State Policy Research Articles

GENDER PARITY POLICY IN THE PUBLIC SERVICE SYSTEM IN NORTH AMERICA

The article is devoted to the study of gender parity policy in the public service system in North America. Particular attention is paid to the United States of America and Canada. The article characterizes and describes the historical development of gender policy in these countries. Dependencies, patterns and determinants that may affect the state of gender parity in a particular region are analyzed. The author analyzes the laws and other regulations of the national legislation of North American countries that regulate issues related to gender parity, non-discrimination and access to public service. The author examined the gender ratio of public administration representatives in various positions in North America. The author analyzes the institutional system of North American countries and identifies the bodies and officials authorized to implement, monitor and supervise compliance with gender policy. The positions of the representatives of the United States and Canada on the introduction and application of gender quotas for access to leadership positions are analyzed and summarized. The sources of the state gender policy formation in the United States of America were analyzed and highlighted. Particular attention is paid to non-governmental organizations as an important factor that has a significant impact on public policy in this area. Based on the study, it was found that the number of women in parliaments does not necessarily demonstrate a high level of gender parity in this region. It was also found that the application of gender quotas in access to public service does not necessarily have the desired and envisaged by the state policy consequences. The author describes different approaches to gender policy, analyzes successes and challenges in this area.

Licensure Policies May Help States Ensure Access To Opioid Use Disorder Medication In Specialty Addiction Treatment.

Despite the devastating toll of the overdose crisis in the United States, many addiction treatment programs do not offer medications for opioid use disorder (MOUD). Several states have incorporated MOUD requirements into their standards for treatment program licensure. This study examined policy officials' and treatment providers' perspectives on the implementation of these policies. During 2020-22, we conducted thirty-one semistructured interviews with forty policy officials and treatment providers in nine states identified through a legal analysis. Of these states, three states required treatment organizations to offer MOUD, and two prohibited organizations from denying admission to people receiving MOUD. Qualitative findings revealed that licensure policies were part of a broader effort to transition the specialty treatment system to a model of care more consistent with medical evidence; states perceived tension between raising quality standards and maintaining adequate treatment capacity; aligning other state policies with MOUD access goals facilitated implementation of the licensure requirement; and measuring compliance was challenging. Licensure may offer states an opportunity to take a more active role in ensuring access to effective treatment.

Systemic White supremacy: U.S. state policy, policing, discrimination, and suicidality across race and sexual identity.

Although suicide rates are stable or decreasing among White communities, rates are increasing among Black communities, a trend that appears to be disproportionately affecting Black lesbian, gay, bisexual, and queer (LGBQ) people. To understand the structural drivers and mechanisms of these trends, we examined associations between U.S. state-level racist and heterosexist criminal legal policies and policing, discrimination, and suicidality among White and Black, heterosexual and LGBQ, communities. We recruited 5,064 participants in 2021 using online census-driven quota sampling. Structural equation modeling estimated associations from objective indicators of racist and heterosexist criminal legal policies to self-reported police stops, discrimination, and suicidal ideation and behavior. For White heterosexual participants, racist (β = -.22, SE = 0.03, p < .001) and heterosexist (β = -.26, SE = 0.03, p < .001) policies were negatively associated with police stops. For White LGBQ participants, racist and heterosexist policies were not significantly associated with police stops. For Black heterosexual participants, racist (β = .30, SE = 0.11, p = .005), but not heterosexist, policies were positively associated with police stops. For Black LGBQ participants, racist (β = .57, SE = 0.08, p < .001) and heterosexist (β = .65, SE = 0.09, p < .001) policies were positively associated with police stops which, in turn, were positively associated with discrimination and suicidal ideation and behavior. Results provide evidence that racist and heterosexist state policies are linked to policing and interpersonal drivers of suicide inequities and suggest that repealing/preventing oppressive policies should be a suicide prevention imperative. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

School Meals for All: A Qualitative Study Exploring Lessons in Successful Advocacy and Policymaking in Maine and California

BackgroundThe COVID-19 pandemic focused national attention on food insecurity, equity, and the role of school meal programs in supporting children, families, and communities. In doing so, the pandemic created a rare policy window—an opportunity to advance a longstanding public health goal of guaranteed access to free school meals for all students. In July 2021, California and Maine became the first states to authorize school meal for all legislation (also known as universal free meals). ObjectiveThe aim of this study was to explore perspectives of policymakers, state agency officials, and advocates on the conditions and mechanisms that facilitated passage of school meal for all legislation in California and Maine. DesignA qualitative case study was conducted. ParticipantsBetween December 2021 and June 2022, semistructured interviews were conducted with 30 policymakers, state agency officials, and advocates. Statistical analysis performedInterviews were analyzed using principles of content analysis. Key themes are organized using Kingdon’s multiple streams framework for public policy. ResultsEleven key themes were identified. Lessons are drawn from the policy and advocacy strategies used to advance laws in California and Maine. For instance, paving the way with incremental policy change, tailoring messaging to diverse audiences, and organizing at the grassroots and grasstops levels were critical to success of advocacy efforts. ConclusionsPromising practices can guide efforts to expand access to school meals and advance other child nutrition policies in other states and nationally. Moving forward, lessons learned from implementation of universal free school meal legislation in California, Maine, and other early adopters should be documented and shared.

Evolution of Professional Standards: Reflecting on the Past to Inform the Future

Clearly defined professional standards result in better prepared professionals who positively impact outcomes for children and families by ensuring an effective workforce. This article describes the evolution of early intervention early/childhood special education preparation standards from the on-the-job competencies of the 1960s to the historic 2020 Initial Practice-Based Professional Standards for Early Interventionists/Early Childhood Special Educators (EI/ECSE Standards), in concert with the evolution of the profession itself. Influencing factors include (a) changes in federal legislation and policy, (b) ages and characteristics of children served, (c) growing knowledge of effective practices, (d) collaboration with other disciplines, and (e) ongoing advocacy for EI/ECSE as a profession. The article concludes with a vision for using these EI/ECSE Standards to guide the future local, state, and national agenda of the profession around preservice preparation and accreditation, professional development, state and federal policy, cross-disciplinary collaboration, and standards-informed research.

IT’S ALL IN THE ACTION

CASE SETTING The prevalence of metabolic syndrome in patients with serious mental illness is almost double the prevalence reported for the general population of Australia. Cardiometabolic disease and mental illness are overrepresented in adult prison populations, with people in custody significantly more likely to have cardiovascular disease and Type 2 diabetes. The Forensic Hospital, is a mental health facility with 140 beds that sits within Justice Health NSW. It is specifically designed for people who have mental illness and have been involved with the criminal justice system, as well as those who are considered to be at high risk in the community. The Ministry of Health and Justice Health NSW have several documents that make reference to the importance of screening for Metabolic Syndrome however barriers exist at the patient, staff, and organisational level to implementing the recommended physical health guidelines in a high secure forensic mental health setting. TREATMENT It’s All In The Action is a Quality Improvement project led by the Forensic Hospital’s Senior Exercise Physiologist and Rehabilitation Coordinator. The initiative focused on embedding physical health intervention for Forensic Hospital patients at risk of or diagnosed with metabolic syndrome through the establishment of the Metabolic Care Team. RESULTS A defined physical health pathway to intervention within the Forensic Hospital in the form of a physical health MDT, atypical in the Forensic Mental Health setting. REFLECTIONS/LEARNINGS The presentation will outline the steps taken in a ground up approach to address the growing concern of systemic neglect and achieve service level change. It will demonstrate translation of best practice research as well as State and National policy and guidelines into tangible action for a significantly marginalised population group. Finally, it will reflect on the sustainability of this initiative, the integration of partnerships, and recommendations for prospective next steps.

Values and Evidence in Gender-Affirming Care.

This commentary responds to the article "What Is the Aim of Pediatric 'Gender-Affirming' Care?," by Moti Gorin, in the same issue of the journal. Gender-affirming care is often treated as exceptional and subject to heightened scrutiny. This exceptionalization results in its being held to stricter evidentiary standards than other forms of medical interventions are. But values and value judgments are inextricable from the practice of evidence-based medicine. For gender-affirming care, values shape what counts as "strong" evidence, whether the legitimacy of transgender identity is assumed versus treated as something to be investigated, how to characterize the testimonial accounts of trans and gender-nonconforming patients, and more. We argue that these kinds of questions are part of the practice of medicine, not exceptional to transgender people and gender-affirming care. However, litigation of evidence for gender-affirming care in state and national policy underscores the moral urgency of thinking carefully about what values ought to guide evidence.

