Overview of TEFT Project

Transcription

1 Testing Experience and Functional Tools (TEFT) Functional Assessment Standardized Items (FASI) Lilly Hummel, JD, MPA, Senior Director of Policy Lindsay B. Schwartz, Ph.D., Senior Director, Workforce & Quality Improvement Overview of TEFT Project 1.Testing Experience of Care survey for HCBS 2.Help states develop personal health records for wavier populations 3.Development of electronic Long-Term Services and Supports (eltss) standards and interoperability (S&I) framework with ONC 4.FASI component building on interoperability efforts to align functional measurement in HCBS programs (part of CMS larger data standardization efforts) 1

2 Overview of Project TEFT FASI Develop & field test a setting-agnostic, interoperable set of data elements, called items that can be used for standardized functional assessment across community-based long term services and supports (CB-LTSS) populations. Focus of testing is on the reliability and validity of these items Two rounds of data collection Submit to National Quality Forum (NQF) HCBS FASI Why Standardize? Eases data collection burden Data can be used across states to evaluate complexity of population covered and impact of variations in access to care Examine cost-effectiveness of HCBS waiver program 2

3 State Participation in TEFT FASI Project Six states are participating in the TEFT FASI component Arizona Colorado Connecticut Georgia Kentucky Minnesota Sampling Method Round 1 Individuals already enrolled in state programs expecting to receive an interim or follow-up visit from their case managers between June and December 2016 Clients will be sent a letter that explains the study and requests participation Letter will come from the state Target for sampling is 314 assessments per program population group Older Adults (65+) Younger adults (18 to 64) with physical disabilities, and Adults of all ages with Intellectual/developmental disabilities Severe mental illness (SMI) or Traumatic brain injury (TBI) 3

4 Administration of FASI Assessments will be conducted by agencies already serving the participants except Minnesota which will have a research agency conducting assessment Assessors have to complete an online training module Electronic PDF will be used to collect data and will not contain any PHI Estimated time burden from pilot study All FASI sections average 28 minutes per respondent All FASI sections median 30 minutes per respondent Data Collection FASI Round 2 States are required to demonstrate use of items, if at all in their program management activities Includes what populations they will include What items to collect How items will be used in management or reporting systems 4

5 State use of the FASI Possible uses include: Develop person-centered service plans Determine eligibility for different state programs Monitor quality and measure program impact Report across multiple programs within a state and across states, especially rebalancing initiatives Update systems to reflect national measurement standards Create exchangeable data platforms Timeline of TEFT FASI Project TEP work to develop FASI December Data Analysis 2017 States to finalize plans for demonstration efforts June -December 2016 Round 1 Data Collection March 2017 Final Analysis to CMS TEP 10 5

6 Functional Assessment Standardized Items (FASI) Primarily a subset of the CARE item set Four domains Function (mobility, self-care) Instrumental activities of daily living (IADLs) Assistive devices Living Arrangements, caregiver assistance and availability Not intended to be a comprehensive, universal or uniform assessment tool Focus is on functional ability Domains of FASI Function IADLs Assistive Devices Living Arrangements, Caregiver Assist, Self-care Eating Oral hygiene Toileting hygiene Bathing Dressing Mobility Sit to lying Sit to stand Transfers Ambulation Carrying/Picking-up object Wheelchair Meal Prep Housework Shopping Telephone Medication management Financial management Wheelchair Lift Walker Cane Bed rail Grab bars Shower/commode chair Lift chair Glasses/contact lenses Hearing Aid Communication device Living arrangements Assistance in the home Availability of paid and unpaid assistance Self-care Mobility IADLs Medication Supervision Advocacy 6

7 Coding of FASI Coding based on usual performance in past 3 days using 6-point scale If person s performance changed during past month, also code most dependent performance Independent Setup or cleanup assistance Supervision or touching assistance Partial/moderate assistance Substantial/maximal assistance Dependent Option for activity not attempted due to refusal, N/A, or due to medical/safety concerns CARE vs FASI Tool 4 sections of CARE tool are included: Subset of Section I. Administrative items Subset of Section V. Impairments Subset of Section VI Functional status Subset of Section VII. Discharge status New items included in function section that measure mobility in community Personal priority items included in subsection to indicate resident s top two priorities in the section for the next 6 months 7

8 Where to find the FASI? 1.Go to ncal.org 2.Click on the link for Community Operations 3.Choose Clinical Practice Guidelines on the menu Comments on FASI Individual comments due to CMS July 1, 2016 Comments to AHCA/NCAL for consideration of inclusion due June 15, 2016 Comments requested on: Necessity and utility of the proposed information collection for the proper performance of the agency s functions The accuracy of the estimated burden Ways to enhance the quality, utility, and clarity of the information to be collected The use of automated collection techniques or other forms of information technology to minimize the information collection burden Any other aspect of this collection of information 8

9 Contact Lilly Hummel Lindsay B. Schwartz 9