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Mike

Ryan & Policy experts detail rationale for “Connect2Impact” Clearinghouse & evidence-based child welfare programming

May 24, 2022 by Mike

By: AIF Staff

The American Idea Foundation, in consultation with Stand Together, the Sorenson Impact Center, and Notre Dame’s Lab for Economic Opportunities, worked together to create a user-designed clearinghouse that enables caseworkers to identify evidence-based programs and refer children and families to them. 

The clearinghouse, Connect2Impact, was born from a desire to help social service providers identify evidence-based programs more easily. It was designed to fill an information gap that exists in the poverty-fighting space between end-users and those recommending programs and researchers who have evaluated these strategies. In short, it is all too difficult for harried caseworkers or parents to identify programs that truly work, so the clearinghouse aims to centralize this information with an emphasis on evidence and data. 

The federal government has attempted to address this information gap before. It passed the Families First Prevention Services Act which required a new clearinghouse to show which poverty-fighting programs work and which do not. The federal government has also required other clearinghouses — for education, for welfare programs, for job-training programs – but they are rarely utilized by people on the ground. 

Connect2Impact serves to make information about evidence-based programs and strategies available to individuals and families. It started first with child and family welfare programs and plans to broaden the scope of searchable programs going forward.  

The decision to start with child and family welfare programs was made because of the profound effects the COVID-19 pandemic will undoubtedly have on our nation’s youth. A year of isolation, a prolonged disruption of regular routines, and a lengthy removal from in-person schooling is expected to negatively impact all children. Those children at-risk of entering into foster care are even more vulnerable. 

In April 2022, Speaker Ryan convened and moderated a conversation about the thinking behind the Connect2Impact clearinghouse and the importance of promoting evidence-based strategies that make tangible differences in the lives of children. Ryan was joined in conversation by: 

  • Sara Peters, Vice President of Impact and Evaluation, Stand Together Foundation
  • Brendan Perry, Project Design Manager, Wilson Sheehan Lab for Economic Opportunities
  • Lilly Myers, Impact Strategy at Sorenson Impact Center

Excerpts from the policy panel, which have been edited lightly for clarity, follow. Video of the panel discussion can be accessed HERE

Sara Peters on the rationale behind the user-designed Connect2Impact clearinghouse

“Two weeks into COVID-19, I was leading a portfolio practice group and I was talking to a number of non-profit executive directors who were facing the reality of reduced budgets and an increase in program sign-ups. They were dealing with a lot of the sign-ups that they weren’t predicting — people who are anticipating getting laid off or people who were worried and on the precipice of poverty. These people were increasing the needed dosage of programming and they wanted families to receive it but program directors didn’t think they were ideally prepared to serve all of those new clients.

 “I started to have some conversations about why isn’t there a clearinghouse that is client-focused and customer-focused, where you have some predictive algorithms where we can load some information from randomized control trials and external validations and some other programmatic characteristics? It would be a clearinghouse where users can self-select the characteristics that matter and over time, we can have a recommendation engine that program directors and program leaders and families can use when looking for services.” 

Brendan Perry on the Literature Review that informed Connect2Impact’s approach

“What we learned was that while there are a lot of studies out there and a lot of research has been done on child welfare programs, around 500 studies that we found, there are really far too few studies that are conducting rigorous research with large enough sample sizes where you’re able to get a really clear result. 

“And so, after we went through all of these, there are maybe only 20 or so studies that met our highest level of rigor and the highest level of a sample size. This really leads to a landscape where there is less causal evidence on the effectiveness of programs, which is less than ideal for such an important issue. Broadly, I would say we learned that there’s a need for more rigorous, large-scale studies on child welfare programs that not only improve our understanding of what works, but also for whom they have worked.” 

Lily Myers on working with Utah-based providers to make Connect2Impact relevant:

“After the initial pilot program, a beta-version of the website was created and seeded with programs that were evidence-based and local to Salt Lake County. We were able to sit down with supervisors and practitioners from the Utah Department of Child and Family Services to have them actually use the website, walk them through the features, and get their feedback on what was useful and what they wanted to see from it. 

“Overall, the response was incredibly positive. They were very excited about this kind of tool. A lot of times, the way that they find programs for their clients is word of mouth or something even as rudimentary as Googling to find what’s local to them. So, the opportunity to have a tool that combines what programs are actually local to their area that they can feasibly recommend for their clients and what the evidence is behind them, that was very valuable to those practitioners….”

