In The Media Archive

CHRT welcomes eight new team members

Full time staff members

CHRT has welcomed five new full time staff members.

Tiffany R. Brent is CHRT’s business development director. She has extensive experience in the public health sector, working in the nonprofit health care community with and for various organizations, partnerships, and collaborations throughout her career. Prior to joining CHRT, Brent was executive director of the Voices of Detroit Initiative (VODI) and also held positions at Southeast Michigan Beacon Community (SEMBC), Greater Detroit Area Health Council (GDAHC), and Soar Technology, Inc. Brent holds a juris doctorate from the University of Detroit Mercy School of Law and a bachelor’s degree in social relations and policy from Michigan State University’s James Madison College

Jeni Chapman is a project manager on CHRT’s finance team. She supports CHRT’s work partnering with community organizations focused on enhancing quality of life and removing barriers to improve health equity. Before joining CHRT, Chapman was the project and regulatory coordinator for the Physician Organization of Michigan Accountable Care Organization (POM ACO).

Brady Kinnersley is CHRT’s financial specialist. Kinnersley works with CHRT’s business development and programmatic teams on project budgets and spend down reports. Before joining CHRT, Kinnersley was a grants accounting analyst at the University of Toledo in Ohio. He has experience reviewing, analyzing, and evaluating the grant budget process, developing financial reports, and providing oversight on externally funded grants and contracts. Kinnersley is an alumnus of Pi Sigma Epsilon, a professional sales and marketing business fraternity. He is currently pursuing a master’s degree in finance and holds a bachelor’s degree in finance from the University of Toledo.

Kimberly Snodgrass is a health communications analyst at CHRT. She supports communications for Washtenaw County’s Public Safety and Mental Health Preservation Millage, Washtenaw County’s Law Enforcement Assisted Diversion and Deflection program, the Washtenaw Health Initiative, and more. She is a recent graduate of the University of Michigan’s School of Public Health, where she concentrated in health behavior and health education. She has a particular interest in primary prevention strategies and using low-cost health communications strategies to connect individuals to care. Prior to joining CHRT as a full time staff member, Snodgrass supported the communications team part-time for nearly two years as a intern. Snodgrass has also worked in suicide prevention for the American Foundation for Suicide Prevention and at the University of Michigan Prevention Research Center.

Holly Quivera Teague is a health policy analyst at CHRT, where she began her work as the 2022 Rebecca Copeland Intern. Quivera Teague is managing CHRT’s two fellowship programs and supporting other health policy projects. Quivera Teague graduated from the University of Michigan’s School of Public Heath, concentrating in health behavior and health education, in the spring of 2022. She has interests in health equity and social justice, including improving child health policies, reducing health disparities, improving health care utilization among people of color and undocumented immigrants, researching place-based and occupational health outcomes, and improving health and social service integration in communities of color.

Interns

CHRT is happy to welcome three interns.

Jadrienne Horton joined CHRT through the American Evaluation Association’s 2022-2023 Graduate Education Diversity Internship program. At CHRT, Horton will be supporting the research and evaluation team with the evaluation of Washtenaw County’s Law Enforcement Assisted Diversion and Deflection (LEADD) program. In 2017, Horton obtained her bachelor’s degree in health and community wellness with a minor in social services from the University of West Georgia. She is now a dual master’s candidate in public health and social work at 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.

Abigail Lindsay is an intern working on CHRT’s policy data analytics team to improve community-based long-term care services for vulnerable seniors and individuals with disabilities. Lindsay is a second-year master’s student at the University of Michigan’s School of Public Health concentrating in health management and policy. She is passionate about improving community health by advocating for just policies that address upstream social determinants of health. She has interests in aging, health equity, healthy community design, health care reform, and social welfare programs. She obtained her bachelor’s degree in nursing from the University of Michigan in 2017. Before starting her master’s, she practiced as a critical care registered nurse delivering clinical care at teaching hospitals, where she led quality improvement projects to enhance patient safety. Additionally, she worked as a nurse epidemiologist for the Detroit Health Department, where she managed a specialty COVID-19 investigation team that assessed infection control practices to isolate and interrupt outbreaks in nursing homes.

Kyra Martin is a health policy intern at CHRT, working primarily with the MI Community Care team to provide long-term, coordinated, and multidisciplinary care management for people with complex needs. Martin is a second-year master’s student at the University of Michigan’s Gerald R. Ford School of Public Policy, concentrating on public health and policy analysis. She is passionate about using data to identify, research, and advocate for policy solutions to health crises. She has interests in health equity and women’s public health, including reproductive justice, intimate partner violence, and maternal mortality. Before coming to Michigan, Martin was a legislative intern on the Hill and worked at the American Institutes for Research conducting mixed-methods research and evaluation. Martin graduated from the University of Chicago in 2018 with a BA in economics and political science.

