Research / Journal abstracts

A new Health Services Research Journal is a dedicated issue to Cash & Counseling. Review the summary of 15 articles; topics include public/private partnerships, research design and methodological issues, evaluation, consumer enrollment and experiences, costs, worker issues and case histories. Also find two commentaries on Cash & Counseling, one on the international context and the other about social experimentation.

Explore the impact of consumer-directed support on the economic, health, and social outcomes between families enrolled in the program and those on a waiting list. Caregivers reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did the waiting list group.

The December Gerontologist highlights a study which reviewed the state-level Medicaid 1915c data from 1992-2001 and compared state predictors of waiver utilization and expenditures for waivers serving both older and working age individuals relative to waivers serving individuals with intellectual and developmental disabilities. The results found that increased community-based-care capacity appears to be an important factor in efforts to expand the availability of Medicaid community-based-care.

This paper assesses the effect of consumer-directed care on the emotional, physical, and financial well-being of the primary informal caregivers of the Medicaid beneficiaries who voluntarily joined Arkansas's Cash and Counseling demonstration. The implications of the demonstration find that permitting interested Medicaid beneficiaries to direct their own in-home supportive services reduces burden on informal caregivers, which may help reduce beneficiaries' nursing home use.

This study compared the use of treatments for attention-deficit hyperactivity disorder (ADHD) among three distinct subpopulations of Medicaid-insured youths who have very different mental health needs and patterns of service use: those with federally documented disability, those in foster care, and those in families with low income. This one-year, cross-sectional study of community mental health services used administrative data.

Changes in characteristics, insurance status, and health care access were illustrated in this study that analyzed survey data on Social Security Disability Insurance (SSDI) beneficiaries during the six-year window surrounding SSDI entitlement. Findings suggest that there are significant gaps in the safety net for disabled workers before, during, and after the transition to SSDI.

Under 1115 Research and Demonstration waivers granted by HCFA, the CCDE program was implemented in three states: Arkansas, New Jersey, and Florida. Consumers are able to choose between traditional agency-delivered personal assistance services and their cash equivalent. Outcomes from the treatment and control groups are compared in areas such as client satisfaction, quality of care, costs, the types and amounts of personal assistance services received.

This study was designed to determine whether regulation effects the quality of care in licensed board and care home.

This article reports on Arkansas' telephone survey of consumers and surrogates. The survey focused on consumer satisfaction with current services and consumers’ and surrogates’ perceptions regarding the cash option. Survey data address how Arkansas can reach the most interested consumers and surrogates, what messages Arkansas should emphasize in its communications and marketing, and what issues should be explored further in postsurvey focus groups.

Description of LTC system for elders and younger persons with disabilities in Alabama in 2001