CHRT is pleased to welcome the 2024 Health Policy Fellowship cohort  

Instructor speaking to a class of students

The Center for Health and Research Transformation (CHRT) at the University of Michigan is pleased to announce its 2024 Health Policy Fellowship cohort. 

More than 125 health researchers, policymakers, and nonprofit leaders have completed the fellowship since its launch in 2012. Many fellowship alumni occupy influential roles as policymakers and leaders across Michigan. 

The 2024 fellowship cohort will include:

  • Chelsea Alcock, Legislative Assistant, 52nd District, Michigan House of Representatives
  • Dr. Frank Conyers, Clinical Assistant Professor, Department of Neurology, Michigan Medicine 
  • Samantha Cornell, Director of Community Based Services, Access Health
  • Elizabeth Crenshaw, Director of District and Constituent Services, 7th District, Michigan Senate 
  • Jennifer Day, Community Building Manager, Michigan Breastfeeding Network
  • Thye Fischman, Manager of Government Relations,  Department of Government Relations, Michigan Medicine
  • Morgan Foreman, Director of Constituent Services, 55th District, Michigan House of Representatives
  • Shannon Jackson, Program Manager, Residents in Action
  • Stephen Jackson, Policy Advisor, Michigan Senate Democrats
  • Dr. Patrick Johnson, Resident, Department of General Surgery, Michigan Medicine 
  • Dr. Beth Kuzma, Clinical Associate Professor, Department of Nursing, Michigan Medicine 
  • Kristina Leonardi, Director of Aging and Community Services Division, Michigan Department of Health and Human Services
  • Kelsey Ostergren, Director of Health Policy Initiatives, Michigan Health and Hospital Association
  • Beverly Ryskamp, Chief Operating Officer, Network 180

The program is an immersive four-month experience that brings together a diverse group of professionals to foster collaboration among policymakers, researchers, and nonprofit professionals. 

“The CHRT Fellowship enhanced my ability to think about policy—from the formulation of the research questions to the translation of the research findings to inform policy in real- time,” says Dr. Renuka Tipirneni, Assistant Professor of Internal Medicine, University of Michigan Medical School and Institute for Healthcare Policy & Innovation. “I valued going through the experience with an incredible cohort of both policymakers and researchers. This inter-sectoral peer mentorship enhanced my training and helped me build connections that I hope will last for my entire career.”

The 2024 cohort of Health Policy Fellows will engage in interactive workshops and learning sessions in Ann Arbor, Detroit, Lansing, and Washington, DC. These sessions are designed to provide fellows with opportunities to gain insights into local, state, and federal health policy landscapes. Orientation briefings will cover essential topics such as the legislative process, Michigan state government structure, strategies to effectively communicate with legislators, and the challenges in building sustainability for nonprofit organizations.

For further information about the CHRT Health Policy Fellowship and to apply for the 2025 cohort, please contact Holly Quivera Teague, Fellowship Program Manager, at

CHRT is grateful for the generous support of our 2024 fellowship sponsors: Blue Cross Blue Shield of Michigan, the Michigan Health Endowment Fund, Michigan Medicine, and the Michigan State Medical Society. 

How CHRT’s program evaluation team helps organizations create successful, sustainable programs

Melissa Riba

Melissa RibaCHRT’s program evaluation team works with stakeholders to design, analyze, synthesize, and report on evaluations. They aim to improve programs by assessing progress, demonstrating impact, and developing lessons learned.

We sat down with Melissa Riba, the program evaluation team lead, to learn more about the team’s projects, purpose, and intended impact.

What are some of the challenges CHRT’s program evaluation team addresses?

The program evaluation team works with organizations that have identified a problem and created an intervention or program to address it. They’re doing great work, built on their evidence and experience, and they know they’re changing people’s lives. Their challenge is demonstrating that.

Evaluation can be a challenge for organizations because it’s a very time intensive, deliberate, systematic process. It’s a lot more extensive than simply identifying data or metrics, and it needs to be incorporated into early planning of a program to do it well. Often, organizations are trying to get a program up and running quickly and they don’t have the time or resources to plan evaluation. 

