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Medicaid: Home and Community Based Waivers Using a database compiled by the American Public Human Services Association (APHSA), the General Accounting Office in a May, 1999 report estimated that 118 of the over 200 HCBS waivers in 1997 provided personal care to almost 331,000 individuals. "Personal care" is only one of over 25 different types of services that can be offered under Medicaid home- and community-based services (HCBS) waivers. "Because data on the costs associated specifically with personal care services within each waiver are not readily available, information on HCBS waivers and spending encompasses many related services," says he GAO. "The estimate of the number of recipients is likely to be an undercount, because as many as 16 waivers did not cite the number of enrollees. States had anywhere from one to six HCBS waivers offering personal care that varied greatly in the number of clients served and per capita cost." Most HCBS waivers are relatively small -- half of the waivers in the database indicate that they served fewer than 1,000 individuals. Forty-three states and the District of Columbia provide personal care under an HCBS waiver; 24 states and the District of Columbia offer both the Medicaid PCS benefit and one or more HCBS waivers, according to the GAO report. "HCBS waivers are also likely to target a specific population or group of individuals," said the GAO report. Over 50 percent of HCBS waivers offering personal care focused on the elderly, people with physical disabilities, or both, and individuals with developmental disabilities. These two groups accounted for over 80 percent of consumers for HCBS waivers with personal care (see "Who Do Waivers Serve?") Clients Served by Medicaid HCBS Waivers With Personal Care, 1997 A |C |D |F |G |H |I |K |L |M |N |O |P |R |S |T |U |V |W Alabama Mentally retarded or developmentally disabled people 3,290 Aged and disabled people 6,316 Disabled people 362 Arkansas Disabled adults who are 21 to sixty-four 60 California Mentally retarded or dev. dis. people who are technology-dependent 35,105 Aged and disabled people 8,314 People with HIV/AIDS b 2,792 Colorado Aged and disabled people 5,843 People with HIV/AIDS 101 Chronically mentally ill people who are over eighteen 79 People with traumatic brain injury 70 Developmentally disabled people who are 18 and older c Connecticut Disabled people who are 18 to 64 and need help with 2+ ADLs c People with traumatic brain injury who are 18 to 64 c Delaware People with HIV/AIDS-related conditions 174 District of Columbia Mentally retarded or developmentally disabled people who are 22 and older 75 People who are 65 and older c Florida Aged and disabled people who are 18 and older 16,943 Mentally retarded or developmentally disabled people 10,302 Aged and disabled people who are 18 and older 1,380 People with AIDS 8,000 Mentally retarded or developmentally disabled people who are over eighteen 116 Elderly people c Georgia Aged and disabled people 16,500 Mentally retarded or developmentally disabled people 2,109 Disabled adults who are 24 to 64 d 121 Hawaii Mentally retarded or developmentally disabled people 512 Aged and disabled people 338 People with AIDS/ARC e 104 Iowa People with HIV/AIDS 29 Mentally retarded people (including children) 4,530 People with traumatic brain injury who are 30 to sixty-four 30 Mentally retarded or developmentally disabled people and mentally retarded children with disabilities 374 Elderly people 2,236 Idaho Aged and disabled people 21 and older 1,429 Mentally retarded or developmentally disabled people 21 and older 415 Illinois Disabled people 12,021 People with HIV/ARC/AIDS 984 Mentally retarded or developmentally disabled adults 5,224 People who have been disabled by an acquired traumatic brain injury c Indiana Aged and disabled people 2,467 Mentally retarded people and those with related conditions 1,201 Kansas Aged and disabled people 3,150 Physically disabled people who are 16 to sixty-four 1,880 People with traumatic brain injury d 160 Kentucky Aged and disabled people 11,500 Adults and children with traumatic brain injury c Louisiana Mentally retarded or developmentally