As we reported last week, the deal reached on fiscal 2018 spending included several boosts for programs that serve youth and families. Click here for our analysis of that, plus our full chart of youth spending in 2018.
Youth Services Insider also spotted a few studies mandated by the bill, mostly without funding, that relate to children and families. Here’s a rundown of some new research on the horizon as a result of the deal:
Birth Settings
Recent research conducted by the University of Maryland and Boston University showed that the percent of births occurring outside a hospital increased by 72 percent between 2004 and 2014. This includes women who delivered at home, or at birth centers.
The National Institute of Child Health and Human Development is instructed to work with the National Academy of Sciences (NAS) to analyze the existing research about outcomes related to birth setting. Among the things Congress wants to know:
- Assessment of risk factors
- Access to, and choice, in birth settings
- Social determinants that influence risk and outcomes in different birth settings
- Financing models for childbirth across settings
- The licensing, training and accreditation issues related to maternity care across all settings
School Discipline
The hotbutton issue when it comes to how schools handle misbehavior is the decision to cast out students, either by way of suspension or expulsion. Recent research suggests that both actions happen frequently, and happen disproportionately to African-American students.
Less attention is paid to punishments on school ground, particularly the practice of isolating or physically restraining students.
“There is concern that seclusion and restraint issues continue to be chronically underreported,” the spending bill said.
The Department of Education Office for Civil Rights has received data on incidents of both. The bill instructs the Government Accountability Office (GAO) to analyze those numbers, identify schools that have developed better alternatives to seclusion and restraint, and set forth recommendations for better data collection.
“There continues to be no evidence that using restraint or seclusion is effective in reducing the occurrence of the problem behaviors that frequently precipitate the use of such techniques,” said Obama-era Education Secretary Arne Duncan, in a 2012 report issued by the department.
Overdose, Addiction and Recovery Services
The Comprehensive Addiction and Recovery Act (CARA) was signed into law by President Obama in 2016. It was the first piece of major federal legislation to address the growing opioid epidemic, and included grant programs to help states and local governments with things like drug treatment for pregnant and parenting women, training and use of naloxone to reverse overdoses, and medication-assisted treatment for recovery.
The spending bill awards $2 million to NAS for a review of CARA. It starts with a report in the next three months that lays out the “metrics for achievement of such outcomes shall be determined,” and then sets a five-year window to measure the program’s success, with a three-year window for an interim report.
In other words, Congress wants NAS to figure out how to gauge if CARA works, and then spend five years gauging it.
YSI could see the scope of this review expanding at some point to include the state opioid grants made under the 21st Century Cures Act, which began at $500 million per year and ballooned to $1.5 billion for 2018 under this spending deal. There is some concern already about the granting out of this money.