National report finds vast disparities in state Medicaid programs

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United Cerebral Palsy has released its annual national rankings of state Medicaid programs for their performance in providing community living options, as opposed to institutional arrangements, for people with disabilities.

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The top five states on the list, which was based primarily on information from the fiscal year 2010, were Arizona, Michigan, California, New Hampshire and Vermont. The five worst performing states, which was largely similar to other recent reports,  were Virginia, Illinois, Arkansas, Texas, Mississippi.

“It is the duty of a civil society such as ours to aid these individuals, who are often the most vulnerable members of society,” the report stated. “Yet some states do much better than others in having the needed political will and sound Medicaid policies necessary to achieve this ideal.”

The report found that 36 states meet the 80/80 community standard, meaning that 80 percent of the state’s Medicaid-support individuals with disabilities are housed in community settings and that 80 percent of the state’s Medicaid resources are spent on community supports.

While the report mentioned that states are continuing to move beyond large, state-run institutions – 205 of the 354 state institutions have closed since 1960 – states continue to fall short in keep up with the increasing demand for community support. Nationwide, 268,000 people are on the waiting list to receive Home and Community Based waiver services, which provides funding to allow people to live in their homes and avoid becoming unnecessarily institutionalized.

The report also looked at the various states’ ability to monitor abuse and safety conditions in state-run facilities. It also provides information on each states record in providing employment opportunities for people with disabilities. In only nine states nationwide are more than a third of the workforce of people with intellectual and developmental disabilities employed in competitive employment.

The United Cerebral Palsy website provides links to detailed information on services provides each states’ programs, as well as tools for measuring changes in the state’s services over time.