Appendix III (continued)

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

Kentucky

Tool or Measure Set: Kentucky Acquired Brain Injury Participant Program Evaluation
Data Source: Consumer survey
Respondent: Consumer
Mode of Data Collection: Face-to-face interviews
Total Items/indicators: 18
HCBS MS Domains: Effectiveness, Efficiency, Person Centeredness/Autonomy, Safety, Timeliness, Access, Health and Welfare, Quality of Life
Populations: Adults with acquired brain injuries
Developer: Division of Long Term Care and Community Alternatives, Brain Injury Services Branch
Use history: Revisions to the current tool were made in 2005. The brain injury waiver has used some type of evaluation or satisfaction survey since its inception.
States Currently Using: Kentucky
Psychometric Testing: Not specified
Summary: Instrument measures consumer satisfaction with waiver services through 18 statements that the consumer indicates agree/disagree/no comment. Two open-ended questions prompt consumers to indicate most helpful things services have accomplished and areas for improvement.

Tool or Measure Set: Adult Day Care Recipient/Caregiver Survey
Data Source: Consumer survey
Respondent: Consumer
Mode of Data Collection: Mail survey
Total Items/indicators: 14 close-ended, one open-ended narrative
HCBS MS Domains: Person Centeredness/Autonomy, Health and Welfare, Quality of Life, Unmet Need
Populations: Aged, blind, and disabled, or those individuals meeting nursing facility level of care and receiving care in their home and/or community. The care provider types include home health agencies and adult day health care (ADHC) agencies. Service settings are adult day healthcare centers and the recipient's home.
Developer: Division of Long Term Care and Community Alternatives, Department of Medicaid Services
Use history: The recipient/caregiver survey is endorsed by the Department for Medicaid Services, the Department of Mental Health and Mental Retardation, and SHPS (Medicaid Peer Review Organization). Surveys are mailed out to recipients statewide. There currently are no collection results or known response rates. Medicaid does receive surveys directly in rare instances and Medicaid nurse consultant/inspectors do directly provide survey tools to members when there is a question of client satisfaction at the time of a direct Medicaid review of services.
States Currently Using: Kentucky
Psychometric Testing: Reliability and validity have not been tested however the questionnaire content is designed to elicit responses from recipients of services outlined in the home and community-based waiver (HCBW).
Summary: The tool developed by Medicaid used to determine the quality of care delivered to Medicaid recipients in the HCBW and ADHC programs is distributed statewide by all agencies providing these programs. The questionnaire consists of 14 questions requiring yes or no responses and one (1) open-ended question for the respondent to have the opportunity to divulge other concerns. Brief instructions are given at the top of the one-page form for the completion and submission of the questionnaire.

Return to Appendix III Contents

 

Louisiana

Tool or Measure Set: State of Louisiana Department of Health and Hospitals Draft Outcomes and Indicators across Individuals with Developmental Disabilities, Adults with Physical Disabilities, and Older Adults
Data Source: Administrative data, consumer survey, provider survey licensing data, record reviews, claims data
Respondent: Consumer survey not yet specified
Mode of Data Collection: N/A
Total Items/indicators: 96 indicators
HCBS MS Domains: Access, Person Centeredness/Autonomy, Unmet Need, Health and Welfare, Coordination of Long-Term Care and Other Services, Safety, Qualified Providers, Quality of Life, Equity, Efficiency
Populations: Adults with developmental disabilities, nonelderly adults with physical disabilities, elders with cognitive or physical impairments
Developer: Louisiana Department of Health and Hospitals, with technical assistance from Human Services Research Institute and the Muskie School of Public Service.
Use history: Draft list of indicators, still under development, that will eventually apply to all of the State's waivers.
States Currently Using: Louisiana (planned)
Psychometric Testing: Tools still not defined
Summary: This indicator list reflects the work to date of the State and its contractors to identify desired indicators and potential data sources to support them. They are organized along 10 dimensions: access, service planning and delivery, health, safety, qualified providers, community and social connections, employment/day supports, housing, rights, responsibilities and risk, and system performance. Individual indicators are indexed to the relevant CMS assurance for Medicaid HCBS. Not all indicators apply to all three populations. While this measure set is designed to be cross-cutting, individual waivers may also collect additional data for quality purposes.

