Expediting Permanency: Legal Representation for Foster Children in Palm Beach County

This report describes the evaluation of the Foster Children's Project (FCP) of the Legal Aid Society of Palm Beach County, Florida, which provides legal representation to children who have been placed in substitute care as a result of child abuse or neglect. The primary purpose of this study was to examine the impact of FCP on the nature and timing of children's permanency outcomes and juvenile court milestones. The study also identifies and describes the program elements or practices that serve to define FCP, and explores the broader impact that FCP has had on the child protective service system in Palm Beach County. Data were drawn from several sources, including juvenile court case files, child welfare administrative records, and interviews with legal and social service professionals. Children represented by FCP were found to have a significantly higher rate of exit to permanency than children not served by FCP. In the main, this difference appears to be a function of much higher rates of adoption and long-term custody among FCP children. Interestingly, the higher rates of adoption and long-term custody experienced by FCP children were not found to be offset by significantly lower rates of reunification. Together, study findings suggest that FCP's efforts to individualize children's court-approved case plans served to clarify the basis of, and thus expedite, court decisions concerning parent and agency compliance with parent's case plan requirements. The study also discusses implications for other jurisdictions seeking to expedite permanency though juvenile court reforms, including the provision of representation to children

Scaling Up: Bringing the Transitional Care Model Into the Mainstream

Describes features of an innovative care management intervention to facilitate elderly, chronically ill patients' transitions among providers and settings; the adopting organization; and the external environment that affect its translation into practice

Regional data exchange to improve care for veterans after non-VA hospitalization: a randomized controlled trial

BACKGROUND: Coordination of care, especially after a patient experiences an acute care event, is a challenge for many health systems. Event notification is a form of health information exchange (HIE) which has the potential to support care coordination by alerting primary care providers when a patient experiences an acute care event. While promising, there exists little evidence on the impact of event notification in support of reengagement into primary care. The objectives of this study are to 1) examine the effectiveness of event notification on health outcomes for older adults who experience acute care events, and 2) compare approaches to how providers respond to event notifications. METHODS: In a cluster randomized trial conducted across two medical centers within the U.S. Veterans Health Administration (VHA) system, we plan to enroll older patients (≥ 65 years of age) who utilize both VHA and non-VHA providers. Patients will be enrolled into one of three arms: 1) usual care; 2) event notifications only; or 3) event notifications plus a care transitions intervention. In the event notification arms, following a non-VHA acute care encounter, an HIE-based intervention will send an event notification to VHA providers. Patients in the event notification plus care transitions arm will also receive 30 days of care transition support from a social worker. The primary outcome measure is 90-day readmission rate. Secondary outcomes will be high risk medication discrepancies as well as care transitions processes within the VHA health system. Qualitative assessments of the intervention will inform VHA system-wide implementation. DISCUSSION: While HIE has been evaluated in other contexts, little evidence exists on HIE-enabled event notification interventions. Furthermore, this trial offers the opportunity to examine the use of event notifications that trigger a care transitions intervention to further support coordination of care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02689076. "Regional Data Exchange to Improve Care for Veterans After Non-VA Hospitalization." Registered 23 February 2016

Territorial cooperation in Europe: challenges and opportunities for the EU energy governance

ooperation between European territorial authorities is a developing phenomenon which has reached a certain degree of harmonization through the instruments provided by the Council of Europe and the European Union. The Third Additional Protocol to the European Outline Convention concerning Euroregional Cooperation Groupings (ECGs), together with Regulation (EU) n. 1302/2013 amending Regulation (EC) n. 1082/2006 on European Groupings of Territorial Cooperation (EGTCs), provided new means to improve and institutionalize the governance of key sectors, such as the environment and energy, which require a combination of different and contrasting concerns as well as the involvement of all levels of government. The paper will explore the trends that characterize territorial cooperation in Europe, with particular regard to the means provided by the EU, and will point out their potential contribution in dealing with the main issues affecting current EU energy policy, especially as regards the European Commission’s attempt to shape a resilient European Energy Unio

