Coronavirus Aid Research Articles

Entrepreneurial Performance: Determinants of Performance in Stimulus-Oriented Granting

Local governments consistently face challenges of economic depression and the unexpected events that precipitate them, such as COVID-19. The depressions leave governments taxed for resources, infrastructure, and time. These depressions are often helped by large infusions of federal grant dollars, otherwise known as stimulus-oriented granting. Key variables in determining success in spending these stimulus dollars include government structure and different forms of capacity. These are traditionally tested characteristics that governments already possess. What we know less about is how governments take advantage of these spending opportunities without regard to the resources that are under their control. This is referred to as entrepreneurial orientation. Using the American Recovery and Reinvestment Act (ARRA), this study tests the effect of entrepreneurial orientation, form of government, and capacity on local government spending of federal grant dollars, specifically in stimulus-oriented granting. This study has implications for other stimulus-oriented granting, such as the COVID-19-motivated, Coronavirus Aid, Relief and Economic Security Act (CARES).

Open for Economic Activities during the COVID-19 Pandemic: Factors Related to State Reopening Policies in a Federal Policy Vacuum

What factors influence state governors to issue an executive order to reopen economic activities more or less quickly when removing the COVID-19 pandemic restrictions? Without comprehensive federal guidelines, state governors were faced with an administrative dilemma in devising mitigation policies that promoted safe public health measures while encouraging more business activity. Following the federal directive to reopen in April 2020, governors in all 50 states signed executive orders, but some waited longer than others. We argue that variation in the timing of the enactment of initial executive orders is influenced by political factors, financial resources factors, interstate factors, and problem severity of the public health incidence. Using an event history analysis, our Cox proportional hazard regression model suggests that states with unified Republican governments, more state funding obtained from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and participation in regional collaboration resumed activities earlier compared to states with more neighbors that issued reopening executive orders and states with more per capita income. Results indicate that, in crisis situations, unified political partisanship, the receipt of federal funding, and coordination with other states facilitate rapid policy adoption.

Even in a Pandemic, Partisanship and Capacity Matter: The Effects of Partisanship and Grant Experience in the CARES Act

The last two decades have seen significant growth in the use of stimulus granting (Cogan and Taylor, 2011; citation omitted). A key motivator is to combat economic decline and distress. But, more recently, these efforts have been to both mitigate economic downturn in addition to curtailing the more significant issue of COVID-19 sickness and death. The Coronavirus Aid, Relief and Economic Security Act (CARES Act) passed truly out of an emergency in terms of both human and economic life. The question becomes whether current research on stimulus-oriented granting holds or does prompt grant spending amid the COVID-19 crisis play by different rules? Does partisan congruence between a state governor and president matter? Does having experience with intergovernmental grants and other measures of capacity make a difference? This study tests the factors that influence stimulus-oriented granting, what I also refer to as prompt spending, in the context of the CARES Act.

The effect of the rescue plans and the need for policies to increase economic growth

This paper evaluates the economic impact of discretionary fiscal and monetary actions taken in the United States during 2020 and 2021. The fiscal actions are The Coronavirus Aid, Relief, and Economic Security Act, or the “CARES” Act, passed in March 2020; The Consolidated Appropriations Act, passed in December 2020; and The American Rescue Plan Act, passed in March 2021. The paper focuses on the impact of the “economic impact payments” that underlie these fiscal actions. The paper also examines discretionary monetary policy actions taken during the same period. The overall implication is that there is a need to return to policies that increase economic growth and stability, including rules-based fiscal and monetary policy, rather than to continue with these one-time discretionary actions.

CARES and crime

PurposeThe US signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March 2020 to alleviate the harsh economic effects of the pandemic and related shutdowns. A substantial part of the bill expanded and increased unemployment insurance payments, where a growing area of research estimates strong anti-poverty effects. The authors examine the effect of these policies on crime.Design/methodology/approachThe authors use new event study and difference-in-differences techniques to estimate the effect of increasing unemployment insurance payments on property crime and violent crime. Then, the authors estimate the effect of expanded unemployment qualification programs on crime. The authors use a rich set of controls including unemployment, contemporaneous policies and mobile device tracking data to estimate the degree to which people stayed at home.FindingsThey find that increasing unemployment insurance payments decreased crime by 20%, driven by a 24% decrease in property crime. The authors also find suggestive evidence that expanding unemployment qualifications decreases crime.Practical implicationsThe authors find a new and substantial benefit of expanded unemployment insurance beyond their antipoverty effects.Originality/valueTo the authors' knowledge, this is the first study that directly examines the impact of the CARES Act on crime.

Inflation: The problems for aquaculture

Inflation: The problems for aquaculture

Airline market exit after a shock event: Insights from the COVID-19 pandemic

During the COVID-19 pandemic, passenger demand for air transportation declined drastically. In the Unites States (U.S.), the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided financial assistance. In return, commercial passenger airlines were given minimum service obligations, which allowed airlines to remove markets (flights between origin and destination airport pairs) from their networks as long as they continued operating in all cities that they serviced pre-pandemic. A binary logit methodology is used to model airline-market level decisions to continue operating in a market or to exit it. Two time periods are modeled: during normal operating conditions (before the pandemic) and after a major shock event (after the beginning of the pandemic). Results show that after the pandemic, 8.4 times more airline markets are exited as compared to before. Interestingly, the probability of exit is found to vary widely across markets, airports, and airlines. Some market characteristics have a high probability of exit both before and after the pandemic, including low passenger revenue per available seat mile, low flight frequencies, and flights to/from multi-airport cities. In contrast, other market characteristics impact airlines’ market exit decisions in only one time period rather than both. For example, during normal operating conditions, airport size does not impact market exit. However, after the pandemic, the probability of exit is 1.8 to 2.2 times higher for the larger hub airports as compared to the smallest airports (non-hubs), a result that is explained within the context of the CARES Act minimum service obligations.

Mortgage Relief: Who CARES?

We analyze the effects of being ineligible for mortgage payment relief by examining the aftermath of the Home Affordable Refinance Program (HARP). Using a comparable sample of borrowers with publicly (Freddie Mac) and privately (Bbx) securitized loans we compare loan performance and quantify potential wealth, consumption, and credit consequences for prime borrowers whose loans were placed in private securitization pools and who were thus ineligible for a government relief program. We show that restricting program benefits to include only borrowers in federally backed mortgage pools results in significant loss in wealth (through reduced prepayment and increased default) for those otherwise similar borrowers whose loans are placed outside of GSE pools. The greatest detriment is documented in CBSAs with the largest housing price declines. The results shed light on the potential consequences of an identical provision in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) which provides mortgage forbearance relief to qualifying borrowers, whose loans are placed in a government backed mortgage pool.

Make the Invisible Underbanked Visible: Who Are the Underbanked?

When the COVID-19 pandemic caused businesses to close and triggered high unemployment in 2020, millions of unbanked U.S. households, those without a bank account, had to wait for weeks and months for their stimulus checks to arrive. The delayed delivery of stimulus checks issued by the Coronavirus Aid, Relief, and Economic Security (CARES) Act sheds light on the critical role that safe, affordable financial services and products play in people’s ability to cope with financial shocks. Dialogues over banking practices have been framed with a banked-unbanked dichotomous framework that masks more nuanced understandings of households’ financial realities, including the underbanked, who use a bank account and alternative financial services simultaneously. Using data from the 2015 National Financial Capability Study, this study identifies and compares predictors of being underbanked and unbanked, respectively. We found that the underbanked group is a sizable, distinctively different group. Income volatility and welfare benefit receipt are both associated with being underbanked rather than unbanked. Our findings call for expanding the current, limited framework to gain more complete, nuanced understandings of banking practices.

Utilization Gaps During the COVID-19 Pandemic: Racial and Ethnic Disparities in Telemedicine Uptake in Federally Qualified Health Center Clinics.

