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Prepared for the Los Angeles County Probation DepartmentPromising Services for
Justice-Involved Youth
A Scoping Review with Implications for the Los
Angeles County Juvenile Justice Crime Prevention Act—Appendixes
D. MICHAEL APPLEGARTH, P’TRICE JONE


(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


nile delinquen*” OR “juvenile detention” OR “juvenile
probation” OR “juvenile corrections” OR “justice-involved youth” OR “juvenile offender*” OR “delinquen*” OR “court-involved youth” OR “juvenile crime” ) OR KW ( “juvenile justice” OR “juvenile de


uptive” OR “externaliz*” OR “oppositional” OR “defiant” OR “violen*” OR “substance use” OR “substance abuse” OR “substance dependence” OR “drug use” OR “drug abuse” OR “drug depend*” OR “addict” OR “co-occurring disorder*” OR “risk* behavior” OR “at-


OR “delinquen*” OR “court-involved youth” OR “juvenile crime” ) OR AB ( “juvenile justice” OR “juvenile delinquen*” OR “juvenile detention” OR “juvenile probation” OR “juvenile corrections” OR “justice-involved youth” OR “juvenile offender*” OR “del


est practice*” or “evaluat*” or “program evaluat*”) OR
KW
 (“evidence-based practice*” or “best practice*” or “evaluat*” or “program evaluat*”)
AND
TI (“Recidiv*” OR “Reoffen*” OR “Desist* ” OR “Risk*” OR “Outcome”) OR SU (“Recidiv*”
OR “Reoffe


pout*”
OR “expelled” OR “gang involvement”)
AND
TI (“evidence-based practice*” or “best practice*” or “evaluat*” or “program evaluat*”)
AND
TI (“Recidiv*” OR “Reoffen*” OR “Desist* ” OR “Risk*” OR “Outcome”) OR SU (“Recidiv*”
OR “Reoffen*”


“at risk youth” OR “problem youth” OR “truan*” OR “expulsion” OR “suspension” OR “drop* out” OR “dropout*” OR “expelled” OR “gang involvement”)
AND
Document Title, Publication Title, Subject Heading: (“evidence-based practice*” or “best practice*


 A., and
Kathleen J. Bergseth, “The
Impact of Reentry Services on Juvenile Offenders ’ Recidivism, ”

Youth Violence and Juvenile
Justice, Vol. 6, No. 3, July 2008,
pp. 295– 318. Care coordination  Youth with existing
out-of-home
placement s •


si -
experimental  Justice
Wright, Emily M., Ryan Spohn,
and Michael Campagna,
“Responding to Crossover
Youth: A Look Beyond Care coordination  Youth in the juvenile
justice and child welfare system • Treatment (n = 210)
• Comparison (n = 425)


ve Justice Interventions
on Recidivism Outcomes Among
Juvenile Offenders, ” Youth
Violence and Juvenile Justice,
Vol. 15, No. 4, October 2017,
pp. 465– 480. Diversio n Youth diverted from
juvenile court  • Restorative justice
(n = 284)
• Comp


(n = 179)
Dembo, Richard, Jennifer
Wareham, and James Schmeidler, “Evaluation of the
Impact of a Policy Change on Diversion Program Recidivism and Justice System Costs: 12 -
Month Follow -Up,” Journal of
Offender Rehabilitation, Vol. 41,
No. 3,


erred to
juvenile court  • Treatment (n = 143),
• Comparison (n = 143) RCT  Justice, other
Kethineni, Sesha, and Jonathan
A. Grubb, “An Evaluation of
Redeploy Illinois on Juvenile Diversion  Youth (medium to
high risk), nonviolent offenses
 •


Stephanie Bontrager,
Kristin Winokur Early, Gregory Hand, and Steven Chapman, “Juvenile Justice Interventions:
System Escalation and Effective
Alternatives to Residential
Placement, ” Journal of Offender
Rehabilitation, Vol. 52, No. 5,
2013, pp


etention Overreliance, ” Journal of
Juvenile Justice, Vol. 5, No. 2,
Fall 2016, pp.  12–30
. Diversion  Youth who violated
community supervision
 • Treatment (n = 121)
• Comparison (n = 124) Quasi -
experimental  Justice
Vose, Brenda, and Kelly


olved youth
(n = 93)
• Non–gang- involved youth
(n = 315) Quasi -
experimental  Justice
Celinska, Katarzyna, Hung -En
Sung, Chunrye Kim, and
Margret Valdimarsdottir, “An
Outcome Evaluation of
Functional Family Therapy for Family intervention


 James
Schmeidler, Amy Hartsfield, and
Werner Wothke, “Psychosocial
Functioning Among Juvenile
Offenders 12 Months After Family Empowerment Intervention, ” Journal of
Offender Rehabilitation, Vol. 32,
Nos. 1–2, 2000c, pp.  1–56
. Family interve


nal
referral  • Treatment (n = 81)
• Comparison (n = 85) RCT  Mental health
Henggeler, Scott W., Elizabeth
J. Letourneau, Jason E. Chapman, Charles M. Borduin,
Paul A. Schewe, and Michael R.
McCart, “Mediators of Change
for Multisystemic Ther


on for first -Time
Juvenile Offenders:
Comparisons with Probation and
Dropouts on Recidivism, ”
Journal of Commu nity
Psychology, Vol. 32, No. 2,
2004, pp.  177– 200. Family intervention  Youth with first -time
offenses  • Treatment (n = 267)


“Family
Integrated Transitions: A Promising Program for Juvenile Family intervention  Youth incarcerated
with co -occurring
substance use and mental health disorders and released on parole
 • Treatment (n = 105)
• Comparison (n = 169) Quasi -
exp


ally Supported Interventions to Reduce Adolescent Sexual Risk Behavior: A Randomized
Controlled Trial, ” Journal of
Adolescent Health, Vol. 67,
No. 1, July 2020, pp.  53–60
. Health -focused  Justice- involved
youth  • Treatment (n = 125)
• Comp


ease Interview
Skills of Adolescent Males in a
Juvenile Residential Treatment Facility, ” Journal of Applied
Behavior Analysis, Vol. 53,
No. 4, September  2020,
pp. 2303– 2318
. Other  Youth in a juvenile
facility who have been adjudicated of a


ulu ’s Girls
Court, ” Women and Criminal Problem -solving
courts and other court
interventions  Adolescent girls in
juvenile court  • Treatment (n = 60)
• Comparison (n = 70) Quasi -
experimental  Justice, other    32 Citation  Program Type  Po


tcome Study, ” Justice
Quarterly, Vol. 33, No. 2, 2016,
pp. 291– 318
. Problem -solving
courts and other court
interventions  Youth in drug court  • Treatment (n = 686)
• Comparison (n = 686) Quasi -
experimental  Justice
Abrams, Laura S., Sar


ommitted a serious
offense  • Full sample n = 133
• Justice- involved youth
(n = 64)
• At-risk youth (n = 69) Quasi -
experimental  Justice
Lancaster, Chloe, Richard S.
Balkin, Roberto Garcia, and Alexandra Valarezo, “An
Evidence -Based Approa


ntation for Juvenile
Alcohol and Drug Offenders, ”
Journal of Offender
Rehabilitation, Vol. 43, No. 3,
2006, pp.  49–72. • Did not attend  presentation
(n = 72)
• Comparison (n = 84)
Viola, Wendy Elaine, Eric S.
Mankowski, and Mary Elisabeth


Comparative Psychotherapy  Youth on probation  • Treatment (n = 39)
• Comparison (n = 31) RCT  Justice   39 Citation  Program Type  Population  Sample Size  Study Design  Outcome
Measure(s)
Criminology, Vol. 56, No. 1,
February 2012, pp.  61–80


baum, Chloe A., and
Shabnam Javdani, “Expressive
Writing Intervention Promotes Resilience Among Juvenile Justice- Involved Youth, ”
Children and Youth Services Review, Vol. 73, February
2017,
pp. 220– 229. Psychotherapy  Incarcerated youth  • n


ual Abuse: Journal of Research and Treatment, Vol. 18, No. 4, October 2006,
pp. 401– 421
. Psychotherapy  Youth adjudicated of
sexual offense  • 9 studies  Meta -analysis  Justice
Thoder, Vincent J., and Joseph
D. Cautilli, “An Independent
Evalu


l F. McCaffrey, Kirsten Becker, and Andrew R. Morral, “Long- Term
Effect of Community- Based
Treatment: Evid ence from the
Adolescent Outcomes Project, ”
Drug and Alcohol Dependence, Vol. 107, No. 1, February 2010,
pp. 62–68
. Substance use
tre


with a Substance Use Disorder:
Gender Sensitive Substance
Abuse Intervention, ” Journal of
Offender Rehabilitation, Vol. 49,
No. 7, 2010, pp.  479– 494. Substance use
treatment  Female youth
committed to youth
development center
with a subs


