Health and Human Development Magazine - Summer 2012 / SPECIAL SECTION: HPA

Special Section:

Department of Health Policy and Administration

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Special Section: Department of Health Policy and Administration

Peter Kemper Appointed to Department of Health and Human Services Peter Kemper, professor, was appointed a deputy assistant secretary in the U.S. Department of Health and Human Services. He is now leading the Office of Disability, Aging, and Long-Term Care Policy, one of four units within the Office of the Assistant Secretary for Planning and Evaluation. To assume the full-time position, Kemper retired from Penn State at the end of August 2011.

“It is an exciting time for a health services researcher to work in Washington because of the many challenges the country faces in implementing health and long-term care policy,” said Kemper. “I am honored to have the opportunity to take on my part of this challenge.”

An expert on long-term care services and supports, Kemper has led a number of studies on the cost of care for the elderly as well as on the lifetime risk of needing long-term care services and supports.

His research on home care includes an evaluation of the channeling demonstration, a large, randomized experiment that tested the effects of public financing of home care for the elderly. He also analyzed state options for the design of home care programs, case management in home care, and the effects of state Medicaid home

care spending on the unmet need for personal care. Most recently, his research has investigated options for improving the jobs of direct care workers and of reducing turnover in these jobs.

“As a health services researcher at Penn State, I have worked to develop evidence to improve long-term care policy,” said Kemper.

“In my new role, I hope to draw on evidence and analysis to inform decisions concerning disability, aging, and long-term care policy.”

According to Department Head Dennis Shea, Kemper’s collaborative research efforts on long-term care organizations have helped to identify critical areas for policy makers and long-term care leaders to target to improve the quality of care. “This is a fantastic opportunity for Peter to make a contribution to the future of longterm care services and supports in America,” he said.

Kemper previously served as a commissioner on the Medicare Payment Advisory Commission and as the workgroup leader on the Clinton health reform effort. Before joining the faculty at Penn State, he was the vice president of the Center for Studying Health System Change, director of the Division of Long-Term Care Studies at the Agency for Health Care Policy and Research, and director of the Madison Office of Mathematica Policy Research. He earned a bachelor’s degree in mathematics at Oberlin College and a doctorate in economics at Yale University.

David Katz Presents 15th Mayers Lecture

By Rebecca Ritter, senior in HPA David Katz began his speech with a poem by Robert Frost: “I have miles to go before I sleep.” This related well to Katz’s presentation, as he talked about how without proper exercise and nutrition, people will begin to lose “miles”—or years—of their lives due to health risks associated with obesity.

Katz, the president and founder of Turn the Tide Foundation, Inc., was this year’s speaker at the 15th annual Stanley P. Mayers Endowed Lecture, which was held in early April. The title David Katz of his speech was “Food as Medicine: The Case for a Figurative Spoon Full of Sugar.”

Katz spoke of his belief of “the power of lifestyle as medicine over medical destiny.” He stressed that if citizens improve their lifestyles, they have the opportunity to improve their own health. Eating right and performing daily exercise can impact an individual’s health, he pointed out, adding, “The master levers of medical destiny are feet, forks, and fingers.” To Katz, feet represent how much a person keeps his or her body moving and forks and fingers representing the food that he or she puts into the body.

Katz explained that the growing problem of obesity, especially of childhood obesity, in the United States needs to be addressed in order to improve the health of the nation as a whole. “Obesity is the greatest threat we face and it is out of control,” he said, sharing illustrations of vastly increasing rates of obesity in the United States. These charts were color-coded to show patterns of obesity

across the United States. At the red end of the scale, there was more obesity present in that area. As the years went by, more states became covered in red.

Katz explained the impact of diabetes in relation to high obesity levels.

Type II diabetes is a result of being overweight and having an unhealthful diet. Katz suggested that “if obesity has us in the frying pan, diabetes will put us in the fire.” He stressed his frustration over the fact that many children now have Type II diabetes, which previously was known as adult onset diabetes.

Katz noted that risks can be diminished by changing one’s lifestyle. He estimated that an 80 percent reduction in heart disease, a 90 percent reduction in diabetes, and a 60 percent reduction in cancer is possible if people take the opportunity to eat more healthfully and to exercise.

