Reports

The Council on Quality and Leadership (CQL) proudly offers the cross-walk between CQL’s new Quality Measures 2005 and The Centers for Medicare and Medicaid Services Quality Framework for Home and Community Based Services (HCBS). This cross-walk is intended to help align the Quality Framework with valid and reliable strategies for gathering and reporting data and evidence. The Cross-Walk clearly demonstrates how CQL’s Quality Measures 2005 provide an integrated approach to quality management.

To assist states in developing and implementing home and community-based waiver programs, CMS has developed a Quality Framework. The purpose of this background memo is to help Cash and Counseling states apply the framework and incorporate the necessary waiver assurances as they develop their quality management plans for consumer directed programs. This paper offers examples that operationalize the quality framework and tables about participants: Access, Safeguards, Outcomes and Satisfaction.

This memorandum presents state-by-state data on Medicaid long term care expenditures in Federal Fiscal Year 2004 (October 2003 through September 2004). The accompanying tables present data on Medicaid Expenditures for Long-Term Care services from 1992 to 2004. A new table this year shows the effect of supplemental nursing facility payments in some states on expenditure data. A separate file ranks states based on the proportion of LTC spending for community services.

This entry presents data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 1999-2004. As in previous years, information is classified for each individual HCBS waiver by the target population served in order to present information on the distribution of HCBS waiver expenditures across long term care populations. Tables include waiver spending by target population; growth in spending; expenditures by state; distribution of expenditures.

This paper synthesizes the ideas and practices of states as they seek to improve the quality of HCBS services. The purpose of this paper is: to promote the exchange of information among states regarding the use of discovery methods for HCBS services; to identify and share the various approaches that states are using to identify gaps, redundancies, strengths and weaknesses in their HCBS quality systems; to discuss ways to prioritize activities and select quality improvement activities.

The State of South Carolina implemented a state-wide automated monitoring system whose real time data allows for monitoring & verification of the providers delivering services under the state's home and community-based services waivers. The toll-free number allows providers to check-in and check-out as they deliver services in a participant's home, while the database inferfaces with claims data to minimize fraudulent billing. The database has empowered waiver service recipients.

South Carolina developed a simplified provider agreement to make Medicaid enrollment easier for providers that normally do not provide Medicaid services. The State piloted the agreement in an Independence Plus Medicaid Home and Community-Based Services Waiver and in a Nursing Home Transition Grant. The six-item agreement contains only the minimum federal requirements for Medicaid providers and can allow Medicaid participants to receive services, equipment, etc. from non-traditional providers.

The State of Minnesota contracts with the White Earth Nation to provide functional eligibility determination and case management for Medicaid and state-funded home and community-based services for seniors. Tribal staff report their member are more likely to use the services when they can access them through familiar tribal health services. The federal government pays 100% of costs for Medicaid services provided by tribal organizations.

The state of Wisconsin developed this piece in a continuing attempts to explain what is meant by \"quality management\" as separate from all the other things waiver staff do that promote quality. It's useful, for example, when interviewing local waiver staff about their QM practices, or give a report to different departments and management about the grant project. The Quality Cycle is also illustrated within the report.

For older adults and individuals with disabilities, some website designs can pose access problems. Users may be unable to use a website’s navigational menu, fill out online forms, or even access content. Addressing accessibility issues is important. This brief addresses the adaptation of standard website construction techniques to meet the needs of the target populations. It includes considerations & strategies for design that are informative, functional and useful for these populations.