Family Caregivers of Individuals with Intellectual and Developmental Disabilities: Experiences with Medicaid Managed Care Long-Term Services and Supports in the United States

2016 ◽  
Vol 13 (4) ◽  
pp. 287-296 ◽  
Author(s):  
Heather J. Williamson ◽  
Elizabeth A. Perkins ◽  
Annie Acosta ◽  
Maureen Fitzgerald ◽  
Jui Agrawal ◽  
...  
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
Managed Care ◽  
Family Caregivers ◽  
The United States ◽  
Intellectual And Developmental Disabilities ◽  
Medicaid Managed Care ◽  
Services And Supports

Fiscal Stewardship, Choice, and Control: The Context of Self-Directed Services for People With Intellectual and Developmental Disabilities (IDD) in the United States

2019 ◽  
Vol 57 (2) ◽  
pp. 158-171 ◽  
Author(s):  
Matthew D. Bogenschutz ◽  
Matthew DeCarlo ◽  
Jennifer Hall-Lande ◽  
Amy Hewitt
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
Cost Savings ◽  
Data Interpretation ◽  
The United States ◽  
Intellectual And Developmental Disabilities ◽  
Political Climate ◽  
Services And Supports ◽  
High Level ◽  
And Control

Abstract 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 satisfaction and positive outcomes for people who use self-directed programs as well as cost savings for state IDD service systems. This study explored the ways in which state IDD service administrators think about how self-direction may be used as a method of achieving cost savings while providing opportunities for people with IDD and their families to exercise choice and control. Informed by 54 high-level IDD service administrators in 34 states, and guided by a thematic analysis approach to data interpretation, the study found evidence that administrators typically see strong potential for self-direction to have cost-savings benefits, while also fostering choice. In the current political climate, the need for cautious fiscal stewardship may become a stronger driving force behind self-direction for people with IDD in the United States.

scholarly journals Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

2018 ◽  
Vol 30 (1) ◽  
pp. 11-21 ◽  
Author(s):  
M. P. DeCarlo ◽  
M. D. Bogenschutz ◽  
J. A. Hall-Lande ◽  
A. S. Hewitt
Keyword(s):  
Developmental Disabilities ◽  
The United States ◽  
Support Staff ◽  
Self Determination ◽  
Intellectual And Developmental Disabilities ◽  
Thematic Map ◽  
Human Service Delivery ◽  
State Administrators ◽  
Services And Supports

Self-direction is an approach to human service delivery within long-term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with intellectual and developmental disabilities. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships, as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

scholarly journals Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

2019 ◽  
Author(s):  
Matthew Peter DeCarlo ◽  
Matthew D. Bogenschutz ◽  
Jennifer Hall-Lande ◽  
Amy Hewitt
Keyword(s):  
Developmental Disabilities ◽  
The United States ◽  
Support Staff ◽  
Self Determination ◽  
Intellectual And Developmental Disabilities ◽  
Thematic Map ◽  
Human Service Delivery ◽  
State Administrators ◽  
Services And Supports

Self-direction is an approach to human service delivery within long term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with IDD. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

Families of Individuals With Intellectual and Developmental Disabilities: Policy, Funding, Services, and Experiences

2013 ◽  
Vol 51 (5) ◽  
pp. 349-359 ◽  
Author(s):  
Amy Hewitt ◽  
John Agosta ◽  
Tamar Heller ◽  
Ann Cameron Williams ◽  
Jennifer Reinke
Keyword(s):  
Developmental Disabilities ◽  
Research Priorities ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Policy Makers ◽  
Home Support ◽  
The Status ◽  
Services And Supports ◽  
At Home

Abstract Families are critical in the provision of lifelong support to individuals with intellectual and developmental disabilities (IDD). Today, more people with IDD receive long-term services and supports while living with their families. Thus, it is important that researchers, practitioners, and policy makers understand how to best support families who provide at-home support to children and adults with IDD. This article summarizes (a) the status of research regarding the support of families who provide support at home to individuals with IDD, (b) present points of concern regarding supports for these families, and (c) associated future research priorities related to supporting families.

