Cathy Cope Melissa Hulbert Centers for Medicare & Medicaid Services
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South DakotaPrimary PurposeThe grant’s primary purpose was to expand the capabilities of the State’s Parent Training and Information Center by creating a Family to Family Health Care Information and Education Center (FHIC) that will (1) provide information, referrals, and education about health care and home and community-based services statewide to those caring for children with special health care needs (CSHCN); (2) connect those caring for CSHCN with local training opportunities, information, services, advocacy, and other parents of CSHCN; (3) provide culturally competent training and information for the Native American and Spanish-speaking families of CSHCN; and (4) collaborate with existing FHICs to promote the philosophy of individualized, family-directed support. The grant was awarded to South Dakota Parent Connection, Inc. (SDPC), which is the State’s only Parent Training and Information Center. Results
Lessons Learned and Recommendations
ProductsOutreach Materials Grant staff produced a brochure with basic information on services and supports for families of CSHCN and professionals who work with families, which is available on the SDPC website. Educational Materials Grant staff developed workshop curricula for SDPC staff and volunteer Parent Trainers to work with families and health care professionals. The curricula included the following topics: Navigating the Health Care Maze, Patients’/Parents’ Bill of Rights, Health Care Resources in South Dakota, and Child Abuse and Reporting. The workshop handouts are available in English and Spanish, and interpreters are available for Hispanic families. Technical Materials SDPC staff served on the revisions and reprint committee for the Folder of Information and Life Experiences, a family record-keeping system. Their participation ensured that health care information relevant for families of CSHCN was included in the FILE. The system has 10 folders to help families sort and find papers related to the following: Family Records, Developmental History, Medical, Therapies, Individual Family Service Plan/Individual Education Plan, Letters/Contact Info, Evaluations/Consents, Respite Care/Child Care, Transition, and Legal & Life Planning. WisconsinPrimary PurposeThe grant’s primary purpose was to develop a training curriculum and sustainable methods for delivering it so that parents of children with disabilities and special health care needs (CDSHCN), including those in under-represented segments of the community, can be knowledgeable and effective navigators of their child’s system of care. Other grant objectives were to increase coordination among existing, state-funded information and assistance activities, to increase the availability of health and community resources for CDSHCN, and to support parent involvement to shape these resources and develop the infrastructure for a sustainable Family to Family Health Care Information and Education Center (FHIC). The grant was awarded to Family Voices of Wisconsin (hereafter, Family Voices), a nonprofit organization that is part of the national Family Voices network, which promotes a system of comprehensive health and community supports based on fundamental principles that ensure the health and well-being of CDSHCN and their families. The role of Family Voices is to advocate for the inclusion of these principles in the design, implementation, and delivery of services and supports throughout Wisconsin (see http://www.wfv.org/fv/aboutfvwi.html). Results
Additional funding for the FHIC has been secured through a grant from the federal Maternal and Child Health Bureau and through a contractual arrangement with the Title V program to build and support a statewide network of parents who can present their views on policy, quality improvement, and program development. This contract will complement the activities of the CMS grant and sustain the parent training network beginning in 2009. Family Voices is also meeting with several counties and the United Way to discuss future work together, and continues to seek opportunities and funding to broaden its base and to provide greater organizational stability.
Parents from across the State were recruited to participate in a train-the-trainers program, resulting in a statewide network of 25 parent trainers who are supported to provide the face-to-face training to families and providers. The parent training network meets bimonthly via conference call and annually for a 2-day event. The conference calls provide additional content information on elements of the training and the annual meeting enables the parent trainers to refresh their skills, to acquire more information, and to network with other parent trainers. Individual calls are also used to provide one-to-one support to trainers on a personal level. Grant staff paid particular attention to the recruitment of minority parents, and unique versions of the curriculum were developed for Native American families in collaboration with the Great Lakes Intertribal Council, for African American families in collaboration with FACETS, and for Latino families in collaboration with Family Support 360. The curriculum was also translated into Spanish. As of July 2008, more than 500 parents and providers had participated in training offered in 38 locations around the State. An evaluation of the trainings demonstrated very high participant satisfaction.
