319189
Electronic monitoring in Medicaid Home and Community Based Services Waivers for people with intellectual and developmental disabilities
While the number of available caregivers for people with intellectual and developmental disabilities (IDD) is reducing, the number of people who need care and support is steadily increasing, effectively creating a vacuum of care.
Purpose
Despite noted benefits, electronic monitoring is relatively new for people with IDD. Medicaid Home and Community Based Services (HCBS) Section 1915(c) waivers are a critical funding stream for people with IDD’s long-term support needs in the United States. In order to examine the implementation of electronic monitoring technology for people with IDD, we examined which state HCBS waivers were providing electronic monitoring services and how they were doing so.
Methods
Nationwide HCBS waiver data relating to IDD was obtained from the United States CMS Medicaid.gov website for FY 2013. We then examined this data to determine, if applicable, the electronic monitoring services provided, the projected number of users, and the average cost of each unit of service. We also examined the electronic monitoring service definitions to determine themes across services.
Results
Our findings highlight that electronic monitoring services are largely not being utilized for the more than 600,000 people with IDD on Medicaid HCBS waivers. We found a very small portion of states (7.1%) provided any type of electronic monitoring services. Only a very small fraction (0.1%) of the total FY 2013 waiver spending was projected for electronic monitoring services. The average projected cost per person and the average hourly rates for these services also varied widely.
Discussion
Electronic monitoring services are effective methods to expand community care while at the same time being cost effective. In moving forward it is important to remember that electronic monitoring technology needs to not only be cost effective but also improve care; electronic monitoring technology cannot serve as a substitute for personal care and interaction.
Learning Areas:
Communication and informaticsPublic health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related research
Social and behavioral sciences
Learning Objectives:
Describe how states are utilizing electronic monitoring services for people with IDD in Medicaid HCBS waivers
Identify ethical dilemmas related to the implementation of electronic monitoring services
Keyword(s): Disabilities, Medicaid
Qualified on the content I am responsible for because: I have been a graduate research assistant for a nationally funded grant focusing on Medicaid services for people with intellectual and developmental disabilities for 5 years. My interests include the many ways Medicaid services are provided for people with intellectual and developmental disabilities in the community, and the empowerment of people with intellectual and developmental disabilities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.