The Making Sense of Having Disabilities

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1 2013 RESEARCH IN REVIEW Mathematica informs evidence-based decision making through rigorous studies and analyses. Mathematica s Research in Review is a snapshot of some of this year s research results.

2 Disability The Youth Transition Demonstration (YTD): Lifting Employment Barriers for Youth with Disabilities The transition from youth to adulthood is difficult for many young people, particularly those with disabilities. The Social Security Administration s (SSA s) YTD was designed to help youth with disabilities maximize their economic self-sufficiency as they move from school to work by providing supports such as workbased experiences, system linkages, and SSA waivers and benefits counseling. Mathematica s rigorous YTD evaluation tested six site-based approaches to assisting youth with disabilities, and interim findings indicate that the program shows promise for improving employment outcomes for these youth, although the sites had varying degrees of success. In Miami, members of the program group each earned an average of $895 during the year after they entered the evaluation, compared with $588 for their counterparts in the control group. In West Virginia, program group members earned $1,559 each, compared with $1,035 for control group members. Annual earnings in year following enrollment The final report on the YTD evaluation, expected in 2015, will document whether these positive short-term impacts were sustained for up to three years. It will also offer lessons regarding the replication of these programs in other settings. West Virginia and Miami-Dade County: 75% increase in employment rates West Virginia $1,559 $895 Miami $1,035 $588 Produced for: Social Security Administration Read More: Infographic, Issue Brief, Report on West Virginia Youth Works, Report on Miami-Dade s Broadened Horizons, Brighter Futures Program Group Control Group Program Group Control Group 1

3 Early Childhood FACES: Data Highlight Children s Progress During Head Start The Head Start Family and Child Experiences Survey (FACES) tracks children s school readiness skills, family and classroom contexts for learning, and quality indicators for teachers and programs over multiple cohorts. Mathematica will continue to direct the survey through a newly awarded contract for FACES Children make gains in early writing, early math, and letter-word knowledge during their time in Head Start, but other than in the last category, they still lag behind national norms. Teachers report that children show gains in social skills and approaches to learning, as well as decreases in problem behaviors, while in Head Start. Children s progress in early literacy and mathematics Children s progress in social-emotional skills Average for sameage children = Average Standard Score Average Score Produced for: Office of Planning, Research, and Evaluation; Administration for Children and Families; U.S. Department of Health and Human Services Read More: Infographics, Full Report, Data Tables Letter-Word Knowledge Early Writing Early Math Head Start Entry Head Start Exit Social Skills (range = 0 to 24) Problem Behaviors (range = 0 to 36) Approaches to Learning (range = 0 to 3) 2

4 Education The Talent Transfer Initiative (TTI) TTI was developed to determine whether a monetary incentive can attract high-performing teachers to lowperforming schools, what impact such teachers would have on their students test scores, and whether the teachers would stay when the incentive payments ended. Mathematica s evaluation showed that student achievement in elementary school math and reading increased by 10 to 25 percent of a standard deviation in classrooms taught by TTI teachers and that 60 percent of TTI teachers remained beyond the two-year incentive period. Researchers estimate that TTI could save more than $13,000 per grade level per school compared with the investment in class-size reduction needed to achieve similar gains in elementary school test scores. Cost savings would be lower if middle school results are taken into account, but higher if we consider the possibility of long-term impacts. $ Focal teachers impact on test scores in elementary schools Most TTI teachers stayed at their schools Cost savings from TTI per grade, per school Produced for: U.S. Department of Education, Institute of Education Sciences Read More: Press Release, Fact Sheet, Full Report, Research Recap Video Standard Deviations Math Reading Year 1 (All districts) Math Reading Year 2 (Cohort 1 districts) Percent of Teachers Retained TTI Group non-tti Group Program Year 1 93% 70% Program Year 2 Bonus Payment Period 60% 51% Post- Program $7,445 All Schools $13,154 Elementary 3

5 Family Support The Economic Well-Being of Lesbian, Gay, and Bisexual (LGB) Youth Aging Out of Foster Care LGB youth aging out of foster care may find it difficult to achieve economic self-sufficiency because they are often victims of harassment and may be adversely affected by non-lgb-friendly foster homes or frequent placement changes. Chapin Hall, a subcontractor of Mathematica, used data collected as part of the Midwest Evaluation of the Adult Functioning of Former Foster Youth (the Midwest Study) to examine the characteristics and economic well-being of LGB youth aging out of foster care, compared with their heterosexual peers. 22% of the LGB respondents reported being homeless for at least one night since aging out of foster care, compared with 17% of their heterosexual peers. 26% of the LGB respondents reported not having any earnings during the past year, compared with 19% of their heterosexual peers. $ Mean earnings: LGB = $8,934 Heterosexual = $9,294 Median earnings: LGB = $6,500 Heterosexual = $6,000 61% LGB Respondents 61% of the LGB respondents experienced at least one of five economic hardships, compared with 47% of their heterosexual peers: 47% Heterosexual Peers Produced for: Office of Planning, Research, and Evaluation; Administration for Children and Families; U.S. Department of Health and Human Services Read More: Issue Brief not enough money to pay rent not enough money to pay utilities gas turned off electricity turned off phone service disconnected 4

