Developmental/Intellectual Disabilities

This GAO report examines 1) the extent to which states have Supplemental Security Income/Disability Insurance (SSI/DI) advocacy contracts with private organizations; 2) how SSI/DI advocacy practices compare across selected sites; and 3) the key controls the Social Security Administration has to ensure these organizations follow SSI/DI program rules and regulations. The GAO identified 16 states with some type of SSI/DI advocacy contract in 2014.

The Community First Choice (CFC) HCBS plan of California has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the California State Plan.

The Community First Choice (CFC) HCBS plan of Montana has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Montana State Plan.

The Community First Choice (CFC) HCBS plan of Oregon has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the Oregon State Plan.

The Community First Choice (CFC) HCBS plan of Maryland has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Maryland State Plan.

Community-based organizations will be notably impacted by States' implementation of MLTSS programs. Case studies on ombudsman programs and care/service coordination–culled from the MLTSS intensive at the 2013 HCBS Conference–complement the issue brief on CBO readiness. The ombudsman case studies highlight activities in Wisconsin, Hawaii, & Minnesota, while the care/service coordination case studies discuss CBO experiences in Massachusetts & Ohio. Both studies feature successful CBO practices.

This report describes the different strategies that four states are utilizing to improve the integration and coordination of care for individuals with mental health and substance use disorders. These strategies include introducing new managed care arrangements and care coordination mechanisms, enhanced payment to providers to deliver comprehensive services, and the full integration of physical and behavioral health services in managed care contracts.

Recent interest among policymakers in helping Social Security Disability Insurance (SSDI) beneficiaries return to work has increased the desire for knowledge about the employment activities of people with disabilities before they apply for benefits. This brief summarizes results from a working paper, conducted through the Social Security Administration's Disability Research Consortium, on the experiences of SSDI applicants before they apply for SSDI.

The Non-Elderly Disabled Category 2 (NED2) Housing Choice Voucher Program aimed to increase access to affordable housing for non-elderly people (age 62 and under) with disabilities currently residing in institutions, such as a nursing home. This evaluation examined the program's implementation in a subset of communities that received NED2 vouchers and estimated the impact of the program on the change in the rate of community transitions among the eligible population.

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.