Research in CTS (formerly CROW) Meeting: April 4, 2025

 Present:    Olivia Garrow, Emily Houston, Amanda Kennedy, Jerry Landau, Ben Littenberg, Emma Rose McCadden, Gail Rose, Liliane Savard, Connie van Eeghen (9)

1.    Warm Up: Mountain biking is so good!  
2.    Emma Rose McCadden-Vt Dev Disabilities Services: Conflict Free System of Care – evaluation of policy
a.    Dept of Disability is part of AHS: coordinates services with developmental and intellectual disabilities
i.    Funding is through Medicaid waivers
ii.    15 agencies throughout the state: 10 Designated Agencies and 5 special agencies
b.    Past concern: Conflict of Interest across agencies to ensure there is free choice, quality and outcome measures, fiduciary relationship for those who hold the funds and use the funds to deliver services
c.    In 2014: mandated to mitigate potential CoIs at DVSD
i.    Onboarding new Case Management organizations so that fund holder and service delivery are different organizations
ii.    Now in compliance with Medicaid
d.    Emma’s assignment: measure impact of transition to conflict free environment on the beneficiaries
i.    Aim 1: measure changes in access to care and health outcomes; evaluate shifts in percention in service Q and self determinations
1.    Seamless care
2.    Shared management
ii.    Aim 2: measure gaps
e.    Design: mixed methods
i.    Quant: surveys, pre/post, on perceptions of care, percentage of engagement in shared management
ii.    Qual: pre/post interviews to explore experience
1.    Tandem study: provider experience
f.    Sampling: No language exclusion criteria, which is tricky
i.    Surveys created to include communication liaisons
ii.    Trialed, before and after transitions
iii.    Outcomes on existing pathways, plus Green Mountain Self Advocate Group to make sure they are included
g.    Surveys
i.    Patient perception of patient centeredness
ii.    Medicaid existing HC systems and providers survey – all 15 agencies pre change
h.    Qualitative data will follow Caring About Me framework
i.    Data analysis
i.    Descriptive
ii.    Between provider findings
iii.    Pre/Post analysis
iv.    Qualitative themes
j.    Reported
i.    Annual report in 2026 and shared with professional and regulatory groups
ii.    Shared with advocates: Green Mountain Self Advocates
k.    Discussion
i.    How to ensure that pre/post populations are the same and are matchable. Agencies are the usual contact point for accessing individuals
ii.    The balance between accuracy and inclusion
iii.    Process of recruitment of patients through agencies: Randomization across tiers, case management organizations, utilization of services received, and demographics. Consider asking agencies for full lists of clientele. There are 3500 patients; hoping for 700-800 respondents.
l.    Research question: how does the transition change the experiences and outcomes of the patients?
i.    Consider coding in terms of experiences, and/or Medicaid’s objectives (e.g. shared decision making), and/or quality of care framework
ii.    Emma will recruit coders from the quality review team in her department.

Recorded by: CvE