Information provided by AAPD - back to Long-Term Care Issues

FY 2006: Medicaid Expenditures for Institutions
versus Community-Based Services - Information Bulletin #216 (8/07)


Steve Gold, The Disability Odyssey continues

Medicaid data for FY 2006 provides extremely helpful information to analyze and compare how your State distributes and allocates its Medicaid Long Term Care expenditures between its institutional versus community-based services.

Nationally, for all disabilities, 60.6 % of MA's long term care expenditures went to institutions, i.e, both to nursing homes (for disabled persons of all ages, "PD/A," physical disabilities/aged) and to intermediate care facilities (for persons with "MR/DD," mental retardation/ development disabilities). In contrast, 39.4% of all MA's long term care expenditures went for community services, i.e., for waivers (i.e., both PD/A and MR/DD), personal care option, and home health services in the community.

To understand the balance or ratio, think of a scale, with nursing homes and ICF MR/DD on the side, representing institutional expenditures, and, on the other side of the scale, with waivers, personal care and home health services, representing the community-side expenditures.

To have a clearer or more accurate picture of the scale, it's necessary to break down and compare specific institutions with specific community services.

When disabilities are broken down by MR/DD and PD/A, a dramatic difference exists in the 60.6 % national long term care distribution.

For persons receiving MR/DD services, nationally only 39.3% went for institutions (ICF-MRs) and 60.7% was spent for community-based services. That's correct: less Medicaid funds go to institutionalize persons with MR/DD in the institutions than goes to provide community-based services.

In dollars, $ 12.5 b was spent on MR/DD institutions versus $ 19.3 b spent for community-based services. While it's still much too much for MR/DD institutionalization, it's a significantly better balanced than for persons with disabilities.

For persons with PD/A (regardless of their age), 71.4 % was expended on nursing facility institutional services and 28.6% on community-based services. In dollars, nursing homes received $ 47.7 b to institutionalize persons with PD/A versus $ 19.2 b was spent for community-based services.

In dollar amounts that we can identify with, for people with PD/A, $2.48 was spent on nursing homes for every $1.00 in the community. Compare that with MR/DD, where "0.65 was spent on the ICF/MR institutions for every $1.00 spent in the community.

Quite a difference. Why the lopsided distribution based on type of disability?

Have advocates for persons with PD/A devoted as much effort as advocates for persons with MR/DD to eliminate the a state's institutional bias?

Are the MR/DD advocates better organized than the PD/A advocates? More aggressive? Better at the political process?

Do MR/DD advocates have more clout at the State level than PD/A advocates?

Why hasn't there been a public discussion on the lopsided MR/DD versus PD/A distributions?

Surely, people with MR/DD or with PD/A are equally valuable and important, and they deserve the same opportunity to reside in the community.

Let's look at the differences in each State. The following chart provides two columns - the first for MR/DD and the second for PD. For each, we provide the ratio of expenditures, i.e., the amount of institutional expenditures for each $1 of community expenditures.

How does your State compare?

Ratio of expenditures for institutional versus community; that is, how much MA funds were spent in institutions for each MA $1 spent in the community?

MR/DD Institution vs Community PD Institution vs Community
Alabama $0.15 to $1 $7.94 to $1
Alaska $0 to $1 $0.94 to $1
Arizona* n/a $1.53 to $1
Arkansas $1.42 to $ 1 $2.84 to $1
California $0.53 to $1 $1.07 to $1
Colorado $0.19 to $1 $1.99 to $1
Connecticut $0.68 to $1 $4.02 to $1
Delaware $0.34 to $1 $6.63 to$1
D. C. $4.51 to 1 $2.69 to $1
Florida $0.40 to $1 $6.88 to $1
Georgia $0.46 to $1 $5.16 to $1
Hawaii $0.10 to $1 $4.89 to $1
Idaho $1.04 to $1 $1.48 to $1
Illinois $1.66 to $1 $3.88 to $1
Indiana $1.50 to $1 $11.33 to $1
Iowa $1.05 to $1 $3.05 to $1
Kansas $0.28 to $1 $1.79 to $1
Kentucky $0.74 to $1 $4.18 to $1
Louisiana $2.48 to $1 $4.75 to $1
Maine $0.27 to$1 $2.99 to $1
Maryland $0.13 to $1 $5.05 to $1
Massachusetts $0.24 to $1 $3.08 to $1
Michigan $0.02 to $1 $5.27 to $1
Minnesota $0.19 to $1 $1.33 to $1
Mississippi* $253.60 to zero $40.50 to $1
Missouri $0.74 to $1 $2.35 to $1
Montana $0.20 to $1 $2.47 to $1
Nebraska $0.43 to $1 $3.93 to $1
Nevada $0.44 to $1 $2.10 to $1
New Hampshire $0.02 to $1 $6.47 to $1
New Jersey $0.84 to $1 $3.87 to $1
New Mexico $0.11 to $1 $0.86 to $1
New York $0.74 to $1 $1.77 to $1
North Carolina $1.30 to $1 $1.32 to $1
North Dakota $1 to $1 $16.60 to $1
Ohio $1.11 to $3.74 to $1
Oklahoma $0.51 to $1 $2.75 to $1
Oregon $0 to $1 $.82 to $1
Pennsylvania $0.48 to $1 $7.31 to $1
Rhode Island $0.04 to $1 $7.60 to $1
South Carolina $0.84 to $1 $3.99 to $1
South Dakota $0.27 to $1 $8.51 to $1
Tennessee $0.66 to $1 $87.31 to $1
Texas $1.69 to $1 $1.19 to $1
Utah $0.50 to $1 $9.16 to $1
Vermont n/a $2.68 to $1
Virginia $0.74 to $1 $3.34 to $1
Washington $0.33 to $1 $0.87 to $1
West Virginia $0.30 to $1 $3.50 to $1
Wisconsin $0.35 to $1 $2.30 to $1
Wyoming $0.22 to $1 $4.03 to $1
National $0.65 to $1 $ to $1

This data was computed from the CMS' MA reports from each state based on actual expenditures. The data is compiled by Thompson/Medstat, to whom we are very appreciative.



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