Medicaid Home Care Waiting Lists: 2016-2025 Analysis

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.