Public Policy 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 …

Economic Security Of Older Women In Maine, Kimberly I. Snow Mhsa, Elizabeth Gattine Jd, Sammy-Ellie Mackinnon Msw

Disability & Aging

The Economic Security of Older Women in Maine: Data Report provides a snapshot of how women compare to men on measures such as wages and income, caregiving status, living arrangements, and rates of disability—factors that can impact Maine women's ability to meet their needs with the resources they have. The report, compiled by staff at the University of Southern Maine's Cutler Institute, informs an initiative led by the Maine Women's Lobby Education Fund and the Maine Council on Aging to identify gaps and pathways to support the health and economic security of older Maine women and all Mainers, now and …

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.

An Analysis Of The Universal Home Care Program: Considerations For Implementation With The Context Of Maine's Existing Ltss Programs, Eileen J. Griffin Jd, Elizabeth C. Gattine Jd, Louise Olsen, Stuart Bratesman Mpp

Disability & Aging

A citizen initiative on the November 2018 ballot (Question 1, An Act to Establish Universal Home Care for Seniors and Persons with Disabilities) would establish a "Universal Home Care Program" (UHC Program) to serve older adults and persons with a disability living in Maine. This report does not constitute either support for or opposition to the referendum but is intended as an independent assessment of how the UHC Program could be implemented if it were to be approved by Maine voters. This analysis focuses on the implications of the UHC Program within the context of the Medicaid and …

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, …

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 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.

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 …

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 …

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 …

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.

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.

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.

Overview Of Mapping Applications In Health Research, Helen Hemminger Mmhs

Disability & Aging

No abstract provided.

Snapshot 2008: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

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 …

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, …

Addressing Potential Conflicts Of Interest Arising From The Multiple Roles Of Colorado’S Community Centered Boards, Maureen Booth Mrp, Ma, Eileen Griffin Jd

Disability & Aging

This document summarizes the information we gathered, our analysis of potential conflicts of interest, and recommendations for addressing opportunities for improvement. The information we gathered is based on document review, input from stakeholders, and a review of practices in four other states.

Maine State Employee Survey On Disability, Commission On Disability And Employment, Department Of Financial And Administrative Services Bureau Of Human Resources, Muskie School Of Public Service University Of Southern Maine

Disability & Aging

The Executive Order regarding Maine State Government as a Model Employer of people with disabilities was signed on February 24, 2006. The order included several action steps, including a survey of State employees to ascertain the prevalence of workers with disabilities in State employment.

Maine’s Bureau of Human Resources and the Commission on Disability and Employment were named to oversee this survey. The University of Southern Maine’s Muskie School of Public Service administered the survey and analyzed results. Each of these three organizations are members of an Executive Order Working Group designed to overall all action steps under the Executive …

Final Report Technical Assistance To Improve Quality Oversight Of The Oklahoma Advantage Waiver, Maureen Booth, Louise Olsen

Disability & Aging

No abstract provided.

The Impact Of Medicare Special Needs Plans On State Procurement Strategies For Dually Eligible Beneficiaries In Long-Term Care, Paul Saucier, Brian Burwell, Thomson Medstat

Disability & Aging

No abstract provided.