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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Zogg, Cheryl K.; Scott, John W.; Metcalfe, David; Gluck, Abbe R.; Curfman, Gregory D.; Davis, Kimberly A.; Dimick, Justin B.; Haider, Adil H.
    Reference Type: Journal Article
    Year: 2019

    Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.

    Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.

    Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado,...

    Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.

    Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.

    Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado, Illinois, Minnesota, New Jersey, and New Mexico) and 4 nonexpansion (Florida, Nebraska, North Carolina, and Texas) states.

    Interventions/Exposure Policy implementation in January 2014.

    Main Outcomes and Measures Changes in insurance coverage, outcomes (mortality, morbidity, failure to rescue, and length of stay), and discharge to rehabilitation.

    Results A total of 283 878 patients from Medicaid expansion states and 285 851 patients from nonexpansion states were included (mean age [SD], 41.9 [14.1] years; 206 698 [36.3%] women). Adults with injuries in expansion states experienced a 13.7 percentage point increase in discharge to rehabilitation (95% CI, 7.0-7.8; baseline: 14.7%) that persisted across inpatient rehabilitation facilities (4.5 percentage points), home health agencies (2.9 percentage points), and skilled nursing facilities (1.0 percentage points). There was also a 2.6 percentage point drop in failure to rescue and a 0.84-day increase in length of stay. Rehabilitation changes were most pronounced among patients eligible for rehabilitation coverage under the 2-midnight (8.4 percentage points) and 60% (10.2 percentage points) Medicaid payment rules. Medicaid expansion increased rehabilitation access for patients with the most severe injuries and conditions requiring postdischarge care (eg, pelvic fracture). It mitigated race/ethnicity-, age-, and sex-based disparities in which patients use rehabilitation.

    Conclusions and relevance This multistate assessment demonstrated significant changes in insurance coverage and discharge to rehabilitation among adult trauma patients that were greater in Medicaid expansion than nonexpansion states. By targeting subgroups of the trauma population most likely to be uninsured, rehabilitation gains associated with Medicaid have the potential to improve survival and functional outcomes for more than 60 000 additional adult trauma patients nationally in expansion states. (Author abstract)

  • Individual Author: Avellar, Sarah ; Covington, Reginald; Moore, Quinn; Patnaik, Ankita; Wu, April
    Reference Type: Report
    Year: 2019

    Children who are supported emotionally and financially by their fathers fare better, on average, than those without such support. Despite wanting to be strong parents, providers, and partners, many low-income fathers struggle to fulfill these roles. Recognizing both the importance of fathers and the challenges that they might face, Congress has authorized and funded grants for Responsible Fatherhood (RF) programs for more than a decade. The Office of Family Assistance (OFA), in the Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services awards and oversees these grants. The grants aim to help fathers be effective and nurturing parents, engage in healthy relationships and family formation, and improve economic outcomes for themselves and their families. OFA funded and ACF’s Office of Planning, Research, and Evaluation oversaw a contract with Mathematica Policy Research to conduct the Parents and Children Together (PACT) evaluation. The PACT RF impact study was a large-scale, random assignment examination of four federally funded RF...

    Children who are supported emotionally and financially by their fathers fare better, on average, than those without such support. Despite wanting to be strong parents, providers, and partners, many low-income fathers struggle to fulfill these roles. Recognizing both the importance of fathers and the challenges that they might face, Congress has authorized and funded grants for Responsible Fatherhood (RF) programs for more than a decade. The Office of Family Assistance (OFA), in the Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services awards and oversees these grants. The grants aim to help fathers be effective and nurturing parents, engage in healthy relationships and family formation, and improve economic outcomes for themselves and their families. OFA funded and ACF’s Office of Planning, Research, and Evaluation oversaw a contract with Mathematica Policy Research to conduct the Parents and Children Together (PACT) evaluation. The PACT RF impact study was a large-scale, random assignment examination of four federally funded RF programs that received grants in 2011. This brief presents the impacts of those programs on fathers’ parenting, relationships, economic stability, and well-being about one year after the fathers enrolled. (Excerpt from introduction)

  • Individual Author: Northrop, Rebecca; Jones, Christopher; Laluces, Dalton; Green, La Tonya; Crumel, Kenya; Vandawalker, Melissa; Henry, Meghan; Solari, Claudia D.; Locke, Gretchen; Khadduri, Jill
    Reference Type: Report
    Year: 2018

    The Frank Melville Supportive Housing Investment Act of 2010 introduced significant reforms to the Section 811 supportive housing for non-elderly adults with disabilities, including the new Section 811 Project Rental Assistance (PRA) Program and a mandated evaluation of its implementation and effectiveness. The Phase I is an implementation evaluation focused on the initial 18 months (Jan 2015-June 2016) of program implementation by the first 12 grantees funded through the Fiscal Year (FY) 2012 grant competition. It provides an overall picture of how the demonstration was implemented in the initial states and analyzes differences in program design, target population, and housing and service strategies. The overarching research questions include an assessment of the following aspects of program implementation: partnerships between state housing and health and human services or Medicaid agencies; property and unit selection strategies; target population outreach and referral approaches; supportive services availability; and major challenges and successes. Grantees spent much of the...

