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Improving Children's Health Through Health Services Research

Children's Health Services Researchers Meeting: Speaker Biographies

Improving Children's Health Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research was explored, including public and private funding opportunities, networks for conducting research, and uses of research in policy and practice.

Improving Children's Health Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research was explored, including public and private funding opportunities, networks for conducting research, and uses of research in policy and practice. The meeting was sponsored by the National Association of Children's Hospitals and Related Institutions (NACHRI), the American Academy of Pediatrics (AAP), the Agency for Healthcare Research and Quality (AHRQ) and the Packard Foundation, the Association for Health Services Research (AHSR), the RWJ Foundation and Data Harbor Inc. provided support.

Welcome and Introduction

W. David Helms, Ph.D. has led the Alpha Center, a non-partisan, non-profit health policy center since it was established in 1976. Effective January, 1999, Dr. Helms also became the Chief Executive Officer of the Association for Health Services Research (AHSR), a national membership association formed exclusively to promote the field of health services research and to strengthen the relationship between the users and producers of research.

For the Alpha Center, Dr. Helms has directed a wide range of health policy and planning projects for Federal and State government agencies, State and local health planning agencies, and private foundations. He serves as program director for the Robert Wood Johnson Foundation's (RWJF) State Initiatives in Health Care Reform program. Through the Center's contract with the Agency for Healthcare Research and Quality (AHRQ) and its User Liaison Program, he conducts workshops and develops research reviews for senior State and local health officials. He also serves as project director for the National Leadership Institute on Public Purchasing, funded and supported by RWJF and the Health Care Financing Administration (HCFA).

Prior to his work with the Alpha Center, Dr. Helms was director for research and program development for a comprehensive health planning agency. He has served on the Governing Council of the American Public Health Association and on the board of directors of the American Health Planning Association, and he is a member of the National Academy of Social Insurance. He received his doctorate in public administration and economics, in 1979, from the Maxwell School of Citizenship and Public Affairs, Syracuse University.

Overview of the Children's Health Services Research Field

Lisa Simpson, M.B., B.Ch., M.P.H. has served as deputy administrator of the Agency for Healthcare Research and Quality (AHRQ) since September 1996. The Agency for Healthcare Research and Quality is the Department of Health and Human Services (HHS) lead Agency for health services research and health care quality. In the last three years, she oversaw AHRQ's reorganizations, budget cuts and expansions, and the Agency's transition from clinical practice guidelines to the promotion of evidence-based practice and an enhanced focus on quality measurement and improvement.

During 1998, Dr. Simpson oversaw a major effort to align the Agency's planning, budgeting, and reporting activities to move the Agency to a more accountable and user-driven research agenda. She has also been active in national activities to advance quality measurement, serving on advisor committees of the National Committee for Quality Assurance, the Joint Commission on Accreditation of Health Care Organizations' Council on Performance Measurement, and the American Medical Association.

As a board-certified pediatrician, Dr. Simpson also spearheads the Agency's initiatives in promoting children's health services research. She is an active member of the Department's efforts to assist States in the implementation of the new Child Health Insurance program (CHIP). She speaks and writes frequently about the opportunities and challenges for improving children's health in this country. Dr. Simpson is an adjunct professor at Johns Hopkins University School of Public Health. Dr. Simpson currently serves on the Editorial Board of Maternal and Child Heath Journal and the Editorial Advisory Board of The Future of Children.

Prior to her services at AHRQ, Dr. Simpson was a senior policy analyst in the HHS Office of the Assistant Secretary for Health. She was a fellow at the Institute for Health Policy Studies, School of Medicine, University of California, San Francisco from 1991 to 1993; and was the Director of Maternal and Child Health for the State of Hawaii from 1988 to 1990, where she oversaw the implementation of numerous innovative community-based health programs for women and children. She received a doctorate of medicine (MB., BCh) from Trinity College, Dublin, Ireland and earned a master's in public health from the University of Hawaii.

