Research / Journal abstracts

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Work-Life Differences and Outcomes for Agency and Consumer-Directed Home-Care Workers - abstract

This study published in The Gerontologist indicates a mixed portrait of experience and outcomes between service models and worker groups. On most dimensions of stress and satisfaction, consumer-directed workers report outcomes equal to or more positive than agency workers. The study is comprised of a random sample of 618 telephone interviews with workers in the In-Home Supportive Services program in California.

Short URL: http://www.advancingstates.org/node/51573

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Personal Assistance Services Cooperatives: Final Report

A study was conducted on consumer-directed personal assistance services (PAS) cooperatives, with an emphasis on workplace PAS. This report presents case studies of seven cooperatives, describes advantages of consumer-run cooperatives, identifies funding issues and sources, and presents considerations for those contemplating starting. It contains a review of the literature which reveals only a few examples of successful consumer-directed PAS cooperatives in the US, however, they show promise.

Short URL: http://www.advancingstates.org/node/51464

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Cash & Counseling: Improving the Lives of Medicaid Beneficiaries Who Need Personal Care or Home and Community-Based Services

This final report summarizes the findings from five years of research on how each of the three demonstration states implemented its program, and on how the programs have affected the consumers who participated, the consumers’ paid and unpaid caregivers, and the costs to Medicaid. The analysis is based on an experimental design to ensure that the estimates of program effects are unbiased, and has sample sizes that are adequate to detect program effects of policy-relevant magnitudes.

Short URL: http://www.advancingstates.org/node/51454

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Let the Sunshine In: Ensuring Public Involvement in State Medicaid Policy Making

States now have more discretion in changing Medicaid policies; consumers and advocates want to make sure they have a voice in that. This AARP Public Policy Institute Issue Paper examines the processes states have in place to solicit public input into Medicaid policy changes developed and implemented through Section 1115 waivers or State Plan Amendments (SPAs). Recommendations are offered on how federal and state governments can improve or enhance existing opportunities for public involvement.

Short URL: http://www.advancingstates.org/node/51429

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Putting Consumers First in Long-Term Care: Findings from the Cash & Counseling Demonstration and Evaluation

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.

Short URL: http://www.advancingstates.org/node/51213

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Consumer-Directed Supports: Economic, Health, and Social Outcomes for Families

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.

Short URL: http://www.advancingstates.org/node/51086

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Variation by Disability in State Predictors of Medicaid 1915c Waiver Use and Expenditures

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.

Short URL: http://www.advancingstates.org/node/50812

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Easing the Burden of Caregiving: The Impact of Consumer Direction on Primary Informal Caregivers in Arkansas

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.

Short URL: http://www.advancingstates.org/node/50691

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Multimodal Treatment for ADHD Among Youths in Three Medicaid Subgroups: Disabled, Foster Care, and Low Income

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.

Short URL: http://www.advancingstates.org/node/50278

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Health Care When Workers Need It Most: Before And After Entry Into The Social Security Disability Insurance Program – Journal Abstract

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.

Short URL: http://www.advancingstates.org/node/50111

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