BackgroundThe Coronavirus Aid, Relief, and Economic Security (CARES) Act led to the rapid implementation of telemedicine across healthcare office settings. This innovation has the potential to improve healthcare use and ensure continuity of care. However, this delivery model could have an unintended consequence of worsening racial/ethnic disparities in healthcare utilization if adoption varies across sub-populations.ObjectiveTo examine associations between telemedicine use and race/ethnicity between 3/1/2020 and 11/30/2020, and the influence of other individual- and geographical-level factors on this relationship.DesignCohort studyParticipantsEMR data from 55 clinics in a FQHC networkMain MeasuresThe dependent variable was visit type (in-person vs. telemedicine). Predictors of interest were patient race and ethnicity. To account for repeated visits within each patient nested within clinic, a three-level, mixed-effects, multivariable, logistic regression model was used. Subgroup analyses examined correlates of telemedicine use in African American and Hispanic cohorts, separately.Key ResultsThe analytic sample included 233,302 visits for 67,733 unique patients. African Americans (OR = 0.65, 95% CI: 0.61, 0.69), Asians (OR = 0.58, 95% CI: 0.52, 0.65), and American Indians / Alaska Natives and other Pacific Islanders (OR = 0.82, 95% CI: 0.70, 0.98) were significantly less likely to use telemedicine compared to Whites. Hispanics were also less likely to have a telemedicine visit (OR = 0.49, 95% CI: 0.47, 0.51) compared to non-Hispanics. Nonacute visits were more likely to be conducted via telemedicine. Distance to clinic exhibited a dose-response relationship such that patients who lived farthest from the clinics were most likely to have telemedicine visits. In the subgroup analyses to examine predictors of telemedicine use, the dose-response relationship between distance from clinic and telemedicine use persisted, with increasing distance associated with increasing likelihood of telemedicine use, in both African American and Hispanic cohorts. Nonacute visits were associated with telemedicine use in the Hispanic cohort, but not in the Black / African American cohort.ConclusionRacial/ethnic disparities in telemedicine use persisted among this cohort. However, telemedicine improved utilization for African Americans and Hispanics living farther away from the clinic.

Hyperpigmentation: Looking beyond hydroquinone

Hyperpigmentation is the most common complaint in the age group 40-45years, seeking consultation for skin disorders. Hydroquinone is a commonly used depigmenting agent in clinical practice for treating hyperpigmentation. Prolonged use of hydroquinone has been associated with cancer risk and exogenous ochronosis. The CARES (The Coronavirus Aid, Relief, and Economic Security Act) Act of 2020has instituted significant changes to hydroquinone containing OTC (over the counter) products, and consequently, many hydroquinone-based OTC products had to be withdrawn from the market. Henceforth, products containing hydroquinone would need US Food and Drug Administration approval via new drug application pathways for commercialization. Alternative treatment options to hydroquinone in clinical practice are reviewed in this paper with regard to their safety and efficacy vis a vis hydroquinone. Also, new potential treatment options such as thiamidol, Polypodium leucotomos, and glutathione are discussed. The review shows that these alternative depigmenting agents can be rationally combined to achieve desired treatment goals in the management of hyperpigmentation.

Transition to telemedicine and its impact on missed appointments in community-based clinics

Background and objective The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic. Method This retrospective study used appointment-level data from 55 Federally Qualified Health Centre clinics in Texas between March and November 2020. To account for the nested data structure of repeated appointments within each patient, a mixed-effects multivariable logistic regression model was used to examine associations between telemedicine use and missed appointments, adjusting for patient sociodemographic characteristics, geographic classification, past medical history, and clinic characteristics. The independent variable was having a telemedicine appointment, defined as an audiovisual consultation started and finalized via a telemedicine platform. The outcome of interest was having a missed appointment (yes/no) after a scheduled and confirmed medical appointment. Results from this initial model were stratified by appointment type (in-person vs. telemedicine). Results The analytic sample included 278,171 appointments for 85,413 unique patients. The overall missed appointment rate was 18%, and 25% of all appointments were telemedicine appointments. Compared to in-person visits, telemedicine visits were less likely to result in a missed appointment (OR = 0.87, p < .001). Compared to Whites, Asians were less likely to have a missed appointment (OR = 0.82, p < .001) while African Americans, Hispanics, and American Indians were all significantly more likely to have missed appointments (OR = 1.61, p < .001; OR = 1.19, p = .01; OR = 1.22, p < .01, respectively). Those accessing mental health services (OR = 1.57 for in-person and 0.78 for telemedicine) and living in metropolitan areas (OR = 1.15 for in-person and 0.82 for telemedicine) were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Patients with frequent medical visits or those living with chronic diseases were more likely to miss in-person appointments but less likely to miss telemedicine appointments. Conclusions Telemedicine is strongly associated with fewer missed appointments. Although our findings suggest a residual lag in minority populations, specific patient populations, including those with frequent prior visits or chronic conditions, those seeking mental health services, and those living in metropolitan areas were less likely to miss telemedicine appointments than in-person visits. These findings highlight how telemedicine can enable effective and accessible care by reducing missed healthcare appointments. KEY MESSAGES Telemedicine was associated with 13% lower odds of missed appointments. Patients with frequent medical visits or those living with chronic diseases were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Patients seeking mental health services were less likely to miss telemedicine appointments but more likely to miss in-person appointments. Similarly, those living in metropolitan areas were less likely to miss telemedicine appointments but more likely to miss in-person appointments.