State of the Science

Barbara Starfield, M.D., M.P.H. is the University Distinguished Service Professor with appointments in the Department of Health Policy and Management and Pediatrics at the Johns Hopkins University Schools of Public Health and Medicine. She is also the director of the Johns Hopkins University Primary Care Policy Center. Dr. Starfield's overriding concerns are understanding the impact of health services on health, especially with regard to the relative contributions of primary care and specialty care on reducing social inequities in health. Her focus is both on clinical care and on services to populations as well as the inter-relationships between the two. She received her BA degree from Swarthmore College, her MD degree from the State University of New York (Health Sciences Center in Brooklyn), and her MPH degree from the Johns Hopkins University.

Dr. Starfield is a fellow of the American Academy of Pediatrics and a member of the Institute of Medicine. She is the recipient of numerous national awards, most recently including the first Pew Primary Care Research Award (1994), the Distinguished Investigator award of the Association for Health Services Research (1995) and the American Public Health Association's Martha May Eliot Award (1995).

Dr. Starfield's 1992 book, Primary Care, is widely regarded as a seminal contribution to thinking and assessment of the subject. Her 1998 book, Primary Care: Balancing Health Needs, Services, and Technology, provides innovative methods to evaluate the attainment and contributions of primary systems and practitioners, and complements her earlier book by highlighting the additional areas of equity in health services and health, and the overlap between clinical medicine and public health. She has also made contributions in the areas of health status measurement for children and adolescents, and in case-mix assessment and adjustment.

Evolution of Pediatric Outcomes Research

Carolyn Clancy, M.D. a clinical researcher and a practicing internist, directs the Agency for Healthcare Research and Quality (AHRQ) Center for Outcomes and Effectiveness Research. She is an associate clinical professor at George Washington University's Department of Health Care Sciences and Georgetown University's Department of Family and Community Medicine. Dr. Clancy holds a bachelor's of science, magna cum laude, in math and chemistry from Boston College (1975) and a doctorate of medicine from the University of Massachusetts School of Medicine (1979).

Dr. Clancy has held other senior positions at AHRQ since 1990. From 1984 to 1990, she was an assistant professor of medicine and director of the Medical Clinic at the Medical College of Virginia. She also taught at the Hospital of the University of Pennsylvania and served as an attending ER physician at Thomas Jefferson University Hospital in Philadelphia. Her health services research priorities include issues such as quality, access, and the impact of delivery system changes. Her medical specialties include primary care medicine and women's health. Dr. Clancy has authored and co-authored 5 medical books, published over 40 articles in peer-reviewed medical journals and presented more than 30 research papers at academic conferences. She currently chairs the Research Committee of the Society for General Internal Medicine, where she has held other leadership roles since 1988.

Translating Research into Practice: Quality Measurement and Improvement

Kevin B. Weiss, MD, MPH is associate professor and director of the Center for Health Services Research at the Rush Primary Care Institute, Chicago, IL. Prior to joining the Rush System for Health, he was associate professor of Health Care Sciences and Medicine at the George Washington University Medical Center in Washington, DC and Research Fellow at the Center for Health Policy Research at the George Washington University. He has previously held positions at the National Center for Health Statistics, at the Centers for Disease Control and Prevention, at the National Institute of Allergy and Infectious Diseases (NIAID), and at the National Institutes of Health (NIH). While at NIAID, his principal activity was the development and implementation of the National Cooperative Inner City Asthma Study. Dr. Weiss was Chair of the National Asthma Education and Prevention Program's Task Force on Cost-Effectiveness, Quality of Care and Financing of Asthma Care sponsored by the National Heart, Lung and Blood Institute (NHLBI) of the NIH. He recently co-chaired the Asthma Collaborative in the Breakthrough Series of the Institute for Healthcare Improvement. He is also a former Robert Wood Johnson Generalist Physician Faculty Scholar.

Dr. Weiss is currently engaged in collaborative epidemiological and health services research projects involving: primary care oriented information systems development, outcomes measurement and quality improvement. He is also principal investigator of the Pediatric Asthma Care Patient Outcomes Research Team (PORT)—a large multi-site randomized controlled cost-effectiveness study of the national guidelines for the treatment of asthma in pediatric population, jointly funded by the Agency for Health Care Policy and Research and NHLBI/NIH.

