The study sample was selected from IHSS recipient listings in 2005. It included anyone in the program as of January 1 of that year, or who entered the IHSS program sometime during the calendar year. The inclusion rules assured that we obtained all waiver recipients in each of the target age categories as well as recipients in Advance Pay and Restaurant Meals vouchers. Analyses involving Medicaid claims-records (such as to include medical diagnoses or to compare health outcomes) reduced the sample to persons participating in Medicaid through fee for services. Those enrolled in Medicaid managed care programs were excluded as Medicaid claims are not submitted for managed care covered services. Appendix A provides an elaboration of the steps used to select, screen, and qualify IHSS recipients into the study sample.