Program Evaluation Home and Community-Based Waiver Services Essay

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Program Evaluation

TOPIC: Essay on Program Evaluation Home and Community-Based Waiver Services Assignment

Home And Community-Based Waiver Services (HCBS) program is an assistance that allows reimbursement for certain chronically ill, disable and elderly people who are not otherwise covered by the Medical aid program. The debate over the rising costs of the institutional healthcare has led to the passage of Omnibus Budget Reconciliation Act (OBRA) of 1981. (Miller, 1992). Under the HCBS program, people remain in their homes and communities, and the waivers allow people to receive services that are not covered under the traditional Medicaid program. Since 1981, states have used the autonomy of Section 1915(c) under Social Security Act to establish home and community-based waiver programs. Under this program, the states provide wide range of services to the participants, and the legislation allow states to recognize many individuals who at risks to be placed in the medical facilities in their homes, and communities. (Kitchener, Terence Miller, et al. 2005).The growth of HCBS program is traced back to 1988 when it has been identified that "a disproportionate percentage of Medicaid resources were being used for institutional long-term care." (Duckett, 2000. P 123). Additionally, many residents of both intermediate and nursing facilities frequently report unsatisfactory quality of life. With the increase in the number of deinstitutionalized people who are experiencing the developmental disabilities, many states establish the HCBS waiver program under the "Omnibus Budget Reconciliation Act of 1981 and was incorporated into the Social Security Act (the Act) at Section 1915(c)." (Duckett, 2000. P 123). This statue represents the recognition of states that many individuals are at risks of institutionalizations, and these individuals could be supported in their homes and communities. The HCBS is widely recognized by many states after the U.S. Supreme Court ruled out that states have the obligation to ensure that people with disabilities should not be forced to remain institutionalized when better and appropriate setting is available. The court also indicated that states should provide effective working plan to place qualified people in the less restrictive setting. Under the waiver programs, states can furnish array of services not otherwise covered by the Medicaid program. One of advantages of HCBS is that the participants are able to have bond with their family and friends at costs similar to the institutional care. Under the HCBS waiver, the service is provided to elderly people or individuals who are developmental and physically disables or people who are mentally retarded. The HCBS waiver is also targeted to individuals with specific illness such as people affected with AIDS or children who are technology-dependent.

Different states in the United States have flexibility in designing their HCBS programs. (Duckett, 2000). To implement HCBS program, each state must assure the federal Department of Health and Human Services (DHHS) that it will protect welfare and health of consumers. Under Alaska Home and Community-based Services, the state provides HCBS services for the children and adults experiencing diabetes, and people with experiencing developmental or mental retardation, Epilepsy, Autism, Cerebral Palsy and other people experience related disability.

This proposal formulates the research objective to provide greater understanding on the effectiveness and efficiencies of the Home and Community-Based Waiver Services program in Alaska.

Research Objectives

The research objective is as follows:

To investigate the efficiency and effectiveness of Home and Community-Based Waiver in Alaska.

The proposal explores the ability of the program to increase the number of elderly and disable people who use this program instead of being institutionalized in the hospitals or nursing homes.

Background and need for the Evaluation

Evaluation is the comparison of the impact of the program against the agreed plan. Evaluation reveals what the program has accomplished so far. The evaluation of the program is essential to assist the policy makers and consumers to determine whether the HCBS program is cost effective and is designed to serve the need of the consumers. The evaluation is very critical to assess the benefits and shortcoming of the program since it has been introduced in Alaska. Through critical evaluation of the program, the benefits and shortcoming of the program will be identified and the method to improve the program will be proposed.

The program evaluation focuses on the efficiency, effectiveness and the impact of the program on the consumers. The efficiency refers the extent the inputs such as money, staffs, time and so on have been able to provide appropriate output for the program. Effectiveness is measured as the extent the program has been to achieve its specific objectives. For example, the HCBS in Alaska is designed to improve the health of elderly disable people at costs comparable to Medicaid. Through evaluation, the impact of the program is identified, and this refers to the extent the program has been able make a difference to the problem situation. (Shapiron 2009).

