Innovations in Design and Utilization of Measurement Systems to Promote Children's Cognitive, Affective, and Behavioral Health Workshop Summary (2015) / Chapter Skim
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2 Maximizing the Value of National, State, and Local Measurement Systems
2 Maximizing the Value of National, State, and Local Measurement Systems
Pages 5-20
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From page 5... ...
The state also has a strong county government system, with 23 counties plus the City of B altimore, "so everything that you do, you need to automatically multiply by 24," said Sheridan. The state's economy is grounded in its academic and educational institutions, its proximity to Washington, DC, its medical institutions, and its thriving hospitality and tourism industry -- which Sheridan referred to as "eds, beds, feds, and meds." 5
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From page 6... ...
"We could train you up on it in an afternoon and feel like you'd have the basic principles." It has limitations in being produced only on an annual basis, not being a powerful tool for day-to-day management, and not being comprehensive. But "even with those limitations, it's proved to be valuable over time." The second data structure is a statewide process called State Stat that was introduced by Governor Martin O'Malley after he was elected in 2006.
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From page 7... ...
To increase the use of the school breakfast program, the state convened a number of players at the state level, foundations, and corporate partners, and this group together mounted an outreach program that has encouraged schools to make breakfast part of the school day. From 2007 to 2008 and from to 2014 to 2015, the number of children eligible for a free or reducedprice lunch who ate a free or reduced-price breakfast at school every day rose from 44.6 percent to 60.9 percent.
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From page 8... ...
"I don't think the United States Congress is going to be offering a lot on that front for a number of years." A major challenge at the state level is to make it safer and more attractive to invest in prevention. "It costs less to stay at the Four Seasons every night than it does for us to place you in a hardware-secured juvenile detention facility, but I am having a hard time getting folks to say that $2,000 a year for highquality afterschool programming is a good investment.
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From page 9... ...
Eligibility files were combined with health care claims from in-patient, long-term care, prescription drug treatment, and other claims to develop an extensive dataset of information about the health care that children receive throughout the United States. Medicaid claims data are very useful in examining national trends and intra-state health care policies.
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From page 10... ...
For children and teens under 20 with at least one diagnosis in a health service claim of conduct disorder, oppositional defiant disorder, and/or ADHD, outcomes were analyzed by sex, age, race and ethnicity, state, and delivery type (fee for service or managed care)
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From page 11... ...
Robert Goerge, senior research fellow at Chapin Hall, pointed out that subgroups of families are at highest risk of their children experiencing adverse childhood experiences. These families tend to be characterized by a combination of attributes: • Chronically unemployed parents • Very low socioeconomic status • Long-term welfare program participants • Single-parent families • Mothers who had their first child as an adolescent • Families without grandparents living with them • Alcohol, drug use, mental illness • Inadequate parenting skills, family breakdown, parental stress and mental illness, domestic violence, and parental history of maltreat ment during childhood • Community-level low socioeconomic status, living in an impover ished community, family size, and sibling spacing To learn more about these families, Chapin Hall has created an Integrated Database on Child and Family Programs in Illinois that combines data from law enforcement, foster care and child maltreatment investiga
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From page 12... ...
The database combines data from a number of social service agencies. NOTE: AABD = Aid to the Aged, Blind, and Disabled; CPD = Chicago Police Depart ent; IDB = Integrated Database; SNAP = Supplemental Nutrition Assistance m Program; SSI = Social Security Income; TANF = Temporary Assistance for Needy Families; UI = Unemployment Insurance; WIA = Workforce Investment Act.
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From page 13... ...
. The data collected by Chapin Hall demonstrate that a small number of families use a large portion of the state's highest-cost services, including expenive and intensive health, human service, and corrections programs.
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From page 14... ...
At an even more detailed geographic level, some census tracts have more than 60 percent of children living in multisystem families, with some tracts above 90 percent. Furthermore, the percentage of children living in multisystem families is tightly correlated with education failure, Goerge noted.
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From page 15... ...
That's why they're on the streets." Future research directions for multisystem families include identifying unique characteristics of such families in specific places, discovering the problems that may have the greatest impact on the current state of the family, revealing whether single individuals account for multiple problems within a Mental Health 220,878 Foster Care 106,784 Substance Abuse 72,161 Adult Incarceration 56,649 Juvenile Incarceration 8,564 0 50,000 100,000 150,000 200,000 250,000 Number of Families with Each Problem FIGURE 2-4 Types of problems experienced by families. Mental health was the most common problem for families.
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From page 16... ...
At the same time, the federal government is requiring evidence-based practice and evaluation in many areas of social programs, which is a major challenge, given the lack of research expertise in these agencies. Importantly, data-sharing agreements are becoming more complicated as identity theft becomes more prevalent, as federal regulations proliferate, and to the extent that sometimes leaders and legal teams can view information as power and perceive that data sharing could potentially lead to negative media.
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From page 17... ...
Incentives have to be put into place for all jurisdictions to use their data to get smarter about what they are doing, Goerge emphasized, and all federal research projects should be reviewed so that they are effectively using administrative data. USING DATA TO IMPROVE PATIENT-CENTERED OUTCOMES: A PERSPECTIVE FROM THE MEDICAID MEDICAL DIRECTORS The Medicaid Medical Directors Network, which started as a knowledge transfer project of the Agency for Healthcare Research and Quality, has been meeting since 2005 and is now part of the National Association of Medicaid Directors.
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From page 18... ...
The research process was to agree on research questions based on input from the state Medicaid medical directors and staff, to define data parameters with the state data staff, to set up data submissions, to analyze the resulting data, and to report the results and make the link to policy. One interesting thing about this process is that the states are motivated by comparing their results with other states, Schiff noted.
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From page 19... ...
Electronic health records, even knowing one small piece such as body mass index is available, would help with monitoring data. In conclusion, Schiff listed several possible topics for the forum to consider: • Foster care and educational outcomes • Autism treatment and outcomes registry • ADHD diagnosis and educational outcomes • Psychotropic medications and race/ethnicity • Behavioral health screening and mental health services • Social complexity and improved well-being All of these issues are vertically relevant at all levels of the system.
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From page 20... ...
Medicaid Medical Directors Learning Network (MMDLN) and Rutgers Center for Education and Research on Mental Health Therapeutics.
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