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

Appendix III: Compendium of Measures and Tools Identified Through the Medicaid Home and Community-Based Services Measure Scan as of July 5, 2007

Appendix III (continued)

VI. Tools and Measures Developed by Providers

Tool or Measure Set: Chimes Performance Metrics
Data Source: Administrative data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 55 metrics
HCBS MS Domains: Effectiveness, Efficiency, Health and Welfare
Populations: Individuals with intellectual disabilities
Developer: Chimes Family of Services
Use history: Metrics have been in use since approximately 2003
States Currently Using: Providers in New York, Connecticut, Pennsylvania, Delaware, Maryland, Virginia, and Arkansas
Psychometric Testing: Not specified
Summary: Measures are reported in a matrix of focus areas (Finance, Service, and Workforce) by criteria (Efficiency, Effectiveness, Satisfaction). Most are related primarily to goals for the agency (market penetration, staff turnover and compensation, fundraising). A few are related to the health and welfare of clients, such as injuries and medication errors.

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VII. Proprietary Tools and Measures

Miscellaneous Private and Public Organizations

Tool or Measure Set: Pediatric Quality of Life Inventory, Version 4. 0 (PedsQL 4. 0)
Data Source: Consumer Survey
Respondent: Consumer and Proxy (proxy only for children under age 5)
Mode of Data Collection: Self-report
Total Items/indicators: 23 items in the generic core scale
HCBS MS Domains: Unmet Need
Populations: All children
Developer: Center for Child Health Outcomes, Children's Hospital and Healthcare Center, San Diego, CA
Use history: Testing results published in 2001
States Currently Using: Unknown
Psychometric Testing: Reliability and validity with chronically ill children established in peer-reviewed literature
Summary: The Generic Core Scales are composed of parallel child self-report instruments and parent proxy forms. Five-point response scale used for children ages 8 to 18 (mode differs for younger children). The tools comprise 4 subscales: physical, emotional, social, and school functioning.

Tool or Measure Set: Child Health Questionnaire
Data Source: Consumer Survey
Respondent: Parent (for children under age 10) or older child
Mode of Data Collection: Not specified
Total Items/indicators: Two parent versions with 28 and 50 items. Child version (for children ages 10 and older) has 87 items.
HCBS MS Domains: Health and Welfare, Quality of Life
Populations: Children with chronic conditions
Developer: Healthact CHQ
Use history: Proprietary instruments, license must be obtained from the developer
States Currently Using: Unknown
Psychometric Testing: Validation results published in peer-review article. According to the developer, the Quality of Life surveys go through a rigorous development process combining feedback from clinical experts, adult and child interviews, and comprehensive psychometric testing.
Summary: This is a quality of life tool that has been validated (peer-review article available) for healthy children, as well as those with chronic conditions. The instruments have been approved by the Scientific Advisory Committee of the Medical Outcomes Trust.

Tool or Measure Set: Personal Life Quality Protocol (PLQ)
Data Source: Consumer Survey and Medical Records
Respondent: Varies by instrument-consumers, case managers, direct care staff, proxies
Mode of Data Collection: In-person interviews and review of medical records
Total Items/indicators: 28 different instruments-number of indicators depends on which instruments are used.
HCBS MS Domains: Quality of Life
Populations: Individuals with intellectual disabilities
Developer: James Conroy, PhD, Center for Outcomes Analysis
Use history: Generic Complete Version 4. 8 copyrighted in 2001
States Currently Using: Obtain from developer.
Psychometric Testing: Website lists many reports and articles evaluating the reliability of "the most important indicators" including interrater reliability, test-retest, and internal consistency.
Summary: The PLQ is a comprehensive battery of Quality of Life measurement instruments. It is modular-individual scales and measures can be selected or left out, depending on the research and quality improvement goals.

