319% 17\u201325%\n7\u201312% 4\u201310% 2\u20136% 1\u20135%\naaaa\n13,700\n500 7,100\n The Affordability of Flood Insurance in Ne"] [3.0872936248779297, 16.778911590576172, " with household size to classify households by income category. It is also combined with various expenses to determine the proportion of income spent on housing costs, which is another potential metric used to determine eligibility for an affordabili"] [3.0635528564453125, 16.744434356689453, "ome and net worth for households nationwide. It provides a basis for esti- mating how much the number of program beneficiaries would decline if an asset test were imposed on top of an income test.\n11 Note that these percentages do not include renters"] [2.909118175506592, 16.50678062438965, "ch may overstate the take-up rate to some extent.12 In this study, the policies were matched using both geocoded location and address, which we believe provides a more accurate estimate of the take-up rate.\nThe 2012 take-up rate outside the high-risk"] [2.9390878677368164, 16.600692749023438, "012\n2016\n In study areaa\nHigh-risk zones of 2007 FIRM\nOutside high-risk zones of 2007 FIRM\nFor properties with mortgagesb High-risk zones of 2007 FIRM\nOutside high-risk zones of 2007 FIRM\nFor properties without mortgagesb High-risk zones of 2007 F"] [2.897516965866089, 16.59955596923828, "d not know if they had flood insurance (pen- ultimate column of Table 2.5). For this group, it was much more common not to have flood insurance according to the PMF.\nTable 2.5\nComparison of Reported and Actual Flood Insurance Coverage\n Flood Insuranc"] [2.872966766357422, 16.58012580871582, " a substantial fraction of one- to four-family structures are\n 1\u201349 50\u201399 100\n101\u2013 150\u2013\n200\u2013 250 149 199 249\nCoverage (in thousand $)\n0 1\u201349\n50\u201399 100\nNOTE: Data are based on properties in the study sample with a flood insurance policy as of Ju"] [2.7465083599090576, 16.44622230529785, "nts coverage as of June 2016 (N = 885). Affordability of Flood Insurance\nFlood Insurance Premiums\nIn this section, we examine the amount paid for NFIP coverage in the study area. Before doing so, we review the rating methods available to structures i"] [2.799147367477417, 16.502025604248047, "ns are met within a ten-year period regard- less of change of ownership: (1) two flood insurance claim payments for separate losses, each more than $1,000; (2) three or more flood insurance claim payments for separate losses, regardless of amount; (3"] [2.8378500938415527, 16.5428466796875, "igher\u2014averaging $1,650. A few policyholders outside the high-risk zones are using elevation-based rates\u2014but these are likely because of errors in the flood zone provided on the PMF given that FIRMs do not provide a BFE outside the high-risk zones.\nHo"] [3.1191437244415283, 16.82556915283203, "ack to the National Housing Act of 1937. The regulations promulgated pursuant to this act originally offered public housing to families with incomes less than five to six times the rent. This rule was quickly changed to limit maximum rent to 20 perce"] [3.084209680557251, 16.79825210571289, "that size household (very low income). As can be seen, the PITI ratio exceeds 0.4 for many households, particularly low-income households. Note that the PITI ratio exceeds 0.4 for very few households with incomes\n27 These regulations were established"] [3.069732427597046, 16.77113151550293, ",000 43% 1,500 16% 3,900 41%\nModerate- and middle-income households (income 80\u2013165% of\nAMI)\n0 to 0.3\n> 0.3 and \u2264 0.4\n> 0.4 (housing burdened)\n11,200 70% 2,700 17% 2,000 12%\nHigher-income households (income > 165% of AMI)\n0 to 0.3\n> 0.3 and \u2264 0.4\n> 0."] [2.8205370903015137, 16.5043888092041, "00 (out of 42,700 owner-occupied one- to four-family properties).30\n30 If the properties without flood insurance paid the average premium for flood insurance that other properties do (approximately $1,880 in the high-risk zones and $530 outside the h"] [2.753471851348877, 16.482362747192383, "s us to characterize the effects of changes in the FIRM, ceteris paribus. Although the advantages of pre-FIRM rates may well be largely elimi- nated by the time a revised map is in place, we calculate how much premiums would change under the PFIRM if"] [2.751694679260254, 16.495193481445312, "The weighting procedure is explained at the end of Appendix A.\nPremiums are generated for the scenarios described in Table 3.1. In all cases, the full premium including all fees is projected. Scenario A characterizes the situation on the eve of Hurri"] [2.7747230529785156, 16.542150497436523, "ew levels at an 18-percent com-\n3 Eight inches is the 75th percentile of estimates by the New York City Panel on Climate Change on the amount of SLR by sometime in the 2020s (see Horton et al., 2015, p. 41).\n4 It may well be that 8 inches of SLR will"] [2.8009002208709717, 16.498849868774414, "n the right direction.\nThe deductible assumed reflects the observed deductible chosen by NFIP policy- holders in New York City in 2016 (see Table 2.6).\nFigure 3.1 shows the coverage limits assumed in the premium projections for the one- to four-famil"] [2.7670552730560303, 16.513240814208984, "of stories Flood zone Elevation difference Location of contents Location of M&E Building coverage Contents coverage\nExample Value\nPre-FIRM\nSingle family\nHas basement\n3 (including basement)\nA\n3 feet below BFE Throughout structure\nIn basement\n$250,000 "] [2.7786552906036377, 16.474180221557617, "s from the April 2015 rate schedule for a one- to four-family structure in an AE zone, with two or more floors, contents located throughout the structure, and M&E in the basement.\nSomewhat unexpectedly, changes in the NFIP rate schedule between 2012 "] [2.7755699157714844, 16.488140106201172, "NOTE: Premiums include all fees.\na 22,200 one- to four-family properties.\n$800\n$1,900\n$3,000 $3,900\n$9,100\n$3,500\n$2,800\u2013 4,100\n$800\n$1,900\n$3,100 $4,300\n$10,700\n$4,100\n$3,300\u2013 4,800\n$400 $400 $400 $400 $500 $500\n$400 $500 $500 $400 $700 $700\n$400 $7"] [2.7623817920684814, 16.478221893310547, " elevation- based rates. Policyholders may not be taking advantage of elevation-based rates because of lack of information. Most homeowners may not be aware that they are paying pre-FIRM subsidized rates or that an EC would lower their premiums (an E"] [2.7510335445404053, 16.486839294433594, " structure considered earlier in this chapter (Table 3.2). The elevation difference was \u20133 feet under the 2007 FIRM and the base premium was $2,500 (Table 3.4). If the PFIRM were adopted, the elevation difference would\nFlood Insurance Premium Scenari"] [2.7246291637420654, 16.46665382385254, "an it is in the 2007 FIRM (see first column of Figure 3.6). Premiums fall for less than 5 percent of properties, which results in a $400 decline in the average premium.\nFigure 3.4\nDifference Between Structure Elevation and PFIRM BFE in the Study Area"] [2.7702677249908447, 16.478899002075195, "y 50 percent from $3,000 to $4,500. Now, 5 percent of property owners face annual premiums of $12,000 or more.\n46 The Cost and Affordability of Flood Insurance in New York City\nWithout grandfathering, pre-FIRM rates are of considerable benefit. It ma"] [2.7071306705474854, 16.477703094482422, "dfathered rates (see Appendix F for details).\nEliminating pre-FIRM rates when grandfathering is allowed does not make any difference for newly mapped properties (scenario E is the same as scenario D in\n10 The standard X-zone rate is also referred to "] [2.788590669631958, 16.483699798583984, " in sce- nario H by 7 and 13 percent over scenario G, respectively. These percentage increases are similar to those discussed above for the properties already in the high-risk zones.\nHousing Burden Under Different Premium Scenarios\nPremium increases "] [2.6756210327148438, 16.456317901611328, "hering and without pre-FIRM rates\nG. Without grandfathering or pre-FIRM rates\nMedian\n$3,000 $3,100\n$3,100 $5,600\nPercentage Change from Scenario B\n\u2014 3%\n3% 7%\nMedian\n$500 $500\n$2,700 $4,200\nPercentage Change from Scenario B\n\u2014 0%\n440% 740%\nPremium for "] [2.8165860176086426, 16.444429397583008, "mium for the 25,800 newly mapped properties would gradually increase from $500 to $2,700, even with grandfathering.\nThe removal of grandfathering would have considerable consequences for all one- to four-family properties in the study area. For those"] [2.940729856491089, 16.373939514160156, "nsurance in New York City\nSubarea Risk Profiles\nThis study focuses on one- to four-family properties. Table 4.1 reports the number of one- to four-family properties in each of these subareas and the estimated number that are owner occupied.\nThe locat"] [2.913529634475708, 16.32932472229004, " in Canarsie have a separate residential unit in the basement (see Figures 4.3 and 4.4).\nBuilding and Typology\nResidential areas in Canarsie consist primarily of one- and two-family attached and semidetached buildings. There is also a concentration o"] [2.9329323768615723, 16.350051879882812, "er geography than this neighbor profile repre- sents. The smaller geography was originally selected by DCP for its unique building and land use conditions, but then the area was expanded to include a larger neighborhood context (Alan Zaretsky, person"] [2.9325387477874756, 16.34956932067871, "ring- ing homes, even detached homes, into compliance with current floodplain manage- ment standards would be challenging, as it would mean filling in cellars or basements (NYC Planning, undated[f]). Another constraint with attached homes is that mos"] [2.929107189178467, 16.344085693359375, "d.\nRAND RR1776-4.9\n Flood Insurance Affordability in Five Vulnerable Subareas 63\nBuilding and Typology\nLow-density residential, mostly one- and two-family residences (see Figure 4.10), char- acterizes the area. More than 90 percent of residences were"] [2.9305667877197266, 16.347454071044922, " water interacted with electrical equipment. The flooded streets made it difficult for fire trucks and emergency responders to get through and resulted in fires burning unabated. This destroyed 175 homes and businesses (City of New York, 2013).\n Floo"] [2.920011520385742, 16.33871078491211, "tal inundation on the East Shore. Floodwater traveled as far as one mile inland, causing damage to homes and businesses in its path.\nBuilding and Typology\nMany of the beach bungalows built early in the 19th century have been retrofitted to provide ye"] [2.9081029891967773, 16.436229705810547, "\nCanarsie again stands out in terms of income and housing burden. An estimated 54 percent of households in owner-occupied one- to four-family homes in Canarsie are low income, very low income, or extremely low income (first column of Table 4.3). More"] [2.807863235473633, 16.45769500732422, "sing burdened are located in the middle and eastern parts of the peninsula, not the western end, where the Breezy Point cooperative is located.\nPremium Scenarios by Study Subarea\nWe break out premiums by study subarea for two of the premium scenarios"] [2.804020404815674, 16.455398559570312, "300\u2013 7,600\n$1,100 $4,000\n$5,600 $28,500\n$35,600\n$14,100\n$11,200\u2013 16,900\n$2,800 $4,000\n$4,700 $6,900\n$12,300\n$5,900\n$5,100\u2013 6,700\n$1,100 $3,000\n$4,200 $5,600\n$24,200\n$6,100\n$4,600\u2013 7,600\n premiums on the East Shore. At least 5 percent of property owne"] [2.789733648300171, 16.41520118713379, "onfidence Percentage Interval\n54% 40\u201368% 25% 13\u201343%\n21% 11\u201335% 39% 29\u201350% 31% 21\u201345% 29% 20\u201339% 33% 28\u201339%\n NOTE: These values are based\nnot add exactly to total because of rounding to nearest 100. Sample weights are described in Appendix A.\na The "] [2.8054354190826416, 16.505495071411133, "e west end of the Rockaways is particularly hard hit.\nThe premium increases in scenario G cause a substantial increase in the percent- age of households that are housing burdened in all subareas. The percentage that is housing burdened in Canarsie in"] [2.81990909576416, 16.538291931152344, "ese higher coverage levels because it is desirable for property owners to have the resources available to recover after a flood (subject to the policy limits offered by the NFIP).\nThis chapter focuses on the implications of shifting from scenario B t"] [2.8145248889923096, 16.55628204345703, "nded to the nearest $1,000.\n Effects of Flood Insurance Premium Increases on Households and Neighborhoods 79\nTable 5.1\nMarket Value of One- to Four-Family Properties in the Study Area, Owner-Occupied Residences Only\n Property Value (2016 $)\n$235,000"] [2.8422060012817383, 16.56311798095703, "nt to consider how long the household will purchase insurance. As presented in Chapter Two and Dixon et al. (2013), we know that homeowners who are not required to purchase flood insurance are less likely to purchase flood insurance. We also know tha"] [2.798262596130371, 16.56044578552246, "s fully paid because of lax enforcement or other factors, then he or she would be willing to pay a higher price for the home.\n4 A very small number of properties even increase in value after their flood insurance rates decrease.\n Effects of Flood Ins"] [2.8225040435791016, 16.560302734375, "venue\nSuch large changes in property value have several further implications. One is that declines in property value directly map to declines in property tax revenue. Property tax rates in New York City are quite high, and the base rate for most one-"] [2.9195804595947266, 16.58702278137207, "ts are somewhat higher in low-income areas, this simply reflects that low-income households have more limited ability to access other sources of funding if their resources become constrained. As such, the ability-to-pay literature has found that once"] [2.8698196411132812, 16.536331176757812, "ke-up rates for homes without mortgages and homes out- side the current high-risk flood zone are approximately 30 percent. Even absent pre- mium increases, the take-up rate among this latter group is likely to drop over time for two reasons. First, t"] [2.8185765743255615, 16.555744171142578, "ffective FIRM is likely to increase from approxi- mately 30 percent to 70 percent as the flood zones and premiums move from those in scenario B to those in scenario G. That is, these households will now be subject to the mandatory purchase requiremen"] [2.8917856216430664, 16.538410186767578, "se by $22 million. We estimate the mortgage default rate will increase by 50 percent to 1.5 percent of homes with mortgages per year. Most of these defaults will be in the high-risk areas of the current FIRM. Some study areas, such as the Rockaway Pe"] [3.0530903339385986, 16.680801391601562, "rently a member of the CRS, but is investigating whether it would make sense to join.\nThe first step to evaluating CRS eligibility entails a FEMA Community Assistance Visit (CAV); FEMA ini- tiated a CAV in New York City in 2015, and it is currently i"] [3.069790840148926, 16.7891788482666, "to a flood insurance affordability strategy in this report. That topic warrants further study.\n individuals or businesses presumably have too many assets to justify assistance\nfor flood insurance premiums.\n2. Coverage levels. The outcomes for each de"] [3.0563807487487793, 16.777132034301758, "ned households estimated in Chapter Two (Table 2.9).\nFlood Insurance Affordability Program Options 89\n 90 The Cost and Affordability of Flood Insurance in New York City\nTable 6.2\nNumber of One- to Four-Family Households in Owner-Occupied Properties b"] [3.0596401691436768, 16.741491317749023, "f the risk of increasing flood insurance premiums. Incorporating the gradual\n4 Other New York City housing assistance programs such as the New Housing Opportunities Program, Mixed- Income Program, Taxable 80/20, and Coop Housing Program provide benef"] [3.0940475463867188, 16.819194793701172, " less than 165 percent of AMI would receive benefits from the program. When flood insurance premiums without the program are equal to those in premium scenario B, households receive $33 million in premium subsidies annually. The average flood insuran"] [3.0645174980163574, 16.79526710510254, " to $13 million. It then increases as the participation rate rises.\nTable 6.4\nDesign 1: Enrollment and Program Cost Under Different Program Participation Assumptions\nFlood Insurance Affordability Program Options 93\n Participation Rate\n2016 flood insu"] [3.0606863498687744, 16.782955169677734, "olds in study area that are housing burdened\nWithout the program\nWith the program\nAnnual program cost\nScenario B (2007 FIRM with Pre-FIRM Rates)\n31,700 9,700\n22,000\n23%\n22% $33 million\nPremium Scenario\nScenario E (PFIRM, with Grandfathering and No Pr"] [3.0820109844207764, 16.80236053466797, "e\n80% premium\n50% of AMI 165% of AMI\n31,700 (28,800\u201334,600)\nMore Broadly Targeted Program\n70% premium\n80% of AMI 165% of AMI\n31,700 (28,800\u201334,600)\n$34 million (27\u201340)\n9,700 $13 million $2,100\n$720 0.87\n0.81\n22,000 $21 million $1,900\n$940 0.22\n0.20\n "] [3.061075210571289, 16.861652374267578, "00 $62,000\n$93,000 $128,000 (50% of AMI) (80% of AMI) (120% of AMI)(165% of AMI)\nHousehold income\n(Percentage of AMI for a three-person household)\nRAND RR1776-6.4\nhouseholds. Figure 6.4 shows the PITI ratio for three hypothetical households, first wh"] [3.074583053588867, 16.80451774597168, "hreshold is 0.4 and the program eligibility cutoff is 165 percent of AMI.\na 95-percent confidence intervals in parentheses.\nTable 6.7 reports the costs, enrollment, and impacts of the housing burden\u2013based flood insurance affordability program depicte"] [3.0715248584747314, 16.79939079284668, "would be without the program (not shown in table).\nTable 6.10 shows the outcomes for a more narrowly targeted program and a more broadly targeted program. In the more narrowly targeted program, the PITI ratio threshold is increased to 0.5 and program"] [2.934338092803955, 16.64626121520996, "nts coverage. If instead of buying a policy with a $2,000/$2,000 deductible, the property owner bought a policy with a $10,000/$10,000 deductible, the premium would be 20 to 25 percent lower.9 Figure 6.5 shows the benefit structure when there is a lo"] [3.0300087928771973, 16.75601577758789, "ncial loss.\n Figure 6.5\nSubsidy Structure for Deductible Subsidy\nFlood Insurance Affordability Program Options 103\n Maximum deductible reimbursement\n$16,000\n RAND RR1776-6.5\n$62,000 (80% of AMI)\n$128,000 (165% of AMI)\nHousehold income\n(% of AMI for "] [3.066141366958618, 16.796733856201172, "utoff is 165 percent of AMI.\na 95-percent confidence intervals in parentheses.\nTable 6.12\nDesign 3: Enrollment and Program Cost Under Different Program Participation Assumptions\n Participation Rate\n2016 flood insurance take-up rates (36% and 50%)a\n50"] [3.0228326320648193, 16.749135971069336, "ent of AMI) to finance the mitigation measures.13 To ensure that a mitigation measure pays off over time, we require the present value of the premium reductions to exceed the cost of the mitiga- tion measure. We refer to such mitigation measures as c"] [3.0266988277435303, 16.75784683227539, "mine the number of properties for which the mitigation measure is fea- sible and whether the household is eligible for the program. For example, basement infill is only feasible for structures with basements, and households are only eligible for a gr"] [2.967332601547241, 16.70922088623047, "mitigation measure (further discussed in this section).\nWe examine the impacts of structure mitigation under two different premium scenarios: scenarios B and G. Pre-FIRM rates and grandfathering have been removed from scenario G, so scenario G is pre"] [2.883902072906494, 16.618999481201172, "dations do not depend on the location of M&E, so this mitigation measure is not cost-effective for this type of struc- ture. For structures with basements, lower premiums are available if the M&E is raised out of the basement. For enclosures and craw"] [3.0172247886657715, 16.75714683532715, " and allowing pre-FIRM rates. As can be seen from the first row of the table, some type of mitigation is feasible, and the household passes the income test (income less than 165 percent of AMI) for a substantial share of the 42,600 owner-occupied pro"] [3.032139301300049, 16.777225494384766, " loans depends on the distribution of household income for each structure type. For example, it turns out that grants are provided for all 190 structures that are elevated, which means that income of all these households is less than 80 percent of AM"] [3.052384853363037, 16.79288673400879, "e Cost and Affordability of Flood Insurance in New York City\nTable 6.17\nDesign 4: Mitigation Grants and Low-Interest Loans\u2014Program Outcomes with Full Participation Using Premium Scenario G (2015 Rate Schedule with No Grandfathering, No Pre-FIRM Rates"] [3.0312423706054688, 16.794031143188477, "nd the flood risk indicated by the PFIRM, is $120 million (see last row of Table 6.5) and is reproduced in the first row of Table 6.18. The second row shows the present value of the subsidy when there is no mitigation. The subsidy continues only as l"] [3.0480995178222656, 16.76875114440918, "higher.\nSummary of Findings\nThis chapter has examined different approaches for providing assistance to households that have difficulty paying flood insurance premiums. Five designs were developed and their performance modeled. Table 6.19 pulls togeth"] [3.035428285598755, 16.783283233642578, " Program\na Benefit Cost with Full Participation\nmitigation cost; large premium reduction flood risk exceed $600 Benefits of reduced\n$10,500\n$31 million\n0\n190\nStructure elevation\n Affordable Flood Insurance Beneficiaries Flood Insurance Unaff"] [2.9877681732177734, 16.726484298706055, "cent of AMI.\nWhile moving to risk-based rates under the PFIRM increases the number of structures for which mitigation is attractive, it also increases the number of households that are housing burdened and the costs of the subsidy-based designs (desi"] [2.8342177867889404, 16.553752899169922, "d losses. Replacement cost is greater than building coverage for about 45 percent of the structures with flood insurance.\nUsing a definition of housing burden based on the PITI ratio, flood insurance is currently burdensome for approximately 11,000 ("] [2.824326753616333, 16.54405975341797, "e impacts of shifting from premiums that are based on the 2007 FIRM and current FEMA pricing practices to premiums that are based on the PFIRM and the elimination of grandfathering and pre-FIRM rates. We found that newly mapped properties will see th"] [3.0076260566711426, 16.717227935791016, " for relatively few structures given the 2007 FIRM and the 2015 NFIP rate schedule.\nThe mitigation measures become considerably more attractive assuming risk- based rates based on the PFIRM. For example, the number of households eligible for a struct"] [3.024031400680542, 16.43370246887207, "cess that was used to extrapolate from the study sample to all one- to four-family properties in the study area.\nSampling Approach\nSample Frame\nThe sample frame includes 48,089 one- to four-family structures in the high-risk zones of the PFIRM (the s"] [3.0915255546569824, 16.376096725463867, " first stage, a minimum sample of 200 structures was drawn from each of the six study subareas. The minimum size of 200 structures at the first stage was selected so that, with a 25-percent response rate, a two-sample t-test comparing the mean afford"] [3.13362717628479, 16.41090202331543, "ing as percentage of income \u2264 25\n> 25.1 and \u2264 35\n> 35\nWater depth in flood that occurs with a 1% annual change (in feet)\n\u22641\n> 1 and \u2264 2 > 2 and \u2264 3\n> 3 and \u2264 4 >4\nCount Percentage of Total\n2,800 100%\n358 13% 267 9% 293 10% 578 21% 435 16% 869 31%\n1,2"] [3.0714714527130127, 16.413928985595703, "he property owner will be kept strictly confidential and the names of properties owners or the addresses of properties participating in the study will not be shared directly with the city.\nBoth the website and the invitation letters indicated in mult"] [3.085193157196045, 16.36328887939453, "nable additional phone- based outreach to encourage participation in the study. The list obtained included phone numbers for 78 percent of the properties in the sample set. Calls were made to property owners who had not responded to the initial two i"] [3.050217628479004, 16.39038848876953, "s that resulted from the extensive recruitment efforts are shown in Table A.3.\nFigure A.3\nFlood Insurance Fact Sheet Provided to Study Participants\nSurvey Methods 133\n RAND RR1776-A.3\n134 The Cost and Affordability of Flood Insurance in New York City"] [3.0412349700927734, 16.385759353637695, "ricane Sandy (NYC Build It Back, undated[b]).\nAs can be seen from Table A.4, properties in the STAR program, with a flood insurance policy, and in the Build It Back program are all more likely to complete the survey as well as to complete the survey "] [2.9867942333221436, 16.439817428588867, "1.0005 for weights for properties with completed surveys and 1.0153 for weights for properties with com- pleted surveys and ECs.\nThe design effect for the study (mean of squared weights divided by [mean of weights]2) is 1.45.\n For Study Sample\nMinimu"] [2.923961639404297, 16.434797286987305, "sehold\n\u2013 B25119e3: median income of renter-occupied household.\n\u2022 FEMA effective FIRM for New York City (2007 FIRM database), with an effec- tive date of September 5, 2007, was downloaded from the FEMA Map Service Center. The database contains informa"] [2.90873122215271, 16.414331436157227, "the HAG and LAG were assigned to each parcel polygon.\nCalculate Maximum Flood Zone and BFE from Preliminary and 2007 FIRMs for Each Parcel\nEach parcel was assigned the maximum flood zone from the effective FEMA FIRM database and the preliminary FEMA "] [3.1468558311462402, 16.381206512451172, " to speak English for the popula- tion 5 years and over,\u201d was downloaded at the census-tract level and analyzed. The top three languages besides English were identified per census tract. Then the census tracts with the initial 1,400 study addresses i"] [3.0665876865386963, 16.4067440032959, " as subsequent mailings and telephone outreach, online questionnaire completion, scheduling the EC surveys, gift card mailings, and overall study progress. These fields were maintained throughout the study as specific study activities (e.g., mailings"] [3.04435658454895, 16.418954849243164, "ally exported into spread- sheets set up for specific additional activities. This included the creation of phone track- ers for use by outreach teams and trackers for door-to-door canvassers.\nDoor-to-Door Maps\nAs described in Appendix A, study outrea"] [3.0837013721466064, 16.79714012145996, "Geodatabase 145\n146 The Cost and Affordability of Flood Insurance in New York City\nprogram. The Build It Back database contained BBLs, so a first pass match was made using the BBLs. However, because of the presence of multi-address parcels (e.g., coo"] [3.1197166442871094, 16.83437156677246, "82,900 $93,250\n$103,600 $111,900 $120,150 $128,500 $136,750\nMiddle (165% of AMI)\n$99,700 $113,950 $128,200 $142,400 $153,850 $165,200 $176,650 $188,000\nUpper Cutoff for Income Category\n SOURCE: \u201cIncome Limits,\u201d undated.\nNOTE: The New York, New York"] [3.0350725650787354, 16.73451042175293, "d Program Participation (SIPP), 2008 Panel, Wave 10 (U.S. Census Bureau, undated[c]). Net worth is defined as total assets less total liabilities. Annual wages for each income quintile are calculated by the authors using SIPP 2008 Panel, Wave 10. We "] [3.04630184173584, 16.744731903076172, "argely driven by the principal and interest components, which we exam- ine as total mortgage expenditure. Table D.1 estimates that just more than one-quarter of households have no mortgage. Households in the high-risk flood zone that have a mortgage "] [3.0290563106536865, 16.73636817932129, "ts do vary with income, others do not. Households with more income do tend to purchase more expensive houses, and hence tend to spend more on principal, interest, and property taxes. However, other costs associated with homeownership, such as utiliti"] [3.0424630641937256, 16.750062942504883, "00 43.0% 3,500 8.2% 1,200 2.8% 600 1.4%\nPercentage of household income spent on property taxes\n0% < x \u2264 3% 3% < x \u2264 6% 6% < x \u2264 10% 10% < x\n7,900 18.3% 16,700 38.6% 10,100 23.4%\n8,500 19.6% Percentage of household income spent on utilities\n0% \u2264 x \u2264 5"] [2.944662094116211, 16.666614532470703, "ble D.2\nFraction of Income Spent on PITI and Utilities by One- to Four-Family Households in Study Area, Owner-Occupied Residences Only\n Number of Percentage of Households Households\n95% Confidence Interval\n NOTE: These values are based on a\nmay not"] [2.855846405029297, 16.627107620239258, "ilding coverage\n33% In 2,800 sample, with < $250,000 166 in building coverage and contents\ncoverage\n SOURCE: Coverage amounts are taken from the 2016 NFIP policy database. Mortgage balance is taken from the property owner survey and reflects mortgage"] [2.784907341003418, 16.465333938598633, "Rate Type and Parameters\nNon-elevation-based rates NFIP rate table\nFlood zone Structure type Occupancy Residency\nElevation-based rates in AE zones NFIP rate table\nFlood zone Structure type Number of floors Elevation difference M&E\nElevation-based rat"] [2.7239596843719482, 16.48043441772461, " premium) for\nother policies\n1 The NFIP rating schedules always assume that contents are distributed throughout single-family residences.