Cutler Institute for Health and Social Policy

MRHRC Publications

Maine Rural Health Research Center offers working papers, research and policy briefs,and selected publications in PDF format, which are read by Adobe Acrobat Reader.

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Working Papers and Policy Briefs: 2004 - Present

The working papers and publications available on this site are intended for reference use only. They may not be copied or distributed without permission of the Maine Rural Health Research Center.

Working papers that are available in PDF format are indicated by the Adobe Acrobat icon . Please click on this icon to see the document in PDF format.

Title

Year

Full Text Version

Research/ Policy Brief

Adverse Childhood Experiences in Rural and Urban Contexts

2016 Research & Policy Brief only

Rural Opioid Abuse: Prevalence and User Characteristics 

 2016 Research & Policy Brief only

Pilot Testing a Rural Health Clinic Quality Measurement Reporting System

2016 Research & Policy Brief only

Rural Adults Delay, Forego, and Strategize to Afford Their Pre-ACA Health Care

2015 Research & Policy Brief only

Out-of-Pocket Spending among Rural Medicare Beneficiaries

2015

Implications of Rural Residence and Single Mother Status for Maternal Smoking Behaviors

2015 Research & Policy Brief only

Adoption and Use of Electronic Health Records by Rural Health Clinics: Results of a National Survey

2015    

Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace

2015

Profile of Rural Residential Care Facilities: A Chartbook

2014  

Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use among Adults with Diabetes

2014 Research & Policy Brief only

High Deductible Health Insurance Plans in Rural Areas (Working Paper); Rural Residents More Likely to be Enrolled in High Deductible Health Plans (Policy Brief)

2014
Integrated Care Management in Rural Communities 2014

Health Insurance Coverage of Low-Income Rural Children Increases and is More Continuous Following CHIP Implementation 2014

Research & Policy Brief Only

Meaningful Use of the Electronic Health Record (EHR) by Rural Health Clinics

2014

Telemental Health in Today's Rural Health System

2013  Research & Policy Brief Only

Challenges and Opportunities for Improving Mental Health Services in Rural Long-term Care

2013

 
Patterns of Care for Rural and Urban Children with Mental Health Problems

2013

Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences?                                              2012    
Health Care Access Among the Rural Uninsured 2011  Published.
See citation below
 
Impact of Employment Transitions on Health Insurance Coverage of Rural Residents 2010    
Access to Mental Health Services and Family Impact of Rural Children With Mental Health Problems 2010    
Safety Net Activities of Independent Rural Health Clinics 2010    
The Provision of Mental Health Services by Rural Health Clinics 2010    
Mental Health Services in Rural Jails 2010    
Availability, Characteristics, and Role of Detoxification Services in Rural Areas 2009    
Rural-Urban Differences in Health Care Access Vary Across Measures 2009 Research & Policy Brief only  
Private Health Insurance in Rural Areas: Challenges and Opportunities 2009 Research & Policy Brief only  
Profile of Rural Health Insurance Coverage: A Chartbook 2009    
Rural Coverage Gaps Decline Following Public Health Insurance Expansion 2009 Research & Policy Brief only  
Access to Rural Mental Health Services: Service Use and Out-Of-Pocket Costs 2008 Published.
See citation below
 
Use of Mental Health Services by Rural Children 2008    
Rural-Urban Differences in Work Patterns Among Adults with Depressive Symptoms 2008    
Active Living for Rural Youth 2008 Published.
See citation below
 
Rural Inpatient Psychiatric Units 2007 Published.
See citation below
 
Distribution of Substance Abuse Treatment Facilities Across the Rural-Urban Continuum 2007    
Substance Abuse Among Rural Youth 2007 Published.
See citation below
 
Uninsured Rural Families 2007 Published.
See citation below
 
Out-of-Pocket Health Care Spending and the Rural Underinsured 2005 Published.
See citation below
 
Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey 2005 Published.
See citation below
 
Are Advanced Practice Psychiatric Nurses a Solution to Rural Mental Health Workforce Shortages? 2004 Published.
See citation below
 

 

To request a copy, call or email:

