Medicine and Health Sciences Commons^™

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 …

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 …

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

Mainecare Stage A Health Homes Year 1 Report: Implementation Findings And Baseline Analysis, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana, Deborah A. Thayer Mba

Population Health & Health Policy

In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Affordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary …

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.

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 …

"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 …

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.

Analysis Of 2006 Maine Emergency Department Use: A Study Conducted On Behalf Of The Emergency Department Use Work Group Of The Maine Advisory Council On Health System Development, Carolyn E. Gray Mph, Catherine Mcguire Bs, Beth Kilbreth, Tamar Chitashvili

Population Health & Health Policy

This study, conducted on behalf of the Emergency Department Use Work Group of the Maine Advisory Council on Health System Development provides an analysis of visits to hospital emergency departments in Maine that took place in 2006. The study relied on two sources of data: a comprehensive file of hospital discharge records provided by the Maine Health Data Organization; and comprehensive claims records for most privately insured residents in Maine and most MaineCare members. The 2006 data used for this analysis pre-dated some of the initiatives undertaken by the Department of Human Services to improve access to primary care and …

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.

Barriers To Medicare Hospice Utilization: A Qualitative Study Of Maine's Medicare Hospice Providers, Judith B. Tupper Dhed, Ches, Cpps

Disability & Aging

This report, prepared for the Maine Hospice Council and funded by the Carpenter Foundation, presents findings of a qualitative study of barriers to hospice utilization. This study includes the perspectives of all 26 Medicare certified hospice providers in Maine. Significant findings of the qualitative study include: A continuing need to educate the general public about hospice and the Medicare benefit. Maine health care providers have low referral rates to the hospice programs and often misunderstand the regulations and guidelines of the hospice benefit. The referral process to hospice programs is based on fragile systems of communication, fraught with potential miscues, …

A Review Of The Literature On End-Of-Life Care: Setting A Research Agenda For Maine, Julie T. Fralich Mba, Jennifer D. Lenardson Mhs, Hillary Skillings

Disability & Aging

In 2002, Last Acts, a national campaign of the Robert Wood Johnson Foundation, issued a report assessing the states on access to end-of-life care and policies supporting its provision. Quite striking for the hospice providers and other stakeholders of Maine, the state ranked second to last in hospice use among persons over age 65 in their last year of life. Although anecdotal and unpublished data suggest that hospice use is on the rise in Maine, concerns about the low use rate remains a concern to those interested in end-of-life care in the State.

In order to better understand the factors …

Use Of The §1915 (C) Federal Waiver Application: The Experience Of Eight States, Maureen Booth Mrp, Ma, Julie T. Fralich Mba, Hilary Skillings

Disability & Aging

Research staff at the Muskie School of Public Service, USM were requested to evaluate the effectiveness of the revised HCBS waiver application process from the perspective of states. This report summarizes the purpose, scope, approach and findings of the evaluation. The evaluation was designed to provide qualitative information on states' experience using the new HCBS waiver application for initial and renewal waiver applications. The evaluation examined four major issues:

Clarity/Consistency

: Are the waiver application components (Application, Technical Guide, Review Criteria) clearly understood and do they promote consistent interpretation?

Relevancy/Adequacy

:Do the application components address the range of waivers and …

Caring For People With Alzheimer's Disease Or Dementia In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Romaine Turyn

Disability & Aging

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being.

Housing And Service Options For Older Adults In Maine, Julie T. Fralich Mba, Kate Maggioncalda

Disability & Aging

Older adults want to live at home and in their community as independently as possible for as long as possible (Bayer & Harper L, 2000). The housing and service needs of older adults vary greatly by age, by condition, by setting, by geographic region, and over time. Some older adults do not require any supportive services; others need services that may range from assistance with shopping to extensive need for nursing care. Needs also fluctuate in response to acute events (often requiring hospitalizations), or other temporary changes in health status. The challenge is to have a mix of private and …

Performance Measurement: Managing And Using Home And Community-Based Services Data For Quality Improvement, Maureen Booth Mrp, Ma, Julie T. Fralich Mba

Disability & Aging

The Data Management and Use Series represents the third in a group 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.

Reporting: Managing And Using Home And Community-Based Services Data For Quality Improvement, Taryn Bowe, Maureen Booth Mrp, Ma, Stuart Bratesman Mpp, Julie T. Fralich Mba

Disability & Aging

The Data Management and Use Series represents the third in a group 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.

Data Quality And Analysis: Managing And Using Home And Community-Based Services Data For Quality Improvement, Julie T. Fralich Mba, Maureen Booth Mrp, Ma, Robert G. Keith Phd

Disability & Aging

The Data Management and Use Series represents the third in a group 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.

Results Of The Maine Experience Survey: Adults With Physical Disabilities Consumer Directed Waiver, Carolyn E. Gray Mph, Louise Olsen, Julie T. Fralich Mba

Disability & Aging

As a part of the grant activities of the Real Choice Systems Change grant from the Centers for Medicare & Medicaid (CMS), the need for a survey of consumers on the Consumer Directed Physically Disabled Waiver (also called the Consumer Directed or CD Waiver) was identified. This report provides the results of the in-home survey that was conducted by the Muskie School. The CD Waiver serves people age eighteen and older with severe physical disabilities that meet nursing facility level of care, are their own guardian and have the ability and desire to self-direct the personal care services they receive …

Discovery Methods For Remediation And Quality Improvement In Home And Community Based Services, Julie T. Fralich Mba, Maureen Booth Mrp, Ma, Carolyn E. Gray Mph, Taryn Bowe, Stuart Bratesman Mpp

Disability & Aging

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.