News & Bulletins Archive
New results generated by a team of UMBC researchers (from The Hilltop Institute, the Department of Public Policy, and MIPAR) recently revealed that persons with serious mental illness (SMI) who also have co-occurring substance use disorders (SUD) appear less likely to use or benefit from programs designed to help them find work and stay employed. Based on careful Maryland Medicaid and public mental health system data exploration from the mid-2000s when “place and train” supported employment (SE) programming efforts were expanded in the state, researchers found that SE uptake rates were on the order of 1.6 to 2.8 percent among those with SMI and SUD, whereas the analogous range was significantly higher at 4.1 to 4.7 percent for those with SMI only. Moreover, among persons receiving SE at some point, follow-up data into the years 2007-2010 indicated that rates of employment for the co-occurring group was only 19 percent compared to 29 percent for the SMI group without SUD. Future work will consider apparent antecedents to these disparities toward the development of strategies to increase SE uptake among persons with SMI and SUD. Additional work will look at uptake correlates and strategies more broadly.
This research was lead by Dr. David Salkever (UMBC Department of Public Policy) with funding support from the U.S. National Institute of Mental Health. Dr. Salkever presented these results at an April 2015 meeting in Barcelona, Spain. Hilltop Senior Research Analyst Michael Abrams, MPH, was a co-investigator on this work, and most of the analytic data set creation took place at Hilltop. For more information about this research, contact mabrams@hilltop.umbc.edu.
Presentation Citation: Salkever, D., Gibbons, B., Abrams, M., & Baier, K. (2015, April 15). Disparities in access to and effectiveness of evidence-based supported employment for persons with co-occurring serious mental illness (SMI) and substance use disorder (SUD): Evidence from a state-wide policy intervention. Fourth International Congress on Dual Disorders. Barcelona, Spain. View the presentation.
Hilltop is a partner with Benefits Data Trust (BDT), the Maryland Departments of Health and Mental Hygiene (DHMH) and Human Resources (DHR), and the Johns Hopkins University School of Nursing on a newly funded research grant from the Robert Wood Johnson Foundation to measure whether specific non-clinical interventions–such as enrollment into federally funded public benefit programs–improve health outcomes and reduce health care costs. The research team will study the impact of SNAP (food stamps) and home energy assistance on community-dwelling older adults eligible for both Medicare and Medicaid (dual-eligibles) residing in Maryland—a particularly vulnerable population with high health care costs. This research will provide a roadmap to understanding the true impact that safety net programs have on health care outcomes. For more information, contact Mike Nolin.
The Hilltop Institute’s Hospital Community Benefit Program has just released an update of its online resource, the Community Benefit State Law Profiles, and has published a new issue brief, Hospital Community Benefits after the ACA: State Law Changes and Promotion of Community Health.
The Hilltop Institute has published an annual report of activities and accomplishments under the memorandum of understanding it has with the Maryland Department of Health and Mental Hygiene (DHMH) for fiscal year (FY) 2014 (July 1, 2013, through June 30, 2014). Hilltop’s interdisciplinary staff provided a wide range of services, including Medicaid program development and policy analysis; HealthChoice program support, evaluation, and financial analysis; long-term services and supports program development, policy analysis, and financial analytics; and data management and web-accessible database development. Hilltop has been providing services to DHMH for over 20 years, and this state/university partnership has received national acclaim. Read the report.
Hilltop Senior Research Analyst Michael T. Abrams, MPH, and Policy Analyst Carl H. Mueller, MS, are co-authors of a new study published in the Journal of Pediatrics titled Transcranial Doppler Screening of Medicaid-Insured Children with Sickle Cell Disease. The work was conducted in collaboration with researchers at Johns Hopkins and University of South Carolina medical schools under the direction of David G. Bundy, MD.The study found that letters to parents and doctors of children with sickle cell disease (SCD) did not succeed in increasing their use of a simple screening technique (transcranial Doppler imaging: TDI) for stroke risk, even as children with SCD are known to be at markedly heightened risk for stroke. The research, conducted largely at The Hilltop Institute, used Medicaid administrative data to identify a calendar year 2010-2011 cohort of individuals aged 2-16 years with SCD. Researchers measured 6-month post-letter TDI use in a group of 117 subjects whose parents and doctors were sent letters, and in a comparison group of 433 subjects who were not targeted by that mailing. Pre-intervention, annualized screening in the full SCD cohort (n=829) was just over 23 percent. Six-month follow-up on those who did not receive screening in the pre-intervention period was 7.2 percent in the group receiving the mailing and 8.6 percent in the comparison group. This difference was non-significant after adjusting for numerous covariates. Accordingly, this work reveals that a single mailing to parents and providers is not a sufficient method for increasing TDI use in youth with SCD. One important correlate that did emerge from this work is that specialist visits (e.g., to a hematologist) did significantly increase the use of TDI irrespective of the mailing. This incidental finding suggests that referral to a sickle cell specialist is more effective than referral for a specific procedure to address this serious illness, at least in terms of receiving important preventative screening. For more information, contact Hilltop team lead Michael Abrams (mabrams@hilltop.umbc.edu).
