Self-directed Support: Impact of Hiring Practices on Adults with Intellectual and Developmental Disabilities and Families

Abstract The study examined the differential experiences and outcomes for people with intellectual and developmental disabilities and their families receiving self-directed services based on the type of personal support worker hired (parents, siblings, other relatives, friends, and agency staff). The sample consisted of 372 participants in a self-directed waiver program who used personal assistance services. Results indicated that the caregiver's satisfaction with the personal support worker, self-efficacy in managing personal support workers, and mental health varied significantly based on type of personal support worker hired. Also, the physical health and daily choice making of the adults with disabilities differed significantly by type of personal support worker hired.

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

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-51.01.001 ◽

2013 ◽

Vol 51 (1) ◽

pp. 1-21 ◽

Cited By ~ 58

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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The Development of Choice-Making and Implications for Promoting Choice and Autonomy for Children and Youth with Intellectual and Developmental Disabilities

Choice, Preference, and Disability ◽

10.1007/978-3-030-35683-5_9 ◽

2020 ◽

pp. 179-194

Author(s):

Michael L. Wehmeyer ◽

Karrie A. Shogren

Keyword(s):

Developmental Disabilities ◽

Children And Youth ◽

Intellectual And Developmental Disabilities ◽

Choice Making

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Policy and Practice Note: Policy, Safety, and Regulation with Regard to Ontario Home Care Clients and Personal Support Workers

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980821000209 ◽

2021 ◽

pp. 1-9

Author(s):

Pamela Hopwood ◽

Ellen MacEachen

Keyword(s):

Home Care ◽

Service Providers ◽

Community Health Care ◽

Support Worker ◽

Policy And Practice ◽

Personal Support ◽

Home And Community Care ◽

Personal Support Workers ◽

Physical Care ◽

Home Care Safety

Abstract In light of COVID-19 and elevated concerns for the health of older Canadians receiving care, this Policy and Practice Note explores the confluence of the current home care policy landscape and the organisation of personal support worker (PSW) work, and highlights the need to consider governance of PSW work generally, and in-home and community care especially. PSWs are currently not professionally regulated, nor is there a central site documenting location, education, or any form of verification of the PSW workforce. Home care PSWs often provide physical care in isolated settings with no in-person supervision. In home and community health care, complaints about PSWs can be scattered among different service providers or client files not linked to or searchable by PSW name. This policy note explores how these factors and the currently unregulated status of PSWs affect home care safety in general as well as in the context of COVID-19, Ontario’s decentralised home care system, and efforts towards professional regulation.

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