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New Ideas for a Do-Something Congress No. 5: Make Rural America’s Higher Education Deserts Bloom

Posted on February 26, 2019 by The Progressive Policy Institute

As many as 41 million Americans live in “higher education deserts” – at least half an hour’s drive from the nearest college or university and with limited access to community college. Many of these deserts are in rural America, which is one reason so much of rural America is less prosperous than it deserves to be.

The lack of higher education access means fewer opportunities for going back to school or improving skills. A less educated workforce in turn means communities have a tougher time attracting businesses and creating new jobs.

Congress should work to eradicate higher education deserts. In particular, it can encourage new models of higher education – such as “higher education centers” and virtual colleges – that can fill this gap and bring more opportunity to workers and their communities. Rural higher education innovation grants are one potential way to help states pilot new approaches.

THE CHALLENGE: HIGHER EDUCATION “DESERTS” ARE HANDICAPPING RURAL AMERICA

For millions of Americans, distance is as big or bigger a barrier to higher education access as finances. According to the Urban Institute, nearly one in five American adults—as many as 41 million people—lives twenty-five miles or more from the nearest college or university, or in areas where a single community college is the only source of broad-access public higher education within that distance. Three million of the Americans in these so-called “higher education deserts” also lack broadband internet, which means they are cut off from online education opportunities as well (1).

Rural students have lower rates of college-going and completion.

More than four in five people in higher education deserts – 82 percent – live in rural areas. This could be one reason why fewer rural Americans attend or finish college.

In 2016, 61 percent of rural public school seniors went on to college the following year, according to the National Student Clearinghouse, compared to 67 percent for suburban students (2). Only 20 percent of rural young adults between 25 and 34 have four-year degrees, says the USDA’s Economic Research Service, compared to 37 percent of young adults in urban areas (3). Moreover, the urban-rural gap in college degree attainment is growing. From 2000 to 2015, the share of college-educated adults rose by 7-points in urban locales compared to 4-points in rural areas.

Less-educated rural areas are falling behind while better educated cities leap ahead.

With more and more jobs demanding ever higher levels of skill, disparities in access to higher education are translating to vast disparities in the distribution of jobs and opportunity throughout the United States, including a widening urban-rural divide. Wealthy urban areas are getting richer, while rural areas are increasingly lagging.

The Economic Innovation Group (EIG), for instance, reports that of the 6.8 million net new jobs created between 2000 and 2015, 6.5 million were created in the top 20 percent of zip codes, which were predominantly urban (4). These prosperous, job-creating zip codes are also the best-educated. EIG further finds that 43 percent of residents in the top 10 percent of zip codes has a bachelor’s degree or better, compared to just 11 percent in the bottom 10 percent. While a four-year degree is of course not a prerequisite for a good living, the heavy concentration of highly-educated workers is indicative of the imbalance in economic opportunities between rural and urban areas.

Most of the nation’s least educated and most impoverished counties are rural.

If education and prosperity are linked, so conversely are poverty and the lack of educational attainment.

Out of 467 U.S. counties identified by the USDA as “low education” counties – places where 20 percent or more of the population has less than a high school diploma – 79 percent are rural (5). These counties tend to be clustered in the rural South, Appalachia, along the Texas border and in Native American reservations and also suffer from higher rates of poverty, child poverty and unemployment.

THE GOAL: ERADICATE HIGHER EDUCATION DESERTS AND ENSURE EVERY RURAL AMERICAN HAS HIGHER EDUCATION ACCESS

Better access to higher education in rural areas, especially for the many millions of “nontraditional” students who are now increasingly the norm (6), can help close the gulf in opportunity between urban and rural areas. Greater opportunities for convenient, affordable higher education would allow more rural Americans to finish their degrees or pursue occupational credentials, qualifying them for higher-skilled, better-paid jobs. Rural students would also benefit by not being forced to leave home for school – not only lowering costs for students but potentially slowing or even reversing the population declines plaguing rural areas. Institutions of higher education can also serve as engines of economic development in the communities they serve. They can work with businesses to turn out the skilled talent they need and provide research or other support.

THE PLAN: CREATE RURAL HIGHER EDUCATION INNOVATION GRANTS TO ENCOURAGE NEW MODELS OF HIGHER EDUCATION REACHING RURAL AMERICA

While it’s unrealistic to establish a new college, community college or university in every rural area that needs one, emerging models for delivering higher education potentially offer a creative, cost-effective and effective alternative. These new models can also expand the ability of workers to obtain high-quality occupational credentials, which in many instances are likely to be more practical, affordable and desirable than pursuing a two-year or four-year degree.

