Long Term Services and Support: System Assessment and Evaluation

Managing a High-Performance Medicaid Program

Abstract: 

This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals.  The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

Key Findings:

  • Federal and state governments share responsibility for administering Medicaid;
  • Medicaid's responsibilities go significantly beyond those of other insurers and programs;
  • Medicaid is evolving and faces a set of new opportunities and challenges;
  • Adequate administrative capacity is key to realizing the goal of running a high performing Medicaid program.

Suggested Citation:

Griffin E, Riley T, Wachino V, Rudowitz R. Managing a High-Performance Medicaid Program. Menlo Park, CA: Kaiser Commission on Medicaid and the Uninsured; October, 2013.

Publication Type: 
Report
Publish Date: 
October 21, 2013
URL: 
http://kaiserfamilyfoundation.files.wordpress.com/2013/10/8476-managing-a-high-performance-medicaid-program.pdf

Mental Health Services in Rural Long-Term Care: Challenges and Opportunities for Improvement

Abstract: 

Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. In this Research & Policy Brief (and accompanying Working Paper), we consider challenges and opportunities for improving mental health treatment delivered to long-term care recipients in rural settings. As background, we note the prevalence of mental health problems in long-term care populations, describe deficiencies in the mental health care afforded to long-term care recipients, and identify barriers that hinder the remediation of these deficiencies in rural settings. We also outline a rationale for enhancing mental health services in long-term care. We then discuss new approaches that have been implemented or could be used to effect positive transformations in the delivery of mental health services to rural long-term care populations. We underscore the potential for synergies between these innovations and provisions introduced under the Affordable Care Act (ACA) of 2010. Finally, we delineate policy considerations for promoting new mental health service models in rural long-term care settings.

Suggested citation:

Talbot, J.A., & Coburn, A.F. (2013, June). Mental health services in rural long-term care: Challenges and opportunities for improvement. (Research & Policy Brief #50). Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center.

Publication Type: 
Research and Policy Brief
Publish Date: 
June 20, 2013
Author: 
URL: 
http://muskie.usm.maine.edu/Publications/MRHRC/Rural-Mental-Health-Services-LTC.pdf

Challenges and Opportunities for Improving Mental Health Services in Rural Long-Term Care

Abstract: 

Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. In this report (and accompanying Research & Policy Brief), we consider challenges and opportunities for improving mental health treatment delivered to long-term care recipients in rural settings. As background, we note the prevalence of mental health problems in long-term care populations, describe deficiencies in the mental health care afforded to long-term care recipients, and identify barriers that hinder the remediation of these deficiencies in rural settings. We also outline a rationale for enhancing mental health services in long-term care. We then discuss new approaches that have been implemented or could be used to effect positive transformations in the delivery of mental health services to rural long-term care populations. We underscore the potential for synergies between these innovations and provisions introduced under the Affordable Care Act (ACA) of 2010. Finally, we delineate policy considerations for promoting new mental health service models in rural long-term care settings.

Suggested citation:

Talbot, J.A., & Coburn, A.F. (2013, June). Challenges and opportunities for improving mental health services in rural long-term care. (Working Paper #50). Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center.

Publication Type: 
Report
Publish Date: 
June 20, 2013
URL: 
http://muskie.usm.maine.edu/Publications/MRHRC/WP50-Rural-Mental-Health-Services-LTC.pdf

Maine's Community Living Program: Implementation and Outcomes

Abstract: 

Over the last five years, options counseling has evolved from a general set of activities and functions within Area Agencies on Aging and Aging & Disability Resource Centers (AAAs/ADRCs) to a more standardized and generally accepted role within the Aging Network. With the award of the Community Living Program (CLP) grant in 2009, Maine proposed to develop more consistent methods for identifying people at risk of residential facility placement and to begin to develop standards for the options counseling functions. In 2010, Maine was also awarded an Options Counseling Standards Grant which has provided support for furthering the work started under the CLP grant.

