Research staff at the Muskie School of Public Service, USM were requested to evaluate the effectiveness of the revised HCBS waiver application process from the perspective of states. This report summarizes the purpose, scope, approach and findings of the evaluation. The evaluation was designed to provide qualitative information on states' experience using the new HCBS waiver application for initial and renewal waiver applications. The evaluation examined four major issues: Clarity/Consistency: Are the waiver application components (Application, Technical Guide, Review Criteria) clearly understood and do they promote consistent interpretation? Relevancy/Adequacy: Do the application components address the range of waivers and options available to states and are they useful in clarifying the design of the state's waiver program? Burden: Do the application components and processes promote efficiency of state effort? Impact: Do the waiver application components strengthen the waiver program? States identified four primary areas of benefit from the new waiver application process.
Overall Benefits States identified four primary areas of benefit from the new waiver application process. They found that the waiver application:
Facilitated communication and coordination within the State and with CMS;
Clarified the expectations of CMS regarding roles and responsibilities;
Improved the overall consistency and accuracy of the waiver application;
Improved and strengthened the organization and design of the waiver programs
This report documents the experience of the Student Multi-Agency Resource Team (SMART), an emerging school and community-based crisis intervention resource initiated in the public school district in Portland, Maine in 2001. The overarching goal of the SMART is to ensure that students with emotional and behavioral disturbances receive services in the least restrictive setting and that services are coordinated across all life domains. This report discusses the lessons learned during the early development and implementation of the Portland SMART and it incorporates strategies and methods used in similar initiatives in other states. The feedback we gathered from parents, community-based providers, and school personnel who participated in the SMART process form the basis of the lessons learned findings. We hope this report will benefit other schools and community organizations interested in initiating or expanding a similar family-centered resource in Maine. In addition to exploring the benefits and barriers to implementing a SMART process, the report includes practical guides, checklists, brochures, and evaluation forms that may be adapted by schools or organizations wishing to incorporate them into their programs.
While it is established that rural residents often seek care for mental health problems in primary care settings, or in some cases in a Community Mental Health Center, lack of providers and lack of insurance may lead those with mental illness to the hospital emergency room (ER). Critical Access Hospitals (CAHs) are, by definition, located in small, remote and underserved rural communities and must offer 24-hour emergency services. In such communities, access to local mental health services is more likely to be a problem, and the ER may be a key piece of the mental health ?safety net.? This study investigates the extent and types of cases that present with mental health problems in CAH ERs, as well as the resources available to ER staff for addressing such problems and what actually happens to such patients.
Emergency department managers in a random sample of 422 CAHs in 44 states completed a telephone survey (response rate 84.7%) responding to questions about prevalence of mental health problems in their ER and what options they had for responding to such problems. In addition, 184 of these hospitals completed ER logs documenting all ER visits in two 24-hour periods, with details about presenting symptoms, treatment, and final disposition.
What do program managers need informed about with data quality management? Many rely on technical staff to actually conduct the technical aspects of data import, cleaning and analysis. Nevertheless, it is important for a program manager to understand the process and to provide the time and resources necessary to produce reliable and accurate data. This paper focuses on ways to assure the accuracy, discusses tools for analyzing trends and patterns and provides tips on interpreting results.
In 2008, the Maine Department of Health and Human Services, Office of MaineCare Services, contracted with the Muskie School of Public Service to design and complete a survey of Maine physician practices. The survey was administered by mail with telephone follow-up between August 29, 2008 and April 3, 2009. Two hundred forty-five (245) physicians and 364 office managers responded, representing 414 separate practice sites. The survey obtained information on respondents' experience with MaineCare, perceptions of MaineCare's business practices, attitudes towards potential incentives for MaineCare participation, and satisfaction with MaineCare program elements, such as the Primary Care Physician Incentive Payment (PCPIP) and Primary Care Case Management (PCCM) management fee.
The objectives of this project were to document current quality management and improvement efforts across departments and programs, develop criteria for selecting areas for potential coordination or collaboration, select a collaborative project to improve the quality of care to persons with disabilities, and design and implement this project. The project chosen was in the area of serious event management. This report outlines the process of project selection, pre-design planning and system design for a reportable event system for aged and disabled populations.