Developing HCBS alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of long-term care dollars still go toward institutional care, the national percentage of spending on HCBS has more than doubled from 19 percent in 1995 to 41 percent in 2007. This article presents a summary of the main trends to emerge from the latest (2006) expenditures and participant data for the three main Medicaid HCBS programs. 

Ng, Terence; Harrington, Charlene; O’Malley, Molly 

Real Choice Systems Change; Personal Assistant; Person Centered Planning; Medicaid; Independent Living; Formative Evaluation; Eligibility; Caregiving; 1915c; Medicaid spending; HCBS waivers; mandatory home health benefit; optional state plan personal care services benefit; provider reimbursement rates; home health benefit; personal care services benefit; waiting list data;1915(i); 1915 (j); deficit reduction act; money follows the person; University of California, San Francisco; UCSF 

Consumer/Participant Direction, State/Agency Information 

Data, Reports 

Kaiser Family Foundation 

Alabama, Arizona, Delaware, District of Columbia, Florida, Georgia, Kansas, Louisiana, Mississippi, New York, Rhode Island, Texas, Utah, Vermont, All States/Territories 

12/11/2009 

Kaiser Commission on Medicaid and the Uninsured
1330 G Street NW
Washington, DC 20005

kcmu@kff.org
202-347-5270