Appendix III: Compendium of Measures and Tools

Environmental Scan of Measures for Medicaid Title XIX Home and Community-Based Services Measure Scan as of July 5, 2007

Identified Through the Medicaid Home and Community-Based Services Measure Scan as of July 5, 2007

This compendium was developed by Sara Galantowicz, Erin McGaffigan, and Becky Selig of Thomson Healthcare under Contract No. HHSA 29020060042C and was submitted to the Agency for Healthcare Research and Quality March 7, 2008. Kerstin Gerst contributed to this compendium by searching databases and researching references.

This appendix has been edited to check for grammatical and spelling errors but has not been edited to conform to Government Printing Office style. In addition, some items, such as database fields, appear verbatim from their original source (such as the database).

Contents

I. Introduction
II. List of Data Elements for Measures Database
III. Federally Sponsored Tools and Measures
   Administration on Aging
   Agency for Healthcare Research and Quality
   Aging and Disability Resource Centers
   Centers for Medicare & Medicaid Services
   Health Resources and Services Administration
   National Institute on Disability Research and Rehabilitation
   Substance Abuse and Mental Health Services Administration
IV. Tools and Measures Developed in Academic and Research Settings
   Universities
   Institutes and Other Research Organizations
   Specific Research Inquiries
   Other
V. Tools and Measures Developed or Endorsed by Associations and Accrediting Bodies
   Associations
   Accrediting Bodies
VI. Tools and Measures Developed by Providers
VII. Proprietary Tools and Measures
   Miscellaneous Private and Public Organizations
   National Core Indicators Project
VIII. Tools and Measures Developed by and for Individual States
   Alabama
   Arizona
   Arkansas
   California
   Colorado
   Connecticut
   Delaware
   Florida
   Georgia
   Idaho
   Illinois
   Iowa
   Kansas
   Kentucky
   Louisiana
   Maine
   Massachusetts
   Michigan
   Minnesota
   Mississippi
   Montana
   Nebraska
   Nevada
   New Hampshire
   New Jersey
   New York
   North Carolina
   North Dakota
   Ohio
   Oklahoma
   Oregon
   Pennsylvania
   Rhode Island
   South Carolina
   South Dakota
   Tennessee
   Texas
   Vermont
   Virginia
   Washington
   West Virginia
   Wisconsin
   Wyoming
Abbreviations
Index to Tools and Measures and Their Developers

I. Introduction

This compendium provides selected information about the tools, measures, and measure sets identified using the methodology articulated in the Medicaid Home and Community-Based Services (HCBS) Measure Scan Methodology Report, released April 4, 2007. It is by no means definitive or exhaustive and includes only those items identified before the closing date of the Formal Call for Measures (July 5, 2007). Additional measures identified after July 5, 2007, but before March 21, 2008, are identified in Appendix IV.

In an attempt to be comprehensive, the inclusion criteria were liberally applied, to cover as many measures with potential relevance to assessing Medicaid HCBS quality as possible. Each measure set or tool is presented in summary form; Section II provides a complete list of all the data fields in the Measure Scan database that could ultimately be populated. For ease of review, measures are grouped by type of developing or sponsoring entity: Federal agency, academic, association/accreditor, vendor/proprietary, provider, and State government. These categories are not always mutually exclusive, so a decision was made to use the grouping that seemed most appropriate.

Return to Appendix III Contents

II. List of Data Elements from Measures Database

The Medicaid HCBS Measures Database was designed to store detailed information about the instruments and tools used to generate quality indicators. It also included information about each individual measure, including numerator, denominator, item wording, and psychometric properties (when available). When populated, this database will allow users to search for individual measures and tools using a variety of criteria.1

Below is a list of all the instrument-level and measure-level data elements for the database structure.