“It was a big endeavor to just map out and characterize the programs offered to children and families within Salt Lake County. But from there, we’ve discussed opening it up to Utah as a whole and characterizing all of the state’s programs. I think it would be tremendously useful and impactful moving into other states and even starting just with larger cities.”

Ryan on the government’s lagging behind in developing data-driven child welfare strategies

“Until recently, policymakers have ignored the child welfare space. The recent passage of the Families First Prevention Services Act was the first major reform to this area going back to the early 1980s. This isn’t for a lack of problems that the system has been experiencing – far too many children were taken out of their homes too quickly, while other children were left languishing in really difficult situations. We just weren’t getting it right. 

“Thankfully, there are a number of hard-working individuals in this space who are working to provide permanent safe homes to children. And even more importantly, we are working to prevent the need for youth to enter the foster care system in the first place. The creation of a searchable and accessible website for caseworkers and for other people who refer children and families to the child welfare space seemed necessary and that’s why we created Connect2Impact.”  

Perry: Expanding usage of evidence-based programs requires more research and greater dissemination

“One part of it is getting research and one part is getting the study results into the hands of practitioners. I think the Connect2Impact tool is going to be really vital in bridging that gap. And as you said, I think it also revealed to us that there are some important research questions that aren’t adequately addressed in the existing literature. One of which might just be what the effects of these programs are on some of the long-term outcomes. 

“It’s great to know what the effect of program X is on reunification or days in foster care. But it would be even more helpful to know what the effect of program X is on high school completion, college completion, interactions with the criminal justice system, and earnings down the road, and to understand the long-term impact of these programs….”

“In terms of what researchers should be doing to make evidence more usable, obviously, academic papers are a big part of what researchers do and they’re important to validate results but we need to stop thinking about academic papers as an end-product in any way. If a paper that’s evaluating your program is published and then it just sits on the shelf of another academic, it’s really not doing what it’s supposed to be doing and that is to inform the end users, the case managers who are sitting there with clients and policymakers who are making decisions. 

“There is some onus on researchers and I know that we feel this a lot, but we have to take academic results and then package them and disseminate them in a way that can be used by the audiences that really need the information. I think this tool will go a long way in bridging that gap but there’s certainly a need for more work to be done on this and the creation of evidence and how evidence is disseminated to these different groups.”

Sara Peters on how evidence matters, but simple factors may matter more to end-users: 

“From my discussions with practitioners, [the value of evidence] varied a lot based on their ability or frequency of using evidence in the behind-the-scenes decision-making of the programs that they use. From the evidence standpoint… it’s not as cut and dry as is there evidence or isn’t there evidence. All of these trials and studies have some kind of limitations and how applicable they are on certain sample populations. 

“So, we realized the big thing that practitioners are looking at and do care about is the sample population and the groups that this research was done on and that ended up being a strong piece of information that workers on the ground want to see and want to be able to assess for themselves.”

Brendan Perry on how Notre Dame’s Lab for Economic Opportunities helps non-profits utilize data 

“It’s definitely a long and exciting process sometimes, but really, it’s all about finding those innovators who are on the ground, who are doing something that they believe is moving the needle on poverty. It’s about those groups that are having a positive impact and showing these organizations the basics and the importance of doing impact evaluations.

“And then from there, our goal is really walking hand-in-hand with them to see how we can overlay a research design that’s going to be minimally impactful to their everyday work because we know that doing research is just another thing on their plate sometimes. We want to take as much of the burden from them as possible so that we can design a rigorous study in the least invasive way. 

“Once we get it up and running, we work with them to understand the results and that brings us to how we disseminate results. One thing that we’ve begun to do as a way of sort of increasing dissemination is to build engagement plans with our partners about how to use results – whether those results are positive, negative or neutral – so that we can communicate to their internal teams what the results were, what they mean, and then communicate with other providers in the same space to put on different webinars, to have connections to funders, to help make connections to the media, connections to local policymakers, and be able to promote the result in a way that’s going to improve programming for their current clients and their future clients…. 

“Then finally, a big part of using evidence is replication so when we find those all-star, rock-star programs, it’s about making sure that we can package those programs and describe them in a way that makes them easy to scale and replicate in other places.”

This panel discussion on child welfare was part of a quarterly series of policy conversations hosted by the American Idea Foundation to draw attention to evidence-based policies aimed at expanding economic opportunities. Past policy conversations have focused on building a 21st century workforce, reforming the Earned Income Tax Credit, reducing recidivism and promoting 2nd chances, and properly implementing Opportunity Zones.  

