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12.22 Most Popular Posts from 2016

Thursday, December 22nd, 2016 | Allison Rizzolo

Thanks for visiting On the Agenda, the Public Agenda blog, in 2016! Here are the posts that most interested readers this year. Many of them come from our series on Key Talents for Better Public Participation – we hope you put those skills to work in 2017!

10) Cultural Competence and Engaging Youth: As they build coalitions and recruit participants, participation leaders should think explicitly about cultivating skills for cultural competency and boosting youth involvement.

9) Building Coalitions and Networks: Successful public participation is often built on the foundation of strong relationships among leaders and citizens.

8) Providing Information and Options: Issue Framing: If an issue is framed well, participation leaders will be better able to direct productive dialogue about the problem.

7) Managing Conflict: Understanding the basics of how to manage differences can go a long way toward improving public participation.

6) On Participatory Budgeting and Democracy, We Need Patience, Research And Clear Goals: We have some work to do before we can understand if and how PB is improving democracy in the U.S. and Canada.

5) Elevating Public Views to Rebuild Faith in Higher Education: We believe that efforts to boost college attainment will have the best chance of succeeding if they are informed by and responsive to the needs and perspectives of the American public. Do you agree?

4) Expanding Diversity in STEM Education: With the majority of Americans convinced that STEM skills are crucial for the nation's future, addressing barriers to diversity and expanding STEM opportunities for all students seems a critical goal.

3) Deepening Public Participation: Summary and Resources: Whether dealing with an immediate challenge or building long-term infrastructure, participation skills are a valuable asset for anyone’s proverbial toolkit.

2) Understanding the Debate on Charter Schools: A Nonpartisan Perspective: Given the tenor of public dialogue around the presidential transition, we’re likely to see even more division and emotion emerge around the already controversial topic of charter schools. That’s where we come in.

1) Ten Key Talents for Better Public Participation: Part 1: Throughout the summer (and fall), we shared a series on key skills to help local leaders engage citizens.

Perennial favorites:

A number of our top blog posts this year weren’t even published in 2016! Here are posts from years past that remain interesting to our readers present-day.

Paying for Quality Over Quantity in Health Care: Why the Public Ought to Be Engaged: Engaging hospitals and doctors is crucial to making payment reform work for Medicare, and to proving to private insurers that it can work for them too. It's to policymakers' advantage to include patients in the conversation about payment reform as well. (February 2015)

Parent Involvement in Education - What Really Matters Most?: Just as there are different ways to understand parent involvement, there are also different ways to define student success. (September 2014)

Most Americans Think Government Should Do More to Fight Obesity - Or Do They?: The school lunch dispute is one of several that have emerged when governments try to take stronger steps to combat the country’s rising obesity rates. Is there an appropriate and effective role for government in improving what we eat and helping us maintain healthier weights? What are Americans’ views? (June 2014)

What are you interested in reading about in 2017? Leave your thoughts in the comments below, or tweet us at @PublicAgenda.


12.20 Vallejo: A model for broader engagement in participatory budgeting

Tuesday, December 20th, 2016 | Allison Rizzolo

In most cities, participatory budgeting, or PB, is limited to capital funds: longer-term infrastructure projects such as schools, parks, streetlights and street repaving. Vallejo, California, is the first community in the U.S. to allow voters to propose projects that include services and programs along with capital projects.

PB was adopted in Vallejo 2012-13, shortly after the city declared bankruptcy in 2008. Officials looked to PB to rebuild trust between community members and public officials. They also designed their PB process to fund programs and services, which suffered the deepest cuts following the city’s bankruptcy.

Scholars suggest that, for PB to have significant social impacts in the U.S, the process ought to be applied broadly, beyond capital infrastructure projects. Is PB in Vallejo different from other communities for having funded services and programs?

We asked Alyssa Lane, who coordinates PB in Vallejo from her position in the city manager’s office to weigh in. Here’s what she says about the benefits of PB in Vallejo:

We have seen that the program projects give residents a sense of empowerment and a feeling of giving back to the community. The PB process has given those of us who work for the city better insight into the communities’ needs beyond physical infrastructure and revealed how community members’ diverse priorities align with one another. Additionally, PB brings forth ideas and priorities that may help guide community groups to set their spending priorities for years to come or to encourage them to pursue continued funding from other city, state or federal sources.

Using PB to allocate funding to programs and services has also had its challenges. In particular, it requires more resources – for a process that already is resource-heavy. There are also additional legal issues when PB is used to fund programs and services, especially for projects associated with minors, projects that require allocating funds to private individuals and projects that allocate funds to support programs or services on private properties. Finally, while program and service projects are important and benefit an identified group in need, sometimes they serve a much smaller proportion of the population compared with capital projects.