That’s where we can come in as consultants. We work hand in glove with the program to demonstrate impact and make the case for the program’s value – or to identify adjustments required to make the desired impact. This is often necessary to get continued funding to sustain or expand the program, because funders want to know the program is having the desired impact. As third party evaluators, we also provide the essential objectivity of an outside perspective.

As well as demonstrating value to funders and other stakeholders, we work on continuous quality improvement. By collaborating closely with the implementation organization, we identify areas where they should make mid-course adjustments. We provide quarterly data and information so they can see if they’re on track towards their targets, and discuss solutions if they’re not.

People working in health care and combating health disparities have a great deal of expertise and passion. Everyone undertakes these programs to improve people’s lives. We partner with them to demonstrate that they are indeed having an impact or consult on program adjustments to improve impact.

What projects are in the team’s portfolio now, and what do you anticipate their impact will be?

One project that we’ve been working on for five years is an evaluation of the behavioral health primary care integration process with the state of Michigan. We’ve been looking at how to integrate care and improve information sharing to improve care for the patient. As this project is winding down, we’re seeing a lot of impact.

We’re also working on a smaller pilot program in Detroit with an early childhood education center. Providers there observed that a lot of caregivers experience health disparities or behavioral health needs like postpartum depression. They’re piloting an evidence-based peer-to-peer program with a small cohort of moms to improve wellness, reduce depression and anxiety, and support parent-child relationships. On the program evaluation team, we often work with a small pilot to show outcomes and gather lessons learned, and then help our client make the case to expand it. This project is exciting because if this program does well the organization can expand the model to other parts of the state.

The program evaluation team has a robust portfolio, and we’re working on several other projects now as well, including evaluating the Certified Community Behavioral Health Clinics (CCBHC) in Michigan.

What processes does the team use to advance projects?

We use a culturally relevant and equitable evaluation framework for our projects. I’ve been doing evaluations for more than 25 years, and one common issue is that the exercise of evaluation is not always inclusive of a vulnerable community in a culturally relevant, equitable, appropriate way. Over the last few years, we’ve been incorporating this framework into all that we do to address this issue. We look through the perspective of the people being impacted by the program and seek input and guidance from people with lived experience. 

To achieve this, we focus on methods and how we collect data. We take into account health literacy and aim to understand where people are coming from. For example, when we were working on a project to integrate care in a pediatric practice, we initially wanted parents to take a brief survey. We realized that wouldn’t be appropriate because there may be multiple children present at an appointment, or children fussing, and the parents didn’t have time for a survey. Based on collaboration and feedback, we adjusted our method and had much more success. 

It comes down to being flexible. We work very collaboratively with our partners to make sure our evaluation is grounded in the reality of the work they’re doing and the community they’re working in.

We’re also really passionate about lessons learned. People get a little scared about evaluation, like you’re being judged. But that’s not our approach. We’re focused on the successes and the challenges, and how we can learn from them.

Everyone on our team is passionate about taking the hard work that our clients do on a daily basis and demonstrating its impact. Our team is very multidisciplinary, and our work is very applied. We take on the really messy projects. Our interns often say that our work is very different from what they learned in their evaluation classes, because we’re grounded in the real world and focused on adding value without getting in the way of our clients’ important work. It’s so exciting when we can see the impact immediately.

Health and Social Equity team members include: 

Joshua Traylor named executive director of the Center for Health and Research Transformation

Joshua Traylor

Joshua Traylor, MPH, senior director at the Health Care Transformation Task Force in Washington, DC, has been named executive director of the Center for Health and Research Transformation (CHRT), an independent nonprofit policy center at the University of Michigan. Traylor will take the helm on November 1.

“The board was unanimous and enthusiastic about selecting Joshua Traylor for the role of executive director,” says Tony Denton, CHRT board chair and senior vice president and chief operating officer of the University of Michigan Health System – Michigan Medicine. “Traylor’s work with diverse stakeholders, his systemic approach to complex challenges, and his commitment to health equity will advance CHRT’s mission to inform and support policies and practices that improve population health.” 

Throughout his career, Traylor has developed deep expertise in health care reform strategies and has led cross-sector work to extend care to the uninsured and to address barriers to successful reform efforts in Medicare, Medicare Advantage, Medicaid, state employee, and privately insured populations. 

As a senior director of the DC-based Health Care Transformation Task Force, Traylor has worked with health care providers, purchasers, patient advocates, policymakers, and regulators to develop recommendations and resources for public and private sector payment and care delivery improvements. He has also worked with federal agencies and stakeholders and collaborated on a series of grants aimed at enhancing health equity, improving maternal health, involving patients and communities in health care decision-making, and addressing health-related psychosocial needs. 

Prior to his role at the Task Force, Traylor was a member of the Prevention and Population Health Group and the State Innovations Group at the U.S. Center for Medicare and Medicaid Innovation. At the Innovation Center, Traylor worked on the design of the Integrated Care for Kids Model, developed financial models to forecast the impact of proposed care delivery and payment reforms, identified strategies and recommendations for Medicaid care delivery and alternative payment reforms, and worked with State Innovation Model awardees to implement Medicaid reforms.

“My first position after graduate school was as an early career fellow at CHRT working on data analytics and the Washtenaw Health Initiative. The fellowship experience was invaluable for me and continued to inform my work at CMMI and HCTTF,” says Traylor. “I am thrilled to have the opportunity to work with the talented CHRT staff, board members, and partners to further CHRT’s mission of improving the health of people and communities and to continue to develop future leaders in this space.” 

“The board is deeply grateful to Robyn Rontal for her willingness to serve as interim director of CHRT, maintaining CHRT’s mission, vision, and values during this transition,” says Denton. “Her steady leadership has kept CHRT on course while improving its fiscal and operational position in important ways.”

CHRT’s 2021 impact report highlights the organization’s local, state, and national work to inspire evidence-informed policies and practices that improve the health of people and communities.

Introducing CHRT’s 2023 Rebecca Copeland Interns: Jennie Scheerer and Ashya Smith

Ashya Smith
Ashya Smith
Jennie Scheerer

We are pleased to announce that Jennie Scheerer and Ashya Smith have been chosen to serve as CHRT’s 2023 Rebecca Copeland Interns. 

Jennie Scheerer will primarily work with CHRT’s health policy and research and evaluation teams. She is interested in the intersection between maternal and reproductive health, anti-racism, and U.S. domestic policy.  

“Everyone with a uterus should have access to safe and equitable healthcare,” says Scheerer.

Before joining CHRT, Scheerer interned with the department of obstetrics and gynecology and the University of Michigan Institute for Healthcare Policy and Innovation (IHPI). As a research assistant, Scheerer helped manage research projects on abortion access and Title X family planning programs in Michigan.

Scheerer is a 2024 dual master’s candidate in public health and public policy at the University of Michigan. She holds a bachelor’s degree in human development and social relations from Kalamazoo College. 

Ashya Smith is interested in Black maternal health care, health equity, reducing health disparities, and improving healthcare access. She graduated from the University of North Carolina – Chapel Hill’s Gillings School of Global Public Health, with a master’s in health policy in 2023. 

While at the University of North Carolina, Smith interned for Birth Detroit and the United States of Care. In these roles, she learned how to use policy to advocate for marginalized communities. Smith also spent two years working on kidney policy research projects as a policy associate at the Arbor Research Collaborative for Health.

In 2019 Smith earned a bachelor’s degree from the University of Michigan in international studies, with a focus on global health and environment. During her undergraduate career, she interned at the Black Aids Institute as a UCLA Public Health Scholar, worked in sickle cell research in Ghana, and assisted in diabetes and food insecurity research at the University of Michigan School of Public Health.

