State Expenditures on Home and Community Based Services and Use of Formal and Informal Personal Assistance: A Multilevel Analysis

The study examines the association of state HCBS expenditures with use of formal and informal personal assistance by Americans aged 70 and older with functional limitations. After controlling for other factors, the authors find that persons residing in states with higher HCBS expenditures were more likely to use formal personal assistance, but not less likely to use informal assistance. Data were from state expenditures and the Assets and Health Dynamics among the Oldest Old Survey.