Here’s a breakdown of the key takeaways from the provided text, focusing on waiting lists for home care services:
1.The Problem with Waiting List Numbers:
* Inflated Numbers: Waiting list numbers don’t accurately reflect the actual need for home care services. A meaningful portion of people on lists may not ultimately be eligible.
* Ohio’s Impact: A large portion of the recent decrease in waiting list size (nearly half) was due to Ohio implementing an eligibility assessment, removing nearly 70,000 people from the list.
* Lack of Screening: A key issue is that many states don’t screen for eligibility before adding people to waiting lists.
2.States with the Biggest Waiting Lists:
* Six States Dominate: Florida, Iowa, Oklahoma, Oregon, South carolina, and Texas account for over half (325,000) of all people on waiting lists, and none of these states screen for eligibility.
* Disproportionate Share: A disproportionate number of people on waiting lists live in states that don’t screen for eligibility (ranging from 40-54% of the total waiting list population between 2022-2025).
3. Why People are on Waiting Lists (Even if Thay Don’t Need Services Yet):
* Future Need: People frequently enough enroll in anticipation of future needs, especially in states with a “first-come, first-served” system.
* Early Enrollment: Families sometimes add children to lists at a young age, assuming they’ll need services later.
* Comprehensive Services: Waivers frequently enough offer extensive support (employment, housing, 24/7 care), making them desirable.
4. Who is Typically on the Lists?
* Individuals with I/DD: The majority of people on waiting lists (74% overall) have Intellectual and Developmental Disabilities (I/DD).
* State Differences: This is especially true in states that don’t screen for eligibility (81% I/DD). In states that do screen, it’s 55%.
* Other Groups: Older adults and those with physical disabilities make up about 23% of the list, with the remaining 4% including medically fragile children, people with brain/spinal cord injuries, mental illness, or HIV/AIDS.
* not representative: People on waiting lists are not representative of the overall Medicaid population or those who actually use home care. People with I/DD are overrepresented on waiting lists compared to those receiving services.
In essence, the text highlights that waiting list numbers are a flawed measure of need due to inconsistent screening practices and proactive enrollment, with a significant concentration of waiting list individuals in a handful of states that don’t assess eligibility.
