The 2014 U.S. Centers for Medicare and Medicaid Services "Settings Rule," which took effect in 2023, restricts Home and Community Based Services funding for adults with intellectual disabilities to small integrated settings and person-centered supports. The Settings Rule responds to the fact that community services, mandated by the…

Background: This study evaluated the Step-by-Step Parenting Program (SBSPP) to prepare expectant parents with intellectual disabilities to care for their newborns. Method: Two expectant parents with intellectual disabilities were seen once or twice weekly in their homes for about 2 h over 16 and 20 weeks (21 and 27 sessions), respectively. The key…

The implementation of technology in home-based services takes place in contextualised socio-material practices negotiated through interactions between a diversity of actors. Prerequisites for succeeding in this process are time and competence, and that use of the technology is experienced as meaningful, for both the support staff and the resident.…

Recognizing the crisis the COVID-19 pandemic represents to the Home- and Community-Based Services (HCBS) service system and the health, safety, and quality of life of people with intellectual and developmental disabilities (IDD), states temporarily amended their HCBS programs to strengthen service delivery. States are able to temporarily amend…

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…

Many children with fragile X syndrome (FXS) have complex communication needs and may benefit from augmentative and alternative communication (AAC). This qualitative study explored how four mother--child dyads used AAC in the home. Data were collected using participant observations, open-ended interviews, and record reviews, and analyzed using…

Background: The realization of the family-centered approach (FCA) in home-based support (HBS) for families with children with an intellectual disability (ID) in Flanders was investigated, and parents' and family workers' perspectives were compared. The relation between parents' educational level, the family worker's education, and his/her…

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how…

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…

People with intellectual or developmental disabilities (IDD) live in many different types of settings including homes of their own, with a family member, with a host or foster family, or in a provider owned or operated setting. Most live with a family member and receive informal supports from family members and friends. Some also receive supports…

Introduction: Literature suggests that although behavioral therapy is an effective means of intervention for children with disabilities, family participation in these programs is often lacking. Several barriers exist to meaningful parent education and parent-professional partnerships, which can lead to lower quality outcomes for both the…

Background: Changing family sociodemographic factors, increased life expectancy for people with an intellectual disability, deinstitutionalization and policy prioritization of the family as the principal care provider, presents new challenges to care sustainability. Method: A qualitative study design was employed, entailing focus groups and…