Commons committee recommends significant increase in funding for AIDS strategy

A House of Commons committee says that current funding for the Canadian Strategy on HIV/AIDS should be more than doubled. It calls for designated funding for inmates and First Nations and Inuit peoples, and for HIV vaccine research. Finally, it says that more federal government departments need to become involved in the response to AIDS.     

Correctional Service Canada to undertake Safer Tattooing Practices Initiative

In 1994, the Expert Committee on AIDS and Prisons recommended that tattooing equipment and supplies be authorized for use in federal correctional institutions, and that prisoners who would offer tattooing services to other prisoners be instructed on how to use tattooing equipment safely. Ten years later, Correctional Service Canada (CSC) has finally announced that, as part of a Safer Tattooing Practices Initiative, it will set up safer tattooing pilot projects in six federal prisons in 2004, and evaluate the initiative.     

Telemedicine--the diagnostic tool of the future

The most immediate concern in the development of telemedicine programs, technology, and equipment is the continuation of federal funding. As Congress continues its efforts to balance this year's federal budget, funds for research generally and particularly for the pilot programs discussed above could be cut or eliminated. Federal funding is surprisingly important to the rapid maturation of telemedicine. Without these pilot projects, HCFA believes that it would be unable to assess the effect of Medicare reimbursement for telemedicine consultations. Without such assessment, HCFA may be unwilling to relax the current restrictions on reimbursement for telemedicine outside of pilot programs. HMOs and third-party payors would then be less likely to support telemedicine programs and reimburse providers who participate in them. Similarly, without the promise of federal or private reimbursement, the telecommunications industry will find it harder to justify continuing research and development in new technologies. Nonetheless, even a complete elimination of all federal research monies is likely only to slow the growth of telemedicine, not stop it.     

Federal funding formulas and the 1980 census

Distribution of federal funds has achieved equal status with Congressional reapportionment as a motivation and justification for the Census of Population and Housing. This article describes the effects that U.S. population redistribution during the 1970s, as measured by the 1980 Census, will have on the spatial distribution of federal grants-in-aid provided to state and local governments through programs with formula-based funding systems. The conclusion is that funding changes will not match population changes. The overall redistribution of federal grants-in-aid to state and local governments occurring in response to incorporation of 1980 Census population counts into federal funding formulas will be far less than the level of population redistribution since 1970. Use of intercensal data, formula specifications, limited geographic specificity in many formula allocations, and nonformula determinants of formula-based grants all weaken the relationship between Census-measured population change and the receipt of federal funds at the local level. Despite all the intervening factors, it is probably that in many programs there will be some redistribution of funds when the 1980 Census counts are incorporated into the allocation formulas. But the importance of measurement errors and threshold and reclassification effects may equal that of true population change in determining the funds received by local communities.     

Drug policy in Canada--the way forward

This article is one of a series commissioned to mark the tenth anniversary of the Canadian HIV/AIDS Legal Network, discussing past developments and future directions in areas of policy and law related to HIV/AIDS. It takes a critical look at Canada's drug policy. Despite calls for a balanced approach focused on reducing drug-related harm, Canada's method of dealing with problems of illicit drug use has remained prohibitionist in nature, and by far the greatest part of federal funding is devoted to supply-reduction initiatives. Considerable changes in policy and law are needed to significantly reduce the harms associated with injection drug use in Canada. These include developing a comprehensive and integrated strategy, exploring alternative legal frameworks, piloting innovative approaches to reducing injection-related harms, and investing in broad social policies that address the determinants of injection drug use.     

Medical liability and health care reform

We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.     

Attracting federal research funds: Why so much from so many goes to so few

This paper addresses the question of the distribution of federal research funds. It is noted that the top five institutions in terms of federal funding occupy very stable and extremely high rankings in terms of the quality of their academic programs in a variety of fields. It is suggested that this is part of their overall strategy for achieving organizational effectiveness. The implications for technology generation and transfer are discussed. In view of the various theories of organizational effectiveness, it is noted that research oriented universities that consistently win in the quest for federal research funds have developed both the structure and atmosphere necessary for responding to external groups.     