Tool or Measure Set: Ask Me!—Survey for Maryland Developmental Disabilities Administration (DDA)
Data Source: Consumer Survey
Respondent: Consumer or proxy (about 25% of all responses)
Mode of Data Collection: Peer interviews
Total Items/indicators: Items are grouped to produce assessments in eight domains-questions not in the public domain
HCBS MS Domains: Quality of Life, Unmet Need, Person Centeredness/Autonomy
Populations: Individuals with developmental disabilities
Developer: The original survey instrument is a melding of the Quality of Life Questionnaire, by Robert Schalock, Ph.D. and Ken Keith, Ph.D. and Signs of Quality, a booklet developed by People on the Go of Maryland that examines the concept of quality in DDA services. The Ask Me! Survey was subjected to several reviews in fall 1996 by People on the Go members to make the survey more applicable to Marylanders with developmental disabilities, simpler to administer and easier to understand. In fiscal year (FY) 2000, Project staff, Dr. Gordon Bonham and other stakeholders, including members of People on the Go began revising the questionnaire for copyright purposes. FY 2003 introduced a new survey, based solely on Signs of Quality, principles of self-determination, and the new DDA regulations. The survey tool is under copyright and may not be used without the written express written permission of The Arc of Maryland.
Use history: Ask Me! is a Consumer Quality of Life Survey administered by The Arc of Maryland for the Maryland Developmental Disabilities Administration (DDA). All community programs licensed by the State DDA participate in the survey. The survey interviews people who receive services. Interviewers are people with developmental disabilities. Annually, about 1400 people are surveyed about their quality of life and satisfaction with services. The survey issues statewide findings and recommendations to DDA. The survey has been implemented in Maryland since FY 1998, resulting in the ability to have longitudinal data on many individuals.
States Currently Using: Maryland
Psychometric Testing: Stakeholder input and review to provide content validity, additional psychometric testing described in annual report.
Summary: Ask Me! is based on the belief that persons with developmental disabilities able to elicit more meaningful responses from those receiving services than traditional surveyors, as a result of their firsthand understanding of disabilities and services. There are eight domains to the survey: Social Inclusion, Physical Well-Being, Interpersonal Relations, Material Well-being, Emotional Well-Being, Self-Determination, Personal Development, and Rights.

Tool or Measure Set: Activity Measure for Post-Acute Care (AM-PAC™)
Data Source: The instrument can be administered using responses coming directly from a patient, by professional judgment, or proxy report. Three AM-PAC versions are currently available: outpatient short forms; a free-standing computer version; and a Web-based computer version.
Respondent: Consumer, proxy or professional
Mode of Data Collection: N/A
Total Items/indicators: Basic Mobility Domain: 101 items
Daily Activity Domain: 70 items
Applied Cognitive Domain: 69 items
HCBS MS Domains: Safety, Effectiveness, Person Centeredness/Autonomy, Equity, Access, Qualified Providers, Health and Welfare, Administrative Oversight, Unmet Need, and Quality of Life
Populations: The AM-PAC was designed to be used with adults across patient diagnoses, conditions and settings where post acute care is being provided.
Developer: Alan Jette, PT, PhD, Stephen M. Haley, PT, PhD, Wendy Coster, OT, PhD, Peng Sheng Ni, MD, MPH, Boston University, Health and Disability Research Institute
Use history: Computerized software has been developed for data entry and for customizing the items assessed. Several studies have been done of this tool.
States Currently Using: None known
Psychometric Testing: Initially, AM-PAC test items were administered to a large sample of patients from different care settings with different diagnoses. Factor analytic work identified three distinct, interpretable factors that accounted for 72% of the variance: Applied Cognition (44%), Daily Activities (19%) and Basic Mobility (9%). These factors were verified by a confirmatory factor analysis (Haley et al. 2004) and defined as the three AM-PAC domains. Using Item Response Theory (IRT), items in each domain were scaled along a continuum of item difficulty. Items that were redundant or did not fit the model were eliminated. The remaining items formed the AM-PAC item banks, which included a wide range of items calibrated along a continuum of difficulty. Information on reliability and validity has been published.
Summary: The Boston University Activity Measure for Post Acute Care (AM-PAC) is an activity limitations instrument developed using the World Health Organization's International Classification of Functioning, Disability and Health (ICF). According to the ICF, an activity limitation is defined as "difficulty in the execution of a task or action by an individual."1 The AM-PAC was developed as a functional outcomes system that can be used across post acute care settings and consists of a comprehensive list of 240 functional activities (i.e., the item bank).

