Digital Commons Network^™

A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps

Emergency Medical Services (EMS)

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …

Assessing The Impact Of Inequality On Political Activity And Class Consciousness, Matthew Prouty

Thinking Matters Symposium

Since 1980, the United States has experienced stagnating wages, higher levels of inequality, and intensifying political polarization. Despite this, U.S. domestic economic policy has not undergone the fundamental transformation needed to combat these systemic challenges. Why have these policies remained in place when they have a negative impact on the aggregate working class, and why has the working class not used American Democracy to change these policies? Could it be that the rising inequality has led to reduced political engagement with the remaining voters being more devout participants to their ideology than effective policy? Although there is an abundance of …

Understanding How Nimby-Ism Shapes Portland, Maine’S Homeless Policies: A Qualitative Study, Eleanor Ginder

Thinking Matters Symposium

On June 17, 2019, after a prolonged period of community concern, the Portland City Council voted to relocate the city’s homeless shelter from the rapidly gentrifying Bayside neighborhood to a wooded area at the city limits. As municipal shelters continue to move away from metropolitan areas, the impact of NIMBY-ism on local and state policies related to homelessness cannot go unnoted. By analyzing publicly available testimony that occurred in the months after the decision to relocate, a variation of NIMBY-ism begins to emerge. This phenomenon, which could be referred to as “neo-NIMBY-ism” is characterized by individuals with lived experience of …

The Economic Impacts Of School Closure In Rural Maine, Heather Perry

Muskie School Dissertations

The purpose of this case study research was to examine the economic impact of school closures on three rural communities in Maine. I created a conceptual framework around six healthy community economic markers. Each of the six markers are studied in 2010 when schools were closed and then again in 2016. This data, in addition to perceptions data from stakeholders in each of the three communities was studied to determine if the closure of the school had any impact on these healthy economic markers. Findings suggest that there were no negative impact to the economic markers studied within the three …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

Adults Using Long Term Services And Supports: Population And Service Use Trends In Maine, Sfy 2016, Kimberly I. Snow Mhsa, Ba, Frances Jimenez Ba, Tina Gressani, Louise Olsen

Disability & Aging

All of us have likely either used, will use, or know someone who uses long term services and support (LTSS). They enable us to live with dignity and as much independence as possible and offer us the opportunity to remain involved and productive in our communities. The need for LTSS can arise suddenly after injury or illness or a life-long condition. But how ever the need arises, the impact is the same—services such as personal care, work support, home health care, and residential care provide not just for individual health and comfort, but also for interaction, inclusion, and engagement with …

Lg Ms 013 Equalitymaine Archives Finding Aid, Karin A. France

Search the Manuscript Collection (Finding Aids)

Description:

The Maine Lesbian/Gay Political Alliance (MLGPA) was formed in 1984 to advocate for LGBT issues and to educate the public, media, and politicians about them. Now known as EqualityMaine, over the last twenty-five years, the organization has worked to secure civil rights legislation, pass hate crimes protection laws, promote workplace equality and ensure responsible HIV/AIDS policies. The Archives contains organizational records of MLGPA and EqualityMaine, and other materials.

Date Range:

1984-2009

Size of Collection:

14.5 ft.

The Affordable Care Act’S Medicaid Expansion And Food Insecurity Rates, Mary Moran

Muskie School Capstones and Dissertations

Many Americans face difficult financial decisions, often regarding the allocation of limited resources. Household resources may be split among the costs of food, clothing, housing, transportation, childcare, utilities, and health care. For some households, this allocation may present a challenge to purchasing sufficient food, leading to food insecurity. Defined by the United States Department of Agriculture (USDA) as “a household-level economic and social condition of limited or uncertain access to adequate food” (2017), food insecurity may decrease when other financial-related aspects of life improve. An improvement in access to affordable health care, as seen through the recent Medicaid expansion under …

Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah T. Croll Mph, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd

Long Term Services and Supports

The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.

This study used Medicare Current …

Financial Exploitation Of Maine's Older Adults: An Analysis Of Maine Adult Protective Services And Legal Services For The Elderly Case Records, State Fiscal Years 2010-2016, Eileen Griffin Jd, Catherine Mcguire Bs, Kimberly I. Snow Mhsa, Ba

Disability & Aging

The goal of this study was to capture information about the amount of money Maine’s older adults have lost to financial exploitation, along with information about those exploited, the perpetrators of financial exploitation, the type of loss, and amount of money lost. This report summarizes key findings emerging from this analysis. In particular, we found that, when compared to Maine’s general population of adults age 60 and older, the victims of financial exploitation served by Maine's Adult Protective Services (APS) and Legal Services for the Elderly (LSE) are more likely to be age 80 and older, female; and widowed, single, …

Charting A Pathway Forward: Redesigning And Realigning Supports And Services For Maine's Older Adults, Eileen Griffin Jd, Elizabeth C. Gattine Jd

Disability & Aging

The current growth of the population age 65 and older is one of the most significant demographic trends in the history of this country and is especially significant for Maine, where the number of people age 65 and older is growing even faster than the rest of the nation. By 2025, over a quarter of Maine’s population is expected to be age 65 and older. Because the cost of long term paid support is out of reach for many Mainers, public financing—particularly Medicaid financing—is an essential tool for addressing the long term support needs of older adults. But Medicaid is …

