Physical and behavioral healthcare integration (Multnomah County)

Work focused on the intersections of physical and behavioral health, particularly behavioral health’s impact on emergency care and physical healthcare costs.

Addictions, mental health, and the ER: A preliminary approach to exploring the connections between behavioral health and emergency healthcare utilization
Research brief on impact of behavioral health diagnoses on emergency department utilization; spring 2017

Lessons learned from analyzing substance use, mental health, and emergency department visits via claims data
Blog post for AEA 365; summer 2017

Impact of behavioral health on healthcare utilization
Research brief from larger paper analyzing impact of behavioral health diagnoses and treatment utilization on overall healthcare expenditures; fall 2017

Acute care risk tool (Multnomah County)

Predictive analytics tool developed for Multnomah County that aids in identifying clients in crisis before hospitalization became necessary. Utilized subject matter expert interviews, literature reviews, and subsequent Cox survival analysis and logistic regression to identify variables that predict acute care events, and reverse-engineered a weighted predictive algorithm that generates risk scores for care coordinators’ and other front-line mental health staff’s use.

Risk assessment and prevention: development of a risk took to aid in predicting and preventing acute care events
Documentation on development of predictive algorithm and current applications; spring 2019

ORGOVTUG presentation
Presentation given at the Oregon Government Tableau Users Group; spring 2019

AEA conference presentation
Presentation given at the annual American Evaluation Association; fall 2018 (session handout here)

COPPER poster
Poster presented at the quarterly Community of Practice for Professional Evaluators & Researchers; fall 2018

We All Count article
Article written for data equity website on tackling issues of equity and ethics in predictive analytics; summer 2019

Other behavioral health acute care work (Multnomah County)

Other work focused on psychiatric hospitalizations and emergency services.

Evaluation brief: Treatment connections & readmission risk after engagement with the Multnomah Intensive Transition Team, 2017-2018
Research brief from a longer paper examining MITT’s success in connecting clients to treatment post-hospitalization, and its long-term impact on hospitalizations; fall 2019

Evaluation brief: Examining healthcare costs before and after engagement with the Multnomah Intensive Transition Team, 2017-2018
Research brief from a longer paper examining MITT’s success in reducing overall healthcare expenditures for program clients; winter 2019

Psychiatric hospitalization readmissions: Examining the factors impacting risk of readmission into psychiatric facilities
Research brief from larger paper using Cox survival analysis to determine what factors predict readmission into psychiatric facilities, and identify what interventions may decrease that risk; spring 2017

Children’s psychiatric hospitalizations and length of stay
Research brief on the relative impact of length of stay on readmission, relative to outpatient engagement afterwards and other factors; spring 2015

Composite scoring systems (Multnomah County)

Scoring system for different behavioral health levels of care that brings together different metrics across multiple areas of performance into a single quality score for each provider, using a formula sensitive to each provider’s case mix. Developed with the national move toward value-based payment systems and desire to better understand and improve upon performance in mind. Mental health outpatient scoring system is complete, and now governs incentive payments to high-performing providers. Substance use detox, residential, and outpatient scoring systems are nearing the final phase of development.

AEA conference presentation
Presentation given at the annual American Evaluation Association; fall 2019 (session handout here)

Getting to the “big picture”: Development of composite scoring systems for mental health and substance use programs
Presentation given in multiple settings as overview to completed mental health mental health score and in-progress substance use scores; winter 2019

Composite score manual: Mental health outpatient services, Levels A through D
Documentation of metrics and scoring for mental health outpatient providers; rev. fall 2019

Care coordination pilot programs (Multnomah County)

Addictions Benefit Coordinator program – 2016 evaluation brief
The Addictions Benefit Coordinator (ABC) team is a specialized outreach team that seeks to connect Medicaid clients with substance use disorder, particularly those that are high utilizers of detox or other acute care services, or who have had trouble getting access to treatment, to substance use treatment and/or any other level of care suited to their needs. This was an early promotional writeup with early evaluation results from the pilot; this is now a permanent program at Multnomah County.

Substance use and gambling (Multnomah County)

A selection of work related specifically to addictions.

Substance use and criminal justice: challenges and opportunities
Research brief on the intersections of substance use and criminal justice, including explorations of demographic disparities and co-occurring mental health disorders, relative efficacy of treatment options in reducing recidivism, comparison of the impact and prevalence of different substances, predictors of who accesses treatment, and exploration of suitability of jail setting as additional opportunity for medication-assisted treatment induction for those with opioid use disorder; spring 2019

Tri-County Region Opioid Trends
Contributor to report analyzing opioid use trends in the tri-county (Multnomah, Clackamas, and Washington County) region; primary author of the section on treatment (p. 41-52); fall 2016

Recognizing the connection: integrating gambling help into alcohol and drug treatment
Evaluation of problem gambling intervention included in presentation given by colleagues at National Council on Problem Gambling annual conference (slide 21+); summer 2015

