Request for Quality Measures for Medicaid Home and Community-Based Services, 30800-30803 [07-2732]
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30800
Federal Register / Vol. 72, No. 106 / Monday, June 4, 2007 / Notices
owned by the bank holding company,
including the companies listed below.
The applications listed below, as well
as other related filings required by the
Board, are available for immediate
inspection at the Federal Reserve Bank
indicated. The application also will be
available for inspection at the offices of
the Board of Governors. Interested
persons may express their views in
writing on the standards enumerated in
the BHC Act (12 U.S.C. 1842(c)). If the
proposal also involves the acquisition of
a nonbanking company, the review also
includes whether the acquisition of the
nonbanking company complies with the
standards in section 4 of the BHC Act
(12 U.S.C. 1843). Unless otherwise
noted, nonbanking activities will be
conducted throughout the United States.
Additional information on all bank
holding companies may be obtained
from the National Information Center
website at www.ffiec.gov/nic/.
Unless otherwise noted, comments
regarding each of these applications
must be received at the Reserve Bank
indicated or the offices of the Board of
Governors not later than June 29, 2007.
A. Federal Reserve Bank of Kansas
City (Donna J. Ward, Assistant Vice
President) 925 Grand Avenue, Kansas
City, Missouri 64198-0001:
1. FirstBank Holding Company,
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100 percent of the voting shares of
FirstBank of Arizona, Phoenix, Arizona
(in organization).
Board of Governors of the Federal Reserve
System, May 30, 2007.
Robert deV. Frierson,
Deputy Secretary of the Board.
[FR Doc. E7–10677 Filed 6–1–07; 8:45 am]
BILLING CODE 6210–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Request for Quality Measures for
Medicaid Home and Community-Based
Services
Agency for Healthcare Research
and Quality (AHRQ), DHHS.
ACTION: Notice of request for measures.
rwilkins on PROD1PC63 with NOTICES
AGENCY:
SUMMARY: The Agency for Healthcare
Research and Quality (AHRQ) is
soliciting the submission of survey
instruments and items that could be
used to measure the quality of Medicaid
home and community-based service
(HCBS) programs. Specifically, AHRQ is
interested in metrics related to assessing
the performance of such programs,
20:34 Jun 01, 2007
Jkt 211001
Please submit data collection
instruments and supporting information
about their development and/or use no
later than 30 days after publication of
this notice. AHRQ will not respond
individually to submitters, but will
consider all submitted items and
instruments and publicly report the
results of the review of the submission
in an aggregated form.
DATES:
Submission should include
a brief cover letter, a copy of the
instrument or items for consideration
and supporting information (e.g., a
users’ guide, citation(s) or copies of
supporting article(s)) as specified under
the Submission Criteria below.
Submissions may be in the form of a
letter or e-mail, preferably with an
electronic file(s) as an e-mail
attachment. Responses to this request
should be submitted to: D.E.B. Potter,
Center for Financing, Access and Cost
Trends; Agency for Healthcare Research
and Quality, 540 Gaither Road, Suite
500, Rockville, MD 20850, Phone: (301)
427–1564, Fax: (301) 427–1276; E-mail:
D.E.B.Potter@ahrq.hhs.gov.
To facilitate handling of submissions,
please include full information about
ADDRESSES:
Agency for Healthcare Research and
Quality
VerDate Aug<31>2005
client functional outcomes and client
experience of, and satisfaction with,
Medicaid HCBS services and supports.
This initiative is in response to the
mandate within the Deficit Reduction
Act (DRA) of 2005, Public Law 109–171,
Section 6086(b) that AHRQ develop
such measures, in consultation with
relevant stakeholders. In preparation for
this task, AHRQ is conducting an
environmental scan of existing tools that
could be adapted or used for assessing
the quality of Medicaid HCBS services
and supports.
Based on the agency’s initial
methodological work, there are several
quality domains the resulting measure
set could assess, including: timeliness of
determining need and providing
services and supports, personcenteredness, safety, equity, efficiency
and, effectiveness of services and
supports, qualifications of providers,
client health and welfare, program
administrative oversight, access, unmet
need among current program
participants, and coordination of longterm care services with other service
providers. For example, relevant
measures might include items from a
consumer survey that ask about receipt
of services or experience with select
providers, or metrics that use program
administrative data to determine if
providers meet program qualifications
or if assessments are done on a timely
basis.
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the instrument developer and/or a
designated contact.
• Name
• Title
• Organization
• Mailing address
• Telephone number
• Fax number
• E-mail address
Also, please submit a copy of the
instrument or items for consideration,
and evidence that it meets the
submission criteria below. It is
requested (but not required) that citation
of a peer-reviewed journal article
pertaining to the instrument, to include
the title of the article, author(s),
publication year, journal name, volume,
issue, and page numbers where article
appears be included.
Submitters must also provide a
statement of willingness to grant to
AHRQ the right to use and authorize
others to use submitted measures and
their documentation as part of any
future instrument or measure set that
may result from developing the
statutorily-mandated Medicaid HCBS
measure set. Electronic submissions are
encouraged.
FOR FURTHER INFORMATION CONTACT:
D.E.B. Potter at the address above.
