Evaluation of the Clerical Triage Pilot Program’s Implementation Process

The Monterey County Department of Social Services (MCDSS) has created a pilot program to their caller system in an effort to increase the caller satisfaction. The name of this pilot program is the Clerical Triage pilot program; which will be implemented at the administrative area of MCDSS. This capstone project will focus on following the implementation of the Clerical Triage Pilot Program and the short term results that occurred. This project gives a clear representation of how an implementation will look like if implemented to a caller system. The results will affect the call volume, and caller wait time; this will ultimately lead to the overall success or failure rate of the Caller System. The Macro level problem is the increased lack of accessibility to services in MCDSS can potentially contribute to a lack of social welfare. The Micro level problem is the caller satisfaction rate is too low for the caller system in MCDSS. For both the Micro and Macro level problems the recommendations both apply. They are the following; create an equal training system and language for all workers in all queues, build reports frequently in order to view updates and alter the implementation, all findings to be used as a basis for future programs

Informe del cumplimiento tributarío correspondiente al periodo fiscal 2007 de una empresa importadora y comercializadora de productos para la iluminaciòn

The present document is a report of tax compliance for the period fiscal of 2007 to an importing and marketer company of lighting products. The audit was conducted for the purpose of expressing an opinion on the tax compliance within the period 2007, according to the requirements of the Ecuadorian Accounting Standards, Regulations for the Implementation of the Internal Tax Regime Law, other agreements and regulations, with the aim of reconciling the general ledger accounts with the corresponding statements, assessing the reasonableness and identify possible contingencies, and finally suggest the necessary corrections. As a result, developed the tax audit report with all the formalities of law, based on the models proposed by the Tax Administration for the independent audit, in addition to the models required by the IRS for filing the report and its annexes. At the end of the report provides a chapter of conclusions and recommendations, in order that the reader has a better understanding about accounting and tax treatments

Independence at Risk: Older Californians With Disabilities Struggle to Remain at Home as Public Supports Shrink

Presents findings about aging Californians with disabilities who depend on paid public programs and unpaid help to live at home. Makes policy recommendations, including consolidating long-term care programs and enhancing support for caregivers

An online experiment to assess bias in professional medical coding.

BackgroundMultiple studies have documented bias in medical decision making, but no studies have examined whether this bias extends to medical coding practices. Medical coding is foundational to the US health care enterprise. We evaluate whether bias based on patient characteristics influences specific coding practices of professional medical coders.MethodsThis is an online experimental study of members of a national professional medical coding organization. Participants were randomly assigned a set of six clinical scenarios reflecting common medical conditions and asked to report encounter level of service codes for these clinical scenarios. Clinical scenarios differed by patient demographics (race, age, gender, ability) or social context (food insecurity, housing security) but were otherwise identical. We estimated Ordinary Least Squares regression models to evaluate differences in outcome average visit level of service by patient demographic characteristics described in the clinical scenarios; we adjusted for coders' age, gender, race, and years of coding experience.ResultsThe final analytic sample included 586 respondents who coded at least one clinical scenario. Higher mean level of service was assigned to clinical scenarios describing seniors compared to middle-aged patients in two otherwise identical scenarios, one a patient with type II diabetes mellitus (Coef: 0.28, SE: 0.15) and the other with rheumatoid arthritis (Coef: 0.30, SE: 0.13). Charts describing women were assigned lower level of service than men in patients with asthma exacerbation (Coef: -0.25, SE: 0.13) and rheumatoid arthritis (Coef: -0.20, SE: 0.12). There were no other significant differences in mean complexity score by patient demographics or social needs.ConclusionWe found limited evidence of bias in professional medical coding practice by patient age and gender, though findings were inconsistent across medical conditions. Low levels of observed bias may reflect medical coding workflow and training practices. Future research is needed to better understand bias in coding and to identify effective and generalizable bias prevention practices

Deportation Worry, Cardiovascular Disease Risk Factor Trajectories, and Incident Hypertension: A Community-Based Cohort Study.

Background Worry about deportation has been associated with cardiovascular disease risk factors in cross-sectional research. No research has evaluated this association longitudinally or examined the association between deportation worry and incident cardiovascular disease outcomes. Methods and Results We used data from an ongoing community-based cohort of 572 women primarily of Mexican origin. We estimated associations between self-reported deportation worry and: (1) trajectories of blood pressure, body mass index, and waist circumference with linear mixed models, and (2) incident hypertension with Cox proportional hazards models. Nearly half (48%) of women reported "a lot," 24% reported "moderate," and 28% reported "not too much" deportation worry. Higher worry at baseline was associated with nonlinear systolic blood pressure and mean arterial pressure trajectories. For example, compared with not too much worry, a lot of worry was associated with a faster initial increase (β, interaction with linear year term: 4.10; 95% CI, 1.17-7.03) followed by a faster decrease in systolic blood pressure (β, interaction with quadratic year term: -0.80; 95% CI, -1.55 to -0.06). There was weak evidence of an association between deportation worry and diastolic blood pressure and no association with body mass index, waist circumference, or pulse pressure trajectories. Among 408 women without baseline hypertension, reporting a lot (hazard ratio, 2.17; 95% CI, 1.15-4.10) and moderate deportation worry (hazard ratio, 2.48; 95% CI, 1.17-4.30) were each associated with greater risk of incident hypertension compared with reporting not too much worry. Conclusions Deportation worry may contribute to widening disparities in some cardiovascular disease risk factors and outcomes over time

Le bon café et thé : a cross border business opportunity

This document serves to lay out a general Business Plan for Le Bon Café et Thé, an innovative coffee and tea shop offering hot and cold beverages, as well as “Bubble Tea” an innovative and exclusive product in the area. The entrepreneur wants to analyze the cross-border differences between setting up this business in San Sebastian or Bayonne, in the Basque Country region, in order to decide on the most favorable country to invest in

The Rio Games Legacy in Mobility: Challenges Beyond Infrastructure

The City of Rio de Janeiro, Brazil, a city of 6.5 million inhabitants, had several years to plan, invest, and prepare for the 2016 Olympic and Paralympic Games. A significant part of these efforts were in mobility infrastructure and operations, as they would become a fundamental legacy for the city. Silva, Maiolino and Torres, who were involved in these efforts in various capacities, discuss this experience and some of the challenges that go beyond investments in infrastructure such as behavior and operational changes

Guidelines for authors

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