RISP State Profiles FY 2020

Intellectual or Developmental Disabilities (IDD); LTSS: Long-Term Supports and Services; ICF/IID: Intermediate Care Facilities for Individuals with Intellectual Disabilities; 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)

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FY 2020 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 2020 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 Waiver-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 of 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 2020

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 Idaho

Idaho provided data for about half of the items on the FY 2020 survey. The number of people on the state IDD caseload did not include people living in ICF/IIDs. Settings are reported by license or certification size rather than actual occupancy. The significant decrease in expenditures for children on the Medicaid waiver is the result of several factors. In FY 2020, DDA terminated the Children’s waiver and implemented the Medicaid state-plan funded Children’s DD enhancement program. Children no longer must meet ICF/ID level of care to qualify for services. Medicaid waiver expenditures increased as many children aged out of children’s services and due to a settlement agreement, which permits adult Waiver recipients to use their largest annual DD budget allocation since 2011 for services while DDA works to determine a court-approved budget allocation process. ICF/IID expenditures are reported only for a subtotal of recipients. Alternate data for Waiver and ICF/IID expenditures are from Mathematica (Murray et al, 2023). Alternate data for ICF/IID and nursing home residents are from AHCA (2020a, 2020b, & 2020c).