Is it an abortion: Classification of pregnancy-ending interventions after 24 weeks in the presence of lethal fetal anomalies

ObjectiveTo determine how obstetrician-gynecologists categorize pregnancy-ending interventions in the setting of lethal fetal anomalies. Study DesignWe conducted a sequential explanatory mixed methods study of U.S. obstetrician-gynecologists from May to July 2021. We distributed a cross-sectional online survey via email and social media and completed qualitative telephone interviews with a nested group of participants. We assessed institutional classification as induced abortion versus indicated delivery for six scenarios of ending a pregnancy with lethal anomalies after 24 weeks, comparing classification using McNemar chi-square tests with Benjamini-Hochburg correction for multiple comparisons with false discovery rate of 0.05. We performed thematic analysis of qualitative data and then performed a mixed methods analysis. ResultsWe included 205 respondents; most were female (84.4%), had provided abortion care (80.2%), and were general OB/GYNs (59.3%), with broad representation across pre-Dobbs state and institutional abortion policies. Twenty-one qualitative participants had similar characteristics to the whole sample. Scenarios were classified as induced abortion by the majority of respondents, ranging from 53.2% for 32-week induction for anencephaly, to 82.9% for feticidal injection and 24-week induction for anencephaly. Mixed methods analysis revealed the relevance of gestational age (later interventions less likely to be considered induced abortion) and procedure method and setting (dilation and evacuation, feticidal injection, and freestanding facility all increasing classification as induced abortion). ConclusionThere is wide variation in classification of pregnancy-ending interventions for lethal fetal anomalies, even among trained OB/GYNs. Method, timing, and location of ending a nonviable pregnancy influence classification, though perinatal outcome is unchanged. ImplicationsThe classification of pregnancy-ending interventions for lethal fetal anomalies after 24 weeks as indicated delivery versus induced abortion is reflective of sociopolitical regulatory factors as opposed to medical science. The regulatory requirement for classification negatively impacts access to care, especially in environments where induced abortion is legally restricted.

“Disheartened and Powerless”: How Abortion Providers Discuss Moral Distress Under Dobbs [ID 2683590

INTRODUCTION: Moral distress occurs when providers feel powerless to provide ethical health care. We analyzed how abortion providers discuss moral distress since the Dobbs decision. METHODS: In 2023, we distributed an IRB exempt survey measuring moral distress to U.S. abortion providers through professional listservs. Surveys included an optional open-ended section where participants reflected on their experience of moral distress. Using thematic analysis, we compared open-ended responses between providers practicing in states protective and restrictive to abortion. Open-ended responses were deidentified, so we categorized “protective” and “restrictive” based on the written description of practice environment. RESULTS: Of 253 practitioners who completed the survey, 57% practiced in “protective” states and 43% practiced in “restrictive” states (using Guttmacher's classifications). Of these, 164 (64%) completed the optional, deidentified, open-ended section. Providers who indicated practicing in restrictive environments experienced moral distress arising from being forced to turn patients away or provide substandard care, the instability and ambiguity of abortion laws, and feeling powerless to use the specialized skills central to their identities as providers. Providers who indicated practicing in protective environments experienced moral distress arising from witnessing burdens placed on patients seeking care and the substandard care out-of-state patients received, a lack of resources to accommodate increased clinical volume, and encountering restrictive institutional policies despite the protections afforded by permissive state policy. CONCLUSION: Restrictions on abortion care can harm providers through their experiences of moral distress. Moral distress can lead to provider burnout and attrition, which exponentiates provider shortages and can ultimately lead to poor patient outcomes.

Avorter : pratique universelle et transculturelle. Le combat des femmes argentines dans la légalisation de l’avortement

The legal implications of abortion worldwide do not confer the same rights or conditions on women. Although abortion has been practiced for centuries in all societies, it remains highly unequal in legislative terms throughout the world. This article traces the historical, socio-cultural and political contexts in which decisions to criminalize and decriminalize abortion have been made, particularly in Argentina. Representations of the status of the fetus and of women's social condition that have been developed by each society, provide additional insight into the issues surrounding this universal and transcultural practice. The female body, and its procreative function, correspond to the interests of state policies. The fight by Argentinian women to legalize abortion is an example of rebellion against the weight of patriarchal traditions.

United States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies

BackgroundThe field of maternal health has advanced significantly over the past decades. However, the United States continues to have poor outcomes in comparison with other industrialized nations. With emerging evidence on the promise of doula care, states are including doula care under their Medicaid programs. MethodsWe conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care. FindingsOf 740 records identified, 100 met inclusion criteria. Outcomes fell into four areas: birthing people's outcomes, infant outcomes, systems of care and implementation, and cross-cutting issues. Data on outcomes related to doula care in the literature were predominantly clinical, even though doulas are not clinical providers. Although some studies have found associations between doula care and improved clinical outcomes for birthing people and infants, the evidence is limited due to small sample sizes, study methodology, or conflicting conclusions. Doula outcomes are underexplored in the literature, with mainly qualitative data describing low levels of diversity and equity within the doula workforce and ineffective payment models. When cost-effectiveness estimates have been calculated, they largely rely on savings realized from averted cesarean births, preterm births, and neonatal intensive care unit admissions. ConclusionsAs state Medicaid programs expand to include doula care, policymakers should be aware of the limitations in the evidence as they plan for successful implementation, such as the narrow focus on certain clinical outcomes to quantify cost savings and conflicting conclusions on the impact of doula care. An important consideration is the impact of the reimbursement rate on the adoption of doula care, which is why it is important to engage doulas in compensation determinations, as well as the development of improved metrics to untangle the components that contribute to maternal health outcomes in the United States.

