Cutler Institute for Health and Social Policy

Population Health and Health Policy

John Gale

Research Associate II
John Gale

Office

434 Wishcamper Center

Contact Information

Phone: (207) 228-8246

Education: University of Southern Maine, BS Business Administration, 1979; University of Southern Maine, MS Health Policy, 2003.

Areas of Expertise: Access to and delivery of mental health services, particularly in rural areas; integration of mental health and primary care services; rural health; access and financing issues; primary care delivery systems; limited service hospital models; physician management and reimbursement issues.

Research Interests: Mr. Gale has over a decade of experience in rural health and rural mental health research as well as sixteen years senior management experience in primary care, mental health and substance abuse practices. He has published a number of articles, reports, and book chapters in the areas of rural mental health, safety net, primary care, and hospital issues. His work has included studies of the national Medicare Rural Hospital Flexibility Program, the informal safety net in rural communities, and the use of state health policy research to inform federal and state policy;  surveys of Rural Health Clinics; evaluations of the state Rural Hospital Flexibility Programs in Maine and New Hampshire; an assessment of the RWJ Southern Rural Access Program; and the management of the Mental Health Technical Assistance Program for the Mental Health Funding Collaborative in Maine.

Mr. Gale has served on Board of the National Association for Rural Mental Health and was a 2002 Fellow in the US Department of Health and Human Service Secretary's Primary Care Policy Fellowship. He currently serves on the Board of Trustees for the National Rural Health Association, the Rural Health Clinic Advisory Committee of the National Organization of State Offices of Rural Health, and the Association for Community Health Improvement Advisory Council.  Mr. Gale was recently appointed to the National Quality Forum's Rural Health Committee, which will provide recommendations to the US DHHS regarding performance measurement issues for rural and low-volume providers such as Critical Access Hospitals, Rural Health Clinics, and Community Health Centers.

Publications

Date Title Typesort descending
2012 Substance abuse and use in rural America Book Chapter
2012 Integrating care in rural areas Book Chapter
2014 Integrated Care in Rural Areas Book Chapter
2014 Substance Use and Abuse in Rural Areas Book Chapter
2015 Understanding the Business Case for Telemental Health in Rural Communities Journal Article
2008 Substance Abuse by Youth and Young Adults in Rural America Journal Article
2005 Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms Journal Article
2010 Characteristics of Inpatient Psychiatric Units in Small Rural Hospitals Journal Article
2007 Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms Journal Article
2007 Exploring the Community Impact of Critical Access Hospitals Report
2006 Creating Progam Logic Models: A Toolkit for State Flex Programs Report
2007 The Community Impact of Critical Access Hospitals [Policy Brief] Report
2006 Emergency Medical Services (EMS) Activities Funded by the medicare Rural Hospital Flexibility Program Report
2006 Quality and Performance Improvement Grant Activities under the Flex Program Report
2008 Maine Barriers to Integration Study: Environmental Scan Report
2001 Medicaid Managed Behavioral Health in Rural Areas Report
2008 The Community Benefit and Impact of Critical Access Hospitals: The Results of the 2007 CAH Survey [Briefing Paper] Report
2006 Review of State Flex Program Plans 2004-2005 Report
2009 Maine Barriers to Integration Study: The View from Maine on the Barriers to Integrated Care and Recommendations for Moving Forward Report
2012 Linking Community Assessment and Community Benefit Strategies. Report
2012 Why Do Some Critical Access Hospitals Close Their Skilled Nursing Facilities While Others Report
2007 Distribution of Substance Abuse Treatment Facilities Across the Rural-Urban Continuum Report
2015 Exploring the Business Case for Children's Telebehavioral Health Research and Policy Brief
2008 The Community Benefit and Impact of Critical Access Hospitals: The Results of the 2007 CAH Survey [Policy Brief] Research and Policy Brief
2016 Pilot Testing a Rural Health Clinic Quality Measurement Reporting System Research and Policy Brief
2016 Rural Opioid Abuse: Prevalence and User Characteristics Research and Policy Brief
2008 Distribution of Substance Abuse Treatment Facilities Across the Rural-Urban Continuum [Research & Policy Brief] Research and Policy Brief
2007 State Initiatives Funded by the Medicare Rural Hospital Flexibility Grant Program Research and Policy Brief
2009 Few and Far Away: Detoxification Services in Rural Areas Research and Policy Brief
2010 Encouraging Rural Health Clinics to Provide Mental Health Services Research and Policy Brief
2008 Developing Indicators to Document the Community Impact of Critical Access Hospitals Research and Policy Brief
2009 Availability, Characteristics, and Role of Detoxification Services in Rural Areas Research and Policy Brief
2011 Provision of Long Term Care Services by Critical Access Hospitals Research and Policy Brief
2013 Telemental Health in Today's Rural Health System Research and Policy Brief
2014 Collaborative Community Health Needs Assessments: Approaches and Benefits for Critical Access Hospitals Research and Policy Brief
2010 Provision of Mental Health Services by Rural Health Clinics Working Paper
2012 Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences? Working Paper
2015 Rural Health Clinic Readiness for PCMH Recognition Working Paper

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.

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