SUPPLEMENTARY INFORMATION
Submission Criteria
Items and instruments submitted
must focus on evaluating the
performance of home and communitybased services, client experience of, and
satisfaction with, these home and
community-based services and
supports, as well as related client
functional outcomes. Such services are
defined broadly to include at a
minimum the array of services included
as HCBS under Section 1915(b), (c), or
(b) and (c) of the Social Security Act
(the Act), HCBS as a State plan option
under Section 1915(i), as well as selfdirected personal assistance services
under Section 1915(j), and HCBS under
Section 1115 of the Act, and HCBS
demonstrations, as authorized under
Section 6071 of the Deficit Reduction
Act of 2005. For the purpose of this call
for measures, the listed services are
interpreted broadly to include Medicaid
home health care services, Medicaid
personal care services, and Medicaid
targeted case management services.
Submitted materials should be
designed to measure (i.e., quantify)
program performance, client functional
outcomes (including social role
functioning), and/or client experience
related to any of the following areas:
The timeliness of determining need and
providing services and supports,
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Federal Register / Vol. 72, No. 106 / Monday, June 4, 2007 / Notices
person-centeredness, safety, equity,
efficiency and effectiveness of services
and supports, qualifications of
providers, client health and welfare,
program administrative oversight,
access, unmet need among current
program participants, and coordination
of long-term care services with other
service providers.
Measures submitted must be relevant
or readily adaptable to collection of
information on the Medicaid HCBS
service experience of people with
chronic disabilities, including the
following populations:
• Physically- and/or cognitivelyimpaired elders, including those with
dementia;
• Adults or children with intellectual
or developmental disabilities;
• Children whose physical,
intellectual and/or mental health
disabilities significantly impair their
ability to participate in age-appropriate
activities (e.g., schooling and play),
including children with special health
care needs;
• Adults with severe and persistent
mental illness;
• Adults with acquired brain injuries;
and,
• Adults with physical disabilities
and/or chronic conditions (such as HIV/
AIDS) that place them at risk of
institutional care.
Unless such measures can be adapted
to HCBS, measures related exclusively
to institutional services, specifically
those provided in a skilled nursing
facility, nursing home, State hospital, or
intermediate care facility for the
mentally-retarded (ICF/MR), will not be
considered, although those that apply to
alternative residential settings eligible
for Medicaid HCBS funding, such as
small group homes and assisted living
facilities will be. Measures specific to
the process of applying for Medicaid
HCBS services (e.g., waiting lists) are
also within the scope of this request. In
addition, measures should be designed
to quantify the experience of current
Medicaid HCBS service recipients;
including caregivers who receive such
services directly (e.g., respite care or
family therapy). Measures related to
non-service recipients, including
measures of staff satisfaction (including
family caregivers as secondary
recipients—as distinguished from direct
recipients) are considered to be outside
the scope of this effort. For a more
detailed list of the home and
community based services, see the
SUPPLEMENTARY INFORMATION section
below entitled ‘‘Types of Home and
Community-Based Services’’:
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AHRQ is particularly interested in
soliciting information from three types
of submitters:
1. Organizations (or persons) who use
(or contract for the use of) another
organization’s survey (or survey item(s))
and the survey/items used are
applicable to (or could be adapted to)
HCBS.
2. Organizations (or persons) who
developed a survey (or survey item(s))
and the survey/items are applicable to
(or could be adapted to) HCBS.
3. Organizations (or persons) who use
another organization’s survey but have
modified the original survey (added
items to, taken items away or changed
the wording) and the resulting hybrid
survey is applicable to (or could be
adapted to) HCBS.
Additional Submission Instructions
Submitter Type 1
Each submission should include the
following information:
• Name of the measure(s)/
instrument(s)/survey(s) used by (or
contracted for by) your organization
• Brief description of the measure(s)/
instrument(s)/survey(s)
• Population intended for
measurement
• Care provider type (e.g., home
health agency, consumer directed
caregiver, assisted living facility, adult
day care provider, skills training
counselor)]
• Service setting (e.g., group home,
client’s home, school, assisted living
facility)
• Domain(s) (i.e., content areas)
• Language(s) the measure(s)/
survey(s) (e.g., number of HCBS
programs, program size(s))
• Where the Submitter’s organization
has used (fielded), and/or is currently
using, the measure(s)/instrument(s)/
survey(s) (e.g., number of HCBS
programs, program size(s))
Submission of copies of existing
report formats developed by the Agency
using the survey to disclose findings to
consumers and providers is desirable,
but not required. Additionally,
information about existing database(s)
(particularly at the state level) for
collecting results gathered using the
instrument(s) or items submitted is
helpful, but not required for submission.
A partial response by a Submitter
Type 1 could be ‘‘* * * our Agency
uses the National Core Indicator’s (NCI)
Child Family Survey (Phase VII version)
for our State’s 1915(c) waiver for
children with special health care needs
* * * for our HCBS program for elders
with Alzheimer’s we use the Participant
Experience Survey (PES) Elder/Disabled
Version (Version 1) * * *’’
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Submitter Type 2
Information about the instrument that
you and/or your organization developed
may be provided (in part) through
submission of peer-reviewed journal
articles). Each submission should
include the following information.