Some states, such as Pennsylvania, Virginia and Maryland, are pioneering new approaches, such as “higher education centers” and virtual colleges, that use technology to broaden students’ options for both traditional college education and occupational training (7). The Northern Pennsylvania Regional College, for instance, operates six different “hubs” scattered throughout the 7,000 square miles it serves, plus numerous “classrooms” using borrowed space from local high schools, public libraries and other community buildings. In addition to conferring its own degrees, it provides the infrastructure for other accredited institutions to extend their reach through “blended” offerings combining virtual and in-person teaching.

Similarly, Virginia’s five higher education centers provide physical infrastructure for colleges and community colleges offering classes as well as occupational training in fields such as welding, mechatronics and IT certification. In Maryland, the Southern Maryland Higher Education Center offers specific courses from ten different institutions, including Johns Hopkins and the University of Maryland. Though relatively new, these institutions are already establishing a track record of success. In South Boston, Virginia, for instance, the Southern Virginia Higher Education Center worked with more than 30 area industries and entrepreneurs in 2017, developed customized training for nearly 150 workers in local companies and placed 173 students into new jobs (8).

Congress should encourage all states to make rural higher education a priority and help more states experiment with new models for accessing higher education in remote areas. One way to do this is to provide seed money in the form of Rural Higher Education Innovation Grants so that states can stand up pilots, evaluate the effectiveness of new models and scale up promising approaches. These grants moreover do not need to be large – the Pennsylvania legislature initially appropriated just $1.2 million to launch what is now NPRC.

As a start, Congress should set aside $10 million in competitive grant funding for states. Funding for these grants could come from an earmark of the money collected from the 1.4 percent excise tax on large university endowments included in the 2017 tax legislation (9).

Read Here: New Ideas For a Do Something Congress No. 5

A Look Inside Monument Academy, a D.C. Public Charter School Designed to Serve Students in Foster Care

Posted on February 22, 2019September 18, 2024 by The Progressive Policy Institute

The industrial-era public education system that America inherited from the last century no longer works for the majority of students. Because it is highly centralized and assigns students to schools based on their home address, it produces cookie-cutter schools that treat all children the same. However, that educational model is profoundly unfair to the majority of America’s children. Kids come from different backgrounds. They speak different languages. They have different interests and different learning styles. They arrive at school on different academic levels.

Whereas traditional public schools attempt to treat most students the same, public charter schools attempt to create best-fit learning environments that meet the specific needs and interest of their students.

When children land in the right school, they flourish in surprising ways.

Nowhere is this more evident than in Washington, D.C. The District has a universal enrollment, and nearly 50 percent of the public school students attend charter schools whose leaders have the autonomy to control their school designs and influence school culture. As a result, the District’s charter sector has an extraordinary number of innovative learning models– STEM, Classics-based, dual-language immersion, Montessori, etc.– creating a variety of educational options so that each student can find a best-fit school.

Reinventing America’s Schools and The 74 recently highlighted some of these unique schools in our Schools of the Future series. However, because D.C. has so many innovative schools, we simply couldn’t cover them all. As such, we encourage you to read Harvard Ed. Magazine’s piece on Monument Academy, a D.C. public charter school designed to serve kids in foster care.

Read the story here.

Valentine for BlackPressUSA, “Developing a universal enrollment system for all Memphis public schools”

Posted on February 21, 2019September 18, 2024 by The Progressive Policy Institute

On any given day, you can find Sarah Carpenter organizing parents in the Memphis area. A single mother of four daughters and 13 grandchildren, Carpenter was an advocate long before becoming co-founder and CEO of The Memphis Lift, which she describes as “a parent organization run by parents, for parents.”

Born and raised in North Memphis, Carpenter says her experience as a single parent prepared her to lead The Memphis Lift. “I have always been an advocate for my daughters and for other’s kids,” she says. “I started in 1995 when I was asked to help open a Family Resource Center in a high school and students without involved parents in their lives took to me. Parents would stop me and say, ‘They are passing my son on to High School and he can’t even read.”

Carpenter and her fellow co-founders met during the training component of a public advocate fellowship funded by the Memphis Education Fund, which educated parents about the landscape in Shelby County Schools (SCS). At the time, SCS had the highest number of “priority schools” –those in which student scores on state exams ranked in the bottom five percent – in Tennessee.

Carpenter and her colleagues have since visited more than 10,000 homes to educate others on the state of Memphis’s schools. SCS students can attend four categories of schools: traditional neighborhood schools, charter schools, charter schools in the state-run Achievement Schools District, and schools in the district’s Innovation Zone.

For Carpenter and her organization, ensuring that all parents – regardless of income – have access to all the options SCS has to offer is paramount.

Continue reading at BlackPressUSA.

