Physicians play important role in families' long-term care decisions. Choice of home care vs. nursing home.

Physicians are often involved in decisions about long-term care for the elderly and adults with disabilities. In Arkansas, some home and community-based services (HCBS) have been established for these Medicaid-eligible populations, as a nursing home alternative, but some are under-utilized. Unnecessary use of nursing home care burdens the state Medicaid budget. A recent study on service utilization suggests that physicians' lack of knowledge about HCBS may be a factor in their under-utilization. A number of programs that enable individuals to remain in their homes in Arkansas, including ElderChoices, Alternatives, the Developmental Disabilities Waiver and the Assisted Living Waiver are described.