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

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entities covering one or more counties and three state-operated agencies
each responsible for serving a local area Florida district offices and
Michigan cmais have discretion in the design and implementation of
waiver program and other services within the broad outlines of state
policy.
We visited each state to conduct interviews with state and local officials,
researchers, service providers, advocates, families, and recipients. These
interviews included state <strong>Medicaid</strong> officials and developmental services
officials and officials in agencies on aging and developmental disability
councils. In Florida, we also visited state district offices in Pensacola and
Tallahassee to conduct interviews with district government and
nongovernment representatives. In Michigan, we visited the Detroit-Wayne
and Midland/Gladwin cmHBs to conduct interviews with government and
nongovernment representatives. We followed up with state agencies to
collect additional information.
The national waiver and icF/?R program expenditure and recipient data
used in this report are from the uAIM on developmental disabilities at the
Research and Training Center on Community living, Institute on
Community Integration, at the University of Minnesota The Institute
collects these data, with the exception of ICFrMR expenditures, directly
from state agencies. The Institute uses icF/mra expenditure data, compiled
by the Medstat Group under contract to HcFA. National data from the
Institute were available thmugh 1995. The expenditure and recipient data
we report for Florida, Michigan, and Rhode Island were provided to us by
the state agencies responsible for developmental services and the
<strong>Medicaid</strong> agencies. The latest complete data available from these three
states were for 1994. We therefore used 1994 national data for comparison
purposes.
Some differences occur in the recipient counts among the national data we
used from the Institute and data we collected from agencies in Florida,
Michigan, and Rhode Island. These differences could affect some aspects
of our comparisons of national trends and trends in the three states,
Institute data on recipients show the total number of persons receiving
services on a given date-June 30 of each year-whereas data for the
three states show the cumulative number of persons receiving services
over a 12-month period. Therefore, data supplied by the states could result
in a larger count of program recipients than the methodology used by the
Institute. This could have the impact of making per capita expenditure
calculations smaller for the state data than for the national data. Our
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