Other Publications: 2004 - Present

2016
2015
  • Lambert, D., Gale, J., Hartley, D., Croll, Z., & Hansen, A. (2015). Understanding the business case for telemental health in rural communities. Journal of Behavioral Health Services and Research. doi: 10.1007/s11414-015-9490-7 [epub ahead of print].
  • Gale, J., & Lambert, D. (2015). Exploring the business case for children's telebehavioral health. (Brief). Washington, DC: The Technical Assistance Network for Children's Behavioral Health, The Institute for Innovation & Implementation.
  • Hansen A.Y., Hartley D. (2015). Promoting Active Living in Rural Communities. San Diego, CA: Active Living Research.
  • Hansen, A. Y., Umstattd Meyer, M. R., Lenardson, J. D., & Hartley, D. (2015). Built environments and active living in rural and remote areas: A review of the literature. Current Obesity Reports, 1-10.
  • Lenardson, J. D., Hansen, A. Y., & Hartley, D. (2015). Rural and remote food environments and obesity. Current Obesity Reports. doi: 10.1007/s13679-014-0136-5
  • Tupper, J. B., Gray, C. E., Pearson, K. B., & Coburn, A. F. (2015). Safety of rural nursing home-to-emergency department transfers: Improving communication and patient information sharing across settings. Journal for Healthcare Quality, 37(1), 55-65. doi: 10.1097/01.JHQ.0000460120.68190.15
  • Ziller, E., Lenardson, J., & Coburn, A. (2015). Rural implications of Medicaid expansion under the Affordable Care Act. Minneapolis, MN: State Health Access Reform Evaluation.
2014
  • Alfero, C., Coburn, A., Lundblad, J. P., MacKinney, A. C., McBride, T., & Mueller, K. (2014). Advancing the transitions to a high performance rural health system. (Paper and Policy Brief). Iowa City, IA: Rural Policy Research Institute. RUPRI Health Panel.
  • Gale, J. (2014). Turning around the struggling rural hospital: Shared responsibility and hard work. Rural Matters: A Publication of the Texas Organization of Rural and Community Hospitals, 3(3), 20.
  • Kilbreth, E., & Ziller, E. (2014). Children's health policy: Promising starts, disappointing outcomes. In J. A. Morone & D. Ehlke (Eds.), Health politics and policy (5th ed.). Independence, KY: Cengage Learning.
  • Lambert, D., & Gale, J. (2014). Integrated care in rural areas. In J. C. Warren & K. B. Smiley (Eds.), Rural public health: Best practices and preventive models (pp. 67-84). New York: Springer Publishing Company.
  • Lenardson, J. D., Hartley, D., Gale, J., & Pearson, K. B. (2014). Substance use and abuse in rural America. In J. C. Warren & K. B. Smiley (Eds.), Rural public health: Best practices and preventive models (pp. 95-114). New York: Springer Publishing Company.
  • Ziller, E. C. (2014). Access to medical care in rural America. In J. C. Warren & K. B. Smiley (Eds.), Rural public health: Best practices and preventive models (pp. 11-28). New York: Springer Publishing Company.
2013
  • Coburn, A.F. (2013). Federal Health Care Reform: An Overview. (Policy Brief). Portland, ME: University of Southern Maine, Muskie School of Public Service.
  • Gale, J.A., & Heady, H.R. (2013). Rural vets: Their barriers, problems, needs. Health Progress, 94(3), 49-52.
  • Nudell, M., Bouthillet, T., Rice, D., Wingrove, G., Cole, D., & Gale, J.A. (2013). Rural acute myocardial infarction survey (RAMIS). International Paramedic Practice, 2(1), 169-175.
  • Pearson, K.B., & Coburn, A.F. (2013). Emergency transfers of the elderly from nursing facilities to Critical Access Hospitals: Opportunities for improving patient safety and quality. (Policy Brief #32). Portland, ME: Flex Monitoring Team. 
  • Talbot, J. A., Coburn, A., Croll, Z. and Ziller, E. (2013), Rural Considerations in Establishing Network Adequacy Standards for Qualified Health Plans in State and Regional Health Insurance Exchanges. The Journal of Rural Health. doi: 10.1111/jrh.12012.
  • Tupper, J. B., Pearson, K. B., Meinersmann, K. M., & Dvorak, J. (2013). Little Shop of Errors: An innovative simulation patient safety workshop for community health care professionals. The Journal of Continuing Education in Nursing, 44. doi: 10.3928/00220124-20130501-63
  • Ziller, E.C. and Riley, T. (2013, March). Examining MaineCare’s coverage options under the Affordable Care Act. Health Policy Colloquium Brief. Portland, ME: University of Southern Maine, Muskie School of Public Service.

