Mental/Behavioral Health Services: Medicaid Home and Community-Based Services 1915(c) Waiver Allocation for People With Intellectual and Developmental Disabilities.

Research has indicated that people who have intellectual and developmental disabilities (IDD) appear to be more vulnerable to having a co-existing psychiatric diagnosis. This study examined Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver applications for people with IDD to determine the mental/behavioral health services proposed. We found that a large variance exists across states in projected spending for services, spending per participant, annual hours of service per participant, and hourly reimbursement rates. Moreover, compared to overall funding we found a general lack of state commitment to mental/behavioral services. States must shore up the capacity of their HCBS 1915 (c) waivers to support people with behavioral challenges in addition to IDD in order to assure that services continue to be delivered in the least restrictive environment appropriate.