Medicaid Home and Community-Based Services. Disability Statistics Report.

Federal Medicaid long-term care regulations do not require states to offer home and community-based service (HCBS) alternatives; rather, they are offered at the discretion of each state. The two most significant Medicaid HCBS programs are the Medicaid 1915(c) HCBS waiver programs and the Medicaid Title XIX personal care services (PCS) optional state plan benefit. This report summarizes the most current data on HCBS, combining data from Health Care Financing Administration sources with data collected by the University of California, San Francisco. This report presents estimates of program participants and expenditures, including breakdowns by specific populations and types of service. Findings from the data include: (1) the total number of participants in the 1915(c) HCBS Medicaid waiver program more than doubled between 1992 through 1997 to 561,510 people; (2) expenditures have grown more than $5.7 billion since 1992 for the waivers; (3) expenditures per Medicaid waiver participant grew 52 percent from 1992 to 1997; (4) on average, waiver participants nationwide were allotted approximately $14,016 each in 1997; (5) waivers primarily assist those with mental retardation and adults with disabilities who have aged; and (6) in 1997, the most used category of service remained respite/home health or personal care. (Contains 17 references.) (CR)