 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Nancy A. Miller, PhD, Policy Sciences Graduate Program, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250, 410-455-3889, nanmille@umbc.edu, Andrea Rubin, MSW, Intercampus Doctoral Program in Gerontology, UMBC, Administration Building, Room 622, 1000 Hilltop Circle, Baltimore, MD 21250, and Charlene Harrington, PhD, Department of Social & Behavioral Sciences, University of California San Francisco, 3333 California St, Suite 455, San Francisco, CA 94143-0612.
Medicaid is the most significant source of public funding for long term care. It is in a key position to determine in what setting, and from whom, individuals with disabilities can access long term care. Although states have increased the share of long term care dollars that support individuals' receipt of long term care in community settings, there is considerable variability across states, and, within states, by disability. In this paper, we extend previous analyses to examine factors that influence community based care expenditures for different subgroups of individuals with disabilities. Our analyses focus on Medicaid 1915(c) waiver expenditures, examining the effect of state level variables shown in previous work to be related to state fiscal effort, on expenditures for five segments of the population -- the frail elderly, individuals with developmental disabilities, working age people with disabilities, persons with AIDS, and children with a variety of disabling conditions. We utilize a random effects panel model for the period 1992 through 2000 to examine variation both within states over time, as well as across states. Our work identfies the extent to which variables amenable to policy influence (e.g., certificate of need) are either shared, or differ across segments of the population with disabilities. We suggest strategies to expand the provision of community based care.
Learning Objectives:
Keywords: Disability Policy, Long-Term Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.