American Journal on Mental Retardation · 2008 · 40 citations · 11 references
Public AffairsHealth PolicySocial PolicyBehavioral HealthHealth Services ResearchMedicaid PolicyCaregivingCommunity-based CareFamily SupportMedicaidDaily Life PerformanceDevelopmental Disability SupportDisability Access To Health CareDisability Health DisparitiesHome-based Services EligibilityIntellectual Disability AssociationMedical Decision-making In Families
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.
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