HD19 - The Feasibility of Extending Medicaid Coverage to Persons with Developmental Disabilities and Mental Illness


Executive Summary:
House Joint Resolution No. 632 requested the Department of Medical Assistance Services to study the possibility of seeking a waiver to extend Medicaid coverage to persons with developmental disabilities and mental illness who are no longer eligible for public programs due to their age, but who still require assistance, guidance, or supervision. This resolution originated from the work of the Joint Subcommittee Studying the Continuation of Services to Young Adults Exiting Publicly Funded Programs, established during the 1994 General Assembly through House Joint Resolution No. 103. Because of concerns about the ability of these young adults to lead independent lives, the Joint Subcommittee studied the continuation of services for young adults exiting publicly funded programs.

The possibility of covering the services needed by these young adults through Medicaid was one of the areas addressed by the Subcommittee. During the Joint Subcommittee's deliberations, DMAS was called upon to present the possibilities of covering this population under Medicaid. After careful analysis, the following options that could be used to make Medicaid services available for a population that is developmentally disabled and mentally ill were offered by DMAS:

1. Expand the Mental Retardation Waiver;
2. Expand the Elderly and Disabled Waiver;
3. Utilize the Assisted Living Waiver;
4. Submit a request for a waiver for persons with mental illness; and,
5. Expand the services available through the State Plan to provide additional community support services for persons with developmental disabilities.

This study examined the feasibility and practicality of each option including the costs and benefits of the services. The analysis revealed that each option had significant programmatic and financial implications. It is recommended that no action be taken at this time to expand these services, chiefly because of the uncertainty of the impending block grant approach to Medicaid.