Bledsoe for USA Today, “Trump border emergency is fake and climate crisis is real. Guess which just got funded?”

Posted on February 19, 2019September 18, 2024 by The Progressive Policy Institute

Donald Trump funds ’emergency’ border wall but relief for victims of wildfires, storms and other climate change-fueled catastrophes must wait.

One emergency, the border wall, is fake, invented by a rogue president desperate for a political win no matter the price. Another, the climate crisis, is real, with tens of millions of citizen victims around the country. Guess which one got funded?

President Donald Trump is risking a constitutional crisis by declaring a false national emergency to fund a border wall that his own government experts say isn’t needed and won’t work, and of which he himself says, “I didn’t need to do this.”

Meanwhile, the bill Trump signed last week to keep the government open leaves out tens of billions of dollars of relief for American citizens who are victims of hurricanes, wildfires and other disasters made worse by climate change.

This should not be a shock to anyone paying close attention. Acting White House Chief of Staff Mick Mulvaney, reacting to earlier reports, last week pointedly denied that the administration would raid relief funds designated for victims of storms and wildfires to get money for Trump’s dubious border wall.

The president, who denies basic climate science and is rolling back key climate protections, would have been taking money from its victims to escape the consequences of his own manufactured government-shutdown crisis — all to build a wall that will be ineffective and even counterproductive in improving border security.

A firestorm of criticism prevented that. Yet here we are about a month later with much the same outcome.

Continue reading at USA Today.

Marshall for Medium: “Will the Senate Defend Our Constitution?”

Posted on February 15, 2019September 18, 2024 by The Progressive Policy Institute

By declaring a national emergency to build a border wall, President Trump has crossed the Rubicon. He has turned a cheap partisan stunt into a bona fide Constitutional crisis.

Congress this week declined to give Trump all the money he demanded to wall off Mexico from the United States. The president has declared an emergency explicitly to defy the will of Congress and usurp its Constitutional power to raise and spend public money. In his contempt for democratic norms, Trump makes no effort to conceal the fact that the alleged ‘emergency’ on the border is a political contrivance to assert his will. Having failed to extort wall funding from Congress through the longest government shutdown in U.S. history, he is willing to violate the Constitution to get a political ‘win.’

Read the full piece on Medium by clicking here.

Press Release: Will the Senate Defend Our Constitution?

Posted on February 15, 2019 by The Progressive Policy Institute

WASHINGTON—Will Marshall, President of the Progressive Policy Institute, today released the followed statement after President Trump declared a national emergency to fund the border wall:

“By declaring a national emergency to build a border wall, President Trump has crossed the Rubicon. He has turned a cheap partisan stunt into a bona fide Constitutional crisis.

“Congress this week declined to give Trump all the money he demanded to wall off Mexico from the United States. The president has declared an emergency explicitly to defy the will of Congress and usurp its Constitutional power to raise and spend public money. In his contempt for democratic norms, Trump makes no effort to conceal the fact that the alleged ’emergency’ on the border is a political contrivance to assert his will. Having failed to extort wall funding from Congress through the longest government shutdown in U.S. history, he is willing to violate the Constitution to get a political ‘win.’

“This is a clear and cynical abuse of presidential power. Trump seems not to understand or care that U.S. presidents aren’t medieval monarchs, who can demand money from parliaments. Now he’s willing to politicize and trivialize presidential authority to declare national emergencies to fulfill a demagogic campaign promise. The White House will now seek to shift funds Congress has appropriated for national defense and other legitimate purposes to finance a stupid ‘solution’ to a non-existent problem.

“All friends of American democracy, regardless of outlook or party, must rally to the defense of the U.S. Constitution’s separation of powers. Shamefully, Senate Republicans have yet to stand up for the Constitution they’ve sworn to defend. Their supine unwillingness to put patriotism above partisanship means that Americans must trust to the courts to stop a rogue president.

“Trump’s power grab will no doubt give fresh impetus to efforts to impeach him. That’s understandable, but for now the wiser course for progressives is to keep the pressure on the Senate to defend its Constitutional powers and institutional prerogatives, and to use all legal means to prevent Trump from spending public money without Congressional authority. We need to keep the public focused clearly on how deeply Trump is damaging not just our political system, but now also the Constitutional framework that has enabled American democracy to endure through genuine national emergencies.”

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New Ideas for a Do-Something Congress No. 4: “Expand Access to Telehealth Services in Medicare”

Posted on February 14, 2019 by The Progressive Policy Institute

America’s massive health care industry faces three major challenges: how to cover everyone, reduce costs, and increase productivity. Telehealth – the use of technology to help treat patients remotely – may help address all three. Telehealth reduces the need for expensive real estate and enables providers to better leverage their current medical personnel to provide improved care to more people.