Four new projects focus on opioid settlement investments, integration, disability care, and behavioral health

The Center for Health and Research Transformation (CHRT) has taken on several new projects over the last few months.

Opioid settlement investments

In the first project, the Center for Health and Research Transformation will provide Michigan recipients of opioid settlement funds with information about evidence-based, evidence-informed, and promising practices to address the opioid epidemic. CHRT will conduct a comprehensive environmental scan of programs and data to identify gaps and “pain points” that help municipalities decide how to put their settlement dollars to use. To accomplish this, CHRT will:

provide municipalities with information about evidence-based interventions that could be implemented using settlement funds, with a focus on programs that have no other source of funding;
assess current, evidence-based best practices and identify how settlement funds can be used to enhance and improve existing programs;
provide local decision makers with information regarding the current state of funding for OUD/SUD treatment, including the publicly funded behavioral health care system
provide local decisions makers with Michigan’s established criteria for spending settlement funds, and
partner with Michigan’s research universities, the State of Michigan, and local municipal organizations to coordinate efforts and develop a technical assistance support system for local efforts.

Public health and primary care integration

In the second project, CHRT will build on the pilot work it completed for the ABIM Foundation to understand best practices in public health and primary care integration. The new project will begin with a landscape analysis of state and local public health and primary care integration efforts across the country. Then the team will conduct interviews with experts and leaders in this space. Finally, CHRT will develop detailed case studies of three innovative states—North Carolina, Washington, DC, and Rhode Island—to illuminate which strategies, tools, and policy levers were employed by these states. CHRT will create a detailed case study of Michigan integration efforts to identify paths to advance the state’s integration and coordination work. Finally, findings will be used to develop a resource guide that includes action items and recommendations that can be employed at the state and local levels to catalyze the integration of public health and primary care systems.

Equity for people from marginalized communities with disabilities

In the third project, CHRT will join a newly funded Equity Center dedicated to enhancing the health and functioning of individuals with disabilities–particularly those from marginalized and underserved communities–through research, education, program development, and policy change. The University of Michigan Center for Disability Health and Wellness (CDHW), outside organizations, and outside investigators will work with the new center to identify and address health care disparities experienced by individuals with physical, cognitive, sensory, and developmental disabilities from marginalized backgrounds through a series of interrelated research projects, rigorous training, knowledge translation, and technical assistance activities. In this project, CHRT’s will enhance the capacity of community organizations and researchers across the United States to create evidence-based policy changes related to equity and disability health. To do this, CHRT will conduct webinars several times throughout the course of the grant, focusing on the policymaking and advocacy process.

Evaluation of Michigan’s Certified Community Behavioral Health Clinics

Finally, CHRT has recently heard that it will be working with the Michigan Department of Health and Human Services, funded by the Michigan Health Endowment Fund, to conduct a thorough evaluation of Michigan’s Certified Community Behavioral Health Clinics (CCBHCs) to determine their impact and guide future expansion in Michigan. CCBHCs offer a new model of care with the potential to increase access to behavioral health services statewide.

Ten years, 122 health policy fellows

In 2012, the Center for Health and Research Transformation (CHRT) launched its first-ever health policy fellowship. Since then, CHRT has welcomed ten fellowship classes of 10-15 fellows per year for a four-month program designed to teach them about health research, policy, and practice.

Fellows bring expertise from their careers in policy, research, and nonprofit management. In the program, policymakers gain a deeper understanding of pressing health issues of the day. Researchers learn effective ways to share their work in the policy space. And nonprofit fellows learn about policy and research, while bringing their own real-world perspectives to the table.

The fellows travel to Detroit, Lansing, and Washington, DC to meet local, state and national elected officials and to better understand the intricate workings of health policy. In addition, research fellows develop op-eds, one-pagers, and other deliverables, getting real-time feedback from health policy experts and nonprofit leaders.

Fellows also attend small group discussions and seminar-style presentations covering:

the history of health insurance and reforms, including the Affordable Care Act, including what they’ve made possible and the challenges that remain,
lessons in effective policy advocacy for researchers who hope to inform policymakers and practitioners for real-world impact,
health spending trends and implications, including prescription drug and insurance pricing,
provider and health plan efforts to maximize quality, eliminate inequities, and minimize costs, some of the biggest challenges of our time,
key policy issue updates with some of the top health legislators and influencers in Detroit, Lansing, and DC,
media engagement strategies, including meetings with some of the top media experts and training on how to write op-eds and one-pagers from experts in the field,
health policy perspectives of small and large businesses—key purchasers of health care insurance, and
introductions to cutting-edge clinical research and timely health policy issues in Michigan and across the nation.

