Turner Publishes Article on Cross-State Differences in Self Directed Services for Older Adults

Posted: 10/16/2025 (CSDE Research)

CSDE Trainee Natalie Turner and co-author Carli Friedman recently authored a study, titled “Examining Cross-State Differences in Self Directed Services Provided Through 1915(c) Waivers for Older Adults”, published in the Journal of Aging & Social Policy. Self-Direction is a service delivery model that allows older adults to select their services and who provides them. This mixed-method study identifies cross-state differences in how states are allowing Self-Direction among the 60 Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers that serve older adults using Framework Analysis and descriptive statistics. Descriptive findings showed significant cross-state differences in Self-Direction design, with high variation in goals set for participation, projected spending on eligible services, and number of eligible waiver services. Read more.