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Rosa Plasencia is Director of the National Core Indicators – Aging & Disabilities (NCI-AD) at ADvancing States. NCI-AD is a collaborative effort managed by ADvancing States and the Human Services Research Institute (HSRI) to collect and maintain valid and reliable data from State Medicaid, Aging, and Disability agencies to provide insight into how publicly-funded services impact the quality of life and outcomes of service recipients. For Plasencia, it is the culmination of a long career serving in various healthcare, policy and nonprofit roles where the common thread has been service and a passion for helping improve health outcomes for older adults and people with disabilities.
Plasencia, 38, says her first exposure to working in healthcare came from her grandfather, who was an internal medicine physician at St. Vincent’s Hospital in Los Angeles where she grew up. Wearing a child-sized white medical coat given to her by her grandfather, Plasencia would accompany him on his rounds. “Since then, I always knew I wanted to do something related to medicine or something where I was directly helping people,” she says.
As an undergraduate at the University of California, Santa Cruz, she worked in the office responsible for securing reasonable accommodations for students. Her first job out of college was at a small Philadelphia based non-profit focused on Black, Indigenous and People of Color (BIPOC) communities serving individuals with HIV/AIDS where she helped run a food pantry and assisted people in applying for Social Security Disability Insurance. She says the experience was affirming. “I thought, ‘yes, I’m on the right path’,” she says.
Plasencia was contemplating getting a social work degree or a law degree. She was nudged towards law at her next job at the American Association for Cancer Researchers where she supported recruitment of female and minority students to pursue careers in STEM fields. She worked with an attorney responsible for running the continuing medical education program. “It was really eye opening to me that you could have a law degree, which brings with it fundamental skills like research, critical thinking, regulatory analysis, those sorts of things, but you didn’t have to be in a courtroom, which is what a lot of people think of when they think ‘lawyer’,” she says.
Plasencia enrolled at the University of Wisconsin, where she was offered a generous fellowship. But the law school’s Center for Patient Partnerships was what really attracted her. Through the Center, students take courses at multiple professional schools including the university’s law and medical school, learn about public policy and work directly with patients on issues like applying for public benefits and consumer health advocacy. “It was such an amazing interdisciplinary learning opportunity,” says Plasencia.
The program also provided valuable networking opportunities. “Alumni of the program worked in protection and advocacy organizations, some people worked in state government doing program administration, some people worked at universities and medical schools, some people were doctors. So, the skills I acquired during the program were transferrable - you could take them with you into meaningful work in the healthcare field.”
While Plasencia was in law school, she also worked at Disability Rights California. “One of the attorneys I worked with suggested that I look into public interest and elder law, and home and community-based services. He just thought my demeanor was a match for those areas. I decided to listen to him, and when I graduated, I ended up first volunteering and then being hired at the Greater Wisconsin Agency on Aging Resources’ Elder Rights and Advocacy Center in Madison, Wisconsin.” The program provides legal services for older adults with economic and social need.
Plasencia was soon recruited by the state of Wisconsin to run the Disability Benefits Specialist Program. She worked in different roles at the State of Wisconsin for almost seven years.
“It was incredibly fulfilling,” says Plasencia. “I have nothing but the utmost respect for state service workers; they are dedicated, passionate, and have to remain nonpartisan in service delivery, regardless of what's going on in state and federal government.”
During the pandemic, Plasencia took a job with ADvancing States as a director on its Long-Term Services and Supports (LTSS) Policy team. Within a few months, she became director of the National Core Indicators – Aging & Disabilities program.
The core indicators are standard measures used across states to assess the outcomes of services provided to individuals and families. Data for the project is gathered through annual in-person surveys of older adults and people with disabilities who receive LTSS in each participating state. These surveys ask about community inclusion, choice, health and care coordination, safety and relationships. The NCI-AD team interprets each state's data and produces reports that can support state efforts to strengthen LTSS policy, inform quality improvement activities, and compare their performance with national norms.
NCI-AD lets participating states include state-specific indicators in their surveys, says Plasencia. “States are looking at things like dental access, durable medical equipment and enabling technology, paid caregivers versus unpaid caregivers and which of these may be linked to better outcomes for their consumers."
This past year, NCI-AD launched a State of the Workforce survey – a provider level survey to help states gather information about direct service workers. There has been an ongoing shortage of direct service workers – those who provide LTSS and home and community-based services – but the shortage was exacerbated by the pandemic when direct service providers left the workforce in droves. “We need to know more about what is happening with direct service workers – their pay, the reasons they leave a job, and what they need in terms of support in order to make policy decisions and push for additional funding supports,” says Plasencia.
Plasencia’s experience with National Core Indicators has helped the Center for Rehabilitation Outcomes Research (CROR) Rehabilitation and Research Training Center (RRTC) on Home and Community-Based Services with the development of HCBS outcome measures.
“Rosa has been instrumental in providing context based on experience with the National Core Indicators measures as we develop our HCBS measure set,” says Bridgette Schram, PhD, project manager of the RRTC on HCBS at CROR. “Her support as a collaborator helps us ensure we are developing measures that bridge current gaps in HCBS measurement and has also help connect us with key people in the field that could further assist in making sure what we use contributes and is feasible to implement.”
Plasencia has served on the RRTC’s Adoption and Implementation Council, which provides input on the measures, for almost two years.
When Plasencia isn’t working, she’s out exploring Madison with her five-year-old son, Theo. “He loves this one path behind our house we call the ‘Dinosaur Path’ because we pretend to collect fossils there,” she says. She also enjoys reading, live music and lately, taking in the fall foliage on long walks with her dog Greta.