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W.K. Kellogg Foundation;
Explore seven grantee stories, letters from our leaders and a look at our Year in Review – each reaffirming WKKF priorities of thriving children, working families and equitable communities, while highlighting the many levels of dynamic interconnections, essential to lasting change.
Issue: Managed care organizations (MCOs) are integral to Medicaid payment and delivery reform efforts. In states that expanded Medicaid eligibility under the Affordable Care Act, MCOs have experienced a surge in enrollment of adults with complex needs.
Goal: To understand MCO experiences in Medicaid expansion states and learn about innovations related to access to care, care delivery, payment, and integration of health and social services to address nonmedical needs.
Methods: Interviews with leaders of 17 MCOs in 10 states that have seen large Medicaid enrollment growth and have undertaken payment and delivery reforms.
Findings and Conclusions: MCO leaders regard their ability to enroll and serve the Medicaid expansion populations as a signal achievement. They have focused on identifying and helping high-risk populations and addressing the social determinants of health. MCOs are testing value-based payment strategies that link payment with performance and are increasingly focused on engaging patients in their care. Leaders report common challenges: setting appropriate payment rates; managing members whose needs differ from traditional Medicaid beneficiaries; ensuring access to specialty care; and effectively implementing payment reform and practice transformation. All point to the need for a stable policy environment and a strong working relationship with state Medicaid agencies.
Poverty Solutions at the University of Michigan;
Children need stability to thrive, but for the more than 36,000 children in Michigan's elementary, middle and high schools who face homelessness, stability is often elusive. Under federal education law all children and youth who "lack a fixed, regular, and adequate nighttime residence" are homeless. These children not only lack a stable place to call home, they are more likely to transfer schools, have long commutes, struggle with poor health, and be chronically absent than their non-homeless peers. All of these daily challenges place homeless students at a greater risk for not meeting grade-level standards and for dropping out of school. Recent research in the State of Michigan has shown homelessness among children to be a key factor predicting student achievement in both rural and urban areas, yet little attention has been given, thus far, to understanding where homeless students in Michigan attend school and how their needs might differ depending on their geographic location. This policy brief seeks to fill that gap so that policymakers and local stakeholders can begin to think about the impact of homelessness in their area and to identify resources to support some of the State's most vulnerable children. Data for this brief comes from school year 2015-16 administrative records collected by every school under the mandate of the Federal McKinney-Vento Act, a law which guarantees homeless student's right to an education.
National Fund for Workforce Solutions;
The Mercy Health, West Michigan case study is the second in CareerSTAT's business practice series on how healthcare employers measure the impact of their investments on frontline workers. This study documents Mercy Health's approach to workforce development and program measurement with a focus on how strategic goals, workforce needs, and programatic tools influence decision making and investment goals.
Michigan Economic Center;
This report is a clarion call from two Michigan economic development organizations to recognize and support the significant contributions that immigrants are making to the revival of the Michigan economy. The authors are concerned that the gains that the state has made in creating an immigrant-friendly environment are being undermined by policies of the Trump Administration. Although immigrants constitute only 6 percent of the state's population, they punch above their weight on many indices of economic activity, including being 25 percent of the state's high-tech start-ups and running firms that employ over 150,000 other people. Immigrants have also brought an infusion of talent and labor to offset the decline in the native-born population over the last 15 years. The authors summarize the many initiatives the state has taken with the support of state, municipal, and industry leaders to promote the state as an immigrant-friendly destination, including the creation of the Michigan Office of New Americans by Republican Governor Rick Snyder. However, policies of the Trump Administration, such as the scaling back of H-1B visas, the travel ban affecting predominantly Muslim countries, and reductions in refugee admissions, threaten to reverse these gains.
Robina Institute of Criminal Law and Criminal Justice;
Michigan has sentencing guidelines that were drafted by a now defunct Sentencing Guidelines Commission, which operated from 1998-2002. These guidelines help to regulate the state's indeterminate sentencing system, and have recently been revised to reflect state and federal constitutional law and new legislation. In 2015, legislation forming the Michigan Justice Policy Commission was enacted to drive future criminal justice reforms. Michigan has had some form of discretionary release since 1885, when an Advisory Board existed to assist the governor in determining whether or not to grant "conditional licenses to go at large." The attributes of the paroling authority have changed greatly over the years; the current 10-member Board structure has been in place since 2011.