\n2 The base premium for PRPs is specified in the NFIP manual for the combination of building and contents\ncoverag"] [2.744913101196289, 16.470874786376953, "e used to calculate the premium in scenario D (2015 rate schedule, PFIRM, with grandfathering, and with pre-FIRM rates):\nStep 1: Step 2:\nStep 3: Step 4:\nStep 5:\nAssign PR6 to each structure.\nAssign PR4 to the structure if the structure is a pre-FIRM "] [2.7126057147979736, 16.46283721923828, " (see boxed cells). The model predicted well on average for all three different rating methods: PRP, non-elevation-rated, and elevation-rated.\nThere was more variation in the difference between the projected premium and the PMF premium for the elevat"] [2.7471396923065186, 16.4558048248291, "or VE B, C, and X\nTotal\nFlood Insurance Premium Model 165\n 154 0 3 157 0 1 0 1 18 1 114 133 172 2 117 291\n SOURCE: Based on 291 properties in a selected sample with a completed EC and building coverage in 2016.\n4 It could also be the case that pr"] [2.7321317195892334, 16.454133987426758, "de crawlspace is misclassi-\n7 3 5%\n712% 59% 24% 59% 24% 24%\n Table E.6\nComparison of Structure Type\nBuilding Type According to EC Completed for Study\nFlood Insurance Premium Model 167\n Structure Type\nAccording to 2016\nPolicy Master File Basement\nBa"] [2.73008131980896, 16.48362159729004, " cumulative loss history will receive an annual 25% rate increase until they reach full- risk (elevation-rated) rates. An insurance agent must make that determination.\nAll other buildings will have annual rate increases of no less than 5% and no more"] [2.754335880279541, 16.468385696411133, "ing.\nIf a post-FIRM policy lapses, it will need to show again that it was built in compliance.\nTable F.2\u2014Continued\nRating Option and Scenario\nConversion\nOn a revised FIRM, property is no longer determined to be in a high-risk flood zone (e.g., its fl"] [2.972362995147705, 16.668582916259766, "rough several steps to ensure data quality. First, we check to make sure the reported monthly payments, if repeated for 30 years, would pay off the reported mortgage balance. For the small number of households that do not pass this test, as well as o"] [2.873854637145996, 16.602624893188477, " insurance prices with flood insurance prices from the 2016 NFIP PMF. For households reporting that all insurance pay- ments were included in their mortgage, this value is $0. If other households did not report a value for expenditure on insurance no"] [2.777722120285034, 16.624616622924805, "chased for 30 years. Under these assumptions, the equation for PV when moving from scenario B to scenario G is\n29 scenario G annual price \u2013 scenario B annual price\nPV = \u2211 t=0\n.\n(1.04 )t where t is time from the present in years.\nEconomic Effects Mode"] [2.8589134216308594, 16.566442489624023, " the current loan-to-value ratio increases. Gyourko and Tracy (2014) find similar results using more recent FHA insured mortgage data, but we use values from Wong, Fong, and Sze (2004) because they cover a broader range of current loan-to-value (CLTV"] [2.987328052520752, 16.493894577026367, " income and housing costs were only asked when the property was the primary residence of the owner. An asterisk at the end of a question indicates that the question was mandatory.\n179\n180 The Cost and Affordability of Flood Insurance in New York City"] [3.008708953857422, 16.435367584228516, "et for Residential Properties, Santa Monica, Calif.: RAND Corporation, RTR-468- FEMA, 2007. As of March 15, 2017:\nhttp://www.rand.org/pubs/technical_reports/TR468.html\nDixon, Lloyd, Noreen Clancy, Bruce Bender, Aaron Kofner, David Manheim, and Laura "] [3.001288890838623, 16.531208038330078, "ortgage Default,\u201d Journal of Urban Economics, Vol. 80, March 2014, pp. 87\u201396.\nHorton, Radley, Christopher Little, Vivien Gornitz, Daniel Bader, and Michael Oppenheimer, \u201cNew York City Panel on Climate Change 2015 Report Chapter 2: Sea Level Rise and "] [2.9497151374816895, 16.34833335876465, "lient-neighborhoods/canarsie.page\n\u2014\u2014\u2014, \u201cEast Shore Neighborhoods,\u201d nyc.gov, undated(b). As of March 22, 2017: http://w w w1.nyc.gov/site/planning/plans/resilient-neighborhoods/east-shore.page\n\u2014\u2014\u2014, \u201cGerritsen Beach,\u201d nyc.gov, undated(c). As of March 2"] [2.999507427215576, 16.654577255249023, "ber 1988. As of April 6, 2017:\nhttps://oig.hhs.gov/oei/reports/oai-04-88-01280.pdf\nU.S Department of Housing and Urban Development, \u201cMortgage Credit Analysis for Mortgage Insurance on One- to Four-Unit Mortgage Loans (4155.1),\u201d hud.gov website, March"] [2.947136878967285, 16.540571212768555, " might increase premiums and analyzes the potential consequences of those increases on households and communities.\nIt also develops and evaluates several different approaches for assisting households that have difficulty affording flood insurance. Th"] [4.901724338531494, 13.856234550476074, " CORPORATION\nInjury and Illness\nSurveillance of U.S.\nAgricultural Workers\nAssessment of Recommendations and Actions Ramya Chari, Amii M. Kress, Jaime Madrigano\nFor more information on this publication, visit www.rand.org/t/RR1500\n Published by the R"] [-0.41307932138442993, 13.587916374206543, "ability, and water resource man- agement and coastal protection. Program research is supported by government agencies, foun- dations, and the private sector. This program is part of RAND Justice, Infrastructure, and Environment, a division of the RAN"] [4.882234573364258, 13.831254959106445, " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nCHAPTER FOUR\nProject Approach: Criteria Development and Assessment of Actions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Criter"] [4.847657680511475, 13.801015853881836, " . . . . . . . . . . . . 59\nReferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61\nFi"] [4.863466262817383, 13.818257331848145, ". . . . . . . . . . . . . . . . . . .\n4.4. PolicyScale........................................................................................\n4.5. Timing Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."] [4.9291605949401855, 13.8839750289917, " . . . . . .\n43\n44 . 45 . 47\n48 . 52\n. 52 .58\nSummary\nAgriculture remains one of America\u2019s oldest and most valued industries, but it is also one of the most hazardous. According to the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries "] [4.885343551635742, 13.839228630065918, "alth and Safety, \u201c2014 Fact Sheet: Childhood Agricultural Injuries in the U.S.,\u201d Marshfield, Wisc., 2014.\n6 NIOSH, \u201cAgriculture, Forestry, and Fishing,\u201d web page, last updated July 11, 2017.\n ix\nx Injury and Illness Surveillance of U.S. Agricultural"] [4.874352931976318, 13.828041076660156, "d information on planned allocation of resources within the AgFF Program, for the costs and resources criterion, we presented general estimates and a descriptive assessment of implications. For each action, we calculated average scores across criteri"] [4.885915756225586, 13.84000015258789, "ity of the Childhood Agricultural Injury Survey by extending the sample to include labor aggregators.\n4.2: Collaborate with the National Agricultural Worker\u2019s Survey to field a supplementary module targeted at children who work as hired farmworkers o"] [4.892597198486328, 13.846653938293457, "1.1: Develop definitions and taxonomy\n5.2: Evaluate sources of surveillance data\n3.1: Field the National Agricultural Worker\u2019s Survey and hired worker survey\n4.1: Improve validity of the Childhood Agricultural Injury Survey\n8.2: Monitor alternative a"] [4.930129528045654, 13.884594917297363, "al thanks to our reviewers, John Mendeloff (University of Pittsburgh) and Christopher Nelson (RAND), who provided valuable and insightful comments that strengthened the report.\n xiii\nAbbreviations\nAg Center AgFF BLS CAIS CDC CIPSEA CWCS DOL EPA\nETA F"] [4.9363908767700195, 13.890785217285156, "f Occupational Injuries and Illnesses (SOII), in 2015, almost 36,000 farmworkers engaged in animal and crop production experienced an injury event (5.8 per 100 full-time workers).5 An estimated 1,900 farmworkers suffered an illness event (31.8 per 10"] [4.926869869232178, 13.881087303161621, " of the National Institute for Occupational Safety and Health in Agricultural Injury and Illness Surveillance\nSome of the agricultural injury, illness, and fatality statistics cited above are the outputs of large and sophisticated data collection eff"] [4.913882732391357, 13.866069793701172, "nd Surveillance Activities at NIOSH\nThe mission of NIOSH, established by the Occupational Safety and Health Act of 1970, is \u201cto develop new knowledge in the field of occupational safety and health and to transfer that knowledge into practice.\u201d15 NIOS"] [4.938769340515137, 13.893717765808105, "Law 101-517, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appro-\npriations Act, 1991, November 5, 1990.\n18 Bureau of Economic Analysis, \u201cRegional Data: Annual State Personal Income and Employment; Full-Time and"] [4.894460678100586, 13.850008010864258, " on adult farmers and farmworkers (\u226520 years) on all farms\nPopulation-based injury survey (NASS) focused on adult farmers and farmworkers (\u226520 years old) on minority- operated farms\nPopulation-based injury survey (NASS) focused on nonfatal injuries t"] [4.920936584472656, 13.87520980834961, "e awareness of farm-related risks to children culminated in NIOSH establish- ing the National Childhood Agricultural Injury Prevention Initiative in 1996.24 Through the initiative, the AgFF Program has supported a wide range of activities to decrease"] [4.914085388183594, 13.867237091064453, "he National Children\u2019s Center (NCC) for Rural and Agricultural Health and Safety.27 Through the Ag Centers, NIOSH has grown regional capacity to address agricultural safety and health issues. As shown in Table 1.1, given the diver- sity of farming op"] [4.981173038482666, 13.934865951538086, "ula- tions by the Occupational Safety and Health Administration (OSHA) under the Occupa-\n27 NIOSH, \u201cCenters for Agricultural Disease and Injury Research, Education, and Prevention,\u201d web page, last updated October 3, 2017.\n28 National Research Council"] [4.974509239196777, 13.92791748046875, "included inpatient and emergency department records, pre-hospital care reports, and death certificates. In addition, electronic news sources were reviewed for their potential as a supplemental source of agricultural fatality reporting.\nTitle: Surveil"] [4.9305620193481445, 13.885249137878418, "atest estimates from the 2015 Farm Labor Survey, about 45 percent of the nation\u2019s farms employ fewer than 11 hired workers (this estimate does not include migrant, seasonal, or unpaid workers).32 In addition, 88 percent of U.S. farms are classified a"] [4.93237829208374, 13.8867769241333, "nomics, the agricultural industry has also witnessed declines in injuries and illnesses across child and adult worker populations. According to data from the Child Agriculture Injury Survey (CAIS), from 1998 to 2012, the rate of childhood agricultura"] [4.9319748878479, 13.886922836303711, "ultural workforce and decline in injury and illness rates, led NIOSH to\n37 NCC, \u201c2014 Fact Sheet: Childhood Agricultural Injuries in the U.S.,\u201d Marshfield, Wisc., 2014.\n38 BLS, \u201cIndustry Injury and Illness Data,\u201d web page, last updated May 10, 2017 ("] [4.898167610168457, 13.852360725402832, "mmendations for improvement: (1) establish strategic goals for improvement in lead- ership, administration, and evaluation; (2) develop a cohesive program that provides national leadership in agricultural, forestry, and fishing safety and health; (3)"] [4.896796703338623, 13.851329803466797, "of this report is to provide NIOSH with a practical assessment of the feasibility and desirability of carrying out actions to meet surveillance-related recommendations given current AgFF Program resources and priorities. Many actions for meeting reco"] [4.888383388519287, 13.84274673461914, " This chapter focuses on the identification of recommendations and the development of actions and introduces the final list of actions we considered in the assessment.\nThe 2012 AgFF Program panel review offered numerous points of guidance for activit"] [4.8991875648498535, 13.85356616973877, "ort\n Theme\nTheme 1: Define and characterize agricultural worker populations at risk\nTheme 2: Review ongoing or new data sources for injury and illness surveillance among agricultural workers\nTheme 3: Analyze, report, and communicate surveillance fin"] [4.906836032867432, 13.86241626739502, " in recommendation 5, we added\nPress, 2008; National Occupational Research Agenda Agricultural, Forestry, and Fishing Sector Council, National Agricul- ture, Forestry, and Fishing Agenda: For Occupational Safety and Health Research and Practice in th"] [4.881719589233398, 13.835782051086426, "sources for use in surveillance), which was not included in the panel report, because of (1) overall need for such an assessment, as evidenced by sources beyond the panel report, and (2) as a complement to action 5.1 (evaluation of the NASS sur- veys"] [4.880566596984863, 13.834540367126465, "ving specific actions.\n 17\n18 Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions\nTable 3.1\nActions by Implementation Mechanism\nAction Description\nActions achievable through extramural funding mecha"] [4.848292827606201, 13.80019474029541, "creased collaboration between funder and awardee, the principal investigator will still ultimately drive the direction of research based on the objectives defined in the original proposal. A potential solution would be to issue a contract. Contracts "] [4.823596000671387, 13.777432441711426, "ry. In 2014, NIOSH issued a funding opportunity announcement (FOA) under the U01 cooperative agreement mechanism to conduct research related to agricultural injury and dis- ease.2 The FOA noted that any application that focused on occupational safety"] [4.871485233306885, 13.825079917907715, "sks and time frames needed to either fully complete the action or ensure that implementation results in meaningful impacts. The satisfactory version refers to our estimation of tasks and time frames that may result in lesser (compared with the ideal)"] [4.875336647033691, 13.829392433166504, "oyment and migration; earnings, benefits, and worksite characteristics; health, safety, and housing; and income and assets, social services, and legal status. NIOSH has worked with DOL since 1999 to add injury modules to the NAWS.6\nBecause of the NAS"] [4.842654705047607, 13.79586410522461, "n an as-needed basis or on request.\nTable 3.5\nImplementation Plan for Actions Achievable Through Direct NIOSH Action\n Action\nAction 6.1 Action 6.2\nOverall Mechanism\nDirect action Direct action\nPartnerships\nPossible Resource Capability Partners Partn"] [4.851620197296143, 13.803953170776367, "the data from the team assessment and the expert input to develop final cost ranges.\n 23\n24 Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions\nTable 4.1\nSummary of Approaches for Estimating Costs\nA"] [4.842982769012451, 13.796107292175293, " timeline estimates.\nPartnerships\nThe two scales presented in Tables 4.2 and 4.3 were used to rate actions on the partnership criterion for resource and capability partner scenarios. The scales cover a range of partnership scenarios that incorporate "] [4.8395490646362305, 13.79280948638916, "ners, and is avail- able in forms that are relevant and usable is critical for the accomplishment of actions and asso- ciated recommendations. The scale in Table 4.3 was used to rate actions on the information availability and accessibility criterion"] [4.839302062988281, 13.792068481445312, "thin a reasonable time frame (e.g., zero to two years); see Table 4.5.\nEstimates for timelines were developed similarly to cost estimates. For actions achievable through extramural funding mechanisms, we again used similar projects as benchmarks to d"] [4.8545989990234375, 13.80777359008789, "In 2016, after completion of the research phase of this project, NIOSH developed a framework for prioritizing research through an assessment of burden (what is the magnitude and severity of the problem and the societal costs), need (why is it importa"] [4.8476152420043945, 13.800661087036133, "e high quality (e.g., collected regularly, have standardized protocols, have large geographic and population coverage, and allow for subgroup inferences) and are useful for many purposes but do not perfectly address the specific action.\nInformation c"] [4.818747520446777, 13.772424697875977, "ome potential for negative impact that could be mitigated through precautionary steps (e.g., robust training and data safeguards).\nAction would moderately decrease the utility of existing information or create minor barriers to access.\nAction would n"] [4.89667272567749, 13.851003646850586, "imitations of each associated action using the assessment criteria as a framework (costs and other resources, partnerships, information availability and accessibility, policy, timing, program surveillance goals and priorities, information quality, an"] [4.866418361663818, 13.8203763961792, "ill vary according to worker characteristics (e.g., age and gender), geographic location of operations, commodity specialization (e.g., fish farm, cereal crops, and type of livestock), and the specific tasks that are performed. Furthermore, the repor"] [4.848438739776611, 13.801945686340332, " award. We estimated a\nTable 5.1\nAction 1.1\u2019s Implementation Plan\n Action\nAction 1.1\nExtramural Mechanism\nContract\nResource Partner\n\u2014\nCapability Partner\nAg Centers, research organizations\nResources\n$150K\u2013$250K\nTimeline\n5 months for initiation; 1\u20131.5-"] [4.9345526695251465, 13.889137268066406, "ther than injury and illness esti- mations, it is uncertain how relevant an ideal classification system might be in practice.\n1 National Occupational Research Agenda Agricultural, Forestry, and Fishing Sector Council, National Agriculture, For- estry"] [4.931432723999023, 13.886139869689941, " States, with most cropland on farms of at least 1,100 acres and many farms five and ten times that size.8 Clearly, the trend in U.S. agricultural production has been to shift away from small farms to very large farms and nonfamily farms. Consequentl"] [4.874962329864502, 13.828354835510254, "e farmwork- ers\u2019 vulnerability, the panel report recommended focusing on hired farmworkers as a priority for surveillance efforts. Action 3.1 addresses this recommendation.\nAction 3.1. Collaborate with the NAWS to field supplementary modules on occup"] [4.881979465484619, 13.835688591003418, "an injury module to be added to the NAWS for a three-year period. The prior interagency agreement specified a sample size of 1,500 at a cost of approximately $700,000. We assumed that an increased sample size would be required in future years to gene"] [4.902869701385498, 13.85679817199707, "yed in any occupation on a farm owned or operated by their parents (or people standing in place of their parents).13 Given their engagement in farm operations and lower experience or skill level, children in agri- culture may face the same hazards af"] [4.863185882568359, 13.817358016967773, "gricultural Workers: Assessment of Recommendations and Actions\nCapability partners: This action pertains specifically to partnership with USDA on the CAIS. Because NIOSH does not itself administer the survey, USDA retains the capabilities necessary f"] [4.873251914978027, 13.82702350616455, "echanisms, and data processing techniques. Because the CAIS is based on NASS survey procedures, the col- lected data are considered to be high quality.\nAction impacts: Improved representativeness would increase the utility of CAIS data; however, ther"] [4.884836196899414, 13.838949203491211, " collected if resources are provided. Overall, data are technically available and acces- sible, but there are resource barriers to actually obtaining the data.\nPolicy: Interagency agreements may require lengthy lead time and coordination to accommoda"] [4.889821529388428, 13.844565391540527, "ssed for their utility in injury and illness surveillance for agricultural worker populations (e.g., federal agricultural and occupa- tional health surveys, state occupational health surveillance systems, trauma registries, death registries, claims d"] [4.849825859069824, 13.803659439086914, "ons would be made for improvements and a strategy forward. See Table 5.5.\nResource partners: Potential partners for this action may include institutions that cham- pion certain data sources for broad-based use, such as NIOSH\u2019s CWCS. Workers\u2019 compen- "] [4.8837432861328125, 13.837064743041992, "r information. The high-end estimate includes the low-end estimate tasks and, in addition to the evaluation, would involve obtaining data from the most-promising sources. This would enable a comparative analysis of injury and illness estimates, and t"] [4.8989338874816895, 13.853367805480957, "ultural worker safety and health risks\nNIOSH has traditionally used grouped five-year age cohorts for children and youth (e.g., younger than ten, ten to 14, 15 to 19). The 15\u201319-year-old aggregation, however, includes individuals who would not be sub"] [4.88557767868042, 13.83970832824707, "e needed data, different kinds of analyses could be performed. Therefore, given the uncertainty regarding how this action might\nTable 5.6\nAction 6.1\u2019s Implementation Plan\nOverall\nAction Mechanism Resource Partner Capability Partner Resources Timeline"] [4.8926568031311035, 13.846484184265137, "tely developed and tar- geted. NIOSH has released demographic data indicating whether children are hired or unpaid (family members).24 According to NIOSH, it would be difficult to release existing data on children who are self-employed, given the sma"] [4.878942012786865, 13.832733154296875, "ion). Reports that lack details on these con- texts limit the ability to accurately define vulnerable groups and identify potentially hazard- ous work settings. Including these descriptions in reports will enable optimal comparability of surveillance"] [4.882169246673584, 13.836702346801758, "s action.\nProgram surveillance goals and priorities: NIOSH AgFF Program leadership consid- ered this action to be an important priority.\nInformation quality: The ability to carry out this action depends on the overall qual- ity and completeness of th"] [4.875057220458984, 13.828937530517578, "develop means for data- sharing and communications).\nCost and resources: Ongoing partnership development will result in uncertain costs, so we do not present fixed estimates. Internal NIOSH resources should be expended to develop a strategy, however,"] [4.8922295570373535, 13.846527099609375, "ns for human health (zoonosis, water contamination, and other environmental changes). In addition to sug- gesting that NIOSH monitor the impact of these new systems on health and safety, the panel recommended that the NCC monitor developments and dev"] [4.871383190155029, 13.824786186218262, "n availability and accessibility: Alternative animal production systems are relatively new and evolving rapidly. There are hypotheses\u2014e.g., increased risk of zoonotic dis- eases from so-called free-range livestock\u2014about the potential injuries and ill"] [4.842685222625732, 13.796157836914062, "ls and priorities, information quality, and action impacts.\nOverall, we found that direct-action and extramural funding mechanisms tended to show higher overall achievability than did actions that depended on partner capabilities for imple- mentation"] [4.840845584869385, 13.794559478759766, "y\n8.1: Partner for zoonotic disease\nMechanism Cost per Year\na Duration Achievability Feasibility Desirability\n(years) Score\nScore Score\n4.20 3.67\n3.60 4.67\n3.40 4.67\n3.20 4.00\n3.20 3.67\n3.00 3.33\n3.00 3.33\n EXF $150K\n$170K 1\nEXF $175K\n$160K 5\nPART $1"] [4.821390628814697, 13.77408218383789, "00 (1.1)\n $2,000,000 (4.2, 8.1)\n Desirability\n5.0\n4.5\n4.0\n3.5\n3.0\n2.5\n2.5 3.0 3.5\n Feasibility\nNOTES: Cost estimates are shown for the satisfactory version of the action. Action 8.1 had the same feasibility and desirability scores as action 4.2"] [4.8347554206848145, 13.786579132080078, "acts. Action items will need to be evaluated individually to ascertain whether the ideal version would need to be implemented. For instance, to properly evaluate the potential value of exist- ing data sources for injury and illness surveillance (acti"] [4.859551429748535, 13.812856674194336, "ons based on average desirability score are the following:\n\u2022 3.1: Collaborate with the NAWS to field supplementary modules on occupational health outcomes among hired farmworkers and perform specific analyses on variability of risk.\n\u2022 4.1: Improve th"] [4.853172779083252, 13.806792259216309, "orkers within these systems.\nEach of these actions would be achieved through a partnership mechanism and, therefore, tended to have lower feasibility scores. In particular, each of these three actions had a low score (2) in the category of informatio"] [4.893844127655029, 13.848769187927246, "validity of the CAIS PART 4.2: NAWS, child injury survey PART 8.1: Partnerships for zoonotic disease PART\nNOTE: EXF = extramural funding; PART = partnerships.\nEstimated Total Cost\n$150K $250K $350K $350K\n$500K\n$800K ~$1 million\n\u2014\n\u2014 \u2014\u2014\u2014\u2014\n Version\nSati"] [4.885950565338135, 13.840188980102539, "rred in spite of challenges that the program has faced in instituting a comprehensive agricultural injury and illness surveillance program over the years. These challenges include the diversity of the agricultural industry itself; changing injury and"] [4.839431285858154, 13.7928466796875, " addition, NIOSH could choose to pursue one or two actions that are considered highly impactful but also high in cost and low in feasibility. Resources would be targeted to building partnerships or gather- ing the resources necessary to enhance the f"] [4.970031261444092, 13.923462867736816, "Fishing Safety and Health Research (U01),\u201d funding opportunity announcement, April 10, 2014. As of March 10, 2016: http://grants.nih.gov/grants/guide/pa-files/PAR-14-175.html\nDepartment of Labor, Child Labor Requirements in Agricultural Occupations U"] [4.9312005043029785, 13.885066032409668, " \u201cA Proposed Classification Code for Farm and Agricultural Injuries,\u201d American Journal of Public Health, Vol. 83, No. 5, 1993, pp. 736\u2013738.\nNational Children\u2019s Center for Rural and Agricultural Health and Safety, \u201cNational Children\u2019s Center for Rural"] [4.9318647384643555, 13.885499954223633, "dc.gov/niosh/topics/aginjury/naws/\n\u2014\u2014\u2014, \u201cAgricultural Safety: National Agricultural Workers Survey (NAWS); Hired Crop Worker Injury Rate Tables,\u201d web page, last updated May 12, 2017. As of August 30, 2017: http://www.cdc.gov/niosh/topics/aginjury/naw"] [4.949841022491455, 13.903471946716309, "ewDocumentInfo.do;jsessionid=F154BA78C7C50C021C8CA9 24EDB72FD5?documentID=1063\n\u2014\u2014\u2014, 2007 Census of Agriculture: U.S. Summary and State Reports, Vol. 1, Washington, D.C., 2009. As of March 10, 2016:\nhttp://www.agcensus.usda.gov/Publications/2007/Full_"] [13.807717323303223, 4.736971855163574, " For more information on this publication, visit www.rand.org/t/RR1775-1\n Library of Congress Cataloging-in-Publication Data is available for this publication. ISBN: 978-0-8330-9793-4\nPublished by the RAND Corporation, Santa Monica, Calif. \u00a9 Copyrig"] [18.600383758544922, 12.574357986450195, " Maltreated children fare worse than their peers on many important outcomes within these domains. The effects can persist and have long-term consequences into adulthood, including reduced labor market productivity, increased involvement with the crim"] [18.573383331298828, 12.602485656738281, "o young adulthood, manifested in numerous ways, including home- lessness, underemployment, criminal conviction, and substance abuse. Overall societal costs associated with child maltreatment may total $80 billion annually (Gelles and Perlman, 2012).\n"] [18.57581901550293, 12.601140975952148, "ion lead to decreases in mal- treatment and improvements in young adult outcomes but do not affect the experiences of children who enter the system and result in small additional costs. Increases in treatment lead to improvements in system experience"] [18.544584274291992, 12.634252548217773, "t events\nin the model (e.g., maltreatment, referral to the system, placement in foster home). The baseline model, therefore, is intended to represent the current situation. We then used the model to assess the average effects relative to baseline of "] [18.58558464050293, 12.592716217041016, "the child welfare system, whether to emphasize in-home options or out-of-home placements.\nWhat Effects Do Individual Policies Have?\nTo understand the effects of individual policies, we estimated how\nthe quantity and quality of preventive services, fa"] [18.596986770629883, 12.58073616027832, "s in the model, such as the Nurse-Family Partnership, have been shown to have a number of positive benefits for children and families beyond reducing the likelihood of maltreatment (Olds, 2006). These benefits include improved infant and child health"] [18.596309661865234, 12.582893371582031, "reservation efforts led to changes in the young adult outcomes, with the largest changes when both quantity and quality of the policy were increased. The effects ranged from 0.4 to \u20139.8 percent for substance abuse, from \u20133.6 to \u201311.2 percent for crim"] [18.60287094116211, 12.574834823608398, "that we considered achieves all these objectives.