Pushing the Envelope: Children's Health Services Research in Communities

David Olds, Ph.D. is professor of pediatrics, psychiatry and preventive medicine at the University of Colorado Health Sciences Center, where he directs the Prevention Research Center for Family and Child Health. He has devoted his career to investigating methods of preventing health and developmental problems in children and parents from low-income families. His original work, carried out in Elmira, New York, examined the effects of prenatal and postpartum nurse home visitation on the outcomes of pregnancy, infant caregiving, and maternal life-course development, and determined the impact of those services on government spending.

A member of the American Pediatrics Society, he has received numerous awards for this research, including the Charles A. Dana Award for Pioneering Achievements in Health, the Lela Rowland Prevention Award from the National Institute of Mental Health, and the Brook Visiting Professorship in Epidemiology from the Royal Society of Medicine. He currently is carrying out an urban replication of the Elmira study in Memphis, Tennessee, a 19 year follow-up study of the Elmira sample, and another replication of the Elmira and Memphis studies in the Denver metropolitan area. The Denver trial examines the unique contributions that paraprofessional and nurse home visitors can make toward improving the health of mothers and children from low-income families. Dr. Olds received his BA from Johns Hopkins University and his Ph.D. from Cornell.

Overview of Congressional Interest in Children's Health and Children's Health Services Research

Peters D. Willson, coordinates all National Association of Children's Hospitals (NACH) public policy activities, including Federal advocacy, State policy services, special projects, publications, meetings, and services by consultants. He staffs the NACH Board of Trustees Council on Public Policy, and he is lead contact on staff regarding Federal graduate medical education policy, pediatric research policy, and CHAMPUS/TRICARE policy. He produces the bi-weekly Washington Update for member hospitals, and the quarterly NACH Washington Report for NACHRI's Children's Hospitals Today.

Building Capacity: Training

What's New, What Needs to Change

Michael Weitzman, M.D. is currently pediatrician-in-chief at Rochester General Hospital and professor and associate chairman of pediatrics at the University of Rochester School of Medicine and Dentistry, where he is also the director of the division of General Pediatrics. He was formerly director of maternal and child health for the City of Boston, and director of General Pediatrics at Boston City Hospital and Boston University School of Medicine. He has conducted research and written extensively on such diverse issues as childhood lead poisoning, chronic illness, passive and prenatal exposure to cigarette smoke, breast feeding, excessive school absences, the academic benefits of the school breakfast program, and the epidemiology of children's mental health problems, risk-taking behaviors, school failure, and childhood asthma. He has published over 150 original articles, chapters, books, and abstracts of scholarly work, and is the co-editor of two pediatric textbooks.

Dr. Weitzman currently serves on the Center for Disease Control's Childhood Lead Poisoning Prevention Advisory Committee, and the National Advisory Committee of the Robert Wood Johnson Generalist Physician Faculty Scholars program. He was the 1997 recipient of the Ambulatory Pediatric Association's Research Award, its most distinguished honor for scholarly achievement, and the fellowship training program in Academic General Pediatrics, which he has directed for the past 8 years, was the recipient of the Ambulatory Pediatric Association's Teaching Award in 1999.

Charles Homer, M.D., M.P.H. is the director of the Children's Hospital Clinical Effectiveness Program, which is located jointly within the Division of General Pediatrics and the Hospital's Department of Hospital Epidemiology and Quality Improvement. Trained in epidemiology at the University of North Carolina at Chapel Hill, he has received both Federal and private foundation support for his work. His work has included critical assessment of the literature on preventive health care for children, assessment of the impact of Medicaid captivation programs on child health care and outcomes, examination of regional variation in hospital use, primary care, and quality of practice, development and evaluation of strategies to improve the primary care of inner city children with asthma, development and evaluation of home based interventions for U.S.-born children of Cambodian refugees, and development of measures to assess parent perceptions of the quality of both inpatient and ambulatory care for children.

Dr. Homer is Principal Investigator on an AHRQ-funded study to develop and implement an automated guideline for the evaluation and treatment of hyperbilirubinemia in newborns. Other current research efforts explore the use of quality improvement methods for improving care in office-based practices, including asthma care and immunizations. He is also co-investigator on a large federally funded study to develop and test measures for assessing patient preferences for their health care and health plans.