Knowledge Of Health Insurance Concepts And The Affordable Care Act Among Rural Residents, Erika C. Ziller Phd

Health System Reform

Health insurance literacy is central to identifying eligibility for coverage and subsidies, choosing a plan, and using optimal healthcare services under the Affordable Care Act (ACA) or other insurance reform initiatives. To fully benefit from policy efforts to improve health insurance access, rural residents must have the ability to select the plan that best meets their healthcare needs. However, a higher proportion of rural residents possess characteristics that may put them at risk of lower health insurance literacy, including lower incomes and educational attainment, less experience with private insurance, and historically higher uninsured rates. Using Health Reform Monitoring Survey data …

Social Isolation And Loneliness In Older People: A Closer Look At Definitions, Mary Lou Ciolfi, Frances Jimenez Ba

Disability & Aging

Social isolation and loneliness are related and the terms are often used interchangeably, but they are distinct concepts with different definitions, health impacts, and interventions. Our population is aging and older people are at increased risk for both social isolation and loneliness and the associated negative health consequences. Understanding the important differences between social isolation and loneliness will help us recognize them earlier in vulnerable populations, engage in more meaningful conversations with older adults about their own risks, and will inform the development and delivery of more individualized, meaningful, and cost-effective interventions.

A Guide For Assessing Older Adults’ Needs On Maine Islands, Beatrice Byrne

Muskie School Capstones and Dissertations

This template may help Maine island communities identify older adults’ needs and island resources, in order to allow older adults to age in the island communities.

Three interviews with island health leaders, one community conversation with older islanders, and one pilot test provided information about what to include in the template.

The template includes a demographic survey, guides for conducting semi-structured interviews and group conversations with older adults and caregivers, a guide and worksheet for analyzing the data, a guide for assessing community resources, a guide for dissemination, and a list of additional resources.

The Role Of Public Versus Private Health Insurance In Ensuring Health Care Access & Affordability For Low-Income Rural Children, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Amanda Burgess Mppm

Access / Insurance

Medicaid and the Children’s Health Insurance Program (CHIP) have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of that coverage in ensuring access to affordable healthcare for rural children. Using data from the 2011-2012 National Survey of Children’s Health, this study …

A Secondary Analysis In Support Of The Community Health Needs Assessment For Oasis Free Clinics, Jillian Wheeler

Muskie School Capstones and Dissertations

Oasis Free Clinics offer free medical and dental services to uninsured, low income adults living in Sagadahoc County, Maine (with the exception of the town of Richmond) and the towns of Brunswick, Freeport, and Harpswell in Cumberland County and Durham in Androscoggin County. Oasis has filled a critical need in providing affordable health care to the working poor with the absence of Medicaid expansion in the state of Maine. The clinic offers wellness checks, women's wellness, prenatal care, chronic disease management, limited mental health counseling, a prescription assistance program and dental care.

Oasis Free Clinics will conduct a Community Health …

Adults Using Long-Term Services And Supports: Population And Service Use Trends In Maine, Sfy 2014, Kimberly I. Snow Mhsa, Ba, Tina Gressani, Louise Olsen, Catherine Mcguire Bs, Stuart Bratesman Mpp, Karen Mauney, Jason Theriault

Disability & Aging

Prepared by research staff at the University of Southern Maine's Muskie School of Public Service for the Maine Office of Aging and Disability Services (the Office), this chartbook provides information on Maine adults who use long term services and supports. This is the first chartbook to reflect all the populations served by the Office: older adults; adults with physical disabilities; adults with intellectual disabilities/autism spectrum disorder or other related conditions; and adults with acquired brain injury. Long term services and supports are a vital lifeline for the thousands of Maine adults who need them, and they account for a significant …

Pilot Testing A Rural Health Clinic Quality Measurement Reporting System, John A. Gale Ms, Anush Yousefian Hansen Ms,Ma, David Hartley Phd, Mha, Andrew F. Coburn Phd

Rural Health Clinics

More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities, and are therefore an important source of primary care and other essential health services for rural residents. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data on the financial, operational, and quality performance of participating clinics. In light of the significant expansion of quality performance reporting and growing use of performance-based payment approaches, it is critically important that RHCs be able to compete in this changing healthcare market. To this end, we piloted the reporting and use of a small set …

Promoting Active Living In Rural Communities, Anush Yousefian Hansen Ms, Ma, David Hartley Phd, Mha

Population Health

This brief summarizes current research on elements of the rural built environment that may be related to obesity or physical activity. Much of this research is qualitative in nature, including evidence and conclusions drawn from rural focus groups, PhotoVoice studies, policy statements, observations from the field, and lessons learned from rural active living interventions.

An Assessment Of The Built Environment And Inclusivity Of Older Adults In Community Planning In Portland, Maine, Elizabeth A. Bissonnette

Muskie School Capstones and Dissertations

This paper focuses on this assessment specific to four: civic participation, housing, transportation, and outdoor spaces and buildings. Four others targeted for study by others include respect and social inclusion, communication and information, community and health services, and social participation. Each domain is reviewed from the perspective of older adults and older although this assessment also benefits people of all ages and abilities. Some data and references were only available with population breakouts of those aged 65 years and older and are noted appropriately.

