Analysis of the California In-Home Supportive Services (IHSS) Plus Waiver Demonstration Program. Methods


Because IHSS (including the IHSS Plus Waiver and Residual Program) is an ongoing statewide program, an experimental design in the implementation and evaluation of the waiver was not feasible. Instead, a quasi-experimental design was used. This design relies on statistical controls to adjust for measured differences between the waiver and non-waiver recipients. This work identifies the circumstances and characteristics associated with the types of providers (e.g., Parent, Spouse, Relative, Non-Relative) used by IHSS recipients, and compares service use/expenditures and other outcomes among provider types adjusting for recipient attributes.

Comparisons of waiver and non-waiver IHSS recipients are organized within age categories, controlling for other characteristics, such as disability severity. Children under age 18 who have Parents as paid caregivers are compared with children whose paid caregivers are Other Relatives or Non-Relatives. Similarly, adults aged 18-64 who have spouses as paid caregivers and elders aged 65 or older whose paid attendants are their spouses are compared with married and unmarried adults in the same age cohort with Non-Spouse providers. Advance Pay and Restaurant Meals vouchers have small recipient enrollments. Analyses of these options are descriptive.

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