Dr. Homer is a consultant to the American Academy of Pediatrics in the areas of health supervision guidelines, guideline development, particularly concerning minor head trauma and attention deficit disorder, and functional outcome measurement. He serves as a member of its Committee on Quality Improvement, and chairs that committee's Subcommittee on Guideline Implementation.

Charles E. Irwin, Jr., M.D. is professor of pediatrics, director of the Division of Adolescent Medicine, and vice-chairman of Pediatrics at the University of California, San Francisco School of Medicine. He is a faculty member of the Institute for Health Policy Studies at UCSF and directs two policy centers focused on health in adolescence and middle childhood. Dr. Irwin has also directed the Interdisciplinary Adolescent Health Training Program at UCSF since 1977. His research has focused on risky behaviors during adolescence, on methods of identifying adolescents who are prone to initiate health damaging behaviors during the second decade of life, and, most recently, on preventive interventions for at-risk youth. He is the author of several publications and the editor of several texts focusing on pediatric and adolescent health.

Dr. Irwin is the recipient of various awards, including an outstanding achievement award for research from the Society for Adolescent Medicine (1985), the National Center for Youth Law's annual award recognizing his research on high risk youth (1988), the Ambulatory Pediatric Association's Teaching Award for training physicians in the behavioral sciences (1990), the Swedish Medical Society's International Lectureship Award (1996), the American Academy of Pediatrics Adele Hoffman Award for Lifetime Achievement in Adolescent Medicine (1988), and the Society for Adolescent Medicine's Outstanding Achievement Award (1999). He also served as the first chair of the American Board of Pediatrics' Subboard of Adolescent Medicine (1991-1998). He earned a BS degree in biology from Hobart College, a B.M.S. degree from Dartmouth Medical School, and an MD degree from the University of California, San Francisco.

John Pestian, Ph.D. is an assistant professor at the Center for Pediatric Research, a joint program of Eastern Virginia Medical School and Children's Hospital of the Kings Daughters, Norfolk, Virginia. He received his doctorate degree in Health Service and Organization Research from Virginia Commonwealth University's Medical College of Virginia. His cognitive specialties include medical informatics and clinical outcomes.

Dr. Pestian directs the Clinical Outcomes research for the Children's Health System, which includes the Children's Hospital of The King's Daughters, and 20 general and surgical care practices. Since graduating in 1995, he has been the investigator/co-investigator on research grants totaling over $2.5 million. He has authored/co-authored articles published in The New England Journal of Medicine, American Journal of Otolaryngology, Journal of Family and Community Health, and Hospitals and Health Services Research.

Dr. Pestian also directs the Health Informatics research unit of the Center for Pediatric Research, which is dedicated to developing technological interventions that enhance the health of a community. He has been the principal investigator in the development of a Web-based school health information system for Virginia's schools and the development of Web-based systems for collecting and analyzing information related to newborn hearing, metabolic and genetic screening. He also holds a patent for using the World Wide Web to bill for healthcare services.

New Policy Developments

Opportunities and Challenges for Children's Health Services Research

Patricia MacTaggart is the director of the quality and performance management group, Center for Medicaid and State Operations, Health Care Financing Administration (HCFA), Department of Health and Human Services. She previously provided leadership in the Office of State Health Reform Demonstration at HCFA. Prior to coming to HCFA, she was the Director of the Medicaid Program for the State of Minnesota. Earlier positions within the Minnesota Department of Human Services include positions as director of Purchasing and Health Care Delivery and as assistant director of Health Care Management. In addition to State and county government experience, Ms. MacTaggart has had private experience as the vice-president of managed care for the Delta Dental Plan of Minnesota. She has also chaired the Medicaid Health Plan Employer Data and Information Set (HEDIS) Work Group for the National Committee for Quality Assurance (NCQA) and represented Medicaid on the NCQA HEDIS 3.0 Committee for Performance Measurement.

Linda Bilheimer, Ph.D. is the Deputy Assistant Director for Health at the Congressional Budget Office. She directs a team of economists who analyze the budgetary and policy consequences of legislative proposals for health care, with particular emphasis on their cost implications for the Federal government and the private sector. Before joining CBO in 1991, Dr. Bilheimer was a senior researcher at Mathematical Policy Research Incorporated in Washington, DC. From 1982 to 1987 she was the director of health statistics and epidemiology for the Arkansas Department of Health. She holds a Ph.D. in economics from Harvard University.

