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Key Questions About Medicaid Home and Community-Based Services Waiver Waiting Lists

MaryBeth Musumeci, Priya Chidambaram, and Molly O'Malley Watts
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Appendix Table 1:   Medicaid HCBS Waiver Waiting List Enrollment, by Target Population and by State, 2017 
State Waiting List Enrollment by Target Population Total Waiting List Enrollment:
I/DD Seniors Seniors & Adults with Physical Disabilities Adults with Physical Disabilities Med. Fragile/
Tech Dep.
Children		 HIV/
AIDS 		 Mental Health TBI/
SCI
Alabama unknown 4,175 19 0 4,194
Alaska 629 0 0 629
Arizona 0 0 0
Arkansas 2,834 0 2,834
California 0 1,650 3,352* 2,600 0 81 7,683*
Colorado 3,115 0 0 0 0 3,115
Connecticut 1,521 0 1,556 231 50 1,643 5,001
Delaware 0 0 0 0 0 0 0 0
DC 0 0 0
Florida 21,017 49,798 0 0 201 71,016
Georgia 6,966 800 44 NR 7,810
Hawaii 0 0 0 0 0 0 0
Idaho 0 0 0
Illinois 19,354 0 0 0 0 0 0 19,354
Indiana 1,368 0 36 1,404
Iowa 2,620 0 3,278 0 1,214 892 8,004
Kansas 3,677 0 807 0 0 0 4,484
Kentucky 5,878 0 0 213 6,091
Louisiana 27,509 38,480 0 65,989
Maine 1,515 0 0 1,515
Maryland 11,023 24,000 120 0 35,143
Massachusetts 0 0 0 0 0
Michigan 0 3,223 0 3,223
Minnesota 237 0 0 0 237
Mississippi 1,652 8,642 2,867 304 13,465
Missouri 0 0 0 0 0
Montana 1,524 539 93 2,156
Nebraska 3,142 0 0 3,142
Nevada 809 198 166 1,173
New Hampshire 105 0 0 105
New Jersey NR 0 0
New Mexico 4,364 13,498 17,862
New York 0 NR 0 unknown NR unknown
North Carolina 11,000 3,487 0 14,487
North Dakota 8 0 0 3 11
Ohio 68,644 0 0 68,644
Oklahoma 7,659 0 42 7,701
Oregon 11 0 99 110
Pennsylvania 9,504 0 0 0 9,504
Rhode Island 0 0 0 0 0 0 0 0 0
South Carolina 10,409 0 0 0 0 0 10,409
South Dakota 350 0 0 350
Tennessee 7,428 0 7,428
Texas 217,786 35,179 28,416 0 281,381
Utah 2,628 139 0 30 83 94 2,974
Vermont 0 0 0 0
Virginia 12,266 0 NR 12,266
Washington 0 0 0
West Virginia 1,317 763 12 2,092
Wisconsin 2,934 1,264 0 4,198
Wyoming 194 0 0 0 194
TOTAL: 472,997 1,987 187,200 11,409 28,952 81 1,357 3,395 707,378
NOTES: I/DD = intellectual and developmental disabilities. TBI = traumatic brain injury. SCI = spinal cord injury. Data include § 1915 (c) and § 1115 HCBS waivers. States may offer more than one § 1915 (c) waiver per target population category. NR indicates state did not respond to question. Blank cell indicates state does not have a waiver serving this population. *CA data include § 1915 (c) waivers only; CA did not report waiver waiting list enrollment for its § 1115 waiver for seniors and adults with physical disabilities.
SOURCE: KFF Medicaid HCBS Waiver Program Survey, FY 2017.
Appendix Table 2: Average Wait Time by Population for Medicaid HCBS Waivers with Waiting Lists, 2017*
Target Population: I/DD Seniors Seniors & Adults with Physical Disabilities Adults with Physical Disabilities Med. Fragile/
Tech Dep.
Children		 HIV/
AIDS 		 Mental Health TBI/
SCI		 All Populations
Average Number of Months Waiting: 66 64 25 13 33 4 11 27 30
NOTES: I/DD = intellectual and developmental disabilities. TBI = traumatic brain injury. SCI = spinal cord injury. Data include § 1915 (c) and § 1115 waivers. *Of the 40 states reporting one or more waivers with a waiting list in 2017, 27 states reported average wait time for at least one waiver with a waiting list (AL, AK, AR, CA, CO, CT, FL, GA, IN, IA, KS, LA, MD, MI, MS, MT, NE, NV, NH, NM, NC, OK, OR, SD, TX, WV, and WY), and 13 states (IL, KY, ME, MN, ND, NY, OH, PA, SC, TN, UT, VA, and WI) did not report average wait time for any waivers with waiting lists.
