Energy Storage: Technology for a More Efficient Grid

Energy storage technologies have the potential to revolutionize the electric grid by allowing for the integration of renewable generation while increasing the utilization and efficiency of current grid assets. These technologies include pumped hydroelectric storage, compressed air energy storage (CAES), flywheels, batteries, thermal energy storage (TES), super capacitors, and superconducting magnetic energy storage (SMES). While energy storage has been implemented in some areas, its benefits are greatly undervalued by current regulatory frameworks leading to suboptimal outcomes for grid operators, utilities, and ratepayers. Large-scale adoption of storage technologies will require regulatory frameworks that recognize the benefits of grid-scale storage across generation, and transmission and distribution. This thesis discusses the need for storage, currently available and developing storage technologies, and the present regulatory environment

Child Development Programs in Community Health Centers

This report, the third in a series that reviews federal health policy related to child development, examines the role of community health centers in providing child development programs for children age 3 and younger. It also presents an analysis of health centers using the Uniform Data System, a database maintained by the federal Bureau of Primary Health Care (BPHC) that contains user, utilization, and financial information on each reporting center. In addition, the report presents findings from a 2000 survey of four categories of child development programs at 79 health centers; examines the new prospective payment system for health centers and its potential impact on the provision of child development services; and offers recommendations for improved delivery of these services at health centers. Health centers administered by BPHC rely on public funds to provide comprehensive medical services, as well as a variety of social services, to low-income, medically underserved communities. By 2000, about 700 health centers served more than 9 million people at nearly 3,000 locations. As of 1999, 129 clinics designated by the federal government as meeting all standards applicable to federal health center grantees were serving another 1.8 million patients. Health centers are a major health care provider for children. They care for one of every six children of low-income families, and serve 1.3 million children under age 6.3 In 1998, births to health center patients accounted for one of five births to low-income families, or one of 10 of all births nationally. Because of their ability to identify at-risk children and to assess their social and primary care needs, health centers are valuable and essential providers of child development services. Findings presented in this report show that health centers provide many valuable programs and services that promote the healthy growth and development of a large number of young children. Maintaining and expanding their ability to seek out at-risk children, screen and assess their needs, and provide appropriate development services are important to improving the health and welfare of children and their families.This report, the third in a series that reviews federal health policy related to child development, examines the role of community health centers in providing child development programs for children age 3 and younger. It also presents an analysis of health centers using the Uniform Data System, a database maintained by the federal Bureau of Primary Health Care (BPHC) that contains user, utilization, and financial information on each reporting center. In addition, the report presents findings from a 2000 survey of four categories of child development programs at 79 health centers; examines the new prospective payment system for health centers and its potential impact on the provision of child development services; and offers recommendations for improved delivery of these services at health centers

Ingredients for Optimal Care: Exploring Factors Associated with Patient Quality Outcomes among Federally-Qualified Health Centers

Primary care practices nationally vary in their performance along key clinical measures. For this reason, policymakers, payers, and providers are increasingly focused on performance accountability and aligning payment to recognize value. The Affordable Care Act (ACA) of 2010 heavily invests in primary care infrastructure, including a major expansion of the Federally-Qualified Health Center program. Health centers already serve more than 20 million predominately low income, minority, and publicly insured or uninsured patients across the country. Despite their high-risk patient population, health centers are not immune to the accountability expectations that come with public investment and increased visibility. This dissertation is the first to thoroughly examine the factors associated with health centers' higher performance on two patient outcome measures: diabetes and hypertension control. It draws from three years of programmatic data from 1000+ health center organizations, as well as state-level data representing key environmental factors that may influence health center capacity for quality improvement. The two performance measures are quartiled and health center differences between quartiles descriptively determined. Analyses then explore the external-, organizational-, and patient-level factors statistically related to achieving high performance as well as the circumstances in which a health center increases the odds of high performance. Findings reveal that high performance on one measure does not necessarily indicate high performance on the other, yet certain common inputs are necessary to support quality improvement efforts across both chronic conditions. Those that increase the odds include state Medicaid adult enrollment rate, number of encounters per hypertensive or diabetic patient, and use of sampling rather than full population data to report the outcome measures. Those that decrease the odds of high performance include dependency on federal health center grant funding and percents of patients who are homeless and racial/ethnic minority. Several others factors are statistically significant for only one particular measure. Findings suggest that more visits for diabetic and hypertensive patients may be the most important contributor to improving patient outcomes. Visit frequency appears to moderate or even overcome patient complexity factors, including chronic illness, homelessness, insurance status, and minority. Results also suggest that state-level environmental factors, principally Medicaid enrollment policy, underlie organizational- and patient-level factors related to quality performance in hypertension and diabetes control. Medicaid expansion states are therefore more likely to see the most gains in quality performance and disparities reduction than non-expansion states. However, findings also indicate that federal health center funding is needed to ensure access to care, particularly for patients with high burdens of chronic illness

Putting children in the picture: improving responses to domestic violence in the emergency department

This paper documents a project that improved identification and responses to domestic violence in an Emergency Department within an Area Health Service. This paper outlines the key elements of the project as part of the dissemination of the findings and also in order for other health services to be able to replicate the successful improvements in practice. It is clear from this project that the Emergency Department can act as a critical gateway to services for women and children living with domestic violence

Scenes from the Shahnama (exhibition)

Co-curator of an exhibition that appeared in the Philadelphia Museum of Art from October 22, 2002 through August 3, 2003

Engaging Community Health Centers (CHCs) in Research Partnerships: The Role of Prior Research Experience on Perceived Needs and Challenges

Despite community health centers’ substantial role in local communities and in the broader safety‐net healthcare system, very limited research has been conducted on community health center research experience, infrastructure, or needs from a national perspective. A national survey of 386 community health centers was conducted in 2011 and 2012 to assess research engagement among community health centers and their perceived needs, barriers, challenges, and facilitators with respect to their involvement in public health and health services research. This paper analyzes the differences between health centers that currently conduct or participate in research and health centers that have no prior research experience to determine whether prior research experience is indicative of different perceived challenges and research needs in community health center settings