Long-Term Supports and Services for Individuals with Mental Illness

Federal mandates and initiatives (e.g., Americans with Disabilities Act, Olmstead Decision) provide an impetus for states to pursue community integration for all individuals. As states continue to reform their long-term supports and services (LTSS) systems, there is a growing interest in determining their successes in achieving a more equitable balance in services. However, findings from the NBIC show that the population most consistently excluded across the LTSS system was individuals with mental illness (MI). Objectives: The purpose of this study is to examine and evaluate the LTSS system of ten states through the NBIP. Approximately 19% of adults currently report having functional limitations and/or mental health problems. These individuals require a range of services to live independently. Despite substantial need for supports and services for the disability community, a gap remains in the availability of supports and services specific to individuals with mental illness (MI). To address this gap, the NBIP is assisting the Centers for Medicare & Medicaid Services (CMS) in identifying populations underserved in the current system. Findings: Approximately half of states provided caregivers of individuals with MI the ability to purchase goods and/or services for care. Gaps were also seen in respite services, health promotion programs, and supportive employment services. In addition, the MI population did not have Medicaid 1915(c) waivers available to them in most of the 10 states. These findings indicate that States may not be considering the unique needs of the MI population as efforts to rebalance systems are made.