Based on her and her colleagues’ experiences, Alyssa offers advice for other communities considering including program and service projects in their PB processes:

  • Before offering program and service projects, implementers need to sit down with all institutional partners—such as city agencies, school districts and community-based organizations that might be implementing these projects—to establish ahead of time what each is comfortable with and has the capacity to take on.
  • The implementing city or district staff should also try to work with institutional partners on all program and service projects and avoid having to take on implementation of these on their own. Find institutional partners who have the right expertise and capacity.
  • Processes should design criteria for program and service projects to include a metric for how many people the project would benefit. If the project is an after-school program or an internship program, does it benefit only a handful of kids or schools, or does it benefit many kids across many schools?
  • Start small and scale up. Programs and services can be complicated to implement and administer, so PB sites should approach these types of projects in a spirit of experimentation.

Read full case studies about PB in Vallejo and in other communities in our report, "A Process of Growth: The Expansion of Participatory Budgeting in the United States and Canada in 2015 – 16."


12.16 Engaging Ideas - 12/16

Friday, December 16th, 2016 | Public Agenda


Words of Wisdom for Public Officials Trying to Connect With Citizens (Governing)
For one, realize that you have the "curse of knowledge."

How Public Engagement is Evolving (Government Technology)
The continuum of public engagement is bookended by social media and face-to-face consultations.

Equality and Equity in Deliberation: Introduction to the Special Issue (National Coalition for Dialogue & Deliberation)
The 11-page article, Equality and Equity in Deliberation: Introduction to the Special Issue (2016), was written by Carolyne Abdullah, Christopher Karpowitz, and Chad Raphael, and published in the Journal of Public Deliberation: Vol. 12: Iss. 2. The authors make the distinction within deliberation between equity and equality, and confront what this means to fairness and participants being able to fully engage in deliberation. The article examines different approaches to inclusion within deliberative theory and practice, as well as, the authors address some challenges and opportunities.


Globalization Doesn't Make as Much Sense as It Used To (The Atlantic)
Both major-candidates abandoned what had come to be the standard pro-globalization position of those vying for the nation’s highest office. Most economists and many think-tank researchers have bemoaned this development, insisting that globalization generally leaves most nations—and most people—better off. But a review of American economic history suggests that something fundamental has changed: Increased globalization may make less sense now than it did in the recent past.

In adults, income inequality drives apathy. In young people, it inspires them to make a difference. (New York University Steinhardt School of Culture, Education, and Human Development)
The findings, published in the November issue of the Journal of Youth and Adolescence, contradict what research has shown among adults, which is that higher inequality results in lower civic engagement. “Despite income inequality having a plethora of negative consequences both for societies and individuals, we view these findings as a testament to the resiliency and optimism of youth,” said Erin Godfrey, assistant professor of applied psychology and the study’s lead author.

The Conservative Plan to Tackle Poverty (The Atlantic)
House Speaker Paul Ryan says that improving the lives of low-income Americans is a top priority. To do that, the GOP plans to help businesses first.

K-12 Education

It Turns Out Spending More Probably Does Improve Education (The Upshot)
A study, published by the National Bureau of Economic Research in July, was conducted by the economists Julien Lafortune and Jesse Rothstein of the University of California at Berkeley and Diane Whitmore Schanzenbach of Northwestern. They examined student test scores in 26 states that have changed the way they fund schools since 1990, usually in response to a lawsuit like Connecticut’s, and compared them with those in 23 states that haven’t. While no two states did exactly the same thing, they all had the effect of increasing funding for the poorest districts.

Students Engage With Scientists at 'Cafes' (Education Week)
A growing number of 'teen science cafes' across the country offer a way for students to ask questions of real scientists in an out-of-school setting.

New Help for States That Want to Bolster Principals (Education Week)
As state officials set agendas for K-12 under the Every Student Succeeds Act, new resources are being released to help them figure out how to elevate school leadership.

How Investing In Preschool Beats The Stock Market, Hands Down (NPR)
A new study on high-quality early learning programs show a robust long-term return on investment. The most potent ingredients? Parental engagement and empathy. That's the crux of a new paper out today, The Life-Cycle Benefits of an Influential Early Childhood Program co-authored by Nobel Laureate James Heckman, a professor of economics at the University of Chicago and the director of the Center for the Economics of Human Development.

Higher Education & Workforce Development

Loan Counseling Program Pilot Participants Unveiled (Politico Morning Newsletter)
The Education Department yesterday announced that it will grant regulatory waivers to 51 colleges and universities so they can experiment with requiring additional loan counseling beyond what’s already mandated by federal law. The department says the pilot program will last “several years” and affect some 100,000 students — half of whom will receive the additional counseling. The remaining half will be the “control group” that only receives the counseling required under existing law. See the full list of the 35 community colleges, 14 public universities, one private nonprofit college and one for-profit school that were selected to participate here.

Bridging Higher Education’s Rhetoric and Reality in a Changing World (The Bill and Melinda Gates Foundation)
From Dan Greenstein: "An increasingly anxious and angry nation vexed by widening gaps in educational and economic opportunity, and a growing sense that too many people are being left behind in today’s America. Where does higher education fit into this picture? I believe it starts with recognizing the gaps between our rhetoric and reality, the places where our aspirations for increasing equity and meeting the economy’s needs simply aren’t being realized."

