Carrie Graham, Senior Research Associate

Open (1) Health Care Reform in California: Evaluation of California's Dual (Medicare/Medicaid) Financial Alignment Demonstration

Open. Apprentices needed for the fall semester. Please do NOT contact faculty before September 11th (the start of the 4th week of classes)! Enter your application on the web beginning August 16th. The deadline to apply is Tuesday, August 29th at 8 AM.

California was one of the first states to implement the Affordable Care Act and has taken the lead in many related health reform initiatives for beneficiaries of public programs like Medicare and Medi-Cal (California's term for Medicaid)

Join a dynamic team of researchers from both UC Berkeley School of Public Health and UCSF Institute for Health and Aging who are evaluating the Coordinated Care Initiative (CCI), California's dual alignment demonstration.

Working on this project will provide students with the opportunity to learn a great deal about health care reform in California and innovation around Medicaid and Medicare integration for vulnerable populations.

The Coordinated Care Initiative is one of 12 federally funded state demonstrations that aim to integrate Medicaid and Medicare services for dually eligible beneficiaries, a population with an often complex array of needs, including medical care, mental health care, and long-term services and supports. In 7 California counties, specially created health plans called “Cal MediConnect” offer dually eligible beneficiaries “coordinated medical, behavioral health, long-term institutional, and home- and community-based services through a single organized delivery system.” Almost 400,000 beneficiaries may be impacted. For more information on the demonstration, go to www.calduals.org

University of California researchers are documenting the impact of the program on dual eligible beneficiaries’ experiences with care, including access, quality and coordination. The study will also examine health system response to the initiative in several sectors, including health plans, medical care providers, behavioral health, skilled nursing, and home- and community-based services. The 3-year evaluation began in January 2015 and will include the following data collection:

• Focus groups with beneficiaries who transitioned to Cal MediConnect were completed in 2015.
• The first wave of a longitudinal telephone survey with dual beneficiaries, comparing CCI and non-CCI counties was completed in 2016
* The second wave of the telephone survey was fielded in early 2017. Longitudinal data analysis comparing first and second waves will be conducted in 2017.
• Telephone interviews with organizations and professionals that serve duals in CCI counties.

The research team works closely with the California Department of Health Care Services and an expert Advisory Group, including stakeholders from a variety of sectors.

In the Fall 2017 semester we will be analyzing the telephone survey data (interviews with beneficiaries) and conducting interviews with stakeholders who serve the duals population.

1) Candidate will assist researchers in compiling preliminary reports of beneficiary survey data: Reviewing output from SPSS or STATA, including frequencies, bivariate statistics and multi-variate statistics.Summarizing statistical results into both narrative and table formats for technical reports and policy briefs.
2) Candidate will assist researchers in summarizing and coding qualitative transcripts from key informant interviews with stakeholders.
3) Create power point presentations of final results.
4) Copy edit reports and briefs.
5) Review literature on the Coordinated Care Initiative and related topics.
6) Create online surveys for health plans and health care providers.

Day-to-day supervisor for this project: Marian Liu, Staff Researcher

Qualifications: 1) Motivated, mature, upper-division student, preferably majoring in public health or similar with an interest in Health Care Reform, the Affordable Care Act, and health care for seniors and people with disabilities; 2) Proficient with Microsoft Excel, Word, Power Point; 3) Excellent writing skills with preferred experience summarizing qualitative or quantitative analysis. 4) We are looking for someone with exceptional organizational skills and attention to detail who can devote approximately 8 hours per week.

Weekly Hours: 6-9 hrs

Off-Campus Research Site: 2140 Shattuck Avenue, 11th Floor (Corner of Shattuck and Center Berkeley, CA)

Related website: http://www.calduals.org
Related website: http://www.thescanfoundation.org/evaluating-medicare-medicaid-integration

Closed (2) Moving Towards Uniform Statewide Reporting: Evaluating California Adult Protective Services’ Readiness to Participate in the National Adult Maltreatment Reporting System

Closed. This professor is continuing with Spring 2017 apprentices on this project; no new apprentices needed for Fall 2017.

