System and Individual Outcomes and Their Predictors in Services and Support for People with IDD

2013 ◽  
Vol 51 (5) ◽  
pp. 298-315 ◽  
Author(s):  
Renáta Tichá ◽  
Amy Hewitt ◽  
Derek Nord ◽  
Sherri Larson
Keyword(s):  
Developmental Disabilities ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Employment Services ◽  
Individual Outcomes ◽  
Research Questions ◽  
National Significance ◽  
Community Based Services

Abstract The growth and advancement of community-based services for people with intellectual and developmental disabilities (IDD) have resulted in vast changes in the long-term services and support landscape as well as in expected outcomes of service systems for service recipients. Investments in IDD research have been made to provide a deeper understanding of these outcomes and to explain them. This article summarizes outcomes and their predictors through systems and individual lenses by examining the research and findings of the Administration on Intellectual and Developmental Disabilities' Data Projects of National Significance that address residential services, employment services, costs of services, and individual outcomes. The article also discusses challenges and debates associated with outcome-related research and poses future research questions.

Day Habilitation Services for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

2016 ◽  
Vol 41 (4) ◽  
pp. 244-255 ◽  
Author(s):  
Carli Friedman
Keyword(s):  
Developmental Disabilities ◽  
Service Utilization ◽  
Fiscal Year ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Total Spending ◽  
Day Habilitation ◽  
Services And Supports ◽  
Community Based Services

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how HCBS waivers allocate day habilitation services for people with IDD. HCBS waivers providing day habilitation services for people with IDD were analyzed to determine service utilization and projected expenditures. In fiscal year 2014, HCBS waivers projected US$5.62 billion of funding for day habilitation services; however, there was wide variance across services in terms of projected total spending, spending per participant, and reimbursement rates.

A National Analysis of Medicaid Home and Community Based Services Waivers for People With Intellectual and Developmental Disabilities: FY 2015

2017 ◽  
Vol 55 (5) ◽  
pp. 281-302 ◽  
Author(s):  
Carli Friedman
Keyword(s):  
Developmental Disabilities ◽  
National Level ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Day Habilitation ◽  
Services And Supports ◽  
National Analysis ◽  
Regulation Changes ◽  
Community Based Services

Abstract Medicaid Home and Community Based Services (HCBS) 1915(c) waivers are the largest source of funding for the long term services and supports of people with intellectual and developmental disabilities (IDD). National-level analyses of HCBS IDD waivers are crucial because of the large variance across states, the recent CMS rule and regulation changes (CMS 2249-F/2296-F), and the ever changing economic and political landscape. Therefore, the aim of this study was to examine state waiver priorities for people with IDD. In FY 2015, 111 waivers projected spending $25.6 billion for approximately 630,000 people with IDD. The services with the most funding were residential habilitation, supports to live in one's own home, and day habilitation. However, our analysis revealed large discrepancies across states and services.

Home- and Community-Based Speech, Language, and Hearing Services for People with Intellectual and Developmental Disabilities

2018 ◽  
Vol 43 (2) ◽  
pp. 111-125
Author(s):  
Carli Friedman ◽  
Ellyn McNamara
Keyword(s):  
Developmental Disabilities ◽  
Community Participation ◽  
Fiscal Year ◽  
Intellectual And Developmental Disabilities ◽  
Hearing Disorders ◽  
Community Based ◽  
Increased Risk ◽  
Alternative Settings ◽  
Community Based Services

Speech language and hearing (SLH) services can improve people with intellectual and developmental disabilities’ (IDD) health, autonomy, and community participation. The aim of this study was to explore how SLH services are offered to people with IDD across the nation, particularly in fiscal year 2015 Medicaid Home and Community Based Services (HCBS) 1915(c) waivers ( N = 111 waivers). Findings revealed, unlike Medicaid state plans, HCBS waivers were often utilized to offer SLH services in alternative settings, like participants’ homes, and provide long-term habilitative care rather than immediate acute care. Given increased risk for and under identification of communication and hearing disorders in people with IDD, adequate access to sufficient SLH services is essential to ensure the rights of people with IDD.

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.

Self-Advocacy Services for People With Intellectual and Developmental Disabilities: A National Analysis

2017 ◽  
Vol 55 (6) ◽  
pp. 370-376 ◽  
Author(s):  
Carli Friedman
Keyword(s):  
Developmental Disabilities ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Self Advocacy ◽  
Participant Direction ◽  
National Analysis ◽  
Community Based Services

Abstract Self-advocacy plays an important role in facilitating the empowerment of people with intellectual and developmental disabilities (IDD), and helps people with IDD develop the skills necessary for the participant direction of services. The purpose of this study was to examine Medicaid Home and Community Based Services (HCBS) 1915(c) waivers across the nation to determine how states were utilizing self-advocacy services for people with IDD. Findings revealed approximately half of waivers provided self-advocacy services; however, less than .01% of waiver spending was projected for stand-alone self-advocacy services. States need to expand the provision of self-advocacy services for people with IDD in order to strengthen their ability to direct their waiver services and exercise their rights.

