241715 Final findings from the national evaluation of Systems Transformation Grants: How states' community long-term support service delivery systems have changed

Sunday, October 30, 2011

Yvonne Abel, MS , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Cheryl Austin, MPH, RD, LDN , Abt Associates Inc, Cambridge, MA
Rosanna M. Bertrand, PhD , Division of Health Policy, Abt Associates, Inc., Cambridge, MA
Claudia Brown, MASocSci , Centers For Medicare and Medicaid Services, Baltimore, MD
Louisa Buatti , Division of Health Policy, Abt Associates, Inc., Bethesda, MD
Meridith Eastman , Independent Consultant, Carrboro, NC
Susan Flanagan, PhD, MPH , Westchester Consulting Group, Washington, DC
Margaret Gwaltney, MBA , Abt Associates Inc., Bethesda, MD
Gretchen Locke, MA , Health Division, Abt Associates Inc., Cambridge, MA
Terry Moore, BSN, MPH , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Allison Muma, MHA , Abt Associates Inc, Durham, NC
Deborah Klein Walker, EdD , Domestic Health Division, Abt Associates, Inc., Cambridge, MA
Between FY2005 and FY2006, the Centers for Medicare and Medicaid Services (CMS) awarded Systems Transformation (ST) Grants to 18 states to support states' efforts to transform their infrastructure to promote more coordinated and integrated long-term care and support systems that serve individuals with disabilities of all ages.

With ST Grantees' five-year grant periods completed, this presentation will highlight the final results of a national evaluation. Building on interim findings from the mid-point evaluation, these findings reveal:

The ability of grantees to maintain progress with completing their objectives and spending grant funds close to the rate of time elapsed in the grant period; The degree to which endogenous factors, such as integration with other grants, positively influenced implementation throughout the grant period while other factors, such as lack of enduring leadership, consistently challenged grant progress; The circumstances under which grantees withdrew certain strategies during the second half of their grant period, while continuing to implement others; The extent to which stages of state transformation varied across the goal areas being targeted by the grant and why some goals (i.e., improving access to long-term supports, increasing choice and control, and developing comprehensive quality management systems) developed more than others by the end of the grant.

The presentation will feature a series of tools used to conduct the national evaluation and how those tools facilitated linkages to grantee-specific efforts and their local evaluations. The session will conclude with an open discussion of lessons learned for grantees and funders.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Identify effective strategies and outcomes associated with systems transformation. 2. Design a dashboard assessment of factors that influence grant implementation. 3. Discuss how tools and lessons learned from this initiative can be applied to other state and federal initiatives.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Project Director for the national evaluation of the grant initiative.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.