• Name of the measure(s)/
instrument(s)/survey(s) developed
• Description of the measure(s)/
instrument(s)/surveys(s)
• Population intended for
measurement
• Care provider type(s) (e.g., home
health agency, consumer directed
caregiver, assisted living facility, adult
day care)
• Service setting (e.g., group home,
client’s home, school, assisted living
facility)
• Copy of the relevant measure(s)/
instrument(s)/survey)s) (e.g., individual
items and response categories)
• Domain(s) (i.e., content areas)
• Language(s) the measure(s)/
instrument(s)/survey(s) is available in
• Reliability of the measure(s)/
instrument(s)/survey(s) (e.g., internal
consistency, test-retest, etc).
• Validity of the measure(s)/
instrument(s)/survey(s) (e.g., content,
construct, criterion-related)
• Response rate(s) obtained when
measure(s)/instrument(s)/survey(s) is
used to measure on the intended
population
• Methods and results of any
cognitive testing associated with the
measure(s), instrument(s) and/or
survey(s)
• Methods and results of any fieldtesting associate with the measure(s),
instrument(s) and/or survey(s)
• Data collection protocols (including
mode and respondents)
• Description of sampling strategies
used for data collection
• Where the Submitter’s organization
has used (fielded), and/or is currently
using, the measure(s)/instrument(s)/
survey(s) (e.g., number of HCBS
programs, program size(s))
• Information about any professional
or organizations endorsements
associated with the measure(s)/
instrument(s)/survey(s)
Submission of copies of existing
report formats developed to disclose
findings to consumers and providers is
desirable, but not required.
Additionally, information about existing
database(s) collecting results gathered
using the instrument(s) or items
submitted is helpful, but not required
for submission. Information about the
instrument may be provided through
submission of peer-reviewed journal
article, if applicable or through the best
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evidence available at the time of
submission.
In submitting measures, submitters
agree to relinquish ownership of any
items developed by the submitter/
organization that are selected to be pat
of the measure set(s) developed by
AHRQ for public use (beginning in 2008
as required by Section 6086(b) of the
DRA). However, item ownership will be
protected during the initial measure
can, and during any subsequent
measure development efforts AHRQ
might undertake.
Submitter Type 3
Information about the original survey
measures and the nature of any survey
measure modifications (including new,
changed or deleted items) is requested
for submission.
For the measures/items based directly
on an existing survey/measure(s) (and
without any changes to the items), the
information described under
Submission Submitter Type 1 is
requested along with copies of the
relevant measures that are actually used
(e.g., individual items and response
categories).
In addition to the original measures
information (requested in the previously
paragraph), information about the
modified measures/items is requested.
Modifications may include question
wording changes, the addition of new
items/measures, and/or the deletion or
original survey items. For the modified
items, the following is requested:
For measures/items based directly on
the original survey items, but modified
with question wording changes,
information (if available) described
under Submission Submitter Type 2 is
requested for modified items. The
reason(s) for question wording change(s)
is also requested, but not required. At a
minimum, a copy of the modified
measures, how the measures are used
and some information about how the
measures were developed is required.
For new items added to an existing
survey, information described under
Submission Submitter Type 2 is
requested. Also requested, but not
required, is (are) the reason(s) for the
addition of the new items. An example
of the latter might be along the lines of
‘‘* * * for our HCBS program for elders
with Alzheimer’s we use the PES Elder/
Disabled Version (Version 1) but have
also added a module to capture
information about medication
management/administration for clients
in a residential settings.* * *’’ At a
minimum, a copy of the modified
measures, now the measures are used
and some information about how the
measures were developed is required.
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20:34 Jun 01, 2007
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In situations where the modifications
to the original survey are simply a
deletion(s) of original survey items (and
with new items added) a description on
of what items were deleted and why is
also requested. An example of the latter
might be ‘‘* * * for our HCBS program
for elders we use the ABC Survey but
drop questions 34–42 at the Agency
does not use this information.’’
In submitting modified measures,
submitters agree to relinquish
ownership of any items developed by
the submitter/organization and that are
selected for use in the measure set(s)
developed and adopted by AHRQ
(beginning in 2008 as required by
Section 6086(b) of the DRA). However,
item ownership will be protected during
the initial measure scan, and during any
subsequent measure development
efforts AHRQ might undertake.
Submitters Types 1, 2 and 3
It is not necessary to submit any
actual data generated from using the
survey instruments.
Types of Home and Community-Based
Services
Both the type and extent of home and
community-based services provided
under Medicaid can vary from program
to program. Below is a partial list of the
broad range of services that have been
provided by States under their Medicaid
HCBS programs; States may provide
additional services.