4. Wraparound services  Youth with affective
or psychotic
disorders in detention centers
 • n = 314 Observational  Justice,
substance
use, mental
health, other
McCarter, Susan Ainsley,
“Holistic Representation: A
Randomized Pilot Study of Wr


tember 2014, pp. 1033–1056.
Baglivio, Michael T., Kevin T. Wolff, James C. Howell, Katherine Jackowski, and Mark A.
Greenwald, “The Search for the Holy Grail: Criminogenic Needs Matching, Intervention Dosage, and Subsequent Recidivism Among Serious


y,” Journal of Consulting and Clinical Psychology, Vol. 77, No. 1, February 2009, pp. 26–37.
Bottcher, Jean, and Michael E. Ezell, “Examining the Effectiveness of Boot Camps: A
Randomized Experiment with a Long-Term Follow Up,” Journal of Research


 Youth,” Journal of Family
Therapy, Vol. 41, No. 2, April 2019, pp. 251–276.
Cervantes, Richard C., Karen Ruan, and Norma Dueñas, “Programa Shortstop: A Culturally
Focused Juvenile Intervention for Hispanic Youth,” Journal of Drug Education, Vol.


Lisa P. Tichavsky, “What Works for Whom? The Effects
of Gender Responsive Programming on Girls and Boys in Secure Detention,” Journal of
Research in Crime and Delinquency, Vol. 52, No. 1, 2015, pp. 93–129.
de Beus, Kimberly, and Nancy Rodriguez, “


ustaining Families, Dissuading
Crime: The Effectiveness of a Family Preservation Program with Male Delinquents,” Journal
of Criminal Justice, Vol. 39, No. 4, July–August 2011, pp. 338–343.
DiClemente, Ralph J., Teaniese L. Davis, Andrea Swartzendr


w J., “Using Police Officers to Enhance the Supervision of Juvenile Probationers:
An Evaluation of the Anchorage CAN Program,” Crime and Delinquency, Vol. 48, No. 1, January 2002, pp. 116–137.
Gibson, Laurel P., Charleen J. Gust, Arielle S. Gillman


 the Juvenile Justice System,” Children and Youth Services Review, Vol. 65, June 2016, pp. 78–85.
Hamilton, Zachary K., Christopher J. Sullivan, Bonita M. Veysey, and Michele Grillo,
“Diverting Multi-Problem Youth from Juvenile Justice: Investigati


. Drinkard, Lynn Falletta, and Daniel J. Flannery, “Understanding
Clinical Complexity in Delinquent Youth: Comorbidities, Service Utilization, Cost, and Outcomes,” Journal of Psychoactive Drugs, Vol. 40, No. 1, March 2008, pp. 85–95.
Javdani, Shabn


Jonathan A. Grubb, “An Evaluation of Redeploy Illinois on Juvenile
Reoffending,” International Journal of Offender Therapy and Comparative Criminology, Vol. 65, Nos. 10–11, August 2021, pp. 1192–1223.
Krakow, Barry, Diane Sandoval, Ron Schrader, Br


J., Scott W. Henggeler, Michael R. McCart, Charles M. Borduin, Paul A.
Schewe, and Kevin S. Armstrong, “Two-Year Follow-Up of a Randomized Effectiveness Trial Evaluating MST for Juveniles Who Sexually.
Leve, Leslie D., and Patricia Chamberlain, “A


 Donat, Jane Cheney,
Timothy M. Fitzpatrick, and Linda Monaco, “Project Back-on-Track at 1 Year: A Delinquency Treatment Program for Early-Career Juvenile Offenders,” Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 39, No. 9


valuation of an
Intimate Partner Violence Prevention Program for Adjudicated, African American, Adolescent Males,” Youth Violence and Juvenile Justice, Vol. 4, No. 4, October 2006,
pp. 368–385.  62 Sawyer, Aaron M., and Charles M. Borduin, “Effects


tivational Interviewing for Incarcerated Adolescents
on Driving Under the Influence After Release,” American Journal on Addictions, Vol. 15,
Suppl. 1, 2006, pp. 50–57.
Steiner, Benjamin, and Andrew L. Giacomazzi, “Juvenile Waiver, Boot Camp, and R


athleen Kemp, Sarah Johnson, and
Larry K. Brown, “Outcomes of a Family-Based HIV Prevention Intervention for Substance Using Juvenile Offenders,” Journal of Substance Abuse Treatment, Vol. 77, June 2017, pp. 115–125.
Trulson, Chad, Ruth Triplett, a


lence and Juvenile Justice, Vol. 18, No. 4,
October 2020, pp. 381–394.
Yoder, Jamie, Rebecca Dillard, Lori Brusman Lovins, and Stuart Berry, “Evaluation II: Risk
Outcomes from a Specialized Treatment and Management Program for Youth Who Commit Sex


D. MICHAEL APPLEGARTH, P’TRICE JONES, STEPHANIE BROOKS HOLLIDAY
Promising Services for
Justice-Involved Youth
A Scoping Review with Implications for
the Los Angeles County Juvenile Justice Crime Prevention Act
From the onset of the first juvenile c


is filed), and 54 percent of cases continued through the court (i.e., petitioned). For the peti-tioned cases, over 200,000 juveniles were adjudicated (53 percent), the equivalent of being found guilty in adult court (Hockenberry, 2022a). For those wh


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


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


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.


comes of interest
(e.g., “outcome,” “reoffen*).
We limited our review to studies published
since the year 2000, published in English, and that included programs or samples in the United States. 5
Empirical studies and meta-analyses that reported
o


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


l programs 4
Health-focused programs (No subcategories) 10
Family-focused interventions Multisystemic therapy 10
Functional family therapy 4
Family empowerment intervention 5
Multidimensional treatment foster care 2
Parenting with love and limi


3) other (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.
1. Diversion Programs
Diversion programs aim to reduce youths’ formal contact with the juvenile ju


ely to reoffend during the two-year follow-up period.
Together, these studies suggest restorative justice
programs might effectively serve as alternatives to formal system involvement for youth.
1.2. Teen Courts
Teen courts are intended for first t


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


t al., 2018).
Two other studies evaluated the effects of the
Mental 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


-based arrested youth. Although the rate of school-based arrest decreased by 84 percent following the program’s implementation, youth who were arrested prior to the program had similar recidivism rates compared with the program youth who, instead of


to evaluate youths’ needs and create a treatment plan prior to the youth’s court date (Kazi et al., 2012). Significant increases in the use of alternative sanctions (i.e., youth cases were adjourned in contemplation of dismissal dependent on youth h


quences associated with detention.
Two studies examined potential methods of
enhancing 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


vism. First, in a national 12
multi-site quasi-experimental study, youth partici-
pating in a drug court had the same or higher odds of recidivating compared with similar peers on probation (Sullivan et al., 2016). Second, in another quasi-experiment


 significantly lower only in felony arrests rates.
Findings from two observational studies suggest
that it is not uncommon for youth who participate in drug court to have, at least initially, some contin-ued substance use, with 79 percent (Hayden, 2


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


studies examined the Crossover Youth
Practice 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’ needs and coordinate case manage -
me


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.
It can be challenging to draw conclusions across


elony arrest (Bahr, Cherrington, and Erickson, 2016).
The articles that used a quasi-experimental
design also supported the use of CBT for reducing recidivism for justice-involved youth. For example, there is evidence that participating in CBT is as


