FY 2017 RISP State Profiles

North Carolina

RISP

Figures

IDD Agency Long Term Supports and Services Recipients by Residence Type

Year

Family

Own Home

Foster/Host

7-15 Group

16+ Group

Unknown*

LTSS Recipients

98

3,086

90

180

4,108

484

2,608

15

10,571

99

3,631

532

347

3,973

349

2,535

3,180

14,547

00

7,193

594

358

7,238

596

2,543

0

18,522

01

10,612

1,343

809

5,908

1,265

2,532

0

22,469

02

15,588

1,986

977

5,236

1,286

2,703

0

27,776

03

16,820

2,135

1,043

5,679

981

2,628

0

29,286

04

16,738

2,222

920

5,317

952

2,450

0

28,599

05

15,058

2,292

955

5,815

1,062

2,468

1,340

28,990

06

16,161

2,144

990

5,750

1,055

2,383

28,219

07

14,869

1,870

1,024

5,815

1,087

2,432

26,703

08

14,782

2,238

1,059

5,098

528

2,201

25,106

09

14,694

2,606

1,094

4,730

178

2,141

24,707

10

13,389

1,486

1,128

2,049

346

2,082

1,614

22,094

11

13,577

1,522

384

1,707

7,221

24,411

12

13,765

3,280

392

2,038

7,252

26,727

13

12,242

1,360

8,222

21,824

14

10,720

13,661

24,381

15

9,197

19,778

28,975

16

7,674

1,591

17,870

27,135

17

7,674

208

2,204

1,446

102

1,663

11,999

25,296

* Unknown setting type or size reported in FY 2017 and gaps in all other years

LTSS and Medicaid Recipients and Waiting for Waivers* 1982-2017

Year

Medicaid ICF/IID Residents

Medicaid Waiver+ Recipients

Waiting for Medicaid Waivers*

LTSS Recipients

Caseload *

1982

2,762

0

4,441

1983

2,848

0

4,451

1984

2,933

17

4,461

1985

3,019

120

4,470

1986

3,104

331

4,480

1987

3,445

328

4,490

1988

3,309

405

4,875

1989

3,173

553

5,259

1990

3,776

731

5,644

1991

4,378

780

6,028

1992

4,502

939

6,461

1993

4,662

1,190

6,894

1994

4,732

1,318

7,326

1995

4,595

1,818

7,759

1996

4,593

3,098

8,192

1997

4,777

3,726

2,450

8,625

1998

4,705

3,986

2,450

10,571

1999

4,616

4,974

2,303

14,547

2000

4,520

5,364

2,074

18,522

2001

4,493

6,141

22,469

2002

4,645

6,013

1,084

27,776

2003

4,500

5,692

1,041

29,286

2004

3,875

6,011

28,599

2005

4,306

6,753

28,990

2006

4,091

7,831

1,630

28,219

2007

4,124

9,309

1,355

26,703

2008

4,176

9,700

1,355

25,106

2009

3,854

10,333

24,707

2010

3,946

11,094

397

22,094

2011

3,613

12,838

24,411

2012

3,930

12,800

8,425

26,727

2013

3,273

12,906

9,900

21,824

21,138

2014

42

12,881

9,130

24,381

25,026

2015

42

13,666

9,569

28,975

27,084

2016

3,160

16,892

10,687

27,135

29,142

2017

3,510

21,786

9,402

25,296

27,782

* Caseload of the State ID/DD Agency, Waiting while living in the home of a family member

Average Spending Per Person by Medicaid Authority in Fiscal Year 2017

Medicaid Authority

Cost/Person

ICF/IID (all)

$113,660

Waiver+ (all)

