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Children and Adults With Long Term Services and Support Needs: MaineCare and Medicare Expenditures and Utilization, State Fiscal Year 2010. Chartbook.

Abstract: 

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 (October 2010;http://muskie.usm.maine.edu/DisabilityAgingProgram/Publications/MaineCare-Medicare-benefit-analysis-SFY2010.pdf) 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 with mental illness, adults with brain injury, adults with developmental disabilities, older adults and adults with disabilities and children with mental illness and children with developmental disabilities. The report includes information on MaineCare-only members and members who are dually eligible for MaineCare and Medicare. Dually eligible members in this report are those considered full benefit members.

Suggested Citation:

McGuire C, Bratesman S, Gressani T, Fralich J, Griffin E.  Children and Adults With Long Term Services and Support Needs: MaineCare and Medicare Expenditures and Utilization, State Fiscal Year 2010. (Chartbook).  Portland, ME: University of Southern Maine, Muskie School of Public Service; December 2012.

Publish Date: 
12-01-2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/MaineCare-Medicare-analysis-Children-Adults-LTSS-SFY2010.pdf

Maine's Community Living Program: Implementation and Outcomes

Abstract: 

Over the last five years, options counseling has evolved from a general set of activities and functions within Area Agencies on Aging and Aging & Disability Resource Centers (AAAs/ADRCs) to a more standardized and generally accepted role within the Aging Network. With the award of the Community Living Program (CLP) grant in 2009, Maine proposed to develop more consistent methods for identifying people at risk of residential facility placement and to begin to develop standards for the options counseling functions. In 2010, Maine was also awarded an Options Counseling Standards Grant which has provided support for furthering the work started under the CLP grant.

Muskie School staff developed a Consumer Satisfaction Survey, A Survey of Options Counselors and Options Counselor Manager/Supervisor Survey. Results of the surveys and data from the follow-up form developed by the Steering Committee are included in the Outcomes section of this report. Muskie staff also conducted the evaluation of Maine's Options Counseling Standards Grant. The results of this evaluation are organized into two main sections: Implementation of Options Counseling which examines the processes, protocols and practices that were developed , and Outcomes which examines the implementation of the options counseling services along four dimensions:

  • Consumer Outcomes;
  • Staff Outcomes;
  • Organizational Outcomes; and
  • System Outcomes.

Suggested citation:

Fralich J, Richards M, Olsen L. Maine's Community Living Program: Implementation and Outcomes. Portland, ME: University of Southern Maine, Muskie School of Public Service; December 2011.

Publish Date: 
12-30-2011
URL: 
http://muskie.usm.maine.edu/Publications/DA/Maine-Community-Living-Program-Implementation-Outcomes.pdf

"Homelike" Characteristics of Maine's Residential Services: A Survey of Maine's Residential Service Settings (2010). Chartbook.

Abstract: 

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 was 82.9%, and survey questions collected information about the facilities' physical characteristics and features, services, resident characteristics, and policies relating to autonomy and privacy.

Suggested citation:

Fralich J, McGuire C, Griffin E. "Homelike" Characteristics of Maine's Residential Services: A Survey of Maine's Residential Service Settings (2010). (Chartbook).  Portland, ME: University of Southern Maine, Muskie School of Public Service; November 2012.

Publish Date: 
11-01-2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/ME-Residential-Facilities-Survey.pdf

Satisfaction Survey Results and Lessons Learned: Maine's Aging & Disability Resource Center (ADRC) Project

Abstract: 

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 at all five ADRCs. The survey was designed to capture the consumer view of the ADRC services in key domain areas including: visibility/trust; efficiency; responsiveness and effectiveness. Also included is a summary of consumer comments that were shared by those responding to the survey and a summary of lessons learned from the administrators at the ADRCs. Significant accomplishments of the ADRCs were reported as training; providing information, resources, navigation assistance and options counseling to a broad spectrum of aging and disabled adults, along with their caregivers; the ability to expand the ARDC's role into the disability community; and the connection with community providers. Challenges reported included the lack of resources and inability of the State Unit on Aging to be approved to apply for future funding; ongoing operations and expansion as a a fully functioning ADRC without the funding to support the additional work, and the need for updated on-line referral database and the staffing to maintain it.

Suggested citation:

Fralich J, Olsen L, Richards M, Bowe, T.  Satisfaction Survey Results and Lessons Learned: Maine's Aging & Disability Resource Center (ADRC) Project. Portland, ME: University of Southern Maine, Muskie School of Public Service; December 2012.

Publish Date: 
12-01-2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/ME-ADRC-Survey-2012.pdf

Maine Direct Service Workforce Survey Results of 2012: A Chartbook

Abstract: 

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 challenges, workforce training and worker qualifications.

This Chartbook provides the results of two direct service workforce surveys conducted in the summer of 2012: one for Personal Attendants who work for adults with disabilities and families in participant-directed programs; and the second for Provider Organizations serving adults with intellectual disabilities and older adults with disabilities.