The New Basel Capital Accord: Structure, Possible Changes and Micro- and Macroeconomic Effects. CEPS Reports in Finance and Banking No. 30, 1 September 2002

During the last 12 years, the 1988 Basel Capital Accord dealing with minimum capital requirements for internationally active financial institutions has grown more pervasive, being integrated into national regulations in most advanced countries. Meanwhile, the limitations and drawbacks of the simple rules on which it is based have become increasingly apparent. In other words, the existence of a gap between supervisory requirements and risk-based measures of economic capital has led to forms of regulatory arbitrage (whereby loopholes in the regulation have been exploited to increase the real leverage of a bank without reducing its capital ratios). Paradoxically, the inability of the 1988 protocol to discriminate between investment grade and junk borrowers might also have made some financial institutions more risk-seeking, instead of helping them control their risks. To address such challenges, the Basel Committee on Banking Supervision has been engaged for several years in a revision process that will finally lead to a New Basel Capital Accord (NBCA). Remarkably, the new Accord is not being engineered inside a secluded laboratory by a handful of regulators and financial rocket-scientists, but its contents have been thoroughly discussed by national supervisors, banks and academics. Thus, the NBCA drafting has become a meeting point for many different perspectives: legal experts, accountants, bank managers, central bankers and finance scholars (to name only a few) have been working together, merging their professional backgrounds to make the NBCA more robust in its structure and parameters. This report tries to provide a complete, up-to-date, critical picture of the new Basel approach to bank capital, by summarising its structure and possible changes, and by focusing on some limitations and pitfalls that might deserve further investigation

Effectiveness and cost-effectiveness of a nurse-delivered intervention to improve adherence to treatment for HIV : a pragmatic, multicentre, open-label, randomised clinical trial

This trial was funded from public money by the Netherlands Organisation for Health Research and Development (ZonMW; grant number 171002208). Aardex provided support on the development of the study website. We thank all the HIV nurses and physicians from the seven HIV clinics involved in the AIMS study for their input and collaboration (Academic Medical Centre, Slotervaart hospital, and St. Lucas-Andreas hospital, all in Amsterdam; the Leiden University Medical Centre, Leiden; HAGA hospital, The Hague; Erasmus Medical Centre, Rotterdam; and Isala clinic, Zwolle), the study participants, and the Stichting HIV Monitoring (SHM) for their support in accessing the SHM database for identifying patient inclusion criteria and developing the Markov model. Finally, we thank and remember Herman Schaalma (deceased) for his contribution to the study design and grant application.Peer reviewedPostprin

Data and Predictive Analytics Use for Logistics and Supply Chain Management

Purpose The purpose of this paper is to explore the social process of Big Data and predictive analytics (BDPA) use for logistics and supply chain management (LSCM), focusing on interactions among technology, human behavior and organizational context that occur at the technology’s post-adoption phases in retail supply chain (RSC) organizations. Design/methodology/approach The authors follow a grounded theory approach for theory building based on interviews with senior managers of 15 organizations positioned across multiple echelons in the RSC. Findings Findings reveal how user involvement shapes BDPA to fit organizational structures and how changes made to the technology retroactively affect its design and institutional properties. Findings also reveal previously unreported aspects of BDPA use for LSCM. These include the presence of temporal and spatial discontinuities in the technology use across RSC organizations. Practical implications This study unveils that it is impossible to design a BDPA technology ready for immediate use. The emergent process framework shows that institutional and social factors require BDPA use specific to the organization, as the technology comes to reflect the properties of the organization and the wider social environment for which its designers originally intended. BDPA is, thus, not easily transferrable among collaborating RSC organizations and requires managerial attention to the institutional context within which its usage takes place. Originality/value The literature describes why organizations will use BDPA but fails to provide adequate insight into how BDPA use occurs. The authors address the “how” and bring a social perspective into a technology-centric area