Drastic Increase in Hospital Labor Costs During the COVID-19 Pandemic Leads to Sustained Financial Loss for an Academic Vascular Surgery Division

The financial impact of the COVID-19 pandemic has fundamentally changed the healthcare environment, with hospitals expected to lose billions in 2021. A preexisting nationwide nursing shortage has drastically worsened during the pandemic, causing a dramatic increase in labor costs and further straining an economically fragile US healthcare system. Although the Medicare Coronavirus Aid, Relief, and Economic Security Act allocated more than $350 billion for distribution in ongoing phases, funds have not been specifically assigned to increased labor costs amid nursing shortages.

Going Virtual When The Doors Close: Addressing Geriatric Workforce Training Needs During A Pandemic

The focus of our Geriatric Workforce Enhancement Program (GWEP) is to enhance long-term services and support (LTSS) and primary care healthcare workforce capacity through interprofessional education (IPE) and to increase patient, family, and caregiver engagement. When it became evident that LTSS settings, schools, and communities were going to be adversely impacted by the COVID-19 pandemic for the unforeseeable future, our GWEP quickly pivoted to address new challenges and initiate technology to continue our programs. In this symposium, we describe four programs implemented or revised during the COVID-19 pandemic. We utilized CARES (Coronavirus Aid, Relief and Economic Security) funding to develop a 3-part Project ECHO on utilizing telehealth in LTSS settings. We pivoted quarterly Fireside Chats – community-based educational programs held at partnering LTSS settings for older adults and caregivers – to bi-weekly and now monthly webinars addressing topics relevant to COVID-19 and combatting social isolation. Because students could no longer attend an in-person IPE course introducing them to long-term care, we revised the course to be online with a partnering nursing home participating in an interactive mock care conference. Finally, a 2-semester undergraduate Honors College project-based course introducing students to successful aging utilized virtual activities to expose students to the challenges of hospice care during a pandemic. With these adaptations, as well as activities that advocated for, and supported, LTSS settings and older adults, our GWEP program was able to continue to provide education and support to the setting and individuals most impacted by COVID-19.

Catastrophe or Catalyst? Reflections on COVID’s Impact on Community Colleges

The COVID-19 pandemic led to a steep decline in enrollments at community colleges, especially among Black, Hispanic, and Indigenous populations, males, and part-time students. The Coronavirus Aid, Relief, and Economic Security Act (CARES) and the American Rescue Plan (ARP) Acts provided funds for emergency aid and engaging disconnected students, and community colleges moved swiftly to shift services and instruction online. In this essay, we discuss how students and community colleges responded to the pandemic and what their experiences reveal about inequities in higher education. We argue that the crisis was worsened by years of underinvestment in these institutions and by entrenched structures and practices that do not address the needs and aspirations of many students. We review evidence on reforms that aim to remake community colleges in ways that improve student outcomes. While COVID-19 can rightly be viewed as a catastrophe, it may also serve as a catalyst for fundamental and lasting improvements in how community colleges are funded, organized, and operated to help more students achieve their goals.

Pre-pandemic to early-pandemic changes in risk of household food insecurity among Maryland families with children.

The objective was to examine risk and protective factors associated with pre- to early-pandemic changes in risk of household food insecurity (FI). We re-enrolled families from two statewide studies (2017-2020) in an observational cohort (May-August 2020). Caregivers reported on risk of household FI, demographics, pandemic-related hardships, and participation in safety net programs (e.g. CARES stimulus payment, school meals). Maryland, United States. Economically, geographically, and racially/ethnically diverse families with preschool to adolescent-age children. Eligibility included reported receipt or expected receipt of the CARES stimulus payment or a pandemic-related economic hardship (n=496). Prevalence of risk of FI was unchanged (pre-pandemic: 22%, early-pandemic: 25%, p=0.27). Risk of early-pandemic FI was elevated for non-Hispanic Black (aRR=2.1 [95% CI 1.1, 4.0]) and Other families (aRR=2.6 [1.3, 5.4]) and families earning ≤300% federal poverty level. Among pre-pandemic food secure families, decreased income, job loss, and reduced hours were associated with increased early-pandemic FI risk (aRR=2.1 [1.2, 3.6] to 2.5 [1.5, 4.1]); CARES stimulus payment (aRR=0.5 [0.3, 0.9]) and continued school meal participation (aRR=0.2 [0.1, 0.9]) were associated with decreased risk. Among families at risk of FI pre-pandemic, safety net program participation was not associated with early-pandemic FI risk. The CARES stimulus payment and continued school meal participation protected pre-pandemic food secure families from early-pandemic FI risk but did not protect families who were at risk of FI pre-pandemic. Mitigating pre-pandemic FI risk and providing stimulus payments and school meals may support children's health and reduce disparities in response to pandemics.

