Research / Journal abstracts

Predictors of service use was examined among four in-home and two community-based services. Results showed that race did not have a significant effect on service use, but gender had a significant effect for some services. The results indicated the importance of social supports and structural factors in predicting use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

Examine factors associated with the use of personal care services (PCS) and the amount of authorized hours in California in 2004-2005. Of those Medicaid-eligible individuals with developmental disabilities living at home, 31% received PCS. When this study controlled for client need, gender, and age, those who were Asian/Pacific Islanders, African Americans, Hispanics, and other races had higher odds of receiving PCS than Whites but were authorized between 16 and 39 hours fewer than Whites.

Review this article addressing family policy questions that are often asked about consumer-directed services. Issues such as quality, suitability, and fraud and abuse are examined. Elder consumers and their caregivers who participated in the Arkansas Cash and Counseling program were interviewed. Analysis of responses demonstrates how this model can address both the needs of consumers with diverse disabilities and policy makers.

Review recommendations offered for maximizing the new Center for Medicare and Medicaid Innovation’s effectiveness in promoting reforms to improve the quality and value of care, while helping achieve health reform’s goals of more efficient, coordinated, and effective services. Suggestions include implementing a variety of payment reform initiatives, including global and bundled payment, and encouraging the implementation of innovative models developed by states and the private-sector.

To inform long-term care reform efforts, a web-based survey of over 1,000 LTC specialists nationwide was conducted. Findings included the need for LTC to be rebalanced toward HCBS settings, though few supported doing so by limiting nursing home bed supply. Although virtually all felt that the federal government was doing a poor job regulating LTC providers, most believed that the approaches used to oversee nursing homes should also be applied to assisted living.

An expert explores patterns in services and spending under long-term care programs and examines the rise in HCBS, the existence of waivers from federal and state coverage requirements, and the changing populations who use long-term care services. He concludes with a discussion on the need to reduce the fragmentation and lack of coordination in LTC services by removing the divide between Medicare and Medicaid programs. Listen to the recorded webinar and find Mr. Ng’s published paper.

Policy makers desire a uniform assessment tool that works well for adults of all ages, but disability assessment can only be as uniform as the underlying measurement is. If ADL or IADL/ADL measures are biased by age, their use with adults of different ages could be misleading. Findings of this study indicate that as demand for community services increases among adults of all ages, an expanded IADL/ADL measure is more useful than ADL.

Looking for journal articles relating to client’s rights, and ethical and legal issues involved in consumer-directed models? Read three seminal academic articles written by prominent professionals in the field.

Many assume that most of the long-term care population is elderly. Not so, according to this study. About half of community-dwelling Americans needing long-term care are younger than sixty five. Research and data collection focusing solely on older adults with long-term care needs misses half of the story. Recommendations of the study include a redistribution in long-term care spending from institutional to non-institutional settings, and from agencies to independent providers.

Read this study that found two significant supportive factors for older adults to remain in communities were use of paid instrumental activities of daily living (IADL) personal care services and awareness of unmet needs. Findings suggest the importance of encouraging older adults to acknowledge their unmet needs and to seek community-based support services early, rather than wait until they have developed more serious needs.