Purpose: The purpose of this study is to investigate the incidence of all-cause mortality, institutionalization, and condition improvement among participants of a state home- and community-based services program (HCBS). Methods: We evaluated the follow-up data of 11,444 individuals with disabilities aged 45-59 years at application who received…

Eleven states offer 1915(c) Home and Community Based Services (HCBS) Medicaid waivers to organize and fund programs that provide in-home and community support services to address the unique needs of children and youth with complex mental health concerns and their families. However, as the COVID-19 pandemic-imposed restrictions on community…

This study's aim was to examine the impact of pandemic emergency Home- and Community-Based Services (HCBS) payments on the continuity and security of people with intellectual and developmental disabilities (IDD). Using a multilevel logistic regression, we analyzed secondary Personal Outcome Measures interviews from 738 people with IDD (March 2020…

Using the 2008-2013 Medicaid Analytic eXtract files, this retrospective cohort study was to evaluate the effect of Medicaid home and community-based services (HCBS) waiver programs on emergency department (ED) utilizations among youth with autism spectrum disorder (ASD). Our study showed that the annual ED utilization rates were 13.5% and 18.8%…

Despite physically relocating "into" the community, many people with intellectual and developmental disabilities (IDD) fail to be meaningfully included "in" the community. The Home and Community Based Services (HCBS) Settings Rule was introduced to expand community integration, person-centered services, and choice. The aim of…

Self-directed home and community based services (HCBS) waiver services and supports for people with intellectual and developmental disabilities (IDD) have become a viable and widely used method of service provision in the United States. Grounded in theories of self-determination, previous literature on self-direction has suggested high…

The Home and Community Based Services (HCBS) settings rule (CMS 2249-F/2296-F) strictly enforces meaningful community-based settings for those receiving Medicaid HCBS funding. Stakeholders have the opportunity to impact states' setting rule plans and hold states accountable to ensure rules are truly community based. Yet, the complex rule can be…

Speech language and hearing (SLH) services can improve people with intellectual and developmental disabilities' (IDD) health, autonomy, and community participation. The aim of this study was to explore how SLH services are offered to people with IDD across the nation, particularly in fiscal year 2015 Medicaid Home and Community Based Services…

Examined public and private costs for nursing home applicants participating in Virginia Nursing Home Pre-Admission Screening Program. Found that applicants diverted to community care were less dependent and had greater informal supports than those admitted, and that public and private payments for community care were lower than for nursing home…

Investigated four kinds of community-based housing and case-managed home care programs for associations with subsequent institutional utilization. Analyses of institutional placement rates and days indicated that significant effects of housing and case-managed home care services were limited to elderly in the high institutional-risk group.…

Examined the use of public services by 1,080 Norwegian older adults. Results showed more than one-third use public services for the aged (i.e., are institutionalized or receive home help or home nursing). The use of services is affected by both need and demand factors. The family's role is discussed. (JAC)

Examines among- and within-group needs and in-home and community-based service utilization by Mexican American, Cuban American, and Puerto Rican elderly people. Needs for care were the strongest predictors of in-home service utilization, and enabling factors were the strongest predictors of community-based service utilization. (JPS)

Interest in the development of community-based long-term care (CBLTC) programs as a substitute for institutional-based care has been steadily growing. The estimated benefits from the Multipurpose Senior Services Program (MSSP), California's intensive CBLTC system, were measured by the expected increase in community residency days for clients for a…

As the number of chronically ill elderly increases and the costs of hospital and nursing home care rises, consideration is being given to alternatives for long-term care. One alternative being explored in California is the Alameda County Homemaker Program which provides home health care to the frail elderly. Interviews were conducted with all 30…

The findings of a 1978 project of the Massachusetts Developmental Disabilities Council on the need for respite care services and the various models for delivery of respite care are reported. Methodology included review of respite care regulations in 12 states, site visits and a survey of Massachusetts programs, and a survey of 339 families with…