Return to Appendix III Contents

 

Maine

Tool or Measure Set: Maine Experience Survey for Adults with Physical Disabilities, Consumer-Directed Waiver
Data Source: Consumer Survey
Respondent: Consumer (or proxy if consumer not able to respond)
Mode of Data Collection: Face-to-face interview
Total Items/indicators: 105 items
HCBS MS Domains: Access, Unmet Need, Health and Welfare, Safety, Quality of Life
Populations: Adults with physical disabilities who direct their own services
Developer: The Muskie School of Public Service, with assistance from The Medstat Group, Inc.
Use history: Survey has been fielded twice with a random sample of participants in Maine's Consumer-Directed Personal Assistance Services (CD-PAS) waiver.
States Currently Using: Maine
Psychometric Testing: Limited cognitive testing, some modifications made based on the first round of field testing
Summary: This tool is a modified version of the Participant Experience Survey, elderly/disabled (E/D) version, with new items developed specifically for self-directed services. Key focus areas included program access, support for self-direction tasks, and availability and quality of direct care workers. The tool underwent iterative rounds of cognitive testing before field testing in 2004. Based on the results of the field test, modifications were made to selected items. Data from both rounds of field use are being used by the State for quality improvement purposes.

Tool or Measure Set: Maine's Consumer Survey about Care Coordination and Home Care Services
Data Source: Consumer Survey
Respondent: Consumer or proxy
Mode of Data Collection: Mail survey
Total Items/indicators: 41 items
HCBS MS Domains: Access, Unmet Need, Person Centeredness/Autonomy
Populations: Elders and adults with physical impairments; excludes adults with cognitive impairments, as determined from Minimum Data Set (MDS) data
Developer: Maine Bureau of Elder and Adult Services
Use history: Spring 2004 version. State suspended use temporarily, will likely resume
States Currently Using: Maine
Psychometric Testing: Not specified
Summary: Items are organized into two focus areas: care coordination, home care services. Data are collected and analyzed by the State for quality improvement purposes. Use of this tool had been replaced by face-to-face interviews with another tool. Use of the in-person tool has been suspended due to lack of resources.

Return to Appendix III Contents

 

Massachusetts

Tool or Measure Set: Initial Slate of Measures for Massachusetts Frail Elder Home and Community-Based Services
Data Source: Multiple sources, including direct participant feedback, client records, and other data collected by providers
Total Items/indicators: 28 draft indicators
HCBS MS Domains: Access, Person Centeredness/Autonomy, Qualified Providers, Safety, Health and Welfare, Effectiveness
Populations: Elders with physical and cognitive disabilities
Developer: Center for Health Policy and Research at the University of Massachusetts Medical School and the Massachusetts Executive Office of Elder Affairs
Use history: Proposed measure set released in April 2007
States Currently Using: Massachusetts (planned) for waiver and State-funded services
Psychometric Testing: Draft measures-pilot testing recommended
Summary:The Massachusetts Office of Elder Affairs tasked a workgroup with the objectives of determining providers current quality management practices, identifying an initial set of measures with which Elder Affairs can gather key quality information on waiver and Home Care participants, and recommending strategies for implementing these measures. The proposed indicators are organized along the domains of the CMS Quality Framework.

Tool or Measure Set: Comprehensive List of Health and Safety Measures for Potential Use in MRDD Systems
Data Source: Potential State data sources identified include administrative data, such as medical records and the State's incident management system, as well as consumer survey data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 164 measures
HCBS MS Domains: Health and Welfare, Safety
Populations: Individuals with developmental disabilities
Developer: This March 2007 draft list was compiled by staff from the University of Massachusetts Medical School and the Human Services Research Institute.
Use history: Draft listing, recommended measures are highlighted. The Massachusetts Department of Mental Retardation ultimately selected only a few of these for initial analysis based on feasibility (i.e., is the data readily available) and relationship to targets for improvement.
States Currently Using: Massachusetts (selected measures only)
Psychometric Testing: Measures drawn from existing tools and datasets. Measures are rated according to a typology similar to that used by the AHRQ Measures Clearinghouse, based on criteria related to reliability, validity, and utility.
Summary: This matrix of health and safety measures, drawn from a variety of sources, was compiled for the Massachusetts Department of Mental Retardation. The indicators are grouped into seven major focus areas: access, outcomes, patient experience, population health, process, structure, and use of services. Focus groups were held with family members of consumers to determine the value placed on indicators in the matrix. The developers are currently adapting this listing so it can be used as a survey of State DD agencies to collect some focused input on what State agency leaders would consider important.

