Why We Remember ⁹⁄₁₁

By Rhiannon Meyers Collette, Communications Manager

The Biden Administration late Thursday unveiled its long-awaited blueprint for lowering the price of prescription drugs, and the 29-page document lays out an expansive strategy for increasing competition and continuing to promote innovation while lessening the financial strain on patients, families, and taxpayers.

What's Happening: Congress has been debating the contours of drug pricing reform, including proposals that would allow Medicare to negotiate the price of drugs and the implementation of an inflation rebate requiring drugmakers to pay back the difference when they hike prices beyond inflation. In the plan released Thursday, the administration threw its support behind these ideas — adding its endorsement at a pivotal moment in the debate. It also endorsed several administrative actions that the U.S. Department of Health and Human Services could deploy to lower drug prices, including testing models to better align payment with the clinical value the drug provides to patients.

 

Why it Matters: We’ve said it before and we’ll say it again — prescription drugs don’t work if you can’t afford them. And right now, an estimated one in every three Americans reports not taking their drugs because of cost. Despite pharma’s fear-mongering about drug pricing reform, the reality is that we can lower drug prices and increase competition while maintaining financial incentives to drive true innovation. We look forward to seeing administrative momentum on the actions outlined in the plan and will continue to support legislative policies that would deliver meaningful action to reduce the price of prescription drugs.

By Evan Mintz, Communications Manager

Defense attorneys typically work for their clients from the beginning of the case until its disposition — but not in the Harris County Public Defender’s Office. Deep in the heart of Texas, a newly created holistic services division helps clients with needs beyond immediate legal representation, such as employment, drug treatment, and mental health services. “We’re a big office that does many different things. And that’s a bit unusual, at least in the scope of public defender offices in the country,” Alex Bunin, the chief public defender, said in an interview with the National Partnership for Pretrial Justice. 

Why It Matters: Just because someone’s case is resolved doesn’t mean the root problem that landed them in court has been solved. “If you don’t have a place to live, that’s why you’re going to get caught for trespassing,” Bunin said.

Holistic representation helps to address these underlying issues that can keep people cycling through the criminal justice system. The idea originated from the Bronx Defenders, a nonprofit public defender organization created in the 1990s. Research by the RAND Corporation has found that holistic defense results in better outcomes, including reduced rates of incarceration and saving taxpayer dollars without risking community safety. 

Other Innovations: The Harris County Public Defender’s Office also practices “participatory defense,” which works to include the families and communities of people involved in the justice system in the defense work. “A lot of times we will encourage families of clients and clients who are out to get together so they can exchange information with each other. And when they see things that are wrong in the system, they are able to organize and make their voices heard.” Bunin said.  

Read the Q&A >

By Rhiannon Meyers Collette, Communications Manager
 

The Biden Administration's proposal to infuse $400 billion to expand Medicaid home and community-based services has been widely cheered among those who see this as an unprecedented opportunity to better care for people who are elderly and/or disabled. These services — which include help with bathing, dressing, meal prep and medication management — are intended to allow people to continue living in their homes and communities (rather than in an institution). 
 

What’s Happening: As policymakers consider plans for strengthening home and community-based services, it's critically important that they consider the impact on people who are dually eligible for Medicare and Medicaid. In a new blog, AV's Arielle Mir and Amy Abdnor teamed up with Allison Rizer of ATI Advisory to make the case that an investment into HCBS presents an opportunity to build meaningful strategies to integrate Medicare and Medicaid to deliver better care and outcomes for a vulnerable group of people.
 

Why it Matters: Integrated care has demonstrated an ability to improve outcomes and lower costs — expanding Medicaid HCBS without taking Medicare into consideration could exacerbate the fragmentation of care that already plagues dual-eligible beneficiaries. "The ultimate success of this investment to prevent institutionalization, to meet beneficiary needs, and to enhance wellness will be determined by integration with medical care and more specifically, Medicare," Mir, Abdnor and Rizer write. "Expanding HCBS won’t work if it’s done in a vacuum."