\nWe estimated the effect of a policy package that combined increases in preventive services and treatment in the form of support for kinship care. The results are summarized as a range for this combine"] [18.589773178100586, 12.589373588562012, "ystem and their outcomes in young adulthood. Family preservation and kinship care efforts also lead to reductions in the overall cost of the system because they promote placements that are less costly than the other options (foster care or residentia"] [18.56559944152832, 12.61378002166748, "mber of important improvements, including more-specific informa- tion on pathways through the system; better data on children\u2019s experiences in the system; and information on how the child welfare system interacts with other related systems, such as e"] [18.578758239746094, 12.594955444335938, "hly engaged and provided invaluable input throughout the entire process. We are particularly grateful for her assistance in identifying and connecting us with experts to provide input into the model.\nSusan Gates, director of RAND\u2019s Office of Research"] [18.583776473999023, 12.589956283569336, "m et al., 2017) and lifetime substantiated maltreatment at 12.5 percent (Wildeman et al., 2014). Child maltreatment has been linked with child and family characteristics, such as a child\u2019s age, race/ethnicity, gender, and special needs status (Sedlak"] [18.579235076904297, 12.596457481384277, "protec- tive and negative effects of the child welfare system are intertwined with the effects of the maltreatment itself, making it difficult to sepa- rate them when looking at outcomes (Masten and Wright, 1998).\nOver time, the effects of maltreatme"] [18.567310333251953, 12.609894752502441, " a mix of state and local funding (DeVooght and Cooper, 2013). This total likely does not include funding for all child maltreat- ment preventive services. The survey that generates these estimates asks about funding for these services provided at th"] [18.56724739074707, 12.609427452087402, "el that estimates the average effect of implementing the policy in all jurisdictions across the country. To simulate the effect for a particular state or locale, the model assump- tions and data would need to be changed to better reflect the populati"] [18.57453727722168, 12.604591369628906, "tment and detection component of the model until he or she leaves childhood.\nSystem Pathways\nThe child welfare system pathways component of the model represents the possible pathways through the child welfare system for a child whose suspected maltre"] [18.573373794555664, 12.60687255859375, "of risk and protective factors ultimately influence how children fare over time. The outcomes are influenced by the circumstances that led to the maltreat- ment itself and, to some extent, the involvement with the child wel- fare system. At the same "] [18.5703125, 12.608065605163574, "stimate the effect of implementing several different policy, program, or practice changes.\nThese steps are briefly described below and in greater detail in Appendix B, available on the project website (www.rand.org/ child-welfare-model).\nStep 1: Lite"] [18.57178497314453, 12.607535362243652, "as poverty rate.1\nTo simulate the experiences of these children, we had to determine their chances of experiencing each of the many child welfare events and/or outcomes in our model. We pooled information from admin- istrative data, survey data, agen"] [18.57147789001465, 12.606226921081543, "thood: underemploy- ment, homeless- ness, criminal conviction,\nand substance abuse.\nand Foster Care Analysis and Reporting System (AFCARS) 2013 data set,\nas well as AFCARS reports 18\u201322. We also reference the National Survey\nof Child and Adolescent W"] [18.572996139526367, 12.605537414550781, "he outcomes model, we estimated the consequences of these childhood experiences on the odds of four kinds of negative life outcomes in early adulthood:4 un-\n3 A typical goal for calibration is to get model outputs that are within the natural variance"] [18.5732364654541, 12.605246543884277, "n how both risk and protective factors interact and the uncertainties about the causal pathways. However, it allows for an understanding of how child maltreatment and system involvement affect outcomes into young adulthood and beyond.\nStep 7: Simulat"] [18.58924674987793, 12.587532997131348, "ltreatment (e.g., neglect and physical abuse); the estimates have been adjusted to account for this.\nEfforts to prevent maltreatment will also occur during this period. Collectively, our model estimates that prevention efforts, such as home visiting "] [18.583694458007812, 12.593576431274414, "is made about whether a child will be kept in the home or placed in out-of-home care.\nLower-risk cases are generally provided in-home services and sup- ports, such as family preservation, parent education, safety planning, and counseling, or are refe"] [18.58102798461914, 12.590921401977539, " in 2016 dollars. As recommended by the National Academies of Sciences, Engineering, and Medi- cine (2016), we apply a discount rate of 3 percent to account for future costs.\n6 Homelessness is defined as spending at least one week as an individual wh"] [18.596107482910156, 12.577106475830078, "eavy drinking, defined as typically consuming five or more drinks three times per week, and drug use, defined as use within the past year of cocaine, amphetamines, hallucinogens, or heroin, but not tobacco, marijuana, or prescription drugs.\n 19\nBelo"] [18.596046447753906, 12.576750755310059, "pproaches, home vis- iting is the most widely studied. A number of assessments have found associations between prevention approaches and reductions in the risk factors for child maltreatment. However, the evidence for reductions in child maltreatment"] [18.598651885986328, 12.580713272094727, "e services lower maltreatment by 42%\n A: Increase quantity\n50% increase in preventive services\nSame as baseline (preventive services lower maltreatment by 30%)\n C: Increase both quantity and quality\n50% increase in preventive services\nPreventive ser"] [18.593595504760742, 12.586505889892578, " Detection, Percentage Change from Baseline\nScenario A \u20130.2%\nMaltreatment episodes\nReferrals to child welfare\nRAND RR1775x1-4.3\nScenario B \u20130.3%\nScenario C \u20130.6%\n \u20131.4%\nprovided by other agencies or community-based organizations may not be incl"] [18.601655960083008, 12.577735900878906, "entive services would reduce lifetime referrals by 0.6 percent relative to baseline.\nSystem Pathway. With fewer overall referrals, fewer children enter and flow through the system (Figure 4.4). In Scenario A, which increases only the quantity of prev"] [18.60035514831543, 12.578632354736328, "he system. Across all the young adult outcomes, reductions range from 3.4 to 3.6 percent.\n\u20131.6%\n\u20131.5%\n\u20131.6%\n\u20131.6%\n\u20133.5%\n\u20133.4%\n\u20133.6%\n\u20133.6%\n 25\nFamily Preservation Services\nFamily preservation programs are designed to prevent out-of-home placements or "] [18.634511947631836, 12.545075416564941, "eipt of supports and services for transition to adulthood\n A: Increase quantity\n10% increase in number of in-home placements;\n10% increase in family preservation services\nSame as baseline\n C: Increase both quantity and quality\n10% increase in number "] [18.56704330444336, 12.611405372619629, "tion services are implemented significantly affects how children fare in terms of subsequent maltreat- ment and detection.\nIn our quantity scenario (A), the average number of maltreatment episodes increased 2 percent. The number of referrals for malt"] [18.598058700561523, 12.581599235534668, " quantity of family preservation services\n 29\n FIGURE 4.9\nEffects of Family Preservation Scenarios on Costs, Percentage Change from Baseline\n+0.2%\nScenario A\nScenario B\nScenario C\n \u20139.9%\n\u20139.1%\n\u20136.7%\n\u20136.2%\n\u201313.7%\n\u201312.7%\n Prevention spending\nCh"] [18.5953369140625, 12.583840370178223, "s themselves, home visiting, mentoring, counseling, respite care, and legal services (Lin, 2014). How and where services are offered varies significantly (for example, they can be peer to peer, provider-led, school-based, or community-based). Trainin"] [18.62986946105957, 12.550223350524902, "ys through the system and have\n11 These services cumulatively reduce the risk of underemployment, substance abuse, criminal conviction, and homelessness by 31, 39, 47, and 73 percent, respectively.\n 32\n FIGURE 4.11\nEffects of Kinship Care Scenarios "] [18.61672019958496, 12.563136100769043, " kinship care in the model (Table 4.4). The first, which focuses on quantity, results in a 50-percent increase in the quantity of funded preventive services and in the number of children placed with kin (Scenario A). The second option focuses on qual"] [18.60257339477539, 12.579558372497559, "rio C will reduce referrals by 0.6 percent.\nSystem Pathway. Under the combined prevention and kinship care approach, increasing quantity will result in small decreases in investiga- tions (\u20130.3 percent) and substantiations (\u20131.3 percent) and an 8.3-p"] [18.6253719329834, 12.554132461547852, "D RR1775x1-4.15\n FIGURE 4.16\nEffects of Combined Approach of Prevention and Kinship Scenarios on Outcomes, Percentage Change from Baseline\nScenario A\nHomelessness Underemployment Substance abuse Criminal conviction\nRAND RR1775x1-4.16\nScenario B\nScena"] [18.601186752319336, 12.576233863830566, "e options that intervene at different points in the system and have been discussed by policymakers. The options work in different ways. Preventive services are designed to prevent child maltreatment from occurring and thus reduce the number of childr"] [18.597251892089844, 12.58065128326416, "er workforce participation, and less reliance on public assistance.\nIncreasing preventive services requires new expenditures to provide services to more children. The increase is partially offset by reductions in spending on screenings, investigation"] [18.59676742553711, 12.582005500793457, "system. Rather, for children who require a temporary out-of-home placement, the option seeks to increase the proportion placed with kin and provide services and supports to the kin caregivers to ultimately decrease time in care and increase the child"] [18.57290267944336, 12.606805801391602, "objectives.\nLimitations\nOur approach has several limitations. The model provides a simplified representation of the child welfare system, which is extremely com- plicated. Building such a model requires many assumptions. In many cases, the available "] [18.554500579833984, 12.628169059753418, "nt with arguments that AFCARS under- represents children who move between many temporary placements and age out instead of finding a permanent placement. However, it is difficult to say how much of the discrepancy represents real differences in the s"] [18.567827224731445, 12.609832763671875, "hway through the child welfare system. Moreover, there is very little evidence that can help to disentangle the effects of maltreatment from the effects of system experience on outcomes. To address this problem, we augmented the information we found "] [18.54493522644043, 12.635724067687988, "implement are made at the state and local levels, so a jurisdiction-specific model is likely more valuable for informing specific policy decisions. Adapting the model to specific jurisdictions would allow a number of import-\nant improvements, includi"] [18.546892166137695, 12.628369331359863, "s of the child welfare system\nor subpopulations of children or families, this is the first attempt to integrate maltreatment risk, detection, pathways through the system, and consequences in a comprehensive quantitative model that can be used to simu"] [16.885053634643555, 8.040090560913086, " Department of Health and Human Services, 2013.\nCourtney, M., A. Dworsky, J. Lee, and M. Raap, \u201cMidwest Evaluation of the Adult Functioning of Former Foster Youth: Outcomes at Age 23 and 24,\u201d Chicago, Ill.: Chapin Hall at the University of Chicago, 2"] [16.820768356323242, 8.03641128540039, "y Connection Discretionary Grants, 2009-Funded Grantees Cross-Site Evaluation Report, Arlington, Va., 2013.\nJames Bell Associates, Profiles of the Active Title IV-E Child Welfare Waiver Demonstrations, Arlington, Va., 2016.\nJones Harden, B. J., \u201cSafe"] [16.817766189575195, 8.033586502075195, "t, Saint Paul, Minn.: Wilder Research, 2012.\nOlds, D. L., \u201cThe Nurse\u2013Family Partnership: An Evidence\u2010Based Preventive Intervention,\u201d Infant Mental Health Journal, Vol. 27, No. 1, 2006, pp. 5\u201325.\nOlds, D. L., J. Eckenrode, C. R. Henderson, Jr., H. Kit"] [16.793527603149414, 8.05199909210205, "tration on Children, Youth and Families; Children\u2019s Bureau, Child Maltreatment 2014, Washington, D.C., 2016.\nWashington State Institute for Public Policy, Intensive Family Preservation Programs: Program Fidelity Influences Effectiveness\u2014 Revised, Oly"] [11.344047546386719, 17.71175765991211, " JUSTICE, INFRASTRUCTURE, AND ENVIRONMENT\nAccess to Medical\nTreatment for Injured\nWorkers in California\nYear 1 Annual Report\nAndrew W. Mulcahy, Madeline B. Doyle, Rosalie Malsberger, Kandice A. Kapinos\nFor more information on this publication, visit "] [11.376241683959961, 17.5784912109375, "ct to peer review and disseminated widely to policymakers, practitioners in law and business, other researchers, and the public.\nICJ is part of RAND Justice Policy within RAND Justice, Infrastructure, and Environment, a division of the RAND Corporati"] [10.3382568359375, 18.98421287536621, "............................................9 Overview of Approach ........................................................................................................................9 Data and Study Sample........................................"] [10.300031661987305, 19.056901931762695, "............................................46\n iv\nAppendix A. Additional Tables.................................................................................................48 Appendix B. Statistical Code Used to Determine Provider and Service Ty"] [10.293608665466309, 19.202552795410156, "s from Injury to First E&M Visit (in Any Setting), by Injury Year and\nBody Part or Condition......................................................................................................25 Table 5.3. Days from Injury to First Non-ED E&M Visit"] [10.29849910736084, 19.198204040527344, "........................................48\nTable A.3. Number of Observations for Timeliness to Care\u2014First Non-ED E&M Visit, by Injury Year and Nature of Injury .......................................................................................49\n"] [10.358271598815918, 18.79827308654785, "rocesses might have affected the decisions of some providers in terms of their interaction with WC patients and the WC system. Although this report is not an evaluation study of the direct impact of these changes, it is important to assess the variou"] [10.333450317382812, 18.807607650756836, "experience (e.g., receipt of guideline-concordant care, aspects of obtaining an appointment and wait times, referral patterns). Finally, outcome measures reflect whether appropriate care was received and, ultimately, whether health was improved. Ther"] [10.352097511291504, 18.924015045166016, "ative data offer an important but limited window into access to care for injured workers. These data can be used to calculate a range of measures related to access to care for injured workers, such as the number of providers who treat injured workers"] [10.329739570617676, 19.00908088684082, "ges in WCIS data completeness. We also note that adjusting for multiple comparisons results in a loss of statistical significance for some of these trends.\n\u2022 We found an increase in the average number of claims per provider from 2010 to 2014 (from 47"] [10.26375961303711, 19.138134002685547, "ge in physician incentives through the transition to a new resource-based relative value scale (RBRVS) fee schedule for practitioner services as part of SB 863 changes, or some other factor. Further research is needed to investigate whether these red"] [10.2989501953125, 19.186594009399414, "rage number of PCPs seen in the year following injury fell slightly, from 1.24 to 1.21, and was relatively similar across injury types.\nPathways of Care\nWe examined \u201cpathways of care,\u201d defined by the initial visit setting and provider type and up to "] [10.400997161865234, 18.810579299926758, "r are related to, access to care for injured workers. In future reports, we will explore other measures, including provider-based measures and measures based on the network of providers. RAND is also separately conducting a study on the effect of the"] [10.639167785644531, 18.578805923461914, "care and indemnity (e.g., wage-replacement) benefits to workers who suffer on-the-job injuries and illnesses. Injured workers are entitled to receive all medical care reasonably required to cure or relieve the effects of their injuries with no deduct"] [10.418994903564453, 18.823440551757812, "Group, 2015). Although this report is not an evaluation study of the direct impact of any specific policy or other change, it is important to assess the various dimensions of access to care in the evolving policy environment to ensure that injured wo"] [10.33098316192627, 18.835369110107422, "ating in the WC system and an analysis of MPN listings.\n 2\nOrganization of This Report\nThis report describes the access measures that we implemented in our monitoring analyses. There are three sets of interrelated analyses. The first set focuses on p"] [10.346205711364746, 18.823572158813477, " Healthcare Quality and Research has devoted significant resources to better measurement (e.g., through the National Quality Measures Clearinghouse). Measures are often differentiated across three key elements: structures, processes, and outcomes (Do"] [10.379884719848633, 18.874284744262695, "s, there are limits to the extent that outcome and structural measures related to access can be calculated from these data (Berenson, Pronovost, and Krumholz, 2013).\nThere are several congressionally mandated access studies about the California WC sy"] [10.335992813110352, 19.23421859741211, ", when they saw them, and what kind of treatment or other health care services was provided. This information can be used to construct a map\u2014or a pathway\u2014to illustrate how an injured worker interacted with providers over time and may better reflect t"] [10.42067813873291, 18.947599411010742, "hom the length of time between each visit was fewer than 31 days.\n7\nFigure 2.1. Pathway Framework\n 8\n3. Data and Methodology Overview of Approach\nThis report includes analyses of WCIS data to examine medical treatment provided from 2010 through 201"] [10.332780838012695, 18.967851638793945, "entifier (NPI)\u2014during our study. The NPI can yield more-accurate counts of practitioners than TINs because each practitioner is assigned a unique NPI. The NPI field was, however, missing for many providers during our study period; as a result, we do "] [10.289897918701172, 19.1929988861084, " with one or more of the qualifying visits within 12 months of injury. We define the first visit as\n\u2022 an E&M visit with any provider: This measure is defined as the number of days from injury to the earliest visit date in any setting\n\u2022 a non-ED E&M v"] [10.419159889221191, 18.99094581604004, "jured workers. We cannot disentangle changes in the number of TINs over time caused by consolidation from decisions to treat or not to treat injured workers.\nThere are more-general limitations to using the WCIS medical data. First, not all WC claims "] [10.306447982788086, 19.15005111694336, " 2014, only about 1.5 percent of the claims were with out-of-state providers, but this varied from year to year, ranging from 1.5 percent in 2013 and 2014 to 5.8 percent in 2008. For these claims, the median time between the injury date and first E&M"] [10.235357284545898, 19.052814483642578, "ight increase using American Medical Association data and a slight decrease using Medical Board data (Coffman, Geyn, and Fix, 2017).\n 14\nFigure 4.1. Trend in Number of Providers Serving WCIS Patients\nSOURCE: Analysis of WCIS data from 2010 to 2014.\nN"] [10.25677490234375, 19.06378936767578, "combined psychiatry and behavioral health into behavioral health because of overlap in specialty. Results reported here are similar when comparing the disaggregated means.\n 16\nTrends in the Number of Claims per Provider\nIn Table 4.2, we present the n"] [10.262541770935059, 19.066301345825195, "0.35 10.71 11.05 13.02 13.26 146.65 148.07 157.45 166.94 178.06 49.46 53.70* 58.96 67.18 62.88 47.16 49.20 52.41 56.16 58.89\nChange (2014 Minus 2010)\n2.91 31.41 13.41 11.73\n SOURCE: Analysis of WCIS data from 2010 to 2014.\nNOTES: We excluded pr"] [10.256340980529785, 19.00535774230957, "70 87.66 535.91 437.81 710.87 981.53 13,85.19 1,452.50 99.21 99.72 365.84 397.10 394.07 416.62 484.39 505.59\n2013 2014\n191.51 214.72 150.09 149.68 188.21 200.33 219.75 216.96 27.02 25.09 160.92 182.60 815.61 865.30 184.60 135.23 149.11 124.58 519.60 "] [10.278186798095703, 19.075008392333984, "thesiology $22,592*\n2011 2012\n$8,108 $8,331 $23,418 $27,009 $65,776 $62,564 $14,476 $13,508\n$9,868 $10,393 $13,105 $13,083 $50,495 $53,309\n$18,476 $20,593 $36,879 $41,777 $35,213 $33,759\n$5,243 $6,162 $124,165* $128,421\n$20,651 $17,816 $12,270 $8,462"] [10.344167709350586, 19.11504364013672, "lts that are qualitatively similar to those reported in Table 4.6.\nThis analysis can identify changes over time in the mix of services utilized by injured workers, which may reflect changes in access. However, other changes, such as changes in clinic"] [10.313970565795898, 19.233577728271484, "s\nE&M\nMedicine Laboratory/pathology Radiology\nSurgery\nOutpatient facility services\nAnesthesia\nDME\nProsthetics/orthotic devices\nOther/unknown\nInpatient hospital stays\nNumber of Injuries (denominator)\n2010\n174.47** 439.99** 503.08** 25.86** 175.59** 18"] [10.299694061279297, 19.213939666748047, " Observations for Timeliness of Care Analysis, by Injury Year and Body Part or Condition\n All Injuries\nLow-back pain\nShoulder injuries\nKnee injuries\nUpper-back and neck injuries All other injuries\n2010\n261,747 44,755 19,012 12,110 7,999 1"] [10.295940399169922, 19.22645378112793, "t wait times increased more for shoulder, knee, and upper-back and neck injuries regardless of setting or provider. In any setting, median wait times for those injuries to have an E&M visit anywhere (even with ED visits excluded) increased from 3 day"] [10.306474685668945, 19.20633888244629, "n Analysis, by Injury Year and Body Part or Condition\n8\n 76543210\nNorthern Region Southern Region Out of State Unknown 2010 2011 2012 2013 2014\n All injuries\nLow-back pain\nShoulder injuries\nKnee injuries\nUpper-back and neck i"] [10.291557312011719, 19.246152877807617, "r injuries Knee injuries Upper-back and neck injuries\nAll other injuries\n1.21 1.21 SOURCE: Analysis of WCIS data from 2010 to 2014.\n1.24* 1.20* 1.18\n* Means in 2010\u20132013 are statistically significantly different from the 2014 mean in the same injury "] [10.281383514404297, 19.227231979370117, " stable wait times\u2014two to three days with non-PCPs and three to four days with PCPs\u2014over the period of our study.\nThere was little geographic variation over time, with slightly shorter wait times in the southern regions. Injured workers who lived out"] [10.266240119934082, 19.245140075683594, "n Table 6.2, we present the median number of days between injury and first visit (branch 1). Overall, there was little change in wait times across the different pathways over time, with most median waits between 0 and 1 days. However, the time from i"] [10.267900466918945, 19.27902603149414, "did so four to five days later, with either a PCP or HOPD visit or a visit in another setting (pathways 4 and 5). The second follow-up (third branch) for injured workers who were first seen at a PCP visit tended to have the third visit within six to "] [10.307252883911133, 19.346187591552734, "the most common. Patterns are similar using earlier years of claims data.\nWe also examined row percentages to understand, within a given pathway, which injury was most common (Table 6.7). Not surprisingly, the \u201cother\u201d injury category comprises the ma"] [10.280226707458496, 19.240554809570312, " the ED are likely to have more encounters overall. However, among those who first saw a PCP for an E&M visit, then a specialist, and who then followed up again with a PCP (pathway 7), 99 percent saw more than one PCP in a year. On average, injured w"] [10.280821800231934, 19.251249313354492, "ack 23.73\n18.47 23.44 16.59 16.57 8.54\nShoulder Knee\n12.21 5.06 12.25 4.95 9.97 5.34 7.12 4.02 8.24 4.73 3.85 2.42\nUpper\nBack/Neck Other\n4.81 54.18 4.59 59.74 5.90 55.34 2.64 69.63 2.50 67.95 2.32 82.86\n SOURCE: Analysis of WCIS data from 201"] [10.273438453674316, 19.23736572265625, "ician\u2019s office or HOPD. This was relatively stable over time.\nThe second visit for care was most often with a specialist or nonspecialist, with a third visit with a PCP. Having the first visit in an ED occurred in only about 10 percent of injuries, w"] [10.299229621887207, 19.039337158203125, "pists (increased by 554 providers) and other (increased by 670 providers).\nFewer providers does not necessarily mean less access, however, if there was inappropriate care in earlier years. Studying this was beyond the scope of our analysis.\nUtilizati"] [10.266737937927246, 19.22633934020996, "jury\nImproving or declining access to care among injured workers could result in changes in the observed volume of or payments for services, particularly in the first year after injury.\nFor most service categories, utilization within 12 months of inj"] [10.386895179748535, 18.966415405273438, "investigation, we do not know whether these are primarily first aid visits, for which no billing was generated, or whether there was underreporting of initial medical visits.\nWe also note that the measures of access to care that we examined are not e"] [10.334000587463379, 18.97199249267578, " to require that the Doctor\u2019s First Report of Occupational Injury or Illness be filed electronically with DWC. In addition, the Labor Code was revised to require DWC to develop a system for electronic reporting by employers of documents related to ut"] [10.305305480957031, 19.236059188842773, "94 16,240 9,476 6,259 126,101 193,270\n2014\n43,921 20,305 11,437 7,758 159,450 242,871\nTotal\nSOURCE: Analysis of WCIS data from 2010 to 2014.\n 48\nTable A.3. Number of Observations for Timeliness to Care\u2014First Non-ED E&M Visit, by Injury Year and Natur"] [10.206859588623047, 19.228422164916992, "11,895\n2,269\n8,593 44,567\n5,438\n3,784 56,178 503 27,668 359 25,888 4,913\n4,062\n10,936\n2,324\n8,665 41,314\n5,588\n3,507 53,514 588 26,375 301 25,471 4,330\n3,891\n11,187\n2,415\n8,434 44,835\n6,085\n3,742 56,393 607 27,274 364 26,274 4,655\n4,471\n7,863\n3,601\n7"] [10.431324005126953, 18.705490112304688, "an Workforce Data Book, Washington, D.C., November 2011. As of August 21, 2018: https://www.aamc.org/download/263512/data/statedata2011.pdf\n\u2014\u2014\u2014, \u201cCalifornia Physician Workforce Profile,\u201d 2015. As of August 21, 2018: https://www.aamc.org/download/4471"] [10.385602951049805, 18.73393440246582, "-\n hospital-settings-than-in-other-clinical-locations\n Donabedian, A., \u201cEvaluating the Quality of Medical Care,\u201d The Milbank Memorial Fund\n Quarterly, Vol. 44, No. 3, 1966, pp. 166\u2013206.\n Haddad, S., and K. Mohindra, \u201cAccess, Opportunities and Communi"] [11.048558235168457, 18.210325241088867, ", Workers\u2019 Compensation: Benefits, Coverage, and Costs, Washington, D.C., October 2017. As of August 17, 2018: https://www.nasi.org/sites/default/files/research/NASI_Workers%20Comp%20Report%2020 17_web.pdf\nCare Consumption,\u201d\n2018:\n55\n, May 2015.\n Pet"] [13.750036239624023, 6.146152973175049, " CORPORATION\nA Community-Based, Focused-Deterrence Approach to Closing Overt Drug Markets\nA Process and Fidelity Evaluation of Seven Sites Jessica Saunders, Allison J. Ober, Beau Kilmer, Sarah Michal Greathouse\nFor more information on this publicati"] [13.85051441192627, 4.3741326332092285, "their experiences. It should be of interest to decisionmakers considering new approaches to addressing overt drug markets and those assessing whether this intervention affected crime and other outcomes in these jurisdictions.\nThe RAND Justice Policy "] [13.736818313598633, 6.261841773986816, "....................... 5 Police Crackdowns ............................................................................................................................... 5 Beyond the Traditional Crackdown............................................"] [13.741113662719727, 6.277925491333008, "................................................................... 32 Step 1: Crime Mapping and Defining a Narrow Target Area ............................................................ 32 Steps 2\u20133b: Steps Leading to Candidate Identification......"] [13.73124885559082, 6.27558708190918, "....................................................................... 51 Implementation of Steps After the Call-In ............................................................................................. 51 Step 8: Increasing Enforcement in th"] [13.732136726379395, 6.232558727264404, "......................................................................................................... 