personal experience survey (pes) michigan model measuring the quality of services in the michoice...
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Personal Experience Survey (PES) Michigan Model
Measuring the Quality of Services in the MIChoice Waiver Program
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PES not PEZ
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What is the PES?
• Created under a CMS contract by MetStat
• Defines “Quality” as services and supports delivered as written in the participant’s care plan.
• Does not define “Quality” from participant’s wants and desires.
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PES Components
• 4 Domains– Access to Care– Choice and Control– Respect and Dignity– Community Integration
• 66 Standard Questions
• Additional six Michigan questions
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Michigan Model
• Consumers hired to collect data
• First round collections at 5 sites
• Second round collection at 3 of 5 sites
• Telephone interview follow-up
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Interviewer Training & Support
• Consumers identified by host site
• MDRC provided one day on site training
• PES User Guide assists in training
• Support provided by MDRC & local site
• MDRC managed reimbursement
• Interviewers as contract employees
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Interviewer demographics
• 3-6 consumers hired at each site
• Seniors and People with Disabilities
• Collectively targeted 40 interviews per site (199 interviews in aggregate)
• Paid $20/hr. plus travel expense
• At two sites consumers did data input
• 3 sites MDRC did data input
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Quality Indicators: Selected DataFirst Round Interviews
• Access to Care– Bathing– Toileting– Groceries
• Respect and Dignity– Staff Listening
• Choice and Control– Choice of Staff
• Community Involvement– Community integration
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Bathing Questions
1. Is there any special help that you need to take a bath or shower?
• Needs Help from Another person• Does not need help from another person• Unclear response• No response
2. Do you ever go without a bath or shower when you need one?
3. Is this because there is no one there to help you?
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Bathing
12182%
Adverse27
18%Positive
148 respondents
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Toileting Questions
1. Is there any special help that you need to get to or use the bathroom?
2. Are you ever unable to get to or use the bathroom when you need to?
• Yes• No• Unsure• Unclear• No response
3. Is this because there is no one there to help you?
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Adverse17
30%
Positive40
70%
57 Respondents
Toileting
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Grocery Questions
1. Is there any special help that you need to get groceries?
2. Are you sometimes unable to get groceries when you need them?
3. Is this because there is no one there to help you?• yes• No• Unsure• Unclear• No Response
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Groceries
Positive13976%
Adverse45
24%
184 Respondents
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Questions: Respect of Staff
• Do the people paid to help you treat you respectfully in your home?– Yes– No– Sometimes– Unsure– Unclear Response– No Response– No staff in home
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Respect of Staff
Adverse8
4%
Positive19096%
198 respondents
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Question, Choice of Staff
• Do you help pick the people who are paid to help you?– Yes– No– Unsure– Unclear Response– No Response– No personal care staff
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Choice of Staff
Adverse55
44%
Positive71
56%
126 respondents
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Community Integration/Inclusion
• Is there anything you want to do outside your home that you don’t do now?– Yes– No– Unsure– Unclear Response– No Response
• What would you like to do? What do you need to make this happen?
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Community Involvement
Positive11759%
Adverse82
41%
199 respondents
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Compare Sites: Community Involvement
199 respondents
57.50%
33.33%
52.50%
29.27% 33.33%
42.50%
66.67%
47.50%
70.73% 66.67%
A B C D E
Adverse Positive
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Out of Home Activities
• Church• Volunteer• Cultural Activities• Get Outside• Shopping• Senior Center• Exercise• Library• Fishing
• Visit Friends & Family• Garden• Visit the sick• SportsMake Happen• Accessibility• Transportation• Companionship• Money
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Employment Questions
(If respondent is under 65 ask question)
• Are you working right now?(Yes, No, Unsure, Unclear Response, No Response)
• What kind of work do you do?
• Did you help pick the job you have now?
• Do you like your job?
• Do you want to work?
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Demand for Employment
47 respondents
Adverse16
34%
Positive31
66%
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Comparison of Indicators
201 respondents
0
50
100
150
200
250
Groceries Toileting Choice Staff Respect HomeStaff
Comm.Intergration
Employment
Adverse Positive
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Second Round
• Collected 6 to 12 months after first round collection
• Will be completed at the end of March.
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Recommendations - Data Use
• Individual sites Review data with Care Managers and with Provider Agencies
• Work in partnership for improvement• Agree upon 2-3 Indicators to improve • Discuss in Quality Collaborative
improvement methods for identified indicators
• Create impact plan• Share learning with collaborative
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Managing Data
• Limited to measuring quality of services from consumer point of view
• Good design of questions – Simple language, Simple questions
• No ability to adjust the language• Easy to manage the data input• Difficult to uniquely manipulate the data• Can add questions but not put them into
the data base.
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Costs – First Round
• 199 interviews (aggregate)
• Average $78/interview– Hourly: $14,078.49– Mileage: $1,711.60– Accommodation: $397.61– Data input: $ 750.00
• Other costs: training, internal supervision of interviewers, data input.
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Consumer Interviewer Site Costs
$0.00
$500.00
$1,000.00
$1,500.00
$2,000.00
$2,500.00
$3,000.00
$3,500.00
$4,000.00
$4,500.00
DAAA TCOA UPCAP/M UPCAP/H WMAAA
total hourly mileage data input accomodation
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Quality of Interviewers
• Telephone Survey of 12% of people who had been interviewed twice
• Results:– 100% felt respected and fully open to
consumer interviewers– Only 1 of 27 indicated a preference for a
waiver agency employee – 3 of 27 people would not participate again
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Cost Recommendations
Keep total costs to average $30/interview
• $25 per interview
• Continue to pay travel expense
• Pay $10/hr for data entry, or data entry in organization.
• Build competent cadre of interviewers at local site (over time less supervision needs)
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Quality Recommendations
• Use PES in local quality plans• Use consumer interviewers• Sites nurture cadre of seasoned
interviewers• Statewide training program (at MDRC or
elsewhere)• Maintain third party data collection• Sites integrate quality improvement
system for interviewers
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For more information contact:
David Youngs
DYNS Services, Inc.
517-927-7255
303-200-8392 (fax)
941-744-5732
www.dynsinc.com
This initiative was funded by a CMS grant to the Michigan Department of Community Health, and implemented by Michigan Disability Rights Coalition (MDRC).
Carolyn Lejuste
MDRC
517-333-2477 ext. 21
517-333-2677 (fax)