Choice-making among Medicaid HCBS and ICF/MR recipients in six states.
Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in non family settings in six states. Everyday choice in daily life and in support-related choice was considerably higher on average for HCBS than for ICF/MR recipients, but after controlling for level of intellectual disability, medical care needs, mobility, behavioral and psychiatric conditions, and self-reporting, we found that choice was more strongly associated with living in a congregate setting than whether that setting was HCBS- or ICF/MR-financed. Marked differences in choice were also evident between states.
Lakin
K Charlie
KC
Research and Training Center on Community Living, University of Minnesota, Minneapolis, MN 55455, USA. lakin001@umn.edu
Doljanac
Robert
R
Byun
Soo-Yong
SY
Stancliffe
Roger
R
Taub
Sarah
S
Chiri
Giuseppina
G
D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health; D002755:Choice Behavior; D003153:Community Health Services / Q000706:statistics & numerical data*; D003657:Decision Making; D003710:Demography; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology* / Q000628:therapy*; D007380:Intermediate Care Facilities / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D012720:Severity of Illness Index; D012944:Social Support; D014481:United States / Q000453:epidemiology