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This issue brief discusses four key issues related to long-term services and supports (LTSS) including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years since the passage of the Nursing Home Reform Act.
In a new analysis of survey data from state Medicaid home care programs, KFF found that in most years since 2016, there have been nearly 700,000 people on waiting or interest lists for expanded home and community-based services (HCBS), with a total of 692,000 across 38 states in 2023 and waiting lists averaging three years. People with intellectual or developmental disabilities make up almost three-quarters of waiting lists, with seniors and adults with physical disabilities…
Rates of long COVID have begun to flatten. About 1 in 10 adults with COVID have reported having long COVID since rates fell in 2023, according to a KFF analysis of the latest data from the Centers for Disease Control and Prevention. If the rate continues to hold steady, new forms of prevention or treatment may be important to achieve future reductions in long COVID. As of March 2024, 7% of all adults (17 million…
As the 25th anniversary of Olmstead nears, more than one-in-10 working age adults have a disability and most do not receive public disability income. Over one-in-10 working-age adults reported having a disability in 2022. A disability is defined as having difficulty with hearing, vision, cognition, ambulation, self-care, or independent living, according to KFF's examination of data on people with disabilities from the American Community Survey. Fewer than a third of working-age adults with disabilities receive…
The COVID-19 pandemic created unprecedented health and education challenges for children with disabilities, many of whom receive special education services. Many children receiving special education services have substantial health care needs, and services available through a child’s health insurance plan, such as Medicaid, can complement special education services. This brief explains how Medicaid and special education services intersect, explores the pandemic’s implications for children receiving special education services, and identifies key issues to watch moving…
This issue brief presents FY 2020 state-level data on the number of people receiving Medicaid HCBS and HCBS spending. This is the latest data available, and the first since the onset of the COVID-19 pandemic. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC. A related brief presents the latest data and highlights themes in key state policy choices about optional HCBS.
The federal government and the states together spent a total of $116 billion on Medicaid home and community-based services (HCBS) in FY 2020, serving millions of elderly adults and people with disabilities, a new KFF analysis finds. Medicaid is the nation’s primary payer for such services, which include assistive technology, personal care to help people with bathing or preparing meals, and therapies to help people regain or acquire self-care and independent living skills. There is…
States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in…
While the toll of COVID-19 on nursing home residents has been well documented, less noticed has been the experience of nonelderly people with disabilities who rely on long-term care services and supports outside of nursing homes. In many ways the two groups face similar health risks from the virus, but nonelderly people with disabilities generally do not have the same high priority status for the vaccine, finds a new KFF analysis. As of early February…
Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
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