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Filed Under: Blog, In The News, Uncategorized Tagged With: Community Organizations Making a Difference

In conversation with Janesville’s “Discovering Democracy” students, Ryan discusses evidence-based policymaking

May 23, 2022 by Mike

By: AIF Staff

Washington, DC – In March at the American Enterprise Institute, former Speaker of the House and American Idea Foundation President Paul Ryan spoke with a dozen high school students from Janesville, Wisconsin as part of the “Discovering Democracy” program.

Every year, AP government students from Ryan’s hometown of Janesville engage in an intensive, academic study of pressing public policy issues. During his time in Congress and after, Ryan has addressed these students and answered questions about their research topics.

In addition to answering questions about fixing our immigration system and reducing student loan debt, Ryan discussed his ongoing work in reforming poverty programs and expanding upward mobility through evidence-based policies and strategies.

Excerpts of Ryan’s conversation with this year’s Discovering Democracy students follow.

On the American Idea Foundation’s Efforts to promote Evidence-Based Solutions:

“My foundation, which is located in downtown Janesville right on Main Street, is focused on “poverty economics” and a big goal of the Foundation is promoting and expanding one of the last laws I wrote, the Foundations for Evidence-Based Policymaking Act.

“When I was head of the House Budget Committee, I had put this giant proposal together that was kind of like one of those comprehensive immigration bills. I put that proposal together to get the conversation going on fighting poverty. I knew I wasn’t going to be able to pass that massive bill so when I was Speaker of the House, we broke that bill up into a dozen pieces. We got Opportunity Zones through the Tax Cuts and Jobs Act. We passed Social Impact Bonds into law.

“And a big piece that we passed was the Evidence Act, which started with the creation of a bipartisan commission and a law that I passed with Patty Murray, a Democratic Senator from Washington State. The goal with the commission was to determine how we could integrate and release data from federal poverty programs in a privacy-compliant way so that government and researchers could get access to this data and determine what works and what doesn’t work.

“In the 50-year War on Poverty, we’ve spent over $15 trillion but we have never really measured whether we were actually really making a difference. We saw that basic, material poverty rates improved because the federal government just gave people money but in terms of upward mobility, in terms of people getting themselves out of poverty, we didn’t do that well.

“What we have learned is that the federal government measures success based on effort, inputs, and dollars spent. It doesn’t measure success based on outcomes and results. We learned that the government never has really had a tool to do this, let alone one to share with the private sector, so we created a Commission to get ideas on how to do precisely that. The Commission came back with their findings and those findings were largely what we put into the Evidence-Based Policymaking Act of 2018 and it was the last thing I passed in the beginning of 2019.

“The result is that the government now has to release all this data on government programs, namely poverty programs, so that researchers in academia, foundations, and within the rest of government can get the data on our poverty-fighting programs to track and measure the evidence of what works and what doesn’t work.

“My Foundation’s primary goal is to make sure this law is well-implemented and executed. It is also focused on advancing those evidence-based strategies that have been demonstrated to show real results. One way we’re doing that is through a user-designed, evidence-based clearinghouse that evaluates the research done on various child welfare strategies around the country. The goal of the clearinghouse is if you want to solve a particular problem, say homelessness, and you’re in Janesville, Wisconsin, you can use this clearinghouse to determine what has been tried in other cities and localities around the country.

“The clearinghouse would have all the evidence, all the literature, and all the program information to show what works and what doesn’t work, so you don’t have to reinvent the wheel. Our goal is to take models that are successful, scalable, and replicable and encourage people to expand them.”

On modernizing the safety net to better assist Americans in-need:

“I’m actually working on a proposal with some scholars here at AEI, which will be released in a book later this year, that is focused on fixing the social safety net so it works better and so it utilizes 21st century technologies.

“Our goal is to smooth out some of the problems in our existing system. The way Americans get benefits from the government is from a mixture of county government, state government, federal government agencies. None of these agencies can coordinate with one another, all of them have different kinds of benefit requirements and cut-off limits which makes it really hard for a person to navigate.

“What’s worse is that when you have a person who is going through life and they start rising and doing well, making money, and obtaining an education, the government has all these arbitrary benefit cliffs that can end up knocking you back further than you would otherwise be if you continued to receive the existing benefits. This is because these programs are sort of “one-size-fits-all” and they don’t comport with an individual’s situation or circumstances or even their family structure.