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 al., 2017).
Krakow et al. (2001) observed changes in PTSD
symptoms and sleep quality for girls in


ure rates of reoffending, finding that this gender-specific intervention did not decrease recidivism for detained boys or girls (Day, Zahn, and Tichavsky, 2015).
A quasi-experimental study of boys that received
an unspecified intensive mental healt


ment results in better juvenile justice outcomes for youth rather than no treatment at all.
5. Psychoeducation
There were 16 articles that evaluated psychoeduca-tional programs. We identified three subcategories of programs, including skills training


arding observational studies, Abrams, Shan-
non, and Sangalang (2008) evaluated an independent living skills–focused program for youth preparing to leave incarceration and found no significant relation -
ship between program participation and new off


e observational studies. In an RCT, Salazar and Cook (2006) evaluated
an intimate partner violence–prevention program administered in the community for adjudicated, predominately African American males. In the post-test assessment, results revealed


oup had significantly fewer sexual
partners 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


that 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.
7. Family-


r. Similarly, Timmons-Mitchell et al. (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


dications found no significant differences between the treatment and control groups of adjudicated youth 12 months post-intervention (Sexton and Turner, 2010).
Two quasi-experimental studies also looked at
the effectiveness of FFT on recidivism. Ce


examined a community-based program for youth who are justice-involved, called Parenting with Love and Limits . This program
provided therapy sessions to youths and their guard -
ians, in addition to offering parenting education ser -
vices. Compared


th youth who did not participate in the program (Trupin et al., 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


h participating in the program are traditionally housed in a separate unit.
Two quasi-experimental studies examined the
effectiveness of the Phoenix Academy program. Initially, this residential treatment program showed positive results (at three, si


, curriculum
compression, 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


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


ing construction trade skills and working on projects (Cohen and Piquero, 2010). Youth who completed the program were more likely to graduate (58 percent compared with 18 per-cent) and had reduced recidivism rates compared with youth who did not comp


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.
11. Risk-Need-Responsivity and
Principles of Effective Correctional I


hnical violation but were not more likely to receive new charges. Lane et al. (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


are summarized in Table 2.
Many diversion programs were associated with
better 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


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).
Finally, psychoeducational programs appeared
to have mixed effects, including life skills train


grams that address criminogenic risk tended to be effective at reducing recidivism.
• Ot
her forms of CBT that target mental health had mixed outcomes, although certain forms of such
therapy appeared to effectively improve mental health.
• So
me oth


study had youth
self-report less delinquent behavior and less victimization.
Other • On
e study suggested that a wilderness program increased youths’ feelings of self-efficacy and hope for
the future, but did not observe reduced recidivism.
• An
ot


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


gram, a newer program providing case management services that is currently expanding (Los Angeles County Depart-ment of Youth Diversion and Development, 2022).
In the category of problem-solving courts and
other court interventions, two court-relat


.
Annie E. Casey Foundation, “What Is Juvenile Justice?” blog
post, December 12, 2020. As of October 11, 2022:  https://www.aecf.org/blog/what-is-juvenile-justice
Baglivio, Michael, and Katherine Jackowski, “Evaluating the
Effectiveness of a Victi


tal Disorders Among Adolescents in Juvenile Detention and Correctional Facilities,” Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 60, No. 1, January 2021, pp. 46–60.
Behnken, Monic P., David E. Arredondo, and Wendy L.
Pac


 and Bonita Veysey, “Effectiveness of Multisystemic Therapy for Gang-Involved Youth Offenders: One Year Follow-Up Analysis of Recidivism Outcomes,” Children and Youth Services Review, Vol. 73, February 2017, pp. 107–112.
Brusman Lovins, Lori, Jamie


na Navrotskaya, Annemarie Madaras, Robert L. Rhyne, Jennifer Hettema, and Christina Phillips, “Pilot Study of an Overdose First Aid Program in Juvenile Detention,” Health Promotion Practice, Vol. 22, No. 5, September 2021, pp. 638–640.
Chassin, Laur


Journal of Criminal Justice, Vol. 35, No. 3, May–June 2007, pp. 337–347. 33
Dembo, Richard, Gabriela Ramirez-Garnica, Matthew Rollie,
James Schmeidler, Stephen Livingston, and Amy Hartsfield, “Youth Recidivism Twelve Months After a Family Empowermen


 Robert G. Morris, and Jonathan W. Caudill,
“Sustaining Families, Dissuading Crime: The Effectiveness of a Family Preservation Program with Male Delinquents,” Journal of Criminal Justice, Vol. 39, No. 4, July–August 2011, pp. 338–343. DiClemente, Ra


y, Jessie Daniels,
Martha Crum, Danielle C. Ompad, and David Vlahov,
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Recidivism Among Young Men Leaving Jail: Evaluation of the
REAL MEN Re-Entry Program,” Journal of Adolescent Health,


ctober 2018, pp. 939–953.
Gray, Doug, Kristin L. Dawson, Todd C. Grey, and William M.
McMahon, “The Utah Youth Suicide Study: Best Practices for Suicide Prevention Through the Juvenile Court System,” Psychiatric Services, Vol. 62, No. 12, December


p. 264–275.
Henggeler, Scott W., Elizabeth J. Letourneau, Jason E. Chapman,
Charles M. Borduin, Paul A. Schewe, and Michael R. McCart, “Mediators of Change for Multisystemic Therapy with Juvenile Sexual Offenders,” Journal of Consulting and Clinica


Problems,” Journal of Juvenile Justice, Vol. 4, No. 2, Fall 2015, pp. 1–12.
Juvenile Justice Coordinating Council, Fiscal Year 2022–23
Juvenile Justice Crime Prevention Act Funding Request Summary: JJCC-JJCPA: FY 22–23 Funding Requests by Service S


ril 2016, pp. 302–325.
Kretschmar, Jeff M., Krystel Tossone, Fredrick Butcher, and
Barbara Marsh, “Examining the Impact of a Juvenile Justice Diversion Program for Youth with Behavioral Health Concerns on Early Adulthood Recidivism,” Children and Y


 Smith, and
Gordon T. Harold, “Multidimensional Treatment Foster Care as an Intervention for Juvenile Justice Girls in Out-of-Home Care,” in Shari Miller, Leslie D. Leve, and Patricia K. Kerig, eds., Delinquent Girls: Contexts, Relationships, and Ad


onal Journal of Offender Therapy and Comparative Criminology, Vol. 57, No. 9, September 2013, pp. 1107–1119.
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Outcomes in Evaluating a Statewide Drug Treatment Program for Youthful Offende


e Court Processing,” last updated February 2017a. As of November 8, 2022: https://www.ojjdp.gov/mpg/litreviews/Diversion_Programs.pdf
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Post-Adjudication Juvenile Probation Services,” las


y 2017, pp. 59–66. Salazar, Laura F., and Sarah L. Cook, “Preliminary Findings
from an Outcome Evaluation of an Intimate Partner Violence
Prevention Program for Adjudicated, African American,
Ado lescent M ales,” Youth Violence and Juvenile Justic


gs from a Program Evaluation in Harris
County, Texas,” Journal o f Experimental C rimino logy, Vol. 13,
No. 2, 2017, pp. 275–285.
Stein, L. A. R., Suzanne M. Colby, Nancy P. Barnett, Peter M.
Monti, Charles Golembeske, and Rebecca Lebeau-Craven,


venile Justice, Vol. 4, No. 3, July 2006, pp. 219–233.
Whitaker, Laura, Sierra Smucker, and Stephanie Brooks Holliday,
A Gap Analysis of the Los Angeles County Juvenile Justice Crime Prevention Act Portfolio , RAND Corporation, RR-1663-1, 2022.
As


, Jason J. Washburn, Leah J.
Welty, Jennifer A. Hershfield, and Mina K. Duncan, The Northwestern Juvenile Project: Overview , Office of Juvenile
Justice and Delinquency Prevention, U.S. Department of Justice, NCJ 234522, February 2013.
Theriot, Ma


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


itment t o the op en
publication o f our research f indings a nd
recommendations, di sclosure o f the
sour
ce of funding o f  published r esearch,
and policies to ensure intellectual
independence. F or more i n formation, v isit
www.rand.org/ab


Wanxiang Innovation
Energy Fusion City
Recommendations for Developing an
Innovation Cluster
Rafiq Dossani, Marlon Graf, Eugeniu Han
Limited Print and Electronic Distribution Rights
This document and trademark(s) contained herein are protected by l


r Science and Technol -
ogy Park, and made recommendations on technology business incubation. In a 2012 report, RAND developed recommendations for a new innovation cluster known as the Sino-
 Sin
gapore
Guangzhou Knowledge City, located in Guangzhou


and occupational safety, energy policy, science and innovation policy, space, and telecommunications.
Questions or comments about this report should be sent to the project leader, Rafiq
Dossani (Rafiq_Dossani@rand.org). For more information about R


eloping an Innovation Cluster
 4.3. Product Pricing for Both End User–Facing Firms and Firms Within the Supply
Ch
ain, by Each of the Four Clusters  ........................................................... 38
 4.4
. The In
dustrial Organization’


t private risk capital.
• Its s
upport services, such as legal and financial services, are comprehensive.
1 An ecosystem  is defined as a community or cluster of connected players that is sustainable. Sustainability  means that
the cluster is able


sks, and time lines. We describe suggested policies related to each sustaining factor below.
1.
 Acc
ess to cutting-edge technology
a. WIE
FC could establish centers of excellence (COEs), initially in collaboration with
ZJU, to be located at WIEFC.