Lessons Learned and Recommendations
ProductsOutreach and Educational Materials
Reports Grant staff produced a report for Wisconsin’s Title V program—Strategies to Increase Minority Parent Participation in Decision Making Roles on Behalf of CDSHCN—to assist in engaging minority families. Part 6 Feasibility Study and Development Grants Report Overview vii Methods viii Organization of This Report viii Enduring Systems Improvements ix Personal Assistance Services and Supports (PASS) ix Money Follows the Person Policies (MFP) ix Self-Directed Services ix Quality Assurance and Improvement ix Lessons Learned and Recommendations x Involving Participants and Stakeholders x Specific Recommendations xi Approaches to Bringing about Systems Change xiii Recommendations for Changes in State and Federal Policy xiii Money Follows the Person and Transition Policy xiii Self-Direction xiv Quality Assurance and Improvement xiv Increasing Access to HCBS and Supporting Community Living xv Conclusion xvi Part 1 Community-Integrated Personal Assistance Services and Supports Grantees 1 1 Section One. Overview 1 Enduring Systems Improvements 1 New Policies to Enable and Support PASS and Self-Directed PASS 2 Increased Options for Self-Directed PASS 2 Increased Access to PASS 3 Improved PASS Quality for Persons with Serious Mental Illness 3 New Methods to Help Participants Recruit and Retain Workers 4 Systems Improvements Beyond the Grant Period 5 Continuing Challenges to Systems Improvements 5 Funding Issues 5 Policy Challenges 5 Workforce Issues 6 Lessons Learned and Recommendations 6 Lessons Learned 6 Involving Stakeholders 6 Self-Direction Programs 6 Recommendations 7 Systems Change 7 Workforce Recruitment, Retention, Education, and Training 7 Self-Direction Programs: State Policy 7 CMS Policy 8 Section Two. Individual CPASS Grant Summaries 9 Arizona 11 Primary Purpose and Major Goals 11 Role of Key Partners 11 Major Accomplishments and Outcomes 11 Enduring Systems Change 12 Key Challenges 12 Continuing Challenges 12 Lessons Learned and Recommendations 13 Key Products 13 Connecticut 15 Primary Purpose and Major Goals 15 Role of Key Partners 15 Major Accomplishments and Outcomes 15 Enduring Systems Change 16 Key Challenges 16 Continuing Challenges 17 Lessons Learned and Recommendations 17 Key Products 17 Louisiana 19 Primary Purpose and Major Goals 19 Role of Key Participating Partners 19 Major Accomplishments and Outcomes 19 Enduring Systems Change 20 Key Challenges 20 Continuing Challenges 20 Lessons Learned and Recommendations 21 Key Products 21 Massachusetts 23 Primary Purpose and Major Goals 23 Role of Key Partners 23 Major Accomplishments and Outcomes 23 Enduring Systems Change 24 Key Challenges 25 Continuing Challenges 25 Lessons Learned and Recommendations 25 Create additional materials to educate participants and families and empower them to assist themselves and translate these materials into multiple languages. 26 Change state rules to allow more flexibility in funding allocations for budgets, because budgets set at the start of a fiscal year may not appropriately address participants’ changing needs in a specific catchment area. 26 Allow for more flexible funding categories to better accommodate individual needs. 26 Minimize the current delay between eligibility determination and start of services. 26 Provide more emergency funding that agencies can use for participants in crisis. 26 Key Products 26 How Can a Community Advisor Help Me? A Guidebook for Using Community Advisors to Help You Find the Choices and Supports You Want 26 First Step Consumer Handbook. How to Get Organized to Find the Help You Need: A Bilingual Guide for Newly Arrived Latino Individuals and Families to the City of Holyoke, Massachusetts 26 Tools for Tomorrow in English, Spanish, Creole, Russian, and Portuguese 26 Nebraska 29 Primary Purpose and Major Goals 29 Role of Key Partners 29 Major Accomplishments and Outcomes 29 Enduring Systems Change 30 Key Challenges 30 Continuing Challenges 30 Lessons Learned and Recommendations 30 Key Products 30 Oregon 31 Primary Purpose and Major Goals 31 Role of Key Partners 31 Major Accomplishments and Outcomes 31 Enduring Systems Change 32 Key Challenges 32 Continuing Challenges 33 Lessons Learned and Recommendations 33 Key Products 33 Texas 35 Primary Purpose and Major Goals 35 Role of Key Partners 35 Major Accomplishments and Outcomes 35 Enduring Systems Change 36 Key Challenges 36 Continuing Challenges 37 Lessons Learned and Recommendations 37 Key Products 37 Virginia 39 Primary Purpose and Major Goals 39 Role of Key Partners 39 Major Accomplishments and Outcomes 39 Key Challenges 40 Continuing Challenges 41 Lessons Learned and Recommendations 41 Key Products 42 Part 2 Money Follows the Person Grantees 1
