Fifteen years ago, no one could have anticipated where the Center for Health and Research Transformation (CHRT) would be today. We’ve gone through many iterations, making our 15th anniversary truly significant.
We were only guaranteed three years of funding when we opened the doors of our center. We started as a grant-making nonprofit to support health services research. For many years, much of our work sought to improve health care and access to care. Then in 2018, we changed our name from the Center for Healthcare Research and Transformation to the Center for Health and Research Transformation. This shift highlighted our recognition of the critical role that health-related social needs and influencers have on the health of communities, as well as the substantive number of projects in our portfolio designed to address those needs.
Today, all of our work asks: How do we create healthier populations, healthier individuals, and healthier communities? Three primary strategies guide our work and help us answer these questions.
The first: To be, and be known as, a key source for evidence-based, non-partisan information on health policy issues and trends.
- Our policy briefs have remained neutral, trusted sources of information. We’ve analyzed a wide range of topics—like ways to recruit and retain behavioral health workers in rural America and effective state and federal policy options designed to support family caregivers—to determine how we can reshape policy to better serve vulnerable populations. We place a lot of attention on disseminating our briefs to policymakers, stakeholders, and other leaders, and have influenced several local, state, and federal policies.
- Our policy fellowship—which is now celebrating its tenth year—has greatly influenced the health policy space. Historically, we’ve welcomed a diverse set of researchers and policymakers. In recent years, we added nonprofit leaders to the fellowship. In the ten years the program has run, we’ve had 122 fellows. And we launched a new fellowship for Detroit Health Department (DHD) staff, the DHD Public Health Practice and Policy Engagement Fellowship. This fellowship program has trained 37 frontline DHD staff to date, helping them build knowledge in systems thinking, data analytics, public policy, and communications. We are currently training our third cohort of DHD fellows.
- Our communications work has grown to be its own area, expanding from supporting CHRT’s core communications to helping partners and funders raise awareness about their programmatic efforts. For example, CHRT’s communications team is working with the national Social, Behavioral, and Economic COVID-19 Coordinating Center (SBECCC) to develop a research report showcasing NIH-funded COVID-19 research projects centered on disparities. The SBECCC hopes the report will help highlight evidence-based COVID-19 mitigation strategies and provide important data to inform future pandemic mitigation strategies across the country.
The second: To help community-based health collaborations improve population health and magnify their impact.
- Our backbone support has helped community-based collaborations like MI Community Care, Vital Seniors and the subsequent Healthy Aging at Home Network, and the Washtenaw Health Initiative get started and off the ground. We’ve also facilitated the evolution of their work. Over time, that has positively impacted both individuals and populations.
- Our technical assistance has facilitated health care delivery transformation, new initiatives, and evolving strategies. For example, we’ve recently worked with the Michigan Department of Health and Human Services to identify more equitable long-term services and supports. In this work, we focus on data analytics and strategic planning to help our state scale solutions to a range of populations.
And the third: To build the evidence base for local and state programs that can be replicated and scaled to improve health and social welfare.
- Our evaluation team has continuously surveyed communities and providers across the state. For example, we were pivotal in helping the state determine how to support the expansion of Medicaid. More recently, our survey work has informed several important briefs on the COVID-19 pandemic and health equity. In 2020 CHRT staff quickly produced resources to help COVID-19 response policies including pieces to identify: best practices for protecting populations in nursing homes and long-term care settings; how to meet the behavioral health needs of Michigan’s prison population; and how to provide safe, temporary shelter for homeless populations.
- Our program management and evaluation work has been a valuable resource to our partners. Recently, we began a project to help determine how opioid settlement funds can help Michigan and its municipalities have a successful impact on substance use disorder treatment and prevention. We also recently began evaluating Washtenaw County’s Law Enforcement Assisted Diversion and Deflection (LEADD) program, which launched as an evidence-based pilot in 2021. And we are just now developing a thorough evaluation of Michigan’s Certified Community Behavioral Health Clinics (CCBHCs) to determine their impact and guide future expansion in Michigan.
CHRT has evolved a lot over the past 15 years. It’s even evolved significantly over the past two years since I assumed my role as executive director in 2020. Reflecting on my time at CHRT, I think of three meaningful shifts we’ve made.
- First, in the last two years, we’ve made a concerted effort to address diversity, equity, and inclusion—both internally through our staff and externally through our work. We believe this effort is a business imperative to support our current strategic plan, our partners and projects, and our future impact. We’ve been exploring an extensive reading list, hosting regular discussions around those readings, and pushing hard to find and attract diverse job candidates. These initiatives have allowed us to build a team that can authentically approach critically important racial, ethnic, and socioeconomic health equity work. We have infused an equity lens into nearly all of our projects. Recent projects include working with a multi-disciplinary national faculty team to provide coaching and guidance to integrated care delivery networks to address health-related social health needs and identifying finance models for addressing social needs with a special focus on supportive housing.
- Second, the COVID-19 pandemic had a large impact for us over the past two years—not just in how we work with partners and funders but also in the emphasis we’ve put on gathering and disseminating information on the pandemic. For example, we evaluated the state’s nursing home hub policy and made numerous recommendations to improve care for nursing home residents, surveyed Michiganders to determine who wasn’t getting vaccinated and why, and produced resources for policy and decision leaders navigating the Public Health Emergency. More recently, we’ve released pieces on the impact of Long COVID, the challenges and opportunities to consider as we make telehealth more accessible for people with disabilities, and how states are combating social isolation and loneliness in adults with disabilities during the COVID-19 pandemic.
- And lastly, we’re increasingly focused on the promotion of health equity. Today, we have a couple of centerpiece projects on equity. And a large subset of our work focuses on underserved and historically marginalized populations. For example, our Promotion of Health Equity project aims to reduce health disparities for residents in five Michigan counties by addressing pressing social needs and connecting patients with complex lives and conditions to needed care. Other health equity projects include our work with the Rehabilitation Research and Training Center to support a new national Equity Center to reduce disparities for individuals from marginalized communities with disabilities and our backbone support to help community agencies improve the county’s homeless response system through new diversion efforts.
CHRT has covered topics including health care access, health care delivery, health care integration, healthy aging, behavioral health, unpaid caregiving, health equity, the social determinants of health, and pandemic response, to name only a few of the areas we’ve addressed in our first 15 years.
We are a team of problem solvers and thought partners working alongside our funders and clients. While our approaches are evidence-based, we can also push the envelope and contribute to the evidence as we identify creative solutions to the pressing health challenges of the day.
I’m grateful to have the CHRT team by my side as we move into our next chapter. Our team is incredibly passionate. Everyone brings a unique perspective and experiences to the table, and I’m continuously humbled to be a part of it.
Terrisca Des Jardins