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Human Services Research Institute

Shaping Human Services Policy and Practice – December 4, 2014

Supporting Families Pie Chart

Developing Systems of Support for Families

The US Administration on Intellectual and Developmental Disabilities awarded a five-year grant to the National Association of State Directors of Developmental Disabilities Services (NASDDDS) to create a Community of Practice to develop systems of support throughout the lifespan for families with members with intellectual and developmental disabilities.

HSRI is part of the national project team along with NASDDDS and the Institute for Human Development at the University of Missouri – Kansas City. Six jurisdictions were selected to participate, including Connecticut, the District of Columbia, Oklahoma, Tennessee, Washington, and Missouri. Activities undertaken in the participating states are guided by a set of principles articulated in the Life Course Framework for Supporting Families. This Framework for systems change incorporates the catalysts for change, strategies for supports, and outcomes organized around facets of community life that are important to people with and without disabilities.

For more information, visit

New Toolkit for Peer Respite Programs

In November, Bevin Croft, an HSRI research associate, and Laysha Ostrow, formerly of HSRI and now president and CEO of Live & Learn, produced and distributed a toolkit to assist peer respite stakeholders through the process of documenting program operations and outcomes. Peer respites are emerging as an alternative to medical interventions for people experiencing or at risk of experiencing a mental health crisis. Staffed and operated by individuals with lived experience of the mental health system, peer respite programs offer voluntary, short-term residential stays with a focus on building connections and mutual, trusting relationships to help people navigate their way through crisis. Recognizing the challenges involved in documenting the efficacy of programs that rely on less-clinical methods, Bevin and Laysha included recommendations on evaluation and data monitoring techniques as well as a number of instruments and tools used by peer respites today.
Access the Peer Respite Toolkit here

Bevin and Laysha also produced a summary of the results from their recent survey of peer respite programs in the United States.
View the Peer Respite Characteristics summary here

Data Ecosystem Slide

Talking Health Data

An increasing number of states are gathering statewide data from insurance carriers and analyzing it for healthcare cost and quality information. Yet, the complexity associated with gathering, storing, and processing these vast amounts of sensitive data can make these databases a daunting endeavor. HSRI’s Leanne Candura shared her knowledge of health data solutions and all-payer claims databases (APCDs) at the National Association of Health Data Organizations annual conference in October. Presenting at a session entitled “From Data to Database,” Leanne discussed ways to improve transparency in the collection and validation of healthcare claims data. As HSRI has found through its overhaul of an APCD for the state of Maine, transparent processes can engender buy-in from stakeholders and lead to higher-quality data.

New Articles by HSRI Researchers

HSRI staff members recently had two articles published in the journal Psychiatric Services.

H. Stephen Leff and Ben Cichocki, along with Clifton Chow (formerly of HSRI), had an article published in the July issue of Psychiatric Services. Based off findings from an HSRI evaluation of SAMHSA’s mental health transformation state incentive grants program, the article focuses on the effects of infrastructure change and concludes that Federal investments should take into account evidence that infrastructure changes alone do not necessarily contribute to better consumer outcomes, support operationally defined infrastructure improvements, require that service improvements accompany infrastructure changes, and provide sufficient resources to oversee grantee behaviors.

View the abstract or full article

Ben Cichocki and Bevin Croft, along with Clifton Chow, had an article published in the September issue of Psychiatric Services. The article examines the impact that the receipt of reasonable accommodations by individuals with psychiatric disabilities had on the amount of hours these individuals were able to work and the duration of their employment. Controlling for covariates suggested by the conceptual model, analyses showed that individuals who reported job accommodations worked an average of 7.68 more hours per month and an average 31% longer at the position. Moreover, each reported job accommodation decreased the person’s risk of job termination by nearly 13%.

View the abstract or full article

NCI Employment Graph

Sharing NCI Findings on Employment Trends and Outcomes

National Core Indicators staff, along with John Butterworth from the Institute for Community Inclusion at UMass Boston, presented during an American Network of Community Options and Resources webinar on October 27. NCI staff discussed findings from NCI data with regard to employment trends and outcomes for individuals with intellectual and developmental disabilities. According to NCI survey data from 2012-13, 15% of respondents were engaged in integrated employment—that is, a paid job in a place where most other workers do not have disabilities. Of those not in integrated employment, 47% want a job, and of those who want a job, 70% do not have employment as a goal in their individual service plan. Individuals with integrated jobs report better outcomes in the domains of relationships, health, and choice. The presentation also reviewed several opportunities for policymakers to increase employment opportunities for individuals with ID/DD.