Enduring Systems Improvements 2 New Assessment and Budgeting Process for Individualized Portable Budgets 2 New MFP Funding Mechanism 2 New Infrastructure/Funding to Support Transition Services and MFP Policy 3 Training to Support Transitions and MFP Policy 3 Increased Access to and Funding for HCBS 4 Increased Access to and Funding for Supported Housing 4 New Process to Involve Consumers in Policy Development 4 Continuing Challenges to Transition and Balancing 5 Lack of Funding for HCBS 5 Lack of Affordable and Accessible Housing 5 Medicaid and State Policies and Practices 6 Lessons Learned and Recommendations 6 Lessons Learned 7 Recommendations 7 Program Implementation 7 Involving Stakeholders 7 State Policy 8 State Medicaid Policy 8 Federal Policy 9 CMS 9
Section Two. Individual MFP Grant Summaries 11 California 13 Primary Purpose and Major Goals 13 Role of Key Partners 13 Major Accomplishments and Outcomes 13 Enduring Systems Change 14 Key Challenges 14 Continuing Challenges 15 Lessons Learned and Recommendations 15 Key Products 16 Idaho 17 Primary Purpose and Major Goals 17 Role of Key Participating Partners 17 Major Accomplishments and Outcomes 17 Key Challenges 18 Continuing Challenges 18 Lessons Learned and Recommendations 18 Key Products 18 Maine 19 Primary Purpose and Major Goals 19 Role of Key Partners 19 Major Accomplishments and Outcomes 19 Enduring Systems Change 20 Key Challenges 20 Continuing Challenges 21 Lessons Learned and Recommendations 21 Key Products 21 Michigan 23 Primary Purpose and Major Goals 23 Role of Key Partners 23 Major Accomplishments and Outcomes 24 Enduring Systems Change 25 Key Challenges 25 Continuing Challenges 26 Lessons Learned and Recommendations 26 Key Products 26 Nevada 29 Primary Purpose and Major Goals 29 Role of Key Partners 29 Major Accomplishments and Outcomes 29 Enduring Systems Change 30 Key Challenges 30 Continuing Challenges 30 Lessons Learned and Recommendations 31 Key Products 31 Pennsylvania 33 Primary Purpose and Major Goals 33 Role of Key Partners 33 Major Accomplishments and Outcomes 33 Enduring Systems Change 33 Key Challenges 34 Continuing Challenges 34 Lessons Learned and Recommendations 34 Key Products 35 Texas 37 Primary Purpose and Major Goals 37 Role of Key Participating Partners 37 Major Accomplishments and Outcomes 37 Enduring Systems Change 37 Key Challenges 38 Continuing Challenges 38 Lessons Learned and Recommendations 38 Key Products 39 Washington 41 Primary Purpose and Major Goals 41 Role of Key Partners 41 Major Accomplishments and Outcomes 41 Enduring Systems Change 42 Key Challenges 42 Continuing Challenges 42 Lessons Learned and Recommendations 43 Key Products 43 Wisconsin 45 Primary Purpose and Major Goals 45 Role of Key Partners 45 Major Accomplishments and Outcomes 45 Enduring Systems Change 46 Key Challenges 46 Continuing Challenges 47 Lessons Learned and Recommendations 47 Key Products 47 Part 3 Independence Plus Grantees 1
Enduring Systems Improvements 2 New Infrastructure for Self-Direction Programs 2 Financial Management and Counseling/Support Broker Services 2 Individual Budget Methodologies 3 Backup Plans and Critical Incident Management 4 Other Infrastructure 6 New IP Option in Waiver or State Plan Program(s) 6 Continuing Challenges to Systems Improvements 8 Lessons Learned and Recommendations 9 Lessons Learned 9 Recommendations 9 Involving Participants and Other Stakeholders 9 Implementing Self-Direction Programs 11 State and Federal Policy 11 CMS 12
