# Assessing the impacts of Medicaid Home and Community Based Waivers for children with Severe Emotional Disturbance

> **NIH NIH K01** · UNIVERSITY OF TEXAS ARLINGTON · 2024 · $169,164

## Abstract

PROJECT SUMMARY
The overall goal of this K01 application is to estimate the impact of 1915(c) Home and Community-Based
Services (HCBS) Medicaid waiver programs for children with Severe Emotional Disturbance (SED) on
behavioral health care service use and expenditures for children with SED. Children with severe SED are at
significant risk for psychiatric long-term care (LTC) use due to the severity of their symptoms and inability to
access alternative community-based behavioral health care. To reduce public financial burdens and family
distress associated with use of psychiatric LTC, one in five states offer 1915(c) HCBS Medicaid waiver
policies. These policies expand the Medicaid-funded community-based service array for children who exhibit a
clinical need for institutional psychiatric care, regardless of family income levels. Though these policies are
intended to prevent psychiatric LTC use by providing alternative community-supports, achievement of these
goals is unclear. Scant existing research lacks either causal inference or generalizability, as they are cross
sectional, regional, or minimally control for clinical variation in program participants. The goal of this K01 is to
train the recipient in the statistical and methodological skills needed to study the impacts of health policy on
service utilization and expenditure outcomes for children and youth with complex behavioral health needs.
Research aims are to 1) create a comprehensive SED waiver policy dataset that codifies the structures and
provisions of these policies across states and over time, 2) identify and compare characteristics of children
enrolled in SED waiver programs and children who use psychiatric LTC among Medicaid-enrolled children with
behavioral health disorders; 2b) assess SED waiver policies and waiver program enrollment’s association with
amelioration of adverse risk factors for LTC, and 3) estimate the effects of the Texas SED Waiver and its
characteristics on Medicaid-reimbursed behavioral health service use and expenditures. The training aims of
the project are to 1) acquire knowledge, skill, and experience in public health law research methods, 2) build
knowledge on the assumptions and applicability of research designs and statistical methods for estimating
causal effects of behavioral health policy interventions using observational and administrative data, 3) apply
current and best practices for defining and measuring behavioral health service use and expenditures using
diverse sources of health claims data and 4) obtain the research, writing, and administrative expertise to
submit a successful R01 grant during the final year of the K01. Training aims will be accomplished through
formal coursework, individualized instruction, seminar and workgroup participation, mentored research, and
conference participation. Research aims will use data from state SED waiver applications merged with
Medicaid claims data from state and federal resources. This project will provid...

## Key facts

- **NIH application ID:** 10832503
- **Project number:** 5K01MH129991-03
- **Recipient organization:** UNIVERSITY OF TEXAS ARLINGTON
- **Principal Investigator:** Genevieve Graaf
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $169,164
- **Award type:** 5
- **Project period:** 2022-05-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10832503

## Citation

> US National Institutes of Health, RePORTER application 10832503, Assessing the impacts of Medicaid Home and Community Based Waivers for children with Severe Emotional Disturbance (5K01MH129991-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10832503. Licensed CC0.

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