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Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder.

Publication ,  Journal Article
Franklin, MS; Bush, C; Jones, KA; Davis, NO; French, A; Howard, J; Greiner, MA; Maslow, GR
Published in: J Dev Behav Pediatr
September 1, 2022

OBJECTIVE: We examined characteristics associated with receiving the North Carolina Home and Community-Based Services Waiver for intellectual and developmental disabilities (I/DDs) and its association with emergency department (ED) utilization. METHOD: Through analysis of the North Carolina 2017 to 2018 Medicaid claims and enrollment data, we examined characteristics (age, sex, race and ethnicity, geography, diagnosis (intellectual disability [ID] with or without autism spectrum disorders or autism spectrum disorder without ID) associated with receiving the NC I/DD Waiver and the association of this Wavier with ED utilization. We identified patients with at least 1 International Classification of Diseases-10-CM diagnosis code for an ID or autism spectrum disorder. We excluded patients with missing county information and whose enrollment in the NC I/DD Waiver program began after October 1, 2017. RESULTS: Only 22% of 53,531 individuals with I/DD in North Carolina received the Waiver. Non-Hispanic Blacks and Hispanic individuals were less likely to receive the Waiver than non-Hispanic White individuals. Adults (>21 years old), men, and urban residents were more likely to receive the Waiver. Individuals who received the Waiver were 31% less likely to use the ED. CONCLUSION: Innovative strategies are needed to provide equitable access to the NC I/DD Waiver and provide services to the 14,000 people with I/DD currently waiting to receive the Waiver. Through the Waiver, those with I/DD can access preventative and therapeutic outpatient services and decrease their need for ED care. These findings highlight the need for policy reform to address inequities in access to the Waiver for individuals with I/DD.

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Published In

J Dev Behav Pediatr

DOI

EISSN

1536-7312

Publication Date

September 1, 2022

Volume

43

Issue

7

Start / End Page

393 / 401

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • North Carolina
  • Medicaid
  • Male
  • Intellectual Disability
  • Humans
  • Ethnicity
  • Developmental & Child Psychology
  • Autism Spectrum Disorder
 

Citation

APA
Chicago
ICMJE
MLA
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Franklin, M. S., Bush, C., Jones, K. A., Davis, N. O., French, A., Howard, J., … Maslow, G. R. (2022). Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder. J Dev Behav Pediatr, 43(7), 393–401. https://doi.org/10.1097/DBP.0000000000001075
Franklin, Michelle S., Christopher Bush, Kelley A. Jones, Naomi Ornstein Davis, Alexis French, Jill Howard, Melissa A. Greiner, and Gary R. Maslow. “Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder.J Dev Behav Pediatr 43, no. 7 (September 1, 2022): 393–401. https://doi.org/10.1097/DBP.0000000000001075.
Franklin MS, Bush C, Jones KA, Davis NO, French A, Howard J, et al. Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder. J Dev Behav Pediatr. 2022 Sep 1;43(7):393–401.
Franklin, Michelle S., et al. “Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder.J Dev Behav Pediatr, vol. 43, no. 7, Sept. 2022, pp. 393–401. Pubmed, doi:10.1097/DBP.0000000000001075.
Franklin MS, Bush C, Jones KA, Davis NO, French A, Howard J, Greiner MA, Maslow GR. Inequities in Receipt of the North Carolina Medicaid Waiver Among Individuals with Intellectual Disability or Autism Spectrum Disorder. J Dev Behav Pediatr. 2022 Sep 1;43(7):393–401.

Published In

J Dev Behav Pediatr

DOI

EISSN

1536-7312

Publication Date

September 1, 2022

Volume

43

Issue

7

Start / End Page

393 / 401

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • North Carolina
  • Medicaid
  • Male
  • Intellectual Disability
  • Humans
  • Ethnicity
  • Developmental & Child Psychology
  • Autism Spectrum Disorder