http://goo.gl/GSiS6I
For consumers with intellectual and developmental disabilities (I/DD) and the provider organizations delivering services (including long-term services and supports), the Medicaid system is complex and different in every state – a challenge covered previously by my colleague Athena Mandros in, Medicaid Services For Consumers With I/DD – You Need A State Roadmap. As we continue to look towards new policies to promote the use of home- and community-based services (HCBS), the complexities continue to grow.
The new HCBS rules are just one more step on the long journey towards moving our service delivery system for consumers with complex support needs away from residential and inpatient care and into more community-based settings. Why are we seeing this shift in delivery setting? Spending is consistently lower for consumers receiving HCBS waiver services, than consumers living in an intermediate care facility (ICF-IDD). And residents of smaller community-based settings are healthier, happier, have better quality of life, and are able to function more independently if they move to a new setting (see Community Living and Participation for People with Intellectual and Developmental Disabilities: What the Research Tells Us).