Analysis of the California In-Home Supportive Services (IHSS) Plus Waiver Demonstration Program. Consistency in Provider Relationships


Classification into Provider Type as used throughout the report was done using the principle of “intention to treat.” For example, ever having a spouse paid as an IHSS provider in 2005 defined one in this group. Similarly, ever having a Parent provider (but no Spouse provider), or an Other Relative (i.e., but no Spouse or Parent) for at least one month defined one in these respective groups. Non-relatives had no family members as providers during the year. In other words, a recipient was defined as being in the highest order of provider type they experienced in the year, with legally responsible providers ranking highest, descending in order through Other Relatives and Non-Relatives. Those consistently without a defined provider relationship were classified as having Non-Relative providers. The intention to treat approach is supported by the cumulative monthly consistency in provider relationships shown in Table 2. Fewer than 6% of the recipients changed provider types during the year. Children were the most consistent, non-aged adults the least consistent. Among specific provider types, Spouses as paid providers were the most likely to vary during the year. Non-relatives were somewhat comparable to Other Relative in the rate of inconsistency or change between provider types.

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