The Our Stories Project was completed by the grant staff to meet the objectives of the grant and, in doing so, support the development of Maine PASA. Additionally, is also serves to recognize the people employed in direct care, direct support and personal assistant jobs, their dedication, and the true value of their work. The oral history project specialist was Jocelyn Barrett.
This is a compendium of three discussion papers on the topics of direct service workers in long-term care and strategies for improving the quality of their jobs and services.
The first paper, Home and Community-Based Services: Workforce and Quality Outcomes describes HCBS programs, the direct service workforce, recommended practices for improving quality, and discusses possible approaches for integrating workforce initiatives into HCBS quality management systems.
What is the Impact of Unions on Quality of Care? discusses effects of unionization on wages, turnover, and quality care and provides an overview of Service Employees International Union (SEIU) initiatives in key states.
Health Coverage for Direct Care Workers, Emerging Strategies discusses work being done to make health insurance benefits more accessible and affordable to individuals working in direct-care and support jobs. The discussion of recent grant-funded projects and initiatives to raise awareness and to implement policies and programs provides a summary of models being used in a number of states.
The papers are not meant to be inclusive for all sectors of the direct care and direct support workforce, nor are they an exhaustive review of the research and demonstration literature. They are meant to provide insight and resource information that highlight current issues and approaches for building and maintaining a quality direct service workforce.
In 2005, the Maine Department of Corrections (MDOC), with support from the National Institute of Corrections, began implementing a series of evidence-based principles in community corrections with the goal of improving the effectiveness of offender management in the community. This study was conducted to determine the types, extent, and frequencies of adult probation recidivism in Maine before and during the implementation period. The study finds that recidivism rates of offenders who entered probation in 2004, 2005, or 2006 did not change significantly across annual cohorts, but lower risk offenders appeared to have improved outcomes in 2006. Higher risk probationers performed worse over the three year period, as they faced greater supervision and case planning requirements. The study concludes that without sufficient cognitive based therapy services, management's increased focus on higher risk offenders will only mean increased supervision, and could lead to higher recidivism outcomes.
This report includes a final list of recommended core quality measures for use in assessing the quality of home and community-based services (HCBS) Waiver services. The indicators are organized according to the HCBS Quality Framework, a document developed by the Centers for Medicare & Medicaid (CMS) to provide a common frame of reference for conducting productive dialogue among stakeholders. The report also includes recommendations for implementing the core quality indicators, lessons learned throughout the three-year grant, and a plan for sustaining the work of this grant.
In 2007, the Maine Department of Health and Human Services, Office of Child and Family Services (OCFS), funded a multi-site project establishing a high-fidelity community based wraparound initiative in Maine. The project, commonly referred to as "Wraparound Maine", is considered an intensive level of care for youth with complex needs and is expected to serve as an alternative to residential treatment. The target population includes youth, ages 5-18, with serious emotional or behavioral disturbance who are either in residential care or at high-risk of such placement. The first Wraparound Maine family was enrolled in March 2007. Later that year, the University of Southern Maine (USM) was contracted to provide technical assistance to OCFS and conduct periodic process and outcome evaluations of the wraparound sites.
This report examines the process by which Wraparound Maine is delivering care to families to determine whether that process is consistent with national wraparound standards. These standards are generally described as the Ten Wraparound Principles.
This Chartbook is an update to the "Assessment of Maine's Long-term Care Needs Baseline Report: Demographics and Use of Long Term Care Services in Maine" report that was produced in 2007. The Chartbook provides historical and projected trends in the demographics of Maine's population. With the aging of Maine's population and its status as the "oldest" state in the nation, the use of long term services and supports surfaces as a key issue of public policy. We hope that the information contained in this report will be useful to state policymakers, legislators, providers, advocates and others with an interest in this subject. The use and expenditure data show historical trends while the population data includes projections. Where possible, national comparisons are provided to show Maine relative to other states.
In 2007, Maine received a grant from the Administration on Aging to implement Healthy IDEAS (Identifying Depression, Empowering Activities for Seniors). Under this grant, the original Healthy IDEAS program was modified and implemented for use with caregivers of people with Alzheimer's disease or dementia. The objectives of the modified program were:
To improve the health and wellness of caregivers
To improve access to services
To enhance the knowledge of care coordinators about caring for people with dementia.
The desired outcomes were improved health and mental health status of caregivers; increased rate of referral to services; high participation and completion rates for the evidence-based programs; and greater consumer choice and control.
This report provides an overview of the initial results of the program implementation and evaluation.