“Get us real jobs:” Supported employment services for people with intellectual and developmental disabilities in Medicaid Home and Community Based Services Waivers

Article type: Research Article

Authors: Friedman, Carli^{a; *} | Rizzolo, Mary C.^b

Affiliations: [a] Disability and Human Development, University of Illinois at Chicago, Chicago, IL, USA | [b] The Council on Quality and Leadership, Towson, MD, USA

Correspondence: [*] Address for correspondence: Carli Friedman, PhD, Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Road, M/C 626, Chicago, IL 60608, USA. Tel.: +1 312 413 1535; E-mail: cfried6@uic.edu.

Abstract: BACKGROUND: Despite their interest in and ability to work in integrated settings the majority of adults with intellectual and developmental disabilities (IDD) in the United States are funneled into segregated settings. OBJECTIVE: Because of the essential role Medicaid 1915(c) Home and Community Based Services (HCBS) waivers play in providing both long-term supports and supported employment services the aim of this study was to examine how HCBS waivers allocated supported employment services in fiscal year 2014. This included an examination of hourly reimbursement rates and annual service prevision per participant as well as variance across states. METHODS: Supported employment services in Medicaid 1915(c) HCBS waivers for people with IDD were analyzed to determine trends, service utilization, and projected expenditures. RESULTS: Although HCBS waivers play a critical role in providing supported employment services for people with IDD, we found wide variability across services and states in terms of projected total spending, projected spending per participant, and service rates. CONCLUSIONS: Expansion of supported employment services is important so people with disabilities can access employment in the most integrated settings possible in alignment with the Americans with Disabilities Act and the Olmstead v L.C. decision.

Keywords: Supported employment, intellectual and developmental disabilities, Medicaid Home and Community Based Services Waivers

DOI: 10.3233/JVR-160847

Journal: Journal of Vocational Rehabilitation, vol. 46, no. 1, pp. 107-116, 2017