Evaluating the Services that People with Disabilities Receive

Under a recent two-year, $250,000 supplemental award from the Administration on Community Living/National Institute on Disability, Independent Living, and Rehabilitation Research, Brian Abery and Renáta Tichá (pictured) and their colleagues within ICI’s Research and Training Center on Home and Community-based Services Outcome Measurement will develop and field-test measures of person-centered service practices. They will also explore the extent to which people with disabilities themselves are provided with opportunities to develop and evaluate home and community-based services.

“Millions of federal and state dollars are currently invested annually in providing community-based services to people with disabilities,” said Abery. “At this point, however, we have a long way to go with respect to being able to measure, in a reliable and valid manner, the quality of services people receive and the outcomes they experience. That has to change.”

People with all forms of disability receive services through the Center for Medicaid and Medicare Services (CMS) Home and Community-based Services (HCBS) Waiver Programs. These services are designed to support people with disabilities to live high-quality lives and achieve the outcomes that they personally desire. In order to achieve those goals, both the services that recipients receive and the outcomes they experience need to be evaluated and the resulting data used to improve outcomes.

Instead of measuring how many times people with disabilities get out each month, for example, states and service providers should ask them questions to understand whether their experiences in the community lead to them feel included. Instead of asking them how much control they have in their lives, they should be asked about whether they have the degree of control they desire over those things that are most important to them.

“The reliable and accurate measurement of HCBS outcomes is critical in improving the effectiveness of services designed for people with disabilities,” said Tichá. “In the absence of this type of information, service providers, policymakers, and most importantly, people with disabilities, are unable to make informed decisions.”