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Choice-making among Medicaid HCBS and ICF/MR recipients in six states
K Charlie Lakin1, Robert Doljanac, Soo-Yong Byun
1Research and Training Center on Community Living, University of Minnesota, Minneapolis, MN 55455, USA. lakin001@umn.edu
Abstract:
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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