C achieve consistently high
standards through advisory support.
What Not to Do
Policies to Attract Leading Firms
Many successful clusters contain one or more global market leaders. Such firms, either by
themselves or in combination with other firms


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.
This may suggest that WIEFC should establish policies for supporting


ties to further the businesses of its members. Specifically,
the BDA will (1)
 faci
litate the introduction of new technologies through licensing, research
programs, and other ways of accessing and developing intellectual property; (2)  dev
elop ta


BDA business development association
BI benchmarking institute
CARS Cluster Initiative Automotive Stuttgart
COE center of excellence
e-mobil BW electro-mobility initiative Baden-Württemberg
IEEE Institute of Electrical and Electronics Engineers
IT i


omponents that together compose a whole.
This is a potentially transformative project for the Group, both because of the Group’s
financial commitment, which is estimated at RMB 200
 bil
lion (the Group’s 2016 gross reve-
nue is RMB 115  bil
lion), a


echnologies across all industries. Many technology parks include community Introduction    3
living spaces. Yet, apart from Stanford Research Park in Palo Alto, California, and Research
Triangle Park in Raleigh-Durham, North Carolina, few technology


 that while these so-called “success factors” may be
necessary 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


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 -
ing start-ups of the 1980s and 1990s,


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.
Despite the large number of such interventions, little is known about w


ergy Fusion City: Recommendations for Developing an Innovation Cluster
Attributes of WIEFC
We list below the desired attributes of WIEFC:
• Its w
orkforce, firms, and research centers are innovative, experimental, and technically
sophisticated.
• It


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


 built around highly educated persons challenges
a long-held concept known as the death of distance , or the idea that digital technologies would
enable high-quality remote working. As Silicon Valley evidently demonstrates, this has not happened, e


; 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


.
Figure 2.1 shows the gross regional product for Baden-Württemberg, which has grown
steadily since the early 1990s, with a brief decline during the 2009 financial crisis, to over 400
 bil
lion euros in 2015. Manufacturing accounts for a substantial


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


ter-Firm Networks
The Stuttgart region hosts a substantial share of national automotive sector employment. It is
home to a supplier network that is both large and sophisticated enough to supply most of the need by large manufacturers for components


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


cisionmaking procedures and strategy formulation when it comes to exploring new products and technologies.
To bridge these knowledge gaps and to cope with ensuing uncertainties, policymakers
and industry associations across the region have been wor


holds an advanced degree, compared
with only 6  perc
ent in the construction sector, further emphasizing the knowledge-intensive
nature of activities in the automotive cluster.
Aside from its high-quality vocational training institutions and trade


0302010
0
Automotive Engineering Manufacturing ConstructionUniversity degree
Vocational certification
No vocational training
Not applicable
Industrial
production16    Wanxiang Innovation Energy Fusion City: Recommendations for Developing an In


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


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 -
scape and are l


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


ed IT base, lack
of connection to local IT firms
Related and supporting industries•
 Dedi
cated network of
suppliers, mainly SMEs• Soph
isticated
tasks and ser-vices in-cluster, routine tasks outsourced•
 Str
ong dependence
on a few large firms c


ome to several major corporations, such as Mitsubi -
shi 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


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


r accessing advanced technologies and processes.
Supply Chains and Inter-Firm Networks
Aichi Prefecture accounts for 40
 perc
ent of total national shipments of transportation equip -
ment and machinery. Large, horizontally integrated firms that act


affected Aichi’s production structure as it has Stuttgart’s. To meet
domestic content requirements and to save costs, the large producers and several of their suppli -
ers have built manufacturing plants around the world. As a result, offshore manuf


 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 -
ers whose economies of scale


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


labor, globalized large
firms, and networked SMEs are the major driving forces for the cluster’s success. Large firms are horizontally integrated and rely on sophisticated SMEs to contribute technology- intensive critical components. However, these


y Chain
Large firms tend to face the most-sophisticated users, i.e., end users or other large firms. Large
firms are horizontally integrated, allowing them to face a diverse variety of end-users. SMEs are of two kinds. Those supplying low-end produc


sk—they deal with the most-sophisticated users, often by introducing new and untested products to clients—they can manage this risk by developing a pipeline of products through their experience of clients of different types and by being responsive to


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


nd universities are largely seen as a source of recruiting fresh employees.
Discussion
In 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


sponsibility of the association.Developing the Wanxiang Innovation Energy Fusion City Cluster    35
The organization of the Taiwan personal computer cluster into associations originated
from the dominance of local SMEs that initially produced simple


ons, such as the Institute of Electrical and Electronics Engineers (IEEE). Talent
is competitively sourced. Once recruited, individual employees take responsibility for their own professional development (Castilla et al., 2000). SMEs do not see it a


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 -
munity colleges play an important role in providin


cts for the automotive sector. Since Wanxiang Automotive is a large player in this sector, we consider its potential role in WIEFC’s development.
The insertion of China into the automotive supply chain occurred over the past three
decades and was d


dustry and with it, Silicon Valley. The automotive industry experienced a potentially
disruptive change with the recent arrival of firms such as Tesla, Inc. Located in Silicon Valley, Tesla’s production model derives from the earlier iterations of t


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


mestic firms, form an “anchor -
ing cluster” of firms through the combined set of technologies and access to markets that they bring.
As we discuss below, the appropriate model for WIEFC is likely to combine elements of
each of the models discussed


, prosperous, and innovative urban center, Hangzhou. Hang -
zhou is an important center for the automotive industry, as well as a center for the country’s digital technology businesses (European Union SME Centre, 2015).
High housing costs and the hu


ea. This program would be managed by the BDA.
3. Att
ract technical and innovative talent through the establishment of a jobs program to
be managed by the BDA.
Policies for Client and Vendor Development
1. Build supply chains by linking firms withi


dents and faculty to obtain experience in real-world engineering proj -
ects carried out at WIEFC. While the main goal of a COE is to solve difficult applied engi -
neering problems through collaborative research and development, a COE can be an exce


ctivities that span the higher value–added activities of the supply chain (Christensen, 2013).
Access to clients. The BDA should develop marketing expertise in support of its member
firms. While firms in WIEFC should be free to conduct their own ma


 an innovative component to developing new standards. Developing the Wanxiang Innovation Energy Fusion City Cluster    45
Note that we are recommending neither particular technology standards nor output stan -
dards for the BI. The evolution of techn


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


ce; their ownership; and their access to human, financial, technological, and other resources. Tables 4.4 and 4.5 outline the industrial organization’s access to resources and product pricing, respec-tively.
Table 4.4
The Industrial Organization’s Ac


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


ionsCompetitive Association, all firmsBanks and venture capitalDeveloping the Wanxiang Innovation Energy Fusion City Cluster    49
Table 4.8
Value of Each Cluster to Large Firms and Small- and Medium-Sized Enterprises
Cluster Large Firms SMEs
WIEFC T


nd A.4 show employment in Hangzhou. The figures indicate that manufacturing
remains significant for the economy of the city.
The national government has, over the past few years, intensified efforts to transition
from an economy driven by investmen


s capital funds; big data firms; and hundreds of technology-linked com -
panies, including Kuaidi Dache, part of China’s biggest taxi-hailing app, and Alibaba Group, China’s largest online retailer.
People and Workforce
Hangzhou’s transformation fro


entages do not total 100 due to rounding.
RAND RR2035-A.5Ph.D.
0.53%Graduate
2%
Undergraduate
18%
Specialized college
42%Other
38%
Figure A.6Recent Graduates Employed in Hangzhou, by Origin
SOURCE: Hangzhou Talent Service Bureau, 2016.
RAND RR2035-


uhang, Deqing, and Changxing, Zhejiang. Amber Energy was successfully listed on the Hong Kong Stock Exchange in 2009.
The renewable energy projects of the Group are concentrated in wind- and solar-power
generation. Wind-power projects are located in


ponent of WIEFC will be hosted by two national
engineering research centers or laboratories, one national innovation center, and several dozen international entrepreneurship teams attracting more than five thousand scientific and techni -
cal person


