“Anything that benefits the workers should benefit the client”: Opportunities and Constraints in Self-Directed Care during the COVID-19 Pandemic

Reuse is restricted to non-commercial and no derivative uses.Self-directed care (SDC) models allow Home and Community Based Services (HCBS) consumers to direct their own care, thus supporting flexible, person-centered care. There are many benefits to the SDC model but access to resources is essential to successful outcomes. Considering the autonomy and flexibility associated with SDC, it is important to understand how SDC responded to the COVID-19 pandemic and the resources available to help manage this situation. We conducted 54 in-depth interviews with HCBS consumers, direct support workers, family caregivers, and providers to examine the impact of COVID-19 on HCBS services in Kansas. Findings illuminate how self-directed consumers carried a lot of employer responsibility, with limited resources and systemic barriers constraining self-determination and contributing to unmet care needs, stress, and burden. Policy flexibilities expanding the hiring of family members were beneficial but insufficient to address under-resourced working conditions and labor shortages that were exacerbated by the pandemic

UPDATING AND TESTING THE PASRR SCREEN IN KANSAS: REAL WORLD IMPLICATIONS

This work is licensed under a Creative Commons Attribution 4.0 International License.Kansas is updating the PASRR (Preadmission Screen and Resident Review) Level 1 screen per new guidance from the PASRR Technical Assistance Committee (PTAC), via a partnership between the State and university researchers. PTAC has directed states to screen for undiagnosed serious and persistent mental illness (SPMI) and also recommends screening for substance related disorders. Stakeholders were engaged through advisory workgroups and a content validity expert panel. These activities led to the creation of a revised PASRR Level-1 screen, but stakeholders also raised several concerns. PASRR law does not require Level-1 assessors to have professional training in mental health diagnoses or treatment, yet new guidelines asks them to screen for undiagnosed SPMI. Further, there are apparent discrepancies between these new guidelines and PASRR Level-2 criteria. Finally, current information management systems are not equipped to handle the higher security protocols associated substance use disorders. The draft instrument was tested with a sample of 103 nursing facility applicants by trained PASRR assessors and inter-rater reliability (IRR) was tested via a standardized vignette with 14 trained PASRR assessors. Only 3% of actual NF applicants were identified as possibly having an undiagnosed SPMI and only 43% of assessors correctly identified symptoms of a suspected SPMI in the standardized vignette, indicating poor validity and reliability in assessing for undiagnosed SPMI during the Level-1 screen. New PASRR guidelines may better ensure that nursing facility residents receive appropriate care for SPMI, however, there are many challenges to ensuring an accurate screen and supporting successful implementation

Media Representations of Offenders in Televison Series Law and Order

Media representations of offenders have varied over time; the rise of television media was an era in which offenders were depicted as active decision makers who committed deviant acts to attain their desires. Overtime, this image evolved into the current depiction of offenders as animalistic and inherently evil white males of upper socioeconomic status who are animalistic. Throughout the life of television media depictions of have ignored offender race, gender, and socioeconomic status, creating constructed realities that do not adequately reflect offenders in the United States. Thus, it is important to study how media depicts crime, criminals, and the criminal justice system. The purpose of this study is to analyze how offenders are represented in media. Data utilized for this study consists of a quantitative content analysis of the portrayal of victims on the television series Law and Order, which was collected over the course of three years by a four person research team and includes information on over twenty seasons of the show. Ten episodes were chosen based on a random sample design from all episodes in seasons 1, 5, 10, 15, and 20. Using this method the data spans the length of the series. Through analyzing this data, I hope to gain greater insight about how media depictions construct offenders. Data from Law and Order will be compared to data on real life offenders to examine how media representations differ from reality

Supplemental Material - “Anything that Benefits the Workers Should Benefit the Client”: Opportunities and Constraints in Self-Directed Care During the COVID-19 Pandemic

Supplementary Material for “Anything that Benefits the Workers Should Benefit the Client”: Opportunities and Constraints in Self-Directed Care During the COVID-19 Pandemic by Carrie L. Wendel, Tracey A. LaPierre, Darcy L. Sullivan, Jennifer Babitzke, Lora Swartzendruber, Tobi Barta, and Danielle M. Olds in Journal of Applied Gerontology.</p