Section Two. Individual IP Grant Summaries 13 Colorado 15 Primary Purpose and Major Goals 15 Role of Key Partners 15 Major Accomplishments and Outcomes 15 Enduring Systems Change 16 Key Challenges 16 Continuing Challenges 16 Lessons Learned and Recommendations 16 Key Products 17 Connecticut 19 Primary Purpose and Major Goals 19 Role of Key Partners 19 Major Accomplishments and Outcomes 19 Enduring Systems Change 20 Key Challenges 20 Continuing Challenges 21 Lessons Learned and Recommendations 21 Key Products 21 Florida 23 Primary Purpose and Major Goals 23 Role of Key Partners 23 Major Accomplishments and Outcomes 23 Enduring Systems Change 24 Key Challenges 24 difficulty securing multi-agency buy-in to the project’s vision and goals; 25 lack of Medicaid Buy-in legislation in Florida; 25 lack of sufficient interagency collaboration; and 25 lack of high-quality benefits planning assistance for individuals with significant disabilities who can earn moderate incomes but need Medicaid coverage. 25 Continuing Challenges 25 Lessons Learned and Recommendations 25 Key Products 26 Georgia 27 Primary Purpose and Major Goals 27 Role of Key Partners 27 Major Accomplishments and Outcomes 27 Enduring Systems Change 28 Key Challenges 29 Continuing Challenges 29 Lessons Learned and Recommendations 29 Key Products 30 Idaho 31 Primary Purpose and Major Goals 31 Role of Key Partners 31 Major Accomplishments and Outcomes 31 Enduring Systems Change 32 Key Challenges 33 Continuing Challenges 33 Lessons Learned and Recommendations 34 Key Products 34 Louisiana 35 Primary Purpose and Major Goals 35 Role of Key Partners 35 Major Accomplishments and Outcomes 35 Enduring Systems Change 36 Key Challenges 37 Continuing Challenges 37 Lessons Learned and Recommendations 38 Key Products 38 Maine 39 Primary Purpose and Major Goals 39 Role of Key Partners 39 Major Accomplishments and Outcomes 39 Enduring Systems Change 41 Key Challenges 41 Continuing Challenges 41 Lessons Learned and Recommendations 41 Key Products 42 Massachusetts 43 Primary Purpose and Major Goals 43 Role of Key Partners 43 Major Accomplishments and Outcomes 43 Enduring Systems Change 44 Key Challenges 44 Continuing Challenges 44 Lessons Learned and Recommendations 45 Key Products 45 Michigan 47 Primary Purpose and Major Goals 47 Role of Key Partners 47 Major Accomplishments and Outcomes 48 Enduring Systems Change 49 Key Challenges 49 Continuing Challenges 50 Lessons Learned and Recommendations 50 Key Products 50 Missouri 53 Primary Purpose and Major Goals 53 Role of Key Partners 53 Major Accomplishments and Outcomes 53 Enduring Systems Change 54 Key Challenges 55 Continuing Challenges 55 Lessons Learned and Recommendations 55 Key Products 55 Montana 57 Primary Purpose and Major Goals 57 Role of Key Partners 57 Major Accomplishments and Outcomes 57 Enduring Systems Change 58 Key Challenges 58 Continuing Challenges 59 Lessons Learned and Recommendations 59 Key Products 59 Ohio 61 Primary Purpose and Major Goals 61 Role of Key Partners 61 Major Accomplishments and Outcomes 61 Enduring Systems Change 62 Key Challenges 62 Continuing Challenges 63 Lessons Learned and Recommendations 63 Key Products 63 Part 4 Quality Assurance and Quality Improvement in Home and Community-Based Services Grantees 1
Enduring Systems Improvements 1 New/Improved Methods to Measure Participant Satisfaction and Other Outcomes 3 New/Improved Provider Standards or Monitoring Tools 5 New/Improved System to Collect, Analyze, and Report Quality Data 5 New/Improved Process or System to Help Ensure Continuous Quality Improvement in Services 6 New/Improved Critical Incident Reporting and/or Remediation Process or System 8 New Methods to Involve Participants in QA/QI Processes and Policy Development 9 Continuing Challenges 10 Lack of Funding 10 Organizational and Administrative Issues 10 Information Technology and Data Collection Issues 11 Policy and Practice Issues 11 Stakeholder Involvement 11 Lessons Learned and Recommendations 12 Lessons Learned 12 Implementing New Participant Surveys 12 Grant Implementation 12 Recommendations 13 Using Peers in Participant Surveys 13 Involving Stakeholders 13 Involving Participants 14 Information Technology and Data Management Systems 14 Quality Management Systems 15 State Policy 15 CMS 16
