The Districts Dime

Using Data and Evaluation to Improve DC’s Education Programs and Services

March 6th, 2015 | by Soumya Bhat

Today, DCFPI is testifying before the Council Committee on Education about the performance of the Office of the State Superintendent of Education (OSSE). Highlights of our recommendations are below, and you can read our full testimony here.

Explore the adequacy of services to students who are homeless: Given DC’s family homelessness crisis, providing educational continuity to homeless students is critical to ensuring that all students can succeed in school. Are children who are homeless being identified? Is the city doing enough to help homeless students get to their school of origin if they want to? The city should assess the capacity of homeless liaisons at schools, ensure the state level coordinator at OSSE is able to effectively support liaisons, and that transportation and other direct supports to students are adequate. 

Continue to engage the public and release data on issues facing the District’s education system: Last year, DCFPI testified on the value of the Statewide Longitudinal Education Data System (SLED) to inform education policy decisions, urging OSSE to develop a more systemic, streamlined way to engage with the public and respond to data requests. Since then, OSSE’s Division of Data, Assessment, and Research staff held meetings with community organizations to share their research agenda and also better understand the data and research priorities of the larger community. We hope this work continues in the next year.

Evaluate the Community Schools pilot program to highlight the program’s impacts: Community Schools use public schools as central hubs for students and the larger community to access integrated services and supports. There are currently six grantees operating Community School partnerships in the District. Ultimately, the District should expand the program, but right now, we should prioritize data collection and evaluation of the model. The city should collect information on key indicators such as school readiness, student attendance, adult education, and families’ access to key services to assess the impact of Community Schools. This will be particularly important to attract additional funding from non-public sources, but also to show District leaders the impacts on student learning, health, family engagement, and other outcomes over time.

Maintain the focus on child care quality, particularly for infants and toddlers: DCFPI would like to hear about progress made with OSSE’s new quality improvement “hubs” in high-need DC neighborhoods, an initiative funded in the FY 2015 budget that has our support. During oversight, we would like to learn more about how this work is leading to increased access to quality child care in the District.

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On March 19th, Come to DCFPI to Learn What’s in Store for the Fiscal Year 2016 Budget!

March 4th, 2015 | by Ed Lazere

With just a few weeks before Mayor Bowser releases her first budget on April 2, join DCFPI for a forum on March 19 on what you can expect in the fiscal year 2016 budget!

Mayor Bowser has made important commitments to invest in affordable housing and address homelessness. Yet the city faces a large shortfall – there isn’t enough money to maintain current support for schools, health care, and DC’s other important services.

What will the mayor do to ensure that residents and businesses continue to get the services they rely on in the face of these challenges? DCFPI has invited key DC government finance leaders to help understand the city’s financial situation and how that affects the upcoming budget.

Matt Brown, Director, Mayor’s Office of Budget and Finance

Jennifer Budoff, Budget Director, District of Columbia Council

Fitzroy Lee, Chief Economist, Office of the Chief Financial Officer

The forum will be held Thursday, March 19 at 9:30 a.m. at DCFPI, located at 820 First Street NE (near Union Station Metro). Coffee and pastries will be available starting at 9:00 a.m.

Please R.S.V.P to Francine Richards at frichards@cbpp.org.

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Better Oversight Needed to Improve Access to Health Services For 175,000 DC Medicaid Participants

February 27th, 2015 | by Wes Rivers

The District should do more to connect residents on Medicaid with basic health services, which would improve their health and reduce District costs by avoiding costly emergency services. That conclusion is based on a recent report on three managed care organizations (MCOs) that have served 175,000 DC Medicaid participants for a year, but have not improved access to health services or coordination of patient care. Better oversight of this program, including more information on the care they provide, could help to improve access, contain health care costs and improve overall health for DC residents.

2-27-15 MCOMost DC Medicaid recipients are assigned to one of three MCOs. The District pays each MCO a fee for each enrollee and in return the company reimburses doctors and hospitals for health care services used. An annual review of the MCO program, from the DC Department of Health Care Finance, suggests that the three managed care organizations have struggled to manage patient’s care and as a result, failed to keep costs down.

  • Only two-thirds of participants regularly visit with a primary care doctor. Seeing a primary care doctor regularly is important to managing health needs, which reduces the use of more costly and intensive services.
  • Over three-fifths of emergency room visits by DC Medicaid recipients are for basic care, and a large portion could have been avoided.
  • One in twelve hospital visits result in a readmission, some of which could be avoided through better service delivery and follow-up care.
  • No MCO provides case management – services for people with higher health needs and chronic health conditions like asthma – to more than 5 percent of members. Case management helps patients get appropriate referrals and follow-up care after seeing a doctor. Given the range of conditions that MCO’s must offer case management services for – including HIV, asthma, mental illness, substance abuse, diabetes, and cardiovascular disease – MCOs should be doing more to identify patients and connect them with services.

Over-reliance on the emergency room and high rates of hospital readmissions cost the MCOs more than $34 million in this first year – which means the MCOs will charge the District more next year.

DCFPI’s transition document for health care details how DC can establish stronger oversight of the Medicaid managed care program. One of the major steps is to collect more data and establish performance benchmarks. Setting standards for things like avoidable emergency room visits can help the city create a payment structure and financial incentives that will lead to better outcomes. The District has already begun this process by collecting the data for the quarterly report, but now that a year has passed, it is time to refine the data and create benchmarks. DCHCF should also allow the public to comment and contribute to the formulation of further data collection and performance standards.

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DC Health Link’s Success Results from Strong Partnerships with the Community

February 25th, 2015 | by Wes Rivers

DC’s online health insurance exchange, www.dchealthlink.com, has helped over 80,000 residents get access to affordable private health insurance and Medicaid. The District’s success in enrollment is due to the efforts of the exchange’s leadership and staff to form meaningful partnerships with community organizations, small businesses, and the health industry.

Community feedback has informed a lot of DC Health Link’s decision making over the last year – building broad support for the exchange’s consumer-friendly rules and regulations, for the way its operations are funded, and for its efforts to educate and assist consumers. The DC Fiscal Policy Institute testified to some of these successes today before the Committee on Health and Human Services. Here’s what we said:

DC Health Link has involved consumers, doctors, and health insurance companies in making policy decisions. The exchange has used working groups to get recommendations from stakeholders regarding key policy issues. This year, DC Health Link sought input to develop the set of requirements that a health plan must meet in order to be certified and sold on the exchange. As a result, health plans will be required to provide standardized data on the number and type of doctors in their network. They also will have to submit information and justification for changes in plan prices. We hope DC Health Link continues to involve the community in policy decisions – especially when developing rules for what it means for a health plan to have an adequate set providers in its network.

DC Health Link has involved stakeholders in their budgeting and financing discussions. This year, DC Health Link held two public forums on its fiscal year 2016 budget request and took community suggestions on funding for its different operations. The exchange also implemented a consumer-friendly way to pay for its operations, on a one-year-basis, using a strategy recommended by one of its stakeholder working groups. While this community engagement was helpful, other agencies that fund activities interconnected with DC Health Link, such as consumer assistance for Medicaid applicants supported by the Department of Health Care Finance, should also be included in budget discussions for the exchange. A report on the funding and activities of all agencies connected to the exchange would help advocates and policy makers understand and assess how well the city is implementing health reform.

DC Health Link relies on partner organizations that help with consumer assistance and outreach. DC Health Link staff have used community feedback to improve the consumer experience. DC has had some technology issues, as the federal government and all state exchanges have, but quick responses by staff and a strong network of people hired to assist consumers have mitigated many enrollment issues. DC Health Link is also using the experiences of brokers, small businesses, and trade associations to inform quality improvement. 

To read a copy of the full testimony, click here.

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Education and Enforcement Are Key to Making Sure Workers Benefit from Minimum Wage and Other Changes

February 24th, 2015 | by Ed Lazere

2.24.15 DOES perfThe District’s leaders have adopted a number of new benefits and protections for people who work in the city, and now it is important to make sure they are fully implemented and enforced.

The city’s minimum wage will rise to $11.50 an hour in 2016, and all workers in the city earn paid sick leave starting with their first day on the job. Legislation adopted in 2014 prohibits employers from asking about an applicant’s criminal record until a job offer has been made. Pregnant workers have the right to reasonable accommodations and are guarded against discrimination. Unemployed residents are now protected against job discrimination.

These new benefits and protections are only meaningful, however, if both employers and workers are aware of them, and if the District makes sure they are enforced. The city should take vigorous steps to inform workers and businesses of these new rights and benefits, and it will need adequate staff to enforce them, including responding to instances when employers fail to comply. The DC Fiscal Policy Institute and others recommend additional resources be provided in the following ways:

  • Public Education: As little as $300,000 would support meaningful dissemination of information on the minimum wage, earned sick and safe leave, and wage theft changes.
  • Ensuring All Workers Get the Minimum Wage and Paid Sick Days: The office that receives and investigates claims from workers when employers do not follow these laws – the Office of Wage Hour within the Department of Employment Services – needs additional staff.  In addition, the city uses administrative law judges to adjudicate claims that are found to be credible, and the city could use more.
  • Protecting Workers against Job Discrimination: The Department of Employment Services and the DC Office of Human Rights would be better able to address discrimination against pregnant workers and jobseekers who are unemployed if they had additional staff.

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