Despite its enormous potential, however, telehealth has hit legal snags over basic questions: who can practice it, what services can be delivered, and how it should be reimbursed. As is the case with any innovation, policymakers are looking to find the right balance between encouraging new technologies and protecting consumers – or, in this case, the health of patients.

Telehealth policy has come a long way in recent years, with major advances in the kinds of services that are delivered. Yet a simple change in Medicare policy could take the next step to increase access and encourage adoption of telehealth services. Currently, there are strict rules around where the patient and provider must be located at the time of service – these are known as “originating site” requirements – and patients are not allowed to be treated in their homes except in very special circumstances. To expand access to telehealth, Congress could add the patient’s home as an originating site and allow Medicare beneficiaries in both urban and rural settings to access telehealth services in their homes.

THE CHALLENGE: LEGAL BARRIERS LIMIT THE POTENTIAL FOR TELEHEALTH TO INCREASE ACCESS TO PATIENT CARE.

Under Medicare, telehealth is defined as “the use of electronic information and telecommunications technologies to support long-distance clinical health care” (1). Each program in Medicare – traditional Medicare, Medicare Advantage, and Medicare demonstration projects – has unique rules limiting when and how telehealth can be used. Because Medicare Advantage has different rules governing telehealth, this brief is specifically focused on the roughly 39 million seniors enrolled in traditional fee-for-service Medicare (2).

In traditional, fee-for-service Medicare, the Social Security Act defines how telehealth services may be covered. As amended in 1997, the law limits telehealth to services that are furnished to beneficiaries in certain types of geographic areas: either a rural health professional shortage area (HPSA) or a county outside of a Metropolitan Statistical Area (MSA). Besides being in a qualifying rural area, the originating site – or where the patient is located – is required to be at a physician office, hospital, rural health center, skilled nursing facility, federally qualified health center, community mental health center, or a hospital-based dialysis facility. In those facilities, patients can receive care remotely from 10 types of distant site clinicians qualified to deliver telehealth services. In other words, traditional Medicare beneficiaries, except in special circumstances, cannot receive telehealth services in their homes.

Though the Centers for Medicare and Medicaid Services (CMS) cannot authorize new originating sites without Congress, it does have the authority to decide which telehealth services are payable under the Medicare Physician Fee Schedule. In 2019, that schedule includes roughly 100 billing codes covering consultations, psychiatric care, smoking cessation, end-stage renal disease management, nutrition counseling, new and existing patient evaluation and management services, and post-nursing facility care. It’s clear that many of these services – particularly psychiatric care and smoking cessation – should not require the patient to drive into a qualifying medical facility and could be effectively delivered in the home.

More beneficiaries could benefit from increased access to telehealth.

To modernize telehealth delivery, Congress directed CMS under the 21st Century Cures Act and the Bipartisan Budget Act of 2018 to start relaxing some telehealth rules in 2019. Thanks to this legislation, beneficiaries under traditional Medicare now have access to a range of telehealth services that fall outside the parameters listed above, including at home. These include:

Allowing Accountable Care Organizations (ACOs) to furnish telehealth services in the beneficiary’s home regardless of geographic location
Permitting ACOs to use teledermatology and teleophthalmology services provided through asynchronous store-and-forward telehealth* technologies
Expanding coverage of telestroke services – a service where emergency department clinicians can consult with stroke specialists in distant locations – to all geographic areas
Providing individuals with end-stage renal (ESRD) disease monthly ESRD-related clinical assessments via telehealth at home after first receiving a face-to-face appointment

Despite these advances, there are still many instances where Medicare beneficiaries
could benefit from telehealth from home but are not permitted to do so under current rules.

It is no surprise that telehealth utilization in traditional Medicare remains low. Though utilization increased between 2014 and 2016, only 90,000 traditional Medicare beneficiaries used 275,199 telehealth services in 2016. This represents roughly a quarter of 1 percent (0.25 percent) of the more than 35 million fee-for-service Medicare beneficiaries included in CMS’s telehealth analysis. Interestingly, growth was highest among the oldest group – those beneficiaries over 85. The data show that 85.4 percent of the traditional Medicare beneficiaries using telehealth services had at least one mental health diagnosis – and that psychotherapy was one of the most used telehealth services. The data also show that telehealth use is higher in states with large rural areas or HPSA. This, no doubt, reflects the legal requirement that patients must be in such areas to receive telehealth services (3).