Students Who Get Better Career Guidance Remember College More Fondly (NPR)
A new survey of 11,483 college graduates, for the Gallup-Purdue Index, found graduates who reported "very helpful" campus career-services experiences were 5.8 times more likely to say their university prepared them for life after college, 3.4 times more likely to recommend their school and 2.6 times more likely to donate to their alma mater than graduates who found their campus career help "not at all helpful."

Report: Choice Deserts: How Geography Limits the Potential Impact of Earnings Data on Higher Education (Urban Institute)
Kristin Blagg and Matthew Chingos’ analysis of data from Virginia indicates that only about a third of high school seniors can use earnings data to make a meaningful distinction between programs of study at two or more institutions.

Health Care

Views of the ACA, Medicare and the nation’s economy (Pew Research Center)
Dan Diamond of POLITICO’s Pulse writes: Nearly 90 percent of public are barely aware of GOP's Medicare reform plan. That's according to a new Pew survey, which found that only 12 percent of respondents had heard "a lot" about Republicans' proposal to change Medicare into a system where future beneficiaries would receive a credit to buy private insurance. Meanwhile, 39 percent of respondents said they had heard "a little" and 49 percent said they'd heard nothing or didn't know. Among respondents who'd heard about the proposal, 49 percent opposed it and 38 percent favored it. However, respondents who had heard a lot about the idea were much more likely to be opposed; 67 percent of those respondents opposed the proposal, while 32 percent were for it.

Editorial: Making 'more skin in the game' for patients work (Modern Healthcare)
Making informed decisions on complicated medical matters is beyond the skill set of most Americans—including college-educated Americans. Most people want choice about what oncologist they see when diagnosed with cancer. But few want the responsibility of choosing their chemotherapy regimen or want to make that choice based on price. There is an alternative.

Why Obamacare Enrollees Voted For Trump (Vox)
Sarah Kliff writes: I spent last week in southeastern Kentucky talking to Obamacare enrollees, all of whom supported Trump in the election, trying to understand how the health care law factored into their decisions. Many expressed frustration that Obamacare plans cost way too much, that premiums and deductibles had spiraled out of control. And part of their anger was wrapped up in the idea that other people were getting even better, even cheaper benefits — and those other people did not deserve the help.

CMS releases its Person and Family Engagement Strategy (CMS Blog)
At the Centers for Medicare & Medicaid Services (CMS), we are working with numerous partners to transform our health care delivery system to one that delivers better health outcomes while spending dollars more wisely. In November of 2015, we updated the CMS Quality Strategy, incorporating the ongoing work to shift Medicare from paying for the number of services provided to paying for better outcomes for patients. We know that a key strategy to achieving better outcomes is to meaningfully engage patients as partners in decisions about their health care. Therefore, one of the six goals outlined in this strategy is: Strengthen person and family engagement as partners in care. Today, we are excited to announce the release of the CMS Person and Family Engagement Strategy, which we believe can lead to significant progress toward this important goal.

Should Big Data Pick Your Next Doctor? (Forbes)
Grand Rounds is focused on matching patients with the right doctors. The company uses a database of some 700,000 physicians, 96% of the U.S. total, and merges it with insurance-claims data and biographical information to grade doctors based on the quality of their work. The idea is to help people find a physician who will give them the right diagnosis the first time around and link patients with experts who can give second opinions. For individuals, it costs $600 to get a doctor recommendation and $7,500 to get a second opinion. Patients are more likely to trust Grand Rounds than their own insurers. When an insurance company denies a claim, employees just become angry; they're willing to believe Grand Rounds if its doctors provide the same reason. "There's nothing like an objective party that is different from the insurance plan," says Donna Sexton, Costco's director of employee benefits.


12.15 Making Health Savings Accounts Work

Thursday, December 15th, 2016 | Allison Rizzolo

One of the health care policies that President-Elect Trump has advocated is an expansion of Health Savings Accounts, or HSAs. Research suggests that HSAs, as they currently exist, primarily benefit wealthier and healthier individuals. What would it take for HSAs to be more equitable, effective and efficient? Over on the Health Affairs blog, our friend Kathryn Philips of the University of California, San Francisco, explores this question.

Kathryn notes that consumer-oriented reforms—like HSAs, health care price transparency and others—have an important role in improving our health care system. There are demonstrated benefits of HSAs. However, these benefits are not applied equally across the public. In particular, low-income individuals are least likely to benefit from HSAs.

Moreover, Kathryn notes an “often neglected aspect of HSAs”:

[T]hey require an educated and savvy consumer who can devote a great deal of time and effort to understanding their plan and shopping for care. I can speak to this from my own experience. I wanted to “practice what I preach” and thus enrolled in a high-deductible health plan coupled with a HSA. How can I shop for care when providers can’t tell me what the price is or they tell me that care is “free” simply because I don’t pay a co-pay up-front? How can I choose between services and providers when I don’t have enough information to do so? How can I navigate through multiple, often contradictory and unlinked websites — one for the health plan, one for carve-out benefits, and one for my HSA? And how can I even remember when to pay for care using my HSA debit card versus asking the provider to bill the plan? In sum, does my HSA cause me to shop more for care? Yes. Does it enhance my pocketbook? Sometimes. Does it improve my health? I’m not sure.