Bar Academy
Evaluation of the 2014 Bar Academy, a full day training for nightlife staff on best practices for public safety; fall 2014

Service to the research/evaluation field (various)

COPPER presentation
Presentation given at the quarterly Community of Practice for Professional Evaluators & Researchers – a discussion of quantitative methods, their place in local government evaluation, and ethical considerations, using the acute care risk tool as example; spring 2019

What comes next?
Regularly invited to give talk to Oregon State University graduate students on academic and professional development, creating your brand, networking, and applying for jobs; presentation from fall 2016

Housing First (Oregon State University)

My main work in graduate school focused on Housing First programs, a low-barrier housing model intended for homeless individuals with mental health and/or substance use disorders. These programs, which do not require sobriety, have been extensively documented as incredibly cost-effective for public healthcare, criminal justice, etc.; however, at the time, research on client outcomes was scarce. My focus was these programs’ impact on client well-being; initially directed toward substance use, but eventually expanded to include mental health symptoms and quality of life/individual goal achievement.

Rethinking change: measuring quality of life outcomes for Housing First residents in Portland, Oregon
Graduate thesis, available via ScholarsArchive@OSU; mixed methods longitudinal study of the experiences of formerly homeless individuals in a local Housing First project; outcomes in substance abuse, mental health, and quality of life were examined, as well as analysis of themes common to improvement or lack thereof; spring 2014

Thesis defense
Thesis defense given in May 2014; unanimous pass with no dissenting votes; spring 2014

Conference presentation
Subset of thesis presentation given at the annual Pacific Sociological Association conference; spring 2014

Housing First: a case study in economics and ethics
Lecture given in undergraduate/graduate slash course on social inequality; spring 2013

From out of sight to the limelight: chronic homelessness, Housing First, and how a marginal human rights idea became economic policy under the Bush administration
Paper written for public policy theory course during master’s program on the history of Housing First as viewed via the lens of the multiple streams framework; spring 2013

Community land trusts (various)

The creation of community land trusts as an innovative affordable housing alternative was a secondary interest in graduate school. My academic work examined the economic viability and the equity implications (e.g., decreasing the racial/ethnic wealth gap via homeownership); during my graduate internship with a local community development corporation, I had opportunity to participate in launching a new trust in Corvallis, OR.

If you think you can’t own a home, think again
Bound community land trust orientation booklet designed and written for Willamette Neighborhood Housing Services; summer 2013 (with inspiration from the generosity of Proud Ground, in sharing their materials)

Establishing a Community Land Trust in Corvallis, OR
Packet created for public community stakeholders’ meeting for consideration of expanding the community land trust model in Corvallis, on behalf of the Corvallis Sustainability Coalition‘s Housing Action Team; spring 2013

Taking Back the Land: The Economic and Equitable Case for Community Land Trusts
Paper written for public policy analysis course during master’s program on community land trusts; spring 2013

Equity and Empowerment: The Case for Community Land Trusts
Presentation on community land trusts given at the second annual Student Social Justice Conference, Oregon State University; spring 2013

Other housing work (various)

Manufactured Housing in Linn County, Oregon: An exploratory report prepared for Willamette Neighborhood Housing Services
Mixed methods market analysis of manufactured housing in Linn County to assist in affordable housing development, including equity, social, legal, financial, and structural considerations, on behalf of Willamette Neighborhood Housing Services; fall 2013

Washington Watch: Crisis Opportunity
Prism article coauthored with Dr. Amy Black; spring 2009

First Step Initiative
Initiative advocating for more recovery support/wraparound d services researched and drafted for IL legislative session, on behalf of Hesed House and Housing Action IL (work done while in undergraduate); fall 2008

Other work (various)

Social Stratification: Poverty in America
Lecture given in undergraduate sociology course at Oregon State University during tenure as graduate teaching assistant; fall 2013 (with inspiration from Dr. Sally Gallagher)

Inequality, Income, and Mental Health
A brief paper offering statistical analysis of the relationship of income deprivation and income inequality to mental health, utilizing Poisson regression analysis; spring 2013

Meaningful Access: Providing Comprehensive Domestic Violence & Sexual Assault Services to Linn & Benton Counties (with presentation)
Coauthor of research report created for CARDV (Center Against Rape & Domestic Violence) in collaboration with fellow colleagues at Oregon State University, analyzing awareness of CARDV’s services and barriers to access (especially among designated at-risk populations), community partners’ perceptions and relationships with the organization, and organizational messaging, with recommendations for improved targeting and outreach; spring 2013

“Religion and American Civic Life” chapter introduction
Chapter introduction written for Religion and American Politics textbook; published 2010

Work by others

Have supervised graduate interns in conducting their own analyses at Multnomah County; featuring some of their excellent work here.

Wraparounds, Medication-Assisted Treatment, and Oregon: A Meta-Analysis
Authored by two graduate interns, Meredith Booker and Joseph Whitley; meta-analysis exploring the impact of both MAT and a wide array of recovery support services on key outcomes for individuals with substance use disorder; summer 2015.