The results of the evaluation is very important, and the results of the evaluation is very useful to examine the extent the program has been able to achieve its target objectives.

Anticipated use of the results of the evaluation

The results of the evaluation are very important, and the use of results will provide the greater understanding on the effectiveness and efficiency of the program. The anticipated use of the evaluation results are as follows:

First, the evaluation results will enhance greater understanding of the Alaska government on the extent the HCBS program has been able to achieve its target objectives. The evaluation will also enable the government to understand whether the program is more cost effective compared to Medicaid program.

Moreover, the evaluation results will assist the government to know the areas where the program needs improvement. In addition, the evaluation results will enhance greater understanding on the importance of the program to the community. The evaluation results will also enhance the greater understanding of the consumers and other stakeholders on the importance of the program.

Stakeholders Involvement

Stakeholder is defined as a person, group or organization that directly or indirectly have interests in the objectives and operation of a program. With respect to Home and Community-Based Waiver in Alaska, the stakeholders are consumers such elderly and, disable people, the government, and the community. Stakeholders involvement is very important to enhance the success of a program. According to UNDP (2009), engagement of stakeholders in a program is very critical to the success of the program. To achieve success in a project, there is a need to engage stakeholders in the planning, evaluating, monitoring, and improving of a program. It is vital to engage the stakeholders to evaluate the progress of a program in order to improve the program performances. The major factor that leads to the failure of a program is lack of stakeholder's involvement. Thus, this proposal will encourage broad and active involvement of the stakeholders. The stakeholders will be involved in the evaluation process of the program, and it is believed that the inputs of the stakeholders will lead to the overall success of the program.

Dissemination plans and anticipated evaluation products.

Effective dissemination plan is very important and it relies on various channels. The disseminate plan will assist the researcher to make the research findings known to the public. The anticipated research findings for this proposal will reveal that the HCBS has been able to achieve its target objectives. For example, the program has been able increase the number of elderly people and disables individuals who participate in the HCBS program. However, the anticipated program results will reveal that the challenges facing the program. The challenges such as escalating increase in the program costs and shortage of staff will be disseminated. The dissemination of these research findings will be through report, conference, electronic communication, journals, website and other information network. The research identifies the dissemination strategy to create the awareness of the findings of the proposal to the stakeholders. The proposal will attempt to consider all these media to ensure that the findings reach wide possible audience. The time frame for the dissemination plan will take approximately 90 days. Table 1 provides the dissemination strategy for the evaluation.

Table 1: Dissemination Strategy for the Evaluation

Broadcast Media

Personal Contact

Academic journals

Clinical specialty associations

Book chapters

Academic detailing

Professional meetings

Informal professional networks

Regular newspapers

Professional meeting

Radio or TV interviews


Academic detailing

Professional conferences

Professional conferences

Technical reports

Special interest newsletters

The anticipated evaluation products is to evaluate the project effectiveness and examine whether the program has achieved the desired objectives. Evaluation plan will make use of user's experience to determine the effectiveness of the program. The collection of the feedback on the quality, effectiveness and relevancy of the program will be used for the evaluation plan. The survey will be used for the evaluation and feedback from the website will be used for the evaluation. The email address will also be displayed on the website to receive the feedback. Through the evaluation procedures, the quality of proposal will be monitored.

There are evaluation questions that could guide the program improvement. The use of the evaluation questions will be used to enhance the greater… [END OF PREVIEW] . . . READ MORE

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APA Style

Program Evaluation Home and Community-Based Waiver Services.  (2011, November 21).  Retrieved October 17, 2021, from

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"Program Evaluation Home and Community-Based Waiver Services."  21 November 2011.  Web.  17 October 2021. <>.

Chicago Style

"Program Evaluation Home and Community-Based Waiver Services."  November 21, 2011.  Accessed October 17, 2021.