Testing Experience & Functional Tools
In March 2014, the Centers for Medicare & Medicaid Services (CMS) awarded Testing Experience and Functional Tools (TEFT) grants to nine states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (CB-LTSS). The grant program, spanning four years through March 2018, is designed to field test a cross-disability experience of care survey and a set of functional assessment items, demonstrate personal health records, and create an electronic LTSS service plan standard.
With the total grant program nearing $42 million, this is the first time CMS is promoting the use of health information technology (HIT) in CB-LTSS systems. TEFT will provide national measures and valuable feedback on how HIT can be implemented in this component of the Medicaid program.
The nine states that received initial planning grant awards were Arizona, Colorado, Connecticut, Georgia, Kentucky, Louisiana, Maryland, Minnesota, and New Hampshire.
Four Grant Components
There are four possible TEFT components in which grantees may participate:
Experience of Care (EoC) Survey
The EoC survey elicits feedback on beneficiaries’ experience with the services they receive in Medicaid CB-LTSS programs. In 2015, all nine grantee states conducted a field test of the survey with a range of CB-LTSS beneficiaries, including frail elderly, individuals with physical disabilities, persons with developmental or intellectual disabilities, those with acquired brain injury and persons with severe mental illness. Grantees will also administer the finalized survey to their CB-LTSS beneficiaries and use the results to assess and improve quality in their programs.
- 2014-2015: Field Test
- HCBS measures are endorsed and added to settings represented in NQF
- 2015-2017: Grantees deploy finalized survey for state use
- January 2017: CAHPS® Home and Community-Based Services Survey National Training Call Part 1 & 2
- Part 1 Research and Development of the Survey January 10, 2017 (transcript)
- Part 2 Administration and State Uses of the Survey January 24, 2017 (transcript)
Functional Assessment Standardized Items (FASI)
Under prior initiatives, CMS invested in the development of standardized functional assessment items for assessing Medicare post-acute care recipients (Continunity Assessment Record and Evaluation (CARE). TEFT grantees will provide a sample of CB-LTSS beneficiaries with differing disabilities with whom the FASI items will be field tested for reliability in 2016. Following the field test, the functional assessment standardized items will be finalized and grantees will then demonstrate item use in their respective CB-LTSS programs.
- 2015 FASI Alpha Test Report January 26, 2017
- 2016: Field Test
- 2017-2018: Grantees demonstrate use of finalized LTSS FASI
Personal Health Record (PHR)
Grantees will demonstrate design, test and launch use of electronic PHR systems for beneficiaries of CB-LTSS. Information available in a PHR may assist the beneficiary, their family, and/or caregivers in making care-related decisions and encourage a more active role in managing care. A PHR has the potential to facilitate more efficient care and enhanced outcomes for beneficiaries and their families. Grantees will be working on this component of TEFT throughout the grant period.
- 2015-2018: Grantees demonstrate use of PHR
Electronic Long Term Services and Supports Standard (eLTSS)
The Office of the National Coordinator for Health Information Technology (ONC) has partnered with CMS to identify and harmonize a service plan standard to enable electronic exchange of information relevant to the care of persons receiving CB-LTSS. Grantees will pilot test an eLTSS service plan standard in conjunction with ONC’s Standards and Interoperability (S&I) Framework. Additional information on these efforts can be found on ONC's S&I Framework site.
- 2015-2017: Grantees pilot eLTSS standard
The table below describes the components in which each grantee is participating:
|State||Test Experience of Care Survey||Test FASI||Demo PHR||S&I Framework Participation||# of Components|
*Louisiana participated in round one Experience of Care data collection.
TEFT Funding Opportunity Announcement
The TEFT funding opportunity announcement opened June 27, 2013 and closed October 3, 2013. While now closed, the Planning and Demonstration Grant for TEFT in Community-Based LTSS Funding Opportunity is available for review.
TEFT Fact Sheet
For more information on TEFT grantee technical assistance, evaluation of the TEFT Demonstration or contact information, please view the TEFT Fact Sheet.
During the TEFT demonstration, at least ten Promising Practice monographs are planned for release. These cover a variety of topics relevant to grantees as they progress through the demonstration.
Monographs released to date:
- Maximizing Data Quality in HCBS Experience of Care Survey Data Collection Efforts (February 2015)
- Grantee Experience with PHR Stakeholder Engagement (June 2015)
- Vender Selection Strategies for HCBS EoC Survey (October 2015)
- Facilitating Person-Centered Health and Care Through Inclusive Design of Technology (November 2016)
Online Training Modules
At least ten technical assistance modules will be developed for the TEFT demonstration. These online recordings cover multiple demonstration-related topics for the TEFT grantees.
Online modules released to date:
- FASI Data Uses May 8, 2017
- Selecting Entities to Participate in Phase I Piloting of the eLTSS Plan July 14, 2015
- Disability Sensibility – The Diversity of Disability in the TEFT Demonstration Grant November 13, 2015
- TEFT 101 Overview October 5, 2016