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Medicaid Home and Community-Based Services: Results From a 50-State Survey of Enrollment, Spending, and Program Policies

This report summarizes the national trends to emerge from the latest (2014) enrollment and spending data for the three main Medicaid home and community-based services (HCBS) programs: (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915 (c) HCBS waivers. It also highlights key findings on 2016 program policies, such as waiting lists, managed long-term services and supports, and provider payment rates.

Key Themes in Medicaid Section 1115 Behavioral Health Waivers

State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people with behavioral health needs, and financing delivery system reforms.

Key Issues in Long-Term Services and Supports Quality

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.

State Variation in Medicaid Per Enrollee Spending for Seniors and People with Disabilities

This issue brief explains the variation in Medicaid spending per enrollee for seniors, nonelderly adults with disabilities, and children with disabilities compared to other populations as well as the variation in per enrollee spending for these populations among states. It also provides a snapshot of state choices about optional eligibility pathways and services important to many seniors and people with disabilities.

Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?

A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults…

Data Note: Data Do Not Support Relationship Between States’ Medicaid Expansion Status and Home and Community-Based Services Waiver Waiting Lists

Some policymakers have been discussing whether state choices to adopt the ACA’s Medicaid expansion come at the expense of providing Medicaid home and community-based services (HCBS) to seniors and people with disabilities. This data note analyzes Medicaid HCBS waiver waiting list data for 2014 and 2015 and concludes that there does not appear to be a relationship between a state’s Medicaid expansion status and changes in its HCBS waiver waiting list.

Linking Medicaid and Supportive Housing: Opportunities and On-the-Ground Examples

There is evidence that supportive housing can contribute to improved outcomes for people experiencing homelessness or at risk of homelessness. It can also advance community integration of seniors and people with disabilities. Medicaid does not pay for room and board, but it can pay for many housing-related services for Medicaid beneficiaries. This issue brief discusses how Medicaid can support integrated strategies and profiles three initiatives that illustrate different approaches to linking Medicaid and supportive housing.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.