• 24 Hour Supervision/Monitoring
• Activities Therapy
• Adaptive Health and Wellness
Services
• Adult Companion Services
• Adult Day Care
• Adult Day Health
• Adult Foster Care
• Adult Residential Care
• Alternative Living/Alternative Care
Facility
• Assisted Living
• Assistive Technology
• Assistive Technology Evaluation
• Assistive Technology Repairs
• Attendant Care
• Attendant Care—Rent/Food for
Unrelated Live-In Caretaker
• Augmentative Communication
• Behavior Management and
Consultation
• Bereavement Counseling
• Case Management
• Case Management Aide
• Chore/Home Maintenance
• Clinic Services
• Clinical Supports
• Coaching/Cueing
• Cognitive/Behavior Services
• Cognitive Rehabilitation
• Community Access
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• Community Connection
• Community Integration Training
• Community Membership
• Community Specialist
• Community Transition Services
• Companion Services
• Congregate Meals
• Consolidated Developmental
Services
• Consultative Clinical and
Therapeutic Services
• Consumer/Family/Caregiver
Training
• Counseling
• Crisis Intervention Services/
Support
• Day Habilitation
• Day Program
• Dental
• Developmental Day Care
• Early Intervention
• Educational Services Habilitation
• Electronic Home Response
• Emergency Move
• Environmental Adaptations/Home
Modifications
• Environmental Engineering
• Escort/Outings
• Exercise Therapy
• Family Counseling
• Financial Counseling and Training
• Financial Risk Reduction
• Fiscal/Employer Agent/
Management Services
• Group Homes
• Habilitation
• Home Accessibility Adaptations
• Home-Based Supportive Care
• Home Delivered Meals
• Home Health Aide
• Home Health Care
• Home Maintenance/Repair
• Homemaker Services
• Hospice
• Housing Access Coordination
• Housing Start-Up
• Independent Living Provider
• Independent Living Skills Training
• Individual Directed Goods and
Services
• Integrated Therapeutic Network
• Interdisciplinary Team
• Life Skills Training
• Live-in Caregiver
• Meal Services
• Medical Equipment/Supplies
• Medical Nutritional Support
• Medically-Related Direct Therapies
• Medication Administration
• Medication Management
• Mental Health Day Treatment
Services
• Mental Illness/Clinic
• Mental Illness/Day Treatment/
Partial Hospitalization
• Mental Illness/Psychosocial
Rehabilitation
• Money Management
• Moving Assistance
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• Night Supervision
• Non-Legend/Non-Formulary Drugs
• Non-Medical Transportation
• Nursing Home Diversion Program
• Nutrition Therapy
• Nutritional Counseling/Assistance
• Nutritional Risk
• Nutritional Supplements
• Occupational Therapy
• Optometry Services
• Over-the-Counter Drugs
• Pediatric Community Transitional
Home Services
• Periodic Nursing Evaluations
• Person Centered Planning
• Personal Adjustment Counseling
• Personal Agent
• Personal Care
• Personal Care Assistance
• Personal Care Coordination
• Personal Care—Rent/Food for
Unrelated Live-In Caretaker
• Personalized Emergency Response
Systems
• Phone Reassurance Monitoring
• Physical Risk Reduction
• Physical Therapy
• Physical Therapy—Extended State
Plan Services
• Physician Services
• Podiatry Services
• Prescribed Drugs
• Prescription Drug Co-Pay
• Preventative/Consultative
• Prevocational Services Habilitation
• Private Duty Nursing
• Professional Care Assistant
• Professional Services
• Protective Services
• Psychiatrist Services
• Psychologist Services
• Psychosocial Counseling
• Psychosocial Nutrition
• Psychosocial Rehabilitation
• Rehabilitation Engineering
• Renal Dialysis
• Residential Care
• Residential Habilitation
• Respiratory Therapy
• Respite Care
• Restorative Assistance
• Retainer Payment for Personal
Caregivers
• Shared Nursing
• Skill Building
• Skilled Nursing
• Socialization/Recreation
• Social Reassurance Therapeutic
Counseling
• Social Work Services
• Special Therapeutic Services
• Specialized Child Care
• Specialized Consultation Services
• Specialized Medical Equipment and
Supplies
• Specialized Psychiatric Services
• Specialized Therapies
• Speech, Hearing, and Language
• Staff/Family Consultation Training
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• Subsidized Housing
• Substance Abuse Treatment/
Counseling
• Support Brokerage
• Support Coordination
• Support Services
• Supported Employment
Habilitation
• Supported Living
• Therapeutic Counseling
• Therapeutic Living
• Therapeutic Management
• Therapeutic Massage
• Therapeutic Resources
• Therapeutic Social and Recreational
Program
• Therapeutic Supplies
• Training and Counseling Services
for Unpaid Caregivers
• Transitional Case Management
• Transitional Living
• Transportation
• Vehicle Modifications
• Visual/Mobility Therapy
• Wandering Alarm System
• Wellness Monitoring
• Wrap-Around Services
• Extended State Plan Services:
Æ Home health care services
Æ Physical therapy
Æ Occupational therapy
Æ Speech, hearing and language
services
Æ Prescribed drugs, except drugs
furnished to participants who are
eligible for Medicare Part D benefits
Æ Dental services
For additional information on HCBS
service, please refer to Appendix C:
Participant Services (pages 99 to 162) of
the Application for a section 1915(c)
Home and Community-Based Waiver
[Version 3.4] Instructions, Technical
Guide and Review Criteria Release Date:
November 2006, Disabled and Elderly
Health Programs Group, Center for
Medicaid and State Operations, Centers
for Medicare & Medicaid Services,
Department of Health and Human
Services, available at: https://
www.cms.hhs.gov/HCBS/
02_QualityToolkit.asp#TopOfPage.