Tool or Measure Set: Functional Independence Measure (FIM) + Functional Assessment Measure (FAM)
Data Source: Assessment data collected by trained observer
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 18 items (FIM) and 12 items (FAM)
HCBS MS Domains: Unmet Need
Populations: Individuals with disabilities, adults with acquired brain injuries
Developer: FIM: Developed by the Uniform Data System for Medical Rehabilitation, State University of New York at Buffalo. FAM: Developed at Santa Clara Valley Medical Center
Use history: The FIM was originally developed in 1983.
States Currently Using: Unknown
Psychometric Testing: Information on the psychometric properties of these tools has been established and published.
Summary: The FIM, an 18-item, seven-level ordinal scale, is the product of an effort to create uniform measurement and data on disability and rehabilitation outcomes. The FIM emerged from a thorough developmental process overseen by a National Task Force of rehabilitation research. The National Task force reviewed 36 published and unpublished functional assessment scales before agreeing on an instrument. The FAM items were developed by clinicians representing each of the disciplines in an inpatient rehabilitation program. The FAM was developed as an adjunct to the FIM to specifically address the major functional areas that are relatively less emphasized in the FIM, including cognitive, behavioral, communication and community functioning measures. The FAM items do not stand alone, but are intended to be added to the 18 items of the FIM.

Tool or Measure Set: Supports Intensity Scale
Data Source: Consumer interview
Respondent: One or more persons who know the individual participant well
Mode of Data Collection: In-person interview
Total Items/indicators: Measures supports requirements in 57 life activities
HCBS MS Domains: Unmet Need
Populations: People with intellectual disabilities
Developer: American Association for Mental Retardation
Use history: Publication date of January 2004. Developed over a five-year period
States Currently Using: Unknown
Psychometric Testing: Tools subject to three rounds of field testing. Psychometric properties have been established and made publicly available.
Summary: The Supports Intensity Scale is an assessment tool designed to measure support needs in medical, behavioral, and life activity areas. The tool has three sections:

• The Supports Needs Scale, which includes 49 activities organized into six subscales (Home Living, Community Living, Lifelong Learning, Employment, Health and Safety, and Social Activities)
• Supplemental Protection and Advocacy Scale
• Exceptional Medical and Behavioral Support Needs, which examines common diagnosis and problem behaviors which may intensify support needs.

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National Core Indicators Project

Tool or Measure Set: National Core Indicators (NCI) Project: Consumer Survey
Data Source: Consumer Survey
Respondent: Section I: Consumer only
Section II: Consumer or proxy
Mode of Data Collection: Face-to-face structured interview
Total Items/indicators: Section I: 24 items support 18 indicators
Section II: 23 items support 8 indicators
Background: 36 items support 6 indicators
Employment Supplement: 11 items support 6 indicators
HCBS MS Domains: Person Centeredness/Autonomy, Safety, Unmet Need, Quality of Life
Populations: Individuals with intellectual and other developmental disabilities
Developer: Human Services Research Institute (HSRI) and the National Association of State Directors of Developmental Disabilities Services (NASDDD)
Use history: The most recent version of this survey was updated in 2003.
States Currently Using: The NCI consumer survey is currently used by 23 States, and one regional center, nationwide.
Psychometric Testing: This tool has undergone both reliability and validity testing in collaboration with State users.
Summary: Information on a presurvey form is used by interviewers to schedule and conduct interviews; this form also collects demographic (background) information. Section I items can only be answered by the consumer; these items are skipped if the consumer cannot provide responses. Another individual who knows the consumer well may serve as a proxy for Section II. State users submit their data from the consumer survey to staff at HSRI for analysis and benchmarking. Survey can be used with consumers receiving HCBS or other types of supports and services.