2012
  • Coburn, A.F., Ziller, E.C., Croll, Z., & Kilbreth, E. (2012, May). Rural implications of geographic rating of health insurance premiums. (Issue Brief). Minneapolis, MN: State Health Access Reform Evaluation Program, Robert Wood Johnson Foundation.
  • Croll, Z.T., Coburn, A.F., & Pearson, K.B. (2012, April). Promoting a culture of safety: Use of the Hospital Survey On Patient Safety Culture in Critical Access Hospitals. (Briefing Paper No. 30). Portland, ME: Flex Monitoring Team. Policy Brief.
  • Lambert, D., & Gale, J.A. (2012). Integrating care in rural areas. In Smalley, K.B., Warren, J.C., & Rainer, J.P. (Eds.), Rural Mental Health. NY: Springer Publishing Co.
  • Lenardson, J., Hartley, D., Gale, J.A., & Pearson, K.B. (2012). Substance use and abuse in rural America. In Smalley, K.B., Warren, J.C., & Rainer, J.P. (Eds.), Rural Mental Health. NY: Springer Publishing Co.
  • Ziller, E.C., Lenardson, J.D., & Coburn, A.F. (2012). Health care access and use among the rural uninsured. Journal of Health Care for the Poor and Underserved, 23(3), 1327-1345.
2011
2010
2009
2008
2007
2006
  • Casey, M., Wakefield, M., Coburn, A. F., Moscovice, I., & Loux, S. (2006, December). Prioritizing patient safety interventions in small rural hospitals. Joint Commission Journal on Quality and Patient Safety, 32(12), 693-702.
  • Coburn, A. F., Loux, S. L., & Bolda, E. J. (2006). Rural hospitals and long-term care: The challenges of diversification and integration strategies. In R. T. Goins, & J. A. Krout (Eds.), Service delivery to rural older adults: Research, policy, and practice. (pp. 103-122). New York, NY: Springer Publishing Co.
  • Gale, J. A., & Lambert, D. (2006). Mental health care in rural communities: The once and future role of primary care. North Carolina Medical Journal, 67(1), 66-70.
  • Lambert, D., & Gale, J. A. (2006, October). Integrating primary care and mental health: Current practices in rural community health centers. Kansas City, MO: National Rural Health Association.
  • Patterson, D. D., Gale, J. A., Loux, S., Yousefian, A. E., & Slifkin, R. T. (2006). Emergency Medical Services (EMS) activities funded by the Medicare Rural Hospital Flexibility Program. (Report No. Briefing Paper No. 8). Portland, ME: The Flex Monitoring Team.
  • Pearson, K. B. (Ed). (2006). Rural health research in progress in the Rural Health Research Centers Program. (10th ed.). Portland, ME: University of Southern Maine, Edmund S. Muskie School of Public Service, Institute for Health Policy, Maine Rural Health Research Center.
  • Sawyer, D., Gale, J. A., & Lambert, D. (2006). Rural and frontier mental and behavioral health care: Barriers, effective policy strategies, best practices. Waite Park, MN: National Association of Rural Mental Health.
  • Ziller, E. C., Coburn, A. F., & Yousefian, A. E. (2006, Nov/Dec.). Out-of-pocket health spending and the rural underinsured. Health Affairs, 25(6), 1688-1699.
2005
2004

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

New Chartbook on the Use of Maine's Long Term Services and Supports (LTSS)

Long Term Services and Supports Cover page image

Long term services and supports (LTSS) are a vital lifeline for the thousands of Maine adults who need them, and they account for a significant portion of the state's Medicaid (MaineCare) budget.This Chartbook prepared by the research staff at the USM Muskie School, provides information on all Maine adults who use LTSS: older adults; adults with physical disabilities; adults with intellectual disabilities/autism spectrum disorder or other related conditions; and adults with acquired brain injury.

The information provided in this Chartbook about the demographic trends that impact Maine's service system as well as data on the typical MaineCare service utilization and expenditures of different LTSS populations will inform the discussion among policymakers, providers, consumers, and advocates as they work together to ensure that Maine’s system of LTSS meets the needs of all its citizens.

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