The Mayers Endowed Lecture honors Stanley P. Mayers Jr., the co-founder of Penn State’s undergraduate program in the Department of Health Policy and Administration. Mayers retired after a distinguished 26-year career at Penn State. He served as head of the Department of Health Policy and Administration for nine years and as an associate dean for undergraduate studies and associate dean for academic studies in the College of Health and Human Development. He created the endowment with help from other HPA faculty members and alumni.

Stanley P. Mayers Jr.

Investigating Children’s Health Disparities When Austin (not his real name) was 2 1/2 years old, his mother took him to the doctor for the first time since he was 9 months old. Because he’d missed three well-check visits, he needed six immunizations. As he received one injection after another, he became more and more hysterical.

According to Marianne Hillemeier, associate professor, Austin’s mother had neglected to take him to the doctor, not because she was a bad mother, but because she did not have health insurance and could not afford the cost of the care.

Hillemeier observed Austin and his mother at a local pediatrician’s office as she was conducting research on the types of developmental screening doctors and nurses perform on their patients. “Austin is an example of a child who may be at risk of developing health problems and of suffering from developmental delays, and because the family has a low income, these problems might not be identified and treated in a timely way,” she said.

In her research, Hillemeier examines the effects of poverty and other factors on children’s physical health and cognitive development. “If I have one finding that stands out, it’s how potentially damaging not having sufficient economic resources can be on children’s health and development,” she said.

Hillemeier and her colleagues Paul Morgan, associate professor of education at Penn State, and George Farkas, professor of education and sociology at the University of California at Irvine, use data from the Institute of Education Sciences’ Early Childhood Longitudinal Study, Birth Cohort. The study compiled data on over 10,000 children starting in 2001 with a goal of providing policy makers, researchers, child care providers, teachers, and parents with detailed information about children’s early life experiences, particularly their health, development, care, and education.

“The study assessed the children at 9 months, 24 months, 48 months, and school age, so we have this wonderful set of data that provides information about patterns of disparities in health throughout early childhood,” she said.

In particular, Hillemeier and her colleagues have been using the data to examine children’s cognitive outcomes, such as how well they perform in school. “We know that by the time kids reach school age there are disparities in how ready they are to start school, but we don’t know when these disparities begin to emerge and what factors contribute to the disparities,” she said. “With the dataset we’ve been able to see that poverty, as well as lower mater-

nal education levels, makes a big difference in how ready children are for school.”

Hillemeier and her colleagues also are finding that children who are born too soon or at low birth weight are at risk of developing health problems and developmental delays. “We don’t really know why some women go into premature labor and deliver their babies early, but it’s more common in low-income families and it really increases the risk for child health problems,” she said.

Researchers previously thought that a solution to this problem would be to help women get access to better prenatal care. But while rates of prenatal care use have increased, the incidence of preterm births remains high. So Hillemeier and her colleagues began to focus on women’s health before they became pregnant.

“We know that psychological stress is associated with preterm birth,” she said. “And we also know that low-income women often deal with stress as they attempt to make ends meet. So we designed a program of improving women’s health before they become pregnant that combines healthy eating, physical activity, and stress reduction, among other health-promoting interventions.”

According to Hillemeier, the program—Strong Healthy Women— was developed by a team of researchers, including herself; Carol Weisman, Distinguished Professor of Public Health Sciences and Obstetrics and Gynecology at the Penn State College of Medicine; Danielle Symons Downs, associate professor of kinesiology at Penn State; Mark Feinberg, research professor and senior scientist at the Penn State Prevention Research Center for the Promotion of Human Development; and others. It has been tested among women in rural, low-income communities in central Pennsylvania. The research team assembled small groups of women and taught them about nutrition and exercise, stress reduction, and the importance of taking vitamins, such as folic acid. “We taught them about things that we know help a person become healthier before they are pregnant,” Hillemeier said.

The team also assembled a control group for comparison that did not receive health instructions. A year later the treatment groups were doing better than the control groups. They were more likely to have lower body mass indices and their pregnancy weight gain for those who had babies was closer to optimal.