11 Figure 3.1. Geographic Representation of Seven Sites................................................................. 14 Figure 3.2. Implemen"] [13.72998332977295, 6.261016368865967, "hese efforts.\nBJA originally had planned to support the training of 12 sites across two training cohorts of six sites each; however, there was much less demand for the training than anticipated. The training and technical assistance (TTA) providers e"] [13.735079765319824, 6.27634334564209, "vations they developed, barriers they encountered, and how well the sites adhered to the BJA model they were exposed to during the training (i.e., fidelity). Process evaluation data collection occurred primarily from March 2011 through April 2012 (so"] [13.73420238494873, 6.276219367980957, "ed and recruited individuals to fill each of the recommended four core roles on the team. During the planning phase, teams varied in how regularly they met, ranging from weekly to monthly. Barriers in the planning phase included difficulty in transla"] [13.734652519226074, 6.277620792388916, "e and heal damaged relationships. Sites employed a combination of activities to engage community members in the intervention, including community meetings, meetings with community leaders, community events, developing and administering community surv"] [13.729240417480469, 6.266789436340332, " continues to communicate with the community personally or through newsletters, meetings, etc., and follow up with the B-listers to ensure that they are not reoffending. Second, on the community side, community members organize and exert their own in"] [13.733308792114258, 6.272709369659424, "rtment, there were challenges because it was initiated at the managerial level; as a result, team members were hesitant to act because they were unsure of support from police department leadership. The Lake County initiative ultimately failed because"] [13.727560997009277, 6.268064022064209, "ffice and the Gary Police Department. During and after the transition, the team stalled and was not able to move forward with completing the targeting phase. In New Orleans, scandals within the police department led to a change in leadership. During "] [13.733414649963379, 6.189464569091797, " and Heather Perez. Also, we would like to acknowledge former team members Robert Davis and Greg Ridgeway, who worked on this piece, and Jim Burgdorf and Russell Lundberg for contributing to the literature review. Additionally, we would like to exten"] [13.732871055603027, 6.2115159034729, "on with police enforcement activities (Caulkins, 1993). In response to these challenges, another approach to addressing overt drug markets has been to implement a drug market intervention (DMI).\nThe goals of the DMI approach\u2014borrowed from the \u201cpullin"] [13.721403121948242, 6.266209125518799, "d Wong, 2009). After the call-in, the DMI team facilitates community mobilization and the formation of strong informal social control, such as formation of neighborhood watch groups and other activities that serve to lower tolerance for drug-dealing "] [13.732858657836914, 6.259293556213379, "o attend the training sessions; sites were not provided with any additional funding for implementation.\nFigure 1.1. Evaluation Logic Model\n Program Elements Short-Term Intermediate Long-Term Inputs Outcomes Impact\n Preparing for the Interventio"] [13.74034309387207, 6.160795211791992, "aluation, including the study settings and the methods used. Chapters Four through Eight present the results of RAND\u2019s process evaluation for each of the five phases, and Chapter Nine presents a discussion of our findings and implementation lessons l"] [13.744221687316895, 6.077961444854736, "at reducing drug crimes and eliminating drug markets, and, if these methods were effective, whether they were worth their cost in terms of community disruption and the damage to policy-community relations\n(Sherman, 1998; Aitken et al., 2002). Some ar"] [13.758146286010742, 6.1212968826293945, "Furthermore, retailers innovated with new forms of distribution that made cannabis dealing more visible in other areas of the city while market participants engaged in violent struggles for market share.\nKennedy and Wong (2009) note that typically af"] [13.730871200561523, 6.206780910491943, " punishment and deter crime (McGarrell et al., 2006).\nAnother key insight in the development of new deterrence approaches is that a large portion of crime is committed by a small number of persistent offenders whose habits may be known and potentiall"] [13.730067253112793, 6.244959354400635, "nnedy, 2009) who are determined not to tolerate overt drug dealing and help prevent it from reoccurring (McGarrell, Corsaro, and Brunson, 2010). To improve the relationship between law enforcement and the community, the DMI involves an effort to exam"] [13.72844409942627, 6.233581066131592, "ommunity, while the police and prosecution maintain the evidence against the B-listers and obtain unsigned arrest warrants to be used as leverage to encourage the B-listers to stop dealing drugs.\n\u2022 Phase III, which is concurrent with Phase II, involv"] [13.733529090881348, 6.236104488372803, "age to the B-listers and non-DMI\u2013involved potential replacement dealers. During this time, the police develop a relationship with the community, demonstrating their commitment to improving the quality of life and preventing the overt market from re-e"] [13.704872131347656, 6.1806254386901855, "ion with law enforcement and internal motivation to comply with the law (Hawdon, Ryan, and Griffin, 2003; Lind and Tyler, 1988; Meares, 2000; Meares, 2008; Tyler, 1990; Tyler, 2004). Police legitimacy has been found to be particularly important in th"] [13.745259284973145, 6.255417346954346, "f the police.\nWhile building more-positive relationships with the community, the DMI also seeks to increase community capacity to begin to exert informal social control to prevent the market from reemerging. Programmatic elements that promote this in"] [13.7269287109375, 6.255018711090088, "evaluations of the efforts in Nashville Providence, Rockford, and Winston-Salem, suggest that the effort reduced crime (Corsaro, Brunson, and McGarrell, 2009; Corsaro and McGarrell, 2009; Frabutt et al., 2009; Kennedy and Wong, 2009; McGarrell, Corsa"] [13.73671817779541, 6.243464469909668, ", pharmaceutical pills, and\nmarijuana\n347,965 Heroin and crack cocaine; some powder cocaine,\nmarijuana, and prescription pills\n96,790 Crack cocaine and marijuana\nDrug Sale Methods in the Target Drug Market\nExport*/Local** Market: Heroin buyers predom"] [13.738667488098145, 6.268854141235352, "ea in northwest Flint, about one square mile, referred to as Flint\u2019s Second Ward. By and large, the area consists primarily of single-family homes populated by a mix of owners and renters, with a few gas stations and fast-food restaurants. Nine in te"] [13.736445426940918, 6.193769454956055, "e St. Johns River, the city is a major military and civilian deep-water port. The local economy is based on services such as banking, insurance, health care, logistics and tourism. Of its more than 500 neighborhoods, those with ongoing poverty and hi"] [13.755236625671387, 6.219691753387451, "scussions among the team members began to delineate the boundaries of a target area for the project using data on drug and violent crime complaints, and began to identify areas where they could get cooperation from neighborhood residents.\nLake County"] [13.816540718078613, 6.149641513824463, "place.\n 18\nshape and size\u2014and their residents stand in sharp contrast to the otherwise suburban, pastoral surroundings of Damascus, which consists of large, single-family dwellings along wide, tree- lined streets. Of the total 5,010 occupied housing "] [13.743856430053711, 6.2161760330200195, "ften in darkness, which also aids criminal activity; law-abiding citizens are fearful of walking in the area. In addition to the established drug market, the area is experiencing problems with illegal dumping of tires, copper theft, open and abandone"] [13.735193252563477, 6.264312267303467, " United States\u2014that is, jurisdictional teams consisting of at least one member of local law enforcement, one prosecutor, someone from the social service sector, and one influential community member\u2014who were interested in implementing a program inspir"] [13.739755630493164, 6.272555351257324, "four trainings were structured to allow time for the following:\n\u2022 brief overview and update of current site activities\n\u2022 spotlighting of local DMI efforts by the host site\n\u2022 team meetings\n\u2022 meetings of functional or like discipline groups\n4 The BJA T"] [13.760360717773438, 6.288502216339111, "n because of frequent variability in implementation procedures across sites (Harachi et al., 1999; Dusenbury et al., 2003).\n22\nProcess evaluation contributes to an understanding of the relationship between program elements and program outcomes (Barth"] [13.749553680419922, 6.285401344299316, "aspects of the program and/or overcame implementation barriers.\nThe RAND team collected data from a number of sources using a variety of methods (e.g., site visits, interviews with all of the team members, and observation of BJA trainings). The team "] [13.731637954711914, 6.276675701141357, " barriers to implementation. RAND also maintained regular communications with BJA TTA provider staff from MSU on site progress. Because multiple TTA sessions were held over a period of years, RAND also received input from the trainers on implementati"] [13.73681926727295, 6.272214889526367, "sessment of planning phase fidelity at each site, and describe planning barriers and innovations.\nForming Teams, Assessing Readiness\nDMI teams should consist of at least one member of law enforcement, one prosecutor, one member of a social service ag"] [13.730201721191406, 6.2768402099609375, "o recruit other team members. In Montgomery County, a city council member suggested the DMI program to the county chief of police. After researching the possibility of adopting the program, the Montgomery County Police Department became enthusiastic "] [13.73233699798584, 6.2721052169799805, "tings\nWeekly\nBiweekly\nMonthly initially; dropped off\nBiweekly initially; dropped off\nMonthly\nMonthly\nBiweekly\n Site\nFlint, Mich.\nGuntersville, Ala.\nJacksonville, Fla.\nLake County, Ind.\nMontgomery County, Md.\nNew Orleans, La.\nRoanoke, Va.\nOn Or"] [13.732090950012207, 6.273576259613037, "osecutor, community service organization, community member) were identified and recruited. As a result, progress in planning for areas outside law enforcement was delayed and the team had difficulty gaining the full support of a social service agency"] [13.733108520507812, 6.266049385070801, " during the planning phase was the procurement of MOUs with the social service providers. Both Flint and Lake County decided to formalize these relationships and formally outline the responsibilities of the community service providers.\nKey Points on "] [13.723943710327148, 6.2268171310424805, "ll relied on crime analyses to select a narrowly defined target area. In Flint, for example, the team examined crime data and chose the area within the city that contained the highest number of serious crimes, but did not identify a discrete drug mar"] [13.731841087341309, 6.269626617431641, "ed from an ongoing narcotics racketeering investigation in the Hoffman Triangle area of the 6th district. From the Racketeer Influenced and Corrupt Organizations (RICO) investigation, officers had been working to document drug dealers in the Hoffman "] [13.732444763183594, 6.274697303771973, "teria for inclusion on the A-list or the B-list were fairly similar across the sites. Most sites agreed that, to be on the B-list, individuals must not have a violent criminal history and no felony or gun charges on their criminal record. There were "] [13.730855941772461, 6.276139259338379, "s. The Roanoke police reported difficulty in finding informants to participate in drug purchases; the team ended up developing special operations to catch drug buyers and turning them into informants.\n\u2022 Police forces played varying roles in building "] [13.731334686279297, 6.270584583282471, "ters had gone on to commit more serious offenses and were not eligible for the B-list within a year of the start of the targeting phase.\n** Did not complete the targeting phase.\nFidelity ratings were determined as follows:\n\u2022 high fidelity: used crime"] [13.746403694152832, 6.289417266845703, " undecided about how to conduct the investigations. The prosecutor\u2019s office wanted to use undercover officers, rather than confidential informants, but the police department argued that its manpower resources were stretched too thin to devote officer"] [13.757655143737793, 6.289385795593262, "ing the target area, with four teams relying on a formal analysis of local crime data (as prescribed in the training model), one using calls for service, and others taking a more strategic approach, such as targeting the only areas with high crime, o"] [13.737954139709473, 6.279551982879639, " the intervention, including community meetings, meetings with community leaders, community events, community surveys, and door-to-door contact with residents (see Table 6.1). All but one of the sites that passed the targeting stage conducted at leas"] [13.728074073791504, 6.2794060707092285, "proximately one year before the call-in. The team held a second community meeting in the month before the call-in. The official Flint website also contained information about the program\u2014which changed names several times over the course\n40\nof a few y"] [13.739409446716309, 6.276895999908447, "rs and leaders of community organizations. Several smaller meetings with community leaders were subsequently held to garner support for the program, but no further community meetings with residents have been held. Many sites also gave media interview"] [13.75312614440918, 6.304527759552002, " Activities; Fidelity to the Model\nAssigned a Mentor/Resource Coordinator to B-Listers\n Flint, Mich. No\nGuntersville, No Ala.\nMontgomery No County, Md.\nRoanoke, Va. Yes\nWorking with the Community Phase Barriers and Innovations\nBarriers. Some sites h"] [13.734456062316895, 6.2764739990234375, "munities\u2019 perceptions of drugs, crime, and the police changed after the intervention.\nKey Points on Working with the Community\n\u2022 Of the sites that moved toward a call-in, most conducted activities to mobilize the community and engage them in the proc"] [13.732022285461426, 6.27541446685791, "s chapter, we discuss site preparation for the call-in, including A-lister arrests and prosecutions, notification of candidates, and conducting the call-in. We then provide our assessment of call-in phase fidelity and describe barriers and innovation"] [13.732515335083008, 6.278010368347168, "able to notify all offenders and/or their families eventually, and when it came time to hold the call-in, most B-listers at each of the sites attended.\nSites used varying approaches for notifying family members (see Appendices E and F for Roanoke\u2019s r"] [13.732047080993652, 6.275826454162598, "sized that the B-listers had an opportunity to avoid the same fate.\nMessage. The message presented was also generally the same: B-listers were informed that the criminal justice system was aware of their drug-dealing activities and had sufficient evi"] [13.733686447143555, 6.276812553405762, "te drug and alcohol screenings. The screenings were never enforced, but the team included this requirement in the hope that the threat of potential testing would deter the B-listers from using.\nIn Guntersville and Montgomery County, the B-listers wer"] [13.731030464172363, 6.2769999504089355, "\n Sites\nFlint, Mich.\nNumber of Community Members in Attendance\n~95\nPresentation of Evidence\nSeparate from community; a stack of B-lister files at front of room; were not shown evidence unless requested\nPlanned to show videotaped evidence but during "] [13.734638214111328, 6.2761311531066895, "market from re-emerging. It consists of two main efforts: one from law enforcement and one from the community. On the law enforcement side, the target area receives additional services, manpower, and prioritized calls for service. Law enforcement pre"] [13.728381156921387, 6.2694830894470215, "eighborhoods, generally for a period of at least three months, which included both additional personnel and attempts to buy drugs. Only Flint was unable to dedicate any additional enforcement efforts in the targeted area, because of budgetary issues."] [13.73538589477539, 6.281748294830322, "ildren, a basketball camp sponsored by the Guntersville Police Department, and a follow-up resident meeting to update the community on intervention-related information. Finally, the Guntersville Public Library, located at the edge of the target area,"] [13.7276029586792, 6.276296138763428, "no arrests were made in the yearlong follow-up period. In Montgomery County, there was a complaint made against one of the B-listers, but this individual had not been arrested in the year after the program.\nThree of the four sites did not assign a me"] [13.731764793395996, 6.274481296539307, "e Flint\u2019s team conducted several community follow-up events, it was unable to secure funding for additional law enforcement or prosecutorial resources in the target area.\n54\nTable 8.1. Increased Enforcement Activities After Call-In; Fidelity to the M"] [13.717765808105469, 6.289906024932861, "asketball camp, a book\n55\nclub, an after-school party, and a second park clean-up evening). A neighborhood watch that the police community relations group developed is also in the works.\nIn Flint, the team came up with an innovative method for monito"] [13.728930473327637, 6.27966833114624, "than 100 Section 8 apartments. Team members held several meetings, and many of them focused on problems within the apartment complex, mainly its disrepair. They were able to get the management company to make a large number of physical changes to the"] [13.730812072753906, 6.2750630378723145, "ms followed training model and should not be taken as judgments how well the teams performed or how effective the intervention and its components were across the sites. Below, we provide a brief summary of site-by-site implementation.\n Table 9.1. Sum"] [13.725610733032227, 6.2660698890686035, " left for a new job.\nNew Orleans, Louisiana\nMany of the obstacles New Orleans encountered focused on not getting enough support and involvement from higher-ranking NOPD officials. Although the initiative began in the police department, it began at a "] [13.703957557678223, 6.30716609954834, "th the community. Moving forward, team members say they hope to continue to build on their community engagement and collaboration efforts with other community groups. Since the original implementation of the intervention, the Flint team has conducted"] [13.70642375946045, 6.2767333984375, "d all but two A-listers received tough prison sentences. However, except for meetings held with management of the apartment complex, efforts to engage the community with formal meetings or events did not occur until after the call-in.\nDuring the call"] [13.723211288452148, 6.259671688079834, "unity hot spot where they made constant patrols and created a relationship with residents. Finally, the Roanoke police began using license plate readers to identify the owners of outside vehicles in the neighborhood; police would then send the owners"] [13.7273588180542, 6.239701271057129, " a case was related to the intervention, and the A-listers and B-listers who were caught violating the terms of their suspended cases were not sanctioned to the fullest extent, thus eroding program credibility.\nLesson Two: Participants should have a "] [13.69980525970459, 6.241802215576172, "he authorization to move forward. As a result, the process of putting together candidate cases stalled. While political situations may not be easy to prepare for, teams should be aware of this issue, and if applicable, bring new leadership on board w"] [13.727577209472656, 6.253055095672607, " (Rogers, 2002; Sales et al., 2006); and that cultivating \u201cchampions\u201d (i.e., well-respected individuals within an organization or community) who can serve as peer consultants and role models also can facilitate implementation and, ultimately, adoptio"] [13.7091703414917, 6.254637241363525, "but there was still a commitment to putting most of the dealers on the B-list; for Southside the B-list share was 79 percent (22 of 28) and in East Side was 81 percent (26 of 32). The fifth DMI in Washington was an anomaly in High Point, with the B-l"] [13.719461441040039, 6.2606120109558105, "DMI replications.3\nWith four of the five High Point DMI\u2019s having B-lister rates hovering around 75 percent and three of the four BJA sites with rates closer to 33 percent, variations could affect outcomes. The high rate of A-listers (and arrests) at "] [20.79698371887207, 8.521832466125488, "onviction: Distribution of crack cocaine\n\u2212 Sentence: ten years; suspend all but 18 months, four years\u2019 supervised probation, stay\naway order\n3. Conviction: conspiracy for distribution of crack cocaine\n\u2212 Sentence: four years; suspend all but nine mont"] [13.741372108459473, 6.277679443359375, "wing forms, which were used in the process evaluation:\n\u2022 Planning Phase Data Collection form\n\u2022 Targeting Phase Data Collection form\n\u2022 Community Organizing Data Collection Form\n\u2022 Call-In Data Collection Form\n\u2022 Post\u2013Call-In Data Collection Form\n\u2022 DMI M"] [13.732634544372559, 6.275964260101318, "ght, their criminal histories, and ultimate case dispositions:\n 1\n2\n3\n4\n5\n6\n7\n8\n9\n10\n11\n12\nCharge Felony convictions\nCase outcome\nSentence\n Did the team make an effort to get community members"] [13.733201026916504, 6.275458812713623, "w many members of the community at large attended the call-in? _____________ Which social service providers were present at the call-in?\n1) 4)\n2) 5)\n3) 6)\nWho spoke at the call-in?\nProsecutor\nPolice\nSocial service providers\nCommunity leaders\nMembers "] [13.73646068572998, 6.275169849395752, "__\nWas there a procedure established for regular reporting of broken street lights, trash, unkept yards, graffiti to appropriate city agencies?\nNo Yese\u0300For how long after the call-in was this procedure in place? _________________ 81\nDid the team publ"] [13.769170761108398, 6.282315254211426, "s to implementation:\na. Identify target area using crime mapping.\nb. Engage the community.\nc. Survey police officers.\nd. Identify street drug dealers.\ne. Review street drug incidents.\nf. Conduct the undercover investigation.\n 84\ng. Establish contact "] [13.753585815429688, 6.292504787445068, " to a meeting on at the located at . You will not be arrested. This is not a trick. You may bring someone with you who is important to you, like a friend or relative. I want you to see the evidence I have of your involvement in criminal activity, and"] [16.69942855834961, 9.450803756713867, "ing/outdoor activities (Frisbee, basketball, croquet, horseshoes) 5:00\u20135:45 p.m. Dinner\n6:00\u20138:00 p.m. Conflict resolution/effective communication\n8:00\u20138:45 p.m. Mindfulness/journaling\n8:45\u201310:00 p.m. Personal hygiene and leisure time/subject-appropr"] [13.696429252624512, 6.100155353546143, "nt Research, Vol. 11, 1996, pp. 12\u201335.\nBaumer, Eric P., Janet L. Lauritsen, Richard Rosenfeld, and Richard Wright, \u201cThe Influence of Crack Cocaine on Robbery, Burglary, and Homicide Rates: A Cross-City, Longitudinal Analysis,\u201d Journal of Research in "] [13.717591285705566, 6.119867324829102, "icy, Vol. 11, No. 2, 2012, pp. 167-199.\nCorsaro, Nicholas, and Edmund F. McGarrell, An Evaluation of the Nashville Drug Market Initiative (DMI) Pulling Levels Strategy, East Lansing, Mich.: Michigan State University, School of Criminal Justice, Drug "] [13.71053695678711, 6.127383232116699, "holas Corsaro, and Edmund F. McGarrell, The High Point Drug Market Initiative: A Process and Impact Assessment, East Lansing, Mich.: Michigan State University, School of Criminal Justice, 2010a.\n\u2014\u2014\u2014, The High Point Drug Market Initiative: A Process a"] [13.226439476013184, 5.607792854309082, "l of Criminal Justice and Security, Vol. 12, No. 4, 2010, pp. 397\u2013407.\nMeares, Tracey L., \u201cNorms, Legitimacy, and Law Enforcement,\u201d Oregon Law Review, Vol. 79, 2000, p. 391.\n\u2014\u2014\u2014, \u201cThe Legitimacy of Police Among Young African-American Men,\u201d Marquette "] [13.686707496643066, 6.091159820556641, "s it Help Reduce Violence? Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice, 1998.\nSaunders, Jessica, Russell Lundberg, Anthony Braga, Greg Ridgeway, and Jeremy Miles, \u201cA Synthetic Control Approa"] [4.652606010437012, 8.085001945495605, " Autonomous Vehicle Technology\nA Guide for Policymakers\nJames M. Anderson, Nidhi Kalra, Karlyn D. Stanley, Paul Sorensen, Constantine Samaras, Oluwatobi A. Oluwatola\n CORPORATION\nFor more information on this publication, visit www.rand.org/t/rr443-2 "] [4.5111894607543945, 8.052916526794434, "rs and by the fees earned on client-funded research.\nThe RAND Transportation, Space, and Technology Program\nThe research reported here was conducted in the RAND Transporta- tion, Space, and Technology Program, which addresses topics relating to trans"] [4.976469039916992, 8.122944831848145, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Potential Effects on Traffic Congestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [15.04949951171875, 5.762645721435547, " . . . . . . . . . . NewYork(S4912).............................................................. Oklahoma (HB 3007). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Oregon (HB 2428) . ."] [5.222896575927734, 7.8321852684021, "t-Range Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bluetooth........................................................................ Wi-Fi........................................................................"] [5.151458740234375, 8.11041259765625, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Conclusion....................................................................... 108\nCHAPTER SEVEN LiabilityImplicationsofAutonomousVehicleTechnology........... 111 Tort Liability f"] [4.943669319152832, 8.18821907043457, "njuries per Million Vehicle MilesTraveled....................................................... 13\n2.3. U.S. Roadway Fatalities per Billion Vehicle Miles Traveled . . . 14\n2.4. Relationship Between Roadway Speed and Roadway Throughput..............."] [4.990808010101318, 8.174884796142578, " externalities,\u201d on other people. For example, every addi- tional driver increases congestion for all other drivers and increases the chance that another driver will have an accident. These externalities have been estimated at approximately 13 cents "] [4.983116149902344, 8.171379089355469, " Level 3 or higher is likely to substantially reduce the cost of congestion, since occupants of vehicles could undertake other activities. These reductions to the costs of congestion will benefit individual AV operators. On the other hand, reductions"] [4.980277061462402, 8.192537307739258, "ency of crashes is reduced, cars and trucks could be made much lighter. This would increase fuel economy even more.\nAVs might reduce pollution by enabling the use of alternative fuels. If the decrease in frequency of crashes allows lighter vehicles, "] [5.036023139953613, 8.067155838012695, "V or the public\nSummary xvii\nxviii Autonomous Vehicle Technology: A Guide for Policymakers\nmore generally. Such research would also be helpful in determining the optimal mixture of subsidies and taxes to help align the private and public costs and be"] [5.089641571044922, 7.957771301269531, "se the environment, AVs use a combination of sensors, including lidar (light detection and ranging), radar, cameras, ultrasonic, and infrared. A suite of sensors in combination can comple- ment one another and make up for any weaknesses in any one ki"] [5.192117214202881, 7.885538578033447, "enge for a technology widely available to the public.\nSoftware upgrades also could pose challenges, as they might need to be backward-compatible with earlier models of vehicles and sensor systems. Moreover, as more vehicle models offer autonomous dri"] [5.018138885498047, 7.949269771575928, "hicle Technology: A Guide for Policymakers\ndards for communications platforms within automobiles, along with issues pertaining to data security, data ownership, and privacy.\nStandards and Regulations\nGovernment regulations and engineering standards a"] [5.175839900970459, 8.095191955566406, "turers to use technology for closer monitoring of driver behavior.\nPolicymakers could also take actions to reduce manufacturers\u2019 liability. Congress could explicitly preempt state tort law remedies, an approach that has some precedents. Congress coul"] [5.005122661590576, 7.997218132019043, "xample, safety regulations and liability rules should be designed with this overarching guiding principle in mind. Similarly, this principle can provide some guidance to judges strug- gling with whether a particular design decision was reasonable in "] [4.952003479003906, 7.99057674407959, "NHTSA NPRM NRC NTIA\nNTSB OEM RITA SAE U-NII V2I V2V VIN VMT\nGreenhouse Gases, Regulated Emissions, and Energy Use in Transportation\nInternational Harmonized Research Activities working group on intelligent transport systems\nInsurance Institute for Hi"] [5.006628036499023, 8.09306812286377, "Meeting and the Transporta- tion Research Board\u2019s Workshop on Road Vehicle Automation.