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State Mental Retardation and Developmental Disabilities Agencies Expenditures for Integrated Employment Services

Data Note 16, 2008

By:

Originally published: 4/2008

Data set: The National Survey of Day and Employment Programs1

Institute for Community Inclusion, State Data Project

In FY2004, the average expenditure per person for integrated employment as reported by state Mental Retardation and Developmental Disabilities (MR/DD) agencies was $6,251 (Table 1). This figure has increased steadily since the mid-1990s indicating that states have slowly begun allocating additional resources towards integrated employment. However, growth in expenditures is likely a result of changes in federal law as opposed to changes in the amount of state dollars available to fund integrated employment. The Balanced Budget Act Amendments of 1997 expanded the eligibility for integrated employment services to all people served under the Medicaid Title XIX Home and Community Based Services (HCBS) waiver. Between FY1996 and FY2004 state, county, or local MR/DD agency expenditures remained constant, while Title XIX waiver expenditures per person for integrated employment increased nearly 250%. It is expected that more recently enacted federal policies such as the New Freedom Initiative (2001) will continue to encourage states to make use of federal Medicaid dollars to fund integrated employment, and likely perpetuate these trends.

Overall, states have increased per-person integrated employment expenditures; however, there is significant variation across states and funding sources (Table 2). The differences in per-person expenditure for integrated employment are important to note but are not necessarily an indication of the quantity or quality of integrated employment services in the state. Washington state and Connecticut both consistently support a high percentage of service recipients in integrated employment, however the state’s per-person expenditures are significantly different. The differences in per-person expenditures are more likely due to variations within each state’s economy than the quantity or quality of integrated employment services.

Table 1: Average Expenditure Per Person Served in Integrated Employment by Funding Source (Number of states reporting data in parentheses)
1996 1999 2001 2004
Title XIX Waiver $1,604 (14) $2,124 (30) $3,311 (29) $4,260 (24)
State, County
or Local MR/DD
$3,894 (17) $3,897 (24) $3,349 (27) $3,849 (25)
Average Expenditure
Per Person (all sources)
$4,730 (26) $5,003 (35) $6,188 (32) $6,450 (31)



Table 2: Average State Expenditure per Person Served in Integrated Employment by Funding Source*
STATE Title XIX State, County, Local Total Reported
Expenditures
AK $12,429 -- $12,429
AL 5,950 2,205 8,155
AR 1,247 -- 1,247
CT -- 14,364 14,541
DC -- 5,645 8,065
DE 6,496 4,016 10,511
FL -- -- 2,631
GA 3,316 3,132 6,390
HI 8,102 8,102 8,102
IA -- -- 1,952
ID -- 3,111 3,116
IN 973 -- --
KY -- -- --
MA 8,895 3,669 12,564
MD 4,027 9,533 13,564
MI -- 4,605 4,605
MO 3,976 256 4,232
MS 2,098 1,884 --
MT 7,091 690 8,810
NC 2,774 2,010 4,784
NE 2,509 3,062 5,570
NJ 3,339 4,912 8,252
NM 5,876 816 5,876
NY 1,395 3,170 4,566
OK 5,108 970 6,078
PA -- -- 6,682
SC -- -- 1,762
SD 763 518 1,319
UT 4,733 1,878 7,059
VA 1,596 8,645 10,241
VT 4,924 6,054 6,054
WA -- 1,560 5,012
WV 578 1,431 1,729
WY 4,047 -- 4,047
Average of
States Reporting
4,260 3,849 6,450
No. of States Reporting 24 25 31

*States without data in any of the three categories have been omitted from this table.


1 Data for this Data Note is from the National Survey of Day and Employment Programs. Since FY1988 the Institute for Community Inclusion has administered the survey to state Mental Retardation and Developmental Disabilities Agencies. The work is funded by the Administration on Developmental Disabilities and is designed to describe the nature of day and employment services for individuals with developmental disabilities.

2 Available funding sources include: Title XX Social Service Block Grants; Title XIX Medicaid ICF/MR funds; Title XX Medicaid Waivers; State, county, or local MR/DD funds; and Other funds.

Suggested Citation

Winsor, J., Dennee-Sommers, B., and Smith, F.A. 2008. State Mental Retardation and Developmental Disabilities Agencies Expenditures for Integrated Employment Services. DataNote Series, Data Note XVI. Boston, MA: Institute for Community Inclusion.

This is a publication of StateData.info, funded in part by the Administration on Developmental Disabilities, U.S. Department of Health and Human Services (#90DN0216). This Data Note was written by Jean Winsor, Brooke Dennee-Sommers, and Frank A. Smith.

State Data is a project of the Institute for Community Inclusion at UMass Boston.