“We are saying that this approach isn’t working. There are a lot of good charities and organizations out there that have proven solutions – like using wrap-around benefits and a case-management “navigator” who works with a person for years to help them walk their way out of poverty. This approach utilizes the government and fills in some of the benefit gaps with private, charitable funds. Groups like Catholic Charities, Lutheran Social Services, the Salvation Army are doing amazing work so let’s break up the government being a single-source provider of benefits, which it doesn’t do very well, and let’s let these other groups get more involved and have resources more closely connected to outcomes….

 “What we’re doing here at AEI is we’re designing a concept of digitizing the social safety net so that you can have a personalized benefit structure for people in poverty. You can have a benefit structure, maybe even one with digital money, that is customized so each person has a different set of resources to meet their unique situation, whether it’s a single mom with three kids or a single guy who may have addiction problems, job problems, or transportation problems.

“Because the government treats everybody the same, it’s a cookie-cutter approach that doesn’t work well. If you digitized the social safety net, you could eliminate a whole bunch of bureaucracy and customize benefits based on a person’s issues. You could also algorithmically phase the benefits off as people rise out of poverty so that each step out of poverty makes financial sense for that person. It sounds far-fetched but I really think you can revolutionize the social safety net with digital technology and programmable money.” 

Filed Under: In The News, Press Release

Paul Ryan on the Future of Health Care & how Congress can make quality care more affordable

May 23, 2022 by Mike

By: AIF Staff

Janesville, WI: Last week, American Idea Foundation President Paul Ryan discussed the future of health care on Health 2049, a podcast hosted by Bisi Williams and Jason Helgerson. The podcast features thought leaders sharing their recommendations, perspectives, and views on what health care might look like in the year 2049.

 In a wide-ranging conversation, Ryan discussed his experiences trying to advance health care reforms during two decades in Congress. He also detailed his preferences for reforming the social safety net and for moving to a more patient-centered health care system that promotes universal access to quality, affordable care and focuses on innovation, competition, and choice.

Paul Ryan, Former Speaker of the House and Founder of the American Idea Foundation

To listen to Speaker Ryan’s entire interview on Health 2049, click here. Excerpts of Ryan’s responses, edited lightly for clarity, follows.

Breaking the policy gridlock by putting ‘ideological sabers aside’:

“We spend two times what anybody else spends per person on health care in the world, but we don’t have a system twice as good as anybody else. It’s nothing close, so I think we can get to that. I think we spend enough money. I think it’s the way we spend our money that needs to be changed and I think we need to have a system that accommodates and encourages competition and choice.

“This also means we have to put the ideological sabers aside. From my side, let’s accept universality. Let’s accept that the government is going to be involved. On the left, let’s accept the private sector is going to be involved as well. This cannot be a government granted right where the government decides, controls and rationalizes healthcare.

“I think both sides of ideological extremes need to be pushed to the side. And I think there’s a center, I’d like to say center-right, but a center-based system that can be had.”

Developing an initial interest in health care policy:  

“I was primarily a fiscal policy guy concerned about debt, deficits, and the dollar as the world’s reserve currency. When you dig into those issues, it basically takes you to the entitlement programs and when you dig into that, it takes you to health care. So, I walked into the health care issue a little later, about two terms into my tenure in Congress because it became very clear to me that this was the biggest fiscal challenge of our country. And I was representing Southern Wisconsin where this was a big concern, a big issue for my constituents, so it became really clear to me that I needed to learn more about health care.

“I spent a number of years just trying to learn about health care from providers, from consumers, from economists, and then I spent a lot of time with the Committees, with the Joint Committee on Taxation, with the Congressional Budget Office, the think tanks, and in the Budget Committee. I was Chairman of Budget and Chairman of Ways and Means, which are the primary health care committees, so I spent a great deal of my time on this issue….

“I produced a number of different bills: Some passed, many didn’t. I had, with Senator Tom Coburn, the conservative alternative to the Affordable Care Act in 2010 and then I built budgets around health care proposals. I’m currently working on something right now with Jim Capretta at the American Enterprise Institute, to be released later in 2022, so I still spend time on the issue.”

What health care might look like in 2049:

“I hope that we have a fully-funded system that does not have trillions of unfunded liabilities and that is not saddling the next generation with insurmountable debt. I hope this system is characterized as one where everyone has healthcare coverage and you have a system where the health inflation rate is nothing like what it is now and it’s closer to the actual nominal inflation rate, which, frankly, is kind of high right now.

“it’s a system known for and driven by innovation, choice and competition, where markets work. It’s a system where markets are designed in such a way to protect those with pre-existing conditions, and that the preferences and fiscal policy are aimed towards helping the sick and the poor, but that everyone has access to a system where they are guaranteed coverage. It is also a system where those with tough health conditions don’t go bankrupt if they get sick. I believe that this is absolutely achievable.”