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


 Pro
fessor Daofei Li, director, Institute for Power Machinery and Vehicular Machinery,
Zhejiang University
• Wan
xiang Group officials63References
Academic Ranking of World Universities, “Academic Ranking of World Universities in Engineering/
Techn


l of Engineering and Technology Management , Vol. 22, No. 1, 2005, pp.
 51
–74.
Castilla, Emilio J., Hokyu Hwang, Ellen Granovetter, and Mark Granovetter, “Social Networks in Silicon Valley,” in Chong-Moon Lee, ed., The Silicon Valley Edge: A Habitat


ation: Relocating Service Provision to India,”
World Development , Vol. 35, No. 5, 2007, pp.
 77
2–792.
Dossani, Rafiq, and Ashish Kumar, “Network Associations and Professional Growth Among Engineers from India and China in Silicon Valley,” American


pgrading of Germany’s Industrial Capabilities on the Horizon,” Deutsche Bank Research, April 23, 2014.
IMF WEO— See International Monetary Fund.
International Monetary Fund, World Economic Outlook , Washington, D.C., 2016.
Japan Automobile Manufactu


17.
Lee, 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.
Liker, Jeffrey K., The Toyota Way: Fourteen Management Pr


Asian Journal of Technology Innovation , Vol. 16, No. 2, 2008, pp.
 83
–112.References    67
Simon, Hermann, The Secret Winners (Hidden Champions): The Success Strategies of Unknown World Market
Leaders [Die heimlichen Gewinner (Hidden Champions): D


mes Higher Education World University Rankings, “Nagoya University,” web page, 2017. As of April 30,
2017:
https://www.timeshighereducation.com/world-university-rankings/nagoya-university#ranking-dataset/589595
Toyoda, Eiji, Toyota, Fifty Years i


17: http://reports.weforum.org/digital-transformation/wp-content/blogs.dir/94/mp/files/pages/files/wef-dti-automotivewhitepaper-final-january-2016-200116a.pdf
Yamawaki, Hideki, “The Evolution and Structure of Industrial Clusters in Japan,” Small Busi


SHELLY CULBERTSON, JAMES DIMAROGONAS, KATHERINE COSTELLO,
SERAFINA LANNA
Crossing the
Digital Divide
Applying Technology to the Global Refugee CrisisCORPORATIONLimited Print and Electronic Distribution Rights
This document and trademark(s) containe


s on such topics as infrastructure, science and tech -
nology, 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


nalysis of technology uses, needs,
gaps, and opportunities for helping displaced people and responding agencies. Our pri -
mary focus is on digital technologies (often referred to as information and communica -
tion technologies) and systems that ca


 the refugee crisis, changes in technology are resulting in changes to each entity’s roles and responsibilities—for example, by creating new roles, simplifying long-
 st
anding
roles, and altering the way that operations and programs are managed. At


ier provided individual per -
spectives on the multiple ways that refugees use technology.
Access to Technology
Refugees in each of the host countries where we conducted focus groups reported that
they typically used mobile devices, primarily smartp


th-based activity.  Several refugees discussed using digital technology for reli -
gious purposes, including accessing the Quran and assistance opportunities at local churches.
•
 He
alth care. Refugees also used digital technology in seeking health


 service is provided and the end user’s experience. Value can derive from a technology’s ability to meet a critical need and lower costs, as well as from such features as flexibility, familiarity, accountability, and privacy.
•
 Ke
y resources  are


ibe the competitive and collaborative environment that could translate to risks and opportunities.
1 The approach is influenced by Michael Porter’s five forces governing competition (Porter, 1979), except our
focus is on the refugees instead of on t


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


ld be conducted periodically, balancing the benefits of retaining vast data sets with the risks of securing the data.
•
 De
velop an ethical framework for technology in humanitarian settings. As part of the
ethical framework, develop guidelines for


munity Services in Pittsburgh, Pennsylvania; and Ipsos in Lusaka, Zambia.
In addition, we appreciate the generous time and insights of the following people
who were interviewed for this study. In particular, we thank the following government and mu


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


fugees.
Refugee:  There are multiple categories of people who have been forcibly displaced.
These include the following (UNHCR, 2019b):
•
 A r
efugee is someone who lives outside of his or her country because of a well-
founded fear of persecution a


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


agement by humanitarian agencies, dissemination of information to displaced people, educational and job-matching tools, personal iden -
tity and property rights management, distribution of humanitarian assistance, coor -
dination among humanitarian a


ntive for participation.
Table 1.1
Distribution of the Focus Groups with Refugees and Internally Displaced Persons
Location Focus Group #1 Focus Group #2
Bogotá, Colombia Refugees from Venezuela,
men and womenRefugees from Venezuela and internally


of stakeholders.
Limitations
Readers should keep several limitations in mind when considering the key findings
and implications of this report. First, the stakeholder interviews (in which we spoke to 30 people) do not necessarily represent the full


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


 also developed smartphone apps that help other refugees navi -
gate 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


Because of these newly available tools, technology is changing aid agencies’ capabilities, approaches to manag -
ing assistance, and mandates. Technology is also changing how food and housing aid is distributed, how information is used and communicat


d data security procedures, which we discuss in more depth
in Chapter Six.
Setting terms and values regarding the use of technology in humanitarian settings.
The aid community sets principles for the use of technology in humanitarian settings. For


h low connectivity . . . . There’s the perception that some of these techs and approaches are just being pushed by senior management as a solution to . . . enhance their profile.
Host Countries
In addition to hosting refugees on their soil, host coun


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 -
texts (laws, financial infrastructure, markets, government policy) lead to var


ment (discussed in more detail in Chapter Five). The interviewees described donors’ reluctance to fund technology systems, instead showing more interest in funding pilots, startups, and apps, and the interviewees attributed this inclination to intere


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.
Developing apps and platforms to meet a particular refug


uting to Technology in Refugee Settings    15
Consortia
Like-minded stakeholders have formed multiple consortia around various topics related
to technology. Such consortia include technology companies, other private-sector com -
panies, universities


usiness Education Coalition, aims to 16    Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis
channel corporate contributions in support of education in emergencies through
partnerships among businesses, UN agencies, NGOs,


anitarian settings. One interviewee described the target as “big problems we need to solve overlaid with where innovation can help us overcome it.” Roles and Responsibilities of Entities Using or Contributing to Technology in Refugee Settings    17
U


pertise, funding,
training, and other tools.
• Co
nsortia bring together different types of stakeholders to share information,
build digital capacity and coordinate technical resources, and generate solutions.
• Un
iversities provide research and


duce postmigra -
tion stress (Mikal and Woodfield, 2015) and contribute to social inclusion (
 Ab
uJarour,
Krasnova, and Hoffmeier, 2018). When asked why refugees prioritize smartphones and internet connectivity, one of our interviewees responded, “


as WhatsApp, Viber, Skype, and Facebook Messenger, are most popular. Our interviewees empha -
sized that these allow for international messaging and calling via Wi-Fi without requir -
ing the user to have a phone number.
In addition, there are techn


t opportunities to them to get out of their constrained position.”
Establishment in New Locations
Refugees have used mobile communication and social media to adapt in host coun -
tries, and humanitarian organizations have used these tools to provide


 directions, some -
thing you cannot always find easily. It’s a new life and a new environment for us.
. . . 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


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


on, 2013; “Brisbane to Help Asylum Seekers and Refugees
Resettle in Australia via Technology,” 2017; Butcher, 2018; Transformify, undated).
Examples include the Transformify Rebuild Lives Program (helping refugees connect with businesses), Refugee


, 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


e received certificates from university partners of digital learning programs, or have completed online degree programs.
Technical and vocational education.  Technology has both facilitated and been
the subject of vocational training for refugees.


inputs (Culbertson et al., 2016). In addition to
 Ac
tivityInfo, individual aid organizations have developed their own software applica -
tions (Mengel, 2018). In the United States, some refugee resettlement agencies use Apricot Software, which was


d model when the coun -
try 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


 2017). How -
ever, 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


nt System for Foreigners, or YOBIS (UNESCO, 2018).
Data in hard-to-reach areas. Data tools also help organizations monitor programs
in dangerous and hard-to-reach areas. Photo-sharing, screen-sharing, and Skype calls enable simulated field visits (Z


UNHCR has an offline registration tool called Rapid Appli -
cation (RApp) (UNHCR, undated-f).
Host countries also conduct biometric registration of refugees and migrants. For
example, Turkey’s Directorate General of Migration Management registers r


d security issues to resolve. As one interviewee said, “Those negotiations haven’t taken place yet and they will be dif -
ficult. . . . This is a very multifaceted issue, and we are only at the beginning of it. We can’t tell you where it is taking us


individual, includ -
ing 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


 to main -
tain 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.
Aid agencies use various technologies to coordinate and manage


