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Environmental Scan of Measures for Medicaid Title XIX Home and Community-Based Services

Appendix V (continued)

Table of Contents

Table A.V.3a. Tested Program Performance Measures

I. Access to Case Management

Measure	Source	Notes
Ability to identify case manager	Participant Experience Survey	Supported by all three survey versions
Ability to contact case manager	Participant Experience Survey	Supported by all three survey versions
Case manager effectiveness and competency (18 indicators)	National Core Indicators Case Management Measures	Individuals with intellectual disabilities. Data for indicators drawn from time measurement studies and consumer surveys.
Ability to identify case manager/support coordinator	National Core Indicators Consumer Survey	Individuals with intellectual or developmental disabilities
Case management for dual diagnosis; case management for medical comorbidity	Center for Quality Assessment and Improvement in Mental Health; quality measures	Persons with severe and persistent mental illness in managed care plans
Waiting time for child case management	Maine Department of Mental Health, Mental Retardation, and Substance Abuse Services	Children with psychiatric disorders
Communication between mental health and primary care for outpatients	Center for Quality Assessment and Improvement in Mental Health; quality measures	Mental health outpatients
Waiting time for case management services (mental retardation)	Center for Quality Assessment and Improvement in Mental Health; quality measures	Individuals dually diagnosed with mental retardation and mental illness
Family received all the professional care coordination that was needed	National Survey of Children With Special Health Care Needs, 2001	Children with special health care needs
Degree to which consumers found it easy to get someone from Medicaid to coordinate their care from different providers	CAHPS® for People With Mobility Impairments	People with mobility impairments enrolled in managed care plans
Client perception of frequency and adequacy of case management contact	Mathematica Waiver Evaluation Consumer Survey	Older adults and people with disabilities
Access to service coordinator (includes 7 items)	Nebraska Family Experience Survey	Families with children receiving HCBS

II. Receipt of All Services in Care Plan

Measure	Source	Notes
Staff spend all required time with client	Participant Experience Survey	Supported by all three survey versions
Attendants/workers/staff work the amount of time authorized in the plan of care	Kansas Department on Aging, Frail/Elderly Consumer Interview Protocol	Older adults
Case manager ensures that participants receive the services identified in the plan of care	Quality Review Indicators for Michigan's Aged and Disabled Waiver	Older adults and disabled people; data are gathered during provider reviews.

III. Care Coordination

Measure	Source	Notes
Percentage of children requiring more than one type of health care service who received needed help coordinating care	PHDS-PLUS (Promoting Healthy Development Survey)	Children only; tool designed for 0-3
Parent's experience with coordination of their child's care	CAHPS®, Children With Chronic Conditions, based on 2 items	Children only
Satisfaction with care coordination (5 items total)	CAHPS® 4.0H (NCQA version), also adult supplemental items	Item developed for health plan participants; may not be relevant to HCBS.
3-item care transition measures (CTM3)	University of Colorado Health Sciences Center	Three-item survey, related specifically to experience upon discharge from a hospital; may be relevant for HCBS participants being discharged back into the community.
Care planning for dual diagnosis	Center for Quality Assessment and Improvement in Mental Health; quality measures	People dually diagnosed with mental illness and substance abuse

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Table A.V.3b. Tested Program Performance Measures Meeting Threshold Criteria

Note: Scoring is explained in Figure 1.

I. Access to Case Management

Measure	Source	Evidence	Populations	Feasibility	Prevalence	Total Score	Notes
Ability to identify case manager	Participant Experience Survey	4	5	3	5	17	Supported by all three survey versions
Ability to contact case manager	Participant Experience Survey	4	5	3	5	17	Supported by all three survey versions
Case manager effectiveness and competency (18 indicators)	National Core Indicators Case Management Measures	3	4	2	4	13	Individuals with intellectual disabilities. Data for indicators drawn from time measurement studies and consumer surveys.
Ability to identify case manager/support coordinator	National Core Indicators Consumer Survey	4	4	3	5	16	Individuals with intellectual or developmental disabilities.
Family received all needed professional care coordination	National Survey of Children With Special Health Care Needs	4	3	3	2	12	Children with special health care needs
Access to service coordinator (includes 7 items)	Nebraska Family Experience Survey	3	3	3	3	12	Families with children receiving HCBS

II. Receipt of All Services in Care Plan

Measure	Source	Evidence	Populations	Feasibility	Prevalence	Total Score	Notes
Staff spend all required time with client	Participant Experience Survey	4	5	3	5	17	Supported by all three survey versions
Attendants/workers/staff work the amount of time authorized in the plan of care	Kansas Department on Aging, Frail/Elderly Consumer Interview Protocol	4	4	3	3	14	Older adults
Case manager ensures that participants receive the services identified in the plan of care	Quality Review Indicators for Michigan's Aged and Disabled Waiver	4	5	4	3	16	Older adults and disabled people; data are gathered during provider reviews.

III. Care Coordination

Measure	Source	Evidence	Populations	Feasibility	Prevalence	Total Score	Notes
Percentage of children with special health care needs who receive coordinated, ongoing, comprehensive care within a medical home	Children With Special Health Care Needs Survey	4	3	3	5	15	Children ages 0-18
Parent's experience with coordination of their child's care	CAHPS®, Children With Chronic Conditions, based on 2 items	4	3	3	5	15	Children only

Page last reviewed June 2010

Page originally created June 2010

Internet Citation: Appendix V (continued). Content last reviewed June 2010. Agency for Healthcare Research and Quality, Rockville, MD.
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