Instrument-Level Fields

  • Tracking number.
  • Date record created.
  • Date of last update.
  • Data entry staff.
  • Instrument Name.
  • Instrument Acronym.
  • Source of Instrument.
  • Developer.
  • Developer affiliation.
  • URL (if appropriate).
  • Citation (if appropriate).
  • Development Process I (check all that apply):
    • Focus groups.
    • Literature review.
    • Cognitive testing.
    • Field testing.
    • TEP/other advisory.
    • Consensus development process.
    • Other (specify below).
  • Release date.
  • Most recent update, if applicable.
  • Populations covered (check all that apply):
    • Elders with physical disabilities.
    • Elders with cognitive disabilities.
    • Adults with paraplegia/quadriplegia/spinal cord injuries.
    • Adults with chronic physical conditions (AIDS/HIV, MS, etc).
    • Adults with acquired brain injuries.
    • Adults with intellectual disabilities (MRDD and related conditions, autism).
    • Adults with severe and persistent mental illness.
    • Dually-diagnosed adults (MH and SA).
    • Medically-fragile children.
    • Children with severe emotional/behavioral disorders.
    • Children with intellectual disabilities.
    • Other (please specify below).
  • Service setting (check all that apply):
    • Assisted living facility.
    • Group home.
    • Recipients' home.
    • Day program.
    • Place of employment.
    • Transportation.
    • Other (please specify below).
  • Current usage.
  • Payment source for services (check all that apply):
    • Medicaid.
    • Medicare.
    • State Funds.
    • AoA.
    • Other federal program.
    • Self pay (out of pocket).
    • SSI/SSDI.
    • Other (please specify below).
  • Satisfaction among current instrument users.
  • Current users' perception of ease of instrument use.
  • Application of findings.
  • Benchmarking available.
  • Source of Benchmarking Data.
  • Data Source (check all that apply):
    • Consumer Survey.
    • Administrative Data.
    • Provider Data.
    • Claims Data.
    • Other (please specify below).
  • Consumer Survey Respondent (check all that apply):
    • Program participant.
    • Proxy.
    • Family Caregiver.
    • Other Caregiver.
    • Other (please specify below).
    • Not applicable.
  • Mode of Consumer Survey Administration (check all that apply):
    • Mail.
    • Phone.
    • In-person.
    • On-line.
    • Written, on-site.
    • Not applicable.
  • Sampling methodology.
  • Frequency of data collection.
  • Entity collecting data.
  • Data collection costs.
  • Exclusions.
  • Cognitive Testing (Y/N).
  • Cognitive Testing Results.
  • Field Testing.
  • Field Testing Results.
  • Longitudinal Sensitivity to Change Assessed.
  • Sensitivity Results.
  • Reliability Testing (check all that apply):
    • Inter-rater.
    • Test-Retest.
    • Alternate Form.
    • Internal Consistency.
  • Validity Testing (check all that apply):
    • Face Validity.
    • Content Validity.
    • Criterion Validity (concurrent or predictive).
    • Construct Validity (convergent or discriminant).
  • Other Psychometric Testing.
  • Other testing.
  • Any endorsements or recognitions by professional organizations.
  • Electronic materials on file (check all that apply):
    • Instrument.
    • Users' guide/instructions.
    • Testing results.
    • Journal article(s).
    • Sample data and reports.
    • Reports developed for consumer use.
    • Other (text).
  • Location of electronic materials.
  • Hard Copy Materials on file (check all that apply).

Measure-Level Fields

  • Measure name.
  • Instrument items used to construct measure.
  • Item Text (if applicable).
  • Narrative description of measure.
  • Construction of the metric.
  • Numerator.
  • Denominator.
  • Focus Area (check all that apply):
    • Program Performance.
    • Client Functioning.
    • Client Satisfaction/experience with care.
  • Quality Domain (check all that apply):
    • Effectiveness.
    • Efficiency.
    • Person-Centeredness/Autonomy.
    • Safety.
    • Timeliness.
    • Equity.
    • Access.
    • Coordination of long-term care and other services.
    • Qualified Providers.
    • Health and Welfare.
    • Administrative Oversight.
    • Unmet Need.
    • Quality of life.
    • Other.
  • Item a scale?
  • Number of items that make up the scale.
  • Scale Testing:
    • Reliability Testing (check all that apply):
      • Inter-rater.
      • Test-Retest.
      • Alternate Form.
      • Internal Consistency.
    • Validity Testing (check all that apply):
      • Face Validity.
      • Content Validity.
      • Criterion Validity (concurrent or predictive).
      • Construct Validity (convergent or discriminant).
    • Items composing scale.