State policy in the field of employment: legal problems and prospects in the conditions of martial law

State policy in the field of employment: legal problems and prospects in the conditions of martial law

Normative legal support of the State policy in the field of education of the Republic of Chad

The modern education system of Chad has a structure similar to most countries of the world. At the same time, since the 1960s, the educational policy of Chad has not overcome the problems of high illiteracy of the population, poor quality of education in the conditions of pedagogy of large groups, repeating a class, gender inequality in education, shortage of school teachers and university lecturers. For modern Chad, it is important to adhere to the constitutional foundations of the State, but there remains a contradiction between the tasks of the State to implement State policy in education and the technical capabilities of managing the modernization of Chadian education based on African values. The article shows the legal basis for the development of the state policy in education in the Republic of Chad.

Transformation of Soviet State Policy in the Field of Motherhood and Childhood Protection at the Turn of 1980–1990s

The scientific relevance of the article is related to the importance of identifying the prerequisites for the transition from protecting motherhood and childhood to protecting the rights of women and children in the state policy in the 1990s. Such prerequisites were of a social nature and marked the beginning of the transformation of Soviet state policy at the turn of the 1980–1990s. Accordingly, the aim of the article is to highlight the social reasons for the transformation of Soviet state policy regarding the protection of motherhood and childhood at the turn of 1980–1990s. To achieve the aim, the article uses historical, logical and cause-and-effect methods. The scientific novelty of the research is defined by a number of documents that have not been previously introduced into scientific circulation. These include paperwork documents of the Supreme Council of the RSFSR and documents related to the implementation of a set of resolutions which are stored in the State Archive of the Russian Federation. The study also includes documents reflecting statistical data, such as report of the USSR on the implementation of the UN Convention on the Elimination of All Forms of Discrimination against Women and documents from the collection of modern political documents of the State Public Historical Library of Russia (GPIB of Russia). Data from periodicals of the indicated years were also used. The study shows that in the context of political changes in 1980–1990s the social issue, due to many political and economic reasons, required a new solution. This entailed, among other things, a change in ideas in society about the tasks of the state in the field of motherhood and childhood. As a result, there was a need to transform policy regarding the protection of motherhood and childhood, which was most fully expressed in the 1990s.

LONG-TERM LENDING FOR PUBLIC-PRIVATE PARTNERSHIP PROJECTS: OPPORTUNITIES AND PROSPECTS

The article is devoted to the topical issues of long-term lending to public-private partnership projects in the context of a permanent shortage of budget funds and the financial instability of business entities. The purpose of the study is to highlight the problems of attracting long-term credit resources by partners in the process of implementing joint projects and to outline areas for their solution. To achieve this goal, general scientific research methods and analytical data from the State Statistics Service of Ukraine and the National Bank of Ukraine were used.The article reveals the main problems in the development of the debt financial instruments market, which make partnership projects between the state and business unattractive for investors. It is argued that the possibility of providing long-term loans depends not only on the actions of the bank, but also on the monetary policy of the NBU, which should ensure the introduction of preferential reserve requirements for banks, the provision of irrevocable deposits, the NBU's approval to refinance banks for the implementation of PPP projects, and the introduction of preferential lending by banks to PPP projects. The authors emphasize the priority importance of the state policy on the development of programs for the availability of long-term loans in the process of implementing partnership projects. Given the underdevelopment of financial instruments for public-private partnerships, the author substantiates the need to use innovative instruments – credit derivatives, the effectiveness of which is confirmed by international experience. The article offers a list of the most effective financial instruments that should be used at each stage of the project life cycle.It is concluded that the recommendations provided will ensure that the partners attract the necessary amount of financial resources in the process of long-term project implementation and will allow them to obtain a synergistic effect from such cooperation.