Adults With Intellectual Disability Or Autism Spectrum Disorder. Executive Summary, Kimberly I. Snow Mhsa, Ba, Stuart Bratesman Mpp, Taryn Bowe, Julie T. Fralich Mba

Disability & Aging

This chartbook describes Maine’s historical trends in meeting the needs of adults with ID/ASD through institutional and community based services in comparison to other states; a detailed analysis of the population’s utilization of different types of services and their costs in SFY 2010; the implementation of the Supports Intensity Scale (SIS) as a means of identifying the supports needs of the adults with ID/ASD; and the complement of providers serving this population in Maine.

Multiple Roles Of Medicaid ...And The Administrative Capacity To Support Them, Eileen Griffin Jd

Disability & Aging

Slides presented at the NAMD 2014 Fall Conference, November 4, 2014

Gender-Responsive Policy Development In Corrections: What We Know And Roadmaps For Change, Erica King Msw, Jillian Foley Mppm

Justice Policy

Lack of gender-informed policy creates challenges for correctional practitioners. When there is a gap between training that is evidence-based and gender-informed and what is written in policy, staff may find themselves hindered in their attempts to work toward establishing a gender-responsive environment. This policy bulletin, released in February 2015 and based on survey data and focus groups with women, is an initial step to determine the existence of gender-informed policy within correctional agencies. The findings of this bulletin provide an overview of the current state of gender-responsive policies for women and define a focus for future research, training and technical …

Improving Home Suitability For Aging In Place: A Review Of Programs To Assist Maine's Seniors Make Necessary Home Repairs And Energy Efficiency Updates, Andrea Westbye

Muskie School Capstones and Dissertations

With its median age of 42.7 years, Maine is the oldest state in the nation and it is getting older. The population 65 and older is growing at a rapid pace and this expansion presents many challenges to communities, particularly in the area of housing. Most seniors want to stay in their homes for as long as possible and adequate, accessible, safe, and affordable housing is a primary factor for successful aging in place. Low income seniors face additional difficulties when aging in place. This paper looks at the availability of home repair/modification and energy efficiency programs for Maine’s low …

A Vision For Berwick: A Case Study Of The Citizen Initiated Visioning Process For Downtown Redevelopment In Southern Maine, John Stoll

Muskie School Capstones and Dissertations

This Capstone follows the downtown redevelopment visioning process in Berwick from the initial presentation to Town Officials up until formal adoption as an addendum to the Comprehensive Plan. Berwick has a monumental task ahead of it as the Town looks to redevelop an 11 acre abandoned factory site that is located directly where a downtown should be. Residents of Berwick had to work with Town Staff to navigate a considerable amount of lingering controversy and to rebuild trust between the public and local government. Members of the Downtown Vision Committee worked tirelessly to reach out to the community through education …

Adults With Intellectual Disabilities Or Autism Spectrum Disorder: Population And Service Use Trends In Maine, 2014 Edition, Kimberly I. Snow Mhsa, Ba, Stuart Bratesman Mpp, Taryn Bowe, Julie T. Fralich Mba

Disability & Aging

This Chartbook is unique in its detailing of the service and costs of adults with intellectual disability or austim spectrum disorder (ID/ASD) in Maine.

Dementia In Maine: Characteristics, Care, And Cost Across Settings [Chartbook], Julie T. Fralich Mba, Stuart Bratesman Mpp, Louise Olsen, Catherine Mcguire Bs, Tina Gressani, Karen Mauney, Catherine Gunn, Romaine Turyn

Disability & Aging

This report provides a baseline picture of the current use of services by people with and without dementia in Maine.

Measurement, Monitoring, And Evaluation Of State Demonstrations To Integrate Care For Dual Eligible Individuals: Massachusetts Evaluation Design Plan., Julie T. Fralich Mba, Maureen Booth Mrp, Ma, Edith G. Walsh Phd, Angela M. Greene Ms, Mba, Melissa Morley Phd, Wayne Anderson Phd

Disability & Aging

CMS contracted with RTI International to monitor the implementation of all State demonstrations under the Financial Alignment Initiative, and to evaluate their impact on beneficiary experience, quality, utilization, and cost. The evaluation includes an aggregate evaluation and State-specific evaluations. This report describes the State-specific Evaluation Plan for the Massachusetts demonstration as of December 16, 2013. The evaluation activities may be revised if modifications are made to either the Massachusetts demonstration or to the activities described in the Aggregate Evaluation Plan (Walsh et al., 2013). Although this document will not be revised to address all changes that may occur, the annual …

Public Pensions And Debt In The State Of Maine, Ryan Knaus

Muskie School Capstones and Dissertations

Maine has taken important steps in recent years to reduce indebtedness and adequately fund their Public Employee Pension System (MainePERS), and is well-positioned relative to other U.S. states. The challenge for the State is to continue financing MainePERS and existing UALs with the same commitment, diligence and prudence.

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.