Return to Appendix III Contents

III. Federally Sponsored Tools and Measures

Administration on Aging

Tool or Measure Set: POMP 5 Caregiver Program Support and Assessment Telephone Survey
Data Source: Other, Caregiver Survey
Respondent: Caregiver
Mode of Data Collection: Telephone Interview
Total Items/indicators: 77 close-ended items, 5 open-ended questions, and 21 demographic items
HCBS MS Domains: Access, Effectiveness, Efficiency, Quality of Life, and Unmet Need
Populations: Elders with physical and cognitive disabilities
Developer: Administration on Aging (AoA)
Use history: Version dated June 3, 2004.
States Currently Using: Tool utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The Performance Outcome Measurement Project (POMP) 5 Caregiver Survey is a 42-item survey designed to assess the type of support provided by the caregiver, effectiveness of caregiver services received, and caregiver access to information and resources. This survey was designed to specifically assess services offered through the National Family Caregiver Support Program. This survey is part of a core set of performance measures for State and community programs for aging operating under the Older Americans Act.

Tool or Measure Set: POMP 5 Case Management Survey
Data Source: Consumer Survey, Proxy Survey, and Administrator Survey
Respondent: Consumer or Proxy and Program Administrator
Mode of Data Collection: Telephone Interview (Consumer and Proxy) and Self-Report (Administrator)
Total Items/indicators: 32 close-ended items and 2 open-ended questions on Consumer and Proxy survey and 13 open-ended questions on Administrator survey
HCBS MS Domains: Access, Effectiveness, Efficiency, Timeliness, Coordination of Long-Term Care and Other Services, and Person Centeredness/Autonomy
Populations: Elders with physical disabilities and elders with cognitive disabilities
Developer: Administration on Aging
Use history: Consumer survey version dated March 23, 2004 and Administrator survey version dated March 8, 2004.
States Currently Using: Tools are utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The Case Management Survey provides a consumer assessment of case management services and the extent to which the services assist clients in remaining independent. Two versions of the client questionnaire were developed: one for clients (or translators) and one for proxies (to answer for cognitively impaired clients). Additionally, an Administrator's survey was developed with the purpose of collecting contextual information about the programs. This survey was developed as part of a core set of performance measures for State and community programs for aging operating under the Older Americans Act.

Tool or Measure Set: POMP 5 Congregate Meals Extended Core Survey
Data Source:Consumer Survey
Respondent:Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 59 close-ended items, 3 open-ended questions, and an additional 7 item satisfaction supplement module
HCBS MS Domains: Access, Effectiveness, Efficiency, Health and Welfare
Populations: Elders with physical disabilities and elders with cognitive disabilities
Developer: Administration on Aging
Use history: Version dated April 19, 2004 and Satisfaction module version dated April 15, 2004.
States Currently Using: Tools utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The Congregate Meals Extended Core Survey is designed to understand the meal preferences and satisfaction of elders who access congregate meals as part of the Older Americans Act nutrition program. This survey was developed as part of a core set of performance measures for State and community programs for aging operating under the Older Americans Act.

Tool or Measure Set: POMP 5 Home Delivered Meals Extended Core Survey
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 59 close-ended items, 3 open-ended questions, and an additional 7 item satisfaction supplement module
HCBS MS Domains: Access, Effectiveness, Efficiency, Health and Welfare
Populations: Elders with physical disabilities and/or cognitive disabilities
Developer: Administration on Aging
Use history: Version dated April 19, 2004 and Satisfaction module version dated April 15, 2004.
States Currently Using: Tool utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The Home Delivered Extended Core Survey is designed to understand the meal preferences and satisfaction of elders who access home delivered meals as part of the Older Americans Act nutrition program. This survey was developed as part of a core set of performance measures for State and community programs of aging operating under the Older Americans Act.

Tool or Measure Set: POMP 4 Information and Assistance Satisfaction Survey
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 25 close-ended items and 14 demographic questions
HCBS MS Domains: Access, Effectiveness, Efficiency, and Timeliness
Populations: Elders with physical disabilities and cognitive disabilities
Developer: Administration on Aging
Use history: Version dated March 13, 2003.
States Currently Using: Tool utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The POMP 4 Information and Assistance Satisfaction Survey is an information and referral survey designed to assess the timeliness and effectiveness of information and referral services. This survey was developed as part of a core set of performance measures for State and community programs of aging operating under the Older Americans Act.