COVID‐19 Relief Laws Benefit Nonprofit Organizations

Legislation creating a $2.2 trillion economic stabilization package to combat the COVID‐19 pandemic became law on March 27, when President Trump signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116‐136). This was the third, and most massive, COVID‐19 emergency relief act passed by Congress in March. There are several features of the act of direct interest and import to nonprofit organizations.

Independent Accountant’s Review Report

Independent Accountant’s Review Report

Saving lives and livelihoods: The Paycheck Protection Program and its efficacy

In March 2020, the COVID-19 pandemic, caused by the SARS-CoV-2 virus, swept through the United States. The necessary but costly non-pharmaceutical interventions (NPIs) including social distancing, stay-at-home orders, and the closing or restriction of most businesses greatly increased the unemployment rate, and put millions of Americans at risk for eviction and bankruptcy. As a part of the relief efforts to mitigate the economic consequences of the shutdown orders, the United States Congress passed The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act, which created the Paycheck Protection Program (PPP). The PPP, administered by the Small Business Administration (SBA), was intended to help small business keep employees on their payroll through loans guaranteed by the SBA that are forgivable if certain conditions are met. This paper, using publicly available data released by the SBA of loans worth $150,000 or greater, analyzes the effectiveness of the program through multiple avenues. On the overall effectiveness of the program, we explore the types of business that received PPP funding, the ranges of loan amounts provided, the types of banks that processed the loans, the cost-effectiveness of jobs saved based on the loan range, and the racial distribution of loan recipients. We also analyze the geographical distribution of loans based on congressional district to look at the influence race and political party had on how much PPP funding each congressional district received. Finally, we look at the how the PPP fit into the context of the COVID-19 pandemic by looking at the number of COVID-19 cases in each state at the time the program was initially closed, the amount of PPP funding for each state and analyzing the relationship between the loan amount per COVID-19 case and the date of reopening in each state, the relationship between the number of PPP loans received, and how long it took until a state reopened. We note that states that received more loans tended to delay their reopening, as a result, one of the main goals of the PPP, limiting the spread of COVID-19 by keeping people at home, was successful in that regard. We determine that the program, while a critical lifeline in a desperate, unprecedented time, had flaws in its deployment related to a lack of preparedness, a lack of equity in which recipients had initial access and how much funding recipients received, and noticeable gaps in the data. Finally, we recommend policy solutions and fixes going forward to bolster our preparedness response at the state and federal level and ensure that going forward, we can do better to meet the missed marks during the acute phase of the coronavirus pandemic.

Sustaining Tribal Fisheries: U.S. Economic Relief Policies during COVID-19

This article reviews the individual spend plans of U.S. states granted a funding allocation under Sec. 12005 of the Coronavirus Aid Relief and Economic Security (CARES) Act to identify consistency with legislative mandates to support Tribal commercial, subsistence, cultural, or ceremonial fisheries negatively impacted by the COVID-19 pandemic. Utilizing critical discourse analysis, this study identifies state discursive practices in supporting Tribal sovereignty in fisheries management for the advancement of Indigenous Ocean justice. State spending plans (n = 22) publicly available and submitted to the National Oceanic and Atmospheric Administration before July 2021 were reviewed. Few of the state spend plans listed impacts to Tribal fisheries due to the pandemic. Only two state plans included Tribal consultation and direct economic relief for commercial, subsistence, cultural, and/or ceremonial losses faced by neighboring Tribes and Tribal citizens. Overall, the protections within the CARES Act for Tribal fisheries were not integrated into state spend plans. The article identifies best practices for state fisheries relief policy content that is affirming of Tribal fishing rights and uses them to help address the ongoing pandemic crisis facing Tribal fisheries. These findings have relevance for future emergency relief programs that are inclusive of Tribal Nations. Honoring Tribal sovereignty and the federal trust responsibility must be the cornerstone of shared sustainable fisheries.