Appendix V (continued)

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

Table A.V.3a. Tested Program Performance Measures

I. Access to Case Management

Measure

Source

Notes

Ability to identify case manager

Participant Experience Survey

Supported by all three survey versions

Ability to contact case manager

Participant Experience Survey

Supported by all three survey versions

Case manager effectiveness and competency (18 indicators)

National Core Indicators Case Management Measures

Individuals with intellectual disabilities. Data for indicators drawn from time measurement studies and consumer surveys.

Ability to identify case manager/support coordinator

National Core Indicators Consumer Survey

Individuals with intellectual or developmental disabilities

Case management for dual diagnosis; case management for medical comorbidity

Center for Quality Assessment and Improvement in Mental Health; quality measures

Persons with severe and persistent mental illness in managed care plans

Waiting time for child case management

Maine Department of Mental Health, Mental Retardation, and Substance Abuse Services

Children with psychiatric disorders

Communication between mental health and primary care for outpatients

Center for Quality Assessment and Improvement in Mental Health; quality measures

Mental health outpatients

Waiting time for case management services (mental retardation)

Center for Quality Assessment and Improvement in Mental Health; quality measures

Individuals dually diagnosed with mental retardation and mental illness

Family received all the professional care coordination that was needed

National Survey of Children With Special Health Care Needs, 2001

Children with special health care needs

Degree to which consumers found it easy to get someone from Medicaid to coordinate their care from different providers

CAHPS® for People With Mobility Impairments

People with mobility impairments enrolled in managed care plans

Client perception of frequency and adequacy of case management contact

Mathematica Waiver Evaluation Consumer Survey

Older adults and people with disabilities

Access to service coordinator (includes 7 items)

Nebraska Family Experience Survey

Families with children receiving HCBS

 

II. Receipt of All Services in Care Plan

Measure

Source

Notes

Staff spend all required time with client

Participant Experience Survey

Supported by all three survey versions

Attendants/workers/staff work the amount of time authorized in the plan of care

Kansas Department on Aging, Frail/Elderly Consumer Interview Protocol

Older adults

Case manager ensures that participants receive the services identified in the plan of care

Quality Review Indicators for Michigan's Aged and Disabled Waiver

Older adults and disabled people; data are gathered during provider reviews.

III. Care Coordination

Measure

Source

Notes

Percentage of children requiring more than one type of health care service who received needed help coordinating care

PHDS-PLUS (Promoting Healthy Development Survey)

Children only; tool designed for 0-3

Parent's experience with coordination of their child's care

CAHPS®, Children With Chronic Conditions, based on 2 items

Children only

Satisfaction with care coordination (5 items total)

CAHPS® 4.0H (NCQA version), also adult supplemental items

Item developed for health plan participants; may not be relevant to HCBS.

3-item care transition measures (CTM3)

University of Colorado Health Sciences Center

Three-item survey, related specifically to experience upon discharge from a hospital; may be relevant for HCBS participants being discharged back into the community.

Care planning for dual diagnosis

Center for Quality Assessment and Improvement in Mental Health; quality measures

People dually diagnosed with mental illness and substance abuse

Return to Contents

Table A.V.3b. Tested Program Performance Measures Meeting Threshold Criteria

Note: Scoring is explained in Figure 1.

I. Access to Case Management

Measure

Source

Evidence

Populations

Feasibility

Prevalence

Total Score

Notes

Ability to identify case manager

Participant Experience Survey

4

5

3

5

17

Supported by all three survey versions

Ability to contact case manager

Participant Experience Survey

4

5

3

5

17

Supported by all three survey versions

Case manager effectiveness and competency (18 indicators)

National Core Indicators Case Management Measures

3

4

2

4

13

Individuals with intellectual disabilities. Data for indicators drawn from time measurement studies and consumer surveys.

Ability to identify case manager/support coordinator

National Core Indicators Consumer Survey

4

4

3

5

16

Individuals with intellectual or developmental disabilities.

Family received all needed professional care coordination

National Survey of Children With Special Health Care Needs

4

3

3

2

12

Children with special health care needs

Access to service coordinator (includes 7 items)

Nebraska Family Experience Survey

3

3

3

3

12

Families with children receiving HCBS

 

II. Receipt of All Services in Care Plan

Measure

Source

Evidence

Populations

Feasibility

Prevalence

Total Score

Notes

Staff spend all required time with client

Participant Experience Survey

4

5

3

5

17

Supported by all three survey versions

Attendants/workers/staff work the amount of time authorized in the plan of care

Kansas Department on Aging, Frail/Elderly Consumer Interview Protocol

4

4

3

3

14

Older adults

Case manager ensures that participants receive the services identified in the plan of care

Quality Review Indicators for Michigan's Aged and Disabled Waiver

4

5

4

3

16

Older adults and disabled people; data are gathered during provider reviews.

 

III. Care Coordination

Measure

Source

Evidence

Populations

Feasibility

Prevalence

Total Score

Notes

Percentage of children with special health care needs who receive coordinated, ongoing, comprehensive care within a medical home

Children With Special Health Care Needs Survey

4

3

3

5

15

Children ages 0-18

Parent's experience with coordination of their child's care

CAHPS®, Children With Chronic Conditions, based on 2 items

4

3

3

5

15

Children only

Page last reviewed June 2010
Internet Citation: Appendix V (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/hcbsapv3ab.html