Projects

A major challenge for Robert Wood Johnson Barnabas Health (RWJBH) primary care practices is managing patients with co-occurring chronic and behavioral health conditions. Integrated behavioral health (IBH) is a solution for improving quality and clinical outcomes for patients with co-occurring behavioral and physical health conditions by embedding behavioral health providers into the primary care setting. This study is a mixed methods, comparative case study using learning health system science to establish the value of IBH at RWJBH, promoting system-wide adoption via three aims: 1) Identify the top critical metrics for establishing the value of IBH; 2) Align the critical metrics with existing datasets at RWJBH practices and build a pilot dashboard; and 3) Assess the preliminary value of IBH in the case study sites. This project is being led by investigators from Rutgers Center for State Health Policy and Rutgers University Behavioral Health Care and is supported by a grant from the Learning Health System Scientist Training and Research in New Jersey (LHS STAR NJ) Research Project Award Program through the U.S. Agency for Healthcare Research and Quality.

Despite high postpartum healthcare needs and high rates of postpartum maternal mortality, traditional pregnancy- related Medicaid coverage ends after 60 days postpartum. Medicaid pays for almost half of all births in the US and disproportionately covers births to the low-income population and people of color. There has recently been increased interest in postpartum Medicaid, including an American Rescue Plan Act (ARPA) option to extend Medicaid one-year postpartum. Prior to this, the March 2020 Families First Coronavirus Response Act (FFCRA) prevented Medicaid disenrollment during the pandemic, thereby extending postpartum Medicaid eligibility. Drawing on Medicaid expertise at the Center for State Health Policy, results from extended postpartum Medicaid eligibility during the FFCRA can inform current postpartum Medicaid policies, including those being implemented under ARPA. Using the Rhode Island All Payer Claims Database, analyses focus on maternal and child coverage and care use changes during the FFCRA, differences by race and ethnicity, and the effects of the COVID-19 pandemic context.

This project is funded under the Robert Wood Johnson Foundation’s research program, “Health Data for Action (HD4A),” which makes valuable data from unique data owners available to researchers to answer important research questions. The goal of the study is to explore the impact of continuous postpartum Medicaid coverage eligibility under the March 2020 Families First Coronavirus Response Act (FFCRA) on postpartum enrollment and health care use. Using T-MSIS TAF data, the study seeks to examine the impact of the FFCRA continuous Medicaid coverage provisions on postpartum Medicaid retention and health care utilization, particularly among racially and ethnically minoritized groups, individuals with severe maternal morbidity, and individuals with Emergency Medicaid. The research team will use TAF data from the 15 included states, aggregated at the state-month level, to examine outcomes for Medicaid enrollees who gave birth between January 2019-June 2021. They will employ rigorous econometric methods to identify the effects of extended postpartum Medicaid eligibility during the FFCRA on postpartum enrollment and health care use. Deliverables will include a project work plan and final narrative. The researchers will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels and other key stakeholders, as part of the deliverables for this grant.

This project explores how immigrant legal status exposures impact the health and wellbeing of older (50+) Latino immigrants. The unauthorized Latino foreign-born population in the US is currently aging in place, leading to a growing number of older Latinos who experienced years of hardship throughout their adult lives and, as older adults, are excluded from the US social safety net system. The aging of the Latino population is thus likely accompanied by two related trends: (1) dramatic increases in the share of older Latinos without full access to the public programs that have been shown to considerably reduce poverty and increase access to health care among older American citizens, and (2) increased reliance by older Latinos on kinship networks – chiefly their middle-aged children – for daily financial and health care needs. Our goal is to document these trends and explore how they impact the health and wellbeing of older Latinos. The project has three specific aims. This work is supported by a grant from the National Institute on Aging (NIA) (R01).

Rutgers Center for State Health Policy (CSHP) will conduct a multi-part evaluation of the Children’s System of Care’s (CSOC’s) Youth ACT (Assertive Community Treatment) pilot, which is focused on providing intensive, multidisciplinary team-based, “in-home” treatment and supports to children/youth with significant mental health needs or complex/challenging behavior with an aim of improving their wellness and functioning within the context of their families, homes and communities. The process component will focus on how the pilot was implemented (focusing on domains such as reach, consistency/fidelity, adaptation); while the impact/outcomes component will focus on how effective it was in making positive changes for the youth and families.

Hudson County Department of Health and Human Services received funding from the US Department of Justice to implement an integrative wellness recovery approach to (1) better address current needs of justice-involved and non-justice-involved opioid-addicted individuals and their families; and (2) to better understand local trends and factors leading to opioid epidemic in the County so they can be mitigated. Hudson County has tasked CSHP to conduct a comprehensive analysis of the reports submitted by Opioid Fatality Review Teams to identify the patterns and emerging trends and, to the extent supported by the data, make recommendations for policy or practice implementation/changes. Please contact Manisha Agrawal, Senior Research Analyst at CSHP, for more information.

Health Data for Action (HD4A), a Robert Wood Johnson Foundation (RWJF) signature research program managed by AcademyHealth, aims to reduce the barriers often faced in accessing rich data by serving as a conduit between data owners and interested researchers. Through each HD4A funding opportunity, RWJF will make valuable data from unique data owners available to researchers, including data from the iPHD Project.

Future Visions is a pilot program through the NJ Department of Children and Families, Children’s System of Care, and offers intensive mobile treatment services for families who have high-needs children/youth aged 5-20 with intellectual and developmental disabilities. The program aims to provide extensive wrap around services to stabilize the children/youth in their homes while building skillsets that advance the goals of independent and productive living and community integration. The Center for State Health Policy, collaborating with the A.J. Drexel Autism Institute, and the Rutgers Boggs Center on Developmental Disabilities, will lead a two-part evaluation of the pilot program including a process evaluation that will examine the provider implementation of the Future Visions model and an outcome evaluation which will assess the impact of the intervention on the participating youth and their families across a range of measures. This project is funded by the NJ Department of Children and Families.