Digital Commons Network^™

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 …

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 …

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.

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 …

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

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 …

Providing Long Term Services & Supports To People With Impaired Decision-Making Capacity: Results Of Data Analysis And Interviews Examining Needs And Characteristics Of Persons With Impaired Decision-Making Capacity In Maine, Eileen Griffin Jd, Louise Olsen, Julie T. Fralich Mba

Disability & Aging

This document:

• Reviews the prevalence of impaired decision-making capacity among adults and older adults receiving publicly funded home care services and supports in Maine, the characteristics of this population group, and the caregivers caring for persons with impaired decision-making capacity.
• Reports on interviews with providers describing their ideas for helping people with impaired decisionmaking capacity live in the community longer.
• Reviews the legal status of persons receiving long term services and supports in Maine, including the presence of a guardian or a Power of Attorney, among those with impaired decision-making capacity across settings.
• Reports on interviews with providers, describing kinds …

Managing A High-Performance Medicaid Program, Eileen Griffin Jd, Trish Riley, Vikki Wachino, Robin Rudowitz

Disability & Aging

Today, the Medicaid program is evolving more rapidly than at any other time in its fifty-year history. States and the federal government are working to maximize the value and efficiency of Medicaid by reforming payment to reward value over volume, integrating effective care coordination across payers, and streamlining key processes like eligibility determinations across coverage programs. Underpinning a state’s ability to implement these reforms is its capacity to manage its Medicaid program effectively and efficiently.

This paper discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states …

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

Satisfaction Survey Results And Lessons Learned: Maine's Aging & Disability Resource Center (Adrc) Project, Julie T. Fralich Mba, Louise Olsen, Mark Richards Bs, Jennifer Pratt, Taryn Bowe

Disability & Aging

The primary goal of Maine’s Aging and Disability Resource Center (ADRC) Project was to empower consumers to make informed decisions about long-term services and supports and to streamline access to existing services and supports through an integrated system. With funding from the Administration on Aging to strengthen and expand the number of Aging and Disability Resource Centers (ADRCs) in the state, all five of the Area Agencies on Aging were committed to becoming and/or strengthening their capacity to be fully functioning ADRCs.

This report provides a summary of the results of consumer satisfaction surveys that were conducted for three years …

Maine Direct Service Workforce Survey Results 2012 [Chartbook], Julie T. Fralich Mba, Eileen Griffin Jd, Danielle Wescott

Disability & Aging

Direct service workers play a central role in the quality of the long-term services and supports provided to older people and people with disabilities in home and community settings. Nationally, and at the state level, there is a critical need for more information about this workforce in order to inform workforce policy and measure improvements in workforce quality and stability over time. Maine was one of seven states to administer baseline surveys under a grant funded by the U.S. Centers for Medicare and Medicaid Service. Survey questions focused on workforce volume, stability, and compensation, as well as, cultural competence, workforce …

"Homelike" Characteristics Of Maine's Residential Services: A Survey Of Maine's Residential Service Settings (2010), Julie T. Fralich Mba, Eileen Griffin Jd, Catherine Mcguire Bs

Disability & Aging

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 …

Members Dually Eligible For Mainecare And Medicare Benefits: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010., Catherine Mcguire Bs, Tina Gressani, Stuart Bratesman Mpp, Julie T. Fralich Mba, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. This first report provides a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008-2010. This report provides baseline data on the characteristics of Medicare-MaineCare members who are dually eligible, the distribution of expenditures across categories of service for MaineCare and Medicare, and the cost of care for people with select chronic conditions. The report includes information on …

Personal Experiences With Mainecare Services From People Who Use Elder And Adults With Disabilities Waiver And Private Duty Nursing/Personal Care Services., Julie T. Fralich Mba, Katherine Rosingana, Mark Richards Bs, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report provides the results from a survey and personal interviews that were conducted with MaineCare members who use long term services and supports -- specifically those who are on the Elder and Adults with Disabilities Waiver and those using Private Duty Nursing (PDN) Services. People who are eligible for these services generally need nursing care and assistance with a combination of activities of daily living (e.g. eating, toileting, mobility, transfer) and instrumental activities of daily living (e.g. meal preparation, grocery shopping, housework). People on the Waiver are medically eligible to be in a nursing home. The purpose of the …

Older Adults And Adults With Disabilities: Population And Service Use Trends In Maine, 2012 Edition, Julie T. Fralich Mba, Stuart Bratesman Mpp, Louise Olsen, Catherine Mcguire Bs, Jasper Ziller, Karen Mauney, Catherine Gunn

Disability & Aging

This Chartbook is an update to the Chartbook: Older Adults and Adults with Physical Disabilities: Population and Service Use Trends in Maine 2010. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services continues to be a critical public policy issue in the State and nationally. The information in this Chartbook is provided to help inform state policy makers, legislators, providers, advocates and others with an interest in this subject.