Penal state power in Latin America: Cases, concepts and questions for the political sociology of penality

AbstractExamining penality across different regions and periods of time allows us to develop both a robust empirical imaginary and conceptual understanding of the commonalities and variation in how penal state power operates. In this article I elaborate key dimensions of penality in contemporary Latin America. Since the late 20th century, Latin American countries have undergone economic and political transformations with profound effects for the organization of their societies and the features and implications of penal state power. First, I situate research on penal state practices in Latin American countries within the broader dynamics of violence and social conflict across the region. Second, I review scholarship on the relationship between the features of penal state policies and reform in the region and the transformative, procedural and cultural dimensions of democracy. Third, I describe initiatives to expand state capacities to incarcerate criminalized people at an unprecedented scale and clarify the relationship of carceral administration to social order and political legitimacy across Latin America. I then conclude by elaborating how penality in Latin America contributes to our broader understanding of the relationship between penal power, state authority, and inequality; and I highlight three lines of inquiry for future research.

Management of budget flows under martial law

Managing budget flows under martial law is important to ensure the security and financial stability of the state, helping to mobilize the necessary resources and concentrate them on financing key needs. This paper aims to identify and outline possible measures to balance the movement of budget flows in order to harmonize them with the goals of state policy in the field of national security. The movement of budget flows of income and expenses was assessed, and trends and changes were identified using economic and statistical methods. The assessment results confirmed the need for reasonable planning of budget flows in the context of the impact of unforeseen military events on the process of budget execution in terms of revenues and expenditures, which leads to failure to meet expenditure indicators, causes a lack of financial resources and an increase in the budget deficit. One of these measures is the improvement of budget planning, which is based on the analysis, detection, and assessment of the probability of occurrence and countering the risks related to the state’s financial system. Correlation-regression analysis confirmed the growing dependence of revenues on official transfers from the EU, foreign governments, international organizations, donor institutions, and government bodies. The results obtained are basic for developing measures to balance incoming and outgoing budget flows under martial law. They provide for the obligation to create a financial support system (including international financial aid) while strengthening state financial control measures for the timely, targeted, effective direction of budget flows, including for the security and defense of the state.

Personnel development under digital economy conditions

Personnel development under digital economy conditions

State Support for Commercialization of Intellectual Activity Results in Socially Significant Industries

The pharmaceutical industry is one of the leaders in terms of the intensity of commercialization of the intellectual activity results (IAR). Its development as a socially significant industry is a priority in the state policy of countries with developing economies, in particular, the countries of the Latin American region (LA). A number of economic conditions for the development of commercialization of the IAR in these countries are similar to the Russian economy. Common barriers to development include dependence on imported substances, inefficient interaction between science and business, lack of public and private investment in R&amp;D, and insufficient development of the intellectual property (IP) institution. At the same time, it is possible to identify common growth drivers: the growth potential of the consumer market, unique natural resources, relatively high scientific potential, and the concentration of R&amp;D in research institutes and universities. The similarity of the conditions helps to suggest that it is possible to adapt the best practices of IAR commercialization formed in the LA, to the Russian economy. The research method used in this article include analyzing published legislative and statistical materials on financial institutions of the LA countries in order to identify problems and experience in overcoming them in the field of commercialization of intellectual property. The analysis of state support for imitation, closed and open models of commercialization of IAR used by pharmaceutical companies in developing economies made it possible to identify successful support mechanisms, as well as positive and negative results of the application of each model. On this basis, as the results of the research recommendations for state support for the commercialization in socially significant industries of the Russian economy are suggested.

State Youth Policy in Recruitment System of Political Leader

The article contains the results of a study, the aim of which was to identify the role of youth policy in the system of recruiting political leaders. In the text, the authors analyze the features of the formation and stages of development of youth policy as a part of state policy aimed at supporting young people and realizing their interests. The article describes existing programs and projects designed not only to support young people, but also to help identify, develop and support their political potential and, consequently, the formation of youth political leadership in Russia. The paper presents the results of an expert survey conducted by the authors in 2023, the aim of which was to determine the features of state youth policy as a tool for the formation and identification of the leadership potential of youth, as well as the integration of its representatives into the country’s political elite through the system of recruiting youth political leaders. As a result, the authors came to the conclusion that recently there has been an evolution of state youth policy in the indicated manner. It acts as the primary mechanism of socialization in the field of political leadership, providing opportunities for building a career in various fields of activity, including in the field of public policy and public administration. At the same time, as a result of the study, the authors came to the conclusion about the fragmented nature of its implementation, expressed in the difference between the declared and actual levels, which meanwhile makes it possible to build career trajectories and social elevators for a certain category of young people, forming the first level of the pool for recruiting political leaders.