Section Two. Individual QA/QI Grant Summaries 19 California 21 Primary Purpose and Major Goals 21 Role of Key Partners 21 Major Accomplishments and Outcomes 22 Enduring Systems Change 22 Key Challenges 23 Continuing Challenges 23 Lessons Learned and Recommendations 24 Key Products 24 Colorado 25 Primary Purpose and Major Goals 25 Role of Key Partners 25 Major Accomplishments and Outcomes 25 Enduring Systems Change 26 Key Challenges 27 Continuing Challenges 27 Lessons Learned and Recommendations 27 Key Products 28 Choice Grant Technologies Project Revised Requirements provides a listing of high-level requirements that were used to fully describe all of the requirements of the web-based applications. 28 DDD Web Applications Development (Choices Grant): System Design Document Version 1.3 describes the configuration and functionality of the web-based applications funded under the grant. This document is intended for use by the designers of the system and those who may be required to maintain it. 28 DDD Web Applications Development Project Phase-I (Choices Grant): Software Requirements Specifications Version 2.4 describes the software requirements that were captured through a detailed study of the business work flow and functions for the web-based applications funded by the grant. This document is intended for use by the designers of the system and those who may be required to maintain it. 28 Connecticut 29 Primary Purpose and Major Goals 29 Role of Key Partners 29 Major Accomplishments and Outcomes 29 Enduring Systems Change 30 Key Challenges 31 Continuing Challenges 31 Lessons Learned and Recommendations 31 Key Products 32 Delaware 33 Primary Purpose and Major Goals 33 Role of Key Partners 33 Major Accomplishments and Outcomes 33 Enduring Systems Change 34 Key Challenges 35 Continuing Challenges 35 Lessons Learned and Recommendations 35 Key Products 35 Georgia 37 Primary Purpose and Major Goals 37 Role of Key Partners 37 Major Accomplishments and Outcomes 37 Enduring Systems Change 38 Key Challenges 38 Continuing Challenges 39 Lessons Learned and Recommendations 39 Key Products 39 Indiana 41 Primary Purpose and Major Goals 41 Role of Key Partners 41 Major Accomplishments and Outcomes 41 Enduring Systems Change 42 Key Challenges 43 Grant staff needed to revise work plan timelines many times and had problems recruiting staff for new QA/QI roles in the Division of Aging. 44 Many of the operational processes and procedures for the complaints, incident reporting, and mortality review systems that were based on the models that best served the population with developmental disabilities (the Bureau’s major focus) needed to be reviewed and tailored to the population served by the Division of Aging. 44 Delays in executing contracts for the incident reporting system caused delays in compiling and reporting aggregate data. 44 Continuing Challenges 44 Lessons Learned and Recommendations 44 Key Products 45 Maine 47 Primary Purpose and Major Goals 47 Role of Key Partners 47 Major Accomplishments and Outcomes 47 Enduring Systems Change 48 Key Challenges 49 Continuing Challenges 49 Lessons Learned and Recommendations 49 Key Products 49 Minnesota 51 Primary Purpose and Major Goals 51 Role of Key Partners 51 Major Accomplishments and Outcomes 52 Enduring Systems Change 52 Key Challenges 53 Continuing Challenges 53 Lessons Learned and Recommendations 53 Key Products 54 Missouri 55 Primary Purpose and Major Goals 55 Role of Key Partners 55 Major Accomplishments and Outcomes 55 Enduring Systems Change 56 Key Challenges 56 Continuing Challenges 56 Lessons Learned and Recommendations 56 One of the drawbacks of administering the survey by telephone was the inability to observe the client and anyone else in the home, making it difficult to know whether a client was being “coached” by a family member or caregiver. 56 The broad range of questions in the survey tool proved unwieldy for individuals who receive only a single service, like the Program of All-inclusive Care for the Elderly or home-delivered meals. Ideally, a shorter survey would be used for programs that provide only a few services. 56 The staff at some Residential Care Facilities were reluctant to let surveyors speak to the residents for various reasons, including concerns about the effect of survey results on the facility and concerns about client confidentiality. 