Decision 5: Quality Assurance
Guidelines for Decision Making
Program evaluation criteria to be documented include:
- Change in consumer well-being and quality of life;
- Numbers of consumers diverted from nursing home care;
- Numbers of consumers diverted from spending down to Medicaid;
- Documentation of cost-savings (or cost-neutrality) to public programs, including Medicaid, as compared to institutional care; and,
- Decrease in Medicaid nursing home utilization.
Quality indicator criteria for the program to be documented include:
- Participant access to services;
- Participant-centered service planning and delivery;
- Provider capacity and capabilities;
- Participant safeguards;
- Participant rights and responsibilities;
- Participant outcomes and satisfaction; and
- Systems performance.
Program Monitoring Protocols
What IT/MIS system will be used for tracking data elements?
- ADRC.(2007). MIS Systems Used by ADRC Pilot Sites.Retrieved January 7, 2009.
- NPower. (2005). Selecting the Right Technology Vendor. Retrieved January 7, 2009.
How will individual consumer-level data and aggregate system-level data be collected and analyzed?
- Applebaum, B., Kunkel, S., Nelson, M., & Schneider, B. (2006). Designing Your Participant Satisfaction Survey. Oxford, OH: Scripps Gerontology Center, Miami University. Retrieved January 5, 2009.
- State Grantee: Florida. (2003). Florida’s Consumer Directed Care-Plus Waiver Operational Protocol (p.42). Retrieved January 7, 2009.
Consumer Complaints and Grievances
How will consumer complaints and grievances be resolved?
- Office of Long-term Care Supports and Services. (2008). ‐Centered Planning for Community Based Long‐Term Care: Practice Guidance for the MI Choice Waiver Sites. Retrieved December 23, 2008.
- Applebaum, R., Schneider, B., Kunkel, S. & Davis, S. (2004).A guide to quality in consumer directed services. Oxford, OH: Scripps Gerontology Center, Miami University (p. 62). Retrieved December 23, 2008.
Provider & FM Oversight
How will the FM Agent be monitored and audited?
- Schneider, B. (2005). Summary of Nine Quality Initiatives. Cash and Counseling. Retrieved December 23, 2008.
- Applebaum, R., Schneider, B., Kunkel, S. & Davis, S. (2004). A guide to quality in consumer directed services. Oxford, OH: Scripps Gerontology Center, Miami University. Retrieved December 23, 2008.
- Flanagan, S. (2007). Key Components of F/EA Quality Management. Retrieved January 5, 2009.
- State Grantee: Michigan. (2006). Michigan’s Self Determination Technical Advisory: Choice Voucher System (Appendix J). Retrieved January 5, 2009.
How will providers be monitored and audited?
- State Grantee: Michigan. (2006). Michigan’s Self Determination Technical Advisory: Choice Voucher System (p. H2). Retrieved January 5, 2009.
- Brown, R.S. & Dale, S.B. (2007). The research design and methodological issues for the Cash and Counseling evaluation. Health Services Research 42(1), 414-445.
- Doty, P., Mahoney, K.J., Simon-Rusinowitz, L. (2007). Designing the Cash and Counseling demonstration and evaluation. Health Services Research, 42(1), 378-396.
- Anita Yuskauskas, April Forsythe. (2006). Everything You Always Wanted to Know About QM Strategies But Were Afraid to Ask. Center for Medicare and Medicaid Services (p. 11). Retreived January 7, 2009.
How will self-directed care be monitored and audited?
- Phillips, B., Mahoney, K., Simon-Rusinowitz, L., Schore, J., Barrett, S., Ditto, W., Reimers, T. & Doty, P. (2003). Lessons from the Implementation of Cash & Counseling in Arkansas, Florida, and New Jersey (p. 20).Retrieved December 23, 2008.
- Brown, R.S. & Dale, S.B. (2007). The research design and methodological issues for the Cash and Counseling evaluation. Health Services Research 42(1), 414-445.
- Doty, P., Mahoney, K.J., Simon-Rusinowitz, L. (2007). Designing the Cash and Counseling demonstration and evaluation. Health Services Research, 42(1), 378-396.