Maine's Community Living Program: Implementation And Outcomes, Julie T. Fralich Mba, Mark Richards Bs, Louise Olsen

Disability & Aging

In 2009, the Office of Elder Services, Maine Department of Health and Human Services (DHHS), was awarded a grant from the Administration on Aging (AoA) under its Community Living Program (CLP). The overall goal of the CLP announcement was to strengthen the capacity of the Aging Network to target and serve individuals at highest risk of residential facility placement by offering flexible services including consumer directed options. Over the last five years, options counseling has evolved from a general set of activities and functions within AAAs/ADRCs to a more standardized and generally accepted role within the Aging Network. With the …

Medicaid Managed Care: Background, Issues, And Options, Julie T. Fralich Mba

Disability & Aging

Managed care is a fundamental shift from the historical fee-for-service payment systems. It provides opportunities for states to transform the delivery and financing of Medicaid financed services and promote and reward improved care outcomes. Implementation of such programs requires thoughtful planning, active stakeholder engagement and an effective administrative infrastructure to manage and operate in a value based purchasing environment.

Summary Report Of The Mainecare Listening Sessions, Anush Yousefian Hansen Ms,Ma, Katherine Rosingana, Nadine Edris Msw

Disability & Aging

In September of 2010, the Muskie School of Public Service conducted four Listening Sessions with MaineCare members to gather in-depth information about their experiences on MaineCare, their likes and dislikes, and suggestions, needs and wants for improving the program. The overall goal of these sessions was to provide rich information to help inform DHHS in their design of a new managed care initiative. Funding for this project was provided by the Maine Health Access Foundation (MeHAF).

Older Adults And Adults With Disabilities: Population And Service Use Trends In Maine, 2010 Edition, Julie T. Fralich Mba, Stuart Bratesman Mpp, Cathy Mcguire Bs, Louise Olsen

Disability & Aging

This chartbook is an update to the “Assessment of Maine’s Long-term Care Needs Baseline Report: Demographics and Use of Long Term Care Services in Maine” report that was produced in 2007. The Chartbook provides historical and projected trends in the demographics of Maine’s population. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services and supports surfaces as a key issue of public policy. We hope that the information contained in this report will be useful to state policy makers, legislators, providers, advocates and others with an interest …

Brain Injury In Maine: A Needs Assessment, Eileen Griffin Jd

Disability & Aging

This document reviews existing Maine policy and programs to evaluate how well they meet the needs of persons with brain injury.

Profiling Maine’S Long Term Support System [Project Brief], Eileen Griffin Jd

Disability & Aging

A recent report by the Muskie School and the Maine Department of Health and Human Services provides a new way of looking at the state’s long term support system. With an emphasis on developing a common approach for description and analysis across programs, the profile reveals that users of long term services and supports in Maine span all age groups and types of service users. In fact, 28% are ages 17 or younger and 29% are between the age of 35 and 64. Long term service users include people with physical impairments, cognitive and intellectual disabilities, and people who need …

Cross-System Profile Of Maine's Long Term Support System: A New View Of Maine's Long Term Services And Supports And The People Served, Eileen Griffin Jd, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Stuart Bratesman Mpp, Kathy Bubar, Romaine Turyn

Disability & Aging

This document provides a new way of looking at Maine's long term services and supports, with an emphasis on developing a common approach for describing and analyzing long term services and supports across programs. A conscious effort was made to organize this profile around the populations served rather than the programs serving them. For that reason, the profile captures information on all of the services accessed by each population group, not only those services administered by a particular program. This broader view provides important information about the full range of service utilization for each population group.

Housing Availability For Clients Of Oamhs By Community Service Network (Csn) Regions, Helen Hemminger Mmhs

Disability & Aging

This report is in response to a request made by Maine's Office of Adult Mental Health Services (OAMHS) to the Muskie School to anlayze existing housing data at the level of the regional community service networks (CSNs) and present information regarding the availability of various housing options by CSNs.

The sections of this report are:

1. General Housing Affordability for Renter Households
2. Homelessness in Maine Based on the Annual Point in Time Survey
3. Inventory of Independent Housing for Adults with Mental Illness
4. Inventory of Supported Living Options for Adults with Mental Illness
5. Reported Unmet Housing Needs

Maine Cdc/Dhhs Demographics And Health Indicator Comparison Tables: Estimates For The Year 2006 And Projections For The Year 2015, Helen Hemminger Mmhs

Disability & Aging

The Maine CDC/DHHS Demographics and Health Indicator Comparision Tables were prepared July 2008 for Maine's Community Service Networks by the Muskie School for Public Service and the Office of Adult Mental Health Services. These tables are based on the District Profiles created by the Maine Center for Disease Control and using data from the US Census and the Maine State Planning Office.

Assessment Of Maine's Long-Term Care Needs Baseline Report: Demographics And Use Of Long Term Care Services In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Karen Mauney, Catherine Mcguire Bs, Louise Olsen, Jasper Ziller

Disability & Aging

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State.

For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness.

In this report, long term care services include:

• Nursing Facility Services
• Private Non-medical Institutions
• Consumer Directed Attendant Services
• Day Health Services
• Elder and …