SOURCE: KFF Medicaid HCBS Waiver Program Survey, FY 2017.
Appendix Table 3: Medicaid HCBS Waiver Waiting Lists by State and ACA Expansion Status, 2013-2017
State Total HCBS Waiver Waiting List Enrollment** Change in HCBS Waiver Waiting List Enrollment, 2013-2017^
2013 2014 2015 2016 2017 Increase Decrease No Change
Expansion States (32 states)
Alaska* 982 982 935 535 629 X
Arkansas 2,823 3,007 2,893 3,278 2,834 X
Arizona** NR NR 0 0 0 X
California** 5,352 3,660 3,592 4,088 7,683 X
Colorado 3,789 3,796 4,218 3,194 3,115 X
Connecticut 1,486 2,078 2,509 2,903 5,001 X
DC NR 0 0 0 0 X
Delaware** NR 0 0 0 0 X
Hawaii** NR 0 0 0 0 X
Illinois 33,114 29,425 31,473 19,163 19,354 X
Indiana* 8,888 5,295 1,914 1,627 1,404 X
Iowa 7,219 8,775 8,505 8,928 8,004 X
Kentucky 453 6,278 6,296 8,190 6,091 X
Louisiana* 57,156 41,492 62,828 73,929 65,989 X
Maryland 26,673 27,129 45,844 36,156 35,143 X
Massachusetts NR 0 0 0 0 X
Michigan* 14,040 14,040 0 3,311 3,223 X
Minnesota 4,820 4,820 4,914 128 237 X
Montana* 2,747 1,298 1,583 1,309 2,156 X
Nevada 1,185 1,271 1,315 1,372 1,173 X
New Hampshire*^ NR 0 0 260 105 X
New Jersey** 50 50 59 0 0 X
New Mexico** 11,239 19,269 5,401 20,070 17,862 X
New York** NR 0 0 0 0 X
North Dakota^ NR 0 0 3 11 X
Ohio 37,385 59,708 62,118 62,546 68,644 X
Oregon^ NR 0 0 134 110 X
Pennsylvania* 18,410 18,416 18,295 9,728 9,504 X
Rhode Island** NR NR 0 0 0 X
Vermont** NR NR 0 0 0 X
Washington 1,351 1,350 0 0 0 X
West Virginia 409 2,188 2,212 1,540 2,092 X
TOTAL EXPANSION STATES: 13 11 8
Non-Expansion States (19 states)
Alabama 2,610 2,610 2,783 5,284 4,194 X
Florida 51,379 76,750 83,365 67,479 71,016 X
Georgia 11,242 11,242 12,201 10,270 7,810 X
Idaho* NR 0 0 0 0 X
Kansas 5,441 5,441 4,897 3,890 4,484 X
Maine* 1,082 2,356 0 1,000 1,515 X
Missouri 844 684 0 0 0 X
Mississippi 8,338 7,843 7,035 9,481 13,465 X
North Carolina 16,565 22,056 20,736 12,068 14,487 X
Nebraska* 1,401 1,299 1,368 2,062 3,142 X
Oklahoma 6,994 6,933 7,225 7,569 7,701 X
South Carolina 6,004 5,656 2,355 11,275 10,409 X
South Dakota 23 23 34 0 350 X
Tennessee** 7,165 7,165 7,564 5,813 7,428 X
Texas** 163,146 163,146 204,550 232,068 281,381 X
Utah* 2,172 2,172 2,241 2,543 2,974 X
Virginia* 7,779 7,779 16,583 16,583 12,266 X
Wisconsin 3,963 3,963 4,333 4,216 4,198 X
Wyoming 745 621 385 202 194 X
TOTAL NON-EXPANSION STATES: 13 5 1
NOTES: NR indicates state did not report data. *State expansion status is as of 2017. All states expanded 1/2014, except AK (9/2015), IN (2/2015), LA (7/2016), ME (1/2019), MI (4/2014), MT (1/2016), NH (8/2014), PA (1/2015), and VA (1/2019). ID, NE, and UT have adopted but not yet implemented expansion. **Data include § 1915 (c) and § 1115 HCBS waivers beginning in 2016, except that CA and NY did not report § 1115 waiver waiting list enrollment; prior years include § 1915 (c) waivers only. ^Change includes 2014-2017 for NH, ND, and OR, as 2013 data are unavailable.
SOURCE: KFF Medicaid HCBS Program Surveys, 2013-2017.
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