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Unmet needs in self-directed HCBS programs
Kevin J Mahoney1, Ellen K Mahoney2, Carmen Morano3
1a School of Social Work Boston College , Chestnut Hill , Massachusetts , USA.
Journal of Gerontological Social Work
|March 21, 2018
Summary
Individualized plans reduced unmet needs for long-term services and supports, but some needs persisted. This study analyzed case studies to understand remaining unmet needs and propose solutions for better care.
Area of Science:
- Social Work
- Health Services Research
- Gerontology
Background:
- Unmet need for long-term services and supports (LTSS) is associated with adverse health outcomes.
- Individualized, self-directed care models offer a potential solution to unmet LTSS needs.
- The Cash and Counseling controlled experiment (CCDE) showed reduced unmet need but persistent gaps.
Purpose of the Study:
- To reanalyze CCDE case studies to identify remaining unmet needs.
- To understand who identifies these unmet needs (participants, caregivers, brokers, clinicians).
- To explore potential strategies for reducing unmet needs from stakeholder perspectives.
Main Methods:
- Collective or multiple case study analysis of 76 CCDE case studies.
- Categorization of unmet needs based on real-life experiences.
- Inclusion of clinician-documented needs not expressed by care recipients.
Main Results:
- Identified five categories of unmet needs.
- Captured unmet needs related to employer and budget management in self-direction.
- Highlighted discrepancies between clinician-documented and recipient-expressed needs.
Conclusions:
- Self-directed care models, while beneficial, still leave specific unmet needs.
- Understanding stakeholder perspectives is crucial for addressing remaining gaps.
- Developing targeted strategies and training for social workers is essential for reducing unmet LTSS needs.
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