Kathryn also draws upon the study we published together in Health Affairs last spring, noting that the use of behavioral economics can create more effective policies.

Read Kathryn’s full post over at Health Affairs. And click here for more on our work regarding consumer-oriented health reform.

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12.13 Can Participatory Budgeting Help Improve Democracy?

Tuesday, December 13th, 2016 | Allison Rizzolo

Americans are frustrated by the state of our democracy. Meanwhile, the relationship between leaders and the public continues to erode. This dynamic isn’t new.

Trust in government has been decreasing for years. Both the public and elected officials have expressed irritation with current and common models of democratic engagement. But this past year, the frustration seems to have reached a crescendo.

At Public Agenda, we’re a bunch of optimists. We believe that democracy CAN work for everyone, and that better models of public engagement are key to this mission. Better public engagement can improve the relationship between leaders and the public. Good engagement strategies also provide everyone with an opportunity to consider differing views. That way, just as engagement can ensure that everyone has a voice in the decisions that affect them, it can also ensure that those voices are productive and meaningful.

One of the fastest-growing forms of public engagement in the U.S. is participatory budgeting, a process that gives residents direct decision-making power in local budgets. Sixty-one communities in the U.S. and Canada used participatory budgeting, or PB, in 2015-16. This is an increase of 33 percent over the previous year.

PB has yielded impressive results in Brazil, where it started in the 1980s. There, it's helped rebuild relationships between elected officials and residents, engaged more people from disenfranchised communities in civic life, reduced corruption and improved the social well-being of a wide range of citizens. Can PB have similar results here?

It may be too soon to tell: PB is relatively new in the U.S. and Canada, where it started in 2009 and 2002 respectively. But in an effort to begin to answer that question, we’ve been serving as an independent evaluator of PB in the U.S. and Canada. We’ve created guidelines and tools for measuring impact, communicated the short-term outcomes of PB across the U.S. and Canada, and studied PB’s potential for generating social change.

We released our most recent contributions this week: a set of resources reporting on outcomes of PB in 2015-16, a white paper examining PB’s potential for reducing inequality and a white paper looking at the role of deliberation in PB. Here’s more info, along with links to each resource:

A Process of Growth: The Expansion of Participatory Budgeting in the United States and Canada in 2015-16: For the second year in a row, we collected data from communities around the U.S. and Canada to tell the story of PB, understand how different communities are using it in different ways and get an idea of short-term outcomes we're already seeing. The report includes recommendations from people leading and evaluating PB on the ground, to help others diversify participation, advocate for PB from the grassroots level and incorporate technology in an equitable way.

Brazil Has Reduced Inequality, Incrementally - Can We Do the Same?: PB in the U.S. and Canada differs in many ways from PB in Brazil. Matt Leighninger explores these differences in this white paper, explaining how they may affect PB's impact in North America. He also provides a series of practical recommendations for practitioners and policymakers to strengthen PB's ability to reduce inequality.

Power to the People! (And Settings for Using It Wisely?): PB employs both direct and deliberative democracy. As the Brexit vote has demonstrated, direct democracy doesn't always lead to smarter, broadly supported policy decisions. This white paper examines the extent to which PB employs deliberative principles and processes, explores the challenges in making PB more deliberative and provides recommendations for public officials and practitioners looking to improve their PB processes.

The Kettering Foundation served as a collaborator for this work. "A Process of Growth" was also supported by the Democracy Fund and the Rita Allen Foundation.

If you’re interested in more information regarding our work with participatory budgeting, or you’d like to check out other resources, including a toolkit for evaluators and a report regarding public officials’ views toward PB, please visit our PB project page.


12.09 Engaging Ideas - 12/9

Friday, December 9th, 2016 | Public Agenda

Every week we curate stories and reports on complex issues. This week: The economic expectations of a divided country. School Choice 101. Adult students talk about college payoff, and a report on cost-saving competency-based education. The benefits of choosing a doctor with low office visit prices.


Is Democracy Doomed? We've Been Here Before. (Real Clear Politics)
We need not assume the worst based on one academic study. And there are plenty of institutional obstacles to Trump’s worst impulses. But we can’t necessarily wait for a Pearl Harbor to galvanize America. If we care about our democracy, we must tend to it every day, and speak out against any threats that may arise.

Getting Voters to Focus on the Things They Actually Know About (Governing)
National elections are flashier, but voters are often far more knowledgeable about local issues. We need to get them more engaged.

Despair and Hope in Trump’s America (The Atlantic)
From James Fallows: Americans are optimistic about the communities they live in—but not their nation. Why?


Americans Expect Economic Improvement in a Deeply Divided Country (The Atlantic)
A new poll reveals some optimism about the post-election economy along with doubts that Donald Trump can bring the country together.

Automation is inevitable. Here's how to make sure we create jobs, not just destroy them. (Vox)
When society invents a new technology that makes workers more efficient, it has two options: It can employ the same number of workers and produce more goods and services, or it can employ fewer workers to produce the same number of goods and services. Jargon-filled media coverage makes this hard to see, but the Federal Reserve plays a central role in this decision. When the Fed pumps more money into the economy, people spend more and create more jobs. If the Fed fails to supply enough cash, then faster technological progress can lead to faster job losses — something we might be experiencing right now.

