Service Delivery

Understanding the Impacts of COVID Policy Changes on Access to Needed Supports for Families With Children Receiving Medicaid HCBS Waiver Services.

Shogren et al. (2023) · Intellectual and developmental disabilities 2023
★ The Verdict

Medicaid HCBS flexibilities allowed during COVID-19 (e.g., telehealth, expanded settings) were valued by families and should be permanently retained where feasible.

✓ Read this if BCBAs who bill Medicaid and want telehealth or respite flexibilities to stay.
✗ Skip if Clinicians who only work with private-pay clients and never use HCBS.

01Research in Context

01

What this study did

The team sent a survey to families who get Medicaid HCBS waiver services for kids with disabilities.

They asked how COVID rule changes like telehealth and paying family caregivers worked for them.

Parents shared if the new flexibilities met their needs and if they wanted them to stay.

02

What they found

Almost every family said the flexibilities helped a lot and should stay forever.

Telehealth and letting services happen in new places were the most loved changes.

03

How this fits with other research

Giesbers et al. (2020) first told state boards to allow telehealth during the lockdowns.

Waldron et al. (2023) now shows families loved those same changes and want them permanent.

Zhang et al. (2022) sounds like it disagrees because privately insured families still struggle to get covered.

The clash is simple: Medicaid families got extra help during COVID while private families did not.

Thompson et al. (2025) gives you a checklist to fight and keep the flexibilities families want.

04

Why it matters

You can wave this paper at payers and say “families already proved telehealth works.”

Use it to lock in remote supervision, parent coaching by video, and paying siblings as respite workers.

The checklist from Thompson et al. (2025) shows you exactly how to write testimony and get the rules written into permanent policy.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add one line to your next treatment plan: “Parent prefers telehealth per COVID flexibilities—request continuation.”

02At a glance

Intervention
not applicable
Design
survey
Population
mixed clinical
Finding
positive

03Original abstract

The COVID-19 pandemic necessitated rapid policy changes to address new demands on disability service systems. A statewide survey of families of people who received Medicaid funded home- and community-based (HCBS) long-term services and supports (LTSS) in one Midwestern state was conducted to understand (1) utilization of services allowed under the policy change, (2) family's experiences if their family member with a disability accessed the services, and (3) family's perspectives on the need for ongoing changes in the future. Overall, the results suggest that a subset of families took advantage of flexibilities introduced into service delivery models during the pandemic, and the changes-when accessed-addressed important needs that a large majority of families that accessed the services hoped would be sustained in the future.

Intellectual and developmental disabilities, 2023 · doi:10.1352/1934-9556-61.6.506