Read the story >

Related: We want to better understand the experiences and perspectives of people who are dually eligible for Medicare and Medicaid, which is why we have issued a request for information to gather feedback on what matters most on integrated care models. We are accepting responses until Thursday, Sept. 16.

Related: Read this very personal essay in support of President Biden’s proposed $400 billion for home- and community-based care: “Home care is literally keeping me alive. But across the country, almost a million children, adults and seniors with disabilities sit on waiting lists for Medicaid’s home- and community-based care, in danger of being removed from their homes and sent to live in institutions.”

By Amanda Moderson-Kox, Director of Evidence-Based Policy
 

An 11-year follow-up report on Project QUEST shows it is the only workforce training program with compelling evidence of sizable earnings impacts sustained more than 10 years after program entry. Project QUEST provides comprehensive support and resources to help low-income adults enroll full-time in occupational training programs at local community colleges, complete the training, pass certification exams, and enter well-paying careers in strong sectors of the local economy in San Antonio.
 

What’s New: This update on the well-conducted randomized controlled trial of the project shows that QUEST continued to increase annual earnings by 15-20% (an average of $5,000 per year) in each of the ninth, 10th, and 11th years after program entry. Importantly, sample members were largely female (88%), Latinx (74%), and, on average, were 30 years of age and earned roughly $13,000 in the year prior to program entry.
 

Why it Matters: The study’s results clearly demonstrate that Project QUEST has made a meaningful and lasting difference in participants’ lives. Additionally, the program produced average earnings gains over the 11-year follow-up period that far exceeded the estimated per-participant cost of approximately $12,500, suggesting the program’s benefits outweigh its costs.*
 

Bottom Line: While we know we keep saying this, we can’t say it enough: This is why the proposed $9 billion Retention and Completion Fund, part of the Build Back Better Act, is game-changing. It is this kind of program — with credible evidence of life-changing results — that will benefit from expanded federal funding.

Read the report >

 

*While these findings are very impressive, we believe they need to be replicated in a second RCT in order to both confirm these results and establish that the program would produce similar effects if implemented in another setting.

Related: We applaud the $9 billion Retention and Completion Fund: Read our statement

Related: We are profiling students whose lives have been transformed by evidence-based college completion programs. Read Part 1 here and Part 2 here.

Criminal Justice

• The Brookings Institution examines how 9/11 helped to militarize police forces across the country, a shift seen during racial justice protests following the murder of George Floyd. “9/11 has transformed not just what is viewed as a threat but also who is perceived as one. Even when a person is an American citizen or has a visa, ‘looking foreign,’ particularly Middle Eastern, can have dire consequences as heavy-handed policing tactics often fall on the most marginalized, vulnerable, and exposed.”
  
  Related: Here & Now’s Robin Young talks to author and columnist Radley Balko about the militarization of policing can sow distrust between police and the community. 
   
• “We don’t need to reinvent the wheel” to reduce homicides in Philadelphia, writes Felicia Parker-Cox in The Philadelphia Inquirer. She lays out a framework for action adapted from a report for AV by John Jay College of Criminal Justice’s Research and Evaluation Center.
   

• An overwhelming and bipartisan majority of Americans support using American Rescue Plan funds to support community violence intervention programs to reduce gun violence, Safer Cities reports.
   

• Texas Monthly asks: Who killed criminal justice reform in Texas? The state that once led the way on reducing mass incarceration is letting politics get in the way of reform.
   
• The American Conservative Union joins the bipartisan chorus of voices calling for Congress and the Biden administration to act on the ​​”unnecessary re-incarceration of thousands of people” on home confinement under the CARES Act. “These people have done all we ask to demonstrate rehabilitation. Returning them to a cell will do little to improve public safety. But it will wreak havoc, not just on the offenders themselves, but their families and employers.”
  
  Related: Here’s a story of someone who is rebuilding his life as the threat of returning to prison looms. 
   
• A nonprofit aims to disrupt the prison phone industry with a free video service, Bloomberg reports.
   
• An Associated Press investigation reveals a pattern of violence and secrecy among the Louisiana State Police force.
   
• California is rolling out a 988 hotline for mental health crisis calls as an alternative to 911, Recordnet.com reports.
   