About the Rebecca Copeland Memorial Internship

Rebecca Copeland was a dual degree student in public health and public policy at the University of Michigan, and graduated with an MPP and MPH in the spring of 2021. 

“Rebecca was deeply committed to improving health, health care, and social justice,” says Terrisca Des Jardins, one of Copeland’s mentors and former executive director of CHRT. “She brought enthusiasm and excellence to analysis of important health policy issues and inspired those alongside whom she worked.”

Des Jardins describes Copeland as “a wonderful human being who brought excellence and critical thinking to everything she did. She was demanding of herself and others, and of society and health care delivery. She was thoughtful, kind and caring. She also had a wicked sense of humor.”

Copeland interned with Nancy Baum, CHRT’s health policy director, working on projects related to improving the public mental health system. 

“Her energy was amazing,” says Baum. “Rebecca showed us just how valuable interns can be in an organization like ours. When an intern is both smart and dedicated to making systems better to improve health, as Rebecca was, they can move mountains,” says Baum.

Rebecca Copeland passed away in July 2021, and CHRT honors her memory by offering the Rebecca Copeland Internship to students at the Gerald R. Ford School of Public Policy.

CHRT welcomes four new team members

New team members

New team membersSince our last newsletter, CHRT has welcomed four new team members. 

Jadrienne Horton

Jadrienne Horton is a project manager for CHRT’s research and evaluation team. Horton previously interned with the team through the American Evaluation Association’s 2022-2023 Graduate Education Diversity Internship program, assisting with the Year 1 Evaluation Report for the Washtenaw County Law Enforcement Assisted Diversion and Deflection (LEADD) pilot. Horton recently graduated with a dual master’s degree in public health and social work from the University of Michigan. She has interests in working with marginalized racial and ethnic minority groups and underserved populations to raise awareness about environmental and social injustices impacting their communities. She is also passionate about incorporating race equity into evaluation and research practices.

Abdullah Hashsham

Abdullah Hashsham is an associate analyst on the health policy and health and social equity teams at CHRT. He assists with the Washtenaw Health Initiative and works with the health policy team on Medicare, Medicaid, and long-term services and supports projects. Before joining CHRT, Hashsham was a research lab technician in the Affinati lab at the University of Michigan, studying diabetes from a neuroscience lens. Additionally, he interned at the Center for Healthcare Innovation, a Chicago-based non-profit, where he supported health equity initiatives on clinical trial diversity, affordable care, and children’s mental health. Hashsham earned his bachelor’s degree in public health from the University of Michigan.

Janan Saba Landsiedel

Janan Saba Landsiedel is a senior project manager at CHRT, supporting the objectives of the health and social equity team. She currently serves as the project manager for the Promotion of Health Equity initiative partnering with regional health organizations, Michigan Medicine, and the Michigan Department of Health and Human Services. Prior to joining CHRT, Saba Landsiedel supported quality improvement initiatives at Henry Ford Health. Additionally, she served as chair of the Michigan State Advocacy Committee for the American Heart Association. She holds a Master of Public Health with a concentration in global health from George Washington University, a bachelor’s degree in psychology from Albion College, and a professional certificate in project management.

Nailah Henry

Nailah Henry is an analyst on the health policy team at CHRT. She is committed to public health education, community health engagement, and advancing the understanding of health disparities. Henry has worked as an associate clinical research coordinator at Michigan Medicine and as a research assistant at Wayne State University and the University of Michigan. She holds a master’s degree and bachelor’s degree in public health from Wayne State University.

Regional Health Collaboratives work to improve behavioral healthcare

The Promotion of Health Equity Project engages six Regional Health Collaboratives — care coordination programs designed to improve a region’s wellbeing – to address health-related social needs and establish a framework for statewide expansion. 

A recent MI Mental Health Series article by Estelle Slootmaker, “Regional Health Collaboratives improving access to behavioral health services,” discusses the goals of these six collaboratives and specifically highlights MI Community Care (MiCC), the collaborative serving Livingston and Washtenaw Counties. 