\nIn the remainder of this chapter, we briefly define different levels of vehicle autonomy, explore why they merit the attention of policymak- ers, and enumerate que"] [5.019418716430664, 8.048201560974121, "ironmental conditions, and in those conditions to rely heavily on the vehicle to monitor for changes in those conditions requiring transition back to driver control. The driver is expected to be available for occasional control, but with sufficiently"] [4.98765754699707, 8.07300090789795, "ly, cars might share sensor information with nearby vehicles, which could provide an AV with more information on which to base its decisionmaking. While some have argued that connected vehicle technology will be central to achieving AV operation (KPM"] [5.068328380584717, 8.021075248718262, "t run, and to fall about twice that in the long run, with a range of \u20131.0 to \u20132.0 (Lee, Klein, and Camus, 1999; Litman, 2012). This implies that as travel costs (time and expenses) reduce by 10 percent, travel is expected to increase: by 7 to 8 perce"] [5.0483808517456055, 8.074716567993164, " blur the line between vehicle and driver, and DMVs are beginning to test and license AVs. State DOTs maintain and operate highway infrastruc- ture, and thus would be responsible for any investments in intelligent infrastructure or the creation and o"] [4.9376444816589355, 8.17287540435791, " (e.g., Small and Kazimi, 1995; Delucchi, 2000; Parry, Wells, and Harrington, 2007; Michalek et al.,\n9\n10 Autonomous Vehicle Technology: A Guide for Policymakers\n2011). These externalities include accidents, congestion, noise, air pol- lution, and gr"] [4.950954914093018, 8.208797454833984, " 2011 (EPA, 2013a), so the social cost of CO2 emissions from light-duty vehicles was nearly $41 billion annually.\nSomewhat confusingly, different externalities are estimated in dif- ferent ways. Impacts from air pollution, GHG emissions, and oil impo"] [4.885488986968994, 8.194668769836426, "will be much higher if it is in a dense city. These estimates are based on data in the United States. The pat- tern of externalities will be different in other countries.\n The Promise and Perils of Autonomous Vehicle Technology 13\nbillions of dollars"] [4.907172203063965, 8.168183326721191, "0 fatalities with much fewer VMT (BTS, 2013). And, similar to the injuries dis- cussed above, pedestrian casualties were a considerable portion of the total, more than 4,400 in 2011. So, light-duty vehicle operation poses a risk not only for other li"] [4.94468355178833, 8.155502319335938, "kless\u2014and can increase avoidance of\n2 This is significant as more than 14,000 of the 32,000 roadway deaths in 2011 involved a single vehicle (BTS, 2013). Of course, driver error is still possible from other vehicles on the road that do not have autom"] [4.97961950302124, 8.16552448272705, "e, are used to pro- vide on-demand paratransit services. The per-trip costs of these ser- vices are often three or more times those of fixed-route transit services (GAO, 2012). Level 4 automation could expand mobility and access at reduced costs. Whi"] [4.9478983879089355, 8.189697265625, "KPMG and Center for Automotive Research, 2012)\u2014a driverless taxi system that over time replaces traditional taxi service, car-sharing programs, and possibly even transit lines. Driver- less taxis could offer the same on-demand, door-to-door convenien"] [4.95436954498291, 8.200642585754395, " operating costs add another 21 cents per mile, including about 15 cents for gas, just under 5 cents for maintenance, and just over 1 cent for tires (note that the AAA data do not include the costs associated with tolls and parking, as these vary con"] [4.992082118988037, 8.165595054626465, "on to the additional per-mile costs asso- ciated with depreciation, insurance, and the like, it is thus possible that reliance on driverless taxis could eliminate the fixed costs of auto\nThe Promise and Perils of Autonomous Vehicle Technology 21\nowne"] [4.988121509552002, 8.15317440032959, "ral- purpose lanes slow to 15 to 20 mph. At the same time, the express lanes carry roughly double the number of vehicles per lane per hour as the congested general-purpose lanes (Obenberger, 2004).\nThe State Route 91 example illustrates how maintaini"] [4.9994683265686035, 8.19046401977539, " 2.2.\nBased on the significant percentage of traffic congestion caused by crashes that AVs could help eliminate and the major improvements in throughput capacity they could enable, there is reason for optimism that the combined effects of these facto"] [4.982280731201172, 8.185796737670898, "e other costs associated with congestion, such as reduced economic efficiency, where AVs could also have a positive impact.\nUnlike many of the other potential benefits of this technology, these benefits are realized by the user of the AV. Indeed, the"] [4.984155178070068, 8.17286491394043, "his should increase the willingness of households, and possibly some firms, to locate farther away from the urban core. Just as the rise of the automobile in the 20th century led to the emergence of sub- urbs and ultimately exurbs by reducing transpo"] [4.9877142906188965, 8.161259651184082, "d cars. At the same time, AVs could support even greater dis- persion of low-density development along the outskirts of major met- ropolitan areas given the ability of owners to engage in other activi- ties as vehicles pilot themselves. These effects"] [4.97470235824585, 8.171086311340332, "e NRC estimated the potential fuel economy improvements to con- ventional vehicles between now and 2050 to be 130 to 250 percent\nThe Promise and Perils of Autonomous Vehicle Technology 29\nFigure 2.5\nAverage Fuel Economy of U.S. Cars and Light Trucks,"] [4.961237907409668, 8.183378219604492, "hybrid cars, and autonomous cars (omitting light trucks) in Figure 2.6.\nHow Light Can We Make Vehicles If There Are Almost No Accidents? To move a vehicle, power is required to overcome inertia, rolling resistance (or \u201cthe street pushing back\u201d) and a"] [4.925919055938721, 8.189323425292969, "y: A Guide for Policymakers\nFigure 2.7\nAverage Weight of U.S. Cars and Light Trucks, 1975\u20132012\n5,500\n5,000\nAverage vehicle weight (lb)\n3,500\n3,000\n2,500\n2,000\n1975 1979 1983\nSOURCE: EPA, 2013b.\nRAND RR443-2.7\n Light truck weight (lb)\nCar weight (lb"] [4.9621052742004395, 8.19533634185791, "ght reductions currently projected. These are substantial, projected as reductions of 20 to 25 percent by 2030 and of 32 to 50 percent by 2050 (NRC, 2013a). The successful deployment of Level 4 automation could then enable additional incremental weig"] [4.971912384033203, 8.18161678314209, "e to travel the same range using batteries that are smaller, and thus cheaper. The improved drive cycles and congestion management from Level 2, 3, and 4 AVs would also allow for smaller batteries. This would reduce the overall cost for consumers, an"] [4.967776775360107, 8.217479705810547, "tion GHG emissions, oil use, and conventional air pollutants (Samaras and Meis- terling, 2008; Michalek et al., 2011). Level 2, 3, and 4 AVs can hasten this transition, with Level 4 AVs also enabling radical redesigns of both electric vehicles and th"] [4.951650619506836, 8.213367462158203, "T demand from new sources. These include the elderly, the young, those without driver\u2019s licenses, and those who explicitly or implicitly value the time or multi- task opportunities afforded by driverless taxis at high rates. But if Level 4 driverless"] [4.9843339920043945, 8.16891098022461, "mental goals are met.\nCosts and Disadvantages\nWhile there are reasons to think that AV technology may increase safety and efficiency, and reduce congestion and emissions per mile\n Annual vehicle-distance traveled (billion miles)\n "] [5.028003215789795, 8.076610565185547, "anies are also important investors in federal, state, and municipal bonds. This entire sector of the economy may well be remade as crashes, and the wealth transfers they occasion, decline in frequency.\nThe eclipse of driving may also have cultural di"] [5.070858001708984, 8.076266288757324, " testing or even operation of a driverless vehicle; Bryant Walker Smith has argued that existing law probably permits the use of driverless cars (Smith, 2012b). Nor are we aware of any documented problems with the test- ing or use of AVs that the leg"] [5.111114978790283, 8.09843635559082, "collision occurs between the autonomous vehicle and another vehicle, object or natural person while the vehicle is operating in auton- omous mode. The autonomous technology sensor data must be captured and stored in a read-only format by the mechanis"] [5.064302921295166, 8.075599670410156, "ions that have been enacted to date.\nNevada (NRS 482.A and NAC 482.A)\n\u2022 Enacted: June 2011, revised July 1, 2013.\n\u2022 Definition of AVs: \u201cAutonomous technology\u201d means technology\nwhich is installed on a motor vehicle and which has the capabil- ity to dr"] [5.0702290534973145, 8.072720527648926, " queu- ing assistant, unless any such system alone or in combination with other systems enables the vehicle on which the technology is installed to drive without the active control or monitoring by a human operator\u201d (Florida House of Representatives,"] [5.060787200927734, 8.076189994812012, "age the autono- mous technology; a visual indicator to indicate when the autono- mous technology is engaged; a system to safely alert the operator if an autonomous technology failure is detected while the autono- mous technology is engaged, and when "] [5.046637058258057, 8.080986976623535, "ve activity on this issue in many other states. These are summarized below:\nArizona (HB 2167)\n\u2022 Introduced: January 2013.\n\u2022 Status:Introduced.\n\u2022 Key features: Defines AVs and autonomous technology (excludes\nindividual driver assist systems) (Arizona "] [5.008762359619141, 8.075394630432129, "ted technology,\u201d \u201cautomated\nvehicle,\u201d \u201cautomated mode,\u201d and \u201cupfitter\u201d; grants civil liability immunity to manufacturers of automated technology for dam- ages that arise out of any modification made by another person to a motor vehicle or an automate"] [5.077741622924805, 8.07028579711914, "hnology: A Guide for Policymakers\nlina General Assembly, 2013, \u00a756-12-10-70); directs the DMV to adopt regulation by January 1, 2015 (South Carolina General Assembly, 2013, \u00a756-12-80). Manufacturer is defined as whoever installs autonomous technology"] [5.055858612060547, 8.062520027160645, "autiously in this area and adopt legislative solutions only in response to clearly identified problems. Further efforts to develop a model stat- ute to promote uniformity in requirements may be useful.2\n1 Bryant Walker Smith has argued that AVs are m"] [4.938965320587158, 8.05681324005127, "ed by Ernst Dickmanns at Bundeswehr University Munich in Germany developed a vision- guided vehicle that navigated at speeds of 100 kilometers per hour without traffic (Lantos and Ma\u0302arton, 2011). Carnegie Mellon Univer- sity\u2019s NavLab developed a ser"] [5.060937881469727, 8.085259437561035, "partici- pated in that competition. In the years since, Google has developed and tested a fleet of cars and initiated campaigns to demonstrate the applications of the technology through, for example, videos highlight- ing mobility offered to the blin"] [5.043541431427002, 7.9791765213012695, "ons\u2014its overall trajectory down the road and immediate decisions such as accelerating and changing directions. These plans are converted into actionable commands to the vehicle\u2019s control system; i.e., steer- ing, throttle, brakes. Many \u201csense-plan-ac"] [5.073915004730225, 8.003729820251465, "road\nsurfaces, poorly marked roads, and detours\n\u2022 traffic events, such as congestion or crashes.\nIt is in making sense of the world that humans often outperform robots. Human eyes are sophisticated and provide nearly all of the sensory data we use to"] [5.032509803771973, 7.978407382965088, "ight detection and ranging, or lidar, systems feature prominently in robotic systems, including AVs. Lidar systems determine dis- tances to obstacles by using laser range finders, which emit light beams and calculate the time-of-flight until a reflec"] [5.089600086212158, 7.94859504699707, "or parking assistance systems and backup warning systems (Ford, 2013). They are also relatively inexpensive, with after-market solutions retailing for as little as $120. Infrared sys- tems are capable of detecting lane markings without the lighting a"] [5.106137752532959, 7.967034816741943, "bility and provided civilian users the same quality signal as military users (National Coordination Office for Space-Based Positioning, Navigation, and Timing, 2014).\n 64 Autonomous Vehicle Technology: A Guide for Policymakers\nGPS is typically couple"] [5.094204902648926, 7.986832618713379, "y and respond to traffic lights. \u201cThe idea is to get the best out of camera-only autonomous driving,\u201d noted one of MobilEye\u2019s executives (Markoff, 2013). Similarly, the winner of the 2013 Intel International Science and Engineering Fair, a 19-year-ol"] [5.104344367980957, 7.93271541595459, "vironmental conditions) can also pose serious performance threats (Hwang et al., 2010). Sensors may fail because of electrical failures, physical damage, or age. It will be critical for AVs to have internal sensing and algorithms that can detect when"] [5.108132839202881, 7.936029434204102, " and ensuring ultra- reliability of public infrastructure for driverless cars may be prohibi- tively expensive, particularly in a time of growing fiscal uncertainty for transportation agencies. Additionally, to be safe and effective, V2V technologies"] [5.10968017578125, 7.97475528717041, "to ensure that the driver is sufficiently engaged\u2014for example, a vibrating seat or wheel, or vehicle screens that show the road rather than entertainment. But while a vehicle manufacturer may carefully limit what is displayed on a vehicle\u2019s screen, i"] [5.165238380432129, 7.947951316833496, " consensus on the legality or ethics of companies\u2019 abilities to collect and extract value from user data.\n 70 Autonomous Vehicle Technology: A Guide for Policymakers\nUniversity, for example, has plans to introduce a driverless shuttle on its campus, "] [5.154087066650391, 7.948083877563477, "sensor readings to a vehicle\u2019s sensors; e.g., sending false lidar returns to a vehicle that is using three-dimensional mapping to navigate through its environment.9 While this may be more difficult to achieve, it may also be more difficult to detect "] [5.036303997039795, 8.002389907836914, "ar-term DOT investments. We touch on these issues briefly here, and discuss them further in later chapters.\nPolicymakers could regulate different specific vehicle capabili- ties: highway vs. city driving, fast vs. slow driving, fully autonomous vs. d"] [5.081875801086426, 7.925369739532471, "ance to road signage and mark- ing standards to make the perception challenge easier. Standardiza- tion across states would also be significantly beneficial; not only for AV owners but also conventional drivers who sometimes struggle to understand co"] [5.262547969818115, 7.83445405960083, "out that obstruction is sensed by one car using this system, information about it can be nearly instantaneously communicated to every other car using the same system.\nSecond, the federal government has supported the development of Dedicated Short-Ran"] [5.269950866699219, 7.7875165939331055, "ons Technologies Used by Autonomous Vehicles\nThe following section will provide a brief explanation of different tech- nologies and identify how they are used in AVs. All of these technolo- gies use radio frequency (RF) spectrum.1\nCommercial Wireless"] [5.381279468536377, 7.763739109039307, " to increase the capacity and speed of wireless data networks using new digital signal processing techniques and modula- tions that were developed around 2000. The LTE wireless interface is incompatible with 2G and 3G networks, so that it must be ope"] [5.523118019104004, 7.6761298179626465, "ol systems. For emergency vehicle warnings, DSRC would enable information to relay forward through traffic, which could clear the way for the emergency vehicle and reduce risks to other drivers.\nForward obstacle detection and avoidance\nEmergency vehi"] [5.273640155792236, 7.830417156219482, "ciety of America, 2013).\nStakeholder Viewpoints on Autonomous Vehicle Communications\nThe Research and Innovative Technology Administration of the U.S. DOT characterized its vision of \u201cconnected cars\u201d as requiring commu- nications in the following way"] [5.241894245147705, 7.854848861694336, "car: General Motors has announced that it will be integrating an LTE connection into all of its 2014 vehicles, whereas Ford has publicly described GM\u2019s integration of LTE as a \u201cmistake,\u201d because integrating any technology into a car that lasts for 10"] [5.259864330291748, 7.824103355407715, "mbined approach of sensors, radar, lidar, and DSRC could accelerate deployment of AVs by bringing costs down for mass- market acceptance. Groupe Speciale Mobile, a European-based orga- nization of global mobile-technology providers, confirmed the vie"] [5.638826847076416, 7.606573104858398, ", to allocate spectrum for use by private, commercial, and state and local government authorities (U.S. Code, 1934). Recently, the FCC\u2019s proposal to release up to 195 GHz of spectrum in the 5.9 GHz band raised concerns about implications of this acti"] [5.697003364562988, 7.570109844207764, " spectrum available for unlicensed devices across the overall radio spectrum.\u201d Specifically, the FCC is considering changes to its Part 15 rules. Part 302(a) of the Communications Act of 1934 gives the Commission authority \u201ccon- sistent with the publ"] [5.713221073150635, 7.560072898864746, "not state that the FCC proceeding should include the 5850\u20135925 MHz band, which is the band assigned to DSRC.5 The U-NII NPRM rec- ognizes the precise assignment from Congress, stating, \u201cthe initiation\n5 SEC. 6406. UNLICENSED USE IN THE 5 GHZ BAND.\n(a"] [5.669734954833984, 7.586380481719971, "850\u20135925 MHz band.\n(c) DEFINITIONS.\u2014In this section:\n(1) 5350\u20135470 MHZ BAND.\u2014The term \u201c5350\u20135470 MHz band\u201d means the portion of the electromagnetic spectrum between the frequencies from 5350 megahertz to 5470 megahertz.\n(2) 5850\u20135925 MHZ BAND.\u2014The te"] [5.621092319488525, 7.617973804473877, "public safety expressed by federal and state agencies and departments that are experts on public safety issues. The FCC also will have to consider the $450 million that the U.S. DOT intelligent transport systems program has invested in researching an"] [5.534904956817627, 7.668300628662109, "rum in the 5.9 GHz DSRC band. Specifi- cally, the joint comments state that\nthe Alliance and Global are skeptical that, as proposed by the Commission, U-NII devices will be able to share, or operate in close proximity to, the 5.9 GHz DSRC band withou"] [5.264645576477051, 7.8215203285217285, " will either accelerate or inhibit deployment of DSRC and AVs.\nInternet access is an important aspect of daily life and business, but DSRC can assist in preventing crash deaths on a major scale. While some have expressed concern about the lack of dev"] [5.223086357116699, 7.877849578857422, "us that building robust security protocols across many different automakers\u2019 vehicles and different communica- tions platforms is likely to be very challenging technically. Similarly, one of the global technology developers who advocated the need for"] [5.089188575744629, 7.9006805419921875, "ogies. We then reviewed stakeholder concerns and the upcoming decision by the FCC on whether to permit sharing of spectrum currently allocated to DSRC. Stakeholders have described a number of technical and policy issues concerning communications and "] [4.891149044036865, 7.9420552253723145, "h prescribe an array of safety standards and test procedures, from crash-avoidance components (such as brakes and indicators) to crashworthiness features (such as seat belts and air bags) to post-crash factors (such as the integ- rity of the fuel sys"] [4.933026313781738, 7.976762294769287, " manufacturers often use these ratings in advertising their cars. More recently, in evaluating cars, NHTSA has noted the presence or absence of crash avoidance systems: electronic stability control, lane departure warning, and forward collision warni"] [4.879673480987549, 8.054703712463379, "004, p. 390) notes the perspective of policymakers and industry experts at the time:\nThey argued that a system of inflatable pillows could be auto- matically deployed inside a vehicle in the event of a collision that would hold occupants in place eve"] [4.930686950683594, 8.04477596282959, "een 1990 and July 2008, primarily due to the extreme force that is necessary to meet the performance standard of protecting the unbelted adult male passenger. Houston and Richardson (2000) describe the strong reaction to these losses and a backlash a"] [5.040315628051758, 8.008390426635742, "NTSB felt that the use of a variety of systems would lead to driver confusion and incorrect interventions and responses to system behavior (NTSB, 2001).\nThere are currently no federal regulations related specifically to AV technologies, though both N"] [4.838667392730713, 7.930195331573486, "bling elements of future systems\u201d (Shulman and Deering, 2005, p. 3). It includes, for example, the For- ward Collision Warning Requirements Project, which addresses alert function and interface requirements through real and simulated tests with human"] [4.956481456756592, 7.949657917022705, "ward Collision Warning Systems: Operating Characteris- tics and User Interface Requirements (2003b); ISO, Transport Information and Control Systems: Adaptive Cruise Control Systems: Performance Requirements and Test Procedures (2007b); ISO, Transport"] [4.9785871505737305, 7.962326526641846, " discussed, driver interaction and involvement is critical to many AV technologies (e.g., warning systems that operate specifically by influencing the driver, and other technologies, such as ACC, that must be activated by the driver and require the d"] [5.1421074867248535, 8.08493423461914, "peration to certain areas or conditions).7\nConclusion\nMandating the inclusion of AV technologies may not be appropriate until at least the following circumstances are met. First, the technology must be mature enough that manufacturers are confident i"] [5.238819122314453, 8.11726188659668, " of this technology. Gary Marchant and Rachel Lindor (2012, p. 1334) outlined one such scenario: 1\nThe technology is potentially doomed if there are a significant number of . . . cases, because the liability burden on the manu- facturer may be prohib"] [5.258235454559326, 8.129154205322266, "this complex issue and its implications would be useful.\n3 Tort is a general term for wrong and is also a term that refers to the general legal field of torts. A negligent tort is a particular category of tort. Other categories include intentional to"] [5.2199177742004395, 8.115840911865234, "defined as \u201ca personal injury resulting in death, serious impairment of body function or permanent serious disfigurement\u201d (Pennsylvania Statutes, Title 75, \u00a71702).\n7 It has proven somewhat disappointing in practice, with costs remaining higher than e"] [5.229361534118652, 8.11268138885498, " and (f) extent to which its value to the community is outweighed by its dangerous attributes.\n Liability Implications of Autonomous Vehicle Technology 115\nholders to invest in them. In Europe, for example, insurers have offered a 20-percent discount"] [5.260381698608398, 8.123435020446777, "less likely to undermine the sense to which the driver retains ultimate responsibility for the vehicle. In contrast, if a car with an engaged autopilot feature crashes into a car in front of it and the driver\u2019s use of the autopilot was proper, it see"] [5.226358413696289, 8.12973403930664, ", new categories of crashes might arise, and these might pose interesting questions of how the liability system sets incentives to coordinate care among parties. For example, suppose that most cars brake automatically when they sense a pedestrian in "] [5.244314193725586, 8.123600006103516, "s and automobile-insurance companies. As responsibility for crashes shifts away from the driver, no-fault systems may become more attractive.\nOn the other hand, these technologies pose challenges for manu- facturers and may increase their liability r"] [5.243662357330322, 8.122903823852539, " large.\nIn contrast, plaintiffs will likely seek to exclude any global cost- benefit analysis that considers the benefits of avoided crashes and try to focus the reasonableness analysis on the specific facts around the crash (for example, was the aut"] [5.251155853271484, 8.123412132263184, "le to victims in lieu of having to prove neg- ligence. Strict liability is conventionally contrasted with negligence because, in theory, it does not require any showing of negligence,\n15 See Anderson (2007) for discussion of these issues.\n Liability "] [5.241394996643066, 8.130592346191406, "m to persons other than users or consumers; (2) to the seller of a product expected to be processed or otherwise substantially changed before it reaches the user or consumer; or (3) to the seller of a component part of a product to be assembled.\n 122"] [5.249642372131348, 8.134856224060059, "duct not reasonably safe.\n Liability Implications of Autonomous Vehicle Technology 123\nstates that a seller is not liable for failing to warn of known risks and risk-avoidance measures that should be obvious.\nStrict product liability is probably the "] [5.247361183166504, 8.12858772277832, "design: consumer expectations and cost-benefit. The consumer-expectation test was explained by one court as follows (Donegal Mutual Insurance v White Consolidated Industries, 2006):\nA product is defective in design or formulation when it is more dang"] [5.234403610229492, 8.123826026916504, "event crashes 80 percent of the time. The other 20 percent of the time, how- ever, the technology does not work and the crash occurs as it would have in the absence of the technology. Victims in those crashes may sue the manufacturer and argue that t"] [5.261740684509277, 8.159347534179688, "for safety. Careful thought and further research may be necessary to determine which costs and benefits should be included in the cost- benefit analysis that accompanies product liability.\nHuman-Computer Interaction\nWe also anticipate litigation arou"] [5.220579147338867, 8.113380432128906, "for new technologies even when the technology seems clearly defective.\n 128 Autonomous Vehicle Technology: A Guide for Policymakers\nsituation that could require a warning and that the instruction manual that accompanied the car clearly set out the li"] [5.271973133087158, 8.126373291015625, "lation that is inconsistent with state tort law. So, for example, product manu- facturers may argue that federal safety regulations preempt inconsis- tent state tort law and preclude lawsuits by injured plaintiffs.\nPreemption is a controversial subje"] [5.293532848358154, 8.088093757629395, "ves that an important function of tort law is corrective justice or civil recourse, one might be skeptical of federal preemption.\nImplied preemption has arisen in the automotive context in litiga- tion over a manufacturer\u2019s failure to install air bag"] [15.68787670135498, 16.32645034790039, "l companies (U.S. Code, 1990). In 1994, the General Aviation Revitalization Act of 1994 created a statute of repose and immunized makers of small air- craft against liability for planes after 18 years from manufacture even if negligence was shown (U."] [5.250145435333252, 8.122671127319336, "Warnings and consumer education will play a crucial role in managing manufacturer liability for these sys- tems. Manufacturers are likely to understate system capabilities during advertising, educate owners when purchasing vehicles with these capa-\nL"] [5.134862422943115, 8.078959465026855, "product, rather than a good that is pur- chased and owned (Smith, 2013b). By doing so, manufacturers may be able to use contract law to limit their liability and better control the way their products are used. Scott (2008) discusses the way this issu"] [5.057095050811768, 8.105244636535645, "s of dollars and would double or triple the cost of most cars. It seems unlikely that consumer demand would be substantial at such a cost. While most stakeholders we interviewed were confident that substantial price reductions will occur, no one seem"] [5.00169563293457, 8.145155906677246, " are. For example, the expected reduc- tion in congestion is a benefit to other motorists, but the reduction in the cost of congestion\u2014because the driver can do other things\u2014 is a benefit to the vehicle operator. If there is an increase in conges- ti"] [5.044782638549805, 7.976517677307129, "expressed concerns that premature regulation on the state level may result in a crazy-quilt of different, and perhaps incompat- ible, requirements. Attempting to meet state regulations could increase costs and make the technology uneconomical.\nNHTSA "] [5.164288520812988, 7.960845947265625, " AV com- munications platforms will need to be standardized, at least through \u201cbest practices,\u201d so developers can address a single platform design instead of many. According to several stakeholders, the size and type of processor is a developmental c"] [5.252140522003174, 8.125967025756836, "tors that \u201ccause\u201d a crash can be arbitrary.