American Dream collapsing for young adults, study says, as odds plunge that children will earn more than their parents (Wonkblog)
Rising income inequality has eroded the ability for American children to grow up to earn more than their parents, according to groundbreaking new research from a superstar team of economists that carries deep implications for President-elect Donald Trump's policy agenda.

K-12 Educatgion

School Choice 101: What It Is, How It Works And Does It Work? (NPR)
President-elect Donald J. Trump said on the campaign trail that school choice is "the new civil rights issue of our time." But talk of school choice is, at best, confusing.

Pay for Success' Funding Model Focus of Policy Toolkit (EdWeek)
As policymakers start to embrace these funding models for early childhood education, how should they make sure they're investing in quality programs? What are the appropriate results to measure, and how should the programs be evaluated?  The Urban Institute released a pay for success toolkit Wednesday to help answer those questions.  See the toolkit here.

Despite Frequent Screen Time, Parents See Selves as Good Examples (EdWeek)
The study, "The Common Sense Census: Plugged-In Parents of Tweens and Teens 2016," aims to analyze how parents contribute to the teen and "tween" media use landscape. Key findings from the study, based upon almost 1,800 parent responses: Parents spend an average of 9 hours and 22 minutes per day on screen time (1:39 for work purposes, and 7:43 for personal purposes.) White parents, better educated parents and higher wage-earners reported spending the least time in front of screens. Seventy-eight percent of parents believe they do a good job of modeling appropriate media use to their children. Mothers are slightly more likely to hold this belief than fathers.

Higher Education & Workforce Development

Older Americans Went Back to School During the Recession. Did It Pay Off? (FiveThirtyEight)
Selinger said that he doesn’t regret his decision, and it eventually began to pay off. After earning his CNA, he took science prerequisites and applied to nursing school for an associate degree. His income doubled when he completed it in May 2013, at age 48. With additional promotions and overtime pay, he now earns more than $60,000 a year — but he’s gone as far as he can with an associate degree. This spring, he began taking classes toward his second bachelor’s.

Touted as the Next Big Solution, Competency Ed Programs That Stress Skills Aren't Always a 'Quick Moneymaker,' Study Says (The Hechinger Report)
rpk Group's research report, “Competency-Based Education: A Study of Four New Models and Their Implications for Bending the Higher Education Cost Curve,” demonstrates the opportunity competency ed offers for higher education to break away from traditional, higher-cost instruction models that have proven resistant to change.

Labor Market Outcomes and Postsecondary Accountability: Are Imperfect Metrics Better Than None? (National Bureau of Economic Research)
Findings suggest a cautious approach: while a mix of feasible labor market metrics may be better than none, reliance on a single metric, especially if measured very early, may undermine policymakers’ ongoing efforts to accurately quantify institutional performance.

Career Clusters: Forecasting Demand for High School through College Jobs (Georgetown Center on Education and the Workforce)
The report, Career Clusters: Forecasting Demand for High School through College Jobs, examines the most promising opportunity for job seekers of varying education levels. Using forecasts, Georgetown’s Center on Education and the Workforce has identified the most promising clusters for job seekers with a high school diploma or less, middle skills such as a certificate or Associate’s degree, and those with Bachelor’s degrees or better.

Health Care

Health Spending Went Up Last Year Because More People Were Getting Care, Report Says (LA Times)
While such surges in health spending have traditionally worried economists and policymakers, the 2015 increase is somewhat different, the new report from independent actuaries at the U.S. Department of Health and Human Services suggests. In the past, mounting prices for hospital stays, doctor’s visits and other medical goods and services were largely responsible for skyrocketing health spending. But the new report indicates that the latest increase – which tracks with a similar uptick in 2014 – was fueled by increased use of healthcare, likely caused by the health law, often called Obamacare.

Crossing State Lines Is No Easy Jaunt For Insurers And Local Regulators (WSJ)
As Republicans gear up to overhaul the federal health law, they face pushback from a couple unexpected corners over one of their goals: Giving health insurers greater ability to sell policies to consumers across state lines. Republicans for some time have billed interstate sales of insurance as a way to heighten competition and lower costs. It is one of the few specific health initiatives displayed on President-elect Donald Trump’s transition website. Still, the GOP is drawing some opposition from state insurance regulators—many of them Republican—and insurance-industry officials, who question how such a plan would work, given that many aspects of insurance are regulated differently by each state. “That sounds like a silver bullet to solve a major problem, and there are no silver bullets,” said Louisiana Insurance Commissioner Jim Donelon. “There are no simple answers.”

Incremental Fixes Won’t Save the U.S. Health Care System (Harvard Business Review)
We need to take bold action to correct our health system’s current trajectory. Incremental shifts, the approach to date, simply won’t address the real challenge confronting the U.S. health care system — that is, a disjointed care delivery system that results in inefficiency, overspending, lack of consumer accountability, and a sub-par experience all across health care. Instead, we need to adopt policies that result in significant discomfort for the laggards and outsized rewards for the leaders.