Dated: May 27, 2007.
Carolyn M. Clancy,
Director.
[FR Doc. 07–2732 Filed 6–1–07; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
National Health Data Stewardship
Agency for Healthcare Research
and Quality (AHRQ), HHS.
AGENCY:
PO 00000
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ACTION:
30803
Request for information.
SUMMARY: There is a growing demand
for healthcare data from many sectors.
Key drivers for this demand have been
surging interest in healthcare
performance measurement and the
information systems needed to
aggregate, process and transmit
healthcare data from which measures of
health care quality may be derived and
to which the measures could be applied.
This need has raised the question of
responsibility for safeguarding the data
beyond the original care setting. This
issue has led various stakeholders to
propose the formation of a publicprivate national health care data
stewardship organization with oversight
of the various uses of healthcare data, as
described below.
For the purpose of achieving a
broader understanding of the issues that
establishment of such an entity may
present, input is requested from the
public and private sectors on the
concept of a national health data
stewardship entity (NHDSE). The
primary purpose of this RFI is to gather
information to foster broad stakeholder
discussion; there are no current plans to
issue a related request for proposals
(RFP).
Responses to this RFI are due no
later than July 27, 2007.
ADDRESSES: Electronic responses are
preferred and may be addressed to:
steward@ahrq.hhs.gov. Written
responses should be addressed to: P. Jon
White, MD, 540 Gaither Road, Rockville,
MD 20850.
A copy of this RFI is also available on
the AHRQ and AQA Web sites. Please
follow the instructions for submitting
responses.
If a response to this RFI is planned,
notification is requested in advance by
a simple response to one of the above
addresses. Such notification is
nonbinding and will not be made
public.
The submission of written materials
in response to the RFI should not
exceed 50 pages, including appendices
and supplemental documents.
Responders may submit other forms of
electronic materials to demonstrate or
exhibit key concepts of their written
responses. If the response is over 20
pages, an executive summary is
requested of the comments, no longer
than 5 pages.
Public access: Responses to this RFI
will be available to the public at AHRQ.
Please call 301–427–1505 between 9
a.m. and 5 p.m. to arrange access. The
RFI and all responses will also be made
available on the AHRQ Web site at
DATES:
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]]>Agencies
[Federal Register Volume 72, Number 106 (Monday, June 4, 2007)]
[Notices]
[Pages 30800-30803]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-2732]
=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Request for Quality Measures for Medicaid Home and Community-
Based Services
AGENCY: Agency for Healthcare Research and Quality (AHRQ), DHHS.
ACTION: Notice of request for measures.
-----------------------------------------------------------------------
SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
soliciting the submission of survey instruments and items that could be
used to measure the quality of Medicaid home and community-based
service (HCBS) programs. Specifically, AHRQ is interested in metrics
related to assessing the performance of such programs, client
functional outcomes and client experience of, and satisfaction with,
Medicaid HCBS services and supports. This initiative is in response to
the mandate within the Deficit Reduction Act (DRA) of 2005, Public Law
109-171, Section 6086(b) that AHRQ develop such measures, in
consultation with relevant stakeholders. In preparation for this task,
AHRQ is conducting an environmental scan of existing tools that could
be adapted or used for assessing the quality of Medicaid HCBS services
and supports.
Based on the agency's initial methodological work, there are
several quality domains the resulting measure set could assess,
including: timeliness of determining need and providing services and
supports, person-centeredness, safety, equity, efficiency and,
effectiveness of services and supports, qualifications of providers,
client health and welfare, program administrative oversight, access,
unmet need among current program participants, and coordination of
long-term care services with other service providers. For example,
relevant measures might include items from a consumer survey that ask
about receipt of services or experience with select providers, or
metrics that use program administrative data to determine if providers
meet program qualifications or if assessments are done on a timely
basis.
DATES: Please submit data collection instruments and supporting
information about their development and/or use no later than 30 days
after publication of this notice. AHRQ will not respond individually to
submitters, but will consider all submitted items and instruments and
publicly report the results of the review of the submission in an
aggregated form.
ADDRESSES: Submission should include a brief cover letter, a copy of
the instrument or items for consideration and supporting information
(e.g., a users' guide, citation(s) or copies of supporting article(s))
as specified under the Submission Criteria below.
Submissions may be in the form of a letter or e-mail, preferably
with an electronic file(s) as an e-mail attachment. Responses to this
request should be submitted to: D.E.B. Potter, Center for Financing,
Access and Cost Trends; Agency for Healthcare Research and Quality, 540
Gaither Road, Suite 500, Rockville, MD 20850, Phone: (301) 427-1564,
Fax: (301) 427-1276; E-mail: D.E.B.Potter@ahrq.hhs.gov.
To facilitate handling of submissions, please include full
information about the instrument developer and/or a designated contact.