Chicago Council on Global Affairs;
This report focuses how immigrants have helped offset native-born population loss and revitalized an aging workforce by examining 46 Midwestern metro areas as a refresh of a similar study published by the Chicago Council on Global Affairs in 2014. Metro areas are a useful barometer by which to measure the impact of immigration because the economies of central cities and their suburbs are tightly connected and because large immigrant communities are found in both central cities and suburbs of metro areas. Also, the extent to which immigration matters to metro-area economies heightens the importance of immigration as an issue and raises the stakes for immigration reform.
Center for Health Policy at Brookings;
The health insurance marketplaces created by the Affordable Care Act (ACA) were intended to broaden health insurance coverage by making it relatively easy for the uninsured, armed with income-related federal subsidies, to choose health plans that met their needs from an array of competing options. The further hope was that competition among health plans on the exchanges would lead to lower costs and higher value for consumers, because inefficient, low-value plans would lose out in the competitive market place. This study sought to understand the diverse experience in five states under the ACA in order to gain insights for improving competition in the private health insurance industry and the implementation of the ACA.
In spring 2016, the insurance marketplaces had been operating for nearly three full years. There were numerous press stories of plans' decisions to enter or leave selected states or market areas within states and to narrow provider networks by including fewer choices among hospitals, medical specialists, and other providers. There were also beginning to be stories of insurer requests for significant premium increases. However, there was no clear understanding of how common these practices were, nor how and why practices differed across carriers, markets, and state regulatory settings.
This project used the ACA Implementation Research Network to conduct field research in California, Michigan, Florida, North Carolina, and Texas. In each state, expert field researchers engaged directly with marketplace stakeholders, including insurance carriers, provider groups, state regulators, and consumer engagement organizations, to identify and understand their various decisions. This focus included an effort to understand why carriers choose to enter or exit markets and the barriers they faced, how provider networks were built, and how state regulatory decisions affected decision-making. Ultimately, it sought to find where and why certain markets are successful and competitive and how less competitive markets might be improved.
The study of five states was not intended to provide statistically meaningful generalizations about the functioning of the marketplace exchanges. Rather, it was intended to accomplish two other objectives. First, the study was designed to generate hypotheses about the development and evolution of the exchanges that might be tested with "harder" data from all the exchanges. Second, it sought to describe the potentially idiosyncratic nature of the marketplaces in each of the five states. Political and economic circumstances may differ substantially across markets. Policymakers and market participants need to appreciate the nuances of different local settings if programs are to be successful. What works in Michigan may not work in Texas and vice versa. Field research of this sort can give researchers and policymakers insight into how idiosyncratic local factors matter in practice.
In brief, our five states had four years of experience in the open enrollment periods from 2014 through 2017. The states array themselves in a continuum of apparent success in enhancing and maintaining competition among insurers. California and Michigan appear to have had success in nurturing insurer competition, in at least the urban areas of their states. Florida, North Carolina, and Texas were less successful. This divergence is recent, however. As recently as the 2015 and 2016 open enrollment periods, all of the states had what appeared to be promising, if not always robust, insurance competition. Large changes occurred in the run-up to the 2017 open enrollment period.
Woodrow Wilson National Fellowship Foundation;
Improving Michigan STEM Teachers and Teaching analyzed the efforts of the W.K. Kellogg Foundation's Woodrow Wilson Michigan Teaching Fellowship, which began in the state in 2010 with the generous financial support of the W.K. Kellogg Foundation. Woodrow Wilson selected and worked closely with six Michigan universities that demonstrated the capacity, willingness, and leadership to create model teacher education programs—rigorous, highly selective, clinically based programs integrating disciplinary content and pedagogical instruction.