Tool or Measure Set: Massachusetts Department of Mental Retardation Quality Indicators
Data Source: Multiple: including consumer survey, administrative survey and certification data, investigations, medication occurrence and reporting systems, employment data, critical incident data, and restraint reporting
Respondent: Consumers and proxies (for National Core Indicators tools)
Mode of Data Collection: Face-to-face structured interview (for NCI)
Total Items/indicators: 57 measures support 33 indicators
HCBS MS Domains: Access, Health and Welfare, Unmet Need, Person Centeredness/Autonomy, Quality of Life, Coordination of Long-Term Care and Other Services, Safety
Populations: Individuals with intellectual disabilities
Developer: Massachusetts Department of Mental Retardation, in collaboration with the Center for Developmental Disabilities Evaluation and Research at the University of Massachusetts Medical School.
Use history: Data for the indicators have been reported annually to stakeholders since 2001, and are used by the State and four regional quality councils to guide quality improvement efforts.
States Currently Using: Massachusetts
Psychometric Testing: Reliability and validity of consumer survey established.
Summary: The indicators are organized around 12 quality outcomes articulated by the Department during its strategic planning process. These outcomes are in the areas of: health, protection from harm, safe environments, human and civil rights, protection of rights, decisionmaking and choice, community integration, community membership, relationships, achievement of goals, work, and qualified providers. Data trends are presented in clear pictorial format to facilitate interpretation by consumers.

Tool or Measure Set: Quality Enhancement Survey Tool (QUEST)
Data Source: Licensing and certification provider reviews, which include consumer interviews and observations
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 65 indicators
HCBS MS Domains: Quality of Life, Qualified Providers, Health and Welfare, Person Centeredness/Autonomy, Unmet Need, Coordination of Long-Term Care and Other Services
Populations: Individuals with intellectual disabilities
Developer: Massachusetts Department of Mental Retardation
Use history: This tool is used to review and certify providers contracting with the Department. The frequency of certification reviews depends on the findings of previous review. Providers who scored well are reviewed every two years; those who do not are reviewed annually.
States Currently Using: Massachusetts
Psychometric Testing: Not specified
Summary: Indicators are aligned with individual quality of life outcomes, such as people are valued and their rights are affirmed, and organizational outcomes, such staff have the skills and knowledge to support individuals' quality of life.

Tool or Measure Set: Evaluation Tool for Certification of Individual Support Services
Data Source: Administrative data generated from provider reviews
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 32 indicators
HCBS MS Domains: Person Centeredness/Autonomy, Safety
Populations: Individuals with intellectual disabilities who direct their own services
Developer: Massachusetts Department of Mental Retardation, Offices of Quality Management and Quality Enhancement
Use history: Used by the State to certify individual providers, coordination of long-term care and other services, qualified providers
States Currently Using: Massachusetts
Psychometric Testing: Not specified
Summary: Individual indicators are organized by four major focus areas: responsiveness/flexibility, choice/control/decisionmaking, safety/emergency response capability, and outreach/advocacy. Reviewers determine whether indicators are present or not. A separate group of organizational indicators, accessing organizational capacity and culture, only apply to providers not subject to full review using the QUEST tool.

Return to Appendix III Contents

 

