title: Expedited service delivery: helping case managers to increase access to services for the poorest older adults.
abstract: Low-income older adults have historically received institutionally based care when they were unable to care for themselves and there was a lack of sufficient formal and informal support to allow them to remain in their own homes. In 1981, revision of federal Medicaid legislation permitted states to provide home- and community-based services (HCBS) for older adults at risk of nursing facility placement in an attempt to prevent unnecessary placement and to offer choice. However, Medicaid-HCBS applicants may have to wait up to 45 days or longer for approval of their financial application. During those 45 days, the applicant may enter a nursing facility because Medicaid-HCBS was not available soon enough to prevent placement. This article presents research on an instrument to help case managers initiate community-based in-home services for the lowest-income Medicaid applicants within 3 to 5 days of initial assessment.
authors.affiliation: Kansas Department on Aging, Long Term Care Research Group, University of Kansas, Lawrence 66045, USA.
authors.forename: K R
authors.initials: KR
authors.lastname: Macmillan
authors.forename: R K
authors.initials: RK
authors.lastname: Chapin
authors.forename: R
authors.initials: R
authors.lastname: Rachlin
mesh_terms: D000368:Aged; D019090:Case Management; D003362:Cost-Benefit Analysis; D006297:Health Services Accessibility; D006299:Health Services for the Aged / Q000191:economics*; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D007182:Income; D008484:Medicaid / Q000191:economics*; D009735:Nursing Homes / Q000191:economics*; D011203:Poverty; D012189:Retrospective Studies; D014481:United States