Partner universities in the state included Eastern Michigan University, Grand Valley State University, Michigan State University, the University of Michigan, Wayne State University, and Western Michigan University. Teaching Fellows completed their clinical experiences in school districts across the state, including Ann Arbor, Battle Creek, Benton Harbor, Comstock, Detroit, Godwin Heights, Grand Rapids, Jackson, Kalamazoo, Lansing, Lincoln, and Ypsilanti.
"Woodrow Wilson Fellows are indeed taking on the challenge of teaching in Michigan's high-need classrooms, and they are well prepared to work with students in those schools," the report states "Michigan students taught by Fellows are four times more likely to be black (61 percent, as opposed to -15 percent for inexperienced non-Fellows); about twice as likely to be eligible for free/reduced price lunch (80 percent, versus 44 percent for non-Fellows); more likely to have changed schools within the school year (31 percent, versus 10 percent for non-Fellows); three times as likely to be English language learners (10 percent, versus 3 percent for non-Fellows), and more likely to have special education needs (16 percent, compared to 10 percent for non-Fellows)."
The analysis found that W.K. Kellogg Foundation Woodrow Wilson Michigan Teaching Fellows were placed in some of the state's most challenging teaching assignments, while bringing more subject matter expertise to Michigan classrooms than did their peers. Fully 100 percent of Woodrow Wilson Fellows hold a Michigan STEM license. By contrast, just 87 percent of new Michigan teachers statewide who taught core STEM classes have STEM licenses.
Information provided by the Center for the Analysis of Longitudinal Data in Education Research (CALDER) at the American Institutes for Research demonstrated that the Woodrow Wilson Teaching Fellowship Program does lead to improved teacher performance in the high-need schools that the program focuses on, as measured by Fellows' impact on student achievement. In addition, compared to students of non-Fellows, students of Woodrow Wilson Fellows showed more growth in middle school math, middle school science, and high school science. The exception was Fellows teaching high school science, who only outperformed the same-district inexperienced comparison group.
As the formal W.K. Kellogg-Woodrow Wilson Teaching Fellowship program concludes, each of the six partner universities demonstrates how the transformation project will be continued in ongoing teacher education efforts across the state. Eastern Michigan University, for instance, has built a new degree program based on the Woodrow Wilson Teaching Fellowship model that is moving, as intended, into non-STEM areas. Michigan State University and the University of Michigan have embedded elements of the WKKF-WW Michigan Teaching Fellowship within their larger teacher education communities. The WKKF-WW Teaching Fellowship program has also resulted in the development of models for specialized preparation programs in other subject areas in Western Michigan University's college of education.
Michigan Department of Education Office of Great Start;
In August 2016, with support from the Max and Marjorie Fisher Foundation, the Michigan Department of Education Office of Great Start and Citizens Research Council of Michigan released a report to improve and inform the federal application to renew Michigan's Childcare Subsidy Program. The Michigan program has been under-subscribed, resulting in unused funding being returned to the federal government — the only state in the U.S. to have done so in 2015. Given the substantial challenges families face in Michigan, the report outlined recommendations that will create a positive impact on both parents, as well as the childcare providers themselves. Creating change in childcare will requirement considerable changes, not just to better support parents, but also to bolster the early education workforce overall.
Vera Institute of Justice;
Police frequently encounter youth running away from home, violating curfew, skipping school, and chronically disobeying adults—misbehavior that can often stem from family conflict and that do not require justice involvement. When alternatives are not available, however, these behaviors can lead to arrests or detention. Families dealing with difficult youth behavior often unwittingly send their youth into the justice system by calling the police because they feel they have nowhere to turn for help. For police, encountering these kinds of situations can be frustrating because they feel limited to suboptimal choices: either ignoring the problem behavior or criminalizing it.This brief explores the creative, collaborative, and community-focused work being done in Nevada, Connecticut, Nebraska, Michigan, Illinois, and Oregon to find productive responses to youth "acting out." The juvenile assessment resource centers, crisis response centers, and crisis intervention teams in these jurisdictions address the needs of youth and connect families to resources and services without the need for juvenile justice involvement.