Employment and Unmet Needs for Home and Community-Based Services for Working-Age Adults with Disabilities

Prior studies have demonstrated the negative impact of unmet need for home and community based services (HCBS) among persons with disabilities. However, no previous population-based studies have examined the relationship of HCBS and employment status among adults with disabilities. This study will examine the association between unmet need for HCBS and employment among a representative sample of working-age persons with disabilities. We used data from the 2007 Massachusetts Survey of Unmet Needs of Adults with Disabilities (n=571). HCBS services included in-home help, case-management services, information, access to medical care, physical/occupational therapy, prescription drugs, meals, assistive technology, home adaptation, transportation, need for assistance with activities of daily living and instrumental activities of daily living. Over two-thirds of respondents (69.6%) self-reported having an unmet need for at least one HCBS, and nearly one fourth (22.3%) reported having an unmet need for 5 or more HCBS. Among those who are employed, 55.4% (95%CI,45.8-64.9) reported at least one unmet need with 12.6% reporting (95%CI,7.2-18.1) five or more unmet needs. Among non-working adults, 84.2% (95%CI,77.2-91.3) reported one or more unmet needs with 32.2% reporting five or more unmet needs (95%CI,24.0-40.4). Preliminary conditional logistic regression analysis controlling for demographics and self-reported health suggests as negative association between unmet need for specific HCBS including case management, in-home care, information, and transportation and employment after conditioning out functional status. We expect the findings to show a negative association between unmet HCBS and employment suggesting the need to broaden the scope of HCBS for working-age persons with disabilities.