disabled people 2,095 People with loss of sensory motor function 103 Aged and disabled people 222 Maryland Mentally retarded or developmentally disabled people 3,600 Maine Elderly people 554 Physically disabled people 204 Disabled people who are 18 to 60 13 People with traumatic brain injury c Michigan Aged and elderly people 2,804 Minnesota Elderly people 6,582 Mentally retarded people and those with related conditions 5,657 Disabled people under 65 2,751 People with acquired traumatic brain injury 290 Missouri Mentally retarded or developmentally disabled people 5,860 People with HIV/AIDS 140 Disabled people and developmentally disabled people who are 21 to sixty-four d c Mississippi Disabled people who are 21 to sixty-four 100 Mentally retarded or developmentally disabled people 325 Montana Aged and disabled people 1,158 Mentally retarded or developmentally disabled people 652 North Carolina Mentally retarded or developmentally disabled people 3,201 North Dakota Mentally retarded or developmentally disabled people 1,792 Aged and disabled people 366 People with traumatic brain injury who are 18 to sixty-four 9 New Hampshire Mentally retarded or developmentally disabled people 1,303 People with acquired traumatic brain injury who are 22 and older d 27 New Jersey Mentally retarded or developmentally disabled people 5,242 People 18 to 65 who incurred traumatic brain injury after age sixeen d 153 New Mexico People with AIDS/ARC 60 Aged and disabled people 1,200 Mentally retarded or developmentally disabled people 1,500 Nevada Frail elderly people 65 and older 898 Elderly people in group care 72 Ohio Aged and disabled people 17,000 Aged and disabled people under 60 3,904 Mentally retarded or developmentally disabled people 2,512 Mentally retarded or developmentally disabled people 18 and over c Oregon Aged and disabled people 19,471 Pennsylvania Physically disabled people c Elderly people 675 Rhode Island Elderly people 65 and over 600 Physically disabled people d 80 South Carolina Aged and disabled people 7,658 People with HIV/AIDS 637 Mentally retarded people and those with related conditions 2,288 People with traumatic brain injury and spinal cord injury 161 Adults who are technology-dependent (ventilator-dependent)d 27 South Dakota People 18 and over who are quadriplegic 39 Tennessee Aged and disabled people 306 Mentally retarded or developmentally disabled people 2,200 Aged and disabled people 150 Texas Aged and disabled people 9,945 Aged and disabled people 21 and older c Utah Physically disabled people c Virginia Aged and disabled people 7,442 Mentally retarded and developmentally disabled people 1,685 Aged and disabled people 18 and over c People with HIV/AIDS who are symptomatic 636 Chronically ill children with traumatic brain injury and adults with traumatic brain injury d 178 Vermont Mentally retarded people and those with related conditions 1,419 Aged and disabled people 780 Washington Aged and disabled people 17,013 Mentally retarded or developmentally disabled people c Developmentally disabled people who are inappropriately placed c < People with HIV/AIDS 69 People with traumatic brain injury d 16 Wisconsin Aged and disabled people 10,670 People who are developmentally disabled 6,936 Mentally retarded and developmentally disabled people 90 Wyoming Developmentally disabled people 611 Aged and disabled people 700 Total: 118 waivers serving 331,467 people nationwide a = Only HCBS waivers offering personal care or attendant care to adults were included in our state analysis of HCFA waivers and auxiliary services. b = Human immunodeficiency virus/acquired immunodeficiency syndrome. c = Data not reported in the APHSA Summary of 1915 (c) HCBS waivers. d = HCBS waivers considered Model Waivers under the Medicaid program. e = AIDS-related complex. Source: American Public Human Services Association (APHSA) * From Adults with Severe Disabilities: Federal and State Approaches for Personal Care and other Services,published May, 1999 (GAO-HEHS 99-101). Download from http://www.gao.gov/    Freedom Clearinghouse is a project of Free Hand Press, publisher of Mouth magazine. Website developed by Cliffwood Organic Works. Website hosted by DIMENET. | E-mail | Home |