The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to identify and develop items for use in post-acute care (PAC) patient-assessment instruments. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, Section 2(a), mandates that CMS develop, implement, and maintain these instruments, known as standardized patient-assessment data elements (SPADEs), for certain PAC settings. RAND was tasked by CMS with developing and testing SPADEs within five areas of focus delineated in the IMPACT Act: (1) cognitive function and mental status, (2) special services, treatments, and interventions, (3) medical conditions and comorbidities, (4) impairments, and (5) other categories. Candidate SPADEs under each of the categories were identified. This multivolume report presents background information on and results of the national Beta test of the set of candidate SPADEs for assessing these focus areas, conducted between November 2017 and August 2018. Volume 2 specifically covers the candidate SPADEs tested, the design and sampling plan, information on training, recruitment, and retention, information on the data collection process, and the analytic plan. Subsequent volumes present the quantitative and qualitative data gathered during testing, as well as analytic comments and recommendations.

This report describes a health and human services needs assessment of Prince George's County, Maryland. Findings from this report can inform Prince George's County's pursuit of a Health in All Policies approach to policymaking.

The World Trade Center (WTC) Health Program (hereafter Program) provides medical monitoring and treatment for its Members: the responders and survivors who were at the WTC and related sites or located within the New York City disaster area during and after the terrorist attacks of September 11, 2001. Scientific research supported by the Program provides an evidence base for the health monitoring and clinical care of Members. In this report, the authors describe the findings and recommendations of a four-year study of the Program's research portfolio and its translational impact. They present results from a mixed methods assessment that integrates (1) a scoping review of nearly 1,000 peer-reviewed publications and thousands of pages of grey literature that reference research related to the health effects of 9/11, (2) stakeholder perspectives gathered through focus groups and interviews, and (3) a review of Program documentation. The report is intended to guide planning by Program leadership as it aims to maximize the impacts of Program research and achieve its goal of translating research into care for those affected by the attacks on 9/11.

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. This is Volume 5 of the final report on the National Beta Test. It describes the identification and testing of candidate SPADEs in the clinical categories of mental status and pain. This volume provides results and significance tests on the feasibility, reliability, validity, stability and change over time, and sensitivity to national representativeness of the candidate SPADEs. The mental status data elements tested consisted of the Patient Health Questionnaire (PHQ)-2 to 9, Patient Reported Outcome Measurement Information System (PROMIS) Depression, and PROMIS Anxiety. The pain data element set tested was the Pain Interview. All four data element sets performed fairly well, showing feasibility, acceptable reliability, and moderate support from assessors.

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. This is Volume 3 of the final report on the National Beta Test. It provides a sample description and reports analyses that evaluate the generalizability of results from the National Beta Test sample, both in terms of the representativeness of the facility/agency-level sample to the national population of PAC facilities/agencies, as well as the patients and residents who participated in the National Beta Test relative to the national population of patients and residents receiving PAC in the United States.

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. This is Volume 8 of the final report on the National Beta Test, which includes the identification and testing of candidate SPADEs developed specifically for patients and residents who are unable to communicate (staff assessments of mental status, mood, and pain). This volume provides results and significance tests on the feasibility, reliability, validity, stability and change over time, and sensitivity to national representativeness of the candidate SPADEs. The data elements tested include the Observational Assessment of Cognitive Function, the Staff Assessment of Patient/Resident Mood, and the Observational Assessment of Pain or Distress. All three data element sets performed reasonably well, with some variability in performance.

The recovery plan for the water sector in Puerto Rico involves not only repairing hurricane-damaged water infrastructure and systems but also fixing the significant legacy challenges in the sector's infrastructure, operations, and governance.

Agriculture remains one of America’s oldest and most valued industries, but is also one of the most hazardous, with farmworkers experiencing high rates of injuries and illnesses. The National Institute for Occupational Safety and Health’s (NIOSH) Agriculture, Forestry and Fishing (AgFF) Program provides leadership to prevent harm to workers in the three named sectors. Since its inception, the AgFF Program has spearheaded numerous surveillance initiatives to understand the magnitude of injuries and illnesses among agricultural worker populations, identify vulnerable groups, and evaluate the effectiveness of intervention measures. In 2012, the program underwent a review from an independent panel convened to evaluate progress in program relevance and impact. While the panel offered a number of recommendations for improving surveillance, it provided little guidance on how to prioritize and achieve the recommendations. In 2015, NIOSH asked the RAND Corporation to assess options for action in response to panel recommendations. The goal of this report is to provide NIOSH with a practical assessment of the feasibility and desirability of carrying out actions to meet surveillance-related panel recommendations, given current AgFF Program resources and priorities. The authors conducted literature reviews and targeted interviews to detail how actions could be implemented and identify barriers to their achievement. For each action, the authors applied criteria relevant to assessing feasibility (costs, partnership engagement, information availability and accessibility, policy barriers, timelines) and desirability (relevance to program priorities, information quality, and impact). Overall, the report identifies a number of actions that balanced both feasibility and desirability for NIOSH to consider as it determines the direction of the AgFF Program.

The devastating events of 2020-including more than 500,000 deaths from coronavirus disease 2019, the highest-ever number of opioid overdose deaths in a 12-month period, and the highest levels of unemployment since 1948-severely stressed disaster-response systems in the United States. The pandemic demonstrated what has been anticipated and studied for some time in resilience science-multisystem impacts from the combination of an acute crisis and ongoing chronic stressors, such as historical structural inequities, that have exacerbated it. The multisystem failure of 2020 provided an important opportunity for researchers, practitioners, and policymakers to discuss what must be done to ensure that the United States is prepared for future challenges of this magnitude. In December 2020, the RAND Corporation and the Robert Wood Johnson Foundation convened a virtual Resilience Roundtable of community resilience researchers and practitioners to take stock of progress on an integrative resilience agenda initially laid out in a 2016 roundtable. In this Perspective, the authors document the recommendations that emerged from evolving resilience literature and the experiences of resilience stakeholders actively working in their communities to create change during 2020. This Perspective has three aims: to describe the evolution of the integrative resilience research agenda first developed at the 2016 roundtable; to lift up the recommendations and concerns of resilience stakeholders that were not present in the 2016 agenda; and to discuss continued gaps in meeting the earlier roundtable's recommendations for integrative resilience, highlighted by the pandemic response.