Tool or Measure Set: POMP Senior Center Participant Survey
Data Source: Consumer Survey and Administrative Data
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 27 close-ended items, 1 open-ended question, and 15 demographic questions. An additional 62 close-ended items and 4 open-ended questions are provided on an optional survey. Descriptor survey has 29 close-ended items and 9 open-ended questions.
HCBS MS Domains: Access, Effectiveness, Quality of Life, and Person Centeredness/Autonomy
Populations: Elders with physical disabilities and elders with cognitive disabilities
Developer: Administration on Aging
Use history: Version dated June 30, 2004.
States Currently Using: Tool utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The Consumer survey assesses participation, barriers to participation, as well as self-reported outcomes in the areas of physical and mental health, social functioning, and volunteer activities. Optional questions assess participation in senior center activities, services accessed while at the senior center, volunteer activities, typical hours of attendance, as well as distance and travel time to the senior center. The information from the descriptor survey allows comparison of results by senior center characteristics. This survey was developed as part of a core set of performance measures for State and community programs of aging operating under the Older Americans Act.

Tool or Measure Set: POMP Transportation Survey
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 27 close-ended items and 14 demographic questions
HCBS MS Domains: Access, Effectiveness, Timeliness, and Efficiency
Populations: Elders with physical and cognitive disabilities
Developer: Administration on Aging
Use history: Version dated March 12, 2003.
States Currently Using: Tool utilized within Older Americans Act programs across the nation.
Psychometric Testing: Currently undergoing reliability and validity testing
Summary: The POMP Transportation Survey focuses on the quality of an agency's transportation service from the perspective of older persons utilizing AoA-funded transportation services. Specific survey topics include reliability, accessibility, flexibility, availability, overall service quality, and impacts on the lives of the users.

Tool or Measure Set: Evaluation of the Cash and Counseling Demonstration Baseline Instrument
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 30 orientation questions, 97 items, and 16 demographic questions
HCBS MS Domains: Access, Effectiveness, Person Centeredness/Autonomy, Qualified Providers, Health and Welfare, and Quality of Life
Populations: Elders with physical and cognitive disabilities, adults or children with mental retardation or developmental disabilities, children with physical or cognitive disabilities, and adults with physical disabilities and/or chronic conditions
Developer: Mathematica Policy Research, Inc.
Use history: Version dated June 14, 2001. Slightly modified versions used in each of the original three Cash and Counseling States. There were 1763 respondents in New Jersey, 2008 respondents in Arkansas, 1814 adult respondents in Florida, and 1003 child respondents in Florida.
States Currently Using: The original Cash and Counseling demonstration is completed.
Psychometric Testing: Survey was developed after a series of focus groups and items were piloted and tested for content validity.
Summary: Baseline survey was administered by telephone to both treatment and control groups participating in the original three Cash and Counseling programs (New Jersey, Arkansans, and Florida). Baseline survey addresses household characteristics, experiences with unpaid help, experiences with paid help, unmet need, satisfaction with care, use of other home and community based services, health and functioning, and predictors of disenrollment. Four and nine month surveys were also administered.

Tool or Measure Set: Evaluation of the Cash and Counseling Demonstration Four Month Survey Instrument
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 94 items
HCBS MS Domains: Access, Effectiveness, Efficiency, Person Centeredness/Autonomy, Timeliness and Qualified Providers
Populations: Elders with physical or cognitive disabilities, adults or children with mental retardation or developmental disabilities, children with physical or cognitive disabilities, and adults with physical disabilities and/or chronic conditions
Developer: Mathematica Policy Research, Inc.
Use history: Version dated October 24, 2000. Slightly modified versions used in each of the original three Cash and Counseling States. There were 789 respondents in New Jersey, 924 respondents in Arkansas, 859 adult respondents in Florida, and 480 child respondents in Florida.
States Currently Using: The original Cash and Counseling demonstration is completed.
Psychometric Testing: Survey was developed after a series of focus groups and items were piloted and tested for content validity.
Summary: Four month survey administered to the Cash and Counseling treatment group within four to six months of entering the program. Focus areas included program participation, use of cash, employer responsibilities, fiscal responsibilities, as well as reasons for disenrollment or never receiving a cash allotment. Baseline and nine month surveys were also administered.