In addition, fellows meet with a growing network of over one hundred fellowship alumni including:

Policymakers like Elizabeth Hertel, director of the Michigan Department of Health and Human Services (2012), Shaquila Myers, chief of staff for Lieutenant Governor Garlin Gilchrist and senior advisor to Governor Gretchen Whitmer (2017), and Renée Smiddy, director of policy at the Michigan Health and Hospital Association (2016).
Researchers like Dr. Michelle Moniz, obstetrician-gynecologist at the University of Michigan Medical School (2018); Dr. Mark Peterson, physical medicine and rehabilitation specialist at the University of Michigan Medical School (2019), and Dr. Renu Tipirneni, internal medicine practitioner and Healthy Michigan Plan evaluator at the University of Michigan Medical School (2018).
Nonprofit leaders like Kristie King, association executive at the Southeast Michigan Senior Regional Collaborative (2022), Elise Bur, director of the Northern Michigan Center for Rural Health (2022), and Kimberly Motter, director of quality and training at Reliance Community Care Partners (2022).

Over the last ten years, CHRT fellows have met dozens of state senate and house majority and minority leaders like Abdullah Hammoud (D) and Mike Shirkey (R), and health policy committee leaders, including Jim Ananich (D) and Mary White (R).

“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 Renu Tipirneni, who graduated from the program in 2018.

Nancy Baum, director of health policy at CHRT, says “there are policymakers in the room with a wealth of knowledge who really know the ins and outs of the policy system. And if you’re a policymaker in Lansing, and you’ve got a piece of legislation you’re analyzing, it’s really great to be able to say ‘I know an expert in this field.’”

CHRT helps facilitate relationships well beyond the four-month program. A couple of times each year, fellowship alumni from all cohorts are invited to attend sessions covering hot policy topics–our most recent session was attended by more than two-dozen alumni. And over ten years, the program’s connective tissue has been extended, allowing participants to build relationships with professionals from outside their areas of expertise.

Thank you to our most recent fellowship sponsors: Michigan Medicine, Blue Cross Blue Shield of Michigan, Michigan State Medical Society, and the Michigan Health Endowment Fund. And thank you to our partners, Kim Ross, Chief Government Relations Officer, Michigan Medicine; Kris Kangas-Kraft, Director of State Relations, Blue Cross Blue Shield of Michigan; and Eileen Kostanecki, Director of Policy Engagement and External Relations, University of Michigan Institute for Healthcare Policy and Innovation.

Project Manager Marissa Rurka discusses physician food interventions

Man looks into a nearly empty refrigerator

Marissa Rurka, a project manager on CHRT’s research and evaluation team, joined Phil Knight, executive director of the Food Bank Council of Michigan, and Gerry Brisson, president and CEO of the Gleaners Community Food Bank, for a conversation about how Michigan physicians screen patients for food insecurity, and what happens next. The Food First Michigan podcast (episode 91) is available online.

During CHRT’s most recent statewide survey of Michigan Physicians, Rurka and other members of CHRT’s research and evaluation team learned that about half of Michigan physicians do not routinely screen patients for food insecurity, and about 40 percent don’t know where to refer patients to meet their food needs. Their findings are published in Physicians screen patients for social needs: what happens next? Survey, analysis, and policy recommendations.

“I think traditionally, there’s this tendency to think about how we can intervene at the physician level,” Rurka told Food First listeners. “What trainings can we bring to physicians? How do we convince physicians to screen more patients?

But there’s this whole other component of that gap, which is, do community-based organizations like food banks have the resources not only to support the patients that are being referred to them, but also to provide closed loop referrals to the health exchange platforms.”

“If we want people to use food—which is fairly inexpensive and very accessible—to help manage their chronic conditions, we’ve got to connect the screening and the referral and the fulfillment of that referral wherever that person goes to get food,” said Brisson, who says that California, Massachusetts, North Carolina, and Oregon have all developed closed loop systems to report back to physicians and health care professionals on the status of referrals.

In Michigan, Brisson and Knight explained, they are expanding an existing 1-800 helpline for physicians to call when they encounter patients with food insecurity.

“So when you talk about 40 percent of the physicians don’t know where to refer someone for food, they’re going to have that 1-800 number. They’re going to come to us. We’re going to find out where they live and what programs they qualify for. And then if they live in one of the five counties that Gleaners serves, we’ll contact Gleaners, they’ll put the box together, and in our perfect scenario, DoorDash will come and pick that box up and deliver it to the patient’s home.”

