Medicaid, a federal-state health financing program for people with low incomes, has long been associated with nursing homes and intermediate care facilities for the mentally retarded. The reason for this is because Medicaid long-term care regulations insist on placing individuals in an institution.
Each state has the option of using home and community-based services instead. These services can be used for home health services, personal care, and skilled nursing assistance in the Medicaid 1915c HCBS waiver program that started in 1981. There is also the Title XIX PCS optional benefit that provides for personal care and assistance with daily living activities.
The Disability Statistics Center in San Francisco studied the use of HCBS waivers by looking at annual state reports and information from its survey. Findings from 1992-1997 included:
The 1915c HCBS Medicaid waiver program grew about 19% each year. In 1992, there were 235,668 waiver participants and in 1997, 561,510 participants.
Costs grew more than $5.7 billion with an annual growth rate of 22%.
Waivers primarily assist people with mental retardation or other developmental disabilities and people who are aged and disabled.
The largest use of services were for respite, home health, and personal care.
This research was supported by the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education. #1013
Harrington, C., & LeBlanc, A. (2001, October). Medicaid home and community-based services. San Francisco, CA: University of California, Disability Statistics Center.