The full reference for this work is: Bundy, D. G., Abrams, M. T., Strouse, J. J., Mueller, C. H., Miller, M. R., & Casella, J. F. (2015). Transcranial Doppler screening of Medicaid-insured children with sickle cell disease. Journal of Pediatrics, 166(1), 188-90. doi: 10.1016/j.jpeds.2014.09.018.
The pubmed citation and abstract can be accessed here: http://www.ncbi.nlm.nih.gov/pubmed/25444529
On December 31, 2014, the Internal Revenue Service (IRS) published final rules implementing the “Additional Requirements for Charitable Hospitals” section of the Affordable Care Act (ACA). These rules relate to tax-exempt hospitals’ community health needs assessments (CHNAs); financial assistance policies (FAPs); and hospital charges, billing, and collection practices.
Read the Bulletin for a summary of the rules.
On December 5, 2014, Hilltop, together with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, CareFirst, and LifeBridge Health, sponsored a public policy forum describing how hospitals and health care providers in Maryland are adapting to the new all-payer model, and the likely effect on the populations that hospitals serve. Click here for the program and presentations.
Hilltop Senior Policy Analyst Stephanie Cannon-Jones, MPP, gave a presentation at the 25th Annual State of the States in Head Injury Conference on October 28, 2014 in Philadelphia, PA. Cannon-Jones’ presentation, Medicaid Expenditures for Persons with Brain Injury while Residing in a Nursing Facility, described the key findings of a study that examined Medicaid expenditures and service utilization patterns of Maryland Medicaid-eligible beneficiaries with a brain injury diagnosis who resided in nursing facilities.
On October 23, 2014, Hilltop held a special event to celebrate its 20th anniversary. Over the years, Hilltop has grown to become one of the most highly regarded university-based health policy research organizations in the country. The event featured Bruce Vladeck, PhD, as the keynote speaker.
Hilltop Hospital Community Benefit Program Director Gayle Nelson gave a presentation at the National Academy for State Health Policy’s 27th Annual State Health Policy Conference on October 8, 2014, in Atlanta, Georgia. In her presentation, titled Leveraging Hospital Community Benefit Requirements, Nelson discussed hospital community benefits and various approaches states could use to leverage them to improve population health.
Hilltop Director of Special Studies Ian Stockwell, PhD, gave a presentation at the National Association of States United for Aging and Disabilities’ National Home & Community Based Services Conference in Arlington, Virginia, on September 18, 2014. In the presentation, titled The Use of Clinical and Functional Assessment Instruments, Stockwell discussed selection and use of assessment tools—which can have a broad effect across program and policy areas—and how this selection and use can help realize the potential to pull individual-level information together to form a complete picture of a program population.
Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, MPH, gave a presentation to the steering committee of the Milbank Memorial Fund-supported Reforming States Group (RSG) at their meeting in Chicago, Illinois, on August 27, 2014. In her presentation, titled Hospital Community Benefit: A Policy Lever for States, Nelson discussed hospital community benefit and the cost of tax exemption; using hospital community benefit as a policy lever; and avenues interested policymakers could explore with respect to their own states’ community benefit landscapes. The RSG is a bipartisan group of state health policy leaders from both the Executive and Legislative branches who, with a small group of international colleagues, have been gathering since 1992 to share information, develop professional networks, and commission joint projects–all in the service of bringing evidence to bear to improve population health.
The Hilltop Institute’s Hospital Community Benefit Program has received a two-year grant from the Kresge Foundation to continue to provide timely information on emerging trends and important issues related to community benefit.
Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, MPH, was part of a panel that presented at an Association of State and Territorial Health Officers (ASTHO) webinar on June 24, 2014, titled Community Health Needs Assessments [CHNAs]: A Tool for Achieving Health Equity. The webinar was attended by state and territorial health officials, their leadership teams, directors of state offices of health equity/minority health and primary care, and partner organizations. Nelson’s presentation, Advancing Health Equity through the CHNA/Implementation Strategy Process, discussed how public health agencies can utilize the CHNA/implementation strategy process to promote health equity and identified key steps in the process for advancing this goal.
Hilltop Policy Analyst Jessica Skopak, JD, PhD, presented a poster at the 22nd Annual Meeting of the Society of Prevention Research, Comprehensive and Coordinated Prevention Systems: Building Partnerships and Transcending Boundaries held, May 27-30, 2014, in Washington, DC. Skopak’s poster, titled Using “The CDC Guide” to Strengthen Partnerships and Inform Evaluation Planning for the Maryland Asthma Control Program, described Hilltop’s evaluation of the partnership component of the Maryland Asthma Control Program. To view the poster, click on the title.