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Getting Rid of The R-Word in Medicaid HCBS

By Carli Friedman, CQL Director of Research

Rosa’s Law, which changed references of ‘mental retardation’ to ‘intellectual disability’ within federal legislation, marked recognition by the federal government that ‘mental retardation’ (the R-word) is outdated and pejorative. However, Rosa’s Law did not apply to many notable federal programs related to disability, such as Medicaid. This manuscript explored if and how the R-word was used within Medicaid Home and Community Based Services 1915(c) waivers, as they are the most prevalent provider of long-term services and supports for people with intellectual and developmental disabilities. Although an overwhelming majority of waivers used the R-word, we found the R-word was used less for later benchmark dates. Waivers provide some of the most advanced community services; the language used in waivers should reflect this.

This article is a summary of the following journal manuscript: Friedman, C. (2016). Outdated language: Use of “mental retardation” in Medicaid HCBS waivers post-Rosa’s Law. Intellectual and Developmental Disabilities, 54(5), 342-353.