Alan Weil, J.D., M.P.P. is the director of the Assessing the New Federalism project at the Urban Institute. This project, the largest in the Institute's 30-year history, is designed to monitor, describe and assess the effects of changes in Federal and State health, welfare, and social services programs. The Urban Institute is a nonprofit, nonpartisan research organization based in Washington, D.C., with the mission of bringing accurate data and objective analysis to public policy debates.

Mr. Weil was formerly the executive director of the Colorado Department of Health Care Policy and Financing. In March of 1997, Mr. Weil was named to President Clinton's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. He also serves on the National Advisory Committee for the Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization program and the Devolution and Federalism Technical Advisory Group for the National Health Policy Forum.

Mr. Weil received his bachelor's degree in economics and political science from the University of California at Berkeley. He holds a master of public policy degree from the John F. Kennedy School of Government at Harvard, and a JD from Harvard Law School.

Lois Salisbury, J.D. is president of Children Now. Children Now acts as a strong and independent voice for children—in the public policy arena, in the mass media, among business leaders and in the community. With a staff of over 30 people, Children Now is a national organization, headquartered in Oakland, with offices in Los Angeles and New York. As President, she provides central leadership for Children Now's vision and strategies, oversees program development and implementation, serves as spokesperson, and sustains a leadership network with others around the country who share Children Now's commitment to improving the lives of children.

Prior to coming to Children Now, Ms. Salisbury was for 19 years a public interest lawyer at Public Advocates where she conducted complex impact and class action litigation concentrating on civil rights and consumer issues, and initiated coalition building and policy development emphasizing health care and education reform. She was the founding chair of Health Access, a State-wide consumer coalition representing over 200 organizations. She has made numerous keynote and media appearances and has published op-ed pieces, major policy papers, and law review articles.

Ms. Salisbury has served on gubernatorial, mayoral, and foundation task forces and advisory boards, and recent appointments include Mayor Riordan's Commission for Healthy Kids, State Superintendent Eastin's Universal Pre-School Task Force, HBO's Family Channel Advisory Committee, and the California Health Care Foundation's Medical Commission Advisory Board. She has also served as national co-chair of the Child and Adolescent Health Measures Advisory Committee, a project of the Foundation for Accountability (FACCT), and the National Committee for Quality Assurance (NCQA).

Her prior experience includes serving as a school administrator, counselor and inner city teacher. She received a J.D. from the University of California, Berkeley, Boalt Hall School of Law, and a bachelor's degree from Reed College.

Funding Opportunities in Children's Health Services Research

Shirley Girouard, Ph.D., R.N. is the vice president of Child Health and Financing at the National Association of Children's Hospitals and Related Institutions (NACHRI). She is experienced in child and adult health services, management, and research. She holds a doctorate in health policy from Brandeis University, a master's in nursing from Yale University, a master's in medical sociology from the University of Connecticut, a baccalaureate in sociology from Eastern Connecticut State College and a nursing diploma from Hartford Hospital School of Nursing. She has held a variety of positions in health care, including administrator, educator, researcher, policy analyst and health care provider. In addition, she has served in elected and appointed positions at local, State, and Federal government levels. Her publications focus on public policy issues and clinical nursing practice.

Gontran Lamberty, Dr.P.H. is the chief of the research branch, and director for the Maternal and Child Health Bureau Research Program. He received his bachelor's degree from Ohio-Wesleyan University, his master's degree from University of Connecticut, and his DrPH from the School of Public Health, John Hopkins University.

Denise Dougherty, Ph.D. is the coordinator of Child Health Activities for AHRQ. As coordinator, she leads AHRQ's Internal Child Health Advisory Group, contributes to AHRQ's policy development in children's and adolescents' health issues, and works with other Federal agencies and relevant external groups on children's and adolescents' health concerns. She wrote the departmental report to Congress, "Pediatric Outcomes Research."

