Day Habilitation Services for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

Friedman, Carli

doi:10.1177/1540796916664337

Cited by 11 publications

(17 citation statements)

References 24 publications

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“…In the mid‐1980s, “supported employment” services initially became available via Medicaid waivers; such services included job coaching, specialized job training, and customized supervision, intended to support individuals with disability in competitive employment positions. These services have been offered and promoted by both the federal and state governments since the 1980s, especially via Home‐ and Community‐Based Services (HCBS) waivers for long‐term services and supports (Agranoff, 2013; Friedman, 2016; Friedman & Rizzolo, 2016; Gettings, 2011; LeBlanc, Tonner, & Harrington, 20000).…”

Section: Subsystem Contextmentioning

confidence: 99%

“…Alongside employment services, most states also offer a variety of other Day Habilitation and Employment services, including non–employment services (i.e., day habilitation or respite), as well as noncompetitive employment‐related supports (i.e., sub–minimum wage) and/or services in nonintegrated settings (i.e., facility‐based/sheltered workshop services) (Friedman, 2016; Friedman & Rizzolo, 2016). Medicaid long‐term services waivers, which are the result of negotiations between the state and federal government, are the primary source of funds for Day Habilitation and Employment services (Gettings, 2011).…”

Section: Subsystem Contextmentioning

confidence: 99%

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Advocacy Coalitions in Low Salience Policy Subsystems: Struggles Under a Smooth Surface

Giordono¹

2019

Policy Studies Journal

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The Advocacy Coalition Framework (ACF), a well‐known framework used to understand policy changes at the subsystem level, is predicated on the idea that coalitions with distinct beliefs compete to influence policy subsystem decisions. The ACF is noted as being most appropriate for, and is typically applied to, high salience policy areas. However, scholars have noted the need to also apply the ACF to less typical application settings in the interest of theoretical refinement. This paper thus explores the applicability of the ACF to Day Habilitation and Employment services systems for working‐age adults with intellectual and developmental disabilities in two U.S. states, Washington and Pennsylvania, both of which have experienced distinct state‐level policy changes during the last two decades despite low levels of public attention and conflict. Using a mixed‐methods approach, the paper identifies the presence of two advocacy coalitions (Employment First and Choice) in both states. The study concludes that there is sufficient evidence to apply the ACF to these low salience subsystems, noting theoretical and practical implications for scholars and policymakers interested in applying the ACF to similar settings.

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Section: Subsystem Contextmentioning

confidence: 99%

Section: Subsystem Contextmentioning

confidence: 99%

Advocacy Coalitions in Low Salience Policy Subsystems: Struggles Under a Smooth Surface

Giordono¹

2019

Policy Studies Journal

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“…Doing so includes also shifting existing resources to prioritize integrated employment models. For example, Medicaid Home and Community Based Services (HCBS) waivers, the largest funder of long-term services and supports of people with intellectual and developmental disabilities (Braddock et al, 2015), currently provide 7 times more funding for day services for people with intellectual and developmental disabilities than supported employment services (Friedman, 2016). Moreover, prevocational services, which are not only segregated but do not provide a clear pathway to integrated employment, are also heavily funded by waivers (Friedman & Nye-Lengerman, 2018).…”

Section: Resultsmentioning

confidence: 99%

Fair-Wages for People With Disabilities: Barriers and Facilitators

Friedman

Rizzolo

2020

Journal of Disability Policy Studies

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Subminimum wage is a prominent and problematic issue affecting the lives of many people with disabilities. For this reason, the aim of this study was to identify the correlates of fair-wages (at least minimum wage) for people with disabilities—which factors facilitate and hinder people with disabilities’ access to fair-wages. We utilized Personal Outcome Measures® interview data from approximately 1,500 people with disabilities to examine how individual, employment, and organizational-level factors correlate with people with disabilities’ access to fair-wages. Binary logistic regression models revealed at the individual-level support needs, guardianship, and residence type all significantly correlate with people with disabilities’ odds of receiving fair-wages. In addition, the ability to experience a number of employment options, as well as decide where to work, produce higher odds of having fair-wages. Finally, our findings also revealed the key role service organizations can play in facilitating people with disabilities’ access to fair-wages. Attention to the facilitators that promote access to fair-wages for people with disabilities, and the barriers that hinder this access is one of the first steps toward ending this discrimination against people with disabilities.

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“…While such a notion seems simple and obvious, individuals have historically not been included in deciding what they do in their daily lives. From a policy perspective, most regulations at state and federal level for day programs or day habilitation programs focus on activities, health care, providing supports for behavioural challenges (Friedman, 2016), teaching skills and becoming independent. There is little or no focus on facilitating relationships and yet, this study shows that it is an essential component to feeling valued in society.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, while residential services are highly regulated, up until 2006 there were no federal standards for day treatment centers (Kaufman, 2006b). Most state-wide regulations have more to do with types of funding provided rather than with ensuring a quality program (Friedman, 2016; Hall et al, 2011; Kaufman, 2006a; Petner-Arrey and Copeland, 2015). However, the literature does suggest important elements that should be in place for a quality day program (Crites & Howard, 2011; Hawkins, 1999; Luckasson and Spitalnik, 1994; Parsons and Reid, 1993; Reid et al, 2001b).…”

Section: The Importance Of Dignity and Choice In Day Programsmentioning

confidence: 99%

The importance of dignity and choice for people assessed as having intellectual disabilities

Frounfelker

Bartone

2020

J Intellect Disabil

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Individuals assessed as having an intellectual disability often spend a significant amount of time in day treatment/day habilitation programs after they graduate from school. The quality of these programs varies widely and is not federally legislated. The purpose of the current study is both to explore factors that lead to higher satisfaction for participants in these programs and to better understand what participants want in a program. Using a grounded theory approach, researchers interviewed 25 participants, staff, and family members in focus group settings to collect qualitative data. Interviews focused on what worked and what could be improved at a program located in Western New York. Using the constant comparative method, themes emerged from the data that pointed to the importance of dignity and choice in a day program to facilitate empowerment, higher levels of satisfaction and self-confidence.

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Day Habilitation Services for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

Cited by 11 publications

References 24 publications

Advocacy Coalitions in Low Salience Policy Subsystems: Struggles Under a Smooth Surface

Advocacy Coalitions in Low Salience Policy Subsystems: Struggles Under a Smooth Surface

Fair-Wages for People With Disabilities: Barriers and Facilitators

The importance of dignity and choice for people assessed as having intellectual disabilities

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