-
tion for journeys and establishment in new locations, language, education, employ -
ment, faith-based activity, health care, identity management, and money management. Finally, we discuss what refugees said were their concerns about technology, inc


 limited data plans, so the interviewees pre-ferred to purchase their own smartphones when possible.
Social Media Platforms
In all six host countries where we conducted focus groups, the majority of refugees stated that Facebook, WhatsApp, or both w


vious chapter, refugees greatly value their ability to access the inter -
net. 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


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


 -
nology most importantly and most frequently for communication with family, friends,
and others. In more than half of the focus groups, refugees expressed a sense of duty to share some information—such as about access to services and assistance—on


r.
Refugees from Venezuela talked about people helping and guiding them along
the way, employing technology:
In our case, obviously there is always a person who receives you. . . . You commu -
nicate by any means, by apps such as WhatsApp or Facebo


ccess:
On the way, they can steal [your phone]. You can get assaulted . . . to get a 10-minute
charge, 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


ful for learning new skills and keeping
up to date in one’s professional field. One sub-Saharan African woman in Greece stated,
I use the tablet for some personal research. For instance, we refugees don’t have
access to schooling. I studied medicin


hool in person. Syrian men in Jordan stated, “I would say that going to school is better,” and “I think the traditional way is better.” Refugees in Colombia and Zambia worried that technology was making children unfamiliar with books.
Employment
Ref


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.
Other refugees who needed a specific type of software to perform tasks for
employers struggled to use th


al or professional qualifications. A man from the Middle East noted that technology helped him while traveling to safety in Greece because, “before you make any movement, you can save your documents.” Another Middle Eastern man in Greece stated, “For


bia, stated, “I got into the
 Fac
ebook
page of an English course and there I registered and sent the application, . . . [but] it was currently all online and I had to pay 67,000 pesos but with a credit card here in Bogotá.” The lack of the credit


sing social media and apps for money management was common: “I feel like all younger people like us use apps like Cash App or like Venmo,” said one woman. Another described sending money via Facebook. A Bhutanese man explained, “I send money out to N


d people extract all their information from them.
Refugee women mentioned vulnerability to harassment or similar problems
online, such as pop-ups with sexually explicit information or photos. One woman in
Zambia said, “There are many bad things on


an in Zambia commented that “it [eats] people’s 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.” Similarly, refugees in Bogotá, Colombia, described the anxiety that occurs when t


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


ies operate in fundamen -
tally 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


is used against them.” We heard similar concerns regarding Syrian refugees.
Key Resources
Resources are anything that can be used to create value, whether monetary or non -
monetary. In the context of developing and deploying technologies in refugee


outside the humanitar -
ian sector, like drones, and say how could we apply that for humanitarian purposes?” We heard examples of both approaches.
The market pull occurs in several ways: Organizations conduct focus groups or
surveys with refugees t


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


o maintain and sustain the training for the life cycle of the product. In the words of one interviewee, “The worst thing you can do is implement a software without a plan for training, uploading, sustaining, maintenance. . . . There’s a lack of aware


e a smooth and cost-effective transition.
Profit Formula
The 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


cies or governments provide stable longer-term funding to maintain technolo -
gies. Other models focus on serving larger, more-affluent populations while support -
ing vulnerable populations as a small part of the business. Some approaches, such as c


me relevant.
Projects driven by funding instead of needs. Donor priorities and available funding
streams, rather than analysis of needs, disproportionally affect what projects get pur -
sued. Interviewees felt that donors tend to favor short-term pr


al Refugee Crisis
by two types of barriers. One involves different small initiatives that all try to solve the
same problem, competing with each other for the user base, and none attaining effi -
ciencies of scale. As a result, an organization might


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 -
pounded by organizations having less authority to make d


usiness model for the delivery of these solu -
tions? How do we make it appealing, compelling, fair to those implementers?62    Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis
Several interviewees described how private-s


y in Refugee Settings    63
a framework for working together to deploy technologies efficiently while maxi -
mizing value across multiple refugee populations and aid agencies in multiple
countries.
• Le
gal, cultural, and other issues relevant to t


s, and bargaining power of customers.64    Crossing the Digital Divide: Applying Technology to the Global Refugee Crisis
• Host country.  Local regulations or attitudes in host countries affect the potential
of a technology solution. Assessments of


itators that can influence the
successful 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


Coppi and Fast, 2019; Latonero et al., 2019; Raymond and Harrity, 2016). As one of our interviewees stated, “In most areas where we try to push tech, it’s totally uncharted territory.” Still, there are some existing starting points that the sector co


tarian Action (Kuner and Marelli, 2017). A Privacy Interna -
tional 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


tar -
ian 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 Two, and each has different perspectives and roles (Raymond et al., 2


ers who trans -
late private information about refugees’ health, children, behavior, and marital rela -
tions without the organizations really knowing whether those interpreters have been sufficiently vetted. Furthermore, aid groups may not be aware


easures. One
interviewee noted that refugees can be particularly adept in protecting their own data: “Every average Syrian is very in tune with all the proxies available in the market. . . . Even those who are illiterate know about proxies and [virt


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


Europol can be a particularly desirable target for breaches (
 Sc
hiemichen, 2018; USAID, undated).
Improper data protection can also make refugees reluctant to provide their data
at all or trust humanitarian aid in general. Refugees’ anxieties abou


in personal data collected from people of young ages (Latonero and Kift, 2018). Storing children’s data can subject them to difficulties transitioning from aid systems to mainstream ones. On the other hand, such tracking can be impor -
tant to childr


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, “What if people are mobility impaired, or with disabilities? How do t


gorithms to help evaluate immigration and visa applications,
increasing efficiency and reducing backlog—to refugees’ benefit. However, the predic -
tive analytics used to conduct risk assessments may incorporate embedded or purpose-ful biases that d


te-sector or organizational goals rather than solely the Ethical, Security, and Privacy Issues Related to the Use of Technology in Refugee Settings    77
best interests of the refugees. For instance, private companies could try to influence
technolo


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


s models (Dimarogonas, 2012).
We built on these models to propose a business model canvas tool tailored spe-
cifically to the application of technology in refugee settings and that a range of stake-holders, including aid agencies, private-sector com


 exist at different levels of abstraction, from strategic levels through detailed implementation. Different stake-holders should use this tool in different ways:
•
 Do
nors (including governments and foundations) and aid agencies should use this
too


st in specific ways to improve
digital infrastructure in their countries for their general populations, which will also improve such systems for refugees.
•
 Do
nors (governments and foundations) and private companies should focus invest -
ments on


le consortia with overlapping mandates have formed to assist in contributing to technology in refugee settings, as described in Chap -
ter Two. These circumstances lead to fragmented, disconnected investments in one-off solutions rather than systems


 at discounted prices or with sustainable funding models.
Improve Technical Capacity in the Humanitarian Community
Planning, deploying, using, and maintaining technical solutions require technical, digital transformation, and business process reengi


le systems and data formats that make sharing and consolidating data difficult and costly. As a result, we suggest the following:
•
 UN
HCR should develop data guidelines for refugee settings that can apply across
all aid agencies. These should incl


