Disparities in Quality of Life Outcomes and Quality of Supports among People with Disabilities Who Receive Home- and Community-Based Services (HCBS)

Abstract Quality of life outcomes are an indicator of people with disabilities’ wants, needs, and experiences. They are also important for Home- and Community-Based Services (HCBS) as they help demonstrate the quality of service provision. The aim of this study was to examine disparities in quality of life outcomes of people with disabilities who receive Medicaid HCBS. Given the role services and supports play in the lives of HCBS recipients, the secondary aim was to examine disparities in person-centered supports. To do so, we analyzed secondary Personal Outcome Measures (POM) interview data from 5,869 people with disabilities who received Medicaid HCBS. We found differences in outcomes and supports based on age, race, disability types, primary communication method, decision-making authority, average hours of support, support needs, residence type, work/day activities, and COVID-19 pandemic interviews. Intervention is needed to ensure all people who receive HCBS have access to high quality services and have a good quality of life. HCBS is a critically important mechanism; it is imperative to ensure it is maximizing the quality of life of those receiving it, through the provision of high quality, person-centered services.