“We have evidence that an intervention before a low-income woman becomes pregnant can improve her health,” said Hillemeier.

“We plan to continue to develop our intervention and extend it to women in urban areas as well.”

Special Section: Department of Health Policy and Administration

Penn State Team’s QR Code Wins REACH Challenge A research team, composed of a faculty member, an alumna, and four Master of Health Administration (MHA) students, has won the 2012 Relevant Evidence to Advance Care and Health (REACH) Developer Challenge, sponsored by AcademyHealth and part of the Health 2.0 Developer Challenge. The project, titled “Real-Time Care Experience Feedback Using QR Codes,” consists of a QR-code application that patients of hospitals can use to inform hospital personnel of their experiences—both good and bad—in real time.

The team included Assistant Professor Deirdre McCaughey; alumna Dominique LaRochelle ’09 MHA; and MHA students Shantanu Dholakia, Ashley Kimmel, Tejal Raichura, and Latoya Tatum.

McCaughey noted that not only will the application benefit patients, but it also will benefit hospitals.

“It is becoming increasingly common for people who are having a negative experience to tweet about it as they are waiting or receiving care or to blog about the experience afterward,” she said. “So now, not only are these patients disappointed with the care they are receiving, but others who did not have the experience can read these tweets and blogs and be influenced by them. In essence, health care organizations are developing reputations via social media that they have little control over.”

McCaughey said that this is a growing concern since patients’ opinions can directly affect hospitals’ revenue streams.

“Under the Value-Based Purchasing Program instituted by the A proto-type test of the team’s project, which beat out seventeen Centers for Medicare & Medicaid Services, Hospital Consumer other projects in the competition, was showcased at the AcademyAssessment of Healthcare Providers and SysHealth National Health Policy Conference, tems (HCAHPS) surveys are sent to former which was held in Washington, D.C. in Feb- “It was a true team effort to patients asking for a rating of the patients’ ruary 2012. bring this project to life and, experiences and the quality of the care they “As a former health care provider, I have for me, an amazing experience received,” she said. “HCAHPS patient-exwitnessed patients’ confusion about why on so many levels.” perience ratings account for a portion of the it was taking so long to see a doctor, and points hospitals earn for patient care, with I have seen family members worried about – Latoya Tatum ’12g HPA earned points directly related to the reimtheir loved ones and unable to get informabursement that hospitals receive from the tion about them,” said McCaughey. “Our application of QR-code Centers for Medicare & Medicaid Services.” technology will enable hospitals to say to patients and their family The team’s QR-code application aims to ensure patients receive the members, ‘We care about you; we are listening to you; and we are best care possible while also helping hospitals receive the highest willing to talk to you about your concerns right now.’” reimbursement possible from the Centers for Medicare & Medicaid McCaughey said that the team envisions that hospitals and waitServices. The group plans to continue working on the process to ing rooms will have placards on their walls designed like stoplights fully develop the protocol and currently is negotiating with select that read, “How are we treating you today?” People can walk up hospitals for beta-sites to test the application. to the placard, use the QR-code applications on their phones to “In our development of this QR-code application, it never occurred to scan the appropriate area (e.g. green for good, red for bad), and be our team what an impact the concept would have,” said McCaughey. directed to a response-specific web survey on which they can note “I speak for the whole research team when I say that we were ecstatic their concerns and comments. Ideally, she said, hospitals would to learn that we had won the REACH Challenge. Now we plan to have a patient-experience response team on call 24/7 to attend to make the idea a reality and to make a substantive improvement in the these concerns immediately. quality of care for patients and their family members.”

New Online MHA Program Launched, Director Named The first of the 76 million baby boomers turned 65 this year. As this generation ages, it will place significant demands on an already strained health care system. To meet this challenge, medical and health services managers—an occupation projected to grow 16 percent in the coming years, according to the Bureau of Labor Statistics—will need the latest knowledge and skills. Penn State’s new master of health administration degree, delivered online, can help working adults prepare for health care management careers.

“We’re already experiencing shortages of nurses, physicians of all kinds, physician assistants, nurse practitioners, radiologists, and other medical technicians,” said Christopher Calkins ’83, ’08g HPA, executive director of the online Master of Health Administration (MHA) program. “The baby boomers and the 32 million who will become insured under the Patient Protection and Affordable Care Act will further challenge the health care system.”