Name
Title
Organization
Mailing address
Telephone number
Fax number
E-mail address
Also, please submit a copy of the instrument or items for
consideration, and evidence that it meets the submission criteria
below. It is requested (but not required) that citation of a peer-
reviewed journal article pertaining to the instrument, to include the
title of the article, author(s), publication year, journal name,
volume, issue, and page numbers where article appears be included.
Submitters must also provide a statement of willingness to grant to
AHRQ the right to use and authorize others to use submitted measures
and their documentation as part of any future instrument or measure set
that may result from developing the statutorily-mandated Medicaid HCBS
measure set. Electronic submissions are encouraged.
FOR FURTHER INFORMATION CONTACT: D.E.B. Potter at the address above.
SUPPLEMENTARY INFORMATION
Submission Criteria
Items and instruments submitted must focus on evaluating the
performance of home and community-based services, client experience of,
and satisfaction with, these home and community-based services and
supports, as well as related client functional outcomes. Such services
are defined broadly to include at a minimum the array of services
included as HCBS under Section 1915(b), (c), or (b) and (c) of the
Social Security Act (the Act), HCBS as a State plan option under
Section 1915(i), as well as self-directed personal assistance services
under Section 1915(j), and HCBS under Section 1115 of the Act, and HCBS
demonstrations, as authorized under Section 6071 of the Deficit
Reduction Act of 2005. For the purpose of this call for measures, the
listed services are interpreted broadly to include Medicaid home health
care services, Medicaid personal care services, and Medicaid targeted
case management services.
Submitted materials should be designed to measure (i.e., quantify)
program performance, client functional outcomes (including social role
functioning), and/or client experience related to any of the following
areas: The timeliness of determining need and providing services and
supports,
[[Page 30801]]
person-centeredness, safety, equity, efficiency and effectiveness of
services and supports, qualifications of providers, client health and
welfare, program administrative oversight, access, unmet need among
current program participants, and coordination of long-term care
services with other service providers.
Measures submitted must be relevant or readily adaptable to
collection of information on the Medicaid HCBS service experience of
people with chronic disabilities, including the following populations:
Physically- and/or cognitively-impaired elders, including
those with dementia;
Adults or children with intellectual or developmental
disabilities;
Children whose physical, intellectual and/or mental health
disabilities significantly impair their ability to participate in age-
appropriate activities (e.g., schooling and play), including children
with special health care needs;
Adults with severe and persistent mental illness;
Adults with acquired brain injuries; and,
Adults with physical disabilities and/or chronic
conditions (such as HIV/AIDS) that place them at risk of institutional
care.
Unless such measures can be adapted to HCBS, measures related
exclusively to institutional services, specifically those provided in a
skilled nursing facility, nursing home, State hospital, or intermediate
care facility for the mentally-retarded (ICF/MR), will not be
considered, although those that apply to alternative residential
settings eligible for Medicaid HCBS funding, such as small group homes
and assisted living facilities will be. Measures specific to the
process of applying for Medicaid HCBS services (e.g., waiting lists)
are also within the scope of this request. In addition, measures should
be designed to quantify the experience of current Medicaid HCBS service
recipients; including caregivers who receive such services directly
(e.g., respite care or family therapy). Measures related to non-service
recipients, including measures of staff satisfaction (including family
caregivers as secondary recipients--as distinguished from direct
recipients) are considered to be outside the scope of this effort. For
a more detailed list of the home and community based services, see the
SUPPLEMENTARY INFORMATION section below entitled ``Types of Home and
Community-Based Services'':
AHRQ is particularly interested in soliciting information from
three types of submitters:
1. Organizations (or persons) who use (or contract for the use of)
another organization's survey (or survey item(s)) and the survey/items
used are applicable to (or could be adapted to) HCBS.
2. Organizations (or persons) who developed a survey (or survey
item(s)) and the survey/items are applicable to (or could be adapted
to) HCBS.
3. Organizations (or persons) who use another organization's survey
but have modified the original survey (added items to, taken items away
or changed the wording) and the resulting hybrid survey is applicable
to (or could be adapted to) HCBS.
Additional Submission Instructions
Submitter Type 1
Each submission should include the following information:
Name of the measure(s)/instrument(s)/survey(s) used by (or
contracted for by) your organization
Brief description of the measure(s)/instrument(s)/
survey(s)
Population intended for measurement
Care provider type (e.g., home health agency, consumer
directed caregiver, assisted living facility, adult day care provider,
skills training counselor)]
Service setting (e.g., group home, client's home, school,
assisted living facility)
Domain(s) (i.e., content areas)
Language(s) the measure(s)/survey(s) (e.g., number of HCBS
programs, program size(s))
Where the Submitter's organization has used (fielded),
and/or is currently using, the measure(s)/instrument(s)/survey(s)
(e.g., number of HCBS programs, program size(s))
Submission of copies of existing report formats developed by the
Agency using the survey to disclose findings to consumers and providers
is desirable, but not required. Additionally, information about
existing database(s) (particularly at the state level) for collecting
results gathered using the instrument(s) or items submitted is helpful,
but not required for submission.
