The recently enacted Patient Protection and Affordable Care Act expands eligibility to Medicaid for millions of near­ poor indi­viduals. Given this expansion, policymak­ers need to understand the nature of the disparities that exist in the quality of care Medicaid beneficiaries receive as com­pared to their privately insured counter­parts. Previous research has demonstrated that as the percentage of Medicaid patients in a physician's practice increas­es, health services and the quality of care received by Medicare beneficiaries and the privately insured decrease. Yet, the literature offers very little information about the impact of a practice's proportion of Medicaid patients on the quality of care received by Medicaid patients themselves. The Capstone team analyzed how the proportion of Medicaid revenue received by a physician's practice influences the disparity in quality of care between Medicaid and privately insured patients. The study assessed whether disparities in the quality of care between Medicaid and privately insured patients occur within or between practices, and whether such disparities are themselves associated with the proportion of practice revenue from Medicaid.

In most public school systems, teacher pay is based solely on level of education and years of teaching experience. Unlike professionals in other fields where per­formance is a factor in determining com­pensation, teachers have little economic incentive to strive for results in their work. During the 2007­2008 academic year, the New York City Department of Education introduced a pilot program whereby teach­ers at high­needs schools would receive bonuses if their schools reached targeted educational outcomes, as measured by test scores and other factors. This pro­gram differs from other incentive pro­grams in that it rewards whole schools for raising overall student achievement, and not individual teachers for the progress that their particular students make. The Capstone team analyzed the impact of the program to determine what effect, if any, school­wide merit pay has on student per­formance and school quality.

The Brennan Center for Justice at the NYU School of Law is a non­partisan think tank that combines public policy and public interest law to advocate for measurable legislative and legal changes that advance fundamental issues of democracy and jus­tice in the legal sector. Following the Citizens United v. Federal Election Commission Supreme Court decision, the Brennan Center for Justice commissioned a Capstone team to examine the impact that corporate independent expenditures have on repre­sentative democracy. To understand the effect, the Capstone team compared trends in democratic indicators such as voter turnout, electoral competitiveness, and corruption convictions across states with varying historical restrictions on cor­porate independent expenditures. The information was compiled and analyzed to support the Brennan Center's campaign finance litigation efforts.

Since its designation as a Children's Hospital by the National Association of Children's Hospitals and Related Institutions, Maimonides Infants & Children's Hospital (MICH) has continually worked to provide the highest levels of quality care in all pediatrics subspecial­ties. Serving over 750,000 children of diverse ethnic, cultural, and linguistic backgrounds in South Brooklyn, MICH identified the need to improve communi­cation between healthcare professionals, patients, and their families. Through inter­views, evidence­based research, and research from other children's hospitals, the Capstone team identified key commu­nication problems and compiled and ana­lyzedthisresearchtoproducerecommendations that MICH can use as it expands services, develops communication strategies, and creates mechanisms to evaluate and measure the organization's success in ful­filling its mission.

Founded in 2001, the International Center for Transitional Justice (ICTJ) works to redress and prevent the most severe viola­tions of human rights by confronting lega­cies of mass abuse. This work entails informing international policymakers of best practices in transitional justice, strengthening the recognition of transi­tional justice as a crucial feature of post­conflict peacemaking and peace building, and contributing to the development of international norms for accountability and justice. On the occasion of its tenth anniversary, ICTJ charged the Capstone team with investigating the role ICTJ played in the development of two seminal transitional justice framework documents that guide practices within the United Nations: the 2004 Secretary­General's report on rule of law and transitional jus­tice in conflict and post­conflict societies; and the 2005 revised UN Mediator Guidelines. The Capstone team reviewed relevant documents and conducted inter­views with UN officials and former and current ICTJ staff and consultants. By doc­umenting successes and key challenges throughout the organization's work, the Capstone team enhanced ICTJ's understanding of its role in creating these frameworks. The Capstone team provided ICTJ with a set of recommendations that will help the organization create more impactful strategies for future policy advocacy.

The United Nations Capital Development Fund (UNCDF) requested a Capstone team to assist in improving the way it allocates basket funds for local economic develop­ment projects. The Capstone team trav­eled to Uganda to perform an institutional assessment of public service delivery in the agriculture sector. The main tasks involved conducting a stakeholder analy­sis for the agriculture sector and docu­menting service functions and the flow of resources to local governments from vari­ous actors, including central ministries, donor partners, and NGOs. The informa­tion generated through this research is intended to facilitate dialogue between central ministries, UNCDF, and the Local Government Finance Commission regard­ing the targeting of resources and techni­cal assistance to local governments.

