Rutgers/NASHP

This tool box is intended to synthesize information that is available from multiple sources about nursing home transition and Money Follows the Person (MFP) initiatives to help states prepare for the MFP Demonstration program created by the Deficit Reduction Act. Each chapter summarizes the state of the field in a particular MFP design component, such as identifying consumers, planning and implementing transitions from an institution, financing MFP, and evaluating programs and progress.

This report tracks the work of 8 Passport caseworkers from 3 different service organizations. Caseworkers noted that clients experienced mixed feelings about the program; they were excited at the prospect of transitioning into the community but also frustrated at the length of time it took to complete the transition. Throughout the survey period, the biggest success experienced by caseworkers was finalizing a client’s housing and assisting them in moving out of a nursing home.

Provides practical information on how state agencies can obtain and use the MDS through Data Use Agreements (DUAs) with the Centers for Medicare & Medicaid Services (CMS). Explores the progress states have made in: using the MDS to facilitate nursing facility transition; identifying barriers that remain; and, suggesting recommendations for changes to the MDS to make it more useful for nursing home transition efforts. We examine three uses of the MDS by nursing facility transition program.

This summary of the Home and Community Based Services (HCBS) State Plan Amendment (SPA) option is based on a review of the Deficit Reduction Act (DRA) and discussion from the April 3, 2006 conference call with CMS staff and Real Choice grantees. The content reflects the Rutgers/NASHP TA collaborations understanding of the legislation and questions raised by grantees. The intent is to highlight what is known about the DRA and some questions about how it will affect States that elect this option.

This paper outlines some of the factors program managers may need to consider in identifying strategies for integrating information to support their quality improvement activities. The focus of this paper primarily is on synthesizing information from different data sources and integrating two or more files. For the more technically minded, the Appendix provides examples of states system integration efforts.

This paper walks through different types of HCBS waiver reports and includes steps for thinking through the purpose, content and format, while tailoring report presentation to meet the needs of specific audiences. Wherever possible, state examples are provided and supplemented by sample reports that combine promising features. Seven types of reports are highlighted that guide program management, inform policy development, measure program outcomes and identify areas for quality improvement.

Presenting numbers and patterns is a critical component of data analysis. Once analyses have been completed, the next step involves sharing key findings with staff and stakeholders and using findings as a basis for decision-making. There are a number of ways to present data and the challenge is in constructing an effective visual. This paper provides an overview of the most frequently used formats and includes tips on how to select among the different types.

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.

What applications can states use to measure home and community based services? The purpose of this report is to outline the key components of performance measurement and to discuss their relevance and potential use in HCBS.The paper also offers practical approaches for states to gradually build a HCBS performance measurement set to serve as the foundation for their quality management activities and CMS required reporting.

This State Policy in Practice brief describes the process of sustaining Connecticut's nursing home transition program. Connecticut focused on bringing key stakeholders (including consumers) together and building evaluation into their efforts to make the case for obtaining state funding for the transition program. This brief is intended to help state policy and program leaders, advocates, and providers learn from their peers and colleagues across the states.