\nAs vehicles take on more of the driving functions that were histor- ically the responsibility of the driver, there may be a shift in our think- ing about accident responsibility. Rather than immediately att"] [5.208714962005615, 8.09072494506836, "s cov- ered in the next five sections.\nFederal Statute Limiting Tort\nCongress could pass a statute that limited liability of car manufac- turers (or immunized them completely) for certain categories of AV technology. Such an approach has some precede"] [5.30014181137085, 8.130522727966309, "s a substantial history with an alternative to con- ventional tort with respect to automobile crashes: no-fault. Currently the law in 12 states, the no-fault system allows crash victims to recover damages from their own auto insurers after a crash in"] [5.2209649085998535, 8.117300987243652, " manu- facturers would face substantially increased liability costs. However, it would still require legislative intervention.\nGuidance for Policymakers and Conclusion 145\nIncorporation of Appropriate Cost-Benefit Tests in Liability Determinations\nAs"] [5.056379318237305, 8.038056373596191, "ugh attempt to measure the more important dimension can be made, but that might not always be possible (Sunstein, 1994). Despite its imperfections, we think that focusing on comparing AV technology to vehicles operated by human drivers will provide u"] [5.0659966468811035, 8.038694381713867, "identified, explore whether the model provides insight regarding how automated road vehi- cle data might be handled. Issues to be explored could include what parties may access personal location information, person- ally identifiable information, veh"] [5.076333522796631, 8.030062675476074, "ed in\u201d to an unneces- sarily inefficient system (Hathaway, 2001). She offers the QWERTY keyboard as an example of an arguably subpar technology that became locked in as a result of the path-dependence of technological and eco- nomic development. In t"] [5.2221245765686035, 8.034496307373047, "ensing of AVs?\n\u2022 Whatpolicyrisksorgapsdoyouanticipateconcerninginsurance law in respect to AVs?\n\u2022 What concerns do you have about privacy protection for data obtained and used by AVs?\n\u2022 What are the communications issues you perceive, particularly co"] [5.203783988952637, 8.07461166381836, "rns extend to everyone, from software makers to infrastructure opera- tors\u2014since it is early in the AV industry\u2019s development, it is a loom- ing issue for all stakeholders. The liability issues appear to be increas- ing from the communications side a"] [5.2963128089904785, 8.089868545532227, "lleagues noted that insurance should be analyzed from a short-, medium- and long-term perspective as far as being an accelerator or inhibitor. In the short term, insur-\nConclusions from Qualitative Interviews with Stakeholders 155\nance costs go up\u2014it"] [5.228052616119385, 7.902286052703857, "e issuer of the certificate. It may be the government or a third party. Some people in government have asked the OEM whether there should be a tag on these data like a vehicle identification number (VIN). The OEM executive explained that all data com"] [5.215954780578613, 7.906050205230713, "cide what data they wish to share and what data they wish to keep private.\nThe automobile association executive we interviewed said data security issues are still unaddressed for AVS. He expressed the need for a credentialing system, and outlined the"] [5.217721939086914, 7.891719341278076, ", they provide another aspect of critical infrastructure and a potential target for a cyberattack. He said all of an AV\u2019s systems had to be designed to resist possible intrusion by hackers, and cited an example where hackers were able to access a car"] [5.283135414123535, 7.80103063583374, "ions within the vehicle that would include car owners bringing their own device (like a smartphone), and some services being embedded into the vehicle (e.g., LTE).\nAn OEM executive concurred with this vision of \u201cembedded vs. tethered\u201d vehicle communi"] [5.284986972808838, 7.805193901062012, "s with Stakeholders 161\ndescribed the need for global harmonization on spectrum and commu- nications issues. He observed that \u201chaving to isolate technology makes it difficult to deploy.\u201d\nAn automobile association executive said his organization had n"] [5.103476524353027, 7.976031303405762, " the United States is generally \u201crobophobic.\u201d The Europeans are confident in precision engi- neering and this provides confidence in precision-engineered vehicles. These consumer attitudes may have a significant impact on AV deploy- ment to the mass "] [4.685623645782471, 8.04001235961914, "ul, Minn.: American Law Institute Publishers, 1998.\nAmend, James M., \u201cGM Links with AT&T to Bring 4G LTE Connectivity in 2014,\u201d WardsAuto, February 25, 2013. As of August 23, 2013: http://wardsauto.com/vehicles-amp-technology/ gm-links-att-bring-4g-l"] [4.687956809997559, 8.024666786193848, "ion, 2002. As of August 19, 2013: http://www.cita-vehicleinspection.org/Portals/cita/autofore_study/ LinkedDocuments/literature/NHTSA%20the%20economic%20impact%20 of%20motor%20vehicle%20crashes%202000%20USA%202002.pdf\nBTS\u2014See Bureau of Transportation"] [4.6344709396362305, 8.044442176818848, ", Santokh Singh, and Chou-Lin Chen, Sampling Design Used in the National Motor Vehicle Crash Causation Survey, Washington, D.C.: National Highway Traffic Safety Administration\u2019s National Center for Statistics and Analysis, DOT HS 810 930, 2008. As of"] [5.2325873374938965, 7.7950897216796875, "onsolidated Industries, 166 Ohio App. 3d 569, 2006.\nDrews, Frank A., Hina Yazdani, Celeste N. Godfrey, Joel M. Cooper, and David L. Strayer, \u201cText Messaging During Simulated Driving,\u201d Human Factors, Vol. 51, No. 5, 2009, pp. 762\u2013770.\nEPA\u2014See U.S. Env"] [4.765980243682861, 8.0458345413208, "ww.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=48460\nFlorida Statutes, Fla. Stat. Title XXIII, Ch. 319, S 145. 2012. As of November 24, 2013:\nhttp://w w w.flsenate.gov/Laws/Statutes/2012/319.145\nFMVSS\u2014See Federal Motor Vehicle Safety St"] [4.702850341796875, 8.032463073730469, " 2013. As of August 21, 2013: http://www.capitol.hawaii.gov/measure_indiv.aspx?billtype=HB&billnumber=146 1&year=2013\nBibliography 171\n172 Autonomous Vehicle Technology: A Guide for Policymakers\nHawkins, Troy R., Ola Moa Gausen, and Anders Hammer Str"] [4.753271102905273, 7.945671081542969, " Seah, \u201cA Survey of Fault Detection, Isolation, and Reconfiguration Methods,\u201d IEEE Transactions on Control Systems Technology, Vol. 18, No. 3, 2010, pp. 636\u2013653.\nIHRA-ITS\u2014See International Harmonized Research Activities Working Group on Intelligent T"] [4.70698356628418, 8.036905288696289, "org/uc/item/3q19n51n\nISO\u2014See International Organization for Standardization.\nJames, Robert W., \u201cAbsolute Liability for Ultrahazardous Activites: An Appraisal of the Restatement Doctrine,\u201d California Law Review, Vol. 37, No. 2, 1949,\npp. 269\u2013283\nKalra"] [4.703669548034668, 8.059544563293457, "2.\nMarkoff, John, \u201cIn Search of a Robot More Like Us,\u201d New York Times, July 11, 2011. As of August 15, 2013:\nhttp://w w w.nytimes.com/2011/07/12/science/12robot.html\n\u2014\u2014\u2014, \u201cAt High Speed, on the Road to a Driverless Future,\u201d New York Times, May 27, 20"] [4.767617702484131, 8.077559471130371, ".gov/About+NHTSA/Press+Releases/2000/U.S.+Transportation+ Secretary+Slater+Announces+Advanced+Air+Bag+Regulation+that+Improv+Benefi ts+and+Reduce+Risks\n\u2014\u2014\u2014, Special Crash Investigations: Counts of Frontal Air Bag Related Fatalities and Seriously Inju"] [4.709036827087402, 7.986867427825928, "bruary 25, 2013.\nNeubauer, Catherine, Gerald Matthews, and Dyani Saxby, \u201cThe Effects of Cell Phone Use and Automation on Driver Performance and Subjective State in Simulated Driving,\u201d Boston: Human Factors and Ergonomics Society Annual Meeting, Octob"] [4.689216136932373, 8.036935806274414, "strians and Vehicles in Low Visibility Conditions,\u201d Osaka, Japan, April 27, 2012. As of August 15, 2013: http://panasonic.co.jp/corp/news/official.data/data.dir/en120427-2/en120427-2. html\nParchomovsky, Gideon, and Alex Stein, \u201cTorts and Innovation,\u201d"] [4.700309753417969, 7.981733798980713, ".: Aldine Pub. Co., 1980.\nSAE\u2014See Society of Automobile Engineers.\nSamaras, Constantine, and Kyle Meisterling, \u201cLife Cycle Assessment of Greenhouse Gas Emissions from Plug-In Hybrid Vehicles: Implications for Policy,\u201d Environmental Science and Techno"] [4.698514938354492, 8.049474716186523, "ndard J2400, August 2003b.\nSorensen, Paul, Martin Wachs, Endy M. Daehner, Aaron Kofner, Liisa Ecola, Mark Hanson, Allison Yoh, Thomas Light, and James Griffin, Moving Los Angeles: Short-Term Policy Options for Improving Transportation, Santa Monica, "] [4.723147869110107, 8.07590103149414, ", Title 15, \u00a76701, Terrorism Risk Insurance Act, 2002.\n\u2014\u2014\u2014, Title 42, \u00a7329, Public Readiness and Emergency Preparedness Act, 2005. \u2014\u2014\u2014, Title 49, Subtitle VI, Motor Vehicle and Driver Programs, 2006.\nU.S. Code of Federal Regulations, Title 49, \u00a71.95("] [4.664162635803223, 8.043874740600586, "ct\nUrmson, Chris, Charlie Ragusa, David Ray, Joshua Anhalt, Daniel Bartz, Tugrul Galatali, Alexander Gutierrez, Josh Johnston, Sam Harbaugh, Hiroki \u201cYu\u201d Kato, William Messner, Bryon Smith, Jarrod Snider, Spencer Spiker, Jason Ziglar, William \u201cRed\u201d Wh"] [4.749820709228516, 8.095044136047363, "Corrective Justice,\u201d Georgetown Law Journal, Vol. 91, March 2003, pp. 695\u2013756.\nZmud, Johanna, Liisa Ecola, Peter Phleps, and Irene Feige, The Future of Mobility: Scenarios for the United States in 2030, Santa Monica, Calif.: RAND Corporation, RR-246,"] [4.598291397094727, 8.555517196655273, " CORPORATION\nDriving to Safety\nHow Many Miles of Driving Would It Take to Demonstrate Autonomous Vehicle Reliability?\n Nidhi Kalra, Susan M. Paddock\nIn the United States, roughly 32,000 people are killed and more than two million injured in crashes "] [4.632905006408691, 8.455596923828125, "ity.\n\u2022 Even with these methods, it may not be possible to establish with certainty the safety of autonomous vehicles. Uncertainty will persist.\n\u2022 In parallel to creating new testing methods, it is impera- tive to develop adaptive regulations that are"] [4.591090679168701, 8.57333755493164, "verifi- cation. Curtain-style air bags, for example, are tested with a combina- tion of component tests to assess inflation time, fill capacity, and other responses in a range of temperature conditions and impact configura- tions, as well as laborato"] [4.585209846496582, 8.585229873657227, " last class of fully autonomous vehicles. Therefore, we use the total fatality, injury, and crash rates of human drivers in the United States as benchmarks against which to compare autonomous vehicle performance. However, the statistical approaches d"] [4.587035655975342, 8.583259582519531, "a certain number of failure-free miles and wishes to know the reliability (or, equivalently, the failure rate) that can be claimed at a particular level of confidence. Alternatively, for a given confidence C and reliability R we can solve for n, the "] [4.585174560546875, 8.587288856506348, "llion miles\n C = 50%\n1.09\n77\n103\n190\n382\n10\n 1 10 100\nFailure rate (failures per 100 million miles)\nSOURCE: Authors\u2019 analysis.\nNOTE: The four colored lines show results for different levels of confidence. The five dashed vertical reference lines in"] [4.585031032562256, 8.58410358428955, "n to determine the sample size (number of miles) required to estimate the fatality rate of the fleet to within 20% of the assumed rate using a 95% CI. We apply Equation 4 to estimate the number of fatalities we would need to observe before having thi"] [4.58489990234375, 8.586264610290527, " to estimate the failure rate with a precision of \u03b4 is:\n\u239bz \u239e2\nx=\u239c1\u2212\u03b12\u239f. (Eq.4)\n\u239bz \u239e \u239c 1\u2212\u03b1/2 \u239f.\n\u239dx\u23a0\n\u239c \u03b4 \u239f \u239d\u23a0\nIf the assumed failure rate (prior to data collection) is \u03bb\u2217 (Mathews, 2010), then Equation 5 implies the number of miles that must be driven "] [4.583346843719482, 8.591291427612305, "n fact they do not\u2014a dangerous proposition for policymakers, technology developers, the insurance industry, and of course consumers.\nTo be able to test the null hypothesis with significance level \u03b1, one can examine the upper confidence bound from Equ"] [4.5863471031188965, 8.584278106689453, "ver fatality (blue), reported injury (purple), estimated total injury (green), reported crash (red), and estimated total crash (orange) rates. Note that the miles needed to be driven approaches infinity as the difference between the human rate and au"] [4.585427284240723, 8.584961891174316, "better than the human driver failure rate. The different lines represent perfor- mance relative to the human driver fatality (blue), reported injury (purple), estimated total injury (green), reported crash (red), and estimated total crash (orange) ra"] [4.587150573730469, 8.579479217529297, "millions)\n Yet even these results are optimistic. We have intention- ally framed this analysis to calculate the fewest number of miles that would need to be driven to demonstrate statisti-\ncally significant differences between autonomous vehi"] [4.587273120880127, 8.583585739135742, "ng 24 hours a day, 365 days a year, at an average speed of 25 miles per hour. For example, one can ask, \u201cHow many miles (years) would autono- mous vehicles have to be driven (row 2) to demonstrate with 95% confidence their failure rate to within 20% "] [4.59154748916626, 8.563220977783203, "re rate is at most...\n275 million miles (12.5 years)\n3.9 million miles (2 months)\n1.6 million miles (1 month)\n(2) to demonstrate with 95% confidence their failure rate to within 20% of the true rate of...\n8.8 billion miles (400 years)\n125 million mil"] [4.437258243560791, 7.958586692810059, "t.gov/pubs/812013.pdf\nBureau of Transportation Statistics, Motorcycle Rider (Operator) Safety Data, Table 2\u201322, Washington, D.C.: U.S. Department of Transportation, 2014a. As of March 3, 2016: http://www.rita.dot.gov/bts/sites/rita.dot.gov.bts/files/"] [4.616652011871338, 7.992666721343994, "les: Opportunities, Barriers and Policy Recommendations,\u201d Transportation Research Part A: Policy and Practice, Vol. 77, July 2015, pp. 167\u2013181. As of March 3, 2016: http://dx.doi.org/10.1016/j.tra.2015.04.003\nFarmer, Charles M., and Adrian K. Lund, \u201c"] [4.607731819152832, 7.995954513549805, "ng, New York: Springer, 2008.\nNational Highway Traffic Safety Administration, Traffic Safety Facts: Crash Stats, Washington, D.C.: National Center for Statistics and Analysis, DOT HS 811 449, March 2011. As of March 3, 2016: http://w w w-nrd.nhtsa.do"] [4.59531307220459, 8.039772987365723, "ogy policy.\nSusan M. Paddock is a senior statistician at the RAND Corporation and a professor at the Pardee RAND Graduate School. Her research includes developing innovative statistical methods, with a focus on Bayesian methods, hierarchical (multile"] [13.799274444580078, 4.670154571533203, "ogram research is supported by government agencies, foundations, and the private sector.\nThis program is part of RAND Justice, Infrastructure, and Environment, a division of the RAND Corporation dedicated to improving policymaking and decisionmaking "] [20.4763240814209, 18.006582260131836, " Consumer Attitudes Toward Data Breach Notifications and Loss of Personal Information\nLillian Ablon, Paul Heaton, Diana Catherine Lavery, Sasha Romanosky\n CORPORATION\nFor more information on this publication, visit www.rand.org/t/rr1187\n Library of C"] [11.386905670166016, 17.573442459106445, "risk management, and insurance. The institute builds on a long tradition of RAND Corporation research characterized by an inter-\niii\niv Consumer Attitudes Toward Data Breach Notifications\ndisciplinary, empirical approach to public policy issues and r"] [20.479291915893555, 18.00973129272461, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Can a Federal Breach Disclosure Law Help?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nAPPENDIXES\nA. Survey Instrument . . . . . . . . . . . . . . . . . . . ."] [20.479663848876953, 18.009313583374023, "n\nTechnology, Such as Computers, Email, and Cell Phones?. . . . . 49\nB.2. How Respondents Found Out About Their Last Breach . . . . . . . 51\nB.3. Demographic Tabulation of Survey Respondents . . . . . . . . . . . . . . . 55\nSummary\n Data breaches con"] [20.47907257080078, 18.009414672851562, "e data gathered and analyzed from this survey come from participant self-report and recall. As such, the data may be incomplete due to limits of memory, underreported due to forgetfulness of past notifications, or overreported due to increased media "] [20.479299545288086, 18.010292053222656, "opped dealing with the company follow- ing a breach.\nMost respondents (89 percent) continued to conduct business with the breached firm, while only 11 percent stopped conducting business with it. One percent reported increasing the amount of busi- ne"] [20.4793643951416, 18.009340286254883, "es can review notification methods and data breach laws to speed up notification and prevent further harm with any stolen data.\nMore than one-quarter of respondents remember receiving a data breach notification in the 12 months preceding the survey, "] [20.479352951049805, 18.009550094604492, ", per- sonal data can appear within days on black markets, enabling crimi- nals to sell financial, health, and identity information (Ablon, Libicki, and Golay, 2014; Ca\u0301rdenas et al., 2009) and causing various forms of identity, tax, and loan fraud ("] [20.478988647460938, 18.00926399230957, "s, or medical information. Some states (California, for example) do not require a disclosure if data other than these were compro- mised or lost (usernames and passwords, for example) (Hoofnagle and King, 2008).\n2 Some commentators believe that the E"] [20.477825164794922, 18.007301330566406, "ications, or overreported due to increased media reporting (e.g., hearing about a data breach and misremembering being a part of it). With that caveat, these results can help establish a baseline of information about consumer attitudes toward data lo"] [20.478748321533203, 18.008676528930664, "ulk of our analy- sis. Our results suggest that most respondents who have lost personal information have had such an experience within the past 12 months. While not a panacea, by focusing only on the most-recent experience, the majority of which has "] [20.479175567626953, 18.008811950683594, "ernment Accountability Office, 2007). This underreporting effect may exist for a number of reasons: (1) a company may not be aware that it has suffered a data breach;7 (2) even if the company is aware, it is not always required to notify the public;8"] [20.478862762451172, 18.008840560913086, "(n = 2,038)\n Age Gender\nFamily income\nRace/ Education Region ethnicity\nOverall\nMale Female\n18\u201334 35\u201349 50\u201364 65+\n$0\u2013$30K $30K\u2013$60K $60K\u2013$100K >$100K\nNortheast Midwest South West\nHigh school or less Some college Bachelor's Postgraduate\nNon-Hispanic"] [20.479129791259766, 18.0085506439209, "ercent versus 19 percent). This may be explained by the notion that those with greater income engage in more financial and recreational activities with more organizations, resulting in an increased risk of compromise of personal information.3\nRegion:"] [20.478713989257812, 18.008596420288086, "ify all individuals, rather than spending time to omit some individuals from select states.\nWe postulate that some of these patterns may also be explained by differential access to information and communication technolo- gies: In the past, those in t"] [20.479434967041016, 18.008750915527344, "ns\nFigure 2.2\nPercentage of Participants Who Recalled Receiving a Breach Notification in the 12 Months Preceding the Survey (n = 2,038)\n Age Gender\nFamily income\nRace/ Education Region ethnicity\nOverall\nMale Female\n18\u201334 35\u201349 50\u201364 65+\n$0\u2013$30K 9%"] [20.478986740112305, 18.008560180664062, "quires notifying organizations to offer identity-theft pro- tection and mitigation services to affected individuals (State Legislature\nrestricted to those who had some interaction with the federal government, either as current or former employees or "] [20.565908432006836, 18.07962417602539, " out (columns). 1, 2, 3, or 4 denotes statistically significant differences from the comfort-level groups (rows), within the ways that participants found out (columns). For example, among those who first learned about the breach from the company dire"] [20.47928237915039, 18.00885772705078, " or by noticing sus- picious activity, for example). On the other hand, some studies have shown that those with higher levels of education often believe that they are less vulnerable (Wash and Rader, 2015).\n13 See, for example, Google Trends search a"] [20.477109909057617, 18.007158279418945, "health history, cannot be changed, and chang- ing a Social Security number, or personal information, such as a physi- cal home address and mother\u2019s maiden name, can be slow, complex, and comes at a great cost. From an attacker\u2019s perspective, these la"] [20.480880737304688, 18.010841369628906, "15) found that less than 10 percent of victims purchase identity-theft protection (4 per- cent) or purchased identity-theft insurance or used a credit monitoring service (6 percent).20 One possible explanation for the low percentages, especially comp"] [20.479217529296875, 18.00853157043457, "es of Assistance (n = 998)?\n Overall\nIf credit card information was taken\nIf health information was taken\nIf information other than credit card or health information was taken\nYes No\n60% 30% 61% 31% 80% 12% 58% 30%\nNot Sure\n10% 8% 8% 12%\n Figure "] [20.479454040527344, 18.008636474609375, "the company any- more.\u201d\n\u2022 did not seem necessary: \u201cI checked my account and nothing was missing\u201d; \u201cI wasn\u2019t interested.\u201d\n\u2022 seemed like a hassle or too much work: \u201cLaziness\u201d; \u201cBasic Apathy\u201d; \u201cHassle.\u201d\n\u2022 no time, or forgetfulness: \u201cI did not have time "] [20.48133659362793, 18.010271072387695, "itudes Toward Data Breach Notifications\nprocess of enrollment could be made easier, and clear benefits could be better communicated.\nConsumer Attrition\nA critical corporate and policy issue concerns consumer attrition in the event of a data breach: A"] [20.480104446411133, 18.00986671447754, " a Ponemon study that found that 20 percent of information technology security practitioners reported that they were unable to deter- mine whether a breach was ever resolved (Ponemon Institute, 2015).\nThat the overwhelming majority of consumers (89 p"] [20.479694366455078, 18.009618759155273, "nsumer Financial Protection Bureau, 2013). Further, the number of consumers who file police reports or take legal action when they become fraud victims is decreasing, although many consumers claim to install antispyware or firewalls on their computer"] [20.479537963867188, 18.012006759643555, "\n14% 5% 10%\n>$100K 49%\n 11%\n16% 3%\n14%\n15% 4%\n17%\n17% 4%\n Gender\nAge\n18\u201334 49%\n35\u201349 50%\n50\u201364 56%\n65+ 46%\nFamily Income\nSurvey Results 31\n Table 2.4\u2014Continued\nEducation\n11% 17% 22% 42\n17% 2%\n52%\nHigh school or less\n1 17% 30% 25%"] [20.478954315185547, 18.00881004333496, "ngly, those in the 18\u201334 age category were significantly less likely to be extreme responders than older age groups. Those with graduate degrees were significantly less likely to be extreme responders than those with less than a high school diploma. "] [20.476926803588867, 18.011211395263672, "umer Satisfaction with Company Response to the Breach\nCompanies can engage in a variety of post-breach activities in an attempt to assuage customers, employees, potential plaintiffs, federal and state regulators, and, in certain cases, Congress. Howe"] [20.479833602905273, 18.010177612304688, "ld take were donating money to organizations that promote cyber- security and simply apologizing to those affected.\nWhen offered the opportunity to elaborate on their responses, respondents commonly described the following:\n\u2022 provide advice on what I"] [20.479351043701172, 18.009342193603516, "U.S. Census Bureau, undated).\n 39\n40 Consumer Attitudes Toward Data Breach Notifications\nongoing law enforcement investigations. Thus, the optimal time for consumer notification of a data breach remains unclear.2\nSixty-two percent of respondents acce"] [20.479604721069336, 18.00951385498047, " actual knowledge.\nWhen examining customer reactions and sentiments following a breach, we found that consumer attrition is only 11 percent, and con- sumers seem to appreciate companies that respond and appear to take responsibility for breaches they"] [20.47968101501465, 18.009601593017578, "0 customers (Levin, 2015). In May 2015, Representatives Randy Neugebauer and John Carney introduced a bill, the Data Security Act of 2015, that would help standardize breach notifications from financial institutions and retailers. At the same time, m"] [20.479736328125, 18.010242462158203, "., suspicious behavior on credit card, locked out of accounts, etc.)\n(Opt2) Yes\u2014I was notified by a 3rd party company (e.g., my bank or credit card company told me)\n(Opt3) Yes\u2014I heard media reports about the data loss (Opt4) No\u2014I first learned of thi"] [20.479736328125, 18.010751724243164, "l, and 5 represents an actions that would greatly improve your satisfaction, please rate the following actions in terms of how much they would affect your satisfaction with a company\u2019s response following a loss/theft of your information.\nApologize to"] [20.479677200317383, 18.009958267211914, "\n Method of Notification\n Category\nPostgraduate Race/ethnicity\nFrom the Company Directly\n53%\nIdentified Suspicious Activity\n12%\nNotified by Third Party/Bank\n14%\nHeard Media Reports\n36%1,2\n30%3 33% 19%1 29%\n30%3,4 31%3,4 16%+\n3%+\n Non-Hispanic 56%4 10"] [20.479660034179688, 18.009313583374023, "ast\nMidwest South West\nEducation\nHigh school or less Some college Bachelor\u2019s Postgraduate\nRace/ethnicity\nNon-Hispanic white\nNon-Hispanic black\nHispanic/Latino 326 16% Non-Hispanic other 112 6%\nNOTE: Percentage totals might not sum to 100 due to round"] [20.479595184326172, 18.009565353393555, "w Forms Improve Consumer Understanding, Aid Comparison Shopping, and Help Prevent Surprises,\u201d fact sheet, November 20, 2013. As of March 6, 2015: http://files.consumerfinance.gov/f/201311_cfpb_factsheet_kbyo_testing.pdf\nGarrison, L., M. Hastak, J. M."] [20.479843139648438, 18.009519577026367, "gton, D.C.: Pew Research Center, May 20, 2015. As of February 8, 2016:\nh t t p : / / w w w . p e w i n t e r n e t . o r g / 2 0 15 / 0 5 / 2 0 / americans-attitudes-about-privacy-security-and-surveillance/\nMicrosoft Corporate Blogs, \u201c#MSFTCOSO POV: "] [20.47974967956543, 18.009363174438477, " . l e g i n f o . c a . g o v / p u b / 15 - 1 6 / b i l l / s e n /\ns b _ 0 5 5 1 - 0 6 0 0 / s b _ 5 7 0 _ c f a _ 2 0 15 0 5 2 2 _ 15 1 6 1 2 _ s e n _ fl o o r . h t m l\nShey, Heidi, \u201cMarket Overview: Customer Data Breach Notification and Respon"] [20.47964096069336, 18.010927200317383, "ers of free credit monitoring; (4) only 11 percent of respondents stopped dealing with the affected company following a breach;\n(5) 32 percent of respondents reported no costs of the breach and any inconvenience it garnered, while, among those report"] [13.929287910461426, 4.077849864959717, " Fostering\nInnovation\nin the U.S.\nCourt System\nIdentifying High-Priority Technology and Other Needs for Improving Court Operations and Outcomes\nBrian A. Jackson, Duren Banks, John S. Hollywood, Dulani Woods, Amanda Royal, Patrick W. Woodson, Nicole J"] [13.9486722946167, 4.070755481719971, "one product of that effort, completed as a joint effort of the RAND Corpo- ration and RTI International. It presents the results of the Courts Advisory Panel, a group con- vened in fiscal year 2015 as part of the NLECTC Priority Criminal Justice Need"] [13.941229820251465, 4.074010372161865, "bout this report should be sent to the project leader, Brian A. Jackson at Brian_Jackson@rand.org. For more information about the Justice Policy Program, see www.rand.org/jie/justice-policy or contact the director at justice@rand.org. For more infor-"] [15.028044700622559, 3.041895866394043, " . . . . .\nMoving Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nCHAPTER THREE\nCourt Technology and"] [15.059017181396484, 2.8995749950408936, "81 87 . 89 101\nCHAPTER FIVE\nConclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\nAn Innovation Agenda Focused on In"] [15.067521095275879, 2.703718900680542, ". . . . . . . . . . . . . . . . . . . . . . . . . .\n..9 . 10\n. 21 22 . 55 56\n4.3. Percentage of High-Priority (Top-Tier) Needs Related to Each Taxonomy\nCategory and Subcategory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "] [15.112367630004883, 2.868788480758667, " . . . . . . . ...\n.\n. 48 . .58 . 66 . 68 . .78 . 94\nSummary\n Society relies on the judicial system to play numerous roles. It is the link between law enforce- ment and the corrections system and serves as a check on their power over citizens. Beyond"] [15.097877502441406, 2.8061254024505615, "rnment broadly defined should do (such as address funding constraints that limit the ability to innovate), and things the public needs to do (such as advocate for changes in law to address current roadblocks to better court performance).