$48,828

Waiver+ 0 to 21 years family home

$15,508

Waiver+ 22+ years family home

$42,950

Waiver+ 0 to 21 years not family home

$302,745

Waiver+ 22+ years not family home

$62,488

Intellectual or Developmental Disabilities (IDD); LTSS: Long-Term Supports and Services ICF/IID: Intermediate Care Facilities for Individuals with Intellectual Disabililties Group: Number of people with IDD in a setting (ICF/IID, group home or other) Waiver+: Medicaid Authorities 1115, 1915 (a)(b)or (b/c), 1915(c)

For more see risp.umn.edu

Larson, S.A., Taylor, B., Pettingell, S., Sowers, M., & Bourne, M.L. (2020). In-home and residential long-term supports and services for persons with intellectual or developmental disabilities: Status and trends through 2017. Minneapolis: University of Minnesota, Research and Training Center on Community Living, Institute on Community Integration.

This project is funded through a cooperative agreement from the Administration on Community Living, U.S. Department of Health and Human Services Grant #90DNPA0001-01.

FY 2017 Profile

Profiles show longitudinal changes in residential settings for LTSS recipients with IDD, state IDD agency caseloads, Medicaid Waiver waiting lists and Medicaid recipients by funding authority. They also show FY 2017 expenditures per person by funding authority, setting type, and age. Blank spaces or breaks in a trend line indicate years in which a data element was not collected or for which a state provided incomplete or no data. Large year-to-year changes often reflect changes in state data sources or methodology, the addition or termination of a funding authority, or inclusion of a narrower or broader set of recipients. The State Notes describe variations from the survey definitions, alternative data sources used, reasons for large year-to-year changes, and other factors affecting data interpretation. Additional national and state data can be viewed in the RISP project’s Chart Gallery at https://risp.umn.edu/viz. Survey questions and operational definitions can be found in the Publications section of the RISP website.

IDD Agency Long Term Supports and Services Recipients by Residence Type

The first chart shows the number of long-term supports and services (LTSS) recipients by residence type (family home, own home, host or foster family home, and group homes) by year. Group settings such as ICFs/IID or Medicaid Wavier-funded group homes are broken down according to the number of people with IDD sharing the home (1 to 3, 4 to 6, 7 to 15 or 16 or more).

Caseload, LTSS and Medicaid Recipients and Waiting for Waivers

The second chart shows changes over time in the number people served by state IDD agencies, the number of people with IDD receiving one or more LTSS in addition to case management, and the number of people with IDD waiting for Medicaid Waiver funded services while living with a family member or in their own home. The waiting list numbers do not include people who already live in a group home or another LTSS setting or who already receive some Medicaid Waiver funded supports. The chart also shows changes in the number of LTSS recipients whose services are funded under the Medicaid ICF/IID program, or under one of several Medicaid Waiver funding authorities (1115, 1915 (a)(b)or (b/c), 1915(c)).

Average Annual Medicaid Per Person Expenditures for FY 2017

The third chart shows average annual per person expenditures for people with IDD living in an ICF/IID, or who receive LTSS funded by specific Medicaid Waiver funding authorities (1115, 1915 (a)(b)or (b/c), 1915(c)). When available, for Medicaid Waiver recipients, annual per person expenditures are also broken down by recipient age as of June 30 (birth to 21 years or 22 years or older) and by living arrangement (family home or any other setting).

State Notes for North Carolina

North Carolina increased the use of (b)(3) services under its Medicaid 1915 b/c waiver in FY 2016. The number of settings and recipients in nonstate settings for FY 2017 was reported by five of the seven Local Management Entities/Managed Care Organizations (LME-MCO). Three of those five LME-MCOs reported all setting as size unknown. FY 2017 expenditures and age breakdowns were reported for 3,510 of 4,406 people in ICF/IID settings.

North Carolina has four state-operated ICF/IID facilities with 16 or more individuals: Caswell Center,

J. Iverson Riddle Development Center, Murdoch Developmental Center, and O’Berry Neuro-Medical Treatment Center (OBNMTC). The Black Mountain Center, a large state-operated Skilled Nursing Facility, is not ICF/IID certified.