Browsing by Author "Clotfelter, Charles"
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Item Open Access Impact of Workplace Health Centers on Health Care Spending and Utilization Among Plant Workers in California’s Central Valley(2020-06) Pothen, MerilEmployers are becoming more active in strategies to reduce health care spending while maintaining or improving health outcomes for employees. Workplace wellness programs (WWPs) are popular, but the research is mixed on their efficacy in reducing spending and unnecessary utilization. Workplace health centers (WHCs), onsite clinics providing primary and additional care, are a viable alternative for self-funded, large employers. This study’s client, a $4.6B privately held agribusiness, opened its WHCs in late 2015 at two of its largest worksites. Analysis of health care-seeking employees with and without access to the WHCs found that access is associated with reductions in total health spending and utilization. The company’s WHCs also disproportionately benefited employees with chronic conditions, causally reducing non-emergent utilization for those with hyperlipidemia and diabetes. Links between WHC access and reduced spending, fewer ER visits, and fewer hospitalizations were also observed for other chronic conditions. By positioning WHCs as a substitute to traditional office visits and urgent care, company leadership can encourage employees to seek care “in house” and therefore have narrower external networks, resulting in cost savings. The chronic conditions population should continue to be the company’s focus in its health and wellness initiatives. Other large, self-funded employers considering WHCs should design their services to replace non-emergent care and cater to employees with chronic conditions.Item Open Access Nonprofit Market Structure and Its Consequences(2017) Vance-McMullen, DanielleThis dissertation is comprised of three papers related to nonprofit market structure and its consequences. I begin with an essay that examines how the recent boom of nonprofit organizations affects giving using the context of the Combined Federal Campaign (CFC). I find that the nonprofit boom has not increased donations to nonprofit organizations. Since a fixed amount of charitable resources is split among more organizations, the average nonprofit receives less funding as the number of organizations grows. The second paper proposes a new definition of nonprofit markets based on individual-level donor behavior and donor-nonprofit network ties. Notably, the new market definition predicts donor substitution among organizations 58% more accurately than the standard nonprofit market definition based on an organization’s subsector and geographic location. The CFC data and this donor-based market definition are also used to examine an important nonprofit policy issue—the relationship between market concentration and nonprofit spending on overhead. In the final essay, I study one of the processes by which competition in the CFC has increased over time—changes in the structure of government contracts. I examine whether fewer, but larger, contracts change performance. I find that contract consolidation does not significantly improve performance. Furthermore, I find no evidence that economies of scale exist in workplace giving.
Item Open Access Policy Options for Rural North Carolina School Districts with Declining Student Enrollment(2011-04-15) Wilson, JeremyThis Report examines the question: “What policies should the Center for Civil Rights promote in order to assist rural North Carolina school districts with declining student enrollment?” North Carolina has several school districts experiencing declining enrollment, and these districts are predominately low-wealth, rural districts concentrated in the northeastern part of the state. Since 1980, 24 North Carolina school districts have had enrollment declines greater than 20%. Three districts—Halifax County, Northampton County, and Hyde County—have had declines greater than 40%. These trends have direct policy implications for affected school districts. Reliance on per-pupil state funding leads to necessary budget cuts and difficult decisions regarding district resources. There are more specific impacts on school size, transportation demands, and curriculum—due to the funding losses and related factors (such as possible school consolidation). This Report utilizes the available state-level education data and census data to describe the effects of declining enrollment. These data define the scope of the problem and help determine correlations between declining enrollment and other issues, such as low student achievement outcomes and system-wide economic difficulties. The Report also performs a case study of eights specific school districts: four with declining enrollment, two constant districts, and two growing districts. With this descriptive framework in place, the Report examines seven policy options that may help address the problems associated with declining student enrollment in rural North Carolina school districts: 1. Alter state funding formulas to delay the effects of year-to-year drops in funding. 2. Provide supplemental state funding for districts experiencing significant declines in student enrollment. 3. Provide for greater use of technology in affected districts. 4. Promote partnerships between affected school districts and other community institutions, including local businesses and community colleges. 5. Establish inter-district resource partnerships. 6. Establish inter-district enrollment arrangements. 