Tool or Measure Set: National Core Indicators Project: NCI Board Membership Survey
Data Source: Survey of contracted community agencies that furnish services to 10 or more individuals.
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 4 Items / 2 Indicators
HCBS MS Domains: Person Centeredness/Autonomy
Populations: Individuals with intellectual and other developmental disabilities and their family members
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities Services
Use history: Data can be submitted annually
States Currently Using: Varied; 8 States submitted this data to the National Core Indicators in the most recent annual cycle (2005-2006)
Psychometric Testing: N/A
Summary: This worksheet is used to determine what percentage of voting board members are either individuals with intellectual disabilities or family members of individuals with intellectual disabilities. Information is collected on a regular, periodic basis concerning the rates of consumers and family members who are voting members of provider agencies' Boards of Directors, using a standardized data collection instrument (Excel format). Survey asks for total number of providers' board members and those that are voting members, as well as those voting members who are consumers or family members of consumers.

Tool or Measure Set: National Core Indicators Project: Family Survey (Adult, Guardian and Child Versions)
Data Source: Family Survey
Respondent: Family members of consumer
Mode of Data Collection: Mail survey
Total Items/indicators: Adult version: 44 items related to experience with services, plus additional demographic items, support 18 indicators
Guardian version: 29 items related to experience with services, plus additional demographic items, support 16 indicators
Child version: 46 items related to experience with services, plus additional demographic items, support 16 indicators
HCBS MS Domains: Access, Person Centeredness/Autonomy, Unmet Need, Quality of Life, Effectiveness, Safety
Populations: Individuals with intellectual and other developmental disabilities
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities Services
Use history: All versions copyrighted in 2003.
States Currently Using: In the most recent annual cycle (2005-2006), 13 States and one regional center submitted Adult Family data, 9 States and one regional center submitted Guardian Family data, and 6 States and one regional center submitted Child Family data
Psychometric Testing: Field tested only
Summary: This tool is designed to gather feedback on both the family's experience with services, as well as their perception of the consumer's experience. There are three separate versions; one for families with adult children who are consumers living at home (Adult), one for families with adult children who are consumers living outside the home (Guardian), and one for families with children who are consumers living at home (Child)

Tool or Measure Set: National Core Indicators Project: Mortality Rate of Persons with MR/DD per 1,000 Served
Data Source: Administrative data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Single indicator assesses number of deaths per 1,000 people with developmental disabilities served
HCBS MS Domains: Health and Welfare
Populations: Individuals with developmental disabilities
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities
Use history: Data requested from member States annually.
States Currently Using: 8 States submitted this data to the NCI project in 2005-2006.
Psychometric Testing: N/A
Summary: State must capture data for all adults receiving developmental disabilities services, via an NCI form or other State form, with the NCI form strongly preferred for comparability reasons. Protocol dictates that data is received for the past five years. If the State has already provided data to the project in previous years, they only need to provide the most recent year's data. States may provide required data via NCI form titled "NCI Protocol for Reporting Mortality Data", or in their own format. The data collection form distinguishes between medicolegal deaths (homicides, suicides, and accidents) and all deaths. The data collection form asks for a breakdown of consumers by type of residence and by disability. *States are NOT identified in the final Mortality report, which is used for internal project purposes only. *