State Medicaid reform under Section 1115 demonstration authority

Given the complexity of federal Medicaid law and the limitations it imposes on state flexibility, it is likely that states will continue to ask the Secretary to grant waivers under Section 1115 to allow them to pursue new approaches to health care reform. The results of currently operational Section 1115 projects involving statewide managed care systems will be useful in evaluating the Medicaid reform measures currently under discussion in other states and at the federal level. In particular, the ability of the states to control Medicaid and indigent care costs and to utilize federal dollars more efficiently should prove important in evaluating a block grant approach to federal Medicaid funding. Moreover, Section 1115 project results that bear on the sufficiency of various Medicaid capitation rate methodologies will also be of value as more states expand the use of managed care arrangements for their Medicaid populations.     

Barack Obama vs Bristol Palin: why the President’s sex education policy wins

The federal government has exponentially increased funding for abstinence‐only sex education over the last few decades, a position supported by former vice‐presidential candidate Sarah Palin’s daughter Bristol. Unfortunately, empirical research indicates that abstinence‐only education is ineffective and may have negative consequences for adolescents. Despite encouragement of abstinence, adolescents continue to engage in sexual relationships, indicating that a different approach to sex education should be supported. This situation raises a number of justice issues because it is important for the government to fund sex education curricula that instruct adolescents on how to protect themselves from pregnancy and STDs. The majority of parents also disagree with the federal funding of abstinence‐only education and support more comprehensive education. This indicates that funding abstinence‐only education is diametrically opposed to community sentiment. Federal funding of abstinence‐only sex education is also problematic as such policies violate a number of adolescents’ constitutional rights. Therefore, the federal government must revise its current sex education policies. President Obama’s proposed plan has the potential to overcome many of these issues associated with abstinence‐only education.     

How Brazil outpaced the United States when it came to AIDS: the politics of civic infiltration, reputation, and strategic internationalization

Using a temporal approach dividing the reform process into two periods, this article explains how both Brazil and the United States were slow to respond to AIDS. However, Brazil eventually outpaced the United States in its response due to international rather than democratic pressures. Since the early 1990s, Brazil's success has been attributed to "strategic internationalization": the concomitant acceptance and rejection of global pressure for institutional change and antiretroviral treatment, respectively. The formation of tripartite partnerships among donors, AIDS officials, and nongovernmental organizations has allowed Brazil to avoid foreign aid dependency, while generating ongoing incentives for influential AIDS officials to incessantly pressure Congress for additional funding. Given the heightened international media attention, concern about Brazil's reputation has contributed to a high level of political commitment. By contrast, the United States' more isolationist relationship with the international community, its focus on leading the global financing of AIDS efforts, and the absence of tripartite partnerships have prevented political leaders from adequately responding to the ongoing urban AIDS crisis. Thus, Brazil shows that strategically working with the international health community for domestic rather than international influence is vital for a sustained and effective response to AIDS.     

