222975 Designing a Resource Allocation Model for Personal Care Services for Children (CSHCN)

Wednesday, November 10, 2010 : 11:24 AM - 11:42 AM

Charles D. Phillips, PhD , Department of Health Policy and Management, Texas A&M University Health Science Center, School of Rural Public Health, College Station, TX
Ashweeta Patnaik, MPH , Public Policy Research Institute, Texas A&M University, College Station, TX
James Dyer, PhD , Public Policy Research Institute, Texas A&M University, College Station, TX
Emily Naiser, MPH , Public Policy Research Institute, Texas A&M University, College Station, TX
Constance Fournier, PhD , Department of Educational Psychology, Texas A&M University, College Station, TX
Timothy R. Elliott, PhD, ABPP , Department of Educational Psychology, Texas A&M University, College Station, TX
        
A model investigating the allocation of Medicaid Pesonal Care Services (PCS) hours of care to children with special health care needs (CSHCN)will be presented. The model is based on an analysis of hours of PCS authorized for a sample of over 2,500 CSHCN receiving PCS services in Texas in 2009. The most important factors in the model were the child's age and their overall ability to perform activities of daily living without hands-on assistance. The model explained roughly one-third of the variance in the hours of PCS authorized for these children. However, when the identity of the case manager making the allocation decision was added to the model, explained variance increased to over 50 percent. To the degree that PCS hours are allocated on some basis other than the child's needs, allocation of scarce public resources for this vulnerable population will be inefficient and risk not meeting children's needs . A case-mix model with guidelines and "corridors" is provided as a management tool that might be used to reduce the role of the case managers identity in determining care levels.

Learning Areas:
Chronic disease management and prevention
Program planning
Provision of health care to the public
Public health administration or related administration
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Identify factors affecting a child with special health care needs (CSHCN) required in-home assistance from the Medicaid Personal Care Services (PCS) program. 2. Describe a resource allocation model developed to provide guidelines for case workers making decisions about the amount of PCS a CSHCN should receive. 3. Discuss the role played by case workers or case managers in determining a child's need for Medicaid PCS.

Keywords: Children With Special Needs, Home Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the analysis for this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5101.0: Unmet need for healthcare among people with disabilities