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Recent studies have begun to describe the breadth and depth of Medicaid Home and Community Based Services (HCBS) programs more fully and although HCBS expenditures have increased rapidly from 1992 through 2006, states are facing serious budget problems which can jeopardize access to and funding for HCBS. This research project, which is directed by Terence Ng and Charlene Harrington at the University of California, San Francisco, is concerned with tracking changes and identifying gaps in these programs and services.
For the Center's purposes, the definition of the Home and Community Based Services includes:
All formal (paid) services delivered in the home and community, as opposed to institutional settings. These include personal assistance services, home health, waiver programs and other services funded by federal and state government. This research area has two goals.The primary goal of this five-year research project is with tracking changes and identifying gaps in HCBS programs and services. It comprises of three streams of research:
A second goal is to develop effective evidence-based interventions to address the needs for PAS. Three projects address interventions.
The Center for Personal Assistance Services is conducting a study of Medicaid Optional State Plan Personal Care Services (PCS) programs. The study involves two main activities. First, better practices (e.g., consumer direction) are identified from the literature to use as criteria for selecting promising programs. Second, detailed case studies are conducted on the promising programs.
State by State Home and Community-Based PAS Data AvailableFind contact information and learn about each Medicaid 1915(c) HCBS waiver in any state.
In a landmark interpretation of the ADA (Americans with Disabilities Act), the Supreme Court decided that people with disabilities have a right to receive care in the most integrated setting appropriate and that unnecessary institutionalization violates the ADA. All states must now comply with the decision. The Center for PAS is tracking the legal and policy ramifications of the Olmstead decision in each state.
Find the total amount of expenditures, expenditures per 1,000 population, the number of participants, and the participants per 1,000 population for various Medicaid HCBS programs: Home Health, Personal Care Services, and the 1915(c) HCBS Waivers. Compare these data with US totals.
Find the total amount of expenditures, expenditures per 1,000 population, the number of participants, and the participants per 1,000 population for several waiver target groups. Compare these data with US totals.
Provides information on the wages received by Personal and Home Care Aides in all 50 states, the District of Columbia and the nation over a 9 year period.
Shows the total funding by state from the Older American's Act Title III Programs and Alzheimer's Disease Demonstration Grants.
State matched funding to some federally funded long-term care programs.
A list of publications produced by the Home and Community-Based PAS project. The citations provide links to abstracts, press releases, and either the entire publication, or information about where to obtain it.
All PAS Center reports and publications related to Home and Community-Based PAS
Recent additions
PHI. (2010, July). State Chart Book On Wages For Personal And Home Care Aides, 1999‐2009. Bronx, NY: . Retrieved 8th July, 2010 from http://www.directcareclea ringhouse.org/download/PC A_Wage_Chart_Book_1999_20 09.pdf
(2010). Personal Care Services Utilization By Individuals with Developmental Disabilities. Family Relations, 59(April), pp.136-151.
(2009, November). Medicaid Home and Community-Based Service Programs: Data Update. Washington, DC: Kaiser Commission on Medicaid and the Uninsured. Retrieved 8-Dec-09 from http://www.kff.org/medica id/7720.cfm
Citations and abstracts of important publications related to Home and community-based PAS. Information on how to obtain the complete text is provided with each citation.
All Home and Community-Based PAS publications
Recent additions:
(2010, Winter/Spring). Advancing Home and Community-Based Services: Transforming Policies, Programs, and Service Delivery in Long-Term Care Boston, MA: Public Policy & Aging Report. Retrieved August, 2010 from http://www.hcbs.org/files /193/9616/PP&AR.pdf
(2010, August). Medicare Doesn’t Work As Well For Younger, Disabled Beneficiaries As It Does For Older Enrollees. Health Affairs, 29(9) Retrieved August, 2010 from http://content.healthaffa irs.org/cgi/content/full/ hlthaff.2009.0962v1 . doi: 10.1377/hlthaff.2009.0962
San Francisco. (2010). Health Care Reform and Family Caregivers. Family Caregiver Alliance: . Retrieved July 28, 2010 from http://www.caregiver.org/ caregiver/jsp/content_nod e.jsp?nodeid=2397
Presentations given by the Home and Community-Based PAS project with links to abstracts, powerpoint files and summaries.
All Home and Community-Based PAS presentations
Recent additions:
Ng, T., & Harrington, C. (2009, Nov 09) Medicaid Home and Community Based Services: Trends in Programs and Policies. Presented at the APHA Annual Meeting & Exposition hosted by American Public Health Association.
More information
Ng, T., & Harrington, C. (2009, Nov 09) Personal Care Services for the Disabled: National Trends in Programs and Policies. Presented at the APHA Annual Meeting & Exposition hosted by American Public Health Association.
More information
Ng, T., Kitchener, M., & Harrington, C. (2007, Nov 19) Medicaid Long Term Care Home and Community Based Services for the Elderly: Trends in Programs and Policies. Presented at the 60th Annual Scientific Meeting of The Gerontological Society of America hosted by The Gerontological Society of America.
More information
The Center for PAS has assembled a list of links to organizations, resources and information available on the web related to Home and Community-Based PAS.
All Home and Community-Based PAS Links
Recent additions:
Disability.gov
http://www.Disability.gov
Disability.gov, is a redesigned federal Web site that connects more than 50 million Americans with disabilities to thousands of trusted resources on disability-related issues, programs and services. Formerly known as DisabilityInfo.gov, the site has been completely redesigned and updated with new social media tools, such as a blog and a Twitter feed, to encourage feedback and interaction among visitors. Disability.gov is not just for Americans with disabilities, but also for parents of children with disabilities, employers, workforce and human resource professionals, veterans, educators, caregivers and many others.
Funding for Long-Term Care Programs
http://www.aarp.org/resea rch/longtermcare/programf unding/
This link provides a collection of research reports, fact sheets, speeches, news releases, congressional testimony, legal dockets and opinions on the topic of "Funding for Long-Term Care Programs".
Steve Gold’s Treasured Nuggets of Information
http://www.stevegoldada.c om
Steve Gold is an experienced disability rights attorney based in Pennsylvania. He maintains this website which is a very useful resource for anyone interested in disability rights in the U.S. The website provides regular bulletins on policy developments, legislation, research and statistics concerning five key issues for people with disabilities: housing, medical assistance/Medicaid, nursing homes, education, and the Americans with Disabilities Act.
The website presents short, easy to read bulletins and also give tips on how to use the facts and figures in state and local lobbying. It also presents sources of further information. It is possible to sign-up online to receive new bulletins by email and there is a searchable archive of all previous bulletins.