THE PROSECUTION AND PUNISHMENT OF INTERNATIONAL TERRORISTS IN FEDERAL COURTS: 1980–1998*

Research Summary: This study reports findings from the American Terrorism Study. The data show that from 1980 to 1998, the U.S. government periodically tried accused domestic and international terrorists through the use of traditional criminal trials. The extent to which federal prosecutors “explicit politicized” these trials (and the success that the politicization had) varied among the types of terrorist groups. Explicit politically was not found to be successful in trials of domestic terrorists but seemed to work for trials involving international terrorists. Over the 20‐year period, however, federal prosecutors began to rely more heavily (and more successfully) on the politicization of the criminal acts by international terrorists. The results also show that international terrorists, like their domestic counterparts, are much less likely to plead guilty. Finally, the study shows that these traditional trials have resulted in international terrorists being punished more severely than domestic terrorists. Unfortunately, the practice of performing these politicized trials within the venue of the federal court system may have been compromised by defense strategies that capitalized on the due process procedures so prominent in the U.S. system of justice. In the wake of the terrorism attacks in September 2001 by foreign nationals, the federal government began to take the next step in its “war against terrorism” by instituting the use of military tribunals. Policy Implications: Although the federal government has been relatively successful in the prosecution of terrorism in America in the past two decades, the movement toward the use of military tribunals has perhaps become inevitable (as the use of the traditional criminal trial for international terrorists manifests weaknesses). In the short term, it is likely that several international terrorism cases stemming from the September 2001 attacks and other subsequent attacks (which may be presumed) will be tried in federal courthouses across the country (even with the advent of military tribunals). Federal prosecutors will need to be trained on the specifics of trying these kinds of cases. In the long term, the use of military tribunals will provide greater ease of prosecution for the federal government. Long‐term consequences such as retaliatory attacks and attacks aimed at the release of political prisoners cannot be ignored by policy makers.     

Changing policy and practice in the child welfare system through collaborative efforts to identify and respond effectively to family violence

The Greenbook provides a roadmap for child welfare agencies to collaborate and provide effective responses to families who are experiencing co-occurring child maltreatment and domestic violence. A multisite developmental evaluation was conducted of six demonstration sites that received federal funding to implement Greenbook recommendations for child welfare agencies. Surveys of child welfare caseworkers show significant changes in several areas of agency policy and practice, including regular domestic violence training, written guidelines for reporting domestic violence, and working closely and sharing resources with local domestic violence service providers. Case file reviews show significant increases in the level of active screening for domestic violence, although this increase peaks at the midpoint of the initiative. These findings, coupled with on-site interview data, point to the importance of coordinating system change activities in child welfare agencies with a number of other collaborative activities.     

AIDS: the first decade.

AIDS has had a profound effect on society and the workplace and has raised legal and social problems for which society was not prepared. This article will chronicle the evolution of federal, state and local law concerning AIDS and the workplace. Although there are some clear-cut answers and guidelines that address the relationship of employer and employee to the AIDS epidemic, current legislation and enforcement of those laws does not adequately address the AIDS victim as a handicapped individual. Emphasis is also placed on the problems peculiar to the health care industry, the constitutionality of present legislation, and the AIDS victim's right to privacy versus the employer's need to know. Finally, some practical solutions and guidelines will be presented that will help the employer deal with the AIDS victim and his or her co-worker.     

Québec: an outbreak of HIV/AIDS-related stigma and discrimination

In the space of a few weeks in January 2004, actions by three different institutions in Québec combined to threaten the human rights of people living with HIV/AIDS, raise the spectre of mandatory HIV testing, and create unnecessary public fears about the spread of HIV infection. In response to what they called "the worst weeks in recent history for people living with HIV/AIDS in Québec," the Canadian HIV/AIDS Legal Network and COCQ-Sida (the Québec coalition of community-based organizations fighting AIDS) called for a province-wide campaign against HIV/AIDS-related stigma and discrimination. A victory was achieved when a Montréal catholic seminary announced that it had backed down from its initial proposal to mandatorily test all applicants for priesthood for HIV, but much more is needed to fight the rapid outbreak of mandatory-testing proposals.     

Smartphone and Tablet Applications for Crime Scene Investigation: State of the Art,Typology, and Assessment Criteria

The use of applications on mobile devices is gradually becoming a new norm in everyday life, and crime scene investigation is unlikely to escape this reality. The article assesses the current state of research and practices by means of literature reviews, semistructured interviews, and a survey conducted among crime scene investigators from Canada and Switzerland. Attempts at finding a particular strategy to guide the development, usage, and evaluation of applications that can assist crime scene investigation prove to be rather challenging. Therefore, the article proposes a typology for these applications, as well as criteria for evaluating their relevance, reliability, and answer to operational requirements. The study of five applications illustrates the evaluation process. Far away from the revolution announced by some stakeholders, it is required to pursue scientific and pragmatic research to set the theoretical foundations that will allow a significant contribution of applications to crime scene investigation.     