By adding the patient’s home as an originating site in traditional Medicare, patients in urban or other underserved areas could also benefit from using telehealth services in their homes. Roughly 80 percent of seniors have one chronic disease and 68 percent have two or more (4). Telehealth can help patients better manage their conditions in the convenience of their own home. According to a 2017 GAO report, a Veterans Health Administration’s (VHA’s) program – that provided home-based telehealth services to veterans with chronic conditions – resulted in a 40 percent reduction in hospitalizations (5).

Telehealth could reduce costs.

In addition to expanding access to high-quality medical services to people in underserved areas, telehealth may also save money. This is crucial because, as Medicare’s Trustees warn year after year, the nation’s health-care program for seniors faces serious financial challenges that threaten its ability to meet its obligations to future beneficiaries. Though it used to have budget surpluses, now, each year, the hospital insurance (HI) fund, which covers Medicare Part A, runs a chronic deficit (6).

Virtual visits are cheaper than in-person care, on average, in the commercial insurance market. In the commercial market, telehealth visits cost roughly $100 less per visit than in-person visits. Generally, virtual consultations are priced at $40–50, while office visits check in at $136–$176 (7). In Medicare, however, online visits are priced the same as in-person visits and usually involve a facility fee to cover the patient’s visit to a medical facility. Savings could be realized from serving patients in home and eliminating redundant facility fees (8).

THE GOAL: EXPAND ACCESS TO TELEHEALTH SERVICES AS A WAY TO IMPROVE ACCESS AND POTENTIALLY REDUCE MEDICARE COSTS

Commercial plans generally permit telehealth originating sites in both rural and urban areas, though they vary with coverage of services provided while the patient is at home. While expanding the coverage of telehealth services in Medicare may increase costs initially, those extra costs could be justified by both the expanded access and the better outcomes telehealth services could deliver. Moreover, in the long run, helping patients manage chronic conditions, avoid hospitalizations, and reduced facility fees will save money.

For example, one program focused on providing acute care at home for older, vulnerable patients with one of nine conditions – exacerbations of congestive heart failure, chronic obstructive pulmonary disease, community-acquired pneumonia, cellulitis, deep venous thrombosis, pulmonary embolism, complicated urinary tract infection or urosepsis, nausea and vomiting, and dehydration – found a 38 percent reduction in mortality for patients treated at home. Appropriately titled “Hospital at Home” outpatients had comparable or better clinical outcomes and saved an average of 19 percent relative to similar hospital inpatients. Among the important components of this program were “telehealth nurses,” who monitored patients’ vital signs remotely via telehealth units installed in patients’ homes (9).

There is an ongoing debate between advocates of telehealth who argue that expanding services increases access to care and other policymakers who caution that telehealth may not act as a substitution for in-person services and instead increase unnecessary utilization without improving outcomes. Because telehealth has been limited to-date, the data are mixed. However, there is clear potential to improve access and convenience, and, over time, that could improve outcomes.

THE PLAN: EXPAND ACCESS TO TELEHEALTH BY ALLOWING REIMBURSEMENT UNDER TRADITIONAL MEDICARE FOR APPROVED TELEHEALTH SERVICES DELIVERED TO PATIENTS’ HOME

Rather than slowly increasing the sites and services allowed under telehealth, Congress should allow CMS to authorize a patient’s home as an originating site so clinicians can deliver medically necessary services via telehealth to patients’ homes.

There’s a precedent for abolishing originating site rules. In 2016, the Department of Defense (DoD) announced that a patient’s home would qualify as an originating site as long as the provider worked at a military treatment facility. Additionally, California has recently proposed abolishing originating site rules in its Medicaid program, saying telehealth originating sites can include, but are not limited to, “a hospital, medical office, community clinic, or the patient’s home.” By expanding the definition of “originating site,” California is moving to allow clinicians to provide more telehealth services. These changes are too recent to have garnered data, but it is clear that other agencies are looking to expand access to telehealth.

Congress should follow suit. Lawmakers could significantly expand access to services by amending the Social Security Act clause that governs originating site rules and expanding the definition to include the patient’s home as a qualifying originating site.

Telehealth has come a long way since it was first authorized under Medicare in 1997. But the laws governing telehealth from 20 years ago are outdated. It’s time to allow Medicare recipients to get telehealth services in their home.

* When health-care providers review patient medical information like lab reports, imaging studies, videos, and other records at another location and at a time that is convenient for them. The service is not delivered in real time.

[gview file=”[gview file=”https://www.progressivepolicy.org/wp-content/uploads/2019/02/PPI_NewIdeas_Telehealth_FINAL.pdf”]

ENDNOTES

1) Health Resources and Services Administration Federal Office of Rural Health Policy. Available from: https://www.hrsa.gov/ruralhealth/telehealth/

2) Medicare Enrollment Dashboard, “Hospital/Medical Enrollment,” Centers for Medicare and Medicaid Services, October 2018. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/Medicare-Enrollment/Enrollment%20Dashboard.html.

3) “Information on Medicare Telehealth,” Centers for Medicare & Medicaid Services, 2018.
https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Information-on-Medicare-Telehealth-Report.pdf.

4) “By the Numbers: The Impact of Chronic Disease on Aging Americans,” CVS Health, January 2017.
https://cvshealth.com/thought-leadership/by-the-numbers-the-impact-of-chronic-disease-on-aging-americans.

5) “Information on Medicare Telehealth,” Centers for Medicare & Medicaid Services, 2018.
https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Information-on-Medicare-Telehealth-Report.pdf.

6) “OASDI and HI Annual Income Rates, Cost Rates, and Balances,” Social Security Administration, 2018. https://www.ssa.gov/oact/tr/2018/lr6g2.html.

7) Daniel H. Yamamoto, “Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services,” Red Quill Consulting, December 2014.
https://www.connectwithcare.org/wp-content/uploads/2014/12/Medicare-Acute-Care-Telehealth-Feasibility.pdf.

8) Ibid.

9) Lesley Cryer, Scott B. Shannon, Melanie Van Amsterdam, and Bruce Leff, “Costs For ‘Hospital At Home’ Patients Were 19 Percent Lower, With Equal Or Better Outcomes Compared To Similar Inpatients,” Health Affairs 31, no. 6 (2012): 1237-1243, https://content.healthaffairs.org/content/31/6/1237.full.

Bledsoe for Forbes, “Green New Deal Must Grow Up Fast To Influence Bills Congress is Already Writing”

Posted on February 13, 2019September 18, 2024 by The Progressive Policy Institute

Little noticed in the media circus surrounding the mere introduction of a non-binding Congressional resolution on the Green New Deal was the deletion of much-criticized and plainly unachievable mandates contained in previous GND versions.

Gone was the impossible diktat requiring 100% renewable energy for the entire economy by 2030. Missing was the politically suicidal and practically infeasible flat-out prohibition on fossil fuels in little more than a decade. Even extraneous language on guaranteed jobs in the resolution had been watered down from earlier texts, and would of course never be a legal requirement in actual climate legislation that passes Congress in any event.

In fact, the more extreme provisions in the GND have served largely to provide Trump and other Republican anti-climate action forces with irresistible political fodder. Republicans hope to scare the American people into opposing sensible climate actions by invoking GND extremism, and have already produced ads with these themes.

Continue reading at Forbes.

Escaping the Startup Trap: Can Policymakers Help Small Companies Grow to Major Employers?

Posted on February 12, 2019 by The Progressive Policy Institute

Starting a new business is hard. Scaling it up to a significant size is harder. Europeans have long fretted about their lack of ‘unicorns’— privately held startups with a valuation of more than $1 billion. More generally, there is a sense that European startups either fail to grow or are bought out by larger companies before they go public or create a significant number of new jobs.

A January 2019 analysis by CB Insights showed only 33 European unicorn companies, compared to 83 in China and 150 in the United States. For example, SoundCloud, an online audio platform, was founded in 2007 in Stockholm and later moved to Berlin. By 2016, it was valued around $700 million, and at one point sought a $1 billion valuation to be sold. However, by 2017, the company was on the verge of bankruptcy, abruptly fired 40 percent of its staff, and closed two offices. By August 2017, the company was valued at just $150 million. Or consider restaurant delivery firm Take Eat Easy, founded in Brussels in 2012. After a year, the company expanded to Paris and raised two rounds of venture capital funding in 2015. Take Eat Easy scaled from 10 to 160 employees and from 2 to 20 cities. But in 2016 Take Eat Easy shut down, citing revenue not yet covering fixed costs and an inability to raise a third round of funding.

Even in the relatively successful United States, it seems that new companies are scaling up less frequently than they used to. The Progressive Policy Institute analyzed Census Bureau data on business dynamics over time, focusing on “young” businesses—aged 6-10 years after being founded. We found that in 2014, 0.05% of young businesses were major employers, defined as having 1,000 or more workers. That’s half the 1994 rate when 0.1% of young businesses were major employers.

Telehealth and vision tests in Washington State

Posted on February 8, 2019 by The Progressive Policy Institute

Washington has long been a leader in both innovation and health care. Telehealth, which lays at the intersection of the two, is an innovative, cost-effective way to deliver health care to underserved populations. Seeing the value of telehealth, Washington State requires health insurance companies, Medicaid managed care plans, and health plans offered to Washington State employees to reimburse health care providers who provide health care services via telehealth technology.