CHRT provides the administrative backbone for MiCC, and is also evaluating the progress of all six collaboratives. The article interviews two CHRT staff members: Ayşe Büyüktür, MiCC program manager, and Jonathan Tsao, senior project manager on CHRT’s research and evaluation team. 

While the Regional Health Collaboratives help patients with a wide range of health and social needs — including housing, medication management, transportation to and from medical appointments, and food security — one of the collaboratives’ key objectives is to improve access to behavioral health care. To do so, each collaborative works with local partners to make behavioral health referrals.

Behavioral health is still stigmatized, Büyüktür says: “Not everyone is comfortable asking for help or knows how to access services … If someone is struggling with behavioral health needs, expecting them to navigate complex systems of care … places extra burden on them.”

“Most of the residents who come to their region’s programs have complex medical, behavioral health, and social needs,” says Tsao. “[Regional Health Collaborative] programs are designed to address all of those needs through care coordination.”

MiCC partners with Washtenaw County Community Mental Health (WCCMH) and Livingston County Community Mental Health.

To coordinate behavioral health care for a MiCC participant, the lead care coordinator arranges care and resources for patients, and community health workers (CHWs) and peer support specialists help patients access these resources. 

CHWs and peer support specialists “meet participants where they are,” says Buyuktur. “They see their living situations. They have the expertise to recognize needs and problems … They are incredibly knowledgeable about community resources. And because they build strong, trusted working relationships with community members based on those individuals’ personal goals, they help to de-stigmatize behavioral health at the individual level.”

MI Mental Health interviews Ayse Buyuktur about the importance of community health workers

CHRT’s Ayse Büyüktür, program manager for the MI Community Care (MiCC) program, recently spoke with MI Mental Health about the extensive work community health workers do to support the behavioral health needs of residents.

Across the state, community mental health agencies enlist community health workers to extend their reach, writes reporter Rylee Barnsdale in “Community health workers bring mental health home.”

Washtenaw County Community Mental Health, for example, partners with MI Community Care to provide CHW services.

MI Community Care works in both Washtenaw and Livingston counties, providing cross-sector care to support the needs of residents with complex lives and conditions. The story outlines how MiCC CHWs–centered at the Washtenaw Health Plan and the Livingston County Community Mental Health agency, support MiCC participants under challenging situations, helping them get the care and support they need.

One role of a CHW is performing home visits to patients to “meet them where they are,” Büyüktür explains. Home visits go beyond “simply helping to make appointments and phone calls,” she continues. During home visits, CHWs also can analyze what state an individual and their home are in and find community resources to improve their conditions, and to lessen feelings of social isolation.

When asked, “Are there changes for CHWs and how health care systems recognize them?” Büyüktür says Michigan “is working out how to pay CHWs who service people on Medicaid,” which is something she and others across the state are really excited about. To appropriately compensate CHWs for their work, though, requires understanding their value.

“[CHWs] do so much for us. It’s hard in some ways to describe it because they are changing lives. That’s not a cliche in this situation. It’s reality.”

Introducing CHRT’s new health and social equity team: A Q&A with Sharon Kim

Sharon Kim

In March, the Center for Health and Research Transformation (CHRT) launched a new team focused on health and social equity.

Though each of CHRT’s teams applies a health and social equity lens to their projects, CHRT desired a specific team to manage major programs under the health and social equity banner, while offering support to clients in pursuit of more complex health and social equity initiatives. 

CHRT brought programs such as MI Community Care, the Promotion of Health Equity project, the Healthy Aging at Home Network, and efforts supporting the Washtenaw Health Initiative under that health and social equity umbrella. 

We sat down with Sharon Kim, the Health and Social Equity team lead, to learn more about the team’s projects, purpose, and intended impact.

Sharon Kim

What are some of the challenges CHRT’s health and social equity team will address?

All of our programs focus on supporting the most vulnerable and underserved folks in our community, but in different ways and with different populations. 