    The Frank Melville Supportive Housing Investment Act of 2010 introduced significant reforms to the Section 811 supportive housing for non-elderly adults with disabilities, including the new Section 811 Project Rental Assistance (PRA) Program and a mandated evaluation of its implementation and effectiveness. The Phase I is an implementation evaluation focused on the initial 18 months (Jan 2015-June 2016) of program implementation by the first 12 grantees funded through the Fiscal Year (FY) 2012 grant competition. It provides an overall picture of how the demonstration was implemented in the initial states and analyzes differences in program design, target population, and housing and service strategies. The overarching research questions include an assessment of the following aspects of program implementation: partnerships between state housing and health and human services or Medicaid agencies; property and unit selection strategies; target population outreach and referral approaches; supportive services availability; and major challenges and successes. Grantees spent much of the period covered by Phase I of the evaluation solidifying partner roles and responsibilities and developing the systems and procedures needed to accommodate this new and complex approach to providing affordable housing for people with disabilities. The pace of attracting properties and units to the program and leasing units has been slower than HUD and grantees expected for a variety of reasons, such as tight housing market conditions (high-price and low-vacancy), difficulty aligning housing and services, program requirements, and location mismatch. (Author abstract) 

  • Individual Author: Dion, Robin; Holcomb, Pamela; Zaveri, Heather; D'Angelo, Angela Valdovinos; Clary, Elizabeth; Friend, Daniel; Baumgartner, Scott
    Reference Type: Report
    Year: 2018

    Broad changes in family demographics have left many children without the support or involvement of their fathers. As a result of high rates of nonmarital births and divorce, millions of American children do not live with both of their parents. Rates of nonresidence are particularly high among groups that tend to face more economic challenges: 58 percent of black children and 31 percent of Hispanic children were living without their biological fathers in 2012. Father absence is associated with a range of unfavorable outcomes for children, including poor social-emotional adjustment, dropping out of school, and experiencing mental health problems as adults.

    Research suggests that the negative effects for children of father absence may be mitigated through greater father involvement. Nonresidential fathers’ greater contact with their children is associated with fewer child and adolescent behavior problems. The quality of father-child interaction also appears to matter. Nonresidential fathers’ engagement in child-related activities has been found to be linked to positive social...

    Broad changes in family demographics have left many children without the support or involvement of their fathers. As a result of high rates of nonmarital births and divorce, millions of American children do not live with both of their parents. Rates of nonresidence are particularly high among groups that tend to face more economic challenges: 58 percent of black children and 31 percent of Hispanic children were living without their biological fathers in 2012. Father absence is associated with a range of unfavorable outcomes for children, including poor social-emotional adjustment, dropping out of school, and experiencing mental health problems as adults.

    Research suggests that the negative effects for children of father absence may be mitigated through greater father involvement. Nonresidential fathers’ greater contact with their children is associated with fewer child and adolescent behavior problems. The quality of father-child interaction also appears to matter. Nonresidential fathers’ engagement in child-related activities has been found to be linked to positive social, emotional and behavioral adjustment in children.

    To address these issues, Congress has funded the Responsible Fatherhood (RF) grant program since 2006. The grant program is administered by the Office of Family Assistance at the Administration for Children and Families (ACF), U.S. Department of Health and Human Services. RF grants require programs to offer services for fathers in three areas: parenting and fatherhood, economic stability, and healthy marriage and relationships.

    The Parents and Children Together (PACT) evaluation is studying four RF programs using a rigorous multi-component research design. Conducted by Mathematica Policy Research for the Office of Planning, Research, and Evaluation at ACF, PACT focuses on three broad areas: fathers’ backgrounds, views, and experiences (qualitative study component), how the programs were implemented (implementation study component), and the programs’ effects on fathers’ outcomes (impact study component). Recognizing that RF programming will continue to grow and evolve, PACT is providing a building block in the evidence base to guide ongoing and future program design and evaluation efforts. (Author abstract) 

  • Individual Author: Walton, Douglas; Wood, Michelle; Dunton, Lauren
    Reference Type: Report
    Year: 2018

    This series of research briefs explores issues of family homelessness that are especially relevant to HHS, to state and local decision makers, and for programs. The Child Separation among Families Experiencing Homelessness brief explores child separations among families experiencing homelessness. It builds upon the fourth brief in this series, “Child and Partner Transitions among Families Experiencing Homelessness,” which looked at family separations and reunifications in the 20 months after being in emergency shelter and the association between family separation and recent housing instability following an initial shelter stay. This new brief provides a more detailed examination of these families and their children before and after the initial shelter stay, revealing more extensive and persistent levels of child separation. It gives detailed characteristics of separated children and examines whether future child separation after a shelter stay is related to either housing instability of previous separations. (Author abstract)

     

    This series of research briefs explores issues of family homelessness that are especially relevant to HHS, to state and local decision makers, and for programs. The Child Separation among Families Experiencing Homelessness brief explores child separations among families experiencing homelessness. It builds upon the fourth brief in this series, “Child and Partner Transitions among Families Experiencing Homelessness,” which looked at family separations and reunifications in the 20 months after being in emergency shelter and the association between family separation and recent housing instability following an initial shelter stay. This new brief provides a more detailed examination of these families and their children before and after the initial shelter stay, revealing more extensive and persistent levels of child separation. It gives detailed characteristics of separated children and examines whether future child separation after a shelter stay is related to either housing instability of previous separations. (Author abstract)

     

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