Impact of Medicaid Managed Care on Illinois's Acute Health Services Expenditures for Adults With Intellectual and Developmental Disabilities

2018 ◽  
Vol 56 (2) ◽  
pp. 133-146 ◽  
Author(s):  
Kiyoshi Yamaki ◽  
Coady Wing ◽  
Dale Mitchell ◽  
Randall Owen ◽  
Tamar Heller
Keyword(s):  
Developmental Disabilities ◽  
Managed Care ◽  
Health Services ◽  
Cost Savings ◽  
Intellectual And Developmental Disabilities ◽  
Fee For Service ◽  
Access To Health Services ◽  
Medicaid Managed Care ◽  
The Difference ◽  
The Impact

Abstract States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on costs by tracking Illinois's Medicaid acute health services expenditures for adults with intellectual and developmental disabilities (IDD) living in the community (n = 1,216) before and after their transition to MMC. Results of the difference-in-differences (DID) regression analysis using an inverse propensity score weight (IPW) matched comparison group (n = 1,134) design suggest that there were no significant state Medicaid cost savings in transitioning people with IDD from FFS to MMC.

Family Caregivers of Adults With Intellectual and Developmental Disabilities: Outcomes Associated With U.S. Services and Supports

2014 ◽  
Vol 52 (2) ◽  
pp. 147-159 ◽  
Author(s):  
Heather J. Williamson ◽  
Elizabeth A. Perkins
Keyword(s):  
Developmental Disabilities ◽  
Family Caregivers ◽  
Service System ◽  
Care Delivery ◽  
Intellectual And Developmental Disabilities ◽  
Physical Health Outcomes ◽  
Services And Supports ◽  
Caregiving Roles ◽  
Mental And Physical Health ◽  
The U.S

Abstract Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver outcomes and their association with existing services and supports for family caregivers of adults with IDD. Twenty-four articles were compiled using the PubMed, Web of Knowledge, PsychInfo, and CINAHL databases. Studies report economic, mental, and physical health outcomes from caregiving roles. The need for comprehensive caregiver assessment is discussed. Understanding and responding to the changing needs of family caregivers is vital to the U.S. disability service system to effectively prioritize formal resources and services.

Employment: Renewed Investments

Inclusion ◽  
2013 ◽  
Vol 1 (1) ◽  
pp. 7-16 ◽  
Author(s):  
David M. Mank ◽  
Teresa A. Grossi
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
Supported Employment ◽  
The United States ◽  
Intellectual And Developmental Disabilities ◽  
Integrated Employment ◽  
Fair Pay

Abstract Supported employment for people with intellectual and developmental disabilities emerged in the 1980s, clearly showing the untapped potential of people to work productively in integrated jobs. Expanding across the United States and other countries, supported employment was shown to be an effective approach to employment across communities and cultures. While supported employment has expanded little in the last decade, there is a renewed investment nationwide and in some other countries. The renewed developments include improvements in supported employment methods, interest in funding based on outcomes rather than services, concern about the persistence of segregated workshops, the need for qualified supported employment personnel, investment in Employment First policies in states, the emergence of litigation promoting integrated employment over segregation, renewed investment in transition, investments in other countries, and the increasingly clear voice of self-advocates with intellectual and developmental disabilities calling for community jobs and fair pay. While there is renewed interest in supported employment, threats remain to further improvement and expansion that must also be addressed.

scholarly journals COVID-19 mortality rates for persons with intellectual and developmental disabilities

2021 ◽  
Vol 2 (1) ◽  
pp. 179-183
Author(s):  
Mark D. Davis ◽  
Scott Spreat ◽  
Ryan Cox ◽  
Matthew Holder ◽  
Kathryn M. Burke ◽  
...  
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
General Population ◽  
General Public ◽  
The United States ◽  
Mortality Rates ◽  
Intellectual And Developmental Disabilities ◽  
Time Points ◽  
Probability Of Death ◽  
Over Time

People with intellectual and developmental disabilities (IDD) appear to have an increased probability of death from COVID-19 once infected. We report infection and mortality rates for people with IDD compared to the general population of eight states at two time points during the COVID-19 pandemic. Note that these eight states contain approximately 1/3 of the population of the United States. These data suggest individuals with IDD are less likely to be infected with the COVID-19 virus (5.62%) than the general public (7.57%). However, while mortality rates for both groups have declined over time, people with IDD are over twice as likely (2.29) to die from the infection as members of the general public.

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