In a report to the Medicaid and CHIP Payment and Access Commission (MACPAC), HMA consultants Sarah Barth, Sharon Lewis and former research assistant Taylor Simmons, provided insight and review of Medicaid services for people with intellectual or developmental disabilities (ID/DD).
HMA provided the final report, Medicaid Services for People with Intellectual or Developmental Disabilities – Evolution of Addressing Service Needs and Preferences which outlines Medicaid program policies and services to support the needs of people with ID/DD. Additionally, MACPAC supported the development of a plain language version designed to be accessible to a wide audience, including people with ID/DD.
Findings from the study revealed variability of state ID/DD systems and gaps in access to services. The Medicaid programs for people with ID/DD continue to evolve, and states are seeking to develop person-centered service delivery systems to better support this population to live healthy lives as fully participating members of the community.
Looking ahead, the project identified future focus areas including:
- Additional health research and data to help policymakers better understand and support effective programs for the population
- Aligning federal performance expectations to support home and community-based services quality could promote additional improvement at the state level
- Consideration of support needs in the context of families, including addressing multi-generational caregiver issues
- Supporting adults with ID/DD to exercise informed decision-making and have their preferences honored and respected
- Further research on the effectiveness of state initiatives designed to address workforce issues to help inform policies that support the stability and quality of the workforce going forward
- Improvements in access to disability-responsive medical care, as well as better coordination across physical health, behavioral health and Home and Community-Based Services (HCBS), to benefit people with ID/DD
- Addressing equity issues and health disparities, including development of culturally responsive services and supports.