Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106103

Terence Ng, MA¹, Martin Kitchener, PhD, MBA², and Charlene Harrington, PhD². (1) Dept of Social and Behavioral Sciences, University of California San Francisco, 3333 California Ave, Suite 455, San Francisco, CA 94118, (415) 502 6330, tng@itsa.ucsf.edu, (2) Department of Social & Behavioral Sciences, University of California San Francisco, 3333 California St, Suite 455, San Francisco, CA 94143-0612

In response to consumer demand and the Supreme Court decision in the Olmstead case, states have unevenly expanded combinations of three Medicaid home and community based services (HCBS) : home health, state plan personal care services (PCS), and 1915(c) waivers. By 2003, the federal-state Medicaid program paid for 40 percent of the nation's estimated $151 billion total long-term care (LTC) expenditures while institutional care (e.g., nursing homes) consumed 67 percent of those expenditures. With 43 states reporting budget deficits, the current National Governors' Association LTC initiative reflects growing concern about Medicaid HCBS and the need for information on program and policy trends. This paper draws from a unique national dataset to present the latest trends in participants, expenditures and policies for the three Medicaid HCBS programs. While data for 2002 show a steady increase in participants and expenditures, these growth rates have slowed since 2001. Findings from the survey of policies such on the programs in 2004 show that states are increasing the number of waiting lists for waiver services. Cost caps such as service and cost limits are also used in almost half the state plan personal care programs and almost a third of home health programs.

Learning Objectives: From this session participants will be able to

(
• identify trends in Medicaid HCBS participants, expenditures and policies, (
• understand state responses to fiscal crisis in terms of Medicaid program trends and policy, and (
• consider the potential impact on access to Medicaid HCBS.

Keywords: Elderly, Long-Term Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.