Economic Impact of Missouri’s Partnership for Hope Home and Community-Based Medicaid Waiver for Individuals With Intellectual and Developmental Disabilities

2016 ◽  
Vol 27 (3) ◽  
pp. 138-147 ◽  
Author(s):  
Kelli N. Barton ◽  
George S. Gotto
Keyword(s):  
Developmental Disabilities ◽  
Economic Impact ◽  
The State ◽  
Federal State ◽  
Intellectual And Developmental Disabilities ◽  
Administrative Authority ◽  
Community Based ◽  
Federal Funds ◽  
Dollar Amount ◽  
Community Based Services

Missouri’s Partnership for Hope (PfH) is a home and community-based services (HCBS) Medicaid waiver that targets services to the needs of individuals with intellectual and developmental disabilities (IDD). PfH is predicated on a unique federal–state–county partnership, where counties may vote to participate in PfH by leveraging funds for services. The aim of this study was to explore the economic impact of PfH. The economic contribution and impact of PfH (October 2010–September 2013) were explored using IMPLAN software and data. Results indicate that a county and state investment of US$3.5 million each leveraged US$11.7 million in federal funds, contributed almost US$22.2 million to Missouri’s gross state product (GSP), and was responsible for more than 435 jobs for Missourians. An estimated 13.8 million of those dollars were “new” to the state’s economy. Economic impact analyses showed that PfH spending facilitated economic growth. The unique structure of PfH grants counties greater administrative authority and allows the state and counties to split the state Medicaid match dollar amount. Furthermore, results indicate that encouraging participants to self-direct services, and providing support for them to do so, is beneficial to a state’s economy, particularly job creation.

The State of Transportation for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services 1915(c) Waivers

2016 ◽  
Vol 27 (3) ◽  
pp. 168-177 ◽  
Author(s):  
Carli Friedman ◽  
Mary C. Rizzolo
Keyword(s):  
Developmental Disabilities ◽  
Public Transportation ◽  
Independent Living ◽  
People With Disabilities ◽  
Transportation Systems ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Transportation Services ◽  
Services And Supports ◽  
Community Based Services

Transportation is the most frequently reported problem for people with disabilities. While some people with disabilities have difficulty with limited or no public transportation systems, others have trouble with inaccessible infrastructures and systems. In addition, people with intellectual and developmental disabilities (IDD) often have trouble with many of the skills that navigating transportation requires. Although accessible transportation is crucial for independent living, Medicaid only requires states cover nonemergency medical transportation and does not require transportation related to other aspects necessary for community living such as accessing work, errands, or recreational activities. The purpose of this article is to examine Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers, the largest provider of long-term services and supports for people with IDD, to see how transportation is provided for people with IDD. Our examination of 99 waivers for FY 2013 revealed 58 waivers provided transportation-specific services and 71 waivers provided transportation within another service. The majority of waivers provided transportation for people with IDD through these two means; however, this transportation was often limited to very specific purposes. From our findings, it appears transportation services for people with IDD in waivers need to be expanded to support community access and integration.

Home and Community Based Services (HCBS) Waivers: A Nationwide Study of the States

2013 ◽  
Vol 51 (1) ◽  
pp. 1-21 ◽  
Author(s):  
Mary C. Rizzolo ◽  
Carli Friedman ◽  
Amie Lulinski-Norris ◽  
David Braddock
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
Real Time ◽  
The United States ◽  
Fiscal Year ◽  
Intellectual And Developmental Disabilities ◽  
Medicaid Program ◽  
Community Based ◽  
Waiver Program ◽  
Community Based Services

Abstract In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States (Braddock et al., 2011). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In FY 2009, federal–state spending for the HCBS Waiver program reached over $25.1 billion and constituted almost half of total funding across the nation that year (Braddock et al., 2011). Considerable effort has been spent investigating Medicaid program expenditures, however, due in part to the unique and state-specific nature of HCBS programs, national-level analysis on the types of services offered to individuals with IDD has not been available. A full understanding of the supports available through the Medicaid program is critical as the United States considers strategies for economic recovery among competing state and federal budget priorities. This article presents the results of an analysis of 88 Medicaid HCBS Section 1915(c) waiver applications for individuals with intellectual and developmental disabilities in 41 states and the District of Columbia. It analyzes IDD data and trends close to the real time intent of states and empowers advocates in presenting timely solutions to real-time issues.

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