Penn State’s program is designed for working adults who want a health care career and for those already working in health care who want career advancement. The college offers the program in collaboration with Penn State Harrisburg. The program is delivered online through Penn State’s World Campus.

Dennis G. Shea, professor and head of the department, said, “We have offered this program at University Park campus since 1987.

Our goal in making the program available online is to take our faculty’s expertise and deliver a high-quality professional master’s degree program for people who can’t relocate.”

The current residential MHA program at Penn State is accredited by the Commission on Accreditation of Healthcare Management

Education and emphasizes strategic thinking, financial management, and communication. That same curriculum will now be delivered online, helping students gain a broad understanding of the U.S. health care system and managing organizations, as well as complete a capstone project. When they graduate, they are prepared to help solve pressing health care issues.

“One of the biggest challenges is balancing increasing demands of patients, families, government agencies, and health insurance organizations for improvements in the quality of care with limited resources,” Shea said.

Penn State plans to have one cohort of thirty students each fall.

Students will progress together through the courses.

Applications are being accepted for fall 2012 for the online MHA program. Visit the website for more information: www.hhd.psu.edu/hpa/grad/mha.html.

Director Prepares for Incoming Cohort

By Ian Morgan ’12g MHA Christopher Calkins is a busy man these days.

The executive director of the online MHA program is dealing with a full plate of duties, which includes creating an advertising campaign for the program to recruit new students, designing the program’s curriculum, and sorting through potential student applications.

Calkins is particularly focused on designing the first two courses in the curriculum, which he is doing in collaboration with Jonathan Clark, assistant professor. The incoming cohort will take two classes in the fall semester: Health Services Organizational Behavior and Introduction to Health Services Organizations and Delivery.

In addition, Calkins has sorted through prospective student applications and said he is pleased with the diversity of the incoming applications. The majority of applicants currently work in the health care industry for organizations such as Geisinger Health System, United Healthcare in Arizona, and the University of Miami.

Christopher Calkins, executive director of the online Master of Health Administration program.

“Applicants are coming in from across the country and are diverse in terms of age, experience, gender, race, ethnicity, and organizational setting,” said Calkins. “I am really looking forward to working with this group of students.”

Special Section: Department of Health Policy and Administration

Treating Chronic Diseases in Africa

By Ashley Brinton ‘10 HPA, ’12g MHA If you were told to think of the most common disease in Senegal, Africa, what would it be? The answer that jumps into many people’s mind is AIDS; however, in Senegal, the AIDS rate is lower than it is here in the United States.

In Senegal, infectious diseases take a backseat to chronic diseases. That’s due, in part, to education and policies to make citizens aware of AIDS and other infectious diseases. However, not much attention is paid, and little infrastructure is in place, to address chronic diseases.

Rhonda BeLue, associate professor, is conducting a research study in Mbour, Senegal, that focuses on patients’ experiences with one chronic disease: diabetes.

Through trips to Senegal over the past three years, BeLue—who works closely with Mow Diaw, the director of health for the County of Mbour and Mbour’s Diabetes Association—has completed fifty-four interviews with diabetes patients about their experiences of living with diabetes in Senegal. The interviews consisted of questions about the good, the bad, and the challenging.

BeLue most recently traveled to Senegal in November 2011, during which she participated in the country’s celebration for World Diabetes Day. The Diabetes Association for Senegal (ASSAD) hosted the celebration and about 100 local diabetics attended. The celebration consisted of a healthful meal, diabetes screenings, rapid HA1C tests, educational sessions on how to use blood-glucose meters, and speeches about diabetes care.

One of BeLue’s goals is to find new ways to provide testing materials to diabetes patients in Mbour. She is also in the process of collecting blood-glucose readers and Splenda artificial sweetener for people in Mbour.

“The celebration was well organized and informative, and I was honored to be part of it,” said BeLue. “The sense of community among the people with diabetes was inspirational.”

“This is an urgent concern because completing an HA1C test is the standard of care for diabetes treatment, and there is still no solution to this problem,” she said.

