Breaking the Language Barrier: A Report on English Language Services in Greater Boston

Assesses Massachusetts' English for Speakers of Other Languages system, demand and supply for services, their quantity and quality, and challenges such as lack of coordination. Recommends ways to reduce gaps in services and raise efficiency and quality

Enhancing Employment Opportunities for Mature Workers Through Training: Case Studies of Employment Services in Massachusetts

Extension of working years among those approaching “normal” retirement ages is receiving increased attention. Much of the impetus is financial. The weakening of private pension systems is leaving increasing numbers of those approaching retirement with inadequate savings. Rising health care costs and the erosion of retiree health benefits also encourages older workers to remain in the workforce. The current recession has greatly escalated the financial concerns of those who are late in their working lives. With the deterioration of financial markets, the values of 401K portfolios have declined enormously. Further, the decline in home prices has left many with substantial reductions in home equity. In addition, some mature workers are among those with home mortgages that exceed the market values of their homes

Pandemic Governance

The COVID-19 pandemic created an unprecedented need for governance by a multiplicity of authorities. The nature of the pandemic—globally communicable, uncontrolled, and initially mysterious—required a coordinated response to a common problem. But the pandemic was superimposed atop our decentralized domestic and international governance structures, and the result was devastating: the United States has a death rate that is eighteenth highest in the world, and the pandemic has had dramatically unequal impacts across the country. COVID-19’s effects have been particularly destructive for communities of color, women, and intersectional populations. This Article finds order in the chaos of the pandemic response by distilling a typology for the predominant intergovernmental relationships that emerged. Two of these behaviors describe intergovernmental conflict. Governments undermined each other by destabilizing and criticizing each other’s actions. They did so at all levels: up (when local governments undermined states), down (when the federal government undermined states), and across (when the federal government undermined itself). Governments abdicated responsibility when they failed to act. Two additional behaviors describe intergovernmental coordination. Governments collaborated when they actively worked together, both vertically and horizontally, to harmonize their policies. And they engaged in bandwagoning when they avoided taking initiative in making pandemic policy, opting instead to follow the leads of others. We argue that these behaviors were the predictable result of well-worn structural and political dynamics. Structurally, pandemic policy lies uncomfortably on two poles of the federal-state division of responsibilities. Ambiguous hierarchies and overlapping roles pushed governments toward conflict rather than coordination. Politically, intense partisanship transformed nearly every governance decision into symbolic, two-sided national battles. These battles provided a default set of relationships that became organizing principles for the pandemic response. We use these insights to sketch the contours of a way forward. To address the role confusion that arose from our multi-sovereigned system of governance, we propose a federal pandemic statute that emphasizes and balances role clarity, state independence, and explicit governmental action that disrupts inequality. To lessen the pull of partisanship, we advocate for the creation of decentralized but inclusive subject-matter networks among international, federal, state, and local authorities

Analysis of Retirement Risk within Massachusetts State Agencies and Use of Post-Retirement Contracting as a Workforce Planning Tool

The public sector is at risk for skills shortages resulting from the retirement of older workers, mainly Boomers, who will be exiting the labor force over the next 5 to 10 years. In Massachusetts, state agencies are recognizing the potential risk to operations resulting from these impending retirements, and agency leaders are beginning to question what can be done to retain older workers, particularly those in leadership, technical or specialized job titles. Incentivizing older workers to continue working beyond the normal retirement age is difficult within the Massachusetts Public Employee Pension System, which is designed to encourage workers to retire after reaching the maximum pension benefit. Agencies have one policy tool at their disposal to mitigate knowledge or skill loss from retirements; a mechanism within the pension laws that allows retirees to return to work as a contract employee. This policy has important implications for state agencies interested in retaining skilled employees, as well as retirees who need to maximize their post-retirement income or wish to continue to work for other reasons. This dissertation will utilize multiple methods and analyses to 1) determine the retirement risk faced by agencies in the Health and Human Services Secretariat, 2) measure the historical utilization of post-retirement contracting, 3) predict future use of such contracting, and 4) analyze the effectiveness and efficiency of the post retirement contracting policy versus other policy options for retaining experienced staff

