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Day Habilitation in HCBS Waivers: A National Analysis

By Carli Friedman, CQL Director of Research

Medicaid Home and Community Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how HCBS waivers allocate day habilitation services for people with IDD. To do so, HCBS waivers for people with IDD providing day habitation services were analyzed to determine service utilization and projected expenditures. In fiscal year 2014 HCBS waivers projected $5.62 billion of funding for day habilitation services. However, there was wide variance across services in terms of projected total spending, spending per participant, and reimbursement rates.