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A screening system for Michigan's home- and community-based long-term care programs.

Brant E Fries1, Lisa R Shugarman, John N Morris

  • 1Institute of Gerontology and School of Public Health, University of Michigan, Ann Arbor 48109-2007, USA. bfries@umich.edu

The Gerontologist
|July 30, 2002
PubMed
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A new screening system for Michigan's MI Choice home and community-based services accurately identifies service eligibility and level of care (LOC). This algorithm significantly outperforms previous methods, improving care management for beneficiaries.

Area of Science:

  • Gerontology
  • Health Services Research
  • Public Health

Background:

  • Home- and community-based services (HCBS) are crucial for aging populations.
  • Accurate screening is vital for efficient resource allocation in publicly funded programs.
  • Michigan's MI Choice program requires effective tools for client assessment.

Purpose of the Study:

  • To develop a screening system for Michigan's MI Choice HCBS programs.
  • To identify individuals eligible for services.
  • To determine the most appropriate level of care (LOC) for program participants.

Main Methods:

  • Utilized the Minimum Data Set for Home Care (MDS-HC) assessment instrument.
  • Identified assessment items predictive of five distinct LOCs.

Related Experiment Videos

  • Defined LOCs included: nursing home, home care, intermittent personal care, homemaker, and information/referral.

    • Main Results:

    • Developed a screening algorithm based on approximately 30 client characteristics.
    • The algorithm demonstrated substantial agreement with expert care manager opinions (kappa = .62).
    • This performance significantly surpassed systems relying solely on activities of daily living (ADL) and instrumental activities of daily living (IADL) (kappa < .40).

    Conclusions:

    • The screening algorithm is effective for telephone-based identification of clients unlikely to receive full services.
    • The system can be used in person to recommend appropriate levels of care.
    • This tool enhances the efficiency and accuracy of HCBS program administration.