Health Policy Commons^™

Characteristics Of Working Supplemental Nutrition Assistance Program Recipients In Maine, According To The 2011 American Community Survey, Victoria Ryan

Muskie School Capstones and Dissertations

The Supplemental Nutrition Assistance Program (SNAP) is a federal program administered by the United States Department of Agriculture (USDA). SNAP is designed to provide assistance in purchasing food to low income households in the United States. In Maine, individual benefits are administered by the Maine Department of Health and Human Services. Formerly (and still colloquially) known as the Food Stamp program, SNAP makes a dollar-value benefit, based on income, household size, household expenses, and a host of other factors, available to households via a debit or Electronic Benefit Card for the purchase of unprepared food from grocery and convenience stores, …

The Price Of A Healthy Diet: For Whom Is It Affordable?, Katheryn L. Harkleroad

Muskie School Capstones and Dissertations

This exploratory study addressed the gaps that current research has ignored. What have been missing are studies that focus on tangible costs of realistic, practical, and healthy meal plans. This study was not intended to measure a national average cost of eating a healthy diet. Rather, its focus was to examine the cost of healthy diet in a specific location.

An Assessment Of The Health Needs Of Maine Veterans And Their Access To Veterans Administration Health Care Services, Kristin Brawn

Muskie School Capstones and Dissertations

On a state level, only a few assessments have been conducted, which indicate that Maine veterans are also experiencing similar mental and physical health issues; however, it does not appear that the adequacy of Maine’s VHA services to meet the needs of Maine’s veterans has been comprehensively evaluated. It is unknown whether the physical and mental health needs of Maine’s veterans are currently being met. Therefore, this project proposes to determine if there is a similar problem among Maine’s veterans in regard to health issues and lack of access to VHA health services, as has been reported at the national …

Safe Routes For Portland: A Comparative Analysis Of The Walking School Bus Model For Maine Schools., Rebecca Spitko

Muskie School Capstones and Dissertations

This purpose of this paper is to identify the effects an increase in active transportation to and from school would have on both commuters and communities, and to examine how to create a successful environment for active transportation models in Maine.

Maine Child Welfare Ncands Data: An Available Tool In Efforts To Reduce Child Maltreatment, Leah A. Bruns

Muskie School Capstones and Dissertations

By not developing programming interventions in recognition of these evidence supported predictive variables, we risk the inevitable continuation of rising child abuse rates and fatalities. The importance of accurate Child Welfare Data cannot be underscored, if we can predict with great accuracy which children will likely be victimized, then we should be able to design targeted abuse prevention programs that will have a greater impact. In light of this research this capstone attempts to better understand child maltreatment, recurrence, and the current 4 child welfare service structure 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 …

An Analysis Of Employment Policies And Their Effect On Work-Life Balance For Caregiving Parents Of Children With Special Needs, Sara Panella

Muskie School Capstones and Dissertations

This capstone addresses the work-­‐life conflict facing employed caregiver parents with special needs children by 1) identifying what employed parents of children with disabilities need from their employer in order to achieve a work-­‐life balance that improves economic security and emotional well-­‐being, and 2) evaluating how well policies address those needs. An investigation of work-­‐family conflict and stress among parents of special needs children is conducted by examining the current literature and conducting interviews with caregivers to explore their work-­‐life balance needs. Policy recommendations are provided, based on an analysis of public and workplace policies currently in use and policy …

Rural Children Experience Different Rates Of Mental Health Diagnosis And Treatment, David Hartley Phd, Mph, Jennifer D. Lenardson Mhs, Nathaniel J. Anderson Ms, Mph, Samantha J. Neuwirth Md

Mental Health / Substance Use Disorders

Research indicates that privately insured, rural adults have lower use of office-based mental health services, but higher use of prescription medicines than their urban counterparts. Patterns for rural children may be different from urban children because of the limited supply of pediatric mental health providers in rural areas, which may lead to reduced access and lower use of mental health services in rural areas versus urban. Using data on children ages 5-17 from the 2002-2008 of the Medical Expenditure Panel Survey, researchers from the Maine Rural Health Research Center find that rural children are significantly less likely to be diagnosed …

Improving Health Outcomes For Children (Ihoc): Summary Of Pediatric Quality Measures For Children Enrolled In Mainecare Ffy 2009 - Ffy 2012, Nathaniel J. Anderson Ms, Mph, Tracey Meagher

Population Health & Health Policy

his report, authored by USM Muskie School research staff, presents the results of the 16 CHIPRA Core Measures that were collected using MaineCare claims or Vital Statistics data and reported in the State of Maine’s FFY 2012 CHIP Annual Report to the Centers for Medicare and Medicaid Services (CMS). Also included in this report are an additional three measures from the Improving Health Outcomes for Children (IHOC) project’s Master List of Pediatric Measures. In addition to presenting results in graphs and narrative, this report also provides measure definitions and background information about each measure topic.

