Appendix V: Tested Measures by DRA Domain (continued)
Environmental Scan of Measures for Medicaid Title XIX Home and Community-Based Services Measure Scan as of July 5, 2007
Appendix V: Tested Measures by DRA Domain (continued)
Table A.V.2a. Tested Experience Measures
I. Respectful Treatment by Direct Service Providers
Measure | Source | Notes |
|---|---|---|
How well clinicians communicate (includes elements of respect) | ECHO 3.0 (all adult versions), based on six survey items | Adult mental/behavioral health consumers; parallel proxy questions developed for children. |
HIV ambulatory care satisfaction: multiple items related to treatment by direct service providers, including clinicians and mental health and substance abuse counselors | New York Department of Health AIDS Institute. Patient satisfaction survey for HIV ambulatory care (PSS-HIV). | Individuals receiving ambulatory care for HIV |
Respectful treatment/careful listening by staff: 6 measures total for in-home, out-of-home and transportation staff | Participant Experience Survey | Measures supported by all three survey versions; additional items with simplified language in mental retardation/developmental disabilities version |
Respectful treatment by home health aides and homemaker staff (3 items each) | Home Care Satisfaction Measure | All items in each domain can be rolled up into global satisfaction score. |
Proportion of people indicating that most support staff treat them with respect | National Core Indicators Consumer Survey | ID/DD only |
Dignity and respect: 5 indicators | Council on Quality and Leadership Basic Assurances | Not all indicators relate to treatment by direct staff; individuals with intellectual or developmental disabilities and people with mental illness |
Staff sensitivity to cultural/ethnic background (additional respect items in consumer surveys) | Mental Health Statistics Improvement Program (adult, family, and youth instruments) | Mental health consumers |
Degree to which consumers report that staff are sensitive to their cultural, ethnic, or linguistic backgrounds and degree to which consumers felt they were respected by staff | Commission on the Accreditation of Rehabilitation Facilities (CARF) | Behavioral health |
Respect items from nursing home CAHPS®: What number would you use to rate: (1) how respectful staff are; (2) how well they listen; (3) how well they explain things in a way you understand? | CAHPS® nursing home long-stay resident instrument | Developed for nursing home settings |
Respectful treatment by transportation staff | Performance Outcome Measures Project Transportation Survey | Survey specific to elderly |
Proportion of people treated with respect and proportion of people from whom staff routinely ask permission before entering their bedroom or private living space | Quality Indicators for Medicaid Services to People With Developmental Disabilities | Individuals with intellectual disabilities |
Frequency of "bad" treatment by paid helpers; provider competency and respect | Mathematica Waiver Evaluation Consumer Survey | Developed for HCBS waiver evaluation across States; language may be appropriate for additional testing or modification. |
Support staff generally respectful and courteous | National Core Indicators Family Survey | Families with at least one child with an intellectual disability |
Respect items: Providers listen to program participants, treat them with respect, are courteous and polite, are age appropriate | EAZI Habilitation and Attendant Surveys | Adults with developmental disabilities. Survey developed with peer input using CMS Systems Change grant funding. |
Respectful treatment by personal care attendants: treat with respect; respect privacy; respect confidentiality; listen carefully | Maine Consumer Experience Survey | Nonelderly adults with physical disabilities who direct their own services |
Respect, dignity, and privacy from providers (7 items in scale) | Nebraska Family Experience Survey | Families of children receiving HCBS |
II. Opportunity To Make Choices About Providers
Measure | Source | Notes |
|---|---|---|
Choice in staff: percentage who do not help choose staff and would like to | Participant Experience Survey | Item present in all three survey tools |
Proportion of people who make choices about their everyday lives, including: housing, roommates, daily routines, jobs, support staff or providers, and social activities. | National Core Indicators Consumer Survey | Measure includes choices in several areas, not just providers. Items specific to provider choice included in survey. Intellectually disabled/developmentally disabled population only. |
Ability to select provider | Performance Outcome Measures Project (POMP5) Case Management Survey | Older adults receiving services from area agencies on aging; limited to those providers offering some degree of self-direction. |
Ability to select providers and support workers | National Core Indicators Family Survey | Families with at least one child with an intellectual disability |
Choice in provider | EAZI Habilitation and Attendant Surveys | Adults with developmental disabilities—survey developed with peer input using CMS Systems Change funding |
Choice and control over providers (10 items) | Nebraska Family Experience Survey | Families of children receiving HCBS |
Choose or hire staff who provide services in the home | New Hampshire Development Services Adult Outcomes Survey | Adults with developmental disabilities; includes family and friends. |
Percentage of clients who took part in choosing who would provide services | Texas Rehabilitation Commission Client Satisfaction Survey | Individuals receiving rehabilitation services |
III. Opportunity To Make Choices About Services
Measure | Source | Notes |
|---|---|---|
Parent's experience with shared decisionmaking | CAHPS® Children With Chronic Conditions Supplemental Items (based on 4 items) | All children with chronic conditions; not specific to HCBS. |
Client involved as much as wanted in treatment decisions | ECHO 3.0 (all adult versions) | Adult mental/behavioral health consumers; parallel proxy items developed for children. |
HIV ambulatory care satisfaction: multiple items related to making choices about treatment options | New York State Department of Health AIDS Institute. Patient satisfaction survey for HIV ambulatory care (PSS-HIV). | Individuals receiving ambulatory care for HIV/AIDS |
Directing staff: program participants who do not help direct staff and want to | Participant Experience Survey | Item present in all three survey versions |
Control over timing of ADL/IADL assistance (5 items: bathing, dressing, transferring, eating, and getting groceries) | Participant Experience Survey, brain injury version | Adults with acquired brain injuries |
Proportion of people who make choices about their everyday lives, including: housing, roommates, daily routines, jobs, support staff or providers, and social activities | National Core Indicators Consumer Survey | Measure includes choices in several areas, not just providers; intellectually disabled/developmentally disabled population only. |
People direct decisions that affect their lives | Council on Quality and Leadership Shared Values | Individuals with intellectual or developmental disabilities and people with mental illness |
People choose services | Council on Quality and Leadership Personal Outcomes Measures | Individuals with intellectual or developmental disabilities and people with mental illness |
Consumer participation in treatment decisions | Mental Health Statistics Improvement Program (adult, family, and youth consumer surveys) | Adults with severe/persistent mental illness |
Degree of active consumer participation in decisions concerning their treatment | Commission on the Accreditation of Rehabilitation Facilities (CARF) | Tested with multiple disability populations |
Ability to select services received | POMP5 Case Management Survey | Older adults receiving services from area agencies on aging; limited to those providers offering some degree of self-direction. |
Proportion of people who make choices about their daily routines and activities | Quality Indicators for Medicaid Services to People With Developmental Disabilities | Individuals with intellectual disabilities |
Participant decides how and when things are done and has choice in tasks performed by paid helpers and in scheduling. | Mathematica Waiver Evaluation Consumer Survey | Developed for HCBS waiver evaluation across States; language may be appropriate for additional testing or modification. |
Decisionmaking (scale including items related to making choices about services and treatment) | Client-Centered Rehabilitation Questionnaires | Recipients of rehabilitation services; may not be relevant to HCBS model. |
Choice and control over personal assistance services (several items, including items specific to choice in ADLs/IADLs) | Personal Assistance Services (PAS) Impact Survey: Consumer Survey | Adults with spinal cord injuries |
Control over daily activity (eating, bedtime, recreational activities) | Schalock Quality of Life Questionnaire | Adults with intellectual disabilities |
Ability to choose where and when to receive services, control over scheduling, tasks completed as participant wants | EAZI Habilitation and Attendant Surveys | Adults with developmental disabilities.� Survey developed with peer input using CMS Systems Change grant funding. |
Customers make informed choices and have control about their services. | Kansas Department on Aging, Frail/Elderly Consumer Interview Protocol | Older adults—performance measure supported by a number of interview items. |
Percentage of consumers who participated as much as they wanted in the development of their care plans | Maine Consumer Experience Survey | Nonelderly adults with physical disabilities who direct their own services |
Percentage of clients who took part in planning the services they received | Texas Rehabilitation Commission Client Satisfaction Survey | Individuals receiving rehabilitation services |
IV. Satisfaction With Case Management Services
Measure | Source | Notes |
|---|---|---|
HIV ambulatory care satisfaction: 14 items related to case management services, including overall satisfaction items | New York State Department of Health AIDS Institute. Patient satisfaction survey for HIV ambulatory care (PSS-HIV). | Developed for individuals with HIV served in ambulatory settings |
Case manager helpfulness | Participant Experience Survey | Item present in all three survey versions |
Satisfaction with case management services: composite score based on 13 items | Home Care Satisfaction Measures | Older adults receiving home care services |
Satisfaction with service coordination: 3 measures (accessible, responsive, supportive) | National Core Indicators Consumer Survey | Intellectually disabled/developmentally disabled population only |
Consumer assessment of case management | Center for Quality Assessment and Improvement in Mental Health | Persons with severe and persistent mental illness enrolled in health plans |
Percentage of people who feel it is a problem to receive advice/assistance from more than one case manager | Indiana Medicaid Select Survey/Integrated Care Program Recommendation | Individuals with disabilities |
Member satisfaction with case management | Assessing Care of Vulnerable Elderly | Community-dwelling older adults |
Proportion of members who report they can easily get in touch with their care coordinator or case manager (also measure of frequency of contact with case manager) | AXIS Healthcare (as reported by Center for Health Systems Research and Analysis) | These items have been incorporated into another tool currently undergoing testing. |
Overall satisfaction with assistance in coordinating care for child with special health care needs | National Survey of Children With Special Health Care Needs, 2001 | Children with special health care needs |
Satisfaction with, effectiveness of case management (13 items on various dimensions of case management, plus one overall satisfaction item) | POMP5 Case Management Survey | Older adults with physical and cognitive disabilities, case management payer not necessarily Medicaid, but items are generic |
Percentage reporting that service coordinators provide needed assistance when requested | National Core Indicators Family Survey | Families with at least one child with an intellectual disability |
V. Client Perception of Quality of Care
Measure | Source | Notes |
|---|---|---|
Experience with care measures from the Young Adult Health Care Survey | Young Adult Health Care Survey | Adolescents 14-18 |
Global rating of counseling and treatment services | ECHO 3.0 (all adult versions) | Adult mental health consumers; parallel proxy items for children. |
Percentage of adult mental health consumers and families of child/adolescent mental health recipients reporting positive outcomes from care | SAMHSA National Outcome Measures | Adult mental health consumers and family members of child/adolescent consumers |
Percentage of parents of health plan members who reported their experiences with family-centered care regarding their children with chronic conditions | CAHPS® 3.0 Health Plan Survey | Children age 17 and under enrolled in a health plan (including Medicaid recipients) |
Satisfaction with transportation services (several dimensions) | POMP Transportation Survey | Developed for older adults receiving services funded by the Administration on Aging |
Overall satisfaction with home-delivered meal program | POMP Home-Delivered Meals Extended Core Survey | Developed for older adults receiving services funded by the Administration on Aging |
Satisfaction with paid help (several related items) | Cash and Counseling Baseline Instrument | Individuals participating in the initial cash and counseling demonstration project |
Satisfaction with paid caregivers | Cash and Counseling Demonstration Expansion: Performance Indicators | Data are not really comparable and indicators are not precisely defined; States use available data to provide information about the domain. |
Satisfaction with paid care (several related items) | Mathematica Waiver Evaluation Consumer Survey | Elderly/disabled waiver participants. Historical data from evaluation could be used for trending. |
Service outcomes (multiple items) | National Core Indicators Family Survey | Families with at least one child with an intellectual disability |
HIV-positive adolescent and adult patient ratings of the care provided to them at their clinic, plus multiple other items related to perception of care experience | New York State Department of Health AIDS Institute; Patient Satisfaction Survey for HIV Ambulatory Care (PSS-HIV) | Clinic-based care included in HIV waivers? |
Satisfaction with staff | Participant Experience Survey, brain injury version | Adults with acquired brain injuries |
Global home health satisfaction (includes case management, groceries, home health aides, homemaker services, and home-delivered meals) | Home Care Satisfaction Survey | Elderly recipients of home care |
Degree to which consumers were satisfied with overall services | Commission on the Accreditation of Rehabilitation Facilities (CARF) | Behavioral health consumers |
Overall satisfaction: Overall, what number would you use to rate the care you get from the staff? | CAHPS® Nursing Home Survey: long-stay resident | Developed and testing for nursing home setting; generic item. |
Satisfaction with mental health services agency: like services, would choose, would recommend | Mental Health Statistics Improvement Program, Adult Consumer Survey |
|
Overall satisfaction with services received | Mental Health Statistics Improvement Survey, Youth Services Survey | Mental health consumers |
Caregiver's overall assessment of formal services received by the person he or she cares for | POMP5 Caregiver Program Support and Assessment Telephone Survey | Respondent is caregiver proxy, not recipient. Survey designed to assess the National Family Caregiver Support Program. |
Perception of care (multiple dimensions covering 14 items) | SAMHSA National Outcome Measures | Developed and tested for mental health population |
Service satisfaction scales: home worker; personal care; home-delivered meals | Service Adequacy and Satisfaction Instrument | Developed and tested with service recipients age 60 and older |
Satisfaction with care; scale based on six items. | Adequacy of Paraprofessional Home Care instrument | Frail older adults |
Program Satisfaction Module | Peer Outcomes Protocol | Mental health consumers in peer programs |
Satisfaction with care provided by personal assistance service staff (several dimensions, including competence and respectful treatment) | Personal Assistance Services (PAS) Impact Survey: Consumer Survey | Adults with spinal cord injuries. Includes questions regarding assistance with sexuality and other potentially sensitive topics. |
Global satisfaction with treatment services | PERMS 1.0 | Individuals receiving mental health and substance abuse treatment |
VI. Residential Experience (satisfaction and choice)
Measure | Source | Notes |
|---|---|---|
Satisfaction with home: (overall, satisfaction with family living and with housemates) | Participant Experience Survey, mental retardation/developmental disabilities and brain injury versions | Slight wording differences between the two survey versions |
Choice in home: 2 measures (overall choice and choice of roommates in congregate settings) | Participant Experience Survey, mental retardation/developmental disabilities and brain injury versions | Slight wording differences between the two survey versions |
Proportion of people who are happy with the people they live with | Quality Indicators for Medicaid Services to People With Developmental Disabilities | Individuals with intellectual disabilities |
Satisfaction with current housing situation | Peer Outcomes Protocol | Mental health consumers |
Choice and decisionmaking in housing (2 measures) | National Core Indicators Consumer Survey | Measures cover choice in more than one area; consumer survey includes specific items related to housing and roommate choice. |
Proportion of people who are satisfied with where they live | National Core Indicators Consumer Survey | Intellectually disabled/ developmentally disabled population only |
People choose where and with whom they live | Council on Quality and Leadership Personal Outcome Measures | Individuals with intellectual or developmental disabilities and people with mental illness; companion measures for children, youth, and families. |
Degree to which consumers report housing situation is better | Commission on the Accreditation of Rehabilitation Facilities (CARF) | Tested with multiple disability populations |
Degree to which consumers report they live in a home of their choosing | Commission on the Accreditation of Rehabilitation Facilities (CARF) | Tested with multiple disability populations |
Satisfaction with current living situation (subjective and objective dimensions) | Lehman Quality of Life Scale | Nonelderly adults with serious mental illness |
Like where you live, choose where you live | New Hampshire Development Services Adult Outcomes Survey | Adults with developmental disabilities |
Satisfaction with current residence | Mathematica Waiver Evaluation Consumer Survey | Elderly and physically disabled waiver participants |
VII.�Client Report of Abuse and Neglect
Measure | Source | Notes |
|---|---|---|
Percentage of adult and adolescent patients assessed who disclosed that they were victims of abuse | Family Violence Prevention Fund. National consensus guidelines on identifying and responding to domestic violence victimization in health care settings. | Specific to intimate partner violence |
Client report of theft | Participant Experience Survey | Item supported by all three survey versions, but wording differs. In addition, elderly/disabled tool refers only to theft by direct care staff; brain injury and mental retardation/developmental disabilities versions refer to theft by anyone. |
Client report of verbal abuse | Participant Experience Survey | Item supported by all three survey versions, but wording differs. In addition, elderly/disabled tool refers only to verbal abuse by direct care staff; brain injury and mental retardation/developmental disabilities versions refer to verbal abuse by anyone. |
Client report of injury | Participant Experience Survey | Item supported by all three survey versions, but wording differs. In addition, elderly/disabled tool refers only to injury caused by direct care staff; brain injury and mental retardation/developmental disabilities versions refer to injury caused by anyone (could be accidental or deliberate). |
Unwanted physical contact | Participant Experience Survey, brain injury version | "Touched in a way you don't like" (anyone) |
People are free from abuse, neglect, mistreatment, and exploitation | Council on Quality and Leadership Basic Assurances | Individuals with intellectual or developmental disabilities and people with mental illness |
People are free from abuse and neglect | Council on Quality and Leadership Personal Outcome Measures | Individuals with intellectual or developmental disabilities and people with mental illness; companion measures for children and youth. |
Proportion of people who report that they are free from abuse and neglect | Quality Indicators for Medicaid Services to People With Developmental Disabilities | Individuals with intellectual disabilities |
Self-reported abuse and neglect | Peer Outcomes Protocol | Adult mental health consumers in peer programs |
People living with respondent who hurt, pester, scare, or anger him/her. | Schalock Quality of Life Questionnaire | Adults with spinal cord injuries |
Injuries/falls while with PAS, along with neglect and abuse, including sexual abuse, by PAS | Personal Assistance Services (PAS) Impact Survey: Consumer Survey | Adults with intellectual disabilities. This is one item in the empowerment/independence scale. |
VIII. Availability of Support for Resilience and Recovery
Measure | Source | Notes |
|---|---|---|
Direct provider staff act as if improvement is possible (support for recovery) | ECHO 3.0 supplemental items | Adult mental/behavioral health consumers |
Staff attention to recovery potential | Mental Health Statistics Improvement Program | Mental health consumers |


5600 Fishers Lane Rockville, MD 20857