Even though individuals who have diabetes in Mbour are knowledgeable about their disease, they cannot always pay for treatment. According to BeLue, of the 100 people with diabetes who came to the World Diabetes Day celebration, fewer than ten had jobs due to the high unemployment rate in Mbour; therefore, most of them lacked the finances to buy products to test and treat diabetes. The participants also had no health insurance, so even those individuals with a job had to pay for their diabetic testing supplies out of pocket.

When asked how she became involved in diabetes research in Senegal, BeLue explained that she had a friend who lived in Senegal who passed away because he didn’t know he had diabetes until it was too late.

Back at home, BeLue is developing a U.S.based association focused on chronic disease management in the global south. In this work, she is focusing on acquiring equipment for hemoglobin AIC (HAIC) testing.

“Senegal is like a second home to me,” said BeLue. “Senegalese and Americans both share many of the same challenges in managing their diabetes. If we can share lessons and encouragement between countries, I hope that we can improve the quality of life of diabetics in both Africa and the United States.”

Photo Courtesy: Rhonda BeLue

Rhonda BeLue (far right) addresses local diabetes patients listening to a speech during World Diabetes Day in Mbour, Senegal.

Student Named President of UPUA

By Megan Switzer ’12 HPA, ‘12g MHA Courtney Lennartz, a junior, has been elected president of the University Park Undergraduate Association (UPUA).

Having been involved in UPUA since her freshman year, Lennartz is currently the longest serving member within the association.

During her tenure, she has been an active participant in a variety of initiatives. As chair of the Academic Affairs Committee, she worked on the implementation of the watch list system, the extension of drop-add, and the subsidization of test-prep classes, in addition to other campus-wide projects. As vice president last year, she worked with the president on the exploration of a laundry automation system, an off-campus database, and the implementation of the off-campus meal plan.

Along with the current vice president Katelyn Mullen, Lennartz said her platform for the next year focuses on four key areas: academics, housing and food services, student life, and campus and community outreach. In addition to the continuation of last year’s initiatives involving a laundry automation system and an off-campus housing review database, the pair’s platform highlights areas concerning tuition, lowered textbook costs, improved recreational facilities access, increased student advocacy, and others.

MHA Student Organization Provides Professional Development and Service Opportunities

By Eric Douglas ’12g HPA When entering the job market, an applicant’s professionalism can be the difference between securing a job offer and continuing the search.

The Master of Health Administration Association (MHAA), a student-run organization consisting of current Master of Health Administration (MHA) students, strives to help its members professionally through a combination of networking and service events. The organization fosters professional growth primarily through four types of activities: workshops, site visits, conferences, and service projects.

Activities in the past year have included a site visit to Hershey Medical Center, which consisted of presentations by HMC executives. Members also attended the Medical Group Management Association conference in Las Vegas and the American College of Healthcare Executives conference in Chicago.

Each year, the MHAA performs a service project that directly benefits the community. Next year’s tentative service project is to partner with Mount Nittany Health System by participating in a Diabetes Awareness Program.

The MHA program looks to maintain its strong reputation by continuing to foster professionalism among its members in all activities and looks forward to the continuation of service projects that benefit the State College community.

She’s in the Navy Now By Latoya Tatum ’12g MHA Master of Health Administration student Amy Dunlap, currently on active duty, will soon be commissioned as a Lieutenant Junior Grade in the United States Navy next May upon completion of her degree. Her commission will mark the culmination of several years of preparation for her chosen career path.

The HSCP is extremely competitive and requires advanced planning. The Navy only offers less than ten HSCP commissions each year, and applicants

As an officer in the Navy in health care administration, it is possible that opportunities could include the option to conduct research to incorporate best practices in health care, to set up operating facilities for humanitarian missions in Third World countries, to supervise the construction of new hospitals, to manage finances at existing hospitals, to manage training programs, and to advise the Navy on ways to improve health care and reduce costs. Dunlap said that she believes her military work will allow her to be a leader and challenge herself personally.

Dunlap does not yet know where she will be stationed when she begins her job. “Wherever I am, I will be helping people, which is very important to me,” she said.