Before joining AHRQ in March 1996, she worked in various roles at the U.S. Congress Office of Technology Assessment. As a program director, she oversaw studies in the residential technologies for elderly people and people with disabilities, educational technology, and technologies in the school-to-work transition. She spent most of her OTA career in OTA's health program, directing and contributing to reports on issues as diverse as quality of care, blood policy and technology, Native American health, mental health, adolescent health, cost-effectiveness of breast cancer screening, the relationship between health insurance status and health outcomes, and the assumptions underlying economic forecasts of alternative health reforms. She holds a Ph.D. in social psychology from Boston University, and spent her pre-Ph.D. years as a municipal finance analyst on Wall Street.

Building Capacity: Research Networks

Using Networks to Conduct Children's Health Services Research

James E. Shmerling, M.B.A. is president of Le Bonheur Children's Medical Center. He has recently been named Senior Vice President of Ambulatory Services for Methodist/Le Bonheur Healthcare. Mr. Shmerling came to Le Bonheur in 1991 as the chief operating officer and senior vice president, and held this position until 1995. Prior to joining Le Bonheur, he served for 4 years as the associate director of Indiana University Hospitals and Administrator of the James Whitcomb Riley Hospital for Children. From 1980-1987, he served in several administrative capacities at the Children's Hospital of Alabama, including his last position as Associate Administrator of Operations. Mr. Shmerling has a master's degree in hospital and health care administration from the University of Alabama at Birmingham and a master's in business administration from Samford University in Birmingham, Alabama. In addition, he has completed coursework in pursuit of a doctorate in health administration from the Medical University of South Carolina.

Mr. Shmerling is a fellow in the American College of Health Care Executives. He currently holds positions on the boards of the Child Health Corporation of America (CHCA), the National Association of Children's Hospitals and Related Institutions (NACHRI), Southern Poison Center, Child Health Alliance of the Mid-South (CHAMS), Hospital Wing, In., and the Le Bonheur Operating Board. Additionally, he recently accepted the invitation to serve as chairman of the Council on Child Health and Financing with NACHRI. He also serves on the boards of the YMCA, the Memphis Jewish Home, the Boy Scouts of America, the Greater Memphis Jewish Federation, and Beth Sholom Synagogue.

Managed Care Research Networks

Andrew Nelson, M.P.H. is the executive director of research for Health Partners Research Foundation. He has a B.A. in Social Welfare and M.P.H. in public health administration from the University of Minnesota, Minneapolis, Minnesota. Mr. Nelson has over 20 years of administrative leadership and research investigation experience in the health and human care fields, and is especially strong in the areas of organizational leadership and the creation of multidisciplinary team approaches to serve a complexity of health/human and community service needs.

Mr. Nelson has been active in many professional and industry organizations, where his roles have included developing research and health care agendas. He has extensive experience in study/project design, grant writing/administration, informational systems design, program/project evaluation, organizational administration and governance. He has participated in shaping national, State and local health care and research agendas. Currently, he serves as executive director of the HealthPartners Research Foundation which includes providing leadership and vision for this public domain research organization with a staff of 85 and with 350 active projects funded by over 7 million dollars in 1998.

Pediatric Research in the Office Setting (PROS)

Emalee G. Flaherty, M.D. is assistant professor of pediatrics at Northwestern University School of Medicine and the medical director of the protective service team at Children's Memorial Hospital in Chicago. For over 10 years, she has participated in office based research projects conducted by both the Pediatric Research in Office Setting network (PROS)—the AAP-sponsored practice-based research network, and by the Pediatric Practice Research Group (PPRG). She is a member of the steering committee of PPRG and she is the Illinois State Coordinator for PROS.

Dr. Flaherty has actively participated in developing many of the studies carried out by these two networks. She recently completed her own study with the help of the practitioners in the PPRG network. This study described the injuries seen in the pediatric office setting and the practitioner's identification and reporting of child abuse injuries. This project was funded by the Agency for Healthcare Research and Quality. She hopes to continue this research with the help of the practitioners in PROS.