Tool or Measure Set: National Core Indicators Project: Reported Incident Indicators
Data Source: Administrative data supplied by State
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Six categories of incidents, each reported separately for 24-hour/licensed settings and all other settings. Some categories (i.e., crimes against individuals) are further broken down (e.g., rape, assault, theft)
HCBS MS Domains: Health and Welfare
Populations: Individuals with developmental disabilities
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities
Use history: Data requested annually.
States Currently Using: 4 States submitted this data to the NCI project for the 2005-2006 cycle
Psychometric Testing: Field tested only
Summary: Participating States provide information concerning the number of incidents (abuse and neglect; restraints, crimes against, serious injuries) in the MR/DD population served. States may provide required data via NCI form titled "NCI Protocol for Reporting Incidents: Abuse and Neglect, Serious Injuries, Restraints, and Crimes", or in their own format. The data collection form distinguishes between these four categories and within each category as well (i.e., different types of crimes: larceny theft, forcible rape, aggravated assault). The data collection form asks for a breakdown of consumers by type of residence and by disability. *States are NOT identified in the final Incidents report, which is used for internal project purposes only. *

Tool or Measure Set: National Core Indicators Project: Staff Turnover Survey
Data Source: Administrative data supplied by State
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 15 items/ 3 indicators
HCBS MS Domains: Qualified Providers
Populations: Individuals with developmental disabilities
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities
Use history: Member States requested to provide data annually
States Currently Using: 6 States submitted this data to the NCI project during the 2005-2006 cycle
Psychometric Testing: Field tested only
Summary: Survey of contracted community agencies that furnish services to 10 or more individuals. Participating States employ a common framework to collect information concerning direct support professional turnover and vacancy rates along with information regarding employment longevity. Specifically, this worksheet is used to calculate statewide turnover rates, average length of employment, and vacancy rates for direct support staff, both those who work with adults and children. Part-time and full-time staff are tracked separately.

Tool or Measure Set: National Core Indicators Project: Day /Vocational /Educational Support Supplement
Data Source: Supplement to consumer survey
Respondent: Varies-see below
Mode of Data Collection: States may obtain required data from: (a) existing information systems; (b) conducting a survey of all contracted day support agencies; or, (c) in conjunction with the consumer survey/interview by using a special supplement data collection tool.
Total Items/indicators: 11 items / 6 indicators
HCBS MS Domains: Unmet Need, Quality of Life
Populations: Individuals with developmental disabilities
Developer: Human Services Research Institute and the National Association of State Directors of Developmental Disabilities
Use history: Member States requested to provide this information annually
States Currently Using: 13 States submitted this data to the NCI project in 2005-2006
Psychometric Testing: Field tested only
Summary: The purpose of this tool is to obtain information concerning the extent to which individuals are involved in integrated employment activities along with data about wages, hours, and job retention. The worksheet items collect data on hours worked and wages earned by employment type (e.g., competitive, facility based) as well as length of employment, source of support, and benefits received. Instructions for completing the worksheet provide detailed definitions for employment type and specifications for submitting data.

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VIII. Tools and Measures Developed by and for Individual States

Alabama

Tool or Measure Set: Participation Satisfaction Survey for Alabama's Technology Assisted (TA) Waiver Services for Adults
Data Source: Consumer survey
Respondent: Consumer or proxy
Mode of Data Collection: Mail survey, may also be completed in person during home visits
Total Items/indicators: Six items
HCBS MS Domains: Unmet Need, Timeliness, Access
Populations: Adults with disabilities receiving assistive technology
Developer: Alabama Medicaid Agency
Use history: Sent annually to participants in this waiver
States Currently Using: Alabama
Psychometric Testing: No
Summary: This waiver is approved for 40 slots and currently has only 4 participants. Each participant is visited annually for a comprehensive review, including completion of the satisfaction survey. The State sets a benchmark of 95% satisfaction for the waiver.

