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Rural Health
Resources by Topic: Home and community-based services

Supportive Services and Caregiving for Older Rural Adults: Policy Brief and Recommendations to the Secretary
Provides an overview of current supportive services and caregiving policies for rural seniors, in terms of availability, accessibility, and acceptability of services. Explores topics including long-term services and supports, telehealth, care coordination, transportation, stigma, and unpaid caregivers, and describes federal programs for older adults. Offers policy recommendations and considerations.
Date: 08/2019
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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National Program Helps Older Adults in Rural Maine and Hawaii Feel More CAPABLE
Highlights CAPABLE (Community Aging in Place—Advancing Better Living for Elders), a national model that connects low-income older adults with an occupational therapist, registered nurse, and home repair services. Features programs implemented in Hawaii and Maine based on this model.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 07/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Support and Services at Home (SASH) Evaluation: SASH Evaluation Findings, 2010-2016
Evaluates the Support and Services at Home (SASH) program in Vermont, which provides support services and care coordination for older adults and people with disabilities in conjunction with affordable housing. Addresses Medicaid and Medicare expenditures, medication management, property management, challenges, and lessons learned. Identifies the percent of rural SASH host properties and differences for rural areas.
Additional links: Highlights
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Arkansas State Plan on Aging: Fiscal Years 2020-2022
Provides direction for long-term care efforts in the state of Arkansas. Focuses on long-term care, mental health, helping seniors remain at home, new Medicare prevention benefits, and preventing neglect and abuse. Highlights population data on rural Arkansas citizens and rural-specific priorities.
Date: 06/2019
Type: Document
Sponsoring organization: Arkansas Department of Human Services
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Older Americans Act: HHS Could Help Rural Service Providers by Centralizing Information on Promising Practices
Focuses on services and resources authorized by the Older Americans Act to help older adults age in place in rural communities. Addresses challenges accessing home and community-based services in rural areas and information on strategies for addressing those challenges. Covers home-delivered meals, congregate meals, transportation, family caregiver services, case management, and homemaker services. Research included interviews with ACL officials, rural area agencies on aging (AAA) in 8 states, rural health experts, and stakeholder groups; a literature review; and site visits.
Date: 05/2019
Type: Document
Sponsoring organization: Government Accountability Office
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Rural-Urban Disparities in Access to Home- and Community-based Services and Supports: Stakeholder Perspectives from 14 States
Examines rural-urban disparities in the supply and utilization of home- and community-based services (HCBS). Identifies factors that impact access to HCBS in rural areas.
Author(s): Daniel Siconolfi, Regina A. Shih, Esther M. Friedman, et al.
Citation: Journal of the American Medical Directors Association, 20(4), 503-308
Date: 04/2019
Type: Document
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Strengthening Medicaid Long-term Services and Supports in an Evolving Policy Environment: A Toolkit for States
Shares strategies states can use to reform their long-term services and supports (LTSS) framework, focusing on improving LTSS in two key areas: rebalancing LTSS to increase the proportion of LTSS provided in community-based settings and integrating LTSS with physical and behavioral health services through managed care. Uses case studies to provide examples of each strategy, and discusses rural considerations throughout.
Additional links: Brief for Legislators, Summary of Reforms
Author(s): Stephanie Anthony, Arielle Traub, Sarah Lewis, et al.
Date: 03/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Aging in Appalachia
Episodes of the radio program "Inside Appalachia," exploring challenges faced by elderly people in Appalachia, and the resources available to them. Topics include caregiver shortages, Alzheimer's disease, dying with dignity, and isolation and loneliness.
Date: 2019
Type: Website
Sponsoring organization: West Virginia Public Broadcasting
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Community-based Palliative Care: Scaling Access for Rural Populations
Explains the role palliative care plays in meeting the needs of patients with serious illness and chronic medical conditions. Discusses challenges to accessing palliative care in rural areas and highlights work in Alaska, California, and Kansas to help address this need.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 10/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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Medicaid Home- and Community-Based Services: Selected States' Program Structures and Challenges Providing Services
Examines the challenges states face in providing home- or community-based care instead of nursing home care under their state Medicaid programs, focusing on Arizona, Florida, Mississippi, Montana, and Oregon. Addresses program funding, workforce issues, eligibility and enrollment, populations targeted for the programs, use of managed care, and more. Includes rural considerations throughout.
Additional links: Full Report
Date: 10/2018
Type: Document
Sponsoring organization: Government Accountability Office
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