Institute on Disability and Human Development 1640 W. Roosevelt Road, Room 245, Chicago, IL 60608, USA.
Intellect Dev Disabil. 2013 Feb;51(1):1-21. doi: 10.1352/1934-9556-51.01.001.
In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States ( Braddock et al., 2011 ). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In FY 2009, federal-state spending for the HCBS Waiver program reached over $25.1 billion and constituted almost half of total funding across the nation that year ( Braddock et al., 2011 ). Considerable effort has been spent investigating Medicaid program expenditures, however, due in part to the unique and state-specific nature of HCBS programs, national-level analysis on the types of services offered to individuals with IDD has not been available. A full understanding of the supports available through the Medicaid program is critical as the United States considers strategies for economic recovery among competing state and federal budget priorities. This article presents the results of an analysis of 88 Medicaid HCBS Section 1915(c) waiver applications for individuals with intellectual and developmental disabilities in 41 states and the District of Columbia. It analyzes IDD data and trends close to the real time intent of states and empowers advocates in presenting timely solutions to real-time issues.
在 2009 财年，医疗补助计划为美国有智力和发育障碍的个人提供了超过 75%的公共长期支持和服务（LTSS）（Braddock 等人，2011 年）。大部分支出归因于家庭和社区为基础的服务（HCBS）豁免计划。在 2009 财年，联邦州对 HCBS 豁免计划的支出超过 251 亿美元，占当年全国总资金的近一半（Braddock 等人，2011 年）。已经投入了相当大的努力来调查医疗补助计划的支出，然而，部分原因是 HCBS 计划具有独特的和州特定的性质，因此，没有关于为智障人士提供的服务类型的全国性分析。全面了解通过医疗补助计划提供的支持至关重要，因为美国正在考虑在竞争的州和联邦预算优先事项中制定经济复苏战略。本文介绍了对 41 个州和哥伦比亚特区的 88 个医疗补助计划 HCBS 第 1915(c) 豁免申请中智障人士的分析结果。它分析了接近各州实时意图的智障数据和趋势，并使倡导者能够为实时问题提供及时的解决方案。