New Policy Developments

Using Data for Policy and Practice

Arthur F. Kohrman, M.D. is professor of pediatrics at Northwestern University Medical School and associate chair for advocacy at Children's Memorial Hospital and department of pediatrics at Northwestern University Medical School. Prior to his service at Northwestern University, Dr. Kohrman was the president and CEO for La Rabida Children's Hospital and Research Center from 1981 to 1996, and he was the Senior Scholar at the MacLean Center for Clinical Medical Ethics at the University of Chicago.

Dr. Kohrman received his bachelor's degree in arts and science from the University of Chicago and his medical degree from Western Reserve University School of Medicine. In 1967, Dr. Kohrman completed his NIH post-doctoral research fellowship in metabolic diseases with the department of pediatrics at Stanford University School of Medicine and in 1968 he completed his NIH special post-doctoral fellowship from Stanford University. Dr. Kohrman is currently a member of the board of directors of the Health and Medicine Policy Research Group.

Steve A. Freedman, Ph.D. is the executive director of the Institute for Child Health Policy of the State University System of Florida and professor of pediatrics, political science and public health. He has the distinction of being one of a handful of non-physicians elected to fellowship in the American Academy of Pediatrics. Prior to his academic career, Dr. Freedman served in senior staff positions in both Florida's Department of Education and its Department of Health. He and his colleagues have designed a number of national model programs including:

  1. A State-wide nurse-based case management program for chronically ill children.
  2. An innovative day health care and developmental facility for medically and technology dependent children.
  3. A school enrollment-based family health insurance program that received the Ford Foundation/Harvard-Kennedy School of Government, 1996 Innovations in American Government Award.

He has testified before Congress and legislatures on child health financing and delivery systems. He serves as chair of the Health and Human Services Commission of the Southern Regional Education Board and served on a committee on comprehensive school health programs of the National Academy of Sciences' Institute of Medicine.

Jane Holl, M.D., M.P.H. received all of her undergraduate and medical education at the Free University in Brussels, Belgium. She completed an internship in New York City and her pediatric residency at the University of Medicine and Dentistry of New Jersey. She was a member of the faculty at the Children's Hospital of New Jersey for 5 years and then moved to the University of Rochester School of Medicine, where she completed a general academic pediatric fellowship and obtained a master's degree in public health, before joining the faculty. Her research focuses on evaluating State-funded health insurance for low-income children and studying the effects of Medicaid managed care. She moved to the Institute for Health Services Research and Policy Studies this past January and was named a recipient of the 1999 Robert Wood Johnson Generalist Physician Faculty Scholars Program. Currently, she is involved in continuing the studies of Medicaid managed care, developing an initiative for Medicaid managed care to improve developmental services, and using MEPS to evaluate the impact of Medicaid managed care, SCHIP, and welfare reform.

Richard H. Sewell, M.P.H. is executive director of the Chicago Health Policy Council in the Center for Health Administration Studies at the University of Chicago. Mr. Sewell is a graduate of Bowling Green State University and he received his master of public health degree from the University of Oklahoma in health administration.

Mr. Sewell has a long history of professional involvement in management, health policy formulation, and planning in the health field. He was president of the Suburban Primary Health Care Council, manager of the Access to Care program in suburban Cook County, and executive director of the Suburban Cook County-DuPage County Health Systems Agency. He is a member of the governing council and the science board of the American Public Health Association, chairman of the board of directors of the Friend Family Health Center and a member of various other organizations.


Grantsmanship and Mock Study Review

Linda Blankenbaker received a bachelor of arts degree from Western Maryland College in French and English education. She taught junior high school French and English from 1966-68. In 1981, Mrs. Blankenbaker returned to the workforce (after making sure her two children could get to school on time), taking a clerical position at the US Department of Agriculture. She held a position at the National Institutes of Health (the former NINCDS) in 1982 and at the National Cancer Institute in 1983. At NCI she worked on the development of the online cancer treatment information database, PDQ. Following implementation of the database, she served as executive secretary to the 2 editorial boards charged with responsibility for maintaining the currency and accuracy of the treatment information in PDQ. She also handled a variety of administrative and management activities for the NCI's International Cancer Information Center which produced other scientific online databases and the Journal of the NCI.