\nix\nx Fosteri"] [15.075180053710938, 2.7442710399627686, " or low-hanging fruit were identified and pulled out.\nThe court innovation agenda is dominated by information and communications needs (orange icons, top left), which made up the majority not just of the high-priority needs (falling on and within the"] [15.091653823852539, 2.8179662227630615, "es of communication, and social media\nAssociated Need\nHigh High Priority Value\nLow- Hanging Fruit\n Adopt commercial alerting tools, u which are available but not widely\nused.\nDesign systems with backup capabilities and prioritize technology support t"] [15.085634231567383, 2.838549852371216, "equipped to handle,\nreflecting the different needs of\nMake the investments needed to allow connectivity, and explore new technologies that make it easier to install wireless Internet in older court buildings.\ndifferent types of courtrooms.a\nDevelop t"] [15.020423889160156, 2.793513298034668, "t a data standard that does not conform to their processes.\nTrain clerks who are entering data u to provide enough detail and\ngranularity to facilitate judges\u2019 tasks\nand activities, including descriptive\nfile names and semantic context information to"] [15.10042953491211, 2.8415184020996094, "he outset.a\nMake broader use of standards\nfor information-sharing to allow compatibility (criminal justice coordinating councils are a potential model to drive change).\nDevelop analysis tools or entities responsible for assessing the implications of "] [15.115035057067871, 2.8462207317352295, "public.\nPursue statutory authority or court procedural rule authority for specialists to appear via video presence to increase efficiency of staff usage.a\nCreate governance structures that limit the level of autonomy that elected judges can have; tha"] [15.042941093444824, 2.6315624713897705, "level category. Full categorization of needs is included in Appendix E. a This need is associated with two categories and is included twice in the table.\nFrom the needs that were rated highly enough for inclusion in our U.S. courts innovation agenda,"] [15.085288047790527, 2.755610942840576, "mats for digital data used in courts to avoid incompatibility problems. Addi- tional needs that were included in the agenda because they were rated as high value or low-hanging fruit also fell in this theme, including the need to adopt data standards"] [15.100691795349121, 2.8212387561798096, "nologies, rather than always requiring technology providers to adapt tools to the historical ways that courts have functioned.\n\u2022 Using technology for notification and public communication. Beyond the need for public notification in the context of eme"] [15.12121295928955, 2.8267288208007812, "ng High-Priority Technology and Other Needs\nable. Judges and others need better tools to quickly parse and understand larger and more- complicated bodies of data related to cases, and to integrate data from multiple criminal justice systems to inform"] [15.114496231079102, 2.880650758743286, " larger system might have more resources available to acquire new technology, but imple- mentation might be more tractable in a smaller system that has less of an investment in legacy systems or fewer staff to train.\nIt is also important to frankly a"] [15.084547996520996, 2.849421977996826, "e in identifying and inviting members of the Courts Advisory Panel. Two anonymous peer reviewers from the National Institute of Jus- tice and Geoffrey McGovern of RAND provided comments on the draft manuscript.\nWe would also like to acknowledge the c"] [15.136208534240723, 2.8603878021240234, "In this effort, we view innovation broadly, including both incremen- tal changes, where agencies improve on current practices, and transformational change, which makes it possible for agencies to pursue their objectives in new ways or make more-radic"] [15.126431465148926, 2.8934006690979004, "utures in detail, simulations that seek to analyze large numbers of possible futures, expert elicitation methods that attempt to leverage the knowl- edge and intuition of many individuals to build collaborative group estimates, and structured analyti"] [15.072171211242676, 2.804030656814575, "he results of that questionnaire as a foundation, attend a one-day, in-person workshop at the RAND Corporation\u2019s Washington, D.C.\u2013area office. The workshop featured a structured elicitation process to explore both current and potential near- term pro"] [8.03172492980957, 0.9760591983795166, "sory panel members and process, additional methodological detail, and the full list of needs from the panel.\nCHAPTER TWO\nThe State of the U.S. Court System Today\nThe court system is one of three main components of the U.S. criminal justice system, wh"] [8.002419471740723, 0.9509721398353577, "ch report directly up to the superior court, while others report directly to the court of appeals (see Figure 2.1). In an effort to facilitate more-uniform procedures within states, many state court systems are \u201cunified,\u201d allowing a single entity to "] [15.133833885192871, 2.858799695968628, "isdiction courts rarely conduct trials. Data from state court records, prosecutor\u2019s offices, and the federal judiciary indicate that less than 5 percent of all felony charges are ultimately disposed through a trial (Rosenmerkel, Durose, and Farole, 2"] [15.092025756835938, 2.9042866230010986, "Justice Statistics, justice expenditures in 2012 totaled more than\nFigure 2.2\nTypical Resolution of Felony Defendants Arraigned in State Courts in the 75 Largest U.S. Counties\nThe State of the U.S. Court System Today 7\n Dismissed (25%)\n Diversion or"] [15.083036422729492, 2.856639862060547, "nd people management. The goal was to get a snapshot of issues that were on the minds of practitioners from a range of courts and roles within the court system, and to capture challenges faced in areas as disparate as technology use and human resourc"] [15.090958595275879, 2.87894868850708, "relieving pressure on court systems that have been dealing with high case burdens for many years, this raises potential questions about equitable access to justice for all populations. The use of alternative dispute resolution mechanisms (e.g., arbit"] [15.109199523925781, 2.8801798820495605, "stem (Bureau of Justice Statistics, 2012). Staffing con- straints and the resulting increase in caseloads has been particularly problematic in individ- ual components of the judicial system, including indigent defense organizations (see Lefstein, 201"] [17.11896514892578, 7.694105625152588, "em-solving courts that focus on drugs, domestic violence, mental health, veterans, re- entry, teens, prostitution, and the homeless. Other states, such as Wyoming, Mississippi, New Jersey, and North Dakota, have only a drug court (Strickland, Schauff"] [14.711650848388672, 3.3641164302825928, " and Economic Disparities in Case Processing and Outcomes\nThere is increasing concern in the United States about the fairness of the justice system, espe- cially about the effect that bias\u2014whether knowing or not\u2014in the enforcement of laws, pros- ecut"] [15.137955665588379, 2.8397655487060547, " The inability to post bail can make it more difficult for individuals to fulfill work, family, and other obligations, which can magnify consequences of incarceration. As described earlier, 97 percent of federal criminal prosecutions are resolved by "] [15.065201759338379, 2.828197717666626, "vide access to files and resources to assist them.\nCourts and Changing Technology\nTechnology can play a role in helping courts perform their functions, but shifts in technology in both society and the criminal justice system can also create challenge"] [14.94565200805664, 2.7648515701293945, " technological availability, (2) could threaten the trial process when jurors and others use those technologies to do their own research outside of what is presented in testimony, and (3) when those in the courtroom take photos or video of proceeding"] [15.083905220031738, 2.9293875694274902, "by the absence of resources to upgrade or replace them (58 percent of respondents).\nThe issues posed by new technology can be particularly challenging when considering the unique court environment and its barriers to adopting and using new technologi"] [15.105987548828125, 2.856358051300049, "s distinct needs and requirements. The functioning of courts involves judges, court administrators, clerks, attorneys, and case litigants. Each group has its own requirements for access to information, data that must be collected and managed, and act"] [15.095718383789062, 2.880141019821167, "pellate review of trial proceedings (Lederer, 2000).\nAs cited previously in our panel results, challenges faced by court systems in building and maintaining internal human capital can also complicate innovation efforts. Societal shifts toward Interne"] [15.112112998962402, 2.8690526485443115, "e of U.S. courts and the potential for innovations to improve performance, the path to realizing the potential of technology and meeting the challenges faced by the U.S. court system starts with the technology and practice environment as it exists to"] [15.104092597961426, 2.9556612968444824, "omy in this work for application to courts.\nThere are five central categories within the taxonomy:\n\u2022 facility operations and population services\n\u2022 person-worn equipment and weapons/force\n\u2022 information and communications\n\u2022 doctrine, tactics, managemen"] [15.101605415344238, 2.882845401763916, "pment and training category captures knowledge and resources for\n2 New branches were needed to capture primary record-keeping methods and tools (which would include court reporting technologies) and public information provision and training for crimi"] [15.093546867370605, 2.9265506267547607, "t records and other documents\nBiometrics and other sensors\n(see also, information collection) attorneyin-fdraestfruectnurde ant\nInformation presentation tools and dashboards\nVoice\n\u2022 \u2022\n\u2022\nJudicial bench information delivery and interfaces\nTablet and mo"] [15.075563430786133, 2.8908402919769287, "ologtichainl g monitoring)\nSpecialized task technologies\nRestraint technologies\nEducation or information delivery\nDelivering services to population\nHealth care delivery\nSee information collection for biometric and other sensors for information system"] [15.11138916015625, 2.8702893257141113, "ncial management systems\n\u2022 Court human resource management systems\nTactics and practices\nTechnology-mediated training tools\nComputational tools\nElectronic document management systems Digital evidence management systems Case management systems\nFine an"] [15.072979927062988, 2.8903496265411377, "d in court facilities, but also the technologies that prosecutors, private attorneys, other criminal justice practitioners, and even members of a jury might have and use during court activities.\nNevertheless, some survey data are available. The Ameri"] [15.037304878234863, 2.896083354949951, "t from Illinois. As a result, while the data appear to be the best available on tech- nology use in courts across the country, they must be interpreted with caution.\n5 It should be noted that there is a literature describing court practice, technolog"] [15.082151412963867, 2.8622374534606934, "he mobile devices of the registered parties.\nPrior to the implementation of [the program], domestic violence victims had to travel to multiple locations to obtain a protective order. . . . Having to travel publicly to multiple locations, usually foll"] [15.100468635559082, 2.877512216567993, "sing from 10 percent to 37 percent) (Poje, 2014; see also discussion in Heerboth, 2013). As discussed in Chapter Two, technology advances within society as a whole are increasing expectations for information technology capability in courts\u2014and that c"] [15.10109806060791, 2.859429121017456, " and Schneider, 2007), but little data are available on what courts are actually doing.8\nInformation Collection\nIn contrast to other components of the criminal justice system\u2014where collection of new information is central to their roles\u2014courts are ge"] [15.109480857849121, 2.845187187194824, " then, in the text for each topic, relate the functional areas to the categories in our comprehensive taxonomy.\n10 Security-related infrastructure and facility technologies and practice are discussed later in this chapter.\n Based on NCSC\u2019s review,11 "] [15.083178520202637, 2.8347485065460205, "rts and court participants\u2014often central in civil proceedings\u2014is the acquisition and analysis of electronic information in case preparation, termed e-discovery.14 It is defined as\n11 NCSC identified a sample of 77 courts of different sizes, geographi"] [15.106289863586426, 2.8425168991088867, " e-discovery productions found that 73 percent of e-discovery costs were spent on document review. Computer-categorized document review techniques, such as predictive coding, identify at least as many documents of interest as tra- ditional eyes-on re"] [15.141514778137207, 2.8612265586853027, "it was available, although a much smaller percentage (31 percent) indicated that it was always available in all courtrooms (Wiggins, 2004). More- sophisticated versions of such software can make transcript-in-progress tools available to court partici"] [15.064553260803223, 2.850386142730713, "paper-based records (Delehandy et al., 2014; Lederer, 2000). Comprehensive recent data on the extent of adoption of digital recording are not available, but in a 2002 survey of federal courtrooms, 18 percent reported being equipped with digital audio"] [14.86072063446045, 2.944380044937134, "ining data from an individual\u2019s criminal history with other factors\u2014such as antisocial personality patterns, procriminal attitudes, substance abuse, procrime social supports, poor relationships, school/work failure, and lack of prosocial recreational"] [15.099936485290527, 2.853024959564209, "such management can support judges in making well-informed rulings quickly. It can also allow courts, criminal justice agencies, and community agencies to collaborate, improve services, and solve community problems. In our taxonomy of criminal justic"] [15.106175422668457, 2.847045421600342, "e\n\u2022 accounting (including front counter, cashier, back office, and general ledger functions)\n\u2022 security\n\u2022 management and statistical reports. (NCSC, 2001a, pp. 2\u20133)\nThe link to accounting functions can also enable caseflow management systems to per- "] [15.10110855102539, 2.848553419113159, "ions could be ongoing, given the continued use of paper or physical submission of some materials or evidence. The extent of adoption of these technologies is not clear, but in the survey of Ohio courts, 51 percent of the courts had some type of imagi"] [15.053025245666504, 2.88553524017334, "rovide efficient check-in processes in order to streamline the juror system. These tools also allow for last-minute recorded information pertaining to trials to be delivered to the prospective jurors (NCSC, undated d). According to a 2014 survey, 63 "] [15.051187515258789, 2.8325607776641846, "on electronically, 13 reported that all information exchanges were electronic (i.e., no information was exchanged via paper). Twenty-four responding courts solely or predominantly used real-time information exchange, 13 solely or predominantly used E"] [15.09002685546875, 2.8448867797851562, "ed sets of people to trans- mit information. Jury management systems (discussed previously) can be linked to notifica- tion systems to remind jurors of their summons and help ensure juror attendance. Some of these systems make it possible for jurors "] [15.11518383026123, 2.8588924407958984, " that guides self-represented litigants through a series of questions (Sandman and Rawdon, 2014). Based on the answers provided, the program will prepare personalized court forms that are ready to be served and filed.\n23 For example, Clarke, 2015.\n24"] [15.10818862915039, 2.884869337081909, "a challenge and an oppor- tunity for court systems. When many independent actors bring their own communications devices to the courtroom, it creates infrastructure demands. At the same time, the proliferation of mobile devices has given courts an opp"] [16.197389602661133, 2.9651408195495605, "ransport defendants or prisoners from jails, which also decreases risk and saves money. However, doing so has raised concerns about whether telepresence is compatible with fairness of the judicial process and the right of the accused to face their ac"] [16.19247817993164, 2.9489786624908447, "Court System: Identifying High-Priority Technology and Other Needs\ncase delays to use an interpreter who is physically present, video remote language interpreta- tion is a solid option and \u201cmay be the best alternative for many rarer languages\u201d (Clark"] [15.185681343078613, 2.8581764698028564, "tation. Data from the ABA survey of attorneys suggest that these cameras are available in many courts but are not widely used (from 2011 to 2014, between 17 and 22 percent of respondents indicated that they are available [Poje, 2014].) \u201cEnhanced whit"] [15.155487060546875, 2.874643564224243, "tween 12 and 27 percent indicated that there were capabilities for them to connect their own devices to court presentation systems (from projection screens, which were available in more than half of courtrooms, to individual monitors for trial partic"] [15.107601165771484, 2.848381996154785, " and the knowledge associated with criminal justice functions. And the route for implementing that doctrine or those tactics in the court system is the training that provides the necessary knowledge for court participants.\nIn the literature and in fe"] [15.14586353302002, 2.8099045753479004, " it was not neces- sary and between one-fourth and one-third indicated that the courtrooms they practiced in did not utilize technology or that courtroom technology was not relevant to their practice, reasons cited among the remainder of respondents "] [14.042354583740234, 3.0021331310272217, "standards for criminal justice information systems already exist to meet this need (see IJIS Institute, undated; NCSC, 2001b). For instance, the Global Information Sharing Initiative created a standard for data exchange models called the Global Justi"] [15.09327507019043, 2.877270221710205, "r physical infrastructure used for such applications\u2014 including designs that provide single points of access to enable screening, lighting and other technologies at the perimeter of buildings (e.g., applying crime prevention through environ- mental d"] [15.09869384765625, 2.8608028888702393, "accounting for paper files.\nPerson-Worn Equipment and Weapons/Force\nIn our taxonomy, the person-worn equipment category covers the equipment and tools (from general use equipment to specialized technology) that criminal justice practitioners use in c"] [15.068363189697266, 2.8516435623168945, "viduals or offenders from place to place, we have covered those roles and functions in our analysis of the corrections sector and therefore omitted them from this work in the interest of clarity.\nCourt Technology and Practice Today 43\n CHAPTER FOUR\nF"] [15.092702865600586, 2.8302555084228516, "nvolving language interpretation, jury and jury selection, long-distance court proceedings, public defense systems, and the training and education of judges and court staff.\n\u2022 Such organizations as ABA, the National Association for Court Management, "] [15.105737686157227, 2.8305108547210693, " address how evidence can come to courts in many different electronic file formats) and (2) steps that could allow courts to take advantage of new opportunities that improvements in technology have made possible. In our work, we therefore define a co"] [15.177872657775879, 2.786189079284668, "preparation and presentation, conducted primarily by attorneys or litigants to pre- pare for a case and to present evidence pertaining to that case at court hearings and trial. This area also includes judicial functions to rule on motions or evidence"] [15.087335586547852, 2.7499210834503174, "fy potential innovations that might relate to one or more areas of concern or opportunity. This avoided focusing on a single ideal future for the court system. For example, some of the problems that are recognized today are, at their heart, resource "] [15.090810775756836, 2.743851900100708, "es efficiently and fairly.\nImprove the competencies of staff through training, education, and readiness. Ensure an independent, impartial, and accountable judiciary.\n From Courts Today to Courts Tomorrow: Identifying and Prioritizing Innovation Ne"] [14.853004455566406, 1.9863505363464355, " to vary, each panelist assigned a rating for each need on a scale of 1 to 9, where 1 meant the need would not be valuable and 9 meant that meeting it could result in a 20-percent or greater improvement in performance or efficiency.6\n3 One issue high"] [14.962937355041504, 2.3969054222106934, "ds identified are practical for existing practice and to identify needs that analysts who are not as intimately familiar with the sector might not. The central challenge in these efforts is that the topics discussed\u2014and, therefore, the needs generate"] [14.826448440551758, 1.8443880081176758, " approach only implicitly includes considerations of cost. The probability of adoption of a solution or technology (our operational success measure) implicitly includes cost, because more-expensive solutions are less likely to be implemented broadly."] [15.035606384277344, 2.577930450439453, " of the need was too high, too low, or correct as is. This final round of prioritiza-\n7 Our approach to identifying and presenting the needs in tiers also had the potential to minimize the effect of this truncation.\n8 The process of consolidation and"] [15.098721504211426, 2.8199307918548584, " technology information to judges and how to recruit and keep information technology staff in court organizations. Needs in this area ranged from the very broad (e.g., the need for training and capability-building for court staff to address the fact "] [15.109110832214355, 2.7969553470611572, "se associated with specialty courts needing to share data with a wider range of orga- nizations and service providers. Needs in this area also included ways that information- sharing could contribute to resolving important problems in courts today. F"] [15.090619087219238, 2.8067777156829834, "er tools for evaluating system security.\n\u2022 Notification and communication. Because court proceedings rely on all the required par- ticipants appearing at the same time, when litigants or defendants do not show up, it cre- ates schedule problems and c"] [15.083869934082031, 2.7070276737213135, "ely under doctrine, tactics, management, and behavioral knowl- edge development and training, with the majority of those needs falling into our management/\nFrom Courts Today to Courts Tomorrow: Identifying and Prioritizing Innovation Needs 55\nFigure "] [15.080881118774414, 2.695812940597534, "formation provided by the Courts Advisory Panel members (on how valuable a need would be to the court system if met, how technically straightforward it would be to achieve,\nFigure 4.2\nPercentage of Needs Contributing to Each Court Objective\n Per"] [15.08527946472168, 2.705862045288086, "rs in one of the needs that bridges categories. Table 4.2 presents the top-tier needs by top-level taxonomy category. The dominance of infor- mation and communication needs in the top-priority list is very different from the category breakdown of the"] [15.107123374938965, 2.828782081604004, "tems when they go down. Develop, exercise, and implement response plans to address technology failure.a, b\nEnsure that electronic and other court data have robust backups and that courts have sufficient control over the data storage to permit this.c\n"] [15.078924179077148, 2.837766408920288, "dges, lawyers, and others)\nMinimal or nonexistent wireless Internet and bandwidth in many court buildings\nPoor access to complete information to inform bail decisions\nPoor access to complete information to inform bail decisions\nDue process concerns a"] [15.06714916229248, 2.8774054050445557, "to support sentencing. The availability and quality of information available to judges for making bail decisions has also been an enduring concern, with discussion in the 1988 Office of Technology Assessment report examining technology\u2019s potential fo"] [15.103540420532227, 2.8764288425445557, "to aid in locating information later.\nExplore whether features of technology systems provide opportunities to better meet the timeliness goals of the justice system (versus just focusing on existing technology and what\nit can do).\nPursue statutory au"] [15.126666069030762, 2.7977843284606934, "ween public access and maintaining sufficient court security\nBacklogs in forensic laboratories and the slow processing of evidence delaying justice\nVendor systems that try to simultaneously meet the needs of multiple stakeholders (e.g., judges, couns"] [15.106083869934082, 2.820251703262329, "h other needs that were not ranked as high priority) highlights a key technology development challenge for courts and a situation where stakeholder concerns and best practices can sometimes pull in multiple directions. The involvement of stakeholders"] [15.093145370483398, 2.8554928302764893, "tem-level tools to assess the cascading effects of changes in criminal justice policy and practice.\nDuring discussion and the prioritization process, panel members commented on indi- vidual needs, providing additional context and nuance based on thei"] [15.076526641845703, 2.7815537452697754, "rmation- sharing\n IT systems for managing mission-related data\n External communications\n Fixed location communications (video)\n Information management (including sharing)\n Information delivery (including communications)\n Information technology\u2014 basic"] [15.067485809326172, 2.891859531402588, "ted to serious barri- ers: \u201cConfrontation Clause objections can prevent this for now\u201d; and \u201cEasy to do technologi- cally, harder to do if there are legal objections.\u201d12 Focusing specifically on remote appearances of crime lab staff, one participant e"] [14.841181755065918, 2.0633623600006104, "e main prioritization discussed above includes consid- eration of value (and the number of court objectives where that value could be realized), likeli- hood of success, and likelihood of broad adoption of the innovation. Although this calculation pr"] [15.07581901550293, 2.7871363162994385, " both sides in a dispute that educates pro se litigants. These needs actually scored quite highly on all three measures in our calculations, but because they were relevant to only one or two of the court objectives, their overall expected values were"] [15.100443840026855, 2.828002691268921, "nd for all sides of disputes. Such calculations would also have implications for time standards for court operations (Steelman, 2010). See also NCSC, undated a.\nc Such role-based and other access- or disclosure-control issues are general issues acros"] [15.112703323364258, 2.793917179107666, "ations and maintenance costs are captured in acquisition decisions and included in out-year budgets.g\n NOTE: Needs are grouped by their top-level taxonomy category. Full categorization of needs is included in Appendix E. Needs that were already incl"] [15.111865997314453, 2.8424811363220215, "ore whether features of technology systems provide opportunities to better meet the timeliness goals of the justice system (versus just focusing on existing technology and what it can do).\nDesign systems that are capable of capturing unstructured but"] [15.106161117553711, 2.849858283996582, "s. Communication between courts and other criminal justice agencies and community support groups is essential to increasing the effectiveness and efficiency of the court system. Having updated, well-developed standards that are widely implemented wou"] [15.087940216064453, 2.732452630996704, "s relatively evenly split between the information and communications category and the doctrine, knowledge, and training category, the high-priority needs were dominated by information and communications issues. That dominance is even stronger when\n 7"] [15.102387428283691, 2.7729368209838867, "e top-tier needs addressed con- cerns about the ability of courts to maintain security and to be prepared for emergencies and other incidents. With respect to security, the need for standards and performance measures for security at different locatio"] [15.069819450378418, 2.873697280883789, "mation of citizens in court records. Tools for better data protection appeared in both the high-value and low-hanging fruit lists.\nAddressing basic technology shortfalls in today\u2019s courts. Panel members raised a number of concerns about the technolog"] [15.182755470275879, 2.8014299869537354, "urt. Social media is a tool that so many members of the public use, and they increasingly assume that they should be able to communicate with government this way. However, courts need guidelines and materials to ensure that both they and citizens und"] [15.132843017578125, 2.8642263412475586, "U.S. Court System\nThis effort, aimed at the national level, sought to frame an innovation agenda for the court system writ large. The value of the result will be driven by application and by how individual agencies or organizations use the identified"] [15.10107707977295, 2.8351871967315674, "nizations with needs and roles to play in court innovation. This effort has provided a set of high-priority needs that rose to the top of our panel\u2019s deliberations, as well as a broader\u2014and much longer\u2014set of innovation options that represent opportu"] [14.638527870178223, 3.4930801391601562, "formation Officer Massachusetts Trial Court Boston, Mass.