• The Prison Policy Initiative’s 2021 “States of Incarceration” report compares incarceration rates in U.S. states to 169 countries around the world.
   
• Fifty years later, The Marshall Project is revisiting the events of the historic Attica uprising, minute-by-minute, at the Twitter handle @atticasghosts.

Health

• In its bid to stop legislation that would make drugs more affordable, Big Pharma argues that lower drug prices for Americans are “too good to be true,” invoking its role in vaccine development and recycling the lie that government intervention would stifle innovation.
   
• Dr. Anita Gupta writes in Forbes on actions we can take now to mitigate the opioid crisis during the pandemic, including expanding equitable access to evidence-based treatment.

Also...

• This case for reforming charitable giving laws begins with the story of a very uncharitable dinner guest, via Chronicle of Philanthropy.
   
• We are celebrating along with army veteran Tasha Berkhalter, whose borrower defense application was approved by the Department of Education. Read more about Berkhalter’s fight to be made whole after being scammed by a predatory for-profit college.
   
• The conspiracy film that energized the “9/11 truther” movement also helped to lay the groundwork for our current age of disinformation, The New York Times writes.

“Twenty Years Later: The Women of 9/11,” a gripping retelling of the attack on America through the eyes of a diverse group of women who share their stories for the first time in 20 years. ABC’s Robin Roberts sits down with a New York City journalist who was on the ground, a firefighter and police officer on the front lines, a retired U.S. Army colonel who was working at the Pentagon, a bystander critically injured by debris, and a forensic anthropologist who helped families identify their loved ones. She also interviews Genelle Guzman, who worked at the North Tower and was the last person pulled alive from the rubble. Their recollections are both painful and inspiring, and it is difficult to watch the scenes of destruction and despair all over again. But by the end, hope emerges in their stories of strength and resilience. “I think that doing the anniversary every year, it brings a lot of comfort and peace to the families,” Guzman says. “It’s something that will never go away. And it shouldn’t.” It’s now streaming on Hulu.

• Actor Michael K. Williams, who died this week, was best known for his role on “The Wire.” But offscreen he was an advocate for criminal justice reform, serving as an ACLU ambassador for ending mass incarceration and working with The Marshall Project to narrate a documentary on prison conditions and upend the narrative around the system. Now, a bill to reduce incarceration rates in New York will be named for him.
   
• I was a little too old for “Blue’s Clues,” but I watched it with my young cousin. Beloved host Steve Burns had a touching message this week for his millennial viewers about why he left the show abruptly, striking a poignant chord with many of his now grown-up fans.
   
• Nine-year-old Adhara Pérez Sánchez has an IQ higher than ​​Stephen Hawking and Albert Einstein, is pursuing two engineering degrees, and hopes to go to Mars someday. She is also using her platform to inspire other children on the autism spectrum to follow their dreams.
   
• Breonna Taylor’s portrait is now in the Smithsonian as part of the National Museum of African American History and Culture’s new exhibition, “Reckoning: Protest. Defiance. Resilience,” opening today.
   
• It’s finally here: Grammy-winner Kacey Musgraves dropped her new album, "star-crossed" today. It's all about heartbreak, and it’s all I could have hoped for. Check out the accompanying film on Paramount+.

Our Complex Care team has issued a request for information (RFI) to better understand the experiences of people who are dually eligible for Medicaid and Medicare. They are gathering information from consumer advocates, thought leaders, and technical assistance providers to help inform future policy positions around care integration for the dual-eligible population. Learn more here.

The Complex Care team is also funding research into how to improve the systems that deliver care to a population of more than 12 million people who are dually eligible for Medicare and Medicaid. Learn more here.

The Criminal Justice and Evidence-Based Policy teams at Arnold Ventures are teaming up to learn more about what works in criminal justice reform in an ongoing request for proposals for randomized controlled trials (RCTs) that will test programs and practices. There is no deadline for submissions.

The Evidence-Based Policy team invites grant applications to conduct randomized controlled trials (RCTs) of social programs in any area of U.S. policy. Details are here.

View all of our RFPs here.