7. Consolidate districts where multiple school districts exist in one county. These options are weighed against the criteria of (1) impact on student achievement, (2) cost, and (3) political feasibility. Information from the available education literature, budget information, and practices employed in other states aid this analysis. The Report also uses interview data, particularly from education officials in the four rural school districts of Halifax County, Northampton County, Weldon City, and Hertford County. In the end, this Report recommends that the Center for Civil Rights should advocate for greater use of technology, community partnerships, inter-district resource partnerships, and consolidation of the three Halifax County school districts. Once the state budget situation improves, the Center should promote adoption of a state supplemental fund for districts facing severe declines in enrollment. This fund should be administered in a “grant-like” fashion, providing incentive-based funding as needed for particular policies and programs.Item Open Access Recommendations for Federal Involvement in School Turnaround Efforts(2013-04-18) Dorman, StephanieExecutive Summary Politicians, policymakers and educators are increasingly concerned that the nation’s lowest performing schools are leaving a significant proportion of disadvantaged students without the skills necessary to lead healthy and productive lives. Therefore, some policymakers and education reformers have placed a high priority on school turnaround efforts aimed to increase student achievement in the nation’s chronically lowest performing schools. School turnaround efforts are those actions taken at state, district, and school levels aimed to improve student performance in the group of lowest performing schools. While states have the authority to take steps to improve low-performing schools, there is variation in the scope and effectiveness of state-led school turnaround efforts. With programs like Race to the Top and School Improvement Grants, the federal government has attempted to help states improve their lowest performing schools by providing additional funding, requirements, and guidelines. However, some federal policymakers are concerned that some states and local education agencies still do not have the funding and expertise to effectively implement these policies. The policy question for this master’s project is: Should the federal government be involved in school turnaround efforts, and if so, what should be that involvement? North Carolina as a Case Study This report focuses on North Carolina as a case study. This case study contains four elements. First, I describe North Carolina’s state-led school turnaround efforts prior to 2010. Next, I detail North Carolina’s efforts after receiving a competitive federal Race to the Top grant in 2010, which included federal funding and requirements to expand the state’s school turnaround efforts. This section also describes state efforts to support schools receiving federal School Improvement Grants, as well as North Carolina’s approach to improving low-performing schools under the Elementary and Secondary Education Act (ESEA) waiver. Third, I look at reports evaluating North Carolina’s turnaround efforts. These reports contain an analysis of performance composite and graduation rates of state-supported “turnaround schools” compared to similar schools not receiving support. Lastly, I interviewed people involved in turnaround efforts at the state, district, and school levels. North Carolina’s School Turnaround Efforts North Carolina’s Department of Public Instruction (NCDPI) has been providing support to underperforming schools in the state since 1997. Between 1997 and 2006, the State Board of Education assigned assistance teams to improve achievement in low-performing schools, identified by state statute. Beginning in 2006, the state changed its approach. Instead of providing assistance teams, NCDPI provided leadership and instructional coaching for administrators and teachers in low-performing schools. During this time, NCDPI’s efforts were conducted with very little federal funding or oversight. Federal involvement in school turnaround efforts increased when North Carolina received a federal Race to the Top Grant in 2010. North Carolina’s school turnaround efforts under Race to the Top are substantially similar those efforts prior to receiving Race to the Top funding. The additional funding has mostly been used to expand NCDPI coaching staff to support turnaround efforts and increase the number of supported schools and districts. Data Analysis Achievement data analyzed by researchers studying North Carolina’s state-led school turnaround efforts indicates that NCDPI support to “turnaround schools” prior to receiving Race to the Top funding significantly and positively contributed to achievement gains, particularly in high schools. Those performance gains were sustained even after NCDPI ended coaching support to those schools. Furthermore, interviews I conducted with state, district, and school administrators provide information about state and local capacity to implement school turnaround efforts, insights into the relative payoffs of NCDPI’s needs assessment and coaching support, the influence of federal requirements through Race to the Top and School Improvement Grants (SIGs) on NCDPI’s efforts on the ground, as well as sustainability challenges for Race to the Top and SIG funding. State, district, and school capacity According to these interviews, the three major things that have allowed NCDPI to engage in its relatively extensive school turnaround efforts are pressure from North Carolina Superior Court Judge Howard Manning, partnerships with consulting organizations, and allocation of agency funding for school turnaround positions. While North Carolina’s efforts have had significant scope, DPI would like to provide support to more underperforming schools. They are however constrained by funding for positions and the special talent needed for turnaround coaching. State, district, and school administrators are concerned that low-performing schools and districts have difficulty attracting and retaining high quality educators. Moreover, those teachers that replace underperforming staff are likely to be less experienced, and therefore require more support. NCDPI’s efforts under Race to the Top and School Improvement Grants (SIG) Federal requirements under Race to the Top have not substantially changed school turnaround priorities on the ground. However, people involved in school turnaround efforts in North Carolina think that federal funding and requirements have provided some benefits, most notably pressure for districts to make tough changes to improve performance. The funding has also allowed NCDPI to hire more staff