MI Community Care (MiCC) is a good example. A coalition of Livingston and Washtenaw County community partners, MiCC is a free care coordination program that initially focused on reducing emergency department use. Now, MiCC helps participants–primarily Medicaid enrollees–meet their health and personal goals. Participants live with challenging and complex needs. MiCC participants often need support with multiple needs such as food, housing, specialized medical care, and behavioral health or substance use conditions. 

CHRT is the backbone organization for the MiCC program. Some partner organizations have become hublets, which means they take the lead with participants, coordinating all the services that that participant is going to need. Hublets are supported by additional partner agencies. All the boots-on-the-ground agencies involved came together and developed the MiCC model themselves. They developed a common consent model, they adopted common comprehensive assessment forms, they’re all using a shared IT platform to coordinate with each other and ensure closed-loop referrals. It’s part of what you see at a national level, this push toward coordinated, holistic, team-based care that’s centered around the patient.

In the U.S. we focus so much of our time and resources on medical settings, but true health care starts where we live, where we work, where we pray, and where we play. Our environment, the way we grew up and the resources available to us, drives health and wellbeing. We have been so focused in this country around providing care after someone gets sick, versus making sure that people have the things they need to be born healthy and stay healthy.

Our programs have the potential to reach and support the lives of our most vulnerable and underserved populations, but there are few mechanisms to pay for social care. We’re looking at sustainability paths from a policy perspective, and from a boots-on-the-ground perspective. But for many of our local players, it’s hard to do this work when you’re worried about keeping the lights on. And going after different funding streams increases the administrative and reporting burden.

Merging all our health and social equity programs under the same umbrella will help us make more efficient use of funding, staff, and other resources, especially for programs that serve overlapping populations and address similar needs. We expect that this will result in improved coordination of services, ensuring a more systemic approach to meeting community needs.

What projects are in the team’s portfolio now, and what do you anticipate their impact will be?

One of our largest projects, the Promotion of Health Equity (PHE) project, is really quite amazing. 

PHE is a Centers for Medicare & Medicaid Services (CMS) funded health equity project administered by the Michigan Department of Health and Human Services (MDHHS). For PHE, CHRT is facilitating a learning network and providing administrative support to six collaboratives: 

Each participating collaborative has already done significant work building a consortium of health care and social service organizations that are working together to serve their geographic regions. 

Bringing together so many regions from across the state, each with their own unique models and challenges, is a tremendous opportunity for all of us. We can address the priorities of the State of Michigan and the Michigan Department of Health and Human Services, such as the state’s social determinants of health strategy and health information technology roadmap. Both include a focus on community information exchange and the ability to integrate data across the clinical and social care settings, which is a central focus of PHE. PHE partners are leveraging the robust data sharing infrastructure they have built. This infrastructure helps to improve the ability for social care organizations to do their vitally important work. Michigan is already a national leader in regard to the sharing of clinical data, and through PHE we are moving another step forward in developing a statewide infrastructure to support data sharing between clinical and social services.

PHE brings together so many amazing partners. In addition to CHRT, core project partners include: the Michigan Health Information Network, Michigan Data Collaborative, Collaborative Quality Initiatives, MSHIELD, and the backbone organizations representing six different regions of the state.

A second project housed in the new CHRT team is a collaborative effort focused on supporting the unmet needs of older adults and their caregivers. It provides support to the aging population in Washtenaw County through a collective impact model. CHRT and its CBO partners successfully completed a CIHN pilot program. During this pilot, they created a shared administrative structure to provide individuals diagnosed with heart disease or diabetes with medically friendly home-delivered meals coupled with SDOH-focused assessments and referrals for additional services. Building on the success of the pilot program, CHRT plans to develop a “Healthy Aging at Home Network” (HAHN), formalizing the alliances developed during the pilot program and scaling up the service offerings for Michigan residents.

In the project, social care organizations come together to coordinate efforts to make sure that seniors—regardless of their economic status, race, ethnicity, or gender—have access to the things they need to age in a healthy way. 

What processes does the team use to advance projects?

