Medicine and Health Sciences Commons^™

Financial Alignment Initiative: New York Fully Integrated Duals Advantage For Individuals With Intellectual And Developmental Disabilities: Preliminary Third Evaluation Report, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Amy Kandilow Phd, Matthew Toth Phd, Amy Chepaitis Phd

Disability & Aging

The New York FIDA-IDD demonstration was launched in 2016 in nine downstate counties and was the first comprehensive managed care demonstration exclusively serving individuals with intellectual and developmental disabilities (IDD) in the nation. Due at least in part to a lack of provider participation, less than 8 percent of eligible beneficiaries enrolled. Beneficiaries who did enroll reported high levels of satisfaction, especially with care coordination and the ease of obtaining durable medical equipment. The MedicareMedicaid Plan’s (MMP) assessment and care coordination model provided person-centered care planning that identified goals and helped to achieve them, improving enrollees’ quality of life. The …

Adult Day Services In Maine: Benefits, Challenges, And Opportunities, Elizabeth Gattine Jd, Eileen Griffin Jd, Kimberly I. Snow Mhsa, Ba

Disability & Aging

In Maine and nationally, adult day services tend to be underfunded and underutilized compared to other types of long term services and supports (LTSS). In part, investment in adult day services is hampered by a lack of standardized data collection and limited research on issues of accessibility, cost-effectiveness, and the impact of adult day services on the broader health system. Lack of uniformity in state regulatory frameworks for licensing, program design, service delivery, and other administrative requirements further complicates cross-state comparisons. Considering these limitations, a key goal of this report is to provide a more detailed and comprehensive understanding of …

The Role Of The Opioid Crisis In Elder Abuse, Kimberly I. Snow Mhsa, Jennifer Pratt, Stuart Bratesman Mpp

Disability & Aging

As the opioid crisis has deepened over the past twenty years, its effect on individuals and families, including older adults, has grown. To find out how the opioid crisis might be impacting elder abuse, neglect, and exploitation in Maine, we conducted a mixed methods analysis of 2015-2018 Maine Adult Protective Services (APS) investigations to determine: 1) Did opioid-related investigations increase over time? 2) Do investigations involving opioid misuse or abuse differ from investigations that don’t involve opioids? 3) What themes or features of cases involving opioid misuse or abuse by clients and/or perpetrators emerge from the data?

Key Findings: The …

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 …

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 …

Living With A Brain Injury In Maine: Individual Experiences, Perceptions, And Needs, Mary Lou Ciolfi, Eileen Griffin Jd, Jennifer Pratt, Mark Richards Bs, Sherry Gildard, Beatrice Byrne

Disability & Aging

Maine has been recognized for its recent progress in improving the lives of person with brain injury within the state. This report is the third brain injury report over the past ten years as Maine continues in its efforts to understand the service needs of persons with brain injury, broaden awareness of the impact of a brain injury, improve treatment options, and ultimately prevent brain injuries, especially in vulnerable populations. The information gained through a survey and through focus group discussions provides further context for upcoming brain injury policy decisions and resource allocation. While the causes and consequences of brain …

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

A Review Of Mental Health Rehabilitation Technician Qualifications And Training Procedures, Kimberly I. Snow Mhsa, Ba, Nadine Erdis Msw, Janice Daley Msw

Disability & Aging

This report was prepared by Kimberly Irvin Snow, Nadine Edris, and Janice Daley of the University of Southern Maine's Muskie School of Public Service and submitted to the Maine Department of Health and Human Service, Office of Substance Abuse and Mental Health Services. Results of this report were also presented in a webinar on November 21, 2014.

The authors investigated the training and certification processes used by other states for their mental health case management workforce. Ten states were selected for indepth comparative review because they provide a certification process for case managers, provide case management services similar to those …

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.

Personal Experiences With Long Term Care Services And Supports, Julie Fralich Mba, Mark Richards Ba, Louise Olsen, Vanessa Bell, Jennifer Pratt

Disability & Aging

This report captures, in a direct way, the first hand experiences of older and disabled consumers of long term care services and supports. In addition, it includes the collective experiences of eight Maine communities regarding the long term care service delivery system in our state.

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.

Snapshot 2011: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

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).

Systems Change In Employment Services For Persons With Serious And Persistent Mental Illness In Maine: Status Report 2006-2009, Helen Hemminger Mmhs, Nadine Edris Msw

Disability & Aging

Employment for people with serious and persistent mental illness (SPMI) is a complex issue impacted by numerous factors. Research studies have documented how integral employment is to recovery; nonetheless, employment rates among this population remain low. Additional studies have documented the barriers to achieving successful employment outcomes, yet resolving these barriers remains a compelling challenge. Compounding this, the national economic recession has brought unemployment rates to extremely high levels for everyone. Maine is faring a bit better than the national average but Maine’s unemployment rate has increased each of the last three years to its current 8.1 % level. Coupled …

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.

Snapshot 2010: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

It's Your Life: Building Connections Through Work - Project Summary Report, Sherrie Winton Med

Disability & Aging

This report gives a detailed description of It's Your Life: Building Connections Through Work project from design, to implementation and evaluation of the workshop sessions. It is our hope that you enjoy learning about this project and that professionals working in the rehabilitation field continue to seek out opportunities to provide co-training models, partnering with adults with disabilities to train their peers.

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 …

State Report Of Unmet Needs For Quarter 3 Fy '09 (Jan- Mar '09), Helen Hemminger Mmhs

Disability & Aging

No abstract provided.

Isp Indicators / Combined Report, Helen Hemminger Mmhs

Disability & Aging

No abstract provided.