The goal of this document …

Global Budgets, Payment Reform And Single Payer: Understanding Vemont's Health Reform, Trish Riley

Population Health & Health Policy

The Muskie School of Public Service hosted two health policy colloquia this April to promote informed discussion throughout the state regarding MaineCare coverage options under the ACA and the implications of Vermont’s move toward a single-payer system.The series, sponsored by the Muskie School Board of Visitors, offers community conversations in which experts from various disciplines and perspectives inform and engage the broader public to explore and debate critical policy issues. On April 22, community and sector leaders joined for Global Budgets, Payment Reform, and Single Payer: Understanding Vermont's Health Reform. Participants discussed Vermont's recent movie toward single payer health …

Improving Health Outcomes For Children (Ihoc) First Steps Phase I Initiative: Improving Immunizations For Children And Adolescents, Kimberley S. Fox Mpa, Carolyn E. Gray Mph

Population Health & Health Policy

This report, co-authored by Kimberley Fox and Carolyn Gray, provides a final evaluation of the initial phase of First STEPS (Strengthening Together Early Preventive Services), a learning collaborative led by Maine Quality Counts to support 24 pediatric and family practices in improving their childhood immunization rates. The evaluation found that all participating practices had higher immunization rates after participating in First STEPS. On average, overall child immunization rates increased by 5.1% at 12 months and 7.1% at 15 months, and average immunization rates across practices increased significantly from 74.2% to 81.3%. Practices also reported significant improvement in the use of …

Examining Mainecare’S Coverage Options Under The Affordable Care Act, Erika C. Ziller Phd, Trish Riley

Population Health & Health Policy

The Affordable Care Act (ACA) was designed to achieve nearly universal access to health coverage in the United States—in part by standardizing Medicaid eligibility across the country so that each state’s program would cover individuals with incomes below 138% of the federal poverty level (FPL), or $15,856 for an individual and $32,499 for a family of four in 2013 (see Figure 1).i However, in June 2012, the U.S. Supreme Court determined that states could not be required to broaden Medicaid and retained the decision as a state option. States that choose to participate may do so by amending their state …

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 …

Federal Health Care Reform: An Overview, Andrew F. Coburn Phd

Population Health & Health Policy

This policy brief discusses three of the main components of the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare". These components are helath insurance coverage, delivery system improvement, and cost containment. The policy brief highlights some of the provision of the law that have already been implemented and those where importnat implementation decisions will have to be made. The brief is authored by Dr. Andrew Coburn, PhD, Professor of Public Health and Director of the Population Health and Health Policy program at the USM Muskie School, and was presented at the Maine Policy Leaders Academy Health Care …

Rural Acute Myocardial Infarction Survey (Ramis), Nikiah Nudell Ba, Nrp, Tom Bouthillet Nremt-P, Don Rice Md, John A. Gale Ms, Gary Wingrove Emt-P

Rural Hospitals (Flex Program)

The purpose of this study is to evaluate why current treatment goals for patients with Acute Myocardial Infarction (AMI) are not being achieved despite a large body of evidence supporting regionalized ST Elevation Myocardial Infarction (STEMI) systems. An online survey tool,developed by the research project team, was used to poll the Critical Access Hospitals in Nebraska in order to understand delay factors and other barriers to executing a STEMI system in a rural area. The authors found that the rural STEMI care system lacks a coordinated systems considered to be essential for urban areas. Several areas of potential failure in …

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 …

Improving Nursing Home Patient Safety In Maine: A Review Of The Ahrq Patient Safety Culture Survey Implementation Process, Andrea Fenner-Koepp

Muskie School Capstones and Dissertations

An organization’s patient safety culture has a powerful influence on the behaviors, strategies, and clinical outcomes of healthcare organizations. The Agency for Healthcare Research & Quality (AHRQ) Patient Safety Culture Survey has been deemed an effective tool for assessing patient safety culture and driving improvement initiatives. There has been little done to assess the quality of patient safety culture in long-term care facilities and, specifically, Maine has not collectively established baseline measures of patient safety culture in nursing home. This capstone reviews the implementation process of the AHRQ Patient Safety Culture Survey in five rural nursing facility pilot sites.

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.

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 …

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

Disability & Aging

No abstract provided.

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

Disability & Aging

No abstract provided.

Performance Measures And Pilot Evaluation Of Georgia’S Medical Assistance Program For Population Below The Poverty Line, Tamar Chitashvili

Muskie School Capstones and Dissertations

In recent years the Georgian health care system has been undergoing fundamental reforms aimed at improving the population’s health status by increasing financial and geographic access to high-quality health care. To address limited financial access to health services of the poor, and protect them from catastrophic expenditures associated with illnesses and improve equity, the government restructured the centralized, financially and administratively unsustainable social security system, with a liberal welfare system focusing on providing a safety net for the poor.

A Community Benefit Reporting Toolkit For Critical Access Hospitals, John A. Gale Ms, Melanie Race Ms

Rural Hospitals (Flex Program)

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 …