Photo Courtesy: Amy Dunlap

Military health care is in Dunlap’s blood. Her mother (an officer) and maternal grandmother were both in the Navy, and her grandfather was in the Army. So, after studying at the Danish Institute for Study Abroad in the Department of Public Health in Copenhagen, Denmark, Dunlap contacted an armed forces recruiter in central Pennsylvania to start the process of applying to the Navy Health Services Collegiate Program (HSCP) for graduate students.

apply years before they are accepted (two years in Dunlap’s case). The HSCP provides generous financial assistance in the form of a monthly salary and a housing allowance for students while they are finishing their degrees.

Special Section: Department of Health Policy and Administration

HPA Student Pays It Forward By Megan Shadduck ’12 HPA

“Many students apply to colleges based on guidance counselor recommendations and how interesting the school website appears,” said Garner-Drummond, a high-school educator and advisor at Mastery Charter High School in Philadelphia. “They have no idea what type of education or setting best suits their needs. These visits provide these young women with a ‘real feel’ for college life.”

Two trips are scheduled each year: one group of young women visits in the fall and one in the spring. Each trip allows for four to five young women in grades 10 through 12 from Mastery Charter High School to visit Penn State. Garner-Drummond works with Aisha Correll, a junior in health policy and administration, and Cydney Actie, a senior in media studies, to organize the trips.

The weekend extends beyond visits to the Berkey Creamery and campus tours. Correll and Actie act as the primary mentors to the highschool students and remain in contact with the young women long after the weekend experience. They are available to the girls as resources and to help answer questions about the application process.

Andrea Garner-Drummond was a member of the Lady Lions in 1999-2000 when the team advanced to the NCAA Final Four.

Health Policy and Administration APG The Health Policy and Administration Affiliate Program Group (HPA APG) seeks to unite HPA alumni (and alumni of predecessor majors) in order to serve alumni, faculty and staff members, and students of the Department of Health Policy and Administration. Below is an update from the HPA APG’s president about current APG activities and ways to become involved.

Mentoring In fall 2011 we hosted the 5th annual “Professionals in the Classroom” (PiC) event. Twenty-four alumni visited more than 750 students in fourteen undergraduate classes and three graduate classes.

• Our third annual Philadelphia-area gathering; this time in conjunction with other health administration schools and organized by the Healthcare Leadership Network of the Delaware Valley (HLNDV).

• A gathering in Washington, DC—our first in that area. More than thirty attendees across many graduation years attended.

Our spring semester Mentoring Program Weekend had the largest participation to date. Thirty-four alumni and students were matched in mentoring partnerships. The “Jump Start Your Career” event, which occurs in the morning on the day of the dinner, featured eight alumni representing various careers within health care.

Each alum hosted a station, which was in a roundtable format. In total, over sixty students from various majors attended!

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Awards/Nominations

Connect with the Affiliate Program Group

Dominique LaRochelle ’09g HPA (MHA), project manager, Quality & Patient Safety Institute, Quality Improvement at the Cleveland Clinic, was awarded the HPA-APG Emerging Professional of the Year Award (Graduate Level).

Communications The APG collaborates with the Department of Health Policy and Administration on a fall print newsletter, which is mailed to all 4,500 HPA alumni, and a spring e-newsletter, which can be viewed at www.hhd.psu.edu/hpa/news.

Social/Professional The APG, in conjunction with the department, hosted three events in the spring: • A gathering at the Duquesne Club in Pittsburgh—our second gathering there in as many years.

Please be sure to keep your contact information updated with the Penn State Alumni Association at: alumni.psu.edu/about_us/contact_us/update_info

Website alumni.hhd.psu.edu/hpa Facebook “Penn State University Health Policy and Administration” “Penn State MHAs” LinkedIn “Penn State HPA Alumni” “Penn State University MHA” APG President Randy Coulthard ’07 Randy.Coulthard2@cigna.com

Photo Credit: Penn State Athletic Communications

By selecting a small number of female high-school students for a weekend each spring and fall, former Lady Lion standout Andrea Garner-Drummond ’00 HPA provides Philadelphia charterschool students the opportunity to experience college life prior to the application process.