Report

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.

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:

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.

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.