The Impact of Emergency Pandemic HCBS Funding on the Continuity and Security of People with Intellectual and Developmental Disabilities.

People volunteered for the interviews, so self-selection bias may affect who was represented. The analysis used existing data, so the researchers could not ask follow-up questions or capture details about how services changed during the pandemic. Each person had one interview point, while pandemic conditions changed over time, so the study cannot show how continuity and security moved within a person over the pandemic. State payment variables were only available for 16 states, so results may not apply to other states or to provider-level differences within a state. Appendix K changes were cumulative and could be added, amended, removed, or received later because of reimbursement lag, so the timing of payment changes is uncertain. The study is observational and used state-level policy data, so it cannot prove that payment increases or retainer payments caused better continuity and security.

Do not read this as proof that raising HCBS rates or retainer payments caused better continuity and security. The study is observational, used state-level policy data, and measured outcomes once, so it shows an association, not proof of cause.