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Medicaid Home and Community-Based Services Programs: 2010 Data Update

Introduction
  1. Distribution of Medicaid spending on long-term care, FY 2011, Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on CMS-64 data as of August 2012, available at http://www.statehealthfacts.org/comparetable.jsp?ind=180&cat=4.

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  2. Olmstead v. L.C., 527 U.S. 581 (1999), available at http://www.law.cornell.edu/supct/html/98-536.ZS.html.

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  3. Distribution of Medicaid spending by service, FY 2011, Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on CMS-64 data as of August 2012, available at http://www.statehealthfacts.org/comparetable.jsp?ind=178&cat=4.

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Medicaid HCBS Participants and Expenditures
  1. Kaiser Commission on Medicaid and the Uninsured, Medicaid Today; Preparing for Tomorrow: A Look at State Medicaid Program Spending, Enrollment and Policy Trends Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2012 and 2013 at 21 (October 2013), available at http://kff.org/medicaid/report/medicaid-today-preparing-for-tomorrow-a-look-at-state-medicaid-program-spending-enrollment-and-policy-trends-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2012-and-2013/.

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  2. Eiken, S., Sredl, K., Gold, L., Kasten, J., Burwell, B., and Saucier, P. Medicaid Expenditures for Long Term Services and Supports in 2011, Thomson Reuters (Revised October 2013), available at http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Downloads/LTSS-Expenditure-Narr-2011.pdf.

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  3. For background about § 1115 waivers, see Kaiser Commission on Medicaid and the Uninsured, Five Key Questions and Answers About Section 1115 Medicaid Demonstration Waivers (June 2011), available at http://kff.org/health-reform/issue-brief/five-key-questions-and-answers-about-section/.

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  4. 42 U.S.C. § 1315(a).

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  5. Self-direction of personal care services is now available to states under the § 1915(j) option, which allows states to offer self-direction provided that states offer personal care services as an optional state plan benefit or through a § 1915(c) waiver.  42 U.S.C. § 1396n(j)(4)(A); 42 C.F.R. § 441.452(a).

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  6. Expenditure data from Eiken, S., Sredl, K., Gold, L., Kasten, J., Burwell, B., and Saucier, P. Medicaid Expenditures for Long Term Services and Supports in 2011, Thomson Reuters (Revised October 2013), available at http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Downloads/LTSS-Expenditure-Narr-2011.pdf; Participant data from Rhode Island Executive Office of Health and Human Services, Report on the Rhode Island General Assembly Senate Committee on Health and Human Services, Designated Medicaid Information July 1, 2010 – December 2010 (June 2011), available at http://www.dhs.ri.gov/Portals/0/Uploads/Documents/Public/GlobalWaiver/MA_Report_July_Dec_2010.pdf; State of Vermont Agency of Human Services, Global Commitment to Health, Quarterly Report (November 2010), available at http://dvha.vermont.gov/global-commitment-to-health/gc-quarterly-rpt-ffy10-qtr-4-final.pdf. Arizona participation counts as reported by state officials to KCMU and UCSF, 2013.

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  7. Medicaid.gov, Waivers, available at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html?filterBy=1915 (c)#waivers.

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  8. For more information about Medicaid managed care, see Kaiser Commission on Medicaid and the Uninsured, Medicaid and Managed Care: Key Data, Trends, and Issues (Feb 1, 2012), available at http://kff.org/medicaid/issue-brief/medicaid-and-managed-care-key-data-trends/; Kaiser Commission on Medicaid and the Uninsured, Examining Medicaid Managed Long-Term Service and Support Programs:  Key Issues to Consider (Oct. 2011), available at http://kff.org/medicaid/issue-brief/examining-medicaid-managed-long-term-service-and/.

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