How Many Consumers With I/DD Are Served By Medicaid HCBS Waivers & How Many Consumers Are On A Wait List?
An OPEN MINDS Market Intelligence Report
In 2011, there were 1,587,850 million consumers receiving home and community-based services (HCBS) through Medicaid waivers. In total, states use 128 waivers to provide HCBS to the I/DD population. The majority of waivers are 1915(c) HCBS waivers, although three states, Arizona, Rhode Island, and Vermont include HCBS in their 1115 waivers. In 2016 there are 1,175,160 waiver spots available for the I/DD population to receive services in the community.
Historically, state Medicaid programs provided care or the I/DD population through state institutions and then in intermediate care facilities for the intellectually / developmentally disabled (ICF/IDD). However, in the 1980s Congress began to allow states to provide home and community-based services (HCBS) through Medicaid. HCBS are services that allow consumers to live in integrated settings in the community successfully and can include: case management, homemaker, home health aide, personal care, adult day health services, habilitation (both day and residential), and respite care.
Following the Supreme Court ruling in Olmstead v. L.C., the federal and state governments began to develop plans to increase community placements for individuals with disabilities being served by Medicaid. A large part of that planning was related to Medicaid waivers, which can be used to comply with Olmstead to provide community-based services.
This report includes a state-by-state review of the Medicaid waivers used to provide HCBS to consumers with I/DD, the number of waiver slots available in each state, and the waiting lists for services in each state. The report also answers the following questions:
- How Do States Provide Medicaid HCBS To People With Disabilities?
- What Medicaid HCBS Waivers Are Available In Each State To Serve The I/DD Population?
- How Many Consumers Are On A Waitlist To Receive HCBS Services?