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Advancing Coordination of Home and Community based Services for the ADRD Population

Award Number: R01AG075929
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2022
PERIOD OF PERFORMANCE END DATE: 01/31/2027

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Advancing Coordination of Home and Community based Services for the ADRD Population - Project Summary Abstract Older adults with Alzheimer's disease and related dementias (ADRD) rely on a broad array of health and social services to address needs ranging from traditional medical care to supports for basic activities of daily living. A critical set of services is those that allow individuals with ADRD to remain at home as opposed to residing in an institutional setting. Referred to as home- and community-based services (HCBS), these services span from clinical services (e.g., skilled home health, in-home palliative care) to services that focus on custodial and social needs (e.g., home health aides, adult day, respite). Despite their widespread use, there is little data characterizing the organizations that deliver HCBS, or how well they coordinate with traditional institutional providers that also care for those with ADRD. Lack of accessible data precludes investigation into availability of HCBS across different geographies, scope of services offered, organizational relationships, quality, efficiency, and beyond. Addressing this gap is particularly essential for the ADRD population because they use HCBS at such high levels. Our proposal, submitted in response to NIA PAR-19-070, focuses on HCBS for those with dementia and offers a multi-method approach to capture systematic data on HCBS organizations and how well they engage in care coordination. Our approach leverages newly-available Medicaid claims/encounter data for HCBS to generate the first publicly-available, national-level datasets that list and characterize the organizations delivering HCBS to the ADRD population. Next, we will identify the organizational networks - including HCBS and institutional organizations – based on which organizations care for the same individuals. Prior work has defined networks of clinical providers that resulted in widely-used measures of healthcare markets (e.g., hospital referral regions). However, the definitions do not include HCBS. Defining networks that include HCBS and serve a shared ADRD population will allow us to characterize the features of the networks (e.g., size, density of ties) in addition to evaluating outcomes (e.g., hospital readmissions, emergency department visits) for those cared for by these networks. Finally, by measuring and comparing care coordination activities in networks with better and worse outcomes (via a large-scale survey of HCBS organizations in those networks), we can identify actionable policy and practice-based strategies that improve care for a vulnerable population. Taken together, our results will inform policy and practice strategies to improve delivery of HCBS for the ADRD population that are currently not well coordinated in relation to our complex and fragmented healthcare delivery system.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $785,896 )
2026	2026	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	000	5	1/22/2026	NON-COMPETING CONTINUATION	$707,308
2026	2026	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	001	5	2/24/2026	NON-COMPETING CONTINUATION	$78,588
														Subtotal = $785,896

Issue Date FY: 2025 ( Subtotal = $770,376 )
2025	2025	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	001	4	6/17/2025	NON-COMPETING CONTINUATION	$62,887
2025	2025	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	000	4	3/6/2025	NON-COMPETING CONTINUATION	$707,489
														Subtotal = $770,376

Issue Date FY: 2024 ( Subtotal = $786,290 )
2024	2024	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	002	3	2/8/2024	NON-COMPETING CONTINUATION	$707,663
2024	2024	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94103	SAN FRANCISCO	USA	Aging Research	003	3	6/10/2024	NON-COMPETING CONTINUATION	$78,627
2024	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	001	1	12/28/2023	NEW	$0
2024	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	1	11/22/2023	NEW	$0
														Subtotal = $786,290

Issue Date FY: 2023 ( Subtotal = $795,450 )
2023	2023	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	2	4/21/2023	NON-COMPETING CONTINUATION	$795,450
														Subtotal = $795,450

Issue Date FY: 2022 ( Subtotal = $757,153 )
2022	2022	REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE	1855 FOLSOM ST STE 425	SAN FRANCISCO	CA	94143	SAN FRANCISCO	USA	Aging Research	000	1	3/18/2022	NEW	$757,153
														Subtotal = $757,153

Grand Total All Awards = $3,895,165

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Advancing Coordination of Home and Community based Services for the ADRD Population

Award Number: R01AG075929

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/01/2022

PERIOD OF PERFORMANCE END DATE: 01/31/2027

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