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Journal of Applied Gerontology
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Who is Being Served? Program Eligibility and Home- and Community-Based Services Use

Evelinn A. Borrayo

Colorado State University, borrayo{at}lamar.colostate.edu

Jennifer R. Salmon

University of South Florida

Larry Polivka

University of South Florida

Burton D. Dunlop

Florida International University

Functional and economic eligibility criteria for publicly funded programs are causal factors in the use of home- and community-based services (HCBS). Thus, the study’s overall hypothesis was that the main program eligibility criteria would determine the particular characteristics of consumers in three of Florida’s HCBS programs: Aged and Disabled Adult Medicaid Waiver (ADW), Community Care for the Elderly, and Home Care for the Elderly (HCE). Data on 464 consumers who were 60 years and older and receiving services in one of the three programs support the overall hypothesis but revealed important exceptions. The ADW program is not serving a more functionally impaired population than the other programs. The HCE program is serving elders who are more cognitively impaired. Consumer-directed long-term care programs like HCE have the potential to better serve frail older adults and their caregivers if more public funding is allocated and other policy modifications are made nationwide.

Key Words: behavioral model of health services use • public policy • home care

Journal of Applied Gerontology, Vol. 23, No. 2, 120-140 (2004)
DOI: 10.1177/0733464804265578
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[Abstract] [PDF]