Two paths for the future of American health care:  

“I think we currently have a system right now that is a fiscal train wreck and we are piling on top of the system unfunded liabilities, which will make for a very, very difficult moment fiscally, right around 2049 actually.

“I look at 2049 and I see either a fiscal train wreck where we lose the dollar’s status as a reserve currency and we have to do immediate budget surgery to the budget where we have to cut benefits back in real time for real beneficiaries, and people who are dependent on these programs and who organize their lives around these promises that have been made by government.

“Or, and this is the glass half-full side of things, things that I think and hope will happen, which is we have a system that doesn’t have a fiscal train wreck, that doesn’t bankrupt the country or our entitlement programs, that is market-based, and that takes taxpayer dollars and puts them where they ought to be, which is toward the sick and the poor.

“As I mentioned, I hope we have a system where you have legitimate health insurance competition and innovation. A system where the American system of innovation is alive and well and we come up with new drugs and new therapies to make our lives healthier, happier, longer. I believe that that’s eminently achievable.

Advancing Patient-Centered reforms to improve health care:

“I have a few white whales in my career that I wanted to slay, that I could never get, one of which is the tax preference for health insurance. The tax exclusion is upside down. We give the biggest tax benefit to the highest income earner and the lowest tax benefit to the lowest income earner. By excluding health care benefits from your job from taxation, the higher the tax rate you have, the bigger the subsidy you get. That is completely wrong. It is the biggest tax expenditure in the tax code. I tried to cap it when I was Speaker and I couldn’t even get the votes for that among Republicans. And the Democrats tried it with the Cadillac Tax, which is very controversial on their side as well and keeps getting pushed around, but so I think Obama was going at it the wrong way with the right idea with the Cadillac Tax. 

“What I wanted to do is repeal that tax exclusion. I wanted to convert it to a fixed, refundable tax credit so that more of the money goes to low-income individuals and families, less to upper-income individuals. We should throw a deduction on top for those people and allow people to take that refundable tax credit to buy health insurance….

“And when you roll into retirement, I’m a big believer in a premium-support model for Medicare. They should be set on a bid-based pricing system so that market bids are what set the rates. Even the Congressional Budget Office, under Doug Elmendorf, built a model that showed it’s the smartest way to reform Medicare. I think this would put Medicare on a much better footing. It reduces the unfunded liability and if we go to a premium-support model with Medicare — with more for the poor, more for the sick, less for the healthy and the wealthy within the Medicare system, where you have a number of plans to choose from, to a premium support model, much like the federal employee health benefit plan, I think you can mitigate or avoid a debt crisis.

“The fee-for-service system, which is more than half debt-financed, is tumbling toward a debt crisis in about the year 2049 and, frankly, if you would convert our system to a premium support system, with the kind of system for the under 65 population that brings in choice and innovation, it would hopefully have a mitigating effect on inflation. Then, I think you’ll have a system for under 65 and for over 65 that works quite well.”

Preserving the Social Contract in a bipartisan way:

“It’s going to be ugly for a while, politically speaking, but I think the math is going to get us. I think the realization that these programs are running into fiscal reality, which jeopardizes their own viability, will spur action.

“The social contract is an important concept. It’s very important…. I see the social contract as extremely important — a viable safety net for the poor, health and retirement security for those who are in old age, and then all the other things we talked about in between.

“For that to be sustained in this century and on, it will have to change. These were designed in the 20th century with 20th century economics, and 20th century debt demographics, all of that is changing for the reasons we just discussed and I think Congress will get there because they will have no choice but to get there. And the bond markets will make them do it.

“I think the only real viable way in the mid-term, not this year, this session, or even probably the next session of Congress, is a commission. I hate it. Like I said, I was on Bowles-Simpson, I served on some of these commissions, but I’m not a big fan of them because I think it’s Congress ducking its responsibility, but Congress is just too broken to take all of this on on their own.

“My buddy, Senator Mitt Romney has a bill with a commission where I think he has an equal number of Democrats and an equal number of Republicans to take on these entitlements and to have a forced up or down vote, like the base closing commission…. I believe the rightly-formed commission in the right Congress with the right President can put before Congress a solution to this problem that can buy us decades and really chip away at this problem and pass Congress in the medium term. I think that’s probably the best and easiest most viable path forward to solve this problem.”

Filed Under: In The News, Press Release

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