57 Locating the clients’ guardians was time consuming, and obtaining permission for their participation in the survey was often difficult. 57 Key Products 57 New York 59 Primary Purpose and Major Goals 59 Role of Key Partners 59 Major Accomplishments and Outcomes 59 Enduring Systems Change 60 The TBI waiver program implemented a statewide across-the-board rate increase for providers and a NYC Metropolitan Area rate differential for select services. 60 Grant funds were used to develop four service-specific training programs and related materials for selected services provided by the TBI and NHTD waivers. The training, which will ensure consistency in provider knowledge of services with an emphasis on person-centered care, is to be used statewide to meet provider staff training requirements. The Department has begun to use the new curricula in the NHTD program. 60 Waiver program staff are developing user-friendly materials for participants that will explain waiver services, address waiver participants’ rights and responsibilities, offer guidance on how to effectively work with service providers, and furnish tools and resources to help participants successfully navigate the HCBS system. 60 Key Challenges 60 Continuing Challenges 61 Lessons Learned and Recommendations 61 Key Products 62 North Carolina 63 Primary Purpose and Major Goals 63 Role of Key Partners 63 Major Accomplishments and Outcomes 63 Enduring Systems Change 64 Key Challenges 65 Obtaining consent from potential interviewees—in particular, those who had guardians—required a great deal of time. 65 Project participants, particularly those who moved into their own apartment, often moved again or had their phone disconnected. Staff asked case managers for contact details, but some were themselves unaware that an individual had moved and others did not return phone calls. 65 Scheduling interviews for demonstration participants who had moved to group homes or residential care facilities was very time consuming. In some instances, interviewers would arrive at the scheduled time and find that the interviewee was out for the day. 66 Continuing Challenges 66 Lessons Learned and Recommendations 66 Key Products 66 Ohio 69 Primary Purpose and Major Goals 69 Role of Key Partners 69 Major Accomplishments and Outcomes 69 Enduring Systems Change 70 Key Challenges 70 Continuing Challenges 71 Lessons Learned and Recommendations 71 Key Products 71 Oregon 73 Primary Purpose and Major Goals 73 Role of Key Partners 73 Major Accomplishments and Outcomes 73 Enduring Systems Change 74 Key Challenges 74 Continuing Challenges 75 Lessons Learned and Recommendations 75 Key Products 75 Pennsylvania 77 Primary Purpose and Major Goals 77 Role of Key Partners 77 Major Accomplishments and Outcomes 77 Enduring Systems Change 78 Key Challenges 79 Continuing Challenges 79 Lessons Learned and Recommendations 79 Key Products 79 South Carolina 81 Primary Purpose and Major Goals 81 Role of Key Partners 81 Major Accomplishments and Outcomes 81 Enduring Systems Change 82 Key Challenges 82 Continuing Challenges 82 Lessons Learned and Recommendations 83 Key Products 83 Tennessee 85 Primary Purpose and Major Goals 85 Role of Key Partners 85 Major Accomplishments and Outcomes 85 Enduring Systems Change 86 Prior to 2004, DMRS’ definitions of abuse, neglect, and exploitation were extremely complex, making it difficult to understand what and when to report. The DMRS investigative Protection from Harm Unit held many meetings with all stakeholders to establish definitions of abuse, neglect, and exploitation that would be more easily understood. Although the new definitions are clear and concise, if in doubt, program participants can report questionable incidents to DMRS staff, who will determine whether the definitions have been met. 86 The Protection from Harm Unit made changes in operational procedures to ensure that participants’ legal representative and/or designated family member are informed about allegations of abuse, neglect, or exploitation, and understand the investigative process. 86 Grant staff developed a new communication system for reporting incidents. Formerly, information was furnished only in aggregated form, which did not provide all of the information needed to enable Adult Protective Services and the Protection from Harm Unit to follow up; the new system requires that reports provide more detailed information about each incident. 