In 1988, Mrs. Blankenbaker transferred to the Office of Medical Applications of Research (OMAR) in the Office of the Director, NIH, where, as a program analyst, she coordinated NIH Consensus Development Conferences. She took a position at AHRQ in 1990, serving as scientific review administrator for a chartered peer review committee. More recently, Mrs. Blankenbaker has assumed responsibilities for overseeing the conduct of AHRQ's peer review activities, as deputy director for the Office of Scientific Affairs and currently as acting director of the Scientific Review Division, Office of Research Review, Education, and Policy, AHRQ.

Jose Julio Escarce, M.D., Ph.D. is senior natural scientist at RAND, where he is co-director of the Center for Research on Health Care Organization, Economics, and Finance and director of the RAND/UCLA/Harvard Center for Health Care Financing Policy Research. Dr. Escarce graduated from Princeton University, earned a master's degree in physics from Harvard University, and obtained his medical degree from the University of Pennsylvania. Following completion of his residency in internal medicine at Stanford University Hospital, he practiced medicine in the National Health Services Corp for two years. He then returned to Penn to obtain his Ph.D. in Health Care Systems from the Wharton School.

Dr. Escarce has served on the Health Services Research Study Section at the Agency for Healthcare Research and Quality and is currently a member of the National Advisory Council for Health Care Policy, Research, and Evaluation of the Department of Health and Human Services. He is Deputy Editor of the journal Medical Care and serves on the editorial boards of Inquiry and Health Services Research. Dr. Escarce's research interest includes physician behavior under economic incentives, access to care, and the impact of managed care on cost and quality.

Anne Marie Gadomski, M.D., M.P.H. is a board-certified pediatrician with a master's degree in public health and a post-doctorate in nutrition. She received her MD from the University of Rochester and completed her pediatric training at Strong Memorial Hospital in Rochester, New York. She is currently a research scientist and attending pediatrician at the Mary Imogene Bassett Hospital in Cooperstown. She has epidemiological, health services and clinical research experience in both national and international settings. Her current research focuses on health services, children's mental health and domestic violence, and pediatric respiratory disease.

Wrap-up and Next Steps

Neal Halfon, M.D., M.P.H. is professor of pediatrics in the School of Medicine and professor of community health sciences in the School of Public Health at the University of California, Los Angeles, and is a consultant in the Health Program at RAND. Dr. Halfon is currently director of the UCLA Center for Healthier Children, Families and Communities and directs the Child and Family Health Program in the School of Public Health at UCLA. Dr. Halfon also directs the federally funded Maternal and Child Health Bureau's National Center for Infancy and Early Childhood Health Policy Research. His primary research interests include the provision of developmental service to young children, access to care for poor children, and delivery of health services to children with special health care needs, with particular interest in children who have been abused and neglected and are being cared for by the foster care system. He has published investigations of immunizations for inner-city children, the health care needs of children in foster care, trends in chronic illnesses for children, and the delivery of health care services for children with asthma, as well as investigations of new models of health service delivery for high-risk children.

Dr. Halfon was recently a co-chair of the Association for Health Services Research's research agenda setting conference, Improving the Quality of Health Care for Children. He serves on the Pediatric Measurement Advisory Panel for the National Committee on Quality Assurance (NCQA) and the Foundation for Accountability (FACCT). Dr. Halfon is also a member of the American Academy of Pediatrics (AAP) Committee on Child Health Financing and the National Association of Children's Hospitals and Related Institutions' (NACHRI) Council on Health and Finance.

Dr. Halfon has served on expert panels for the National Commission on Children, the Maternal and Child Health Bureau's Bright Futures Project, the Agency for Healthcare Research and Quality's Panel on Child Health Services Research, the Bureau of Health Professions' Panel on Primary Care, and the Carnegie Commission on Early Childhood. He received an MD from the University of California, Davis, and an MPH from the University of California, Berkeley. He completed his pediatric residency at the University of California, San Diego and the University of California, San Francisco. Dr. Halfon was a Robert Wood Johnson Clinical Scholar at the University of California, San Francisco and Stanford.

Page last reviewed June 1999
Internet Citation: Improving Children's Health Through Health Services Research: Children's Health Services Researchers Meeting: Speaker Biographies. June 1999. Agency for Healthcare Research and Quality, Rockville, MD.


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