Tool or Measure Set: Annual Indicators for Alabama's Medicaid HCBS Waivers
Data Source: Multiple, including consumer surveys, case management and direct service provider records, complaints, site and home visits, and personnel records
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Seven measures
HCBS MS Domains: Safety, Unmet Need, Access, Person Centeredness/Autonomy, Qualified Providers, Effectiveness, Efficiency
Populations: Elders with physical or cognitive impairments, adults with mental retardation, adults with HIV/AIDS, adults with physical disabilities
Developer: Alabama Medicaid Agency
Use history: Indicators are calculated annually for each of the State's six Medicaid 1915c waivers
States Currently Using: Alabama
Psychometric Testing: No
Summary: Indicators in the measure set are aligned with the CMS Quality Framework and assurances. Based on a review of multiple data sources, State staff determined if participants are satisfied, safe and receiving needed services; if person-centered planning occurs; if clients are able to exercise rights, if sufficient qualified providers exist; and if the system is effective and efficient. Benchmarks are developed for each waiver based on the average baseline value for all waivers. The State also articulated target values for each year and each waiver.

Tool or Measure Set: Alabama's Medicaid Waiver Survey
Data Source: Consumer survey
Respondent: Consumer or proxy
Mode of Data Collection: Mail survey
Total Items/indicators: 13 items
HCBS MS Domains: Person Centeredness, Unmet Need, Effectiveness, Safety, Access
Populations: Elders with physical or cognitive impairments, adults with mental retardation, adults with HIV/AIDS, adults with physical disabilities
Developer: Alabama Medicaid Agency
Use history: Survey tool is sent to a sample of participants from five of the State's six waivers. (Participants in the Assistive Technology waiver have a separate tool.)
States Currently Using: Alabama
Psychometric Testing: No
Summary: Survey consists of 13 yes/no items to gauge client experience in the areas listed above. Resulting data are one of the many sources for the annual indicator report developed by the Medicaid agency for each waiver. A separate home visit tool queries similar domains for clients selected for home visits as part of the State's quality monitoring system.

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Arizona

Tool or Measure Set: Quality Performance Measures for the Arizona Long-Term Care System (ALTCS)
Data Source: Utilization data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 5 measures, with State-set benchmarks. Two more measures are under development
HCBS MS Domains: Health and Welfare, Access, Coordination of Long-Term Care and Other Services
Populations: Elders and adults with physical disabilities
Developer: Arizona Health Care Cost Containment Systems-three measures are drawn directly from the HEDIS measure set developed by the National Committee for Quality Assurance
Use history: Measures are included in the contract for all providers participating in the ALTCS.
States Currently Using: Arizona
Psychometric Testing: Reliability and validity of HEDIS measures have been established. Other measures not subject to testing.
Summary: There are five performance measures that the Arizona Health Care Cost Containment System has designated as specific to the ALTCS; three HEDIS diabetes measures, a measure of the timeliness of HCBS service initiation, and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) participation for children younger than 21. Contracting providers must meet minimum performance standards for each measure. Several exclusions for categories of members do apply. The two additional measures under development relate to influenza vaccinations for people with disabilities and pressure ulcers. All Medicaid LTC program participants are served through the ALTCS.

Tool or Measure Set: Empowering Arizona's Individuals (EAZI) with Developmental Disabilities Consumer to Consumer Survey: Habilitation Instrument
Data Source: Consumer Survey
Respondent: Consumer
Mode of Data Collection: Face-to-Face Interviews
Total Items/indicators: 46 close-ended items and 8 open-ended questions
HCBS MS Domains: Safety, Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Equity, Access, Qualified Providers, Coordination of Long-Term Care and Other Services, Health and Welfare, Unmet Need, and Quality of Life
Populations: Adults with mental retardation or developmental disabilities
Developer: Social Research Laboratory at Northern Arizona University funded through the Arizona Department of Economic Security, Division of Developmental Disabilities
Use history: Version dated July 3, 2006. Survey conducted with individuals who receive day habilitation services.
States Currently Using: Arizona
Psychometric Testing: Field test still ongoing
Summary: Interview takes 30-60 minutes to conduct and is conducted by a consumer. Focus areas include access to day habilitation providers, choice in services, access to effective communication strategies, satisfaction with providers, effectiveness of providers, and quality of life as it relates to services received.

