RTC/OM Maturing HCBS Outcome Measures
What are RTC/OM Measures?
The University of Minnesota’s RTC/OM is following a multi-phased and iterative development and testing process to develop a set of two-tiered measures related to eight different domains of the National Quality Forum’s (NQF) Framework for Home and Community-Based Services (HCBS).
Why are They Important?
RTC/OM Measures are focused on the provider level and have the capacity to be used longitudinally (at multiple points across a specified time period) in order to assess when change has taken place in the outcome HCBS recipients are experiencing.
Person-Centered
The measures are person-centered and focus on assessing the extent to which desired levels of outcomes have been achieved by adult HCBS recipients who experience IDD, physical, age-related, or psychiatric disabilities, as well as people who have TBI/ABI.
Modular
Each of the outcome measures being developed by the RTC/OM is modular in format. Measures can therefore be used independently or in conjunction with other measures as part of a structured interview.
Global
There are two tiers of items within each measure. Tier 1 includes global items designed to gain a broad understanding of each measurement domain/subdomain.
Specific
Tier 2 includes specific items that are intended to elicit more detailed and actionable information on specific domains or subdomains. Tier 2 items can be used to gain more complete information for all or some participant responses to global items.
RTC/OM Development and Validation Phases
RTC/OM measures follow a systematic, six-phase development and validation process to ensure data collected reliable and accurately represent the perspectives of HCBS recipients.
Phase 1: Stakeholder Input
Obtain input from a diverse set of disability stakeholder groups at a national level with respect to what they believe are the most important personal outcomes and indicators of quality assurance
Phase 2: Gap Analysis
Locate, catalog, and examine existing data collection instruments used to assess HCBS outcomes for people with different types of disabilities
Phase 3: Case Studies
Identify existing outcome measurement programs used by states an organizations in which HCBS outcome measures are being implemented
Phase 4: Measure Concept Development
Use an iterative process to refine or develop items addressing the most critical NQF domains and subdomains identified by stakeholders in phase #1 and the resulting gaps in measures identified in phase #2
Phase 5: Measuring the Psychometric Characteristics
Conduct a multi-site evaluation of reliability, validity, item discrimination, and sensitivity to change of prioritized HCBS measures
Phase 6: Risk Adjusters
Review, catalog and evaluate variables used as a risk adjusters of HCBS outcome measures in the current literature
RTC/OM Measurement Packages
Choice and Control Measures
The Choice and Control measures developed by the RTC/OM are designed to determine the extent to which the recipients of HCBS make important decisions and exercise control over those aspects of their daily lives and services. Items allow for a determination of whether those areas in which people exercise control are important to them and the degree to which their control is consistent with their desired degree of choice and control.
Total Number of Items: 46
Freedom From Abuse and Neglect Measures
The Freedom from Abuse and Neglect measure was developed to assess the extent to which HCBS recipients are free from the experience of abuse and neglect and have access to the resources needed to prevent, and when necessary report, and when needed receive the supports needed to recover from such traumatic experiences as well as their perceptions with respect to safety at home and within their community.
Total Number of Items: 26
Person-Centered Planning and Coordination Measures
This suite of Person-Centered Planning and Coordination measures covers multiple aspects of the provision of HCBS in a person-centered manner. It includes measures of Person-Centered Assessment, Person-Centered Planning, Person-Centered Service Delivery and Coordination, and Person-Centered Life Outcomes/Goal Attainment. The focus of the measures is to determine both the degree to which the services and supports a person receives are person-centered in their orientation, the extent to which they take into consideration both the individual’s needs (what is important for the person) and preferences (what is important to the person), and how effectively services are supporting respondents to achieve or make progress toward their personal goals.
Total Number of Items: 77
Transportation Measures
The Transportation measure is designed to measure the degree that the transportation to which a respondent has access meets their needs and preferences. The measures focuses on the availability of the transportation the person prefers to utilize and most often use, its quality, and the extent to which the individual feels safe when using it.
Total Number of Items: 17
Consumer Leadership in System Development Measures
Consumer Leadership in System Development measures focus on two aspects of the leadership recipients of HCBS services are able to exercise over the system that provides them with services and supports. The first focuses on the extent to which the respondent has been involved in leadership activities associated with HCBS. The second measure centers on the extent to which the system including providers of HCBS provide the accommodations and supports the person needs in order to actively participate in the decision- and policy making related to development, implementation, and evaluation of HCBS.
Total Number of Items: 21
Employment Measures
Employment measures focus on three components or sub-measures related to the experience of people who work, are looking for work, or are retired/beginning to plan for retirement. Beyond tracking type of employment, hours worked, and wages, these measures focus in a wholistic manner on the experiences an individual has while on the job including job-related supports, opportunities for advancement, and relationship with both co-workers and customers.
Total Number of Items: 31
Meaningful Community-Based Activity Measures
The Meaningful Community-based Activity measure includes items related to six general categories of meaningful activities: everyday life tasks, social activities, leisure/relaxing activities, physical exercise, educational, and professional activities. The focus is on determining the degree to which respondents have the opportunity to engage in community activities that they value to the extent that meets their needs and preferences as well as their experiences when taking part in these activities.
Total Number of Items: 29
Social Connectedness Measures
The Social Connectedness measure assesses the extent to which the social connections that respondents have with those they consider to be family, friends, acquaintances, and other community members meet their affiliation needs. In addition, items measures the quality of these relationships and the degree of reciprocity that exists within them.
Total Number of Items: 15