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


tive educational technology in refugee
settings, focusing especially on ways that allow refugee education to be scaled up even in contexts with teacher shortages.
Looking Ahead
Through this study, we have found that there is a solid foundation of t


lum Information Database, “Registration Under Temporary Protection: Turkey,” webpage, undated. As of August 14, 2019:  https://www.asylumineurope.org/reports/country/turkey/registration-under-temporary-protection#footnote3_olljd43
Bacishoga, Kasky Bi


t, Core Humanitarian Standard on Quality and
Accountability , 2014.
Coppi, Giulio, and Larissa Fast, Blockchain and Distributed Ledger Technologies in the Humanitarian Sector , London: Humanitarian Policy Group, February 2019.
Corbett, Jennie, Cor


an Gatzweiler, “How Tech Can Bring Dignity to Refugees in Humanitarian
Crises,” The Conversation , May 2, 2018.
Fuchs, Ben, “The Refugee Crisis: How Coders, Apps, and Technology Provide Relief,” Hackernoon ,
March 31, 2016.
Gaffey, Conor, “Five W


ts/files/publications/icrc-002-1067.pdf
James, Eric, and Laura James, “3D Printing Humanitarian Supplies in the Field,” Humanitarian
Exchange , No.
 6
6, April 2016, pp.  4
3–45.
Johnson, Mark W., Clayton M. Christensen, and Henning Kagermann, “Rein


 undated. As of August 14, 2019:
https://www.themigrantsfiles.com/
Mikal, Jude P., and Braden Woodfield, “Refugees, Post-Migration Stress, and Internet Use: A
Qualitative Analysis of Intercultural Adjustment and Internet Use Among Iraqi and Sudane


petitive Forces Shape Strategy,” Harvard Business Review, Vol.
 5
7,
No. 2
, 1979, pp.  1
37–145.
Principles for Digital Development, homepage, undated. As of August 15, 2019:
https://digitalprinciples.org/
PwC, Managing the Refugee and Migrant C


 a Role in Building Social
Solidarity Finance?” United Nations Research Institute for Social Development Working Paper 2016
-1, F
ebruary 2016.
Scriven, Kim, “Humanitarian Innovation and the Art of the Possible,” Humanitarian Exchange ,
No. 6
6, A


on Their Phones in Powerful Photo Series,” The Verge , March 27, 2017.
Transformify, “Rebuild Lives Program: Hire Refugees and Revitalize Post-War Zones,” webpage, undated. As of August 13, 2019:  https://www.transformify.org/page/rebuild-lives-prog


,” webpage, undated-f. As of August 14, 2019:
https://www.unhcr.org/en-us/primes.html
———, “UNHCR Strategy on Digital Identity and Inclusion,” undated-g. As of August 14, 2019:
https://www.unhcr.org/blogs/wp-content/uploads/sites/48/2018/03/2018-


——, “World Bank Group, UNHCR Sign Memorandum to Establish Joint Data Center on
Forced Displacement,” April 20, 2018.
Zikusooka, Monica, Zinet Nezir Hassen, Alison Donnelly, and Rachel Mose, “Conducting
Simulated Field Visits for Insecure Locations


CORPORATION
Injury and Illness
Surveillance of U.S. Agricultural Workers
Assessment of Recommendations and Actions
Ramya Chari, Amii M. Kress, Jaime MadriganoLimited Print and Electronic Distribution Rights
This document and trademark(s) contained h


 sustainability, 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


................................................ 31
Theme 1: Define and Characterize Agricultural Worker Populations at Risk  ........................... 31
Theme 2: Review Ongoing or New Data Sources for Injury and Illness Surveillance Among
Agricu


rkers, government workers, and self-employed workers (exclud -
ing farms with fewer than 11 employees).
4 BLS, “2015 Census of Fatal Occupational Injuries (CFOI): Current and Revised Data,” web page, last updated June 23,
2017 (see the Excel files “


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


Recommendations and Actions Inferred from the 2012 Review Report
Recommendation Action
R1: Develop standard definitions
to help improve knowledge and understanding of populations at risk of worksite exposures1.1: Develop concise definitions of popul


: Ag Center = Agricultural Safety and Health Center; NASS = National Agriculture Statistics Service; USDA =
U.S. Department of Agriculture.xii    Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions


pport through -
out the course of this project. In addition, we also thank those individuals outside NIOSH
who took the time to speak with us about their views on achieving the various recommenda -
tions and actions to improve surveillance and thus


nished.
3 In recent years, however, the
employment of hired farm labor has shown some stability, hovering at 1 million workers (with some fluctuations).
4
Although the number of farms and agricultural workers has declined, the agricultural
sector c


e the vast majority of farms in the nation.10
Children (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


-
tural Injuries in the U.S.,” Marshfield, Wisc., 2014.
12 World Health Organization, “Public Health Surveillance,” web page, undated.
13 NIOSH, “Worker Health Surveillance,” web page, last updated June 26, 2017.Introduction and Project Background


s, employment, or production features of the nation’s farms.
20 NIOSH also provides technical support and cooperative agreement funding
14 Centers for Disease Control and Prevention (CDC), CDC’s Vision for Public Health Surveillance in the 21st Cent


injury survey (NASS) focused on adult farmers and farmworkers (≥20 years old) on minority-operated farms
Childhood Agriculture Injury Survey (1998, 2001, 2004, 2006, 2009, 2012, 2014)National, regionalPopulation-based injury survey (NASS) focused on


pared with 14 and older for nonagriculture work.
23 Under
the parental exemption clause of the FLSA, youth of any age may be employed in any occupa -
tion on a farm owned or operated by their parents (or people standing in place of their parents). S


arch and Practice in the U.S. Agriculture, Forestry, and
Fishing 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


d exposures associated with different production practices (e.g., tech -
nologies or machines used, types of manual operations, pesticide and chemicals applications, and worksite tasks). These differences are challenging: In addition to creating a co


e of agricultural fatality reporting.
Great Plains Center for  Agricultural Health
(http://www.public-health.uiowa.edu/
gpcah/center-projects/surveillance-of-agricultural-injuries-and-fatalities/)IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI (fatali


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


e, 2005.
35 Carolyn Dimitri, Anne Effland, and Neilson Conklin, The 20th Century Transformation of U.S. Agriculture and Farm
Policy , Washington, D.C.: U.S. Department of Agriculture, 2005; James M. MacDonald, Penni Korb, and Robert A.
Hoppe, Farm


NIOSH to external groups. This shift may reflect the extreme uncertainty that the AgFF Program has been operating under for the past few years.
From fiscal year (FY) 2012 to FY  2017, the President’s Budget proposed eliminating
the AgFF Program in


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


, 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


 Agriculture, Forestry, and Fishing Program: Plan to Implement the National Academies Program
Evaluation Recommendations , Washington, D.C., January 2011.13CHAPTER TWO
Project Approach: Identification of Recommendations and Actions
Our project appro


iew of the 2008 National Academies’ evaluation of the AgFF Program and the 2008 NORA—the National Agriculture, Forestry, and Fishing Agenda.
1 Table 2.2 displays the actions for each recommendation. The actions may not cor -
1 National Research Counc


heme 1: Define and characterize
agricultural worker populations at  riskRecommendation 1: Develop standard definitions to help improve knowledge and understanding of populations at risk of worksite exposures
Theme 2: Review ongoing or new data sourc


r recently used by NIOSH) for illness and injury surveillance of agricultural workers.
Recommendation 6 6.1. Identify feasible, desirable alternatives to five-year age groupings for child agricultural workers (<18 years old).
6.2. Stratify data perta


 intramural and
extramural 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


dules on occupational health outcomes
among hired farmworkers and perform specific analyses on variability of risk.
Action 4.1 Improve the validity of the CAIS by extending the sample to include labor aggregators.
Action 4.2 Collaborate with the NAW


nal safety and health to be scored by peer reviewers but also enabled programmatic priorities to drive award deci -
sions among high-scoring applications during secondary council reviews. For the purposes of responding to the panel report recommendat


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


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


r rationale for partners, resources, and timeline estimates.
Actions Achievable Through Direct NIOSH Action
The last grouping includes two actions intended to change the way NIOSH currently reports
data on child injuries and illnesses. We elaborate


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 4.1 summarizes these approaches. Generally, f


estimates, but we note their capture in timeline estimates.
Partnerships
The 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


ints inhibiting partnership.
Capability partnership scenario
1 No existing organizations or individuals can carry out or support completing the action.
2 Information is lacking on who the most relevant partners might be or how potential partners may


n might unfold to develop any timeline estimates.Table 4.3
Information Availability and Accessibility Scale
Rating Information Availability and Accessibility Scenario
1 There are no existing data or information available to address the action.
2 Ther


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.
Policy or legislative barriers exist but can be overcome without large investments of


ot fully support meeting the action (e.g., no categorization of
worker type or farm size).
Information collected would suffer from severe limitations, such as small number of respondents, small
number of cases, long survey intervals, limited geogra


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:
•
 Whi
ch actions are most feasible? Which are least feasible?
• Whi
ch actions are most de


vity in our assessment approach through three
independent 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


erging technologies.
The panel report offered specific guidance for NIOSH regarding developing a taxonomy for
characterizing populations at occupational exposure risk. Ideally, a complete understanding of who is at risk would entail the development


l contract requirements and monitor budgets; facili -
ties and equipment (e.g., computing infrastructure) to facilitate efficient research activities; and managerial and supervisory support to ensure that projects run smoothly.
Cost and resources: We