Tool or Measure Set: Empowering Arizona's Individuals (EAZI) with Developmental Disabilities Consumer to Consumer Survey: Attendant Instrument for Person with Disability
Data Source: Consumer Survey
Respondent: Consumer
Mode of Data Collection: Face-to-Face Interviews
Total Items/indicators: 46 close-ended items and 7 open-ended questions
HCBS MS Domains: Safety, Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Equity, Access, Qualified Providers, Coordination of Long-Term Care and Other Services, Health and Welfare, Unmet Need, and Quality of Life
Populations: Adults with mental retardation or developmental disabilities
Developer: Social Research Laboratory at Northern Arizona University funded through the Arizona Department of Economic Security, Division of Developmental Disabilities
States Currently Using: Arizona
Psychometric Testing: Field testing still ongoing
Use history: Version dated August 14, 2006. Survey conducted with individuals who receive attendant services that are funded through the Arizona Department of Economic Security, Division of Developmental Disabilities.
Summary: Interview takes 30-60 minutes to conduct and is conducted by a consumer. Focus areas include access to attendant services, choice in services, communication with the provider agency and the attendant, satisfaction with provider and attendant services, effectiveness of attendant and attendant provider, and quality of life as it relates to attendant services.

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Arkansas

Tool or Measure Set: Arkansas Quality Management Monitoring of HCBS Waiver Case Records
Data Source: Administrative Data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 25
HCBS MS Domains: Timeliness, Qualified Providers, Administrative Oversight, Effectiveness, Person Centeredness/Autonomy, Health and Welfare, Access
Populations: Elders with physical or cognitive disabilities, Adults with chronic physical conditions, Adults and children with intellectual disabilities
Developer: The Medstat Group, Inc., through CMS National Quality Contract
Use history: These draft performance indicators were developed in 2005 as part of Arkansas' quality management strategies for its three aging waivers.
States Currently Using: Arkansas
Psychometric Testing: N/A
Summary: The Medicaid agency performs case record reviews on randomly selected cases throughout the year and is currently in the process of aggregating data and developing remediations for its first quarterly trend analysis report. Operating agencies will need to provide corrective action plans to respond to identified issues.

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California

Tool or Measure Set: XenologiX Consumer Satisfaction Survey
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interview
Total Items/indicators: 24 items
HCBS MS Domains: Access, Effectiveness, Person Centeredness/Autonomy, and Quality of Life
Populations: Adults or children with mental retardation or developmental disabilities
Developer: XenologiX, in partnership with the Alta California Regional Center
Use history: Developed in 2002. Piloted in one California Regional Center and then expanded to six Regional Centers.
States Currently Using: Unclear if California still uses this tool. Original survey conducted in 2002-2003.
Psychometric Testing: Not specified
Summary: The XenologiX Consumer Satisfaction Survey was not available at the time this summary was written. The tool addresses satisfaction with service coordination, access to information, individual service plans, family service plans, and service providers. The tool was developed for use originally by the Tri-County Regional Center and later expanded to six addition pilot Regional Centers in California. Survey takes approximately 13 minutes to administer.

Tool or Measure Set: Quality of Life for Persons with Developmental
Disabilities Moving from Developmental Centers into the Community (Movers) Survey
Data Source: Consumer Survey
Respondent: Consumer or Proxy
Mode of Data Collection: Face-to-face Interview
Total Items/indicators: 23 items
HCBS MS Domains: Access, Effectiveness, Person Centeredness/Autonomy, and Quality of Life
Populations: Adults or children with mental retardation or developmental disabilities
Developer: Unknown
Use history: Survey has been implemented in California since 1993.
States Currently Using: California
Psychometric Testing: Not specified
Summary: The Movers Survey was not available at the time this summary was written. Survey is administered by the California State University at Sacramento. The survey is conducted annually with individuals who have transitioned from a developmental center. Survey takes approximately 1. 5 hours to complete.

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