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

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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Care That Works: Support and Services at Home (SASH)
Examines the Vermont statewide program utilizing affordable housing communities to provide supportive services and care coordination for older adults and people with disabilities in rural areas. Describes how an on-site wellness nurse and care coordinator works with participants to coordinate assistance provided by social service agencies and community health providers with the services of the housing provider.
Date: 08/2018
Type: Document
Sponsoring organization: Center for Consumer Engagement in Health Innovation
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Implementing a Home Visiting Model in Tribal Communities: Takeaways from the HomVEE Tribal Review
Presents findings on the implementation and effectiveness of a home visiting program in tribal communities. Draws findings from the Home Visiting Evidence of Effectiveness (HomVEE) project's review of research on home visiting in tribal communities. Features sample strategies from reviewed studies.
Date: 02/2018
Type: Document
Sponsoring organizations: Mathematica Policy Research, The Office of Planning, Research, and Evaluation
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The Impact of the Vermont Support and Services at Home Program on Healthcare Expenditures
The Support and Services at Home (SASH) program helps rural and urban program participants access healthcare and support services in order to maintain their health and age securely and safely in their homes. Report estimates the impact of the Vermont SASH program on Medicare expenditures.
Author(s): Amy Kandilov, Vince Keyes, Martijn van Hasselt, et al.
Citation: Cityscape, 20(2)
Date: 2018
Type: Document
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Rural Long-Term Services and Supports: A Primer
Discusses the basics of rural long-term services and supports (LTSS) for older adults including system fundamentals, access, and opportunities and limitations of current policy. Includes models for rural LTSS and suggests priority areas for a high-performing rural health delivery system.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, Erin M. Mobley
Date: 11/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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No Wrong Door: Supporting Community Living for Veterans
Reports on several Veteran-Directed Home- and Community-Based Services (VD-HCBS) programs in 7 states. Presents a breakdown of each program and highlights challenges each program had to overcome. Bases analysis on 2 separate state surveys. Also includes tools useful to building collaborative partnerships between VA medical providers and aging and disability agencies in order to better serve veterans in their communities.
Author(s): Christina Neill Bowen, Wendy Fox-Grage, Kali Thomas, James Rudolph
Date: 11/2017
Type: Document
Sponsoring organization: AARP Public Policy Institute
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State of Care: Wisconsin's Home Care Landscape
Provides a snapshot of the home care landscape in Wisconsin. Includes information on the quality of care, workforce compensation, training, scope of practice, recruitment and retention, and unique challenges in rural areas. Includes statistics on home care workforce demographics in Wisconsin and at the national level, older adult population by county, and labor force participation as well as unemployment rates in Wisconsin by age, education, gender and family composition, and poverty.
Date: 09/2017
Type: Document
Sponsoring organization: PHI
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Aging in Place in Small Urban and Rural Communities
Examines the current state of aging in place, including cost benefits of rural residents living independently and using home health services and public transportation, rather than relocating to assisted living facilities. Includes statistics on costs of various types of senior living situations in North Carolina, Pennsylvania, Missouri, Wisconsin, Mississippi, Maine, New Mexico, and Montana, and aging in place cost savings forecasts for these states.
Additional links: Executive Summary
Author(s): Del Peterson, Ted Rieck
Date: 08/2017
Type: Document
Sponsoring organization: Upper Great Plains Transportation Institute
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State of Care: Minnesota's Home Care Landscape
Provides a snapshot of the home care landscape in Minnesota. Includes information on the quality of care, workforce compensation, training, and unique challenges and changing demographics in rural areas. Includes statistics on home care workforce demographics in Minnesota and at the national level, and older adult population by county.
Date: 07/2017
Type: Document
Sponsoring organization: PHI
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Rebalance Without the Balance: A Research Note on the Availability of Community-Based Services in Areas Where Nursing Homes Have Closed
Describes the existing distribution, including a rural and urban comparison, of community-based services (CBS) in areas where nursing homes have closed, and examines differences in CBS availability. Analysis uses data from local market and population characteristics as well as differences in state policies.
Author(s): Denise A. Tyler, Mary L. Fennell
Citation: Research on Aging, 39(5), 597-611
Date: 06/2017
Type: Document
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