Pandemic Governance

The COVID-19 pandemic created an unprecedented need for governance by a multiplicity of authorities. The nature of the pandemic—globally communicable, uncontrolled, and initially mysterious—required a coordinated response to a common problem. But the pandemic was superimposed atop our decentralized domestic and international governance structures, and the result was devastating: the United States has a death rate that is eighteenth highest in the world, and the pandemic has had dramatically unequal impacts across the country. COVID-19’s effects have been particularly destructive for communities of color, women, and intersectional populations. This Article finds order in the chaos of the pandemic response by distilling a typology for the predominant intergovernmental relationships that emerged. Two of these behaviors describe intergovernmental conflict. Governments undermined each other by destabilizing and criticizing each other’s actions. They did so at all levels: up (when local governments undermined states), down (when the federal government undermined states), and across (when the federal government undermined itself). Governments abdicated responsibility when they failed to act. Two additional behaviors describe intergovernmental coordination. Governments collaborated when they actively worked together, both vertically and horizontally, to harmonize their policies. And they engaged in bandwagoning when they avoided taking initiative in making pandemic policy, opting instead to follow the leads of others. We argue that these behaviors were the predictable result of well-worn structural and political dynamics. Structurally, pandemic policy lies uncomfortably on two poles of the federal-state division of responsibilities. Ambiguous hierarchies and overlapping roles pushed governments toward conflict rather than coordination. Politically, intense partisanship transformed nearly every governance decision into symbolic, two-sided national battles. These battles provided a default set of relationships that became organizing principles for the pandemic response. We use these insights to sketch the contours of a way forward. To address the role confusion that arose from our multi-sovereigned system of governance, we propose a federal pandemic statute that emphasizes and balances role clarity, state independence, and explicit governmental action that disrupts inequality. To lessen the pull of partisanship, we advocate for the creation of decentralized but inclusive subject-matter networks among international, federal, state, and local authorities

Pandemic Governance

The COVID-19 pandemic created an unprecedented need for governance by a multiplicity of authorities. The nature of the pandemic—globally communicable, uncontrolled, and initially mysterious—required a coordinated response to a common problem. But the pandemic was superimposed atop our existing decentralized and uncoordinated governance structures, and the result was devastating: the United States led the world in COVID-19 infections and deaths. COVID-19’s effects have been particularly destructive for communities of color, women, and intersectional populations. This Article makes sense of the early pandemic response by distilling a typology for the predominant intergovernmental relationships that emerged, some conflictual and some collaborative. Governments undermined each other by destabilizing each other’s actions upward (when local governments undermined states), downward (when the federal government undermined states), and across (when the federal government undermined itself). They abdicated responsibility by failing to act. Governments collaborated by actively working together to harmonize policies. And they engaged in bandwagoning to avoid being the first mover in making pandemic policy, opting instead to follow or oppose the leads of others. Despite the seeming chaos of the early pandemic response, these behaviors were the predictable result of well-worn structural and political dynamics. Structurally, pandemic policy lies uncomfortably on two poles of the federal-state division of responsibilities. Ambiguous hierarchies and overlapping policy roles pushed governments toward conflict rather than coordination. Politically, intense partisanship transformed nearly every governance decision into symbolic, two-sided battles, providing a default set of relationships that became organizing principles for the early pandemic response. This Article uses these insights to sketch the contours of a way forward. It proposes a federal pandemic statute that emphasizes role clarity, state independence, and explicit governmental action to disrupt inequality. It additionally advocates for decentralized but inclusive subject-matter networks among federal, state, and local authorities to lessen the pull of partisanship

Correlation of Provider Burnout With Patient Experience

Initiatives to mitigate physician burnout and improve patient experience occur largely in isolation. At the level of the department/division, we found lower physician burnout was associated with a more positive patient experience. Physician Maslach Burnout Inventory data and patient Consumer Assessment of Healthcare Providers and Systems Clinician and Group experience scores were significantly correlated with 5 of 12 patient experience questions: “Got Routine Care Appointment” (−0.632, P = .001), “Recommend Provider” (−0.561, P = .005), “Provider Knew Medical History” (−0.532, P = .009), “Got Urgent Care Appointment” (−0.518, P = .014), and “Overall Rating” (−0.419, P = .047). These correlations suggest burnout and experience might be better addressed in tandem. Principles to guide an integrated approach are suggested. </jats:p