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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
Unmet needcase studiesparticipant directionself direction

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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.