86 Key Challenges 86 Continuing Challenges 87 Lessons Learned and Recommendations 87 Key Products 87 Texas 89 Primary Purpose and Major Goals 89 Role of Key Participating Partners 89 Major Accomplishments and Outcomes 89 Enduring Systems Change 90 Key Challenges 91 Continuing Challenges 91 Lessons Learned and Recommendations 91 Key Products 91 West Virginia 93 Primary Purpose and Major Goals 93 Role of Key Partners 93 Major Accomplishments and Outcomes 93 Enduring Systems Change 95 Key Challenges 95 Continuing Challenges 96 Lessons Learned and Recommendations 96 Key Products 96 Wisconsin 97 Primary Purpose and Major Goals 97 Role of Key Partners 97 Major Accomplishments and Outcomes 97 Enduring Systems Change 98 Grant staff developed a preliminary design for an integrated QM system that has given HCBS professionals a shared vocabulary for discussing and thinking about QM processes. The final report has guided the development of contract requirements and certification standards for the expanding managed care system, which will help to ensure that local agencies fulfill QM requirements. 98 Grant staff created a comprehensive quality assurance plan for Wisconsin’s Functional Screen system, which is used to determine eligibility for long-term services and supports programs, for rate setting, and other purposes. This plan includes activities to enable the DHFS to determine whether the screen is working as intended, to correct deficiencies, and to continually improve it. Responsibility for tasks has been assigned to existing staff, and additional funding has been committed for two new positions to carry out the Functional Screen QM system. 98 Grant staff developed a program of QM training and technical assistance for local care managers, agency managers, and QM staff. The training was delivered to 95 participants statewide in June 2007 through a webcast and has received more viewings since then. The webcast includes most of the basic concepts and material developed during the grant project, and will continue to be used during the State’s expansion of managed care for home and community-based long-term services and supports programs. 98 Key Challenges 99 Continuing Challenges 99 Lessons Learned and Recommendations 99 Key Products 100 Part 5 Family to Family Health Care Information and Education Center Grantees 1 5 Section One. Overview 1 Results 2 Providing Information and Referral Services 3 Developing Informational Materials 3 Providing Education and Training 3 Improving Programs and Informing Policies 4 Lessons Learned 4 Recommendations 5 Policy Issues 5 Services and Supports 6 Section Two. Individual FTF Grant Summaries 7 Alaska 9 Primary Purpose 9 Results 9 Lessons Learned and Recommendations 10 Products 10 Colorado 11 Primary Purpose 11 Lessons Learned and Recommendations 11 Products 12 Indiana 13 Primary Purpose 13 Results 13 Lessons Learned and Recommendations 14 Products 14 Maryland 15 Primary Purpose 15 Results 15 Lessons Learned and Recommendations 16 Products 16 Finding Community Resources, which addresses the specific needs of the participants and matches those needs to local resources. 17 Choosing a Health Care Plan, which offers practical step-by-step information to help families of children with disabilities and special health care needs sort through their health care plan options. 17 Getting Needed Services from Your Managed Care Plan, which explains how managed care health plans work, and takes participants through the steps of referrals, authorizations, and other service barriers. 17 Appealing Insurance Denials covers the appeal process available to families and teaches strategies that can make appeals successful. 17 Montana 19 Primary Purpose 19 Results 19 Lessons Learned and Recommendations 20 Products 20 Nevada 21 Primary Purpose 21 Results 21 Lessons Learned and Recommendations 22 Products 22 New Jersey 23 Primary Purpose 23 Results 23 Lessons Learned and Recommendations 24 Products 24 South Dakota 27 Primary Purpose 27 Results 27 Lessons Learned and Recommendations 28 Products 28 Wisconsin 29 Primary Purpose 29 Results 29 Lessons Learned and Recommendations 30 Products 31 Part 6 Feasibility Study and Development Grants 1