Patients who choose doctors with low office visit prices save hundreds of dollars per year on overall health care costs (Harvard Medical School)
Patients who choose primary care doctors with low office visit prices can rack up considerable savings on overall health care costs according to new research from Harvard Medical School. The report, published Dec. 5 in the December issue of the journal Health Affairs, suggests that office visit costs may be a reliable indicator of what a patient will pay for a wide range of services and procedures.


12.08 Skill Up in 2017 at an Engagement Strategy Workshop

Thursday, December 8th, 2016 | Megan Rose Donovan

The new year is seen as a time to reflect on the past and set goals for the future. In that spirit of self-improvement, we’re on a mission to improve public engagement efforts from coast to coast and the many places in between.

Matt Leighninger and Nicole Cabral will be on the road next year for a number of projects to that end. One project is to deliver full-day, intensive workshops focused on developing leadership skills for stronger engagement in communities. These workshops are especially relevant for city and town managers and other public officials looking to learn about the strengths and limitations of public engagement today.

A workshop we held in Boston in June included elected and aspirant officials, city planners, public engagement professionals, an academic and a democracy activist. As we saw during this workshop, these professionals share many common engagement challenges, from the “usual suspects” who dominate most meetings to the narrow channels of communication exemplified by 2 minutes at a microphone.

In February, Matt and Nicole will host a Public Engagement Strategy Workshop in Silver Spring, Maryland in collaboration with Montgomery County Silver Spring Regional Area. Some details are included below and

Date: Monday, February 6, 2017
Time: 9:00am - 4:30pm
Location: Silver Spring Regional Center, One Veterans Place, Silver Spring, MD 20910
UPDATED: Cost: $250 (by January 9, 2017) or $350 (after January 9, 2017)

A point we should highlight is that the early bird rate ends at the end of this year, on Dec 31st, so commiting to your professional development goals early will get you a $100 discount! NOTE: The early bird rate has been extended to Monday, January 9th. pracownicy z Ukrainy

Do you know anyone in the Silver Spring, MD or Washington, DC, area? Please share this workshop with colleagues and friends here:

Please do reach out with any questions about this workshop or on how to bring one to your community by emailing You can also keep abreast of public engagement developments by


12.06 Voting, Division and Higher Education

Tuesday, December 6th, 2016 | Erin Knepler

The 2016 presidential election cemented a long-perceived trend: our great country is becoming increasingly divisive. Moreover, election results indicate that ideological divisions are largely linked to educational attainment.

Meanwhile, this fall, we witnessed two pieces of conventional wisdom regarding higher education get turned on their heads by the American public. While having a college degree has long been associated with voter participation, this election seems to have interrupted longstanding historical trends. And, while experts and policymakers link college attainment to success in the workforce, Americans told us they no longer perceive this to be true.

Higher Education and Civic Engagement

Traditionally, a person with a college education has a higher likelihood to vote. The 2016 presidential election, however, flipped that historical trend on its head. According to 2016 exit poll data collected by Edison Research, there was an uptick in white male voters with less than a bachelor’s degree – that is, voters who possessed a high school degree, some college or an associate degree.

In order to better understand historical voting trends, I examined Census data collected on reported voting and registration, by age, sex and educational attainment from the past last seven election cycles (i.e., 2012, 2008, 2004, 2000, 1996, 1992, and 1988). The table below details the aggregated reported voting rate. It shows that those with lower levels of formal education have consistently lower voting rates.

While the 2016 voter turnout data is continuing to trickle in over the next few weeks and months, it is becoming clear that education levels did impact this election. I’ve been closely following my favorite data wonk, Nate Silver, and his recent blogs on FiveThirtyEight about the election. Recently, Silver did a full analysis of all 981 U.S. counties with 50,000 or more people and sorted it by the share of the population that had completed at least a four-year college degree. He found that, “it appears as though educational levels are the critical factor in predicting shifts in the vote between 2012 and 2016.” This analysis tells me that our old belief that individuals with a college degree are more likely to vote doesn’t match reality. Other groups are voting at higher rates now too.

Higher Education and Job Attainment

Another thing we often hear from leaders is that college education is important to getting a good job. I still believe this is true, but in recent public opinion research we conducted, supported by The Kresge Foundation, we found that Americans' attitudes toward higher education have shifted in the years since the Great Recession.

Before 2009, increasing numbers of Americans said that a college education is necessary for success in today's working world. But in our 2016 research, just 42 percent of Americans say a college degree is necessary. That’s 13 percentage points lower than what we saw in 2009. We saw pessimism toward higher education grow in other ways as well. For example, nearly half of Americans – 46 percent – say a college education is a questionable investment because of high student loans and limited job opportunities.

Now is a time of great change and turmoil, so we’re not quite sure what it means that these two pieces of conventional wisdom have been flipped.

What we do know is that there’s a huge divide in our country. Given this division seems linked with educational attainment, higher education will remain an important issue. While we all don’t need to see eye to eye, we do need to work together. To do so, we need more dialogue. We need to not only elevate a diversity of voices, but we also need to listen and really hear each other in order to forge common ground. Pubic Agenda and other organizations have a role in helping us improve dialogue and collaboration among leaders and communities.