After an extended period of internal con­flict in Cambodia, decentralization was introduced as part of a larger wave of pub­lic sector reform to promote democratic development and increase participatory governance. Decentralized planning and financing mechanisms were initially pilot­ed and then institutionalized at a lower level (commune), and similar reforms are now being introduced at higher sub­national levels (district and province). The United Nations Capital Development Fund (UNCDF) and The Asia Foundation engaged the Capstone team to assess the recent decentralization efforts in Cambodia. The Capstone team conducted a document review of the decentralization process as well as field interviews with researchers, local and international development part­ners, and government officials at the national and sub­national levels. As a final deliverable, the Capstone team produced an assessment of the sub­national planning process and guidelines, documentation and assessment of the pilot planning process undertaken in the Takeo province, and recommendations for a future subnational planning system for Cambodia.

Today's healthcare environment presents many challenges to nurse leaders, and effective leadership training for nurses is essential to successful transitions from the clinical to the managerial role. Addressing critical competencies and developing the required skills to manage staff and navigate the politics of a health­care institution are instrumental to this process. Along with curriculum content, the method of instruction is key for suc­cessful integration of the nurse into this new role. The Capstone team developed an evidence­based curriculum within a mentorship and project­oriented frame­work that will provide a cohesive starting point to bridge the gap between clinical practice and effective leadership. This cur­riculum will be implemented within the nurse's home institution and with partici­pation of senior leadership in order to reinforce newly acquired skills and the institution's culture.

Effective interdisciplinary communication is associated with reduced length of stay, improved patient safety, and increased employee satisfaction. However, communi­cation breakdowns are common in com­plex hospital settings and multiple com­munication structures often exist within the same organization. The Capstone team sought to evaluate current communication systems and make recommendations for improving interdisciplinary communication in hospital settings. After conducting site visits and staff interviews at Columbia and Cornell, the team identified highly functional interdisciplinary teams at both campuses. The team also evaluated best practices in interdisciplinary communication during site visits to other organizations. Based on characteristics of the highly functional teams, detailed interviews, site visits, and research from an extensive literature review on this topic, the Capstone team developed a pilot program for implementing an effective interdisciplinary communication structure on a hospital unit. Significant components of the pilot program include greater accountability, a focus on teamwork, and strong support from leadership.

Renewable energy is an increasingly important source of US electricity due to concerns about global climate change, energy security, and fossil fuel price volatility. This study focuses on the extent to which state regulatory policies impact state renewable energy generation. The Capstone team's research estimates the impact of Renewable Portfolio Standards (RPS) on a state's overall renewable ener­gy generation. Unlike previous research on the effects of RPS, this study attempts to operationalize a number of elements that comprise RPS, such as annual required share of renewable energy and the threat of penalty, in order to assess whether or not these variations have a significant effect on individual states' production of renewable energy.

In New York City approximately 1,200 youth ages 18­21 leave the foster care sys­tem each year. Because young adults tran­sitioning out of foster care are at greater risk of becoming homeless, the Deputy Mayor for Health and Human Services and the Administration for Children's Services engaged the Capstone team to improve housing outcomes for youth leaving foster care. The Capstone team examined existing support systems through extensive interviews, surveys, and focus groups. In addition, the team examined the policy environment and best practices for programs targeting youth in foster care. The team developed a final report that provides an indepth look at the support systems and housing options available to youth transitioning out of foster care, analyzes strengths and gaps in service, and presents recommendations to improve housing outcomes through changes in process, data collection, communication, and oversight.

Greater New Orleans, Inc. (GNO, Inc.) was charged by the State of Louisiana to coor­dinate the development of a new municipal water management system for the City of New Orleans and portions of its adjacent suburbs. In conjunction with this endeavor, the Capstone team prepared a reference document of case studies detailing best practices in worldwide water management systems, including physical components, financing mechanisms, and implementation strategies. In light of the area's postHurricane Katrina setting, the team emphasized storm water mitigation strategies in other lowlying and floodprone areas. Additionally, the team analyzed potential economic development opportunities and impacts that may present themselves with the implementation of the best management practices. GNO, Inc. will use these recommendations as it engages local political stakeholders, the general public, and consultants who will contribute to the creation of this new plan.