Tool or Measure Set: Evaluation of the Cash and Counseling Demonstration Nine Month Survey Instrument
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: Approximately 401 items
HCBS MS Domains: Access, Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Health and Welfare, Unmet Need, and Qualified Providers
Populations: Elders with physical or cognitive disabilities, adults or children with mental retardation or developmental disabilities, children with physical or cognitive disabilities, and adults with physical disabilities and/or chronic conditions
Developer: Mathematica Policy Research, Inc.
Use history: Version dated June 2002. Slightly modified versions used in each of the original three Cash and Counseling States. There were 1470 respondents in New Jersey, 1739 respondents in Arkansas, 1539 adult respondents in Florida, and 862 child respondents in Florida.
States Currently Using: The original Cash and Counseling demonstration is completed.
Psychometric Testing: Survey was developed after a series of focus groups and items were piloted and tested for content validity.
Summary: Nine month survey administered to both treatment and control groups. Focus areas included health and functional impairment, living arrangements, unpaid in home care, paid in home care, satisfaction with care, unmet need, equipment, supplies and modifications, purchasing of goods and services, hiring workers, spending plans, employer responsibilities, termination of workers, reasons for disenrollment and for never receiving cash allotment.

Tool or Measure Set: Cash and Counseling Demonstration Expansion: Performance Indicators
Data Source: Multiple: utilization and cost data, other data sources left to the State's discretion
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 9 table shells, 57 total lines for data. Indicators not precisely defined; States may use different data sources to report.
HCBS MS Domains: Efficiency, Unmet Need, Quality of Life, Effectiveness, Timeliness
Populations: Adults with disabilities
Developer: Cash and Counseling National Program Office at the Boston College Graduate School of Social Work
Use history: Indicators released in July 2005. Required of the 12 States participating in the second round of the Cash and Counseling demonstration grants.
States Currently Using: Alabama, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, West Virginia
Psychometric Testing: Unknown
Summary: Cash & Counseling is a national program sponsored by The Robert Wood Johnson Foundation (RWJF), the Office of the Assistant Secretary for Planning and Evaluation in the United States Department of Health and Human Services (ASPE/DHHS), and the Administration on Aging (AoA). In addition, the Centers for Medicare & Medicaid Services (CMS) reviews States' Section 1115 demonstration or 1915 (c) waiver applications and provides continuing oversight and technical assistance in the waiver process. The Cash & Counseling approach provides a flexible monthly allowance to recipients of Medicaid personal care services or home and community based services. Participants use an individualized budget to make choices about the services they receive and they are able to make sure these services address their own specific needs. These indicators collect information on the demographics, service utilization and costs of program participants, as well as their satisfaction and unmet needs.


1 The database was not populated during the Measure Scan project, which is Phase I of AHRQ's implementation of Section 6806 of the Deficit Reduction Act of 2005.


Return to Appendix III Contents

Agency for Healthcare Research and Quality

Tool or Measure Set: Experience of Care and Health Outcomes Survey (ECHO) Child Survey
Data Source: Consumer Survey
Respondent: Consumer or (parent or guardian for children aged 17 or younger)
Mode of Data Collection: Data can be collected via mail, telephone or mixed mode. The developers also allow for internet enhancement.
Total Items/indicators: Managed Behavioral Healthcare Organization version has 47 items and 11 demographic questions. Managed Care Organization version has 59 items and 11 demographic questions. 12 supplemental questions also available pertaining to employment, school, quality of life, office staff experiences, medication challenges, tests, and assessments.
HCBS MS Domains: Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Access, Coordination of Long-Term Care and Other Services, Unmet Need, and Quality of Life
Populations: Children with mental health disabilities
Developer: ECHO is part of the family of CAHPS® (Consumer Assessment of Healthcare Providers and Systems) tools. The CAHPS® program is funded and administered by the U. S. Agency for Healthcare Research and Quality (AHRQ), which works closely with a consortium of public and private organizations, including the National Committee for Quality Assurance (NCQA), Human Services Research Institute, Center for Mental Health Services, Washington Circle Group, American Managed Behavioral Health Care Association, and the National Alliance for the Mentally Ill. Access to survey provided by Harvard Medical School. Endorsed by the National Quality Forum
Use history: Released in 2004
States Currently Using: Not known
Psychometric Testing: Version 3.0 validity and reliability testing conducted. Sampling and survey administration protocol provided to ensure statistically significant results.
Summary: Survey evaluates child experiences with behavior health supports. Focus areas include timeliness of services, communication, access to information on medications and available supports, cultural competency, family involvement, perceived improvement in functioning, and patient rights. Spanish versions also available.