A partial response by a Submitter Type 1 could be ``* * * our
Agency uses the National Core Indicator's (NCI) Child Family Survey
(Phase VII version) for our State's 1915(c) waiver for children with
special health care needs * * * for our HCBS program for elders with
Alzheimer's we use the Participant Experience Survey (PES) Elder/
Disabled Version (Version 1) * * *''
Submitter Type 2
Information about the instrument that you and/or your organization
developed may be provided (in part) through submission of peer-reviewed
journal articles). Each submission should include the following
information.
Name of the measure(s)/instrument(s)/survey(s) developed
Description of the measure(s)/instrument(s)/surveys(s)
Population intended for measurement
Care provider type(s) (e.g., home health agency, consumer
directed caregiver, assisted living facility, adult day care)
Service setting (e.g., group home, client's home, school,
assisted living facility)
Copy of the relevant measure(s)/instrument(s)/survey)s)
(e.g., individual items and response categories)
Domain(s) (i.e., content areas)
Language(s) the measure(s)/instrument(s)/survey(s) is
available in
Reliability of the measure(s)/instrument(s)/survey(s)
(e.g., internal consistency, test-retest, etc).
Validity of the measure(s)/instrument(s)/survey(s) (e.g.,
content, construct, criterion-related)
Response rate(s) obtained when measure(s)/instrument(s)/
survey(s) is used to measure on the intended population
Methods and results of any cognitive testing associated
with the measure(s), instrument(s) and/or survey(s)
Methods and results of any field-testing associate with
the measure(s), instrument(s) and/or survey(s)
Data collection protocols (including mode and respondents)
Description of sampling strategies used for data
collection
Where the Submitter's organization has used (fielded),
and/or is currently using, the measure(s)/instrument(s)/survey(s)
(e.g., number of HCBS programs, program size(s))
Information about any professional or organizations
endorsements associated with the measure(s)/instrument(s)/survey(s)
Submission of copies of existing report formats developed to
disclose findings to consumers and providers is desirable, but not
required. Additionally, information about existing database(s)
collecting results gathered using the instrument(s) or items submitted
is helpful, but not required for submission. Information about the
instrument may be provided through submission of peer-reviewed journal
article, if applicable or through the best
[[Page 30802]]
evidence available at the time of submission.
In submitting measures, submitters agree to relinquish ownership of
any items developed by the submitter/organization that are selected to
be pat of the measure set(s) developed by AHRQ for public use
(beginning in 2008 as required by Section 6086(b) of the DRA). However,
item ownership will be protected during the initial measure can, and
during any subsequent measure development efforts AHRQ might undertake.
Submitter Type 3
Information about the original survey measures and the nature of
any survey measure modifications (including new, changed or deleted
items) is requested for submission.
For the measures/items based directly on an existing survey/
measure(s) (and without any changes to the items), the information
described under Submission Submitter Type 1 is requested along with
copies of the relevant measures that are actually used (e.g.,
individual items and response categories).
In addition to the original measures information (requested in the
previously paragraph), information about the modified measures/items is
requested. Modifications may include question wording changes, the
addition of new items/measures, and/or the deletion or original survey
items. For the modified items, the following is requested:
For measures/items based directly on the original survey items, but
modified with question wording changes, information (if available)
described under Submission Submitter Type 2 is requested for modified
items. The reason(s) for question wording change(s) is also requested,
but not required. At a minimum, a copy of the modified measures, how
the measures are used and some information about how the measures were
developed is required.
For new items added to an existing survey, information described
under Submission Submitter Type 2 is requested. Also requested, but not
required, is (are) the reason(s) for the addition of the new items. An
example of the latter might be along the lines of ``* * * for our HCBS
program for elders with Alzheimer's we use the PES Elder/Disabled
Version (Version 1) but have also added a module to capture information
about medication management/administration for clients in a residential
settings.* * *'' At a minimum, a copy of the modified measures, now the
measures are used and some information about how the measures were
developed is required.
In situations where the modifications to the original survey are
simply a deletion(s) of original survey items (and with new items
added) a description on of what items were deleted and why is also
requested. An example of the latter might be ``* * * for our HCBS
program for elders we use the ABC Survey but drop questions 34-42 at
the Agency does not use this information.''
In submitting modified measures, submitters agree to relinquish
ownership of any items developed by the submitter/organization and that
are selected for use in the measure set(s) developed and adopted by
AHRQ (beginning in 2008 as required by Section 6086(b) of the DRA).
However, item ownership will be protected during the initial measure
scan, and during any subsequent measure development efforts AHRQ might
undertake.
Submitters Types 1, 2 and 3
It is not necessary to submit any actual data generated from using
the survey instruments.
Types of Home and Community-Based Services
Both the type and extent of home and community-based services
provided under Medicaid can vary from program to program. Below is a
partial list of the broad range of services that have been provided by
States under their Medicaid HCBS programs; States may provide
additional services.
