title: Trends and issues in the Medicaid 1915(c) waiver program.
abstract: Over the past 15 years, Medicaid 1915(c) home and community-based waivers have made a substantial contribution to States' efforts to transform their long-term care (LTC) systems from largely institutional to community-based systems. By 1997, every State had implemented a waiver program for at least some subgroups of individuals with disabilities, and expenditures increased from