Creating the Perfect Human Race: How Far Will We Go for Designer Families?

Genetic modifications in humans is a fast‐advancing field of science, with very little legal regulation. Scientists recently have developed a technique, clustered regularly interspaced palindromic repeat (CRISPR), which will forever change this field. Before CRISPR, all methods were too expensive and time consuming to facilitate editing human genes. CRISPR is faster and cheaper, making it a very real possibility for all. Since the discovery of CRISPR, research on human embryos has begun, with a success rate showing that creating a genetically perfect family is very real. In 2015, all federal funding for human genome modifications was banned, leaving little federal control. This Note proposes a model statute that allows for research while providing restrictions to prevent harm.     

Distributing State Children's Health Insurance Program funds: a critical review of the design and implementation of the funding formula

The development of formulas to distribute federal funds to states based on demographic data continues to challenge data and policy analysts. Analysts must forward the best objective statistical analysis and data inputs to formula specifications while acknowledging the politics of the legislative process that authorizes federal funding formulas. This article evaluates the federal funding formula for the State Children's Health Insurance Program (SCHIP) using key formula components of need, effort, capacity, and performance. We also examine the operationalization and measure of the target population in the SCHIP funding formula. Legislative decisions on formulas are, by nature, based on compromises that balance competing policy objectives. The analyst's role is to continually review current research standards, data quality, and relevant formula inputs and make recommendations to refine federal funding formulas to better target resources to their intended populations.     

A CALL TO CONGRESS TO GIVE BACK THE FUTURE: END THE "WAR ON DRUGS" AND ENCOURAGE STATES TO RECONSTRUCT THE JUVENILE JUSTICE SYSTEM

While the "War on Drugs" has been criticized in many respects, there has been little attention given to the detrimental impact it has had on children. Fortunately, both state and federal governments are recognizing the problem and have begun taking steps to combat the negative effects the "War on Drugs" has had on children. More work however, still needs to be done. This Note advocates for Congress to amend the Juvenile Justice Delinquency and Prevention Act to induce states to offer rehabilitation to nonviolent youth drug offenders, rather than incarceration, which will reduce incarceration and its detrimental effect on children, promote public safety and save money. As a funding stipulation, the amendment will require states to develop and implement deinstitutionalization programs for nonviolent juvenile drug offenders.     

Controlling post-transfusion hepatitis: a proposal to publicize hepatitis rates of transfusion facilities.

A federal requirement that donor blood be labelled as either "paid" or "volunteer" took effect on May 15, 1978. A major rationale for requiring such labelling is that physicians, now that they can distinguish between categories of blood, will fear liability for post-transfusion hepatitis resulting from the use of paid blood. Thus, supporters of the labelling requirement hope that it will deter the use of high-risk commercial blood. Some paid blood, however, is not commercial blood and in fact may be safer than volunteer blood. The labelling strategy for hepatitis control, therefore, has negative as well as positive attributes. This Article considers the efficacy of blood labelling as a hepatitis control measure and proposes an alternative strategy--the periodic publicizing of hepatitis rates of facilities that perform transfusions--that, if practiced responsibly, could significantly decrease hepatitis transmission rates.     

The Siren’s Song: Federalism and the Cops grants

The federalization of crime control has become a focal point for criminal justice researchers. Because the federal government is limited in how it can affect crime, it often assumes the role of funding agent to state or local governments and places restrictions on the use of these monies. Generally, no consideration is given to state or local concerns. As a result, national crime control policy often becomes mired in issues of federalism. One unintended consequence is the creation of a Siren’s Song, where state and local agencies simply pursue funding dollars to expand their budgets rather than to adopt beneficial policies or make meaningful changes. This paper illustrates this point by examining the federal “100,000 Cops” initiative in one rural West Virginia jurisdiction.