Rurka, who points out that physicians want to help patients in this way, but have a lot of time pressures, said the 1-800 line sounds like a good solution. The easier you can make it for physicians and health care teams, she said, the better it will be.

Health navigators say Medicaid members benefit from plain language, reduced administrative burden

Male holding baby with young boy sitting next to them

On June 30, State of Reform published an article relating the results of a newly released CHRT study about the effectiveness of Michigan Department of Health and Human Services (MDHHS) outreach methods to Medicaid members. The study explored MDHHS communications around the implementation of Medicaid work requirements for the Healthy Michigan Plan (HMP) in early 2020.

While Medicaid communications are traditionally text heavy and technical, MDHHS used simplified language, streamlined the format, and employed attention-grabbing colors and icons in letters to beneficiaries. MDHHS also used administrative data to automatically exempt individuals who were not required to report work hours.

Patrick Kelly, who completed the study while working as a senior analyst at CHRT, explained that “the department took a number of steps to make their communications more easily digestible or human-centered to draw more attention to their communications to Medicaid beneficiaries.”

In a series of focus groups and a survey, health care insurance navigators reported their belief that these new communication interventions worked better than previous methods.

Lessons learned from this study could be effectively applied to other public benefit programs and policies to improve implementation and ensure that everyone can receive the benefits they are entitled to.

Cited publication: Kelly RP, Marcu G, Hardin A, Iovan S, Tipirneni R. Health Navigator Perspectives on Implementation of Healthy Michigan Plan Work Requirements. JAMA Health Forum. 2022;3(6):e221502. doi:10.1001/jamahealthforum.2022.1502

MLive cites CHRT’s study on the impact of long COVID on Michiganders

Microscope picture of a COVID virus. In this article, MLive summarizes research findings about long COVID, and cites CHRT’s study on the disease impact on Michiganders and Michigan’s economy.

“We want to raise an alarm, raise a flag to say ‘hey, this is potentially going to be and could be a really big deal for policymakers, for the state, for the economy, for the health care system and we need to be prepared,” said Melissa Riba, CHRT research and evaluation director.

The CHRT survey found that common ongoing symptoms include breathing issues, loss or distorted sense of smell or taste, and mental health issues, as well as nervous system symptoms, neurologic problems, diabetes, heart problems, kidney damage, and fatigue.

“I like to think this is sort of the tip of the iceberg with long COVID, because everything about this virus and this pandemic and this disease is so new and every day we’re still learning more stuff,” said Riba.

CHRT’S STUDY MAIN FINDINGS ARE:

One in three Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID.
15% of men and 55% of women identified as long haulers.
Michiganders with diabetes were two times more likely to report long COVID.

READ MLIVE ARTICLE

READ CHRT’S BRIEF

CHRT research cited in Michigan Radio story about the effects of long COVID on women

Michigan Radio cites CHRT’s study on the impact of long COVID on Michiganders in “Women may be experiencing more long COVID than men. We don’t know why.” The article by Kate Wells focuses on why women are more vulnerable to long COVID, and other diseases that disproportionately affect women, and how Michigan-based health systems are supporting individuals with long COVID.

“We could possibly approach a million, and even higher than a million, long COVID cases in Michigan,” says Jonathan Tsao, lead author of CHRT’s brief in the story, going on to explain that “long haulers are more likely to be in a worse financial situation than a year ago compared to those who recovered from COVID and those who never got COVID.”

“[With] all these long term chronic conditions, it is very debilitating for individuals to function at their full working capacity,” says Tsao. “Those who’ve experienced these symptoms, they were more likely to either work reduced hours, or decide to voluntarily quit, or even get laid off from their jobs due to the demands of their jobs as well.”

Tsao is hoping employers are paying attention, and make accommodations just “like any other disability that might happen in the workplace.” But women will likely be most impacted — not just because they experience more long COVID, but because they already were more likely to work in sectors that saw COVID-related job cuts, or have to take on caregiving responsibilities during the pandemic.“What we want them to take away from this … is basically that they’re not alone,” Tsao said. “There’s a lot of people who are going through what they’re going through.”

CHRT’s STUDY MAIN FINDINGS ARE:

One in three Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID.
15% of men and 55% of women identified as long haulers.
Michiganders with diabetes were two times more likely to report long COVID.

READ MICHIGAN RADIO ARTICLE

READ CHRT’S BRIEF

CHRT cited in State of Reform: long COVID’s effect on physical, mental, and financial health of Michiganders

State of Reform features CHRT’s research on the impact of long COVID in Michigan.

According to the CDC, long COVID—also known as post-COVID—is when “people who have been infected with the virus that causes COVID-19 experience long-term effects from their infection.” CHRT classified long COVID in people “who have had COVID symptoms continue for weeks or even months after initial infection,” said Jonathan Tsao, Research and Evaluation Project Manager at CHRT and one of the authors of the study.

“Long COVID is still all so new and it’s all new territory. We’re still learning and understanding what the effects of the virus are on physical health, mental health well-being, and financial and economic well-being,” said Melissa Riba, Research and Evaluation Director of CHRT. “We are seeing the intersection of long COVID, income disparities, and gender disparities.”

According to the report, Michiganders who identify as long haulers also suffer from financial hardships. Reports show that some long haulers are more likely to take medical leave, reduce their work hours, have their salaries reduced, or quit their jobs. This is because they are unable to function as they did before COVID.

The main findings are:

1 in 3 Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID. Tsao said if you apply this data to Michigan COVID statistics now—not including COVID deaths—there have been a little over 2 million total cases, which would leave about 700,000 people who might have long COVID in the state.
15% of men and 55% of women identified as long haulers. The study also found that women are nearly 4 times as likely to report long COVID. Tsao said this matches the national research on women affected with long COVID.
Michiganders with diabetes were 2 times more likely to report long COVID. In the study, individuals with diabetes are at a higher risk because the disease impairs the immune system and damages organs.

“Depending on how many future cases of COVID exist, it likely could creep to a million or even exceed a million in the long term,” said Tsao.

READ THE STATE OF REFORM ARTICLE

READ CHRT’S BRIEF

CHRT moves to Arbor Lakes, joining many other University of Michigan centers and institutes

Desk with laptop, landline and cell phone

This spring, CHRT packed up and moved just a couple of miles down the street, still on Plymouth Road, to Arbor Lakes near the University of Michigan North Campus Research Complex (NCRC), a hub for translational research.

At Arbor Lakes, CHRT is joining many other University of Michigan centers and institutes in a warm and welcoming complex of brick buildings with abundant natural light and landscaping.

While staff will miss CHRT’s old home in the Plymouth Building, they’re pleased with the new facilities, which are, in the words of CHRT’s director, Terrisca Des Jardins, “bright, light, and crisp.”

CHRT’s new suite, and shared facilities throughout the Arbor Lakes complex, are well-designed for public gatherings. One shared conference room, in fact, seats close to 150 people in a domed room with terrific A/V technology.

Our new office is just a few blocks from our old one, and it’s a great place for us to be. CHRT hopes to host you at our new facility soon. In the meantime, please make a note of our new address:

4251 Plymouth road
Arbor Lakes 1, Suite 2000
Ann Arbor, MI 48105-3640

Map showing the location in Arbor lake — Map showing the new location in respect to former office address

What is accessibility and why does it matter?

At CHRT, we value equity and information access for all. To further align our practice with these values, our communication team recently increased its expertise in accessibility through WebAIM training, a robust online course offered by Utah State University. Here’s just some of what we learned.

Over 25 million people in the U.S. have a disability (visual, auditory, or cognitive) that impacts their use of computers and the internet. Technologies, such as special screen readers, can alleviate some of these barriers. But to be effective, CHRT’s digital content must also be “accessible.”

There are four guidelines for developing, presenting, and formatting web content for accessibility:

Content must be perceivable, which is concerned with the sensory ability of a user. Font size, color contrast, and alternative text for photos and figures are some of the main ways to make content more easily perceivable.
Content must be operable, which means that the technology and navigation must be adapted to make it easier for readers to physically navigate the document.
Content must be understandable, which refers to the structure of the information in a document. For example, using consistent formatting for headers and subheaders in a linear format helps readers understand content more easily.
Finally, content must be robust, which means that the document remains accessible across a wide range of web platforms and assistive technologies.

Following these principles, accessibility is a continuum with the goal to be as inclusive as possible. CHRT’s communications team is making substantive efforts to boost the accessibility of content across its reports, infographics, and websites.

For more information about the W3C, see Web Content Accessibility Guidelines (WCAG).

News

Full time staff members

Interns

Opioid settlement investments

Public health and primary care integration

Equity for people from marginalized communities with disabilities

Evaluation of Michigan’s Certified Community Behavioral Health Clinics

CHRT’S STUDY MAIN FINDINGS ARE:

CHRT’s STUDY MAIN FINDINGS ARE:

The main findings are: