Founded in 1987, the Thomas Jefferson Program in Public Policy is among the College's most interdisciplinary and collaborative programs, designed to address what the National Commission on the Public Service identified as the "quiet crises" in government -- the need "to attract, develop, and retain professionals of the highest caliber." To respond to this challenge, in 1991 the Jefferson Program enrolled its first class of graduate students. Since that time, over 120 students have graduated from the Program with a Master of Public Policy (M.P.P.) degree. Of these students, 20 graduated with a joint degree in public policy and another specialty area, such as business (M.P.P./M.B.A.), law (M.P.P./J.D.), marine science (M.P.P./M.S.), or operations research (M.P.P./M.S. - Computational Operations Research).

The Program draws heavily from the Departments of Economics and Government and the School of Law, as well as other professional schools (Business, Education, and Marine Science) and several other departments (History, Philosophy, Sociology). The Program's health policy course has been taught by two faculty members, Leonard Schifrin and Jennifer Mellor. Professor Schifrin, Chancellor Professor of Economics, has conducted research in health and medical policy, testified on the health care industry, and consulted on various health policy issues. Professor Mellor, an Assistant Professor in Economics and a former Scholar in the Health Policy Research Program at the Robert Wood Johnson Foundation, currently teaches the Program's health policy course, which, among other things, examines changes in the provision of health care occurring with the growth of managed care. Last year, Professor Mellor was awarded a grant from the National Institute on Aging to examine the factors associated with the decision of elderly individuals to obtain privately-financed insurance for long-term care.
Faculty, students, and staff of the Thomas Jefferson Program in Public Policy and its research arm, the Center for Public Policy Research, conduct numerous evaluation studies related to health services and the delivery of health care. Research has focused on broad national health policies and the delivery of health care services within the Commonwealth and its localities. The Program has investigated both public and private sector issues in the delivery of those services and has developed recommendations to improve their availability and quality.
Since the Jefferson Program began doing grant and contract work, the Center has been awarded over $995,000 to complete 31 policy research projects, of which 10 are health related. During 1998 and 1999, the Center was awarded approximately $228,000 to complete 10 projects - over 50 percent of which was for health-related work. Eighteen faculty members from four departments (Economics, Government, Psychology, and Sociology) and the School of Law have participated in Center research projects as well as over 120 students and 20 staff members.

The Center also has the capability to evaluate science and technology programs. For example, Center faculty have evaluated the NASA Langley Research Center's Small Business Innovation Research Program (SBIR). This research examined and evaluated several outcomes and patterns of SBIR awards and awardees, including commercialization, financing issues, and the degree of customer satisfaction. Center faculty and staff have also worked with Sandia National Laboratories in developing performance measures for the U.S. Department of Energy and reviewing cost-benefit studies.

Virginia Birth-Related Neurological Injury Compensation Program: Study to Increase the Scope and Magnitude of the Program

In 1998, the Center for Public Policy completed a study commissioned by the Virginia General Assembly and sponsored by the Virginia Birth-Related Neurological Injury Compensation Program (the "Program"). The Program is one designed to take the cases of neurologically damaged babies out of the tort system and provide them with benefits, such as medically necessary services, homes, and lost wages when the child reaches age 18. Center faculty and staff analyzed the Program's operation, eligibility criteria for entry into the Program, geographic distribution of cases, benefits provided, fee structure, management of the fund supporting the Program, and the strengths and weaknesses of the Program as viewed by legislators, hospital representatives, insurance company representatives, physicians, nurses, and the parents of severely neurologically injured children who received services through the Program. This report was published as a legislative study for the Virginia General Assembly.

Virginia Department of Medical Assistance Services: Study of Health Care-Related Boards in the Commonwealth of Virginia with Recommendations for Action Pursuant to SJR 317 of 1997

In 1998, the Center completed a study commissioned by the Virginia General Assembly and sponsored by the Secretary of Health and Human Resources and the Virginia Department of Medical Assistance Services (DMAS). The Center reviewed health care-related boards across the Commonwealth and made recommendations as to their consolidation, elimination, or restructuring. Center staff interviewed agency contacts about the boards and presented its findings at a Joint Commission on Health Care hearing. In addition, Center staff created an inventory of health policy-related entities composed of legislators or individuals appointed by the Legislature and reported on the ways in which Georgia, Maryland, North Carolina, and Ohio developed health care policy. The Center's report was published as a legislative study for the General Assembly.

Williamsburg Community Health Foundation: Update and Expand the 1996 Community Health Assessment

In 1999, the Center conducted a community-wide needs assessment of the Greater Williamsburg Area. This study involved identifying the existing health and human services in the region and determining the extent to which these services are utilized. Center faculty and staff conducted a telephone survey of residents and clients of services, a mail survey of service providers and key public officials, and updated demographic data (including selected economic indicators) and health and social indicators for the community.

Virginia Department of Health -- Hampton District

The Center, through Professor Ronald Rapoport's Political Science graduate survey course, surveyed clients and Hampton residents' attitudes toward the Hampton Department of Health. Clients included customers of the City's family planning and maternity clinic, adult primary care clinic, immunization and pediatric clinic, and the Women, Infants, and Children (WIC) program. In addition, the Center, through the survey course, conducted a survey of Hampton residents' beliefs related to teens' health behaviors, Hampton's media campaign, and their own health behaviors.

City of Hampton: Evaluation of Hampton's Healthy Families Partnership Program

For several years, the Center worked with a team of faculty, staff, and students to evaluate the Hampton Healthy Start Program (a program focusing on prevention with special attention given to child abuse and neglect issues). This involved a longitudinal study evaluating the program (using an experimental design), a preliminary benefit-cost analysis, and advisory services related to a variety of issues ranging from help in the City's plans for state and private grants and help with Hampton's own broader strategic plans that deal with healthy families, healthy business, and healthy neighborhoods.

Teaching Physicians Advanced Management Techniques

A study published by the National Committee for Quality Assurance funded by large employers and the HMO industry found that while the HMO's tour preventive care, only 65% ensure that all members under 2 years of age are properly immunized, and only 62% of HMO heart-attach patients who could benefit from taking beta-blocking medications are given the potentially life-saving prescriptions. Over the past seven years, Professors William Geary, James Oliver, Lawrence Ring, Robert Solomon, and Godwin White have developed an award-winning program which helps physicians learn to use advanced management techniques to deliver first-class medical care and control mounting costs. Doctors are realizing that how they manage has a direct impact on the quality of care they can offer. Physicians are clearly caught in a crunch. As managed care affects larger portions of the nation's health care, the former "cottage industry" of individual practices is rapidly being absorbed into large managed-care networks. And these networks can and often do limit the fees they pay doctors, just as easily as they have reduced hospital stays for new mothers.

The team began with an extensive program for Sentara Health Care System in Norfolk which spread to other members of VHA Inc., a nationwide consortium or more than 1,000 not-for-profit hospitals and health-care systems. The program covers marketing, finance, accounting and strategy, but perhaps the most critical element of the seminar is one designed to encourage physicians to become agents of change within their organizations-by probing, encouraging, and leading their colleagues to understand changing conditions and adapt their practices to them. These and other concepts form the core of Solomon's The Physician Manager's Handbook, published in 1997. The program is delivered in six days of instructions spread over two weekends.