As a new team, we are still developing our processes. Everything is a team effort. My role on the team is to make sure that my team has what they need to make their programs successful. I lean on their knowledge, expertise, and passion to advance equity.

The Promotion of Health Equity project is a good example of a team effort. We are bringing together six incredibly different regions with different goals. The CHRT team helps partners define overarching, cross-regional goals for health equity and for social equity. 

We do this by asking: What are the common outcomes that need to come from this? Can we identify shared goals, target populations, or interventions? How do you ensure that all of the different regions and different programs are working toward some of the same end goals and working together effectively?

These questions help us craft a shared vision. 

After determining a shared vision, we create a shared framework and implementation plan. The framework outlines the approach we’re going to take, including strategies for the interventions, for continued outreach, and how we’re going to connect with the state and funders more broadly. Then we determine how to assess the success of our work, not only for the regions individually, but as a whole. 

All of our projects focus on supporting the most vulnerable and underserved folks in our community in a way that’s holistic, coordinated, and uplifts the lived experience of people in the community. 

Health and Social Equity team members include: 

CHRT explores the individual and environmental factors linked to healthy aging for people with long-term disabilities

Since 2018, CHRT has worked closely with one of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDLRR) rehabilitation research and training centers (RRTC). The project, Investigating Disability factors and promoting Environmental Access for Healthy Living (IDEAL), aims to promote healthy aging for people with long-term physical disabilities. 

What we’ve done

For the IDEAL RRTC, housed within the University of Michigan’s Center for Disability Health and Wellness, CHRT has produced multiple articles and policy briefs that elevate challenges and solutions for individuals aging with long-term disabilities.

In a brief titled Housing crisis is magnified for people with physical disabilities. Here’s how we can help, CHRT describes how individuals with physical disabilities are impacted by the U.S. housing crisis and shares ways to make housing more accessible and affordable.

In another brief titled Telehealth for people with disabilities, CHRT recommends national and state policies to make telehealth more accessible, functional, and supportive for people with disabilities, such as incorporating closed captioning during appointments. 

In a third brief, CHRT investigates policy and programmatic solutions for supporting family caregivers, and in a fourth, CHRT explores the additional stress COVID-19 has caused for unpaid caregivers, and why that matters.

And in a 2021 issue of the Annals of Family Medicine, CHRT staff Robyn Rontal, Jaque King, and IDEAL RRTC colleagues describe annual wellness visit (AWV) use among persons with physical disabilities from 2008 to 2016–before, during, and after the rollout of the ACA. 

The Annals article, Annual wellness visits for persons with physical disabilities before and after ACA implementation, reports that while the rate of annual wellness visit use was decreasing before the inception of the ACA, that trend reversed when the ACA rolled out and the use of AWVs among persons with disabilities has continued to increase. 

The analysis, however, also found stark differences in AWV use based on gender, race, and other factors. 

In 2016, for example, commercially insured women with congenital disabilities had the highest rates of AWV use at almost 50 percent. However, Black and Hispanic men with congenital disabilities (commercially insured or Medicare Advantage members) had AWV utilization rates around half that. In addition, people with disabilities were 15 percent less likely overall to use annual wellness visits. 

Recent accomplishments

More recently, CHRT fielded a national survey of disability and aging services organizations and shared findings in a webinar titled, Serving those aging with a long-term physical disability during the COVID-19 pandemic: Challenges, successes, and innovations.

Among the 138 organizations surveyed, close to half (48 percent) changed or cut services during the pandemic, and 85 percent reported that the success of their programs was challenged by financial constraints.

“Organizations play an important role to ensure people with disabilities can age successfully,” says Marissa Rurka. “It’s important to uplift their strategies and share what they did during COVID-19 and how they adapted to unprecedented times.” 

During the webinar, Riba and Rurka facilitated a panel of representatives from four organizations. The Arc Detroit in Michigan, the Ability Center in Ohio, The League in Indiana, and the Thompson Senior Center in Vermont each discussed challenges that their organizations faced as a result of the pandemic. 