Tool or Measure Set: Experience of Care and Health Outcomes Survey (ECHO)—Adult Survey
Data Source: Consumer Survey
Respondent: Consumer or Consumer Proxy
Mode of Data Collection: Data can be collected via mail, telephone or mixed mode. The developers also allow for internet enhancement.
Total Items/indicators: Managed Behavioral Healthcare Organization version has 44 items and 7 demographic questions. Managed Care Organization version has 56 items and 7 demographic questions. 12 supplemental questions also available pertaining to employment, school, quality of life, office staff experiences, medication challenges, tests, and assessments.
HCBS MS Domains: Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Access, Coordination of Long-Term Care and Other Services, Unmet Need, and Quality of Life
Populations: Adults with mental health disabilities and severe and persistent mental illness
Developer: ECHO is part of the family of CAHPS® tools. The CAHPS® program is funded and administered by the U.S. Agency for Healthcare Research and Quality (AHRQ), which works closely with a consortium of public and private organizations, including NCQA, Human Services Research Institute, Center for Mental Health Services, Washington Circle Group, American Managed Behavioral Health Care Association, and the National Alliance for the Mentally Ill. Access to survey provided by Harvard Medical School.
Use history: Released in 2004
States Currently Using: Not known
Psychometric Testing: Version 3. 0 validity and reliability testing conducted. Sampling and survey administration protocol provided to ensure statistically significant results. Endorsed by the National Quality Forum
Summary: Survey evaluates consumer experiences with behavior health supports. Focus areas include timeliness of services, communication, access to information on medications and available supports, cultural competency, family involvement, perceived improvement in functioning, and patient rights. Spanish versions also available.

Tool or Measure Set: CAHPS® Nursing Home Survey-Long-Stay Resident Instrument
Data Source: Consumer survey
Respondent: Consumer
Mode of Data Collection: Face-to-face structured interview
Total Items/indicators: 39 close-ended items, plus selected demographic items
HCBS MS Domains: Quality of Life, Unmet Need, Person Centeredness/Autonomy
Populations: Long-stay nursing home residents
Developer: CAHPS® Consortium: Agency for Healthcare Research and Quality
Use history: Tool released in 2007. Has been field tested in four different locations in the United States and Canada
States Currently Using: N/A
Psychometric Testing: Development included focus group, cognitive testing, and field testing; further testing planned
Summary: One of the family of CAHPS® instruments, the Long-Stay Resident Survey is designed for nursing home residents with lengths of stay greater than 30 days. Items include both bivariate (yes/no) items as well as those requiring residents to rate satisfaction/experience on a 1-10 scale. The instrument comprises the following topics: environment, care, communication and respect, autonomy, and activities.

Tool or Measure Set: Care Coordination Items from the Ambulatory CAHPS® Measure Set
Data Source: Consumer Survey
Respondent: Consumer
Mode of Data Collection: Mail Survey with telephone follow-up
Total Items/indicators: Adult "Core" Clinician & Group Survey: 2 items
Adult Clinician & Group Supplemental Items: 4 items
Adult Health Plan Supplemental Items: 5 items
HCBS MS Domains: Coordination of Long-Term Care and Other Services
Populations: All adults, regardless of disabilities
Developer: CAHPS® Consortium, Agency for Healthcare Research and Quality
Use history: Need data from AHRQ
States Currently Using: Used by health plans and providers nationwide
Psychometric Testing: Measures have been drawn from tools with established reliability and validity
Summary: These items, drawn from three CAHPS® measure sets, address coordination among providers, as well as providers' awareness of the full array of services received by a consumer. They are not specific to people with disabilities or long-term care.