Muskie School staff developed a Consumer Satisfaction Survey, A Survey of Options Counselors and Options Counselor Manager/Supervisor Survey. Results of the surveys and data from the follow-up form developed by the Steering Committee are included in the Outcomes section of this report. Muskie staff also conducted the evaluation of Maine's Options Counseling Standards Grant. The results of this evaluation are organized into two main sections: Implementation of Options Counseling which examines the processes, protocols and practices that were developed , and Outcomes which examines the implementation of the options counseling services along four dimensions:

  • Consumer Outcomes;
  • Staff Outcomes;
  • Organizational Outcomes; and
  • System Outcomes.

Suggested citation:

Fralich J, Richards M, Olsen L. Maine's Community Living Program: Implementation and Outcomes. Portland, ME: University of Southern Maine, Muskie School of Public Service; December 2011.

Publication Type: 
Report
Publish Date: 
December 30, 2011
URL: 
http://muskie.usm.maine.edu/Publications/DA/Maine-Community-Living-Program-Implementation-Outcomes.pdf

"Homelike" Characteristics of Maine's Residential Services: A Survey of Maine's Residential Service Settings (2010). Chartbook.

Abstract: 

To better understand the nature of the residential facilities serving more than 19 percent of Maine’s Long Term Services and Supports (LTSS) population, the Maine Department of Health and Human Services commissioned the Muskie School to conduct a survey of residential facilities as part of its update to Maine’s LTSS profile. The goal of the Maine Residential Settings Characteristics Survey, conducted between July and September 2010, was to measure the "homelike" characteristics of residential settings.

The survey sample comprised a total of 636 facilities which included all licensed residential care facilities or private non-medical licensed institutions. The survey response rate was 82.9%, and survey questions collected information about the facilities' physical characteristics and features, services, resident characteristics, and policies relating to autonomy and privacy.

Suggested citation:

Fralich J, McGuire C, Griffin E. "Homelike" Characteristics of Maine's Residential Services: A Survey of Maine's Residential Service Settings (2010). (Chartbook).  Portland, ME: University of Southern Maine, Muskie School of Public Service; November 2012.

Publication Type: 
Report
Publish Date: 
November 1, 2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/ME-Residential-Facilities-Survey.pdf

Dementia Capable Project: Interviews with Employers who Direct Services of a Person with Dementia

Abstract: 

Citation: Fralich, J., Richards, M., Olsen, L., Bowe, T., Turyn, R., & Caswell, L. (2012, May). Dementia Capable Project: Interviews with employers who direct services of a person with dementia. Portland, ME: University of Southern Maine, Muskie School of Public Service. This report was prepared for the Office of Elder Services, Maine Department of Health and Human Services under a Cooperative Agreement between the Muskie School of Public Service and the Maine Department of Health and Human Services. Funding for Maine's Dementia Capable Consumer Directed Grant was through the Administration on Aging Alzheimer's Disease and Supportive Services Program (ADSSP) and the Maine Department of Health and Human Services, Office of Elder Services, grant number 90AI0028/01.

Publication Type: 
Report
Publish Date: 
May 1, 2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/Dementia-Capable-Project-Employers.pdf

Community Partnerships for Older Adults: A Case Study

Abstract: 

Over the past several decades, federal policy has made states and communities increasingly more responsible for providing long-term care for older adults. The Community Partnerships for Older Adults, a national program of The Robert Wood Johnson Foundation, saw this as an opportunity to explore new, sustainable ways to meet current and future needs for community-based longterm care. This initiative focuses on collaborative organizational partnerships, a distinctive philosophy of teaching and learning through the exchange of experience between communities, and program learning focusing on known factors promoting organizational sustainability. Using principles that emphasize the development of social capital and collective efficacy, the authors present a case study of the early experiences of this initiative to address the challenges inherent in meeting the growing supportive service needs of older adults. The implications of this multisite community intervention for social work education and practice in aging are discussed.

Publication Type: 
Journal Article
Publish Date: 
September 1, 2005
URL: 
http://www.familiesinsociety.org/Show.asp?override=true&docid=3439

Pages

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