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


e two-thirds (69 percent) of all U.S. farms. However, these small farms generate less than 2 percent of total production of food and fiber.
6 This stands in contrast to the top 6 percent of farms, which
accounted for an estimated 75 percent of produ


ata sources for agricul -
tural 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.
Recommendation 3: Expand the scope of knowledge on hired farmworker risk


p Industries,” Washington, D.C.: Pew Research Center,
March 26, 2015; William Kandel, Profile of Hired Farmworkers, a 2008 Update , Washington, D.C.: Economic Research
Service, U.S. Department of Agriculture, 2008.36    Injury and Illness Surveilla


ability of risk would also be useful for devel -
oping interventions to reduce injury risks. Table 5.2
Action 3.1’s Implementation Plan
ActionOverall
Mechanism Resource Partner Capability Partner Resources Timeline
Action 3.1 Partner outreach
or dev


gricultural Occupations Under the Fair Labor Standards Act (Child Labor Bulletin
102), Washington, D.C., June 2007.
13 DOL, “State Child Labor Laws Applicable to Agricultural Employment,” web page, last updated January 1, 2017.
14 NIOSH, “Childhood


A establishes uniform confidentiality provisions across U.S. statistical agencies for information collected for statistical purposes.
17 The goal of the law is to ensure that information provided by participants
in data collection efforts is used on


rvey through
the 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


the future.
Recommendation 5: Establish a comprehensive understanding of data sources relevant to
NIOSH agricultural surveillance-related programming
The 2008 National Agriculture, Forestry, and Fishing Agenda provided strategic research direc-
tion


ple data sources under a common eval -
uation 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 1.2), many of which, th


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 -
Table 5.5
Actions 2.1, 5.1, and 5.2’s Implementation Plan
ActionExtramural
MechanismRes


rveillance
data through better coverage of priority populations and enhanced data quality. Theme 3, how -
ever, seeks to improve data utility through better analysis and communication efforts. Without proper interpretation and communication of data,


 workers (<18 years old).
This action is easy to achieve because NIOSH is already in possession of data from the CAIS
and has indicated that redoing statistical analyses for different age groupings is straightforward and technically simple. However,


idered to be high quality.
Action impacts:  This effort would enhance the utility of childhood agricultural sur -
veillance data. In particular, although overall childhood injuries have declined over the past decade, injuries among children younger t


s and priorities: NIOSH AgFF Program leadership consid -
ered this action to be important.
Information quality:  Because the CAIS is based on NASS survey procedures, the
collected data are considered to be high quality. While NIOSH has reported on h


formation could be provided
on 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


scription of Recommendations and Actions    47
panel report.25 To mitigate these risks, the panel report encouraged NIOSH to form partner -
ships with varied groups, including OIE, IPPC, and the Codex Alimentarius Commission and
to support partnersh


ington, D.C.,
June 2012, p. 13.Table 5.9
Action 8.1’s Implementation Plan
ActionOverall
Mechanism Resource Partner Capability Partner Resources Timeline
Action 8.1 Partner outreach
or developmentUSDA, NCEZID OIE, IPPC, Codex
Alimentarius Commissio


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.
Timel


ect action and partnerships.) Dis -
agreements tended to occur when raters interpreted ratings scales differently, written assess -
ments of actions across criteria were unclear, or a rater had specific knowledge pertaining to an action that presente


 4.33 4.00 4.67
6.2: Stratify child data DA 4.17 4.33 4.00
1.1: Develop definitions or taxonomy EXF 4.00 4.20 3.67
5.2: Evaluate sources of surveillance data EXF 4.00 3.60 4.67
3.1: NAWS, hired farmworker injury survey PART 3.88 3.40 4.67
6.1: Identi


tasks and time frames that may result in lesser (compared with the ideal), but still acceptable, impacts (these two cost estimate Figure 6.1
Scatterplot Showing Relationship Between Feasibility and Desirability Scores for Actions: Ideal Version (excl


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 -
ity and access that could be obtained through such partnerships. While


e types, and knowledge or use of emerging
technologies.56    Injury and Illness Surveillance of U.S. Agricultural Workers: Assessment of Recommendations and Actions
Action 1.1 showed high average combined scores across all feasibility criteria, exce


mita -
tions, poor recruitment numbers, or political or economic factors that cause administrative hardships.
Finally, actions 3.1 and 4.1 were considered of high desirability but low feasibility because
both require partnership actions. In general


ng.
The other option for ranking is to simply use the overall achievability score, which encom -
passes 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


he CAIS PART — $1 million $1 million 1
4.2: NAWS, child injury survey PART — ~$2 million $330K 6
8.1: Partnerships for zoonotic disease PART — — — —
NOTE: EXF = extramural funding; PART = partnerships.59CHAPTER SEVEN
Conclusions
Although it is one of


ns that had high feasibility and desirability scores:
•
 1.1: D
evelop concise definitions of populations at occupational exposure risk, and profile
them by AgFF commodity specialization, demographic factors, work organization pat -
terns, worksite


me and Employment; Full-Time
and Part-Time Wage and Salary Employment by Industry (SA27, SA27N),” 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


a.gov/amber-waves/2011/december/hired-farm-labor-held-steady/
Kandel, William, Profile of Hired Farmworkers, a 2008 Update , Washington, D.C.: Economic Research
Service, U.S. Department of Agriculture, 2008. As of August 30, 2017:
http://digitalcom


12, 2017:  http://www.cdc.gov/niosh/oep/agctrhom.html
———, “The National Academies Evaluation of NIOSH Programs,” web page, last updated July 26, 2016. As
of August 30, 2017:  http://www.cdc.gov/niosh/nas/
———, “About NORA: Partnerships, Research an


of August
30, 2017:  https://obamawhitehouse.archives.gov/omb/circulars_a110/
Passel, Jeffrey S., and D’Vera Cohn, “Share of Immigrant Workers in Production, Construction Jobs Falls
Since 2007: In States, Hospitality, Manufacturing and Construction


eptember 4, 2017:  http://www.ers.usda.gov/topics/farm-economy/farm-household-well-being/glossary.aspx#farm
U.S. Department of Agriculture, Economic Research Service, “Distribution of Farms and Value of Production
Varies by Farm Type,” web page, las


CORPORATION
Provider Fraud in
California Workers’ Compensation
Selected Issues
Nicholas M. Pace, Julia PollakLimited Print and Electronic Distribution Rights
This document and trademark(s) contained herein are protected by law. This representation o


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


 policy.
Questions or comments about this report should be sent to the project leader, Nicholas M.
Pace (nickpace@rand.org). For more information about the RAND Institute for Civil Justice, see www.rand.org/icj or contact the director at icjdirecto


............................................................ 6

Table 5.1. Medicaid and New York State Workers’ Compensation Board Approaches .............. 46
  Table 5.2. Medicaid, Labor Code § 4615, and Labor Code § 139.21 Approaches .........


applicants’ attorneys.
Fraud i n the California Workers ’ Compensation System
Fraud can be characterized as the making of a knowingly false or fraudulent material
statement or material representation for the purpose of deceiving others so that th


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


nformation-rich system, such as that in place in California for workers’ 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


 a work-connected injury only after
separation 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


nsation, but, as a matter of practice, the liens’ 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


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


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.
We think


aspect of the Medicaid approach is that the basis for cutting off payments is grounded
in 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


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’ compensat


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’ compensation program suspension as a result of felony or misdemeanor convictions, all


ast, there is a potential that Labor Code § 139.21’s special lien proceedings will void only a fraction of the outstanding liens filed
by a provider who is later convicted and subsequently suspended. A key phrase in the statute assumes that the tain


ach time a new hunt for fraudsters and their schemes is undertaken. As such, we believe that a centralized and permanent workers’ compensation fraud data unit enhances opportunities for detecting and addressing this very special species of fraud .
S


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


nsurance, members of law enforcement, insurers, employers, labor representatives, government agency personnel, providers, third-party administrators, and applicants’ attorneys. Their thoughtful comments and frank descriptions of fraud in the Californ


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


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


ork.  5 Chapter Two. What Constitutes  Workers’ Compensation Fraud?
Common Types of Fraud
In what might be thought of as its purest form, fraud can be characterized as the making of a
knowingly false or fraudulent material statement or material re


7 U.S. Government Accountability Office (GAO), 2014a, p.  40.  6 independent insurance agents), and claims adjuster fraud.8 Table 2.1 presents various examples
of fraudulent behaviors within each of these six  broad ca


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
in that office had knowledge that such an ac


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


les and policymaker attention. For example, the California Workers’ 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