Panelists discussed how they adapted to those challenges. They also shared opportunities to better serve those aging with physical disabilities.

In April 2023, findings from this survey were published in the peer-reviewed journal, Disabilities, in a special issue of the journal titled: Aging with disabilities. 

The article, Organizations’ Perspectives on Successful Aging with Long-Term Physical Disability, describes the researchers’ methodology and results. Authors define successful aging for this population and which strategies and programs work well. 

What we plan to do 

CHRT policy staff are now conducting an analysis of dually-eligible (Medicare and Medicaid) members with a physical disability and tracking their utilization of annual wellness visits from 2007-2016. 

“We will compare members from a sample of Medicaid expansion states to a sample of states that did not expand Medicaid in order to test the impact of Medicaid expansion,” says Jaque King, associate director of health policy at CHRT.

The team will look at other measures too, such as hospital admissions and emergency department visits pre and post-Medicaid expansion, to test the impact of Medicaid expansion. 

Beyond this project, CHRT has also begun working with UM’s Center for Disability Health and Wellness, led by Michelle Meade, an associate professor in the University of Michigan  Department of Physical Medicine and Rehabilitation, to launch an RRTC Equity Center. 

The new equity center will foster collaboration between organizations and investigators. Participating investigators hail from organizations dedicated to enhancing the health and functioning of individuals with disabilities–particularly those from marginalized and underserved communities.

Collaborating organizations and researchers will analyze existing data, and will develop and evaluate new interventions to change the behaviors of health care providers and systems. CHRT will help center participants learn how to share their findings through policy engagement and advocacy. 


The project is funded through a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RTHF0001). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). 

CHRT’s Interim Executive Director Robyn Rontal is one of the co-PIs.


Michigan’s CCBHCs open mental health access to all

CHRT’s work evaluating Michigan’s Certified Community Behavioral Health Clinics (CCBHCs) was highlighted in a Second Wave Media article, “Michigan’s CCBHCs open mental health access to all.” The article features interviews with CHRT team members Erica Matti, senior health policy analyst, and Jonathan Tsao, research and evaluation project manager. 

CCBHCs provide whole-person care and aim to consider all aspects of a person’s health, including physical, emotional, and behavioral health, as well as social challenges such as financial and housing insecurity. To address these needs, CCBHCs provide a range of mental health and substance use disorder services to individuals, regardless of their income or insurance coverage. 

There are 34 CCBHCs in Michigan, including Washtenaw County Community Mental Health. Of those CCBHC sites, 13 are demonstration sites, which are full-service clinics where anyone can walk in and receive services. The federal government provides 75 percent of the funding for demonstration sites; the other 25% is provided by the state.

The National Council for Mental Wellbeing (NCMW) 2022 CCBHC Impact Report showed that CCBHC status enables clinics to: 

  • serve an average of 900 more people per year than they were able to serve before implementation and
  • increase hiring, with an average of 27 new staff per clinic hired as a result of being a CCBHC. 

The report estimates that in 2022, 2.1 million people were served across all 450 active CCBHCs and grantees nationwide, a 600,000-person (29 percent) increase from 2021.

As the designation of demonstration sites in Michigan is relatively recent, there’s not yet been any Michigan-specific evaluations conducted on the CCBHC model. Michigan recently received federal funding for this purpose and partnered with organizations, including CHRT, to carry out the evaluations. 

“There’s a number of findings that we’re really hoping to see in Michigan including improvements in staffing, training for staff, care, and care coordination,” says Erica Matti. “Care coordination is a huge one for the CCBHC model. the states that have had this for a long time have seen really good improvements in care coordination.”

Tsao outlined that the evaluations have three purposes. First, to understand why Community Mental Health (CMH) centers are implementing the CCBHC model, as well as their successes and challenges in doing so. Next, to deliver an outcomes evaluation of the impact on access to behavioral health services and sustainability. Finally, the evaluations will document lessons learned to help future CCBHC clinics.