Reports

Creating a single assessment tool to be used across age and disability has been an interest of states, policy makers, and providers for years. An interest also exists to develop a consumer-driven participatory assessment where consumers take a more active role. Following review and input from a diverse work group, this tool was piloted for 16 months and a qualitative evaluation was conducted to determine its utility. The development process yielded key findings and recommendations.

Is your program challenged by effective methods to meaningful consumer involvement in the redesign of long-term services and support systems? This report reviews the history and effectiveness of the consumer involvement strategy used from the consumer, state partner, and grant staff perspectives. The report informs future consumer involvement methods in grant activities and other policy decision-making activities and also identifies lessons learned and creates recommendations.

This paper focuses on the experiences and perceptions of community liaisons and the managers of Consumer-Directed Agencies (managers) who participated in the Massachusetts Real Choice Pilot. The experiences of the Real Choice community liaisons and managers provide insight relevant for the larger implementation of the support brokerage component for an Independence Plus option that will be available within the Massachusetts Community First waiver.

Does self-determination refer to a curriculum that teaches students with disabilities to be self-directed problem solvers, a technique for redirecting funding streams to control the dollars allocated for their supports and services, or a philosophy grounded in democratic values and constitutional principles of autonomy and liberty? Or is it two or three of these? TASH invites you to read this Exchange focusing on the need to have more coherence and consistency in terminology/descriptions.

Is there a growing recognition that loneliness, helplessness, and boredom plague long-term care? This report examines six issues facing policymakers: financing and insurance, supporting and educating caregivers, the challenges of changing the physical and organizational environments in which services are delivered, recruiting and retaining a qualified workforce, designing a more effective regulatory control system, and adapting and integrating health information technology to long-term care.

Medicaid clients and advocates have stressed the importance of case management services to ensure that clients have access to supports, choice among providers and services to meet their needs. Quality became a primary topic of discussion for the Quality for Equality (Q4E) Committee. The Q4E identified concerns regarding the process by which the Department and case management agencies incorporate client input into quality improvement initiatives. Review the Q4E’s final report and recommendations.

This report describes examples of more narrowly focused state legislation that is setting the policy and infrastructure for consumer direction, expanding the direct care workforce, and supporting persons who return to the community after living in institutions. The Appendix includes the specific legislative language of selected bills covered in the report.

An advisory committee of consumers, providers, practitioners, advocates and experts worked collaboratively to identify the major challenges preventing people with mental illness from discharging out of nursing facilities and into less restrictive communities. This report is a result of their work and aims to make available a framework for successful transition programs. The best practices described are offered as a guide for service providers, advocates, and mental health clients themselves.

Explore the impact of consumer-directed support on the economic, health, and social outcomes between families enrolled in the program and those on a waiting list. Caregivers reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did the waiting list group.

The Nurse Delegation Invitational Forum brought together 28 participants from seven states to discuss the involvement of unlicensed assistive personnel (UAP) in the provision of health care tasks to long-term care consumers through nurse delegation and consumer direction. The Oregon long-term care system served as the forum centerpiece, with presentations by staff from state programs, the board of nursing, practicing nurses who delegate and visits to several sites in the Portland area.