Approaches to Quality Under Home and Community-based Services Waivers PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download Approaches to Quality Under Home and Community-based Services Waivers PDF full book. Access full book title Approaches to Quality Under Home and Community-based Services Waivers by . Download full books in PDF and EPUB format.
Author:
Publisher:
ISBN:
Category : Community health services
Languages : en
Pages : 92
Get Book Here
Book Description
Author:
Publisher:
ISBN:
Category : Community health services
Languages : en
Pages : 92
Get Book Here
Book Description
Author:
Publisher:
ISBN:
Category : Community health services
Languages : en
Pages : 92
Get Book Here
Book Description
Author: Kathryn G. Allen
Publisher: DIANE Publishing
ISBN: 9780788170898
Category : Medical
Languages : en
Pages : 80
Get Book Here
Book Description
Home & community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. This report reviews: (1) trends in states' use of Medicaid home & community-based service (HCBS) waivers, particularly for the elderly; (2) state quality assurance approaches, including available data on the quality of care provided to elderly individuals through waivers; & (3) the adequacy of federal oversight of state waivers. Charts & tables.
Author: Amy Hewitt
Publisher:
ISBN:
Category : Intellectual disability
Languages : en
Pages : 60
Get Book Here
Book Description
Author: Matt Salo
Publisher:
ISBN:
Category : Health services administration
Languages : en
Pages : 79
Get Book Here
Book Description
Author: Hazal Erçin
Publisher:
ISBN:
Category :
Languages : en
Pages : 170
Get Book Here
Book Description
Most older adults express a wish to age and die in their own homes, yet without a support system, dying at home can be impossible due to high needs for assistance with self-care, mobility, symptom management, and day-to-day functioning at the end of life. The care needs of economically vulnerable, community-dwelling older adults are addressed by Medicaid 1915(c) waivers which allow Medicaid funds to be used to provide home and community-based services (HCBS). Medicaid 1915(c) waivers reach the most economically vulnerable older adults -- also known as "dual eligible" older adults as they are qualified for both Medicare and Medicaid. HCBS waivers allow states to provide services that can help with symptoms, housework, daily activities, caregiver support, and with home safety. There is no federal policy regulating the services provided by Medicaid waiver programs and 1915(c) waivers are offered at the discretion of the states. As a result, states vary dramatically in the availability of the suite of services provided as well as the level of funding, or generosity of these services. These state-level differences may create disparities in the end-of-life experiences among dual-eligible older adults based on the state they live and die in. Aims: This dissertation investigated 1) state variation in Medicaid 1915(c) waiver availability and generosity of HCBS to dual-eligible older adults, and 2) the association between state variation in availability and generosity and end of life experiences. Methods: Three papers were written to answer the aims of this dissertation. First, a policy analysis was conducted to explore the availability and generosity of 1915(c) waivers utilizing three datasets: 1) waiver application documents located at CMS.Medicaid.org, 2) the Medicaid Analytic Extract - Other Services (MAX-OT) dataset, and 3) Genworth State Cost of Care Survey 2013. Analysis of these datasets resulted in summative descriptions of 8 state-level indicators for availability and generosity of HCBS. For the second and third papers, the National Health and Aging Trends Study (NHATS) (Wave 2-7, 2012-2017) was utilized in addition to state-level data summaries created for the policy analysis. For paper 2, regression analyses were used to determine the effect of waiver availability and generosity on unmet end of life needs. For paper 3, regression analyses examined the effect of HCBS on the quality of life reported at the end of life. Results: Substantial variation exists between states in available services, coverage for target groups, service slots available, ability to direct ' own care, and generosity of services. Paper 2 found that 40.26% of the sample had unmet needs for self-care and mobility activities Unmet need for assistance was associated with lower availability of HCBS and less generosity for homemaker services, having dementia, and not having participant direction option. Paper 3 found that 56.07% of low-income respondents reported having a low quality of end of life. Lower quality at the of end of life was associated with fewer available HCBS slots, living alone, higher numbers of chronic diseases, and receiving hospice during the last month of life and. Discussion: Community-dwelling dual eligible older adults nearing the end-of-life experience unmet needs with self-care and mobility activities and low quality of end of life, such as high symptom burden and lower functioning. The findings indicated that 1915(c) waivers could tailor their services for older adults at the end of life due to their higher risk for unmet needs and lower quality of end of life. Generosity for the services and slots available for dual-eligible older adults were also associated with end-of-life experiences of this sample, therefore Medicaid waivers should increase their generosity and slots to better meet the needs of economically vulnerable older adults at the end of life.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132746
Category : Medical
Languages : en
Pages : 344
Get Book Here
Book Description
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
Author:
Publisher:
ISBN:
Category : Government publications
Languages : en
Pages :
Get Book Here
Book Description
Author:
Publisher:
ISBN:
Category : Government publications
Languages : en
Pages : 752
Get Book Here
Book Description
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations
Publisher:
ISBN:
Category : Nursing home care
Languages : en
Pages : 590
Get Book Here
Book Description
