Developmental/Intellectual Disabilities

This report is the latest in a series of annual reports that present expenditures data for Medicaid Home and Community-Based Services (HCBS) waivers authorized under Section 1915(c) of the Social Security Act. Table 1 presents reported Federal Fiscal Year (FY) 2009 expenditures for each HCBS waiver in effect during that year. Table 2 presents HCBS waiver expenditures data from FY 2004 through FY 2009 by state. The remaining tables present data according to the populations served in waivers.

This report is the latest in a series of annual reports on Medicaid long-term care expenditures. Table 1 presents national expenditures data for FY 1997–FY 2009. Tables A through T present state-by-state expenditures data for FY 2004–FY 2009 for specific categories of service. Tables U, V, and W present the distribution of each state’s LTC expenditures among institutional and community-based services.

Ten grants were awarded to states to develop a profile of the publicly funded LTC system and to assist CMS to develop national benchmarks that will be used to measure the degree and success of states' efforts to offer community based LTC services. Review Michigan’s report which focuses on the priority population of the elderly and adults with physical disabilities, but also includes systems that serve adults with developmental disabilities, adults with mental illness and children.

This brief underscores the role of asset development for individuals with disabilities given that they are more likely to be unemployed and live in poverty than any other demographic in the US. It describes some of the interaction between asset accumulation and disability benefits programs, particularly SSDI and SSI, and presents information on Individual Development Account programs and strategies by which Assets for Independence grantees can improve access to IDAs for people with disabilities.

This is the fourth in a series of briefs that focus on affordable housing strategies and state and local partnerships that increase housing opportunities for workers with disabilities. Asset-building strategies that can support affordable rental and homeownership occupancy are discussed, as well as shared equity strategies such as cooperative housing and community land trusts. Also find a link to the entire brief series.

Since the inception of the HCBS waivers, Minnesota has experienced an increased demand to provide services to individuals living in the community. Review a report on county and state use of available resources for the following waiver programs in MN: Community Alternative Care (CAC), Community Alternatives for Disabled Individuals (CADI), Developmental Disabilities (DD), Traumatic Brain Injury (TBI). Overviews of each waiver are provided as well as enrollment and expenditure data.

Examine factors associated with the use of personal care services (PCS) and the amount of authorized hours in California in 2004-2005. Of those Medicaid-eligible individuals with developmental disabilities living at home, 31% received PCS. When this study controlled for client need, gender, and age, those who were Asian/Pacific Islanders, African Americans, Hispanics, and other races had higher odds of receiving PCS than Whites but were authorized between 16 and 39 hours fewer than Whites.

The authors of this report conclude that in the 10 years since the Olmstead decision, there has been little national (though some individual state) progress moving people with disabilities out of nursing facilities and public institutions and into communities with supports. The report includes an overview of Olmstead, institutional data, and recommendations for improvement.

Are MIGs assisting individuals with disabilities to become employed? An annual GPRA report has been produced since 2007. This report builds on previous work, and shows the continued impact of MIG funding in 2008 on programs and services that facilitate employment among individuals with disabilities. As the MIG program approaches the end of its authorized period, many states are committing to evaluating the programs, documenting their impacts, and sustaining the efforts beyond 2011.

Through research, education and advocacy, AAHD’s goal is to contribute to national, state, and local efforts to prevent health complications, and promote wellness, in people with disabilities. They launched the Disability and Health Journal (DHJ), the first peer reviewed, multidisciplinary journal that focuses on these issues. The organization also publishes an informative quarterly newsletter and offers a free on-line clearinghouse through their site.