Content by Keyword: Home and Community-Based Services

A project was funded by ASPE to: (a) gather descriptive information on HCBS waivers, both comprehensive and supports, operated for people with I&DD in 17 states with the supports waivers; (b) determine how supports waivers have emerged as separate and distinct HCBS waivers; (c) better understand the range of participant characteristics and exp

In 1992, the National Academy for State Health Policy published ABuilding Assisted Living For The Elderly Into Public Policy: A Guide For States@ to help state policy makers examine an emerging concept for providing residential, home like settings for elders. The Guide examined the confusion surrounding the use of the term "assisted living" and th

This report provides a brief overview of the limited research on adult day services conducted to date. It presents an overview of state approaches to regulating adult day services for elderly persons. Findings from site visits to adult day service providers in five state, and providers' and stakeholders' views on regulatory issues in their states

Strengthening the financing of intensive home and community services for youth with serious emotional disorders (SEDs) brings into play a complex set of policy issues, regulatory constraints, and payment mechanisms. This report presents critical background information on these topics. It describes important system-of-care principles that have sh

This paper focuses on the elderly, aged 65 and over, who are the primary users of long-term care in the United States. It examines their use of long-term care services, particularly home and community-based care. It describes the kinds of data available on the functionally impaired elderly and their use of such care. [20 PDF pages]

The purpose of this paper is to demonstrate the variability in estimates of disability in the U.S. elderly population as a function of differing definitions of physical disability and cognitive impairment. Differing cut-off points along the disability continuum are employed, in conjunction with the varied definitions of disability, in order to dem

The past decade or so has seen considerable growth in the number of Medicaid programs electing to cover personal care services--from only ten in FY 1979 to 29 in FY 1992. Substantial inter-state variation exists in Medicaid personal care services coverage. In 1988, participation rates per 1,000 aged/disabled Medicaid recipients ranged from a low

This paper presents an overview of the results of the National Long-Term Care Channeling Demonstration, conducted in ten states to test the impact of a community-based system of long-term care upon the functionally disabled elderly. The study examines: program management; federal planning of the project; the objectives of the demonstration; the tw

The primary objective of the research in the National Long-Term Care Channeling Demonstration was to determine the impacts of the demonstration on service utilization, public and private costs, clients and caregivers. The demonstration employed a randomized experimental design with random assignment of eligible participants to either treatment gro

Agencies operating under the National Long-Term Care Channeling Demonstration program had complex assignments to assess the needs of older people requiring long-term care, to determine what services met such needs and to arrange for the delivery of services. Responsibility for a client was spread across several agencies, organizations, and individ

This report reviews and summarizes the research literature on cost-effectiveness of home and community-based services. [32 PDF pages]

This paper reports the findings of an exploratory study to document and analyze selected best practices related to state-administered home and community-based services (HCBS) programs.

This report examines the issues involved in seeking to address the long-term care service needs of persons with severe mental illness (SMI) in a generic long-term care financing and service delivery system, as was proposed in the home and community-based services provisions of the Health Security Act. SMI, as defined by the Center for Mental Healt

This paper was used as a handout at a workshop, held as a catalyst for DALTCP's major new initiative to study ways to expand consumer choice and empowerment in obtaining personal assistance services. [15 PDF pages]

This publication summarizes the results of a study, conducted by Mathematica Policy Research, Inc., for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, to examine the availability of and funding for home- and community-based services for people with AIDS. The study, which also helped

Elderly and younger persons with disabilities who require help from others to perform many of the most ordinary activities of daily living are said to require "long-term care." These services, when provided in the home or other non-institutional settings, may be termed personal assistance services, home and community-based services, or in-home sup

This article appeared in the American Rehabilitation (Volume 24, Number 3, pp27-30). [14 PDF pages]

A generally consistent finding of community-based long-term care demonstrations, including Channeling, is that these programs do not lead to net reductions in long-term care expenditures. Even though reducing nursing home costs was a goal of these demonstrations, none involved systematic managerial and resource allocation strategies specifically d

Health planning efforts for the elderly have been hampered by the lack of reliable estimates of the non-institutionalized long-term care population. Until recently national estimates were virtually non-existent, and reliable local estimates remain unavailable. With the recent publication of several national surveys, however, synthetic estimates ca

The project examined how states have used Medicaid's Personal Care Services Optional Benefit (also called the PC Option), assessed whether coverage regulations for these services be revised, and discussed the ways in which the program might affect public debate about the expansion of public funding for long-term care. The project entailed reviewin