12.02 Engaging Ideas - 12/2

Friday, December 2nd, 2016 | Public Agenda

Every week we curate stories and reports on complex issues. This week: The internet’s role in democracy and librarian’s role in navigating information online. Is college worth it? Recent grads share their experience. And what a data point says about the future of the Affordable Care Act.


Maybe the Internet Isn’t a Fantastic Tool for Democracy After All (New York Magazine)
The recent panicked focus on fixing the “fake news” problem itself seems inadequate, reliant on the belief that merely by ensuring that hoaxes and lies are unable to circulate on social networks, we can return to civil public discourse. That misinformation plagues our politics is a symptom of a larger, more existential problem: The tech industry has disrupted the public sphere and has shown neither the interest nor the ability to reconstruct it. No matter what Facebook might believe, there is no turnkey algorithmic solution that will ensure a perfect civic network. It will always be possible for people who take advantage of networks’ “dumb” nature — their inability to distinguish between legitimate and illegitimate traffic — to flood them with junk.

Community Engagement

Arena To Skip Participatory Budgeting Next Year, Citing Lack Of Interest (DNAInfo)
Ald. John Arena (45th) will skip out on participatory budgeting for 2017, using the year to work through a backlog of planned projects and strategize how to attract more constituents to the process, according to his staff. Just 279 residents voted on how to spend the ward's $1.3 million discretionary budget in May, marking its weakest turnout since Arena rolled out the process in 2013. "Participatory budgeting works best when people actually participate," said Owen Brugh, Arena's chief of staff. "The whole point is to give people direct say over how taxpayer dollars are spent in their community, and we need all those voices if we want it to succeed."


In Life After Coal, Appalachia Attempts to Reinvent Itself (Governing)
The decline of the mining industry started long before the Obama administration and will likely continue even with Trump in the White House. That's why local leaders are starting to diversify their economies and prepare their people for an uncertain future.

Job retraining classes are offered to Rust Belt workers, but many don’t want them (PRI)
All this is not to say that American manufacturing is dead, far from it. It’s still a major part of the US economy, and those in the industry are calling for more investment in the next wave of manufacturing. "I’m not nostalgic for 1950s steel, but I’m really optimistic for 21st-century steel,” says Scott Paul. “Manufacturing is going through an evolution that people call 'Industry 4.0,' and that’s going to take a different set of skills and training.” Back in Indiana, steelworker-turned-HVAC-instructor Dennis Matney says coal workers and everybody in manufacturing should invest some time in more education. “I think that you can resist change all you like. But it’s going to happen regardless. You might as well get with the program.” That can be a tough message to take — that life as you know it, and have known it for generations, is ending. And, as Clinton learned the hard way, it’s not one that a lot of voters wanted to hear.

K-12 Education

Show Me the Data: State Report Cards Must Answer Questions and Inform Action (Data Quality Campaign)
Everyone deserves to know how their public schools are doing, and states are responsible for creating that clear picture. Read our analysis of what we could find in report cards from all 50 states and DC.

U.S. Performance Rising in Math and Science (EdWeek)
U.S. students are generally improving, along with their peers around the globe, according to the latest Trends in International Mathematics and Science Study results. But a longitudinal look shows more of a slow uphill slog than a breakout performance.

Which Teacher Prep Programs Meet Tough New Accreditation Standards? (EdWeek)
Out of 21 teacher preparation programs from 14 states that were seeking accreditation under tougher new standards, 17 have met all expectations and gained accreditation, while four programs have failed to meet all the required standards, according to an inaugural report released on Monday by the Council for Accreditation of Educator Preparation (CAEP).

As Info Landscape Changes, Librarians Take on New Roles (EdWeek)
School librarians increasingly find themselves teaching students how to navigate and consume information online—and helping teachers embed those skills into the curriculum. Michelle Luhtala co-teaches a lesson on news analysis to 11th and 12th grade students at New Canaan High School in Connecticut. She and fellow librarian Jacqueline Whiting frequently partner with classroom teachers at the school to teach media-literacy skills.

Higher Education & Workforce Development

Moody’s: Colleges Can Expect Another Year of Low Growth in Tuition Revenue (Chronicle)
More than 250 institutions responded to the survey, and comprehensive private universities projected the strongest growth, at 3 percent. As in past reports, this year’s report projects overall revenues to increase by about 2 percent and to track closely the rate of inflation. Additionally, Moody’s said low gains in tuition revenue are the “new normal” for colleges. The report cites the increased focus on affordability and a competitive environment as limits on raising tuition.

Interactive: Inside Jobs (The Atlantic)
Hear what 100 American workers have to say about their jobs

The New 'Good Jobs' (City Lab)
Jobs that pay well but don’t require a bachelor’s degree are what many Americans want—and these days, they’re not found on an assembly line.

Is College Worth It? Recent Grads Share Their Experiences (NPR ED)
It turns out they're all satisfied customers. And among the most important subjects they report learning a lot about was themselves — reconciling their plans and dreams with real life.

