State Mental Retardation and Developmental Disabilities Agencies Expenditures for Integrated Employment Services
Data Note 16, 2008
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.
|Title XIX Waiver||$1,604 (14)||$2,124 (30)||$3,311 (29)||$4,260 (24)|
or Local MR/DD
|$3,894 (17)||$3,897 (24)||$3,349 (27)||$3,849 (25)|
Per Person (all sources)
|$4,730 (26)||$5,003 (35)||$6,188 (32)||$6,450 (31)|
|STATE||Title XIX||State, County, Local||Total Reported|
|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.
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.
State Data is a project of the Institute for Community Inclusion at UMass Boston.