6 Health Reform Some Hospitals Are Falling Behind in Meeting Meaningful Use Criteria Health information technology (HIT) is a critical element in the effort to increase the quality and reduce the costs of health care. Medicare s meaningful use criteria establish stages for the full adoption of HIT, including creating necessary systems in stage 1 and expanding the use of those systems in stages 2 and 3 to facilitate effective decision making and to improve care delivery. In an article published in Health Affairs, Mathematica cites progress and challenges in HIT adoption between 2011 and Large urban hospitals continued to outpace rural and nonteaching hospitals in adopting EHR systems. 44% 27% Hospitals with a basic electronic health record (EHR) system Although 42.2% of all hospitals met all the stage 1 meaningful use criteria for adopting an EHR system, only 5.1% had advanced to stage % 5.1% Produced for: Health Affairs Read More: Article Stage 1 Stage 2 5

7 Health Care Quality Measuring the Quality of Children s Health Care in Medicaid and in the Children s Health Insurance Program (CHIP) Medicaid and CHIP jointly served more than 44 million children in federal fiscal year (FFY) 2012, representing more than half the beneficiaries currently enrolled in these programs and more than one-third of children in the United States. The programs help ensure that low-income children have health care coverage and access to a comprehensive set of benefits and other medically necessary services. Mathematica provides technical assistance and analytic support to the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), and states on various aspects of measuring and improving quality in Medicaid/CHIP. Mathematica also collaborated with CMS to produce the 2013 Annual Secretary s Report, which provides an update on the quality of care children receive in these programs. The median rate for combination 3 immunization among children turning age 2 was 68 percent, whereas the combination 1 immunization rate among 13-year-olds was 52 percent. The Chlamydia screening rate among sexually active girls ages 16 to 20 was 60 percent. A median of 41 percent of children prescribed medication for attention-deficit/ hyperactivity disorder (ADHD) had a follow-up visit during the first 30 days. The majority of children had at least one visit to a primary care practitioner, with the median rate ranging from 97 percent among children ages 12 to 24 months to 88 to 91 percent for other age groups. Produced for: Centers for Medicare & Medicaid Services Read More: 2013 Annual Report on the Quality of Care for Children in Medicaid and CHIP Note: Median rates derived from state-reported Medicaid and/or CHIP data. A median of 44 percent of youth ages 1 to 20 received at least one preventive dental service paid for by Medicaid in FFY

8 International Funding Agricultural Training: Evidence from Armenia Many international aid agencies fund large-scale agricultural training programs to improve well-being in developing countries. Mathematica evaluated the effectiveness of one such program in rural Armenia. The program trained more than 50,000 Armenians on the efficient use of irrigation water to cultivate highvalue crops. Researchers examined the impacts of the program on poverty rates, household income, and agricultural practices. Future studies will examine the effects of the Millennium Challenge Corporation s investments in irrigation infrastructure and rural roads in Armenia. Findings There was no evidence that training substantially improved long-term measures of farmers well-being, such as crop cultivation, amount or value of production, revenue, total income, poverty, or consumption. Focus groups and interviews revealed that financial limitations were the most common reason for not implementing new practices. Implications Policymakers should reassess the assumption that programs like this will have consistently large impacts on rural households well-being in developing countries. Produced for: Millennium Challenge Corporation Read More: Working Paper, Full Report Factors to consider in future interventions include more modest training targets, tailoring of practices to farmers circumstances, and better selection of beneficiaries. 7

9 Labor Impacts of Training and Education Offered Through the Trade Adjustment Assistance (TAA) Program Mathematica conducted an impact evaluation of the TAA program, which was designed to provide assistance to manufacturing workers certified as having suffered trade-related job losses. TAA represents a substantial investment of federal funds; in fiscal year 2008, almost $260 million in funding for TAA services was distributed to states, and 42,000 new participants received program services. Findings Nearly two-thirds of TAA participants took part in some form of training and education, compared with only a quarter of similar non-taa workers. As expected, time in training came at the expense of employment. Four years after job loss, TAA participants were employed at the same rate as similar non-taa workers. Completed a training program 55% 24% Received a certificate or degree 51% 21% TAA participants non-taa participants Comparison Produced for: Employment and Training Administration, U.S. Department of Labor Read More: Full Report Percent Employed Quarters 1 to 16 TAA Participants Increased training did $ not lead to improved earnings relative to the comparison group in the four years after job loss. 8

10 Nutrition Measuring the Effect of the Supplemental Nutrition Assistance Program (SNAP) on Food Security SNAP provides cash benefits to low-income households to reduce hunger and promote access to a healthy diet. Households that don t have regular access to enough food for a healthy, active lifestyle are said to be food insecure. Households in which children don t have regular access to enough food are said to have food insecurity among children. In the largest and most rigorous study to date, Mathematica found that SNAP participation is associated with decreased incidence of both household food insecurity and child food insecurity. SNAP was associated with a decrease in food insecurity after six months 65% Household Food Insecurity 32% 55% Child Food Insecurity 22% Start SNAP Participation Six Months on SNAP Produced for: Food and Nutrition Service, U.S. Department of Agriculture Read More: Press Release, Infographic, Research Recap Video, Executive Summary, Full Report Decreases in food insecurity were greatest for households that received large benefit amounts. 9