Individual Respite for Adults Grant Summaries 3 California 5 Primary Purpose 5 Results 5 Lessons Learned and Recommendations 5 Products 6 New York 7 Primary Purpose 7 Results 7 Lessons Learned and Recommendations 7 Products 7 Ohio 9 Primary Purpose 9 Results 9 Lessons Learned and Recommendations 9 Products 10 Rhode Island 11 Primary Purpose 11 Results 11 Lessons Learned and Recommendations 11 Products 11 Individual Respite for Children Grant Summaries 13 Alabama 15 Primary Purpose 15 Results 15 Lessons Learned and Recommendations 15 Products 15 Arkansas 17 Primary Purpose 17 Results 17 Lessons Learned and Recommendations 18 Products 18 Maryland 19 Primary Purpose 19 Results 19 Lessons Learned and Recommendations 19 Products 20 Michigan 21 Primary Purpose 21 Results 21 Lessons Learned and Recommendations 21 Products 21 Oregon 23 Primary Purpose 23 Results 23 Lessons Learned and Recommendations 23 Products 24 Rhode Island 25 Primary Purpose 25 Results 25 Lessons Learned and Recommendations 26 Products 26 Overview of Community-Based Treatment Alternatives for Children Grants 27 Individual CTAC Grant Summaries 29 Illinois 31 Primary Purpose 31 Results 31 Recommendation 31 Products 31 Maryland 33 Primary Purpose 33 Results 33 Recommendation 33 Products 33 Massachusetts 35 Primary Purpose 35 Results 35 Lessons Learned and Recommendations 35 Products 35 Mississippi 37 Primary Purpose 37 Results 37 Recommendation 37 Products 37 Missouri 39 Primary Purpose 39 Results 39 Lessons Learned and Recommendations 39 Products 39 Texas 40 Primary Purpose 40 Results 40 Lessons Learned and Recommendations 40 Products 40 Appendix Real Choice Systems Change Grants for Community Living Reports on the FY 2003 Grantees 1 I. Formative Research Reports 1 Real Choice Systems Change Grant Program: Third Year Report 1 Real Choice Systems Change Grant Program: Fourth Year Report 1 II. Topic Papers 1 Real Choice Systems Change Grant Program: Activities and Accomplishments of the Family to Family Health Care Information and Education Center Grantees 1 Real Choice Systems Change Grant Program: Money Follows the Person Initiatives of the Systems Change Grantees 2 Real Choice Systems Change Grant Program: Increasing Options for Self-Directed Services: Initiatives of the FY 2003 Independence Plus Grantees 2 Real Choice Systems Change Grant Program: Improving Quality Assurance/Quality Improvement Systems for Home and Community-Based Services: Experience of the FY 2003 and FY 2004 Grantees 2 III. Summaries 2 Summaries of the Systems Change Grants for Community Living—FY 2003 Grantees 2
Exhibits Exhibit 1-1. FY 2003 CPASS Grantees 1 Exhibit 1-2. Enduring Improvements of the CPASS Grantees 1 Exhibit 2-1. FY 2003 MFP Grantees 1 Exhibit 2-2. Enduring Systems Improvements of the MFP Grantees 2 Exhibit 3-1. FY 2003 Independence Plus Grantees 1 Exhibit 3-2. Enduring Systems Improvements of the IP Grantees 2 Exhibit 4-1. FY 2003 QA/QI Grantees 1 Exhibit 4-2. Enduring Systems Improvements of the QA/QI Grantees 2 Exhibit 5-1. FY 2003 Family to Family Grantees 1 Exhibit 6-1. FY 2003 RFA Grantees 1 Exhibit 6-2. FY 2003 RFC Grantees 1 Exhibit 6-3. FY 2003 CTAC Grantees 27 Directory: sites -> nasuad -> files -> hcbs -> files sites -> 587 Return function, r i(X) r i(0) r i(1) r i(2) r i(3) 1 0 2 4 6 Thermal Station, I 2 0 1 5 6 3 0 3 5 6 10 sites -> Glossary for Chapter 1 Algorithm sites -> North Carolina Inclusion Initiative Mapping Where Children with ieps are Being Served Purpose sites -> Northern England’s set-jetting locations sites -> Physical custody of 1033 program property accountibility form statement of Physical Custody: By signing for the below 1033 property I am a Law Enforcement Officer of the aforementioned Law Enforcement Agency sites -> Nstructions for Acquiring Excess Equipment online, through the 1033 Program sites -> Memorandum of agreement files -> Acronyms introduction: The most important fact about acronyms and professional jargon is that it is not necessary for any of this work. In fact Download 2.18 Mb. Share with your friends:
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