12 Cities to Work On Pathway Plans (Community College Daily)
National League of Cities is starting a two-year effort to address a major challenge facing cities — ensuring that all residents have access and support to earn industry-valued certificates and degrees with the ultimate goal of gaining meaningful employment.

Seeking Students, Public Colleges Reduce Out-of-State Prices (Associated Press)
"I really believe that this pricing strategy is going to open us up to people looking at the University of Southern Mississippi from places we traditionally haven't drawn from," said Douglas Vinzant, USM's vice president for finance and administration.

Health Care

What Trump Can Learn From Obama's Rough Ride On Health Care (AP)
President Barack Obama took on the problems of a lack of access to health care and high cost, but he and Democrats paid a political price. President-elect Donald Trump has promised to undo much of what Obama put in place, and pledged to make the system better. Although Trump is lacking in specifics, he seems to want to make costs his priority. States, insurers, businesses, and individuals would get more leeway to sort out access. Health care keenly reflects the country's deep political divide. A look at some lessons Trump might learn from Obama's rough ride.

Donald Trump Signals Big Health Policy Changes Are Coming (WSJ)
In tapping Rep. Tom Price and Medicaid consultant Seema Verma Tuesday for top health positions, President-elect Donald Trump has signaled that he intends to put conservative health-policy goals at the forefront of his administration.

Millions Of People Are Having An Easier Time Paying Medical Bills (NPR)
The number of people who say they are struggling to pay medical bills has dropped by 13 million in the past five years, a study finds. An improving economy and the Affordable Care Act are why.

Poll shows Obamacare started looking a lot better after the election (Wonkblog)
Contradictions in Trump voters' opinions of Obamacare.

Some GOP Voters Skittish On Full Repeal, Poll Finds (KHN)
With their party gaining control of both the White House and Congress, some Republican voters are growing hesitant about outright abolition of the Affordable Care Act and instead favoring a more circumspect approach of scaling it back, according to a poll released Thursday.


12.01 Questions from the Audience: Can the Public Have a Real Voice in American Politics?

Thursday, December 1st, 2016 | Public Agenda

During a panel discussion two weeks ago, we explored a number of questions: Can the public have a real voice in American politics? Is too much democracy a bad thing? Can we address our differences and move forward? Will the tools we use currently to engage the public be adequate for the radical moment we are in?

The lively panel conversation concluded with many questions from an engaged and curious audience. Sadly, we did not have the time to answer everyone’s questions. We’d like to take the opportunity to answer a few of the questions audience members submitted here. Have additional questions for us? Leave them in the comments.

Click here to read a recap of the event or watch a video of the discussion here.

Responses to the below questions come from Will Friedman and Matt Leighninger.

Can you talk about the factors that might keep people from "coming to the table" even if the infrastructure/opportunities for them to come to the table (engage) were in place?

There are all kinds of factors that keep people from the table: they’re busy, they’re working multiple jobs, they don’t speak English well, there’s no child care provided, they don’t like public speaking, etc. Dealing with these barriers is important. But focusing too much on the barriers can lead to a somewhat condescending attitude toward people we think of as “disengaged” and somehow “hard to reach.” We assume that the fact that they are disengaged has to do mainly with their own limitations – and we ignore the fact that almost all of us are disengaged most of the time. It is a mistake to deal with the barriers without also making “the table” (whether that’s a meeting, a process, or a website) something that is meaningful, powerful, convenient, and fun.

How would we overcome the lack of trust in government or in the "other" that might keep people from engaging?

Relationships and responsiveness. Public engagement processes that give people a meaningful opportunity to get to know each other and talk about issues tend to build trust because they build relationships – between citizens and public servants, between different kinds of people, between different ideologies and generations. Then, when people find out that the input they gave had an impact on a policy decision, or when their involvement leads to some other kind of good outcome, they gain trust that the system is responsive to them and their interests.

The panel is giving me the impression it feels "the public" didn't have a voice in the current elections. But if a significant part of the public, the 70% without a college degree, didn't have a voice, how was Trump elected?

The point is more that too many members of the public do not feel they have a voice in the decisions that affect their lives, contributing to the profound discontent with the status quo that the election revealed.

How do you get people to the table who don't necessarily want to be there in the first place and aren't motivated by Participatory Budgeting money?

One of the essential facts of engagement: people participate when someone they know and trust asks them to. Other kinds of outreach are nice supplements to that – flyers, e-blasts, articles in the newspaper – but they won’t lead to a large turnout by themselves. Successful recruitment requires a web of relationships of trust. To improve and sustain engagement, we should pay more attention to growing and supporting those webs on an ongoing basis, not just when we face a big decision or a big crisis.

Americans across the political spectrum and in all demographic groups feel disenfranchised and powerless. What role does our non-regulated "system" of campaign finance play?

According to research Public Agenda is conducting, people do feel disenfranchised because they feel that wealthy and powerful special interests control the nation's policy agenda. That doesn't mean that campaign finance reform is all that needs to happen to create a more engaged and empowered public, but it's fair to say that it's a factor.

See all of the #AMPolicy tweets from the event. Join our list to receive notice of our next event.


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