RISP Data Bytes

Background

In 1982, almost all long-term supports and services (LTSS) for people with intellectual and developmental disabilities (IDD) were provided in institutions licensed as Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). Medicaid began offering LTSS in Home and Community-Based Services (HCBS) settings in 1982. This allows people with IDD to receive services while living in their own homes, with family members, in group homes, or in other community settings such as with a host or foster family.

Key Finding

In 1982, 140,752 people with IDD lived in institutions (ICF/IIDs). That year, 1,381 people with IDD received services funded by a Medicaid HCBS waiver. The number of people in ICF/IIDs has been declining since 1993 while the number of people receiving HCBS waiver funded supports has been growing steadily. By 2021, 953,571 people with IDD received HCBS Waiver funded supports but just 63,085 people lived in ICF/IIDs.

Recommendations

Many states are anticipating tighter state budgets over the next several years. This could mean cuts to HCBS Waiver funding because it is an optional service under Medicaid. HCBS Waiver funded services supports more choice and control for people with IDD and usually cost less than living in an ICF/IID. States should continue to invest in Medicaid home and community-based services to promote person-centered support for people with IDD.