3/2/2017 USING HCBS HCBS Quality Measures QUALITY Historically have emphasized acute and • traditional health care outcomes; MEASURES TO Growing emphasis on LTSS and HCBS • SUPPORT quality as states shift towards Managed Long Term Services and Supports COMMUNITY LIVING ”In God We Trust, Everyone Else Please • Ari Ne’eman Bring Data” E-mail: ari@mysupport.com MySupport.com Phone: 202.596.1056 HCBS Quality Measures Key for Quality • Improvement, Holding Health Plans & Providers Accountable Person Centered Planning and Service Delivery and Effectiveness Coordination Number and percent of waiver participants The number of service hours delivered • • with reassessment performed and ISP/IPs minus the number of service hours updated when needs/condition changed. approved (DE MLTSS) (HI MLTSS) Percent responding yes to: Do the services • you receive meet your needs and goals? (NCI-AD) Percent of participants reporting they are the • Proportion of Individualized Care Plans primary deciders of what is in their service • plan. (MN MLTSS) with goals unmet (NY MLTSS) Of the total number of late/missed visits • for each service type, by provider type; Percent HCBS members who report: Their the percent that were: member initiated; • service coordinators help them get what provider-initiated; due to weather/natural they need. (HI MLTSS) disaster. (TN MLTSS) 1
3/2/2017 Self-Directing PWD Across the US Choice and Control Percent responding yes to: Can you see • your friends when you want to? (NCI-ACS) Percent of HCBS members who report: • making choices about everyday lives, including: housing, roommates, daily routines, case manager, support staff or providers, and social activities. (HI MLTSS) Percent of MLTSS members opting to use • self-direction. (NJ, SC MLTSS, others) Source: National Resource Center on Participant Directed Services Self-Direction Across the US Community Inclusion Proportion of individuals in sheltered • workshops who transition to integrated community based employment. (NY MLTSS) Percent HCBS members who report: They • have adequate transportation when they want to go somewhere. (HI MLTSS) Proportion of individuals who have an • integrated job in the community. (NY MLTSS) Source: National Resource Center on Participant Directed Services 2
3/2/2017 Caregiver Support Workforce Percent responding no to: During the past Percent of members reporting that the • • 12 months, has your overall health people who help with personal care always suffered because of your caregiving treat them with courtesy and respect. (WI responsibilities? (GSS-CRR) MLTSS) Percent responding yes to: Before [person] Proportion of direct support professionals • • left the hospital or was discharged, did that meet competencies. (NY MLTSS) you receive clear instructions about any Percent responding no to: Is it difficult for • medical/nursing tasks you would need to you to find attendant providers for your perform for [person]? (CGUS) care? (EAZI) Percent responding yes to: In the last year, Percent responding yes to: My worker is • • have you used any service that took care sensitive and responsive to customs and of [person] so that you could take some traditions of my culture or background. time away from helping? (NSOC) (MAHCSS) Human and Legal Rights Human and Legal Rights Percent of critical incidents reported to Percent responding yes to: At the service • • the state within 30 days, including planning meeting, did you know what was corrective actions taken. (MLTSS Multiple being talked about? (NCI-ACS) States) Critical Incident reporting: per 1000 • Percent responding yes to: Are you able to • enrollees total and by population (HCBS be alone at home with visitors if you want and Institutional). (DE MLTSS) to? (NCI-ACS) Percent of member records reviewed in • which HCBS were denied, reduced, Percent responding yes to: Is the person • suspended, or terminated as evidenced in provided with the support needed to the Plan of Care and consequently, the exercise his or her rights? (POMs) member was informed of and afforded the right to request a Fair Hearing. (TN MLTSS) 3
3/2/2017 Equity Holistic Health and Functioning Percent of recipients using each service, • Percent reporting that they feel lonely, compared by eligibility group. (MN MLTSS) • sad, or depressed “not often,” “almost never,” or “never.” (NCI-AD) Community health service utilization data • Participants in the Demonstration who • for Enrollees, including number of units remained stable or improved in ADL and units per 1,000 enrollees, by age functioning between previous assessment group and gender (MA MLTSS) and most recent assessment. (NY , AZ MLTSS & others) Percent of authorized units paid over time • Percent of HCBS members who were re- • by eligibility group. (MN MLTSS) admitted to the hospital within 30 days of last hospitalization (NJ, NY MLTSS) Percent responding “true” to: I am treated • equally. (PART-E) Systems Performance and Accountability Consumer Leadership in System Development Percent of individuals who are receiving • HCBS versus institutional services. (DE MLTSS, others) Documentation in the form of stakeholder • Percent of HCBS members transitioning meeting agendas and meeting minutes • from the community to the NF for a stay that demonstrate the MCO response to of greater than 180 days (NJ MLTSS) significant concerns raised by stakeholder Members transitioned into the community group participants. (MN MLTSS) • are transitioned into a home and setting of their choice that is fully accessible on day Often reflected in initial MLTSS application • of transition (RI MLTSS) process with CMS, insufficiently tracked on Overall average cost per recipient of long- an ongoing basis. • term care services by eligibility group, lead agency, and demographic group. (MN MLTSS) 4
3/2/2017 WORKER PROFILE O T Workers can describe SL P themselves and Philadelphia, PA 19101 everything they are capable of through a comprehensive profile MY PROFILE MY VALUES MY AVAILABILITY Clear Quality Measures Spark Innovation Hi! I’m Ari. Thank you for taking a look at my profile and considering me as a candidate to be your support worker. Over past 10 years, I have worked with seniors and individuals with disabilities to ensure that they have every opportunity possible to lead an active and fulfilling life. I believe that my clients are the experts in their own experience, and I recognize that disability is a natural part of life. I work to treat my clients with the same kind of dignity and respect that I would expect if/when I receive support worker services myself. I am very friendly, fluent in Spanish, and love animals! I am happy to provide references from previous clients. CONFIDENTIAL 1 8 POWERFUL MATCH QUESTIONS SEARCH We help match Filter and search 19101 people seeking using location support and workers proximity, availability through questions times, gender, age, that determine what’s language, last login important to them time and many other advanced filters Workers Similar to Jason 8.9 miles, Philadelphia, PA 19101 Making sure the person they are supporting is safe 0.9 miles, Philadelphia, PA 19101 Doing what the person they are supporting tells them Helping the person they are supporting to be all they can be 0.9 miles, Philadelphia, PA 19101 1 2 CONFIDENTIAL CONFIDENTIAL CONFIDENTIAL 9 0 5
3/2/2017 Analytics MySupport Dashboard View client and Vendorized by the Golden Gate Regional • worker activity on a Center robust and powerful analytics dashboard that allows any Has approximately 300 people with • graph or table to be disabilities and 600+ worker users in the exported into Excel Greater Bay Area Currently active in California and Iowa • Preparing for Launch in Maryland, Virginia, • Delaware and New York CONFIDENTIAL 2 1 What’s Next in HCBS Quality Measurement? General Quality Improvement • Managed Long Term Services and Supports • Questions? Pay for Performance Reimbursement • Models Emerging in Employment and Residential Services Provider-Level Risk Models (i.e: PACE for • under 50s) 6
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