Title

Poster Session - Expanding occupational possibilities through community-based public policies

Location

Winter Garden

Start Time

16-10-2014 6:00 PM

End Time

16-10-2014 9:00 PM

Abstract

Title: Expanding occupational possibilities through community-based public policies

According to Law (2002) environmental factors significantly influence the community participation of people with disabilities. Wilcock (2005) described a model in which there was a dynamic relationship between environmental factors and occupationally just public policies. The purpose of this pilot study was to examine environmental factors associated with states’ adoption of a particular public policy for children and youth with autism spectrum disorders (ASD) (Eskow, 2012, p. 20). There is evidence that particular community-based policies that broaden the types of services people with disabilities receive decrease institutionalization rates and promote participation in their communities. This expansion of services represents occupational possibilities by broadening the environment in which intervention occurs and promoting opportunities for meaningful engagement (Laliberte Rudman, Huot, & Dennhardt, 2007). These opportunities include respite for family members or in-home aide services that enable organization of homework, familial routines, and engagement in new leisure activities. Further, services may lead to an expansion of the child’s skills in areas such as communication, self-care, and behavior, and, in turn, an expansion of the child’s overall occupational performance.

This pilot study involved in-depth, individual qualitative interviews with key informants from five states regarding their perspectives on adopting and implementing the Medicaid Home and Community-Based Services (HCBS) autism-specific waiver for children and youth in their state. Interview questions were developed from a review of the literature and feedback from content experts. Key informants included government employees familiar with the waiver program and were purposively recruited for this exempt research study through information on state websites. Interviews were conducted using conference call technology and were audiotaped. Following verbatim transcription, interviews were analyzed, member checked, and compiled into results. Findings revealed that personal advocacy and support of an elected official were most critical in the adoption of such a waiver. Challenges to implementation most commonly identified were decisions on population and services as well as limited numbers of qualified providers. The results of this study are informing a larger study addressing impact of services provided to families living in a state with an ASD waiver. This study is of value to occupational scientists as it provides a means to explore aspects of public policies that have the capacity to promote or restrict occupational possibilities for people with disabilities.

References

Eskow, K. (2012). State utilization and impacts of Medicaid HCBS waiver services for families and children with autism. Unpublished grant application/proposal, Department of Family Studies and Community Development, Towson University, Towson, Maryland.

Law, M. (2002). Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 640-649.

Laliberte-Rudman, D., Huot, S., & Dennhardt, S. (2009). Shaping ideal places for retirement: Occupational possibilities within contemporary media. Journal of Occupational Science, 16(1) 18-24.

Wilcock, A.A. (2005). Occupational science: Bridging occupation and health. Canadian Journal of Occupational Therapy, 72 (1), 5-12.

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Oct 16th, 6:00 PM Oct 16th, 9:00 PM

Poster Session - Expanding occupational possibilities through community-based public policies

Winter Garden

Title: Expanding occupational possibilities through community-based public policies

According to Law (2002) environmental factors significantly influence the community participation of people with disabilities. Wilcock (2005) described a model in which there was a dynamic relationship between environmental factors and occupationally just public policies. The purpose of this pilot study was to examine environmental factors associated with states’ adoption of a particular public policy for children and youth with autism spectrum disorders (ASD) (Eskow, 2012, p. 20). There is evidence that particular community-based policies that broaden the types of services people with disabilities receive decrease institutionalization rates and promote participation in their communities. This expansion of services represents occupational possibilities by broadening the environment in which intervention occurs and promoting opportunities for meaningful engagement (Laliberte Rudman, Huot, & Dennhardt, 2007). These opportunities include respite for family members or in-home aide services that enable organization of homework, familial routines, and engagement in new leisure activities. Further, services may lead to an expansion of the child’s skills in areas such as communication, self-care, and behavior, and, in turn, an expansion of the child’s overall occupational performance.

This pilot study involved in-depth, individual qualitative interviews with key informants from five states regarding their perspectives on adopting and implementing the Medicaid Home and Community-Based Services (HCBS) autism-specific waiver for children and youth in their state. Interview questions were developed from a review of the literature and feedback from content experts. Key informants included government employees familiar with the waiver program and were purposively recruited for this exempt research study through information on state websites. Interviews were conducted using conference call technology and were audiotaped. Following verbatim transcription, interviews were analyzed, member checked, and compiled into results. Findings revealed that personal advocacy and support of an elected official were most critical in the adoption of such a waiver. Challenges to implementation most commonly identified were decisions on population and services as well as limited numbers of qualified providers. The results of this study are informing a larger study addressing impact of services provided to families living in a state with an ASD waiver. This study is of value to occupational scientists as it provides a means to explore aspects of public policies that have the capacity to promote or restrict occupational possibilities for people with disabilities.