The rules apply to both real-time transmitted appointments and to “store-and-forward” services which involve information, including images, data and labs, reviewed at a later time – though reimbursement for those services must be explicitly outlined in provider agreements. Telehealth shows particular promise at reducing the costs and hassle associated with renewing contact lens prescriptions.

Langhorne for The 74, “At D.C.’s Ingenuity Prep, Personalized Learning Hasn’t Replaced Teacher Time; It’s Put the Focus Back on Small Groups”

Posted on February 7, 2019 by The Progressive Policy Institute

When Aaron Cuny and Will Stoetzer were thinking about how they wanted to structure their own D.C. charter school back in 2012, they kept returning to the same question: “When were we doing the best work for kids?”

“For both of us, it came down to teaching in a small group setting, where you could think about how to reach kids individually rather than spending the majority of time and mental energy thinking about classroom management,” says Stoetzer.

Stoetzer was a special education teacher and Cuny a resident principal-in-training at D.C. Bilingual Public Charter School, a top-ranked elementary school in one of Washington’s middle-income neighborhoods. Both felt the city lacked quality educational options for kids in the neighborhoods that needed them most.

“In pockets across D.C., some schools had shown that when adults got it right, there was success at educating low-income kids,” says Stoetzer. “Schools like KIPP and D.C. Prep have been very purposeful about producing academic results for low-income kids. Their success inspired us, but we had differences in perspective about how that success might be accomplished.”

When they opened Ingenuity Prep a year later with Cuny as CEO and Stoetzer as COO, they located it in Ward 8, Washington’s poorest neighborhood, and built two essential components into the school’s design so that small group learning could be its main focus: co-teaching and computer-based learning.

Continue reading at The 74.

Investment Heroes 2018: Encouraging and Diffusing Innovation Throughout the Economy

Posted on February 6, 2019 by The Progressive Policy Institute

Despite the low unemployment rate, productivity growth is still stuck in slow gear. Non-farm business output per hour increased by 1.3 percent from the third quarter of 2017 to the third quarter of 2018 – well below the post- war average of 2.2 percent.1 Other countries around the world are also grappling with this slowdown in productivity growth.2 Productivity growth is the primary factor in boosting wages and living standards.

The continued lack of productivity growth arises from several causes. One important issue is a growth shortfall in the amount of capital relative to the amount of labor, where capital represents investment in equipment, structures, software, and other intellectual property.

The Bureau of Labor Statistics (BLS) calculates a measure it calls “capital intensity,” which measures the services produced by capital assets relative to the number of labor hours worked in the non-farm business sector. As shown in Figure 1, capital intensity has grown much more slowly over the past 10 years than in previous 10-year periods.

There has been much debate over the reasons for this shortfall. Some have suggested that corporate managers and stock market investors have become myopic and too focused on short-run returns. Others blame excessive regulation.

But, no matter the reason for the investment shortfall, we think it’s important to identify those companies that are bucking the trend. Starting with our 2012 “Investment Heroes” report, and continuing through this report, we have focused on identifying those companies making the largest capital investments in the United States. By expanding the capital stock, these companies are helping boost productivity and wages, and creating new jobs.

The Progressive Policy Institute’s (PPI) Investment Heroes report provides an exclusive estimate of domestic capital spending for major U.S. companies. Currently, accounting rules do not require companies to report their U.S. capital spending separately. To fill this gap in the data, we created a methodology using publicly-available financial statements from non-financial Fortune 150 companies to identify the top companies that were investing in the United States. That methodology, with small modifications, has been used in each year’s report since the first in 2012.

The Google GDPR Fine: Some Thoughts

Posted on February 1, 2019September 18, 2024 by The Progressive Policy Institute

The GDPR will mean big changes in the way that European and U.S. companies do business in Europe. As we noted at a recent privacy panel, rather than being a matter of speculation, its economic impact has become an empirical question. Will the tighter privacy protections of the GDP slow growth and innovation, as skeptics claim, or will these provisions increase consumer trust and usher in a new era of European digital gains, as supporters say? We await the answers to these questions with great interest.

However, the enforcement stage of the GDPR has not gotten off on the right foot. CNIL, the French National Data Protection Commission, just fined Google 50 million euros for what they called “lack of transparency, inadequate information and lack of valid consent regarding the ads personalization.” The fines were based in part on complaints filed by privacy groups on May 25, 2018, the very day that the GDPR went into effect. Moreover, the complaints were filed in France, despite that fact that Google’s European headquarters are in Ireland.

The location of the complaints is relevant because the most straightforward reading of the GDPR’s “one-stop-shop” principle suggests that the location of a company’s European headquarters is the main factor determining the company’s lead regulator for GDPR purposes. That’s not the only criterion, for sure, but it was only natural for the Irish Data Protection Commission to take the lead role in regulating Google.

The fact that the privacy organizations filed their complaints with France, not Ireland, suggests that they were forum-shopping–looking for a country which would look favorably on the issues they raised. Moreover, France’s willingness to jump to the front of the regulator queue suggests that they were interested in setting a precedent, rather than letting the GDPR process unfold.

Finally, an important part of the rationale behind the GDPR was to further move towards a digital single market, by allowing companies to only deal with a single privacy regulator. If other countries follow France’s lead and find reasons to levy data protection-related fines on multinationals that have their European headquarters elsewhere, then the GDPR will end up fragmenting markets, rather than making them more consistent. That’s a losing proposition for everyone.

Langhorne for The 74, “Creating the Next Generation of Digital Innovators at Washington, D.C.’s First Computer Science-Focused Middle School”

Posted on January 31, 2019 by The Progressive Policy Institute

When I finish writing the statement, that cat will move,” promises Deshaunte’ Goldsmith, a sixth-grader at Digital Pioneers Academy Public Charter School. She presses enter on the keyboard and, sure enough, the animated cat on her screen begins to pace back and forth.

Goldsmith is a member of the founding class at the school knows as DPA, Washington, D.C.’s first computer science-focused middle school. Opened in August, the school is small, serving about 120 sixth-grade students across four classes but has plans to build out to 12th grade. Every day, students take computer science as a part of their core curriculum.

Today, in computers science, Goldsmith is learning how to write conditional statements — such as if the space bar is pressed, the cat will jump — using MIT’s animation-based platform Scratch. First, the students have to identify conditional statements, and then they have to write their own. At the end of class, they have to find and correct the error intentionally planted in the teacher’s code.

“The error’s in the third line of code,” Goldsmith says. “It’s missing part of the conditional statement.”

DPA occupies the second floor of Washington Heights Baptist Church in the Hillcrest neighborhood of the city’s seventh ward. Ninety-eight percent of the students come from wards seven and eight, D.C.’s poorest neighborhoods, and, because DPA’s leadership recruited heavily in the local area, two-thirds of the students went to the neighborhood elementary schools.

Continue reading at The 74.

Press Release: PPI Urges Support for Bipartisan Legislation to Ensure Congressional Review of National Security Tariffs

Posted on January 30, 2019 by The Progressive Policy Institute

WASHINGTON— Ed Gerwin, Senior Fellow for Trade and Global Opportunity at the Progressive Policy Institute (PPI), today released the following statement in response to the introduction of the bipartisan, bicameral Congressional Trade Authority Act:

PPI welcomes the introduction of the Congressional Trade Authority Act by Representatives Ron Kind (D-WI) and Michael Gallagher (R-WI) and Senators Pat Toomey (R-PA) and Mark Warner (D-VA). We urge Congress to enact this responsible and balanced legislation.

The bill would amend the Trade Expansion Act of 1962 to provide Congress with new tools to oversee and either approve or reject the use of tariffs or other trade restrictions for national security purposes. Under the bill, national security trade restrictions proposed by the president would require congressional approval under an expedited, 60-day procedure. National security tariffs imposed within the past four years would also, retroactively, be subject to congressional review. Other reforms in the bill would include tightening the definition of “national security” to prevent the abuse of congressionally delegated powers to restrict trade for security reasons.

As PPI has explained in a recent policy brief, legislation like the Congressional Trade Authority Act is needed to restore an appropriate balance between Congress and the president in the exercise of trade and tariff powers.

Article I, Section 8 of the U.S. Constitution empowers Congress to “lay and collect . . . duties” and “regulate commerce with foreign nations.” For almost a century, in exercising these powers, Congress has delegated significant authority to the president, including the power to restrict import trade for national security reasons.

Past presidents have generally used these delegated security powers prudently. The Trump Administration has not. Instead, it’s imposed “national security” tariffs and quotas on imports of aluminum and steel from longstanding U.S. allies with scant security justification. And the President has threatened to impose “national security” tariffs—to be paid ultimately by American drivers—on imported autos, as well. As PPI has detailed, the Administration’s unfocused tariffs and trade restrictions have cost jobs for American workers, raised prices for American families, increased costs for businesses and state and local governments, and led to crushing retaliation against American exports.

When he signed the Trade Expansion Act of 1962, President Kennedy advocated building stronger trade alliances and warned against “stagnating behind tariff walls.” At the same time, as PPI has explained in the context of China’s technology theft, smart and targeted trade restrictions are sometimes required to address critical national security threats. Congress has crucial roles to play in both promoting open trade and protecting national security. The balanced reforms contained in the Congressional Trade Authority Act would help Congress better exercise these important responsibilities.

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