The Council on Quality and Leadership
By Carli Friedman, CQL Director of Research, & Carine Luxama, CQL Mentorship Student and University of Massachusetts Boston PhD student
People with intellectual and developmental disabilities (IDD) are more likely to have mental and behavior health conditions and disabilities than people without disabilities. Yet, many people with IDD face unmet needs for mental and behavior health supports and services. As a result, they are frequently overprescribed psychotropic medications, may face crisis situations, and may be re/institutionalized. Therefore, availability of these services and supports is crucial.
The aim of our study was to examine if and how states offer mental, behavior, and crisis services for people with IDD in their Home- and Community-Based Services (HCBS) programs. To do so, we analyzed fiscal year (FY) 2021 Medicaid HCBS 1915(c) waivers from across the country.
We found more than 190,000 people with IDD were projected to receive $1 billion of mental, behavior, and crisis services. While almost one-quarter of people with IDD with HCBS were projected to receive mental, behavior, and crisis services through waiver programs, there was significant variation in how these services were implemented across waivers and states. For example, average annual projected spending per person ranged from $416 in New Jersey to $17,885 in Hawaii.