View the presentation from the webinar here

Strategizing Ways to Meet Bed Demand in Milwaukee County

In September, HSRI and the Technical Assistance Collaborative, along with the Milwaukee-based Public Policy Forum, released a report that explores demand and capacity for adult psychiatric inpatient beds in the Milwaukee County system. The report is one product of a multiyear needs assessment and system redesign project—led in part by HSRI Vice President David Hughes—and is part of an ongoing effort by the Milwaukee County Behavioral Health Division to reduce reliance on inpatient and emergency mental health care and expand access to community-based care and treatment. In addition to recommending a specific range for total number of beds based on recommended community investments, the researchers also provide recommended ranges by level of patient acuity (low/moderate and high). They also provide four possible scenarios for meeting longer-term need, based on various implementation, funding and reimbursement factors.

View the full report here

Evaluating Self-Direction in Behavioral Health

HSRI will be conducting an evaluation of a three-year, multistate demonstration project on self-direction. Also called self-directed care, consumer direction, and participant direction, self-direction is a model for organizing services and supports that enables a service user to manage a flexible budget with the help of a specially trained support broker. This summer, the Boston College National Resource Center for Participant-Directed Services (NRCPDS) was awarded funding from the Robert Wood Johnson Foundation for a Demonstration and Evaluation of Self-Direction in Behavioral Health. The NRCPDS is coordinating the effort and has contracted with the mental health team at HSRI to conduct the evaluation.

HSRI’s evaluation involves two main components: a formative process evaluation and a system-level outcome evaluation focusing on service utilization and cost. Through the process evaluation, HSRI will document program design, implementation successes and challenges, strategies for overcoming challenges, and generate a set of guidelines for program replication and sustainability. In terms of outcomes, we will explore self-direction’s impact on service utilization and system costs. HSRI and the NRCPDS will also be partnering with researchers in some participating states to explore self-direction’s impact on other important outcomes such as mental health recovery, wellness, and self-determination.

Growing Our Team

HSRI is proud to introduce a number of new team members brought on board in the last few months. We could not be happier to welcome these incredible individuals who bring an impressive array of skills and research experience to our organization.

Our West Coast office added three new staff members: Michelle DeParrie, a research assistant, and Allison Schisler, a research analyst, are working on the evaluation of Title IV-E waiver demonstration projects in Colorado and Ohio, while Megan Villwock, a research analyst, is working on child and family services projects and intellectual and developmental disabilities projects, providing data management and analysis support.

On the East Coast, Melissa Burnett joined in the role of research assistant, working on behavioral health projects—including national evaluations for HIV, homelessness, and substance abuse programs. Lisa Lundquist joined in the role of research analyst and is working on the cross-site evaluation of the Minority AIDS Initiative for the Center for Substance Abuse Prevention. And interning with HSRI for the 2014-15 school year is Lauren Donahue, a mental health nurse practitioner candidate with Mass General Hospital. Working mainly with HSRI Research Associate Bevin Croft, Lauren will be assisting with self-direction and peer respite projects.

Using NCI Data to Demonstrate HCBS Compliance

In May, National Core Indicators (NCI) published a toolkit that provides states with detailed technical assistance for using NCI data to assess compliance with new Home and Community-Based Setting and Transition Plan Requirements and compliance with Revised HCBS Quality Assurances. The toolkit notes specific NCI data elements that support compliance for each of the following:

  • New Home and Community-Based Setting Requirements
  • Additional Requirements for Provider Owned/Controlled Residential Settings
  • New Person-Centered Service Plan Process Requirements
  • New Person-Centered Service Plan Documentation Requirements
  • Revised CMS HCBS Quality Assurances & Sub-Assurances

Authored by HSRI Policy Associate Elizabeth Pell, this resource has been well received in the field and published in developmental disabilities online resources. Access the NCI Toolkit here

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