\nDavid K. Byers\nAdministrative Director Arizona Supreme Court Phoenix, Ariz.\nKay Chopard Cohen\nExecutive Director\nNational District Attorneys Association Alexandria, Va.\nThe Honorable Amy Daven"] [15.098207473754883, 2.778606653213501, "ctitioners National Criminal Justice Association Washington, D.C.\nRobert A. Zastany\nExecutive Director\nAdministrative Office of the Nineteenth Judicial Circuit Waukegan, Ill.\nCourts Advisory Panel Members 79\n APPENDIX B\nCourts Advisory Panel Pre-M"] [15.0828218460083, 2.7839279174804688, "s unimportant would get a score of 0.\nEach objective can have any number. For example, if you think all these objectives are equally important, all would be scored as 100. If you think they are each of different levels of importance, each score would"] [15.114988327026367, 2.8400988578796387, "nformation per- taining to a specific case from the courts to or between external entities, such as the prosecutor\u2019s office, defense counsel, law enforcement, pretrial services or other supervi- sory agencies, and the public. Functions here include c"] [15.131343841552734, 2.8578696250915527, "enting technologies to support [NAME OF FUNC- TIONAL AREA] in your court system (or the court systems with which you are most familiar)? Please indicate whether each obstacle is major, minor, or not an obstacle in your experience. [Check boxes for ea"] [15.029826164245605, 2.6747303009033203, "vidual level (e.g., ensuring due process and justice for an individual accused of a crime or party to litigation) or at the societal level (e.g., providing access to justice uniformly for all citizens or protecting the public at large by administerin"] [14.907610893249512, 2.111429214477539, "iving a weight from 100 (if it was equally important to the highest-priority objective) to 0 (if it was viewed as unimportant). These scores were then averaged across all panelists\u2019 responses to produce a set of weights on the objectives. The results"] [15.07530689239502, 2.608833074569702, "that could be addressed through research or science and technology investment\u2014that is, the specific needs. The panelists also identified which court objectives each need supported (by marking a simple \u201cyes\u201d if the need supported the objective). In al"] [15.116250038146973, 2.6426796913146973, "ctics, management, and behavioral knowledge development and training\nFacility operations and population services\nObjective\n Percentage of identified needs\n Judges\nAttorneys\nWorking group\nCourt administrators\nand the doctrine, tactics, m"] [15.087085723876953, 2.8417372703552246, " 2).\nDetailed Methodology 93\n94 Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs\nTable D.1\nExample Original and Combined Needs\n Original\nCombined\n Problem or Opportunity\nTechnology reliability is a"] [14.780961990356445, 1.811049222946167, "te storage.\n Figure D.4\nNumber of Original Needs Consolidated to Produce Combined Needs\n80\n70\nNumber of resulting combined needs\n0\nRAND RR1255-D.4\nPrioritizing Court Needs\nDetailed Methodology 95\n 60\n50 40 30 20 10\n 12345\nNumber of ori"] [14.789140701293945, 1.7694610357284546, "kthroughs if an effort to meet the need is successful, multiplied by the probability that such efforts will be technically and operationally successful. Put another way, the score for a need is determined by how beneficial it will be in achieving one"] [14.786741256713867, 1.7820998430252075, "he data points into sets 1, 2, . . . K so that the following measure is minimized:\nmin\u2211K \u2211x\u2212\u03bc2. i=1 xjinseti j i\nHere, \u03bci is the center, or average, of cluster i. This measure, also called the within-cluster sum of squares or cluster cohesion, is one"] [14.779030799865723, 1.7403638362884521, "ly, it is as difficult as an NP (nondeterministic polynomial time) problem.\nDetailed Methodology 97\n 98 Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs\nFigure D.5\nRanges of Expected Values for Tiere"] [14.760671615600586, 1.7546663284301758, "the score for a need broke through the top or bottom of its existing tier (e.g., a Tier 3 need\u2019s normalized score increased above the top of the Tier 3 range), its rank was changed to the tier one rank up or down, even if the new score did not fully "] [15.049571990966797, 2.8522706031799316, "sociated Need\nExamine technologies to help organize and analyze large volumes of more-complicated information. Though some commercial tools\nare available, courts need a\nbetter understanding of how new technology could help manage the effects of digit"] [15.023810386657715, 2.9990832805633545, "icy decisions, ranging from increases in criminal justice capacity to pushes for efficiencies in the system\nConcerns about the suitability of the risk and needs assessments that help determine sentencing and release from the corrections system\nConcer"] [15.090868949890137, 2.860069513320923, "y of examples, see Johnson, 2009; Clarke, 2015; and Cabral et al., 2012.\n104 Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs\nTable E.1\u2014Continued\n Category and Subcategory\nInternal data collection: O"] [15.101408958435059, 2.815995454788208, "ailable for addressing backlogs for processing DNA (deoxyribonucleic acid) evidence (NIJ, 2015b). The broader issue of case backlogs was explored in the National Research Council\u2019s review of forensic science in the United States (Committee on Identif"] [15.105965614318848, 2.8289670944213867, "s for improving appearance rates (Legal Design Lab, 2015).\nk The need for up-to-date source lists is widely recognized; is included in relevant standards, such as those published by ABA (2005); and has been examined in surveys of courts that explore "] [15.18299388885498, 2.8639075756073, "meliness goals of the justice system (versus just focusing on existing technology and what it can do).\nHigh Value\nLow- Hanging Fruit\n External communications\nu\nn For example, Rule 5.2 of the Federal Rules of Civil Procedure includes such guidelines ("] [15.096738815307617, 2.835200786590576, ": Video\nProblem or Opportunity\nMaintaining continuity of operations during natural or other events\nDue process concerns about remote appearances in judicial proceedings\nLimited resources for prosecutors and public defenders (e.g., not enough attorney"] [14.991689682006836, 2.786818742752075, "ird-party information as a result of technology, which is so integrated into the lives of defendants, victims, and police, creating challenges for both prosecutors and defenders\nSpace constraints (physical and virtual) for managing records and eviden"] [15.099990844726562, 2.833754539489746, "lop centralized standards for 1 authenticating electronic documents. Examples of implementation\nare available, but no practice is universally adopted.\nBuild into record entry systems rules 2 or expert tools that help ensure complete data entry and ap"] [15.099300384521484, 2.8300929069519043, "d be digitized).\nDefine requirements that some 3 categories of judicial work product\nneed to be confidential, even if they\nare stored in the same system with official public files.a\nIn the absence of redaction, develop better ways to protect some sen"] [15.102561950683594, 2.8221206665039062, "g this).a\nFull List of Court Needs 111\n Category and Subcategory\nProblem or Opportunity\nConcerns about data quality within the court system as\na result of inconsistency in the way data are entered, limits in clerk knowledge, hiring of individuals wit"] [15.058985710144043, 2.817781448364258, "been shared appropriately.bb\nPromote a common understanding 2 of what it means to share digital evidence (e.g., footage from\na security camera at a private\nsite). Does it mean offering the opportunity to access evidence (similar to physical evidence "] [15.109763145446777, 2.837801456451416, "e use of such tools as encryption.a\nDevelop standards for evaluating the 1 security of cloud storage providers to both inform decisions and assuage concerns.\nTake advantage of records becoming 3 electronic and, rather than having to gather and ship r"] [15.147817611694336, 2.8594911098480225, "a and mobile devices, which enable disclosure of information and cyber harassment\nCourts\u2019 tendency to be reactive to technology changes rather than plan ahead\nLimited resources for prosecutors and public defenders (e.g., not enough attorneys, too hig"] [15.106807708740234, 2.8344132900238037, "eline, could meet this need.\n116 Fostering Innovation in the U.S. Court System: Identifying High-Priority Technology and Other Needs\nTable E.2\u2014Continued\n Category and Subcategory\nProblem or Opportunity\nVendor systems that do not meet needs\nVendor sys"] [15.12557601928711, 2.8391964435577393, "or 2 modify business processes that can\nbe adopted across stakeholders (or\nmatch business processes to existing software capabilities), making it\npossible for technologies to function effectively (examples of consensus development and ranking process"] [15.099949836730957, 2.8233423233032227, "ng, and match processes\nto the goals they are trying to achieve.a\nModify planning and funding processes to ensure that operations and maintenance costs are captured in acquisition decisions and included in out-year budgets.\n2 u\nc Organizational effor"] [15.067815780639648, 2.813978910446167, "ts who cannot afford\nlawyers or procedures that allow\nvictim advocates to take a more central role in the trial process.a\ne NCSC maintains a compendium of state rules on bulk data sale (NCSC, undated e). In 2005, SEARCH, the National Consortium for J"] [15.130375862121582, 2.8523623943328857, "esources to better inform 2 judges\u2019 decisions when appointing counsel (and to inform the public\nabout these decisions), including an assessment of the costs and benefits\nof appointing counsel early versus late.\nAdopt business process reengineering 1 "] [15.11388874053955, 2.8332371711730957, " to decisionmaking.a\nDetermine caseload standards\nto make it possible to perform h assessments across jurisdictions.\n2 u\n3\nUpdate job requirements for court 2 management staff to create a body\nof employees whose technology skills\nare sophisticated en"] [15.062490463256836, 2.8466238975524902, "erformance measures for effective security\nfor different types of courts and locations within a court to minimize intrusiveness for court participants, staff, and the public.a\nIncrease training and build the capability and expertise to addressj chang"] [15.113563537597656, 2.8400633335113525, "instructions to ensure that those using the technology (lawyers, court officers, etc.) understand how to usea it, reducing the probability of errors.\n Societal/legal knowledge development and innovation\nDevelop standards and better 2 technological to"] [15.079485893249512, 2.8926217555999756, "y corrections technologies, such as continuous alcohol monitors and Global a Positioning System monitors.\nPursue statutory authority or 1 court procedural rule authority\nfor specialists to appear via video presence to increase efficiency of\nDevelop i"] [15.114169120788574, 2.8332338333129883, " or fail\nChallenges keeping information technology staff up to speed on emerging technology\nDevelop more exercises and drills 1 to determine likelihood of success,\nsuch as using red teams, performing testing, and actually operating from backup sites "] [15.076322555541992, 2.8817150592803955, "ine best practices to address 2 this misbehavior, which could range\nfrom educational efforts to simple prohibition of mobile devices.d\nDesign court infrastructure to be 3 more welcoming and engaging.a\nDevelop standard lists of basic 1 technology that"] [15.118169784545898, 2.956782579421997, "merican Bar Association, \u201cCourt Funding Best Practices,\u201d web page, undated. As of March 28, 2016: http://www.americanbar.org/groups/committees/ american_judicial_system/task_force_on_the_preservation_of_the_justice_system/Court_Funding_Toolkit/ ABA_T"] [14.924551010131836, 3.0544848442077637, "Carrie A. Schneider, \u201cEmergency Management in the Courts: Trends After September 11 and Hurricane Katrina,\u201d The Justice System Journal, 2007, pp. 20\u201335.\nBlack, Nicole, \u201cLawyers, Cloud Computing, and Innovation: How Cloud Computing Facilitates Innovat"] [14.860129356384277, 3.0595483779907227, "er 2004. As of March 28, 2016: http://www.proselex.net/Documents/JMI%20ELECTRONIC%20FILING.pdf\nCCJ/COSCA Joint Committee on Court Security and Emergency Preparedness, CCJ/COSCA Court Security Handbook: Ten Essential Elements for Court Security and Em"] [14.936196327209473, 3.01183819770813, "ings-in-the-united-states/\nCowan, Bradley M., \u201cChildren in the Courtroom: Essential Strategies for Effective Testimony by Child Victims of Sexual Abuse,\u201d The Army Lawyer, February 2013, pp. 4\u201316.\nCrandall, Nancy, Making a Business Case for Automated "] [14.885496139526367, 3.070326328277588, "ter for State Courts, 2013.\nFederal Judicial Center, Advisory Committee on Evidence Rules: Meeting and Symposium, Chicago, October 9, 2015. As of March 28, 2016:\nhttp://w w w.uscourts.gov/file/18432/\nFlango, Carol R., Deborah W. Smith, Nora E. Sydow,"] [14.937043190002441, 3.049276113510132, "09,\npp. 1\u201321.\nHardenbergh, Don, Robert Tobin, Sr., and Chang-Ming Yeh, The Courthouse: A Planning and Design Guide for Court Facilities, Williamsburg, Va.: National Center for State Courts, 1991.\nHeerboth, Cynthia K., \u201cTechnology and Its Effects on t"] [14.920174598693848, 3.0729780197143555, " 2009, pp. 259\u2013283.\nJoint Technology Committee, Making the Case for Judicial Tools, JTC Resource Bulletin, 2014.\nJudicial Council of California, California Trial Court Facilities Standards 2011, San Francisco, 2011. \u2014\u2014\u2014, Video Remote Technology in Ca"] [14.938952445983887, 3.0854744911193848, "://scholarship.law.wm.edu/facpubs/635\n\u2014\u2014\u2014, \u201cCourt Technology: For Trial Lawyers the Future Is Now,\u201d Criminal Justice, 2004a, pp. 14\u201321. \u2014\u2014\u2014, \u201cIntroduction: What Have We Wrought?\u201d William & Mary Bill of Rights Journal, Vol. 12, No. 3,\n2004b, pp. 637\u20136"] [14.944392204284668, 3.0623879432678223, "74\u2013179.\nMcMillan, James E., Using Technology to Improve Customer Service: Trends 2007, Williamsburg, Va.: National Center for State Courts, 2007.\n\u2014\u2014\u2014, Videoconferencing Survey 2010 Results, Williamsburg, Va.: National Center for State Courts, 2010. A"] [14.95744514465332, 3.0276811122894287, "ies/Courthouse-Design-and-Finance/Resource-Guide.aspx\n\u2014\u2014\u2014, \u201cCourt Website Design: Courts with Mobile Applications,\u201d web page, undated c. As of March 28, 2016: http://www.ncsc.org/Topics/Media/Court-Websites/State-Links.aspx?cat=Courts%20with%20Mobile"] [14.8582181930542, 3.128169298171997, "au/law-professionals/wearable-technology-courtroom/\nOffice of the State Attorney, Fifteenth Judicial Circuit, Digital Evidence and Document Standards, Palm Beach County, Fla., June 2011. As of March 28, 2016: http://www.sa15.state.fl.us/stateattorney"] [13.957489013671875, 3.957751989364624, "thod.html\n\u2014\u2014\u2014, \u201cPriority Criminal Justice Needs Initiative,\u201d web page, Santa Monica, Calif., undated b. As of March 28, 2016:\nhttp://www.rand.org/jie/justice-policy/projects/priority-criminal-justice-needs.html\nRandall, Ronald, James A. Woods, and Ro"] [14.913336753845215, 3.1045749187469482, "inal Justice Record Information, Sacramento, Calif., 2005. As of March 28, 2016: http://www.search.org/files/pdf/RNTFCSCJRI.pdf\nShapiro, Joseph, \u201cAs Court Fees Rise, the Poor Are Paying the Price,\u201d NPR News, 2014. As of March 28, 2016:\nhttp://w w w.n"] [14.826325416564941, 3.0630226135253906, "ronic Evidence: Electronic Evidence Procedures,\u201d August 1, 2012. As of March 28, 2016: http://www.tnmb.uscourts.gov/documents/EEP_APPs.pdf\nU.S. Congress, Office of Technology Assessment, Criminal Justice, New Technologies, and the Constitution, OTA-C"] [15.104588508605957, 2.8695216178894043, "ocial Media,\u201d American Journal of Trial Advocacy, Vol. 36, 2013, pp. 641\u2013653.\nZorza, Richard, and David Udell, \u201cNew Roles for Non-Lawyers to Increase Access to Justice,\u201d Fordham Urban Law Journal, Vol. 41, No. 4, May 2014, pp. 1259\u20131316.\nSociety reli"] [2.80971360206604, -1.6619892120361328, " Jan Osburg, Philip S. Anto\u0301n, Frank Camm, Jeremy M. Eckhause, Jaime L. Hastings, Jakub Hla\u0301vka, James G. Kallimani, Thomas Light,\nChad J. R. Ohlandt, Douglas Shontz, Abbie Tingstad, Jia Xu\n CAPABILITIES, NEEDS, AND MANAGEMENT OPTIONS FOR NASA\u2019S AER"] [2.822597026824951, -1.646848201751709, "nterest to those respon- sible for managing NASA flight research infrastructure and capabilities, aeronautics researchers, and the broader oversight community in the Office of Management and Budget, the Office of Science and Technology Policy, and Co"] [2.822510004043579, -1.6486786603927612, "nts about this report should be sent to the project leader, Jan Osburg (Jan_Osburg@rand.org). For more information about the Science, Tech- nology, and Policy program, see www.rand.org/jie/stp or contact the director at stp@rand.org.\nContents\n Prefac"] [2.85725474357605, -1.6150695085525513, " . . . . . . .\nCHAPTER FOUR\nManagement Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Approach Framework. . . . . . . . . . . . . . ."] [2.799346446990967, -1.6692261695861816, "... 34\n3.1. NASA Aircraft\u2013Related Cost by Type for FY 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n3.2. ARMD Total Aircraft Funding Expected for FYs 2016\u20132020 (Not\n. 39\nIncludingLBFD) .........................................."] [2.8242170810699463, -1.6475529670715332, ". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n5.2. ACTE Sorties and Flight Hours to Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .\n5.3. Scenario 1 Partnering Alternati"] [2.80456805229187, -1.6675256490707397, "creases in ARMD budgets that are expected to persist over the foreseeable future, budget levels over the next ten years similarly cannot be predicted precisely.\nTo address this challenge, we developed high-level needs projections for three different "] [2.8031373023986816, -1.6697006225585938, "ng the portion of the ARMD budget that is spent on flight research\n3. Making the ARMD budget for flight research go further by:\n\u2013 improving the efficiency of NASA\u2019s flight research enterprise\n\u2013 taking different approaches to adjusting flight research"] [2.805295705795288, -1.6671291589736938, " capa- bilities are available and modernized to facilitate progress. Given the extensive breadth of ARMD\u2019s SIP, an explicit prioritization of capabilities (as later described in MO-04) could inform possible infrastructure investments\u2014as well as manag"] [2.807887077331543, -1.665181040763855, "ectation of stable funding, rather than having to plan for contingencies. Projects funded with the next $100 million could be designated as \u201ccon- fident\u201d and managers could prepare in similar fashion. On the other hand, projects for which the funds a"] [2.8066365718841553, -1.6641247272491455, "of poten- tial users. A well-publicized annual survey could be instituted, complemented by less frequent long-term examinations like the Decadal Surveys compiled by the National Academies of Science. Leadership prioritization is key to planning, inte"] [2.787869453430176, -1.6858575344085693, "versely affect pro- gram budgets and lead to delays\u2014even collateral effects on other programs. Explicitly and effectively balancing such risks across all elements involved in flight research (air- craft, airspace, ranges, ground infrastructure, and w"] [2.799713134765625, -1.6730170249938965, "o may have concepts that would benefit from small amounts of flight research but who do not have sufficient funding for flight research (e.g., in a similar way that NASA allocates supercomputing time to researchers). For example, many academics use R"] [2.8022096157073975, -1.6734976768493652, "trate return on investment by articulating benefits, especially in monetary terms, to explain their value (MO\u201015). Whenever possible, NASA should continue to explain potential benefits in both domain and monetary terms. NASA funding ultimately depend"] [2.815443277359009, -1.6563384532928467, "lka, David \u201cNils\u201d Larson, Brad Flick, Sean McMorrow, Steve Schmidt, Albion H. Bowers, David A. Samuels, Chauncey C. Williams, and J. Brett Swanson. At Ames Research Center, we thank Michael Aftosmis, Roy Williams, Munro Dearing, Huy Tran, and Matthew"] [2.822831153869629, -1.6485666036605835, "hout the study and for reviewing an earlier version of this report. We are also indebted to William Welser IV, for his constructive review of this report. Tom LaTourrette, Anita Chandra, and Marjory Blumenthal provided greatly appreciated quality ass"] [2.8244402408599854, -1.647274374961853, "l\nUAS unmanned aircraft systems UHBR ultra-high bypass ratio\nUK United Kingdom\nUSAF U.S. Air Force\nWFF Wallops Flight Facility\nAbbreviations xxi\nCHAPTER ONE\nIntroduction\n Flight research, flight testing, and flight safety analysis are essential compo"] [2.8124775886535645, -1.6598687171936035, "s the use of flight test is specifically indicated.\n 1\n2 Expanding Flight Research\nRAND Corporation to assess its flight research and flight test needs and related capa- bilities, identifying gaps and management options (MOs) that support evolving AR"] [2.809199094772339, -1.6627017259597778, "ecisely.\nDespite these limitations, by using a futures-based approach, we were able to identify broader strategic direction, needed capabilities, and MOs.\nAeronautics Research Needs over the Next Ten Years\nThe 2015 ARMD SIP provided the foundation fo"] [2.810659170150757, -1.6607784032821655, "rior work (e.g., Anton, Gritton, et al., 2004a; Anton, Johnson, et al., 2004b), we examined the conceptual range of needs and capabilities, rather than specific details (e.g., the predicted number of flight hours needed for specific aircraft out to t"] [2.791444778442383, -1.681384801864624, "We compared the needs with the capabilities as a way to identify any gaps or excess. Given the uncertainties already outlined, this gap analysis was at the level of research domains in the SIP thrust areas mapped against the five areas of flight rese"] [2.8066530227661133, -1.665715217590332, "ina and Russia, with which close collaboration in aeronautics research is less likely in the foreseeable future.\nThe timing of this study imposed certain limitations as well. At the time of the kick-off meeting, ARMD had not yet published its SIP nor"] [2.806551218032837, -1.650389552116394, "tion tools. Based on this, we generate a set of three estimates for future needs, representing steady, reduced, and increased demands for flight research.\nSecond, we review flight research capabilities based on existing NASA flight and ground test as"] [2.8044509887695312, -1.6628587245941162, "ter One), we did include UAS-related flight research needs because they feature prominently in NASA ARMD\u2019s SIP and generally also involve non-UAS capabilities; e.g., manned safety chase planes.\n3.\nSupport to space exploration\u2013related efforts (from mi"] [2.8142499923706055, -1.6559884548187256, "um UAS to establish proof of concept and mature the underlying technologies. Technologies with the most promise are scaled to larger aircraft (manned or unmanned) and flight tested. In some cases the goal is autonomous medium UAS operating in the Nat"] [2.807215929031372, -1.6617815494537354, "he develop- ment of next-generation fighters (although such collaborations are outside the scope of the current SIP).\nIn the international arena, Japan and nations within the European Union (EU) have civil aviation research with portfolios similar to"] [2.821166515350342, -1.6507779359817505, "- tion (Tinoco, 2008), as does pushing past TRL 5 (defined as system and component\n12 Expanding Flight Research\nprototype validation in the expected operating environment). When considering the impact of M&S development on flight research, the primar"] [2.810263156890869, -1.6592189073562622, " parallelism with heterogeneous, specialized hardware. This may have negative implications for code generality and computation efficiency. On the algorithmic front, the state-of-the-art industrial CFD remains the unsteady RANS (URANS) codes based on "] [2.794990062713623, -1.6631242036819458, "e.g., motion, lighting). Moreover, faithful representations of vehicle behavior are fundamentally dependent on our ability to accurately characterize aircraft aerodynamics, dynamic response, and control logic across the flight regime, all of which ar"] [2.8050503730773926, -1.6617943048477173, "ay have implications for flight research. For example, the most-profound advances in aviation efficiency in the last half-century have come from improvements in propulsion, specifically through the development and refine- ment of the high bypass turb"] [2.8052237033843994, -1.6633620262145996, "ht research, ground testing still provides controlled environments that can be more heavily instrumented but ground testing no longer benefits from industrial scales of efficiency, given the modern role of CFD. As a result, flight research is more co"] [2.8042502403259277, -1.665395975112915, "fect), the potential futures help explore how these factors might evolve, identify management challenges, and ultimately serve as a backdrop against which to illustrate how the MOs we later develop could help ARMD regardless of what occurs in the fut"] [2.8059446811676025, -1.6643624305725098, "likely to benefit most directly from such a technology demonstrator face potential questions of environmen- tal compatibility and economic viability. Hence, it may be reasonable to expect that the supersonic thrust has to cope with additional, nontec"] [2.8101625442504883, -1.6598848104476929, "sed resources for flight research. This future would include full, robust, stable research in all six SIP thrust areas, additional investments in modifi- able testbed aircraft, and initiation of major investments in both subscale and full- scale X-pl"] [2.8268911838531494, -1.6440300941467285, "ables real-time analysis of flight test data and decisionmaking on envelope expansion and other efforts during a flight\n\u2022 ground-based flight simulation and flight research laboratories to enable risk reduction prior to test flights\n\u2022 maintenance and"] [2.8098301887512207, -1.6604576110839844, "search Capabilities\nNASA\u2019s fleet of more than 60 aircraft\u2014including the aircraft used for flight research\u2014 is distributed across several NASA centers. NASA research aircraft are used for both aeronautics flight research and airborne science research."] [2.8196990489959717, -1.6518619060516357, "1H\nKSC\n3\u00d7 UH1H\nSOURCE: Based on NASA, 2015a.\nNOTE: Aircraft of particular relevance to ARMD are highlighted in bold.\nJSC = Johnson Space Center; KSC = Kennedy Space Center; WFF (GSFC) = Wallops Flight Facility (Goddard Space Flight Center).\nRAND RR13"] [2.816091775894165, -1.6543102264404297, "rthiness, aircraft/cruise missile, and crossover/atmospheric vehicles (aeronautical aspects). Flight test range assets include the Ridley Mission Con- trol Center and Birk Flight Test Facility, supersonic flight corridors, reconnaissance test ranges,"] [2.816436767578125, -1.6546021699905396, "afe testing environment and for overseeing that test site operation occurs under strict safety standards.\nFlight Research Capabilities of U.S. Industry and Academia\nIndustry and academia focus on T&E and R&D, respectively. Both sectors offer sub- son"] [2.8431906700134277, -1.6274784803390503, "chinery Facility.\nNASA supports flight research in academia, and some academic researchers use NASA facilities for testing. Although this relationship might extend further to NASA taking advantage of university flight research equipment and pilots, t"] [2.8324036598205566, -1.6382280588150024, "ve to long-term planning and investing, since they are able to accumulate funding across multiple fiscal years, have more autonomy in setting their own research agendas, and are not prohibited from \u201ccompeting\u201d with commercial enterprises.\nDuring our "] [2.844914197921753, -1.6267942190170288, " will replace their Lear 25 with a Lear 35, and LaRC is pursuing the acquisition of another HU-25C. JSC\u2019s C-9B is already scheduled for retirement, as is one of their T-38s. On the commercial side, the fate of Boeing\u2019s current EcoDemonstrators is unc"] [2.815359115600586, -1.6529210805892944, "on 20E (D\u2010CMET) (D\u2010ADLR) G550\n Boeing:\nDemonstrators 757, 787, Eco\u2010 747 engine 757 engine P&W, GE: Honeywell: testbeds\ntestbeds Calspan:\nG\u2010III, Learjet\n MQ\u20101** MQ\u20109** RQ\u20104*,**\nC\u201012 C\u2010130\nB\u20102 B\u201052 C\u20105 C\u201017\nKC\u2010135\n WFF\nB\u2010200\n(N8NA)\n(N439"] [2.8254554271698, -1.6436878442764282, " Cessna C206 SR\u201022 (N501NA) Columbia Cirrus 300\n(N525NA, HU\u201025C TBD?)\n GRC\n(N608NA)\n(N601NA)\nT\u201034C\nS\u20103B\n DHC\u20106\n(N607NA)\nLear 35\nLear 25*\n(N616NA)\n ARC\nSierra**\n(N707NA)\n AFRC\nB\u2010200 (N7NA, N801NA) (N870NA) (N149AF)+ Ikhana**\nTG\u201014\n("] [2.816035270690918, -1.651550054550171, "II\nSOFIA\n Low Subsonic\n(M<0.3)\nSubsonic\n(0.3