Michigan

Tool or Measure Set: Participant Outcome and Status Measures, Version 1 (POSM)
Data Source: Consumer Survey
Respondent: Consumer (want to avoid surrogate responses)
Mode of Data Collection: Face-to-face structured interview
Total Items/indicators: 87 items rated on a 7-point scale
HCBS MS Domains: Unmet Need, Person Centeredness/Autonomy, Safety, Effectiveness
Populations: Designed for use by persons without major cognitive issues
Developer: Michigan Department of Community of Health and the University of Michigan, developed with funds from Michigan's Real Choice Systems Change grant from the Centers for Medicare and Medicaid Services. Design team also includes staff from Center for Outcome Analysis, DYNS Services, Inc., Tri-County Office on Aging, and Michigan Disability Resource Center.
Use history: Version 1, dated 9/28/06 is a draft tool, still under evaluation. Many issues, such as frequency of data collection and interview type, are still being worked out.
States Currently Using: Michigan
Psychometric Testing: Reliability and validity testing has been conducted by University of Michigan researchers.
Summary: Purpose of tool is to develop a standardized method to measure quality of life for individuals in a variety of long-term care arrangements. It is designed to gauge the extent to which people with impairments live their lives in accordance with their own preferences and goals. Many experience items have "value" pairs. For example, the statement "My workers take an interest in me as a person" is rated on a 7-point Likert scale, and is followed in a subsequent section by a values item "It is important that my workers take an interest in me as a person," also rated on a 7-point scale. Survey is organized along the following major focus areas: availability of paid supports, relationship with support workers, meaningful activities, community integration, personal relationships, personal beliefs, dignity/respect, autonomy, privacy, and security.

Tool or Measure Set: Quality Indicators for Michigan's MI Choice Waiver
Data Source: Administrative and claims data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Eight indicators
HCBS MS Domains: Access
Populations: Elders with physical and cognitive disabilities, adults with physical disabilities, adults with acquired brain injuries, adults dependent on technology
Developer: Michigan Department of Community Health
Use history: Data are collected and trended for use by the State in guiding quality improvement efforts.
States Currently Using: Michigan
Psychometric Testing; Not specified
Summary: The 8 indicators are: average, shortest, longest and next longest number of days between participant enrollment and first date of service; number of participants enrolled in the waiver for longer than 30 days who received no services; percent of predicted number of units and costs versus actual number of unites and costs, and overall provider no show rates. Data are tracked by provider.

Tool or Measure Set: Quality Review Indicators for Michigan's Aged and Disabled Waiver
Data Source: Information gathered during provider reviews
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 85 indicators
HCBS MS Domains: Access, Person Centeredness/Autonomy, Unmet Need, Qualified Providers
Populations: Elders with physical and cognitive disabilities, adults with physical disabilities, adults with acquired brain injuries
Developer: Michigan Department of Community Health
Use history: Used with providers for the Michigan Choice waiver
States Currently Using: Michigan
Psychometric Testing: Not specified
Summary: Checklist of items for review of waiver providers. Reviewers assess whether condition is "evident" or "nonevident" and data are compiled across all providers. Indicators are grouped in the following focus areas, which align with the CMS assurances: intake and eligibility; person-centered planning; services delivery; provider network and availability; provider performance; risk and safety planning; critical incidents; natural disasters and other public emergencies; participant decisionmaking authority; due process; system performance appraisal; quality improvement; procedural administrative processes; and service standards.

Tool or Measure Set: Mission-Based Performance Indicator System (MBPIS), Version 6. 0
Data Source: Administrative Data
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 15 indicators
HCBS MS Domains: Access, Health and Welfare, Unmet Need, Efficiency
Populations: Adults and children with mental illness, adults and children with developmental disabilities
Developer: Michigan Department of Community Health
Use history: The MBPIS was first implemented in 1997 and the number of indicators has been as high as 51. After the State applied new criteria to the measure set, the number of indicators has dropped to 15, and includes measures developed by Federal agencies and national associations. These measures are used to evaluate the performance of community mental health service providers for all persons with mental health issues and developmental disabilities served, including Medicaid beneficiaries. Deviations from State-articulated standards may result in contract action.
States Currently Using: Michigan
Psychometric Testing: Not specified
Summary: The indicators are grouped into four primary focus areas: access, adequacy/appropriateness, efficiency, and outcomes. Data for the indicators are published on the Michigan Department of Community Health's website within 90 days of the close of the reporting system. An external quality review process validates the indicators for Medicaid recipients annually. Outcome indicators range from competitive employment to readmissions, substantiated abuse/neglect/exploitation, and suicide rates.

Return to Appendix III Contents

 

Minnesota

Tool or Measure Set: Senior LinkAge Line Call Center Customer Survey and Community Outreach Survey
Data Source: Consumer Surveys
Respondent: Consumer or Proxy
Mode of Data Collection: Not specified
Total Items/indicators: 8 close-ended items (Call Center Customer Survey) 6 close-ended items (Community Outreach Survey)
HCBS MS Domains: Effectiveness, Coordination of Long-Term Care and Other Services, and Timeliness
Populations: Elders with physical disabilities and elders with cognitive disabilities
Developer: Minnesota Board of Aging and Minnesota Areas Agencies on Aging
Use history: Senior LinkAge line first designed in 1997.
States Currently Using: Minnesota
Psychometric Testing: Unknown
Summary: Senior LinkAge Line is a free information assistance and referral line. The Call Center Customer Survey is used to evaluate individuals' experiences with the call line, specifically in the area of friendliness, timeliness, access to accurate information, and effectiveness. A second survey, the Community Outreach Survey, is provided to those who receive in-person assistance. The survey is used to identify the type of support received from a Senior LinkAge Line representative, satisfaction with assistance, level of increased awareness, and timeliness of response.

Tool or Measure Set: Minnesota Aging and Adult Services Consumer Experience Survey
Data Source: Consumer Surveys
Respondent: Consumer
Mode of Data Collection: Face-to-Face Interviews
Total Items/indicators: 86 close-ended items and 11 open-ended items
HCBS MS Domains: Safety, Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Access, Coordination of Long-Term Care and Other Services, Health and Welfare, Unmet Need, and Quality of Life
Populations: Elders with physical disabilities
Developer: Minnesota Department of Human Services, Aging and Adult Services Division
Use history: Survey developed in 2005 and conducting with approximately 600 clients from the Elder Waiver. Tool was built based on the CMS Participant Experience Surveys, Minnesota's Survey of Older Minnesotans, and Minnesota's Nursing Home Quality of Life Survey.
States Currently Using: Minnesota
Psychometric Testing: Limited
Summary: The Consumer Services Experience Survey is conducted by volunteers to determine elder waiver participants' need for services, access to services, satisfaction with services, and overall quality of life. Survey also assesses individuals' need and access to case management services.

Tool or Measure Set: Minnesota 2003 Personal Care Assistance (PCA) Consumer Survey
Data Source: Consumer Surveys
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interviews
Total Items/indicators: The survey tool was not available at the time of review
HCBS MS Domains: Effectiveness, Person Centeredness/Autonomy, Timeliness, Efficiency, Access, Health and Welfare, Unmet Need, and Quality of Life
Populations: Elders with physical disabilities and cognitive disabilities
Developer: Wilder Research Center, St. Paul Minnesota
Use history: Survey was conducted statewide in 2003 with 455 randomly chosen PCA recipients. Approximately half of the individuals interviewed were proxies.
States Currently Using: Study completed
Psychometric Testing: Unknown
Summary: The PCA program served approximately 6,000 Minnesotans in 2004. Survey focus areas include satisfaction, worker turnover, and flexibility of service environments. The survey tool has been translated into multiple languages, including Hmong, Somali, and Russian and surveys were conducted in the participants' native language.

Tool or Measure Set: Survey of Minnesotans Enrolled in the Medical Assistance for Employed Persons with Disabilities (MA-EPD) Program
Data Source: Consumer Surveys
Respondent: Consumer or Proxy
Mode of Data Collection: Telephone Interviews
Total Items/indicators: 61 close-ended items, 27 open-ended questions, and 13 demographic questions
HCBS MS Domains: Effectiveness, Person Centeredness/Autonomy, Efficiency, Equity, Access, Unmet Need, and Quality of Life
Populations: Adults with mental retardation or developmental disabilities, adults with severe and persistent mental illness, adults with acquired brain injuries, and adults with physical disabilities and/or chronic conditions
Developer: Wilder Research Center through the Medicaid Infrastructure Grant
Use history: Administered in August 2004 to individuals 22- 65 years of age enrolled in the MA-EPD program. Random sample of 690 individuals selected and 450 individuals participated, providing an 80 percent response rate and a sampling error +/- 5 percent.
States Currently Using: Study completed
Psychometric Testing: Not specified
Summary: Survey conducted on behalf of the Minnesota Department of Human Services' Disability Services Division with the intention to identify barriers to maintaining employment, identify barriers in receiving personal assistance services in the workplace, and establish priorities for MA-EPD program improvements. Focus areas include employment history, current work status, access to services, program satisfaction, identification of unmet need, and barriers to employment.

Return to Appendix III Contents

 

Mississippi

Tool or Measure Set: Consumer Surveys for Mississippi's HCBS Waivers
Data Source: Consumer Surveys
Respondent: Consumer or Proxy
Mode of Data Collection: 2 mail surveys and one in-home instrument
Total Items/indicators: Assisted living mail survey: 15 close-ended and 7 open-ended
In-home visit survey: 10 close-ended
Generic satisfaction survey: 6 close-ended and 7 open-ended
HCBS MS Domains: Timeliness, Effectiveness, Person Centeredness/Autonomy, Access, Unmet Need, and Quality of Life
Populations: Assisted living residents-other populations not specified on tools or in cover letter
Developer: Mississippi Medicaid
Use history: Cover letter states surveys were developed by "Mississippi Medicaid to assist in administering the waiver."
States Currently Using: Mississippi
Psychometric Testing: Not specified
Summary: Surveys include general satisfaction items. Assisted living tools ask respondents to rate the effectiveness of the facility and various program staff in selected dimensions along a five-point scale. The in-home tool verifies clients' awareness of the program and satisfaction with staff.

Tool or Measure Set: Mississippi Division of Medicaid HCBS Elderly/Disabled Waiver Quality Compliance Worksheet
Data Source: Record review
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: Records are assessed on 38 different criteria
HCBS MS Domains: Health and Welfare, Coordination of Long-Term Care and Other Services
Populations: Elderly/Disabled waiver participants
Developer: Mississippi Medicaid
Use history: Used by State to "measure timeliness of service provision." Tools used primarily onsite during an onsite postutilization audit review.
States Currently Using: Mississippi
Psychometric Testing: Not specified
Summary: Review items are grouped in the following six categories: Referral Intake Information; Plan of Care; Activity Notes; Billing; Content of Waiver Files; and Discharge Chart Review. Each criterion is assigned a number of points, for a total of 100. Final scores determine level of compliance and frequency of review.

Return to Appendix III Contents

 

Montana

Tool or Measure Set: Montana Department of Public Health and Human Services, Senior and Long Term Care Division, Elderly and Disabled Consumer Quality Assurance Review Process
Data Source: Administrative data collected through provider reviews and consumer interviews
Respondent: Consumer
Mode of Data Collection: Face-to-face interviews
Total Items/indicators: 18 for HCBS waiver providers
16 for personal assistance service providers
12 for self-directed personal assistance services
HCBS MS Domains: Unmet Need, Safety, Quality of Life, Qualified Providers
Populations: Adults and Elderly with physical disabilities
Developer: Senior and Long Term Care Community Services Bureau, Montana Department of Public Health and Human Services
Use history: The Bureau has a schedule for reviewing every provider every three years. When a provider is reviewed, the Bureau selects a random sample of its consumer records to review and conducts face-to-face consumer interviews with 50% of the selected consumers. This tool contains protocols and standards for conducting full, comprehensive reviews (every 3 years) and minimal reviews (in between years). The Bureau uses this process, with slight variations, for reviewing its Medicaid waiver, personal assistance, and self-directed services.
States Currently Using: Montana
Psychometric Testing: Not specified
Summary: The Bureau conducts quality assurance reviews to assess the quality of its home-based service delivery system and to identify where changes may be necessary to better support its consumers.

Tool or Measure Set: Montana Department of Public Health and Human Services, Addictive and Mental Disorders Division, Mental Health Services Bureau Recovery Markers
Data Source: Administrative data collected by case managers, via forms completed by clients
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 5 "markers"
HCBS MS Domains: Quality of Life
Populations: Adults with mental health and/or substance abuse disorders
Developer: Mental Health Services Bureau, Addictive and Mental Health Disorders, Montana Department of Public Health and Human Services
Use history: A data collection form is used by clients with case managers and the information is entered onto the secure and entirely confidential online Recovery Markers webpage. Case managers must complete during every 90 day treatment update.
States Currently Using: Montana
Psychometric Testing: Not specified
Summary: This is a new, web-based data collection and monitoring systems used by the State to track recovery among clients in active treatment. The five recovery markers tracked by the system include: Employment; Housing; Level of Symptom Interference; Level of (substance) Use; and Stages of Change. The Recovery Markers are designed to measure of how consumers are doing in their daily life. Every three months, as they meet with a case manager to review and update treatment goals, consumers are asked to fill in these five markers. Longitudinal data track how these aspects of consumers' lives have changed, and can guide goal development and treatment.

Tool or Measure Set: Consumer Interview for Montana's Severe Disabling Mental Illness (SDMI) Waiver
Data Source: Consumer Survey
Respondent: Consumer
Mode of Data Collection: Structured In-Person Interview
Total Items/indicators: 23 Items: 11 have Yes/No response options, the remainder are open-ended, but most are structured as Yes/No questions
HCBS MS Domains: Unmet Need
Populations: Adults with mental health and/or substance abuse disorders
Developer: Mental Health Services Bureau, Addictive and Mental Health Disorders, Montana Department of Public Health and Human Services
Use history: Consumer visits are conducted as a part of the quality assurance process for the SDMI waiver. The interview sample is 100% of the quality assurance review sample, and should be geographically disbursed within the waiver site, as well as a variety of ages, residential settings and situations.
States Currently Using: Montana
Psychometric Testing: Not specified
Summary: This is a structured annual interview conducted by the State's community program officers. The purpose of the consumer interview is to determine how the consumer measures the quality of services being provided in their home. This also provides the consumer the opportunity to express their concerns and opinions of our programs.

Return to Appendix III Contents

 

Nebraska

Tool or Measure Set: Nebraska Family Experience Survey
Data Source: Consumer Survey
Respondent: Parents of children receiving child care and respite services
Mode of Data Collection: Face-to-face structured interview
Total Items/indicators: 45 indicators reported in final report
HCBS MS Domains: Access, Unmet Need, Quality of Life, Coordination of Long-Term Care and Other Services, Person Centeredness/Autonomy, Health and Welfare
Populations: Children with disabilities (and their family caregivers)
Developer: Nebraska Department of Health and Human Services, in collaboration with The Medstat Group, Inc. Survey development funded through a CMS Real Choice Quality Assurance/Quality Improvement (QA/QI) Systems Change grant.
Use history: Survey administered in 2006 to a sample of families from the State's Aged and Disabled Waiver Program who had high service costs for respite and child care. Interviews conducted and analyzed by staff from the Munroe-Meyer Institute at the University of Nebraska Medical Center.
States Currently Using: Nebraska
Psychometric Testing: Interrater reliability was assessed by having interviewers conduct mock interviews and achieve target scores; scores for the field interviews were within the target range. Content validity achieved through stakeholder involvement in tool development.
Summary: Survey was developed based on focus areas identified by an advisory group of families and community stakeholder. A panel of experts, including families, State staff, researchers, evaluation professionals and agency staff reviewed and edited the items before the tool was fielded. Items organized in five program outcome areas: Access to Service Coordinators; Service Coordinator Interaction with Other Agencies; Choice and Control; Respect, Dignity and Privacy; and Community Integration and Inclusion.

Tool or Measure Set: Nebraska Individual Program Plan (IPP)/Individual and Family Support Plan (IFSP) Review
Data Source: Staff review of consumers' support plans
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 10 indicators in four areas
HCBS MS Domains: Person Centeredness/Autonomy, Health and Welfare
Populations: Individuals with intellectual disabilities
Developer: Nebraska Department of Health and Human Services
Use history: Data are collected by Disability Services Specialists, entered into a State database and reported by region
States Currently Using: Nebraska
Psychometric Testing: State has expressed some concerns about the reliability of the data collection and is working on addressing.
Summary: Focus areas include sufficiency of assessments, identification of priority goals, health and safety and habilitation.

Tool or Measure Set: Nebraska Individual Program Plan Implementation Review
Data Source: Staff review of implementation of consumers' support plans
Respondent: N/A
Mode of Data Collection: N/A
Total Items/indicators: 42 items
HCBS MS Domains: Person Centeredness/Autonomy, Health and Welfare
Populations: Individuals with intellectual disabilities
Developer: Nebraska Department of Health and Human Services
Use history: Data are collected by Service Coordinators, entered into a State database and reported by region
States Currently Using: Nebraska
Psychometric Testing: State reports consistency of findings with other service reviews.
Summary: Focus areas include Rights; Habilitation; Financial; Service Needs; Health and Safety; Work/home Environment. Clients also provide input to review, and forms can be used to determine the need for follow up.

Return to Contents
Proceed to Next Section

Current as of June 2010
Internet Citation: Appendix III (continued): 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/hcbsapiiif.html