Kristin Klopfenstein

Advanced Placement: Do Minorities Have Equal Opportunity?.

Abstract Black and Hispanic high school students enroll in Advanced Placement (AP) courses at approximately half the rate of white students. This paper develops a microeconomic model of the AP participation decision and finds that low income is the single most important factor behind the minority AP participation gap. In addition, minority students enroll in AP math, science, and English at lower rates than comparable white students. Magnet schools promote AP participation among white students but reduce participation among college-bound black students. Race-matched role models promote AP-taking among high-achieving black males, and AP incentive programs have the potential to dramatically increase minority student participation. Policy implications include reducing the impersonal nature of large high schools by creating smaller “schools-within-a-school” while maintaining flexibility across academic tracks, eliminating magnet programs, hiring qualified AP teachers to actively mentor minority students, and implementing incentive programs that promote teacher training and provide incentives for student achievement.

Cross-State Variation in Medicaid Support for Older Citizens in Long Term Care Nursing Facilities

As the baby boom generation con tinues to age, state long-term care for older citizens?whether they are in nursing facilities, community-based residences such as assisted-living centers, or their own homes?likely will become more heavily utilized and expensive. This article examines the factors explaining state support for Medicaid programs for the long-term care of older citizens and how these factors differ

Distinguishing quality of nursing facility long-term care from stringency of enforcement

Nursing facility inspections routinely produce statistics revealing sharp disparities in care at both the facility and the state level. But whether high rates of deficiencies are more indicative of stringent enforcement of standards, leading to improved care, or ongoing poor quality care remains unclear. Until this question is answered, families of nursing facility residents, responsible public officials and interested professionals, are all unable to make sound decisions about long-term care quality. We employ cross-sectional, panel data to compare states on multiple indices of both care quality and enforcement stringency. We use the multi-method-multi-trait approach to distinguish these concepts. We find that low rates of deficiencies are positively associated with independent measures of high quality care. But, a prominent nursing facility enforcement index likely registers poor quality care more than stringency of enforcement since it is associated positively with independent indices of poor quality care and negatively with independent measures of enforcement. Attentive publics can have reasonable confidence that low rates of deficiencies indicate high quality care. High rates tend to reflect glaring deterioration in care quality. They are less signals of stringent enforcement than of obviously poor care which prompts more visible enforcement activities. Sadly, there is little evidence suggesting that these enforcement measures improve state-level care quality and thus reduce cross-state disparities in the quality of nursing facility long-term care. However, at least some of the factors responsible for sharp disparities in nursing facility care lie within the capacity of states to rectify even in the short term.

Do Grade Weights Promote More Advanced Course-Taking?

When calculating class rank, high schools often give additional weight to grades earned in College Board Advanced Placement (AP) courses as an incentive for students to take hard courses. This paper examines changes in student course-taking behavior after an increase in AP grade weights at Texas high schools. We find that raising the magnitude of the AP grade weight in schools already using weights has a small impact that is limited to white students who are not eligible for free or reduced-price lunch (FRPL). When schools introduce grade weights for the first time, the impact is large and widespread with the probability of taking an AP course increasing by 3 to 12 percent and the number of AP courses taken increasing by 0.13 to 0.95 standard deviations. Impacts are largest among students who are not FRPL eligible.

Improving Resident Outcomes in State Medicaid Nursing Facility Long-Term Care Programs: Augmenting CMS Surveys with Modest Changes to a Few State Program Features

Abstract Purpose Federal and state governments collaborate on state Medicaid nursing facility long-term care (SMNF-LTC) programs. These programs are increasingly expensive as the baby-boomers retire. Yet serious resident outcome problems continue in spite of the Centers for Medicare and Medicaid Services’ (CMS) extensive process-focused regulatory efforts. This study identifies a promising and simpler auxiliary path for improving resident outcomes. Methodology/approach Drawing on a longitudinal (1997–2005), 48-state data set and panel-corrected, time-series regression, we compare the effects on resident outcomes of CMS process-focused surveys and four minimally regulated program structural features on which the states vary considerably. Findings We find that each of these four structural features exerts a greater effect on resident outcomes than process quality. Research limitations/implications We suggest augmenting current process-focused regulation with a less arduous approach of more extensive regulation of these program features. Originality/values of chapter To date SMNF-LTC program regulation has focused largely on member facility processes. While regulating processes is appropriate, we show that regulating program structural features directly, an arguably easier task, might well produce considerable improvement in the quality of resident outcomes.