Tool or Measure Set: CAHPS® Item Set for Children with Chronic Conditions
Data Source: Consumer Survey
Respondent: Proxy (parent or guardian)
Mode of Data Collection: Self-report
Total Items/indicators: 31 items, plus a five-item screener to classify children with chronic conditions
HCBS MS Domains: Access, Person Centeredness/Autonomy, Coordination of Long-Term Care and Other Services
Populations: Children with chronic conditions and/or special health care needs
Developer: The chronic condition set for children was developed through the Child and Adolescent Health Measurement Initiative (CAHMI), with substantial input from the CAHPS® Consortium and the Agency for Healthcare Research and Quality (AHRQ). CAHMI's Living with Illness Task Force advised the organization's research staff during the development, testing, and refinement of the children's chronic conditions set.
Use history: In 2002, this optional set of items was integrated into the 3.0 version of the CAHPS® Health Plan Survey child questionnaires.
States Currently Using: Used by health plans nationwide
Psychometric Testing: Yes, as part of Health Plan tool. Endorsed by the National Quality Forum
Summary: To better address the needs of children with chronic conditions (commonly referred to as children with special health care needs), the CAHPS® Consortium decided to adopt an extensive set of items that would enable users to assess the experiences of this population with health plans and health care services. This supplemental set allows sponsors to compare the experiences of children with special health care needs with those of similar children in other health plans and/or the general population of children in the same plan. Items focus primarily on parents' access to information and services for their children, as well as their inclusion in decisionmaking. The item set for children with chronic conditions is currently integrated into the 3.0 version of the CAHPS® Health Plan Survey.

Tool or Measure Set: CAHPS® Item Set for People With Mobility Impairments
Data Source: Consumer Survey
Respondent: Consumer
Mode of Data Collection: Self-report
Total Items/indicators: 21 items
HCBS MS Domains: Access, Unmet Need
Populations: Adults with mobility impairments
Developer: Agency for Healthcare Research and Quality, in collaboration with the following organizations: National Institute for Disability and Rehabilitation Research (NIDRR),Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, and George Mason University Center for the Study of Chronic Illness and Disability.
Use history: The People With Mobility Impairments (PWMI) Item Set was incorporated into the CAHPS® Supplemental Items for Adult Questionnaires in 2007.
States Currently Using: Not known
Psychometric Testing: The development process included input from a Technical Expert Panel, several rounds of cognitive testing, and field testing in Massachusetts and Wisconsin. In the next stage of the CAHPS® program, known as CAHPS® III, AHRQ plans to continue work on this item set, including the development of composite measures. Another focus will be the refinement and testing of items that did not perform well enough to be included with this set; these items address topics that are pertinent to this population, such as coordination of care and the use of personal care assistants.
Summary: Under the CAHPS® II grants, the CAHPS® Team has developed a set of survey items that focus on the experiences of people with mobility impairments (PWMI). These questions can supplement either the commercial or Medicaid version of the Health Plan Survey. The item set was developed in order to enable health plans and other survey sponsors to compare the experiences of people with and without mobility impairments and to determine where improvements in health plan services are warranted to better serve enrollees with these impairments. Topics include pain, maintenance of mobility equipment, and access to services such as physical, speech, and occupational therapy.

Tool or Measure Set: National Quality Measures Clearinghouse
Data Source: Administrative data, Providers, and Consumer Surveys
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Duplicative count of 198 home health measures, 57 occupational therapy measures, and 93 physical therapy measures
HCBS MS Domains: Safety, Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Access, Qualified Providers, Coordination of Long-Term Care and Other Services, Health and Welfare, and Administrative Oversight
Populations: Home care recipients
Developer: Source varies significantly by measure. Collection and description of measures provided by Agency for Health Care Research and Quality (AHRQ)
Use history: Available online
States Currently Using: Unknown-database includes measures from multiple existing datasets
Psychometric Testing: Information provided for individual measures
Summary: Database provides measures for evidence-based health care in seven focus areas: access (24 measures), outcomes (203 measures), patient experience (247 measures), population health (33 measures), process (615 measures), structure (43 measures), and use of services (27 measures). Home health measures include those found in the Home Health Care Survey (2002) and the CMS Home Health Compare Initiative. Focus areas include discharge, mobility, and activities of daily living. Physical therapy measures (i.e., physical functional status) are part of the Focus on Therapeutic Outcomes tool (2006) and Healthcare Effectiveness Data and Information Set (HEDIS®).The Therapeutic Associates Outcomes Systems tool provides occupational therapy measures.

Return to Appendix III Contents

Current as of June 2010
Internet Citation: Appendix III: Compendium of Measures and Tools : Environmental Scan of Measures for Medicaid Title XIX Home and Community-Based Services Measure Scan as of July 5, 2007. June 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/hcbs/hcbsreport/hcbsapiii.html