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The RAND Program Manager's Guide is a tool to help assess program performance, consider options for improvement, implement solutions, then assess how well the changes worked, with the intention of helping those responsible for managing or implementing programs.

Improvised explosive devices (IEDs) have been one of the leading causes of death and injury among U.S. troops. Those who survive an IED blast or other injuries may be left with a traumatic brain injury (TBI) and attendant or co-occurring psychological symptoms. In response to the need for specialized services for these populations, the U.S. Department of Defense (DoD) established the National Intrepid Center of Excellence (NICoE) in Bethesda, Maryland, in 2010. The NICoE's success in fulfilling its mission is impacted by its relationships with home station providers, patients, and their families. The RAND Corporation was asked to evaluate these relationships and provide recommendations for strengthening the NICoE's efforts to communicate with these groups to improve patients' TBI care. Through surveys, site visits, and interviews with NICoE staff, home station providers, service members who have received care at the NICoE, and the families of these patients, RAND's evaluation examined the interactions between the NICoE and the providers responsible for referring patients and implementing treatment plans.

<p class="Pa7"><strong>Objectives: </strong>To understand the health care access issues faced by Los Angeles (LA) County's uninsured and residually unin­sured after implementation of the Afford­able Care Act (ACA) and to identify poten­tial solutions using a community-partnered dialogue.</p><p class="Pa7"><strong>Design: </strong>Qualitative study using a com­munity-partnered participatory research framework.</p><p class="Pa7"><strong>Setting: </strong>Community forum breakout discus­sion.</p><p class="Pa7"><strong>Discussants: </strong>Representatives from LA County health care agencies, community health care provider organizations, local community advocacy and service organiza­tions including uninsured individuals, and the county school district.</p><p class="Pa7"><strong>Main Outcome Measures: </strong>Key structural and overarching value themes identified through community-partnered pile sort, c-coefficients measuring overlap between themes.</p><p class="Pa7"><strong>Results: </strong>Five overarching value themes were identified – knowledge, trust, quality, partnership, and solutions. Lack of knowl­edge and misinformation were identified as barriers to successful enrollment of the eligible uninsured and providing health care to undocumented individuals. Discussants noted dissatisfaction with the quality of tra­ditional sources of health care and a broken cycle of trust and disengagement. They also described inherent trust by the uninsured in "outsider" community-based providers not related to quality.</p><p><strong>Conclusions: </strong>Improving health care for the residually uninsured after ACA implementa­tion will require addressing dissatisfaction in safety-net providers, disseminating knowl­edge and providing health care through trusted nontraditional sources, and using effective and trusted partnerships between community and health care agencies with mutual respect. Community-academic part­nerships can be a trusted conduit to discuss issues related to the health care of vulner­able populations. <em>Ethn Dis. </em>2015; 25(4)487- 494; doi:10.18865/ed.25.4.487</p>