to support low-performing schools and districts. District and school administrators said that using data and professional learning communities are the most beneficial things they have done as a result of their SIG grant. However, state officials argue that the model requirements should be more flexible. They also do not think federal funds should go to underperforming schools without requiring teacher and administrator capacity development and district support. Race to the Top and SIG sustainability State officials and others involved in school turnaround efforts at the state level recognize that after Race to the Top funding ends, NCDPI will likely need to scale back its staff, and therefore its support to schools and districts. The biggest sustainability challenge for SIG recipients is how to keep specialist positions paid for with grant money after their grant ends. For most of the positions, the schools will rely on their school board to provide extra funding, which is not guaranteed. Recommendations for Federal Involvement in School Turnaround Efforts 1. Continue to place a high priority on school turnaround efforts. Federal focus on school turnaround efforts through Race to the Top and School Improvement Grants has been viewed positively overall in North Carolina. In particular, it has helped states and districts to place a high priority on efforts to improve performance in the most underperforming schools. Therefore, school turnaround efforts are a valuable part of the federal government’s education agenda. 2. Help state education agencies plan for school turnaround efforts. According to the literature, many states have limited staff and funding to support low-performing schools. Moreover, NCDPI benefited from evaluating how they could use funding they already had for school turnaround positions, as well as developing expertise and staff recruitment capabilities over time by working with outside consultants. Therefore, federal assistance to help state education agencies reallocate funding for school turnaround positions, assess school and district needs, plan for turnaround efforts—including coaching staff recruitment and matching with schools—could be valuable. Currently this type of assistance is not being provided. However, the U.S. Department of Education should have the staff and expertise to be able to help guide state education agencies and provide support in these ways. 3. Provide information on best practices for model elements to state education agencies through an easy to access online database. Those involved in school turnaround efforts at the state level in North Carolina said it would be helpful to have access to a one-stop-shop of best practices regarding the model requirements. An online resource of best practices could include not only successful cases from the literature, but also a mechanism for states to share information about their efforts and lessons learned. Currently, no such easy to access method of sharing this information exists. 4. Fund more research on school turnaround efforts. Sophisticated studies evaluating the impact of the turnaround model elements are limited. More research is needed to verify whether the model requirements actually cause improvements in student achievement, as well as how implementation designs may affect improvement. It is in the federal government’s best interest for reliable research about these elements to exist, if funding is going to be allocated for turnaround efforts. 5. Make model elements more flexible. Relax requirements that schools meet all model requirements and allow schools to pick requirements according to their needs. The rigidity of the federal model requirements received mixed reviews. It is clear that the professional learning communities and data use requirements are seen as being valuable at the state, district, and school levels. Because not all the model requirements are seen as being equally valuable, it could be beneficial for administrators to be able to select from a menu of requirements, allowing them to tailor to the specific needs of their school or district. 6. Require leadership and instructional capacity development for teachers and administrators as part of funding provided to “turnaround schools.” Instructional and leadership coaching support from NCDPI to low-performing schools and districts has been a key part of North Carolina’s school turnaround efforts. At the state level, policymakers view this support as key to long-term sustainability of achievement gains. Moreover, NCDPI needs assessment and coaching support is viewed positively at the state, district, and school levels. Currently, the School Improvement Grant does not require capacity development for recipient schools and districts. 7. Provide long-term federal funding for: a. Salaries to attract and retain educators in low-performing schools. b. Leadership academies to train leaders for “turnaround schools.” c. Teacher professional development. d. State agencies to hire school turnaround support staff. e. Housing and transportation for teachers to work in rural low-performing areas of a state. Short-term federal funding for school turnaround efforts, such as that which is provided through Race to the Top and the School Improvement Grants (SIGs), makes it difficult for states, schools, and districts to sustain those investments—like additional staff positions or technology—aimed to improve student achievement. It is likely that recipient schools will need support beyond the grant term. Currently, there is no established federal funding stream beyond Race to the Top and SIG short-term grants to support school turnaround efforts. More sustained, stable federal funding for turnaround efforts at the state level would likely be beneficial. The biggest capacity challenge for underperforming schools is attracting, retaining, and developing high quality teachers and administrators. Higher salaries, leadership academies, and housing and transportation for teachers in rural areas would likely help address some of these constraints. Funding for staff positions at the state level would likely also allow state education agencies to support more low-performing schools.