In California, the Adult Protective Services (APS) program is responsible for investigating reports of abuse, exploitation, and neglect among older adults and adults over the age of 18 with physical or mental disabilities. In addition to their investigative responsibilities, APS caseworkers are responsible for assessing clients’ need for services and collaborating with informal and formal support networks to provide preventive and supportive services. The goal is to maintain clients’ independence to live in the community and avoid abuse. With the growth of the older adult population, the number of elder abuse victims is rising.

In 2010, the Elder Justice Act was signed into law as part of the Affordable Care Act. As part of this legislation, the National Center on Elder Abuse was established, and recommendations were subsequently made by the agency to provide services and advance research agendas. Among the recommendations, one of the top priorities is to develop a national APS data system. The Administration for Community Living (ACL) is leading the initiative and developed the National Adult Maltreatment Reporting System (NAMRS) in collaboration with stakeholders such as the National Adult Protective Services Association (NAPSA).

California should be one of the states participating in this nationwide movement. California has the highest number of elder abuse reports, approximately 15% of all reports in the country. In fiscal year 2013-2014, 127,000 new reports were made to the 58 APS programs in California. Additionally, California and Texas have the highest number of confirmed reports, also called substantiated cases, when abuse or neglect was found during APS investigation. Clearly, California’s APS programs are important in providing remedies to abused and neglected older adults. Given the sheer volume of older adults that the state is serving through the APS program, California’s data has the potential to help APS programs, researchers, as well as policymakers to improve services for victims of elder abuse.

In California, APS is a county-run program with data tracked at the local level. This means that each of the 58 counties operate their APS program independently. Each individual county’s capacity to participate in a statewide data tracking system is unknown. Determining this readiness is an essential step in moving California forward towards the compliance of the National Adult Maltreatment Reporting System (NAMRS).

Currently, each county maintains a separate data system, but all programs are required to send monthly updates using the SOC 242 form to the California Department of Social Services (CDSS). The SOC 242 form tracks the number of reports and substantiated cases of abuse by type. This data is then used to inform our understanding of the prevalence of elder abuse in California. However, the SOC 242 form only tracks high-level aggregated data and does not provide any information on the victims or those committing the abuse. The form also does not provide any details about the victim-abuser relationship, or the context of the abuse, neglect, or exploitation. These deficiencies are descried in more detail below.

The proposed study aims to identify what data fields each county APS program in California is currently collecting that is above and beyond the limited data reported in the SOC 242 form. Additionally, this study will gather county APS’ input regarding current and future data collection practices and needs. Interviews will be conducted with APS program administrators from across the state with the goal of laying out a roadmap for moving towards full participation with the National Adult Maltreatment Reporting System (NAMRS).

1) Candidate will assist researchers in summarizing and coding qualitative transcripts from APS interviews: Reviewing output from Dedoose, including frequencies, and finding themes. Summarizing results into both narrative and table formats for policy briefs and academic populations.
2) Candidate will assist researchers in creating new interview guide for upcoming interviews and participate in the interviews if available.
3) Establish Qualtrics survey for new data collection.
4) Create power point presentations of final results.
5) Copy edit reports and briefs.
6) Review literature on APS practice, training, and related topics in elder abuse.

Day-to-day supervisor for this project: Marian Liu, Staff Researcher

Qualifications: 1) Motivated and mature student, preferably with an interest in gerontology, elder abuse research, or/and APS; 2) Proficient with Microsoft Excel, Word, Power Point; 3) Excellent writing skills with preferred experience summarizing qualitative or quantitative analysis; 4) Previous experience with Dedoose or Qualtrics is not required but preferred. 5) We are looking for someone with exceptional organizational skills and attention to detail who can devote approximately 8 hours per week. 6) Students interested in Asian American populations are welcome to apply.

Weekly Hours: 6-9 hrs

Off-Campus Research Site: 2140 Shattuck Avenue, 11th Floor (Corner of Shattuck and Center Berkeley, CA)

Related website: https://aoa.acl.gov/AoA_Programs/Elder_Rights/NAMRS/index.aspx
Related website: http://www.cdss.ca.gov/lettersnotices/EntRes/getinfo/acl/2014/14-42.pdf