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 |
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 |
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