Administración, elección y control fiscal: el contexto de los servicios autodirigidos para personas con discapacidades intelectuales y del desarrollo (DID) en los Estados Unidos

Translated title of the contribution: Fiscal stewardship, choice, and control: The context of self- directed services for people with intellectual and developmental disabilities (IDD) in the United States

Matthew D. Bogenschutz, Matthew DeCarlo, Jennifer Hall-Lande, Amy Hewitt

Research output: Contribution to journalArticlepeer-review

Abstract

Self-directed home and community based services (HCBS) waiver services and supports for people with intellectual and developmental disabilities (IDD) have become a viable and widely used method of service provision in the United States. Grounded in theories of self-determination, previous literature on self-direction has suggested high satisfaction and positive outcomes for people who use self-directed programs as well as cost savings for state IDD service systems. This study explored the ways in which state IDD service administrators think about how self-direction may be used as a method of achieving cost savings while providing opportunities for people with IDD and their families to exercise choice and control. Informed by 54 high-level IDD service administrators in 34 states, and guided by a thematic analysis approach to data interpretation, the study found evidence that administrators typically see strong potential for self-direction to have cost-savings benefits, while also fostering choice. In the current political climate, the need for cautious fiscal stewardship may become a stronger driving force behind self-direction for people with IDD in the United States.

Translated title of the contributionFiscal stewardship, choice, and control: The context of self- directed services for people with intellectual and developmental disabilities (IDD) in the United States
Original languageSpanish
Pages (from-to)158-171
Number of pages14
JournalIntellectual and Developmental Disabilities
Volume57
Issue number2
DOIs
StatePublished - Apr 1 2019

Keywords

  • HCBS waivers
  • Intellectual and developmental disabilities
  • Participant direction
  • Qualitative thematic analysis
  • Self-determination
  • Self-direction
  • Service costs

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.

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