Center for Healthcare Research and Transformation

Promotion of health equity (phe): phe is a u.s. 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: the mid-michigan community health access program in genesee county, multiple partners coordinated by the health net of west Michigan in kent county,the jackson care hub in jackson county,mi community care in washtenaw and livingston counties,muskegon community health innovation region in muskegon county,and the southeast Michigan health association covering seven counties in and around the detroit area. The project aims to help these counties reduce health disparities associated with pressing social needs such as housing instability, food insecurity, transportation,health system complexity, and other socioeconomic factors. We address the priorities of the state of Michigan and the Michigan department of healthand 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 the following 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. Mi community care (micc): the three-year mi community care (micc) project receives funding from mdhhs and from the cares act to convene local health and human service organizations to provide patient-centered, coordinated care to individuals with complex medical, behavioral and social needs. Mi community care (micc) is a coalition of livingston and washtenaw county community partners. It is a free care coordination program that initially focused on reducing emergency department use. Now, micc helps participants-primarily mediicaid 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. They coordinate all the services that that participant is going to need. Hublets are supported by additional partner agencies.

Washtenaw health initiative: the washtenaw health initiative is a voluntary collaboration to improve the health of low-income, uninsured, under-insured, and underrepresented people in washtenaw county. Co-sponsored by Michigan medicine and the st. joseph mercy health system and supported by the Center for health and Research Transformation (chrt), the washtenaw health initiative helps 200+ members and stakeholders work together to: improve coordination across providers and integrate health and human services locally; support community-wide efforts to improve care and services for mental health, substance use, andother health issues impacting vulnerable populations; strengthen community-wide efforts to improve health equity by working closely with the washtenaw county health department; increase insurance coverage among uninsured individuals and help those with medicaid and marketplace health plans maintain their coverage, use it more effectively, and find access to care; help local and regional health agencies reduce service redundancies and use resources more efficiently and effectively; connect community resources to health care organizations and to each other;and explore opportunities to partner with livingston county health and human service organizations.

Washtenaw county community mental health: chrt is working with washtenaw county community mental health to implement the recommendations of the washtenaw county community mental health advisory council. These recommendations for mental health millage investments include expanding crisis services, increasing prevention work, enhancing youth services, addressing substance use service gaps, helping residents better navigate the county's mental health system, and more. Chrt also assist with evaluation and communications, ensuring that the community is aware of service expansions and that staff have the data they need to continuously improve programs and services.

Chrt provided client driven work during 2022: washtenaw county: leadd pilot evaluation chrt is evaluating washtenaw county's leadd initiative to assess its effects on individual client outcomes as well as on the criminal justice and legal systems. Chrt will use a combination of evaluation methods including surveys, interviews, and analysis of existing data sources. State of Michigan: opioid settlement analysis the opioid settlement prioritization survey 2021-22 sought to gather data to understand priorities for settlement funding among individuals across Michigan, including those with lived experience, to inform strategies to address the opioid crisis across the state. The Michigan department of health and human services (mdhhs) worked with the Center for health and Research Transformation (chrt) to analyze results from that survey. Specifically, chrt's team worked with state partners to analyze survey results, and reported back to mdhhs to share its analysis, which is the first step toward offering advice to support policymakers' decision process. Shelter association of washtenaw county: recuperative care sawc's medical recuperative care program uses an evidence-based model to improve health and housing outcomes for homeless individuals in washtenaw county by ensuring that those who would otherwise be on the streets or in an extended hospital stay receive the recuperative care that they need on site. Chrt conducts a mixed methods evaluation alongside sawc's implementation of this recuperative care program to determine if it achieves outlined objectives. Michigan public health institute: ccbhc evaluation 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. 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. The evaluation has 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.