This is the first in a series of papers synthesizing the ideas and practices of states as they improve the quality of home and community based services (HCBS) and supports for older persons and persons with disabilities. Building on the experiences and challenges of the QA/QI Systems Change grantees, the paper addresses four fundamental questions about quality management. The intent is to provide an account of current practice, and a structure for how states view their options. There are two parts to this document, a Discussion Paper and the Appendices, each contained in separate pdf files. The Appendices may be downloaded at http://muskie.usm.maine.edu/Publications/DA/HCBS_QMrolesAppendices.pdf
This Guide is designed to assist policymakers, courts and attorneys in deliberations and decision-making on enabling legislation, licensing standards, rules of court, appointment letters or contracts, and the scope of appropriate authority and functions for court-appointed parent coordinators. The Guide also offers courts and attorneys a yardstick for assessing the propriety of engaging parent coordinators in various types of child custody cases, especially those cases in which domestic violence is alleged by a party or included in a court's findings of fact. The Guide provides information about law and practice related to parent coordination services and then raises issues for consideration by those contemplating the establishment of parent coordination services to support courts and/or families in child custody dispute processes, in particular the issues raised when domestic violence is present.
Well-designed wellness programs can keep healthy employees healthy, support employees with health risks to improve their health behaviors, and facilitate organizational efforts to achieve workforce performance goals. Productivity lost through absenteeism, sickness, and injury was a key driver for the development of the Maine Department of Transportation (DOT) Region 5 wellness program, offered since 2004. In 2008, the Maine DOT engages the University of Southern Maine's Muskie School of Public Service to create a more robust and sustainable evaluation process for their employee wellness initiative, as assist in planning to replicate the Region 5 program across the state. The Muskie School evaluation team developed a logic model as the cornerstone for determining the components for program evaluation. The desired outcome of a "safe, injury-free work environment that costs less to maintain and operates at full capacity" provided the direction to develop activities, inputs, outputs, and short-term outcomes.
This is the second of three papers synthesizing the ideas and practices of states as they seek to improve the quality of home and community based services (HCBS) and supports for older persons and persons with disabilities.
In 2003, the Centers for Medicare & Medicaid Services (CMS) awarded grants to 19 states to enhance their quality management (QM) programs for HCBS programs. CMS contracted with the Community Living Exchange Collaborative to assist states in their grant activities by promoting information exchange and facilitating discussions on topics of common interest. As part of its work with the Community Living Exchange Collaborative, the Muskie School of Public Service, together with grantee states, identified three priority topics for working papers:
1. Quality Management (QM) Roles and Responsibilities
2. Discovery Methods for Remediation and Quality Improvement
3. Data Analysis and Use of Performance Measures
This paper will specifically address the following questions:
Why are discovery methods important?
What are the outcomes that discovery methods seek to assess?
What is a discovery method?
What are the features of a reliable and robust system of discovery methods?
What is a comprehensive yet focused system of discovery methods?
What evidence or other reports are produced from the discovery methods?
An annual publication of Maine's Commission on Disability and Employment and the CHOICES CEO Project. This document is also available in alternative formats upon request by calling (207) 228-8031 or email firstname.lastname@example.org
This paper describes the EMS-related projects that the 45 states receiving funding from the Medicare Rural Hospital Flexibility (Flex) Program proposed to conduct in fiscal year 2004-2005. Since the first full year of funding, the number and range of EMS improvement activities proposed has increased substantially. Because of the variability across states in the specifics of EMS activities proposed in grant applications, a method was sought that would create a logical framework for classifying activities, in order to better understand the types of EMS challenges that states are trying to address with Flex funding. The project team identified the Rural and Frontier EMS Agenda for the Future (R/F Agenda) as an appropriate guide document for cataloging and describing state proposed activities. The EMS activities were assigned to one or more of fourteen EMS attributes from the R/F Agenda. State Flex grant funds are not sufficient to ameliorate all rural EMS problems. Use of the R/F Agenda for classifying state Flex activities not only allows for identification of EMS problem areas that are most frequently being addressed with the use of Flex grant funds, but also identifies those challenges that likely need to be addressed through other mechanisms. This report will provide the EMS, rural health, and federal policy constituencies with an overview of the extent to which nationally recognized rural EMS challenges are being addressed with Flex program funding.
Findings from the project, as well as a preliminary analysis of MaineCare (Medicaid) policies, are presented in this report. The focus of the report is personal care services through MaineCare funding, with a specific focus on services in the workplace. This preliminary report is designed to provide a basis for further research needed to determine personal care needs, demand, cost, benefit, or the impact of policies or practices.
The authors studied the early impact of Part D on older or disabled Medicaid beneficiaries who had prescription drug coverage prior to Part D through MaineCare ("dual eligibles") or the DEL benefit; local and statewide organizations that work with and advocate for Medicare beneficiaries, which often stepped forward to help make Part D work for the beneficiaries; and Medicare beneficiaries who were not duals or DEL enrollees.
This document summarizes results from a full report on postsecondary outcomes among Maine DVR participants. For more information about this study, please contact Nathaniel Anderson, Muskie School of Public Service, PO Box 9300, Portland, ME 04104-9300; email@example.com
Presenting numbers and patterns is a critical component of data analysis. Once analyses have been completed, the next step involves sharing key findings with staff and stakeholders and using findings as a basis for decision-making. There are a number of ways to present data and the challenge is in constructing an effective visual. This paper provides an overview of the most frequently used formats and includes tips on how to select among the different types.