Medicaid Managed Care - U.S. Senate Special Committee on Aging

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variety of other services, such as supervision of or assistance in toileting,
dressing, bathing, carrying out routine chores, managing money, or
accessing public transportation and other community services. Assistance
for such services is often provided on an individual basis rather than for
several persons in a group home. Respite care may also be provided for
family caregivers.
Although the three states we visited have made major commitments to
convert their waiver programs to individualized supports at home, these
changes will require significant change on the part of everyone involved
and could take years to fully implement For example, some public
agencies own or have long-term contracts for the use of group homes or
have encouraged the development of private group homes. In addition,
state officials told us that public agencies and other service providers may
find it difficult to adapt to designing services for each individual living at
home rather than offering services in the more familiar group home
program setting. In addition, some family members and advocates have
expressed concern that the level of funding available for and the range of
services offered under the waiver program may not be sufficient for
individuals who require constant supervision and care.
Med*caid Costs Rose Nationwide, <strong>Medicaid</strong> costs for long-term care services for persons with
<strong>Medicaid</strong> Costs Rose developmental disability rose at an average annual rate of 9 percent
During Planned between 1990 and 1995 as states implemented their planned increases in
Expansion in Persons the number of persons served. Costs rose from $8.5 billion in 1990 to
$13.2 billion in 1995. (See table 3.) Most of the increase reflected increased
Served costs for waiver program services, but increased ICF/MR program costs also
were a factor. Waiver program costs grew primarily because more people
were served as per capita waiver costs increased slightly less than
inflation. icF/mR program cost increases resulted solely from growth in per
capita icFarR program costs, which rose somewhat faster than inflation, as
the number of residents declined. In 1995, per capita waiver program costs
($24,970) remained significantly lower than per capita icFrmR spending
(S71,992).9
'Although Medcaid Co-t oue muh lower for waver pigr -ipiet thn ItCF/MR pogrmo
reerpreots. govrmentrsotog aripeless or wier rogrmhenprotsP titant his coairsn ugt
SCF/MR pognu mtpincome Fmt5h- P uhtO rL grete~ mao- pg..Ma prott- mreipient c
onlc rrc6c tire SSI persna needs ltWaoI- to 1i5, the grace mont nammo wa 418 a
.month o 18,496nnoay, wnhir the eroa nds awn w gl0antkn The a t of SSI
pnt.ram De hree if a choose to appletnet the federal paYteL waiver prgta
renittents ma calso berfit rom Uhe Food Stamp Prau, ome federa hmmmg prag d mae
ad loal go-emmnt pegnt
Pa,. 12
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