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APHA Scientific Session and Event Listing

Recorded presentation

Glen Mays, PhD, MPH¹, M. Kate Stewart, MD, MPH², Holly C. Felix, PhD², and Naomi Cottoms³. (1) Dept. of Health Policy & Management, College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR 72205, (2) College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 820, Little Rock, AR 72205, 501-526-6626, felixholly@uams.edu, (3) Tri-Country Rural Health Network, 419 Cherry Street, Helena, AR 72342

A growing body of evidence demonstrates the effectiveness of home and community-based long-term care services (HCBS) in enhancing health, social functioning, and quality of life for elderly and disabled populations while potentially reducing the need for costly nursing home care. Access to these services remains limited, particularly in rural areas, due to gaps in knowledge about service availability and eligibility and lack of coordination among service providers. Community health worker (CHW) programs have been used successfully to expand access to other types of health services and therefore may hold promise for assisting elderly and disabled individuals obtain needed HCBS. This presentation describes the design and early results of a demonstration program implemented in three rural counties of the Arkansas Mississippi River Delta Region during 2005 that utilizes CHWs, known locally as Community Connectors (CCs), to link Medicaid-eligible elderly and disabled persons to available long-term care (LTC) services. A four-year evaluation employs a quasi-experimental design to track the program's effects on long-term care service use and costs using a matched comparison group of Medicaid beneficiaries in five non-intervention Delta counties. The evaluation assesses (1) the types of individuals reached by the CCs, (2) the types of services to which these individuals are connected, and (3) differences between the demonstration and comparison groups in major components of service use and spending, including nursing home and HCBS care. First-year results provide an initial test of the program's design and operation as well as early projections of its cost-neutrality to Medicaid.

Learning Objectives: Persons who attend this presentation will be able to

• Describe an intervention using CHWs to link persons with long-term care services
• Describe the methodology used to evaluate the cost-effectiveness of the CHW intervention
• Document preliminary findings from a first year cost-effectiveness evaluation

Keywords: Community Health Advisor, Evaluation

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation