eLTSS Plan Content SWG
Homework 3: Validate State Domain Mappings against New eLTSS Domains
Issue Date: May 19, 2015
Due Date: May 22, 2015 by 12:00pm Eastern
Assignment:
Use the document below to validate the initial domain mapping of your state’s domains to the new
eLTSS Domains and Sub-Domains, which are based on the National Core Indicators (NCI) Domains. While
performing the mapping, use the Mapping Feedback column to provide feedback on the mapping.
Example statements include 1:1, broad to narrow, narrow to broad, sub-domain under particular
domain, etc. It may be helpful to think of individual data elements that would fall under a particular
domain when determining what state domain maps to the eLTSS Domain and Sub-Domain.
When you have completed the domain mapping exercise, then list the population(s) to which the
domains correspond below the table. This exercise is a preliminary high-level mapping of your state’s
domains to those defined by the eLTSS Community and will serve as a basis for discussion during
subsequent SWG meetings.
Homework 3: Validate State Domain Mappings against New eLTSS Domains
Due Date: May 22, 2015 by 12:00pm Eastern
Definitions for New eLTSS Domains:
Domain
Sub-Domain
Work
Residence (Aging)
Community Inclusion
Choice & Decision Making
Individual
Outcomes
Relationships
Satisfaction
Self-Determination
Person-Centered Profile
Health
Respect/Rights
Health,
Wellness,
and Rights
Medications
Safety
Wellness
Behavioral Needs (Aging)
Restraints
Access
Service Coordination
System
Performance
Financial/Payer
Information
Service Information
Staff Stability
Family
Indicators
Choice & Control
Definition
People have support to find and maintain community
integrated employment.
NCI Domain for Aging and Disabled (currently being
piloted); formal definition forthcoming.
People have support to participate in everyday
community activities.
People make choices about their lives and are actively
engaged in planning their services and supports.
People have friends and relationships.
People are satisfied with the services and supports they
receive.
People have authority and are supported to direct and
manage their own services.
Interests, goals, preferences, and priorities of a
beneficiary written by the beneficiary in their own
words.
People secure needed health services.
People receive the same respect and protections as
others in the community.
Medications are managed effectively and
appropriately.
People are safe from abuse, neglect, and injury.
People are supported to maintain healthy habits.
NCI Domain for Aging and Disabled (currently being
piloted); formal definition forthcoming.
The system makes limited use of restraints or other
restrictive practices.
Publicly-funded services are readily available to
individuals who need and qualify for them.
Services coordinators are accessible, responsive, and
support the person’s participation in service planning.
Financial information typically includes individual or
household income (including wages, benefits, and
other income) and general assets.
Includes items that are important for the transfer of
information between facilities but were not otherwise
captured, such as information on allergies.
Direct contact staff turnover ratios are low enough to
maintain continuity of supports and efficient use of
resources.
Families/family members with disabilities determine
the services and supports they receive and the
individuals or agencies who provide them.
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Homework 3: Validate State Domain Mappings against New eLTSS Domains
Due Date: May 22, 2015 by 12:00pm Eastern
Family Outcomes
Satisfaction
Family Involvement
Community Connections
Access & Support Delivery
Information & Planning
Goals
Priorities
Cross-Cutting
Sub-Domains
Issues
Interventions
Individual and family supports make a positive
difference in the lives of families.
Families/family members with disabilities receive
adequate and satisfactory supports.
Families maintain connections with family members
not living at home.
Families/family members use integrated community
services and participate in everyday community
activities.
Families/family members with disabilities get the
services and supports they need.
Families/family members with disabilities have the
information and support necessary to plan for their
services and supports.
A defined outcome or condition to be achieved in the
process of person-centered care. Includes beneficiary
defined Goals (e.g., longevity, function, comfort) and
clinician specific Goals to achieve desired and agreed
upon outcomes.
Actions established in order of importance or urgency
to the welfare or purposes of the beneficiary at a given
time.
Reflect the concerns, current status, risks and barriers
to care as well as “likely course” identified by the
beneficiary or other Care Team Members that require
intervention(s), including education or monitoring, to
increase the likelihood of achieving the beneficiary’s or
provider’s Goals of care.
Actions taken to maximize the prospects of achieving
the beneficiary’s or providers’ Goals of care, including
the removal of barriers to success.
Instructions and the performance of monitoring are
subsets of Interventions.
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Homework 3: Validate State Domain Mappings against New eLTSS Domains
Due Date: May 22, 2015 by 12:00pm Eastern
Georgia Domain Mappings:
eLTSS
Domains
Sub-Domains
Georgia Domains
Mapping Success
Work
Residence (Aging)
Community Inclusion
Captured in assessment.
Not explicitly included in
the plan unless relevant
services are being
provided.
Choice & Decision Making
Individual
Outcomes
Relationships
Satisfaction
Self-Determination
Person-Centered Profile
Beneficiary Goals,
Beneficiary Identifying
Information
ADLs/IADLs
Health
Health,
Wellness,
and Rights
Clinical information is not
captured within a plan in
Georgia. Other
documents/forms are
used to capture and hold
that information.
Respect/Rights
Medications
Safety
Wellness
Behavioral Needs (Aging)
May be captured in
Comments/Notes
Restraints
Access
Service Coordination
System
Performance
Financial/Payer Information
Service Information
Staff Stability
Family
Indicators
Service Information
Financial information is
included on a per service
basis under ‘Service
Information
1:1
Care Team Contact
Information
Choice & Control
Family Outcomes
Satisfaction
Family Involvement
Community Connections
Beneficiary Background
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Beneficiary background
includes other items such
Homework 3: Validate State Domain Mappings against New eLTSS Domains
Due Date: May 22, 2015 by 12:00pm Eastern
as living arrangements,
community activities, and
preferred medical
providers
Access & Support Delivery
Information & Planning
Goals
Cross-Cutting Priorities
Sub-Domains Issues
Interventions
These domains were not able to be mapped
to any of the new eLTSS Domains.
Plan Info and Important
Dates
Signatures and Dates
Home Modifications
Equipment and Supplies
Required for Month
Notes/Comments
Target Populations: Elderly, Physical Disability, TBI
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