Key Findings from the Personal Attendant Survey:

  • 51% of direct service workers employed as personal attendants in Maine’s participant-directed programs have an annual household income of less than $22,000.
  • 37% have no source of health-insurance and another 28% are insured under MaineCare.
  • The majority of personal attendants became a personal attendant because a friend or family member needed care (69%). Many also value the personal satisfaction (59%) and flexible schedule (52%) that this work offers. 
  • Most personal attendants express a high level of satisfaction with their work.
  • Personal attendants are less satisfied with their wages.

Key Findings from the from the Provider Organizations:

  • 91% serve people with developmental disabilities, intellectual disabilities, or autism, while 55% serve persons with mental health or psychiatric conditions and 47% serve persons 65 years or older adults and 45% serve people with physical disabilities.
  • Two-thirds of the Direct Service Workers employed by Provider Organizations work 36 or more hours per week.
  • An average of 89 workers per Provider Organization work primarily in residential settings; an average of 29 workers per Provider Organization provided primarily in-home supports.
  • At the same time, the Provider Organizations served fewer people in residential settings than in home settings, with an average of 42 persons receiving residential services and 50 persons receiving in-home supports per Provider Organization. Provider Organizations tended to serve more people in day programs or with rehabilitative or medical supports.
  • Two-thirds of a Provider Organization’s Direct Service Workforce has had more than 12 months of continuous paid employment.
  • Workers providing day program and other community support services tended to be paid more than workers providing job or vocational services, residential services, or in-home supports.
  • 39% of Provider Organizations pay 76% or more of the health insurance premium for their Direct Service Workers.
  • 92% of Provider Organizations offer vacation or paid time off to their full time workers.
  • Provider Organizations were more likely to identify finding qualified workers as a workforce challenge, with worker turnover the second most frequently identified challenge.

Suggested Citation: Westcott D, Griffin E, Fralich J. Maine Direct Service Workforce Survey Results of 2012. (Chartbook).  Portland, ME: University of Southern Maine, Muskie School of Public Service; November 2012.

Publish Date: 
11-30-2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/ME-Direct-Service-Workforce-Survey-2012.pdf

Smoking Cessation 2010-2013

Duration: 
11/1/2010 - 6/30/2013
Director: 
Principal Investigator: 
Collaborators: 
MaineHealth
Abstract: 

For several years, the Center for Tobacco Independence (CTI) has contracted to have phone surveys conducted with a sample of people who call the Center's Help Line. Data from these surveys provide a great deal of information such as the rate of success in quitting tobacco and the methods that are most successful. Beginning in 2009, the Muskie School's Survey Research Center (SRC) became CTI's survey contractor, conducting 730 telephone interviews with a random sample of people who called the Help Line. Following up on the success of that study, SRC will conduct the phone interviews in 2012.

Seatbelts 2011-2012

Duration: 
10/1/2011 - 9/30/2012
Director: 
Principal Investigator: 
Collaborators: 
Maine Bureau of Highway Safety
Abstract: 

In April 2008, Maine began implementing a new primary enforcement law regarding seatbelt use. We now have the opportunity to measure the impact of the new law from several perspectives. This project will examine seatbelt use throughout the state, with an additional rural use component. We will also measure motorcycle helmet use, as well as night time seatbelt use. In addition, in-person surveys will be conducted at a number of Bureau of Motor Vehicle Offices to obtain information about certain driving behaviors. Past study findings have been and will continue to be used by groups such as Maine CDC and Maine Health Information Center. This study will allow the Survey Research Center to continue a long relationship with the Maine Bureau of Highway Safety, the National Highway Traffic Safety Administration, and the Preusser Research Group. It will also provide a rare opportunity to examine the direct effects of a change in law enforcement policy.

Maine Rural Health Research Center 2012

Duration: 
9/1/2012 - 8/31/2013
Director: 
Principal Investigator: 
Abstract: 

Established in 1992, the mission of the Maine Rural Health Research Center is to inform health care policy making and the delivery of rural health services through high quality, policy-relevant research, policy analysis and technical assistance on rural health issues of regional and national significance. The Center's core funding is provided by the federal Office of Rural Health Policy.

Project URL: 
http://muskie.usm.maine.edu/ihp/ruralhealth/

Dementia Capable Project: Interviews with Employers who Direct Services of a Person with Dementia

Abstract: 

Citation:
Fralich, J., Richards, M., Olsen, L., Bowe, T., Turyn, R., & Caswell, L. (2012, May). Dementia Capable Project: Interviews with employers who direct services of a person with dementia. Portland, ME: University of Southern Maine, Muskie School of Public Service.

This report was prepared for the Office of Elder Services, Maine Department of Health and Human Services under a Cooperative Agreement between the Muskie School of Public Service and the Maine Department of Health and Human Services. Funding for Maine's Dementia Capable Consumer Directed Grant was through the Administration on Aging Alzheimer's Disease and Supportive Services Program (ADSSP) and the Maine Department of Health and Human Services, Office of Elder Services, grant number 90AI0028/01.

Publish Date: 
05-01-2012
URL: 
http://muskie.usm.maine.edu/Publications/DA/Dementia-Capable-Project-Employers.pdf

What We Know and Do Not Know About Tiered Provider Networks

Abstract: 

[article abstract]: In response to continuing concerns about escalating health care costs and poor quality care, many health plans have adopted a strategy called

Publish Date: 
08-01-2007
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