Research / Journal abstracts

Discussions were conducted to uncover lessons from abroad for Community Living Assistance Services & Supports (CLASS), a federally run voluntary public long-term care insurance program created under the Accountable Care Act of 2010. Discussions were conducted during an international conference of LTC experts, followed by personal meetings & individual correspondence. Findings indicate that programs in the five countries studied have lessons, both positive & negative, relevant to CLASS design.

Providing personal assistance services (PAS) in the workplace (WPAS) is one approach to support the employment of individuals with disabilities. This study examined the implementation of Medicaid WPAS by collecting & analyzing telephone interview data from key informants selected from county & public authority officials in California in 2010. The results showed that less than a fraction of 1% of individuals with disabilities who used Medicaid personal care services used the services at work.

Autism spectrum disorders are among the fastest-growing developmental disability diagnosis in the US. This growing number highlights the need to learn more about the services & supports that are currently available for adults with ASD, & consider those that will be needed throughout their adult lifespan. The purpose of the study was to investigate how people with ASD are being served across states in HCBS, including service eligibility, state trends specific to autism services & lessons learned.

Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients in California's In-Home Supportive Services (IHSS) program. Outcomes among recipients using relatives as paid providers are compared with those of recipients having non-relatives as providers.

The Exchange website offers busy health professionals and researchers a variety of opportunities to share, learn about, and ultimately adopt evidence-based innovations and tools suitable for a range of health care settings and populations. The site has the following components: Searchable innovations; Searchable QualityTools; Learning opportunities and Networking opportunities.

Highlighted in the report are important developments & directions in NIH-funded research, including: risk for developing Alzheimer’s; genes that play a role in the disease; neuroimaging & biomarkers that detect & track the disease; research into new treatments; lifestyle factors that may worsen or protect against the disease; & help for caregivers. Special features include animation showing the progression of Alzheimer’s in the brain & video interviews highlighting new insights into the disease.

Despite more than $428 billion in spending in FY2008 to assist working-age people with disabilities, services provided are often fragmented, confusing, & less effective than they could be. This brief explains how the government serves a caretaker role. Authors point out that this model runs contrary to the goal of maximizing self-sufficiency embraced by the Americans with Disabilities Act & fails to direct funds to help those with disabilities join, remain in, or return to the workforce.

A review of 36 studies of outcomes for nearly 5,000 people with intellectual & developmental disabilities moving from large institutions to community living arrangements found high consistency in positive change in daily living skills. Studies specifically addressing social skill development, language & communication skills development, self-care & domestic skill development & community living skill development also showed positive outcomes associated with leaving large institutions.

Detailed data on community-based residential services providers indicated a high worker turnover for long-term care costs. The findings indicated that providers were unlikely to reduce turnover on their own, since its associated costs were either tolerably small or borne by others. An analysis indicated that it was socially beneficial for the government to reduce turnover through wage subsidization in this sector.

Nursing home use declined among older adults (65+) in more than 2/3 of states but increased among older working-age adults (31-64) in all but 2 states. This article examines the associations between programmatic characteristics and rates of use. Although greater investment in Medicaid HCBS coupled with reduced nursing home capacity was associated with reduced rates of nursing home care for adults aged 65+, neither characteristic was associated among older working-age adults.