24 Hour Supervision/Monitoring
Activities Therapy
Adaptive Health and Wellness Services
Adult Companion Services
Adult Day Care
Adult Day Health
Adult Foster Care
Adult Residential Care
Alternative Living/Alternative Care Facility
Assisted Living
Assistive Technology
Assistive Technology Evaluation
Assistive Technology Repairs
Attendant Care
Attendant Care--Rent/Food for Unrelated Live-In Caretaker
Augmentative Communication
Behavior Management and Consultation
Bereavement Counseling
Case Management
Case Management Aide
Chore/Home Maintenance
Clinic Services
Clinical Supports
Coaching/Cueing
Cognitive/Behavior Services
Cognitive Rehabilitation
Community Access
Community Connection
Community Integration Training
Community Membership
Community Specialist
Community Transition Services
Companion Services
Congregate Meals
Consolidated Developmental Services
Consultative Clinical and Therapeutic Services
Consumer/Family/Caregiver Training
Counseling
Crisis Intervention Services/Support
Day Habilitation
Day Program
Dental
Developmental Day Care
Early Intervention
Educational Services Habilitation
Electronic Home Response
Emergency Move
Environmental Adaptations/Home Modifications
Environmental Engineering
Escort/Outings
Exercise Therapy
Family Counseling
Financial Counseling and Training
Financial Risk Reduction
Fiscal/Employer Agent/Management Services
Group Homes
Habilitation
Home Accessibility Adaptations
Home-Based Supportive Care
Home Delivered Meals
Home Health Aide
Home Health Care
Home Maintenance/Repair
Homemaker Services
Hospice
Housing Access Coordination
Housing Start-Up
Independent Living Provider
Independent Living Skills Training
Individual Directed Goods and Services
Integrated Therapeutic Network
Interdisciplinary Team
Life Skills Training
Live-in Caregiver
Meal Services
Medical Equipment/Supplies
Medical Nutritional Support
Medically-Related Direct Therapies
Medication Administration
Medication Management
Mental Health Day Treatment Services
Mental Illness/Clinic
Mental Illness/Day Treatment/Partial Hospitalization
Mental Illness/Psychosocial Rehabilitation
Money Management
Moving Assistance
[[Page 30803]]
Night Supervision
Non-Legend/Non-Formulary Drugs
Non-Medical Transportation
Nursing Home Diversion Program
Nutrition Therapy
Nutritional Counseling/Assistance
Nutritional Risk
Nutritional Supplements
Occupational Therapy
Optometry Services
Over-the-Counter Drugs
Pediatric Community Transitional Home Services
Periodic Nursing Evaluations
Person Centered Planning
Personal Adjustment Counseling
Personal Agent
Personal Care
Personal Care Assistance
Personal Care Coordination
Personal Care--Rent/Food for Unrelated Live-In Caretaker
Personalized Emergency Response Systems
Phone Reassurance Monitoring
Physical Risk Reduction
Physical Therapy
Physical Therapy--Extended State Plan Services
Physician Services
Podiatry Services
Prescribed Drugs
Prescription Drug Co-Pay
Preventative/Consultative
Prevocational Services Habilitation
Private Duty Nursing
Professional Care Assistant
Professional Services
Protective Services
Psychiatrist Services
Psychologist Services
Psychosocial Counseling
Psychosocial Nutrition
Psychosocial Rehabilitation
Rehabilitation Engineering
Renal Dialysis
Residential Care
Residential Habilitation
Respiratory Therapy
Respite Care
Restorative Assistance
Retainer Payment for Personal Caregivers
Shared Nursing
Skill Building
Skilled Nursing
Socialization/Recreation
Social Reassurance Therapeutic Counseling
Social Work Services
Special Therapeutic Services
Specialized Child Care
Specialized Consultation Services
Specialized Medical Equipment and Supplies
Specialized Psychiatric Services
Specialized Therapies
Speech, Hearing, and Language
Staff/Family Consultation Training
Subsidized Housing
Substance Abuse Treatment/Counseling
Support Brokerage
Support Coordination
Support Services
Supported Employment Habilitation
Supported Living
Therapeutic Counseling
Therapeutic Living
Therapeutic Management
Therapeutic Massage
Therapeutic Resources
Therapeutic Social and Recreational Program
Therapeutic Supplies
Training and Counseling Services for Unpaid Caregivers
Transitional Case Management
Transitional Living
Transportation
Vehicle Modifications
Visual/Mobility Therapy
Wandering Alarm System
Wellness Monitoring
Wrap-Around Services
Extended State Plan Services:
[cir] Home health care services
[cir] Physical therapy
[cir] Occupational therapy
[cir] Speech, hearing and language services
[cir] Prescribed drugs, except drugs furnished to participants who
are eligible for Medicare Part D benefits
[cir] Dental services
For additional information on HCBS service, please refer to
Appendix C: Participant Services (pages 99 to 162) of the Application
for a section 1915(c) Home and Community-Based Waiver [Version 3.4]
Instructions, Technical Guide and Review Criteria Release Date:
November 2006, Disabled and Elderly Health Programs Group, Center for
Medicaid and State Operations, Centers for Medicare & Medicaid
Services, Department of Health and Human Services, available at: http:/
/www.cms.hhs.gov/HCBS/02_QualityToolkit.asp#TopOfPage.
Dated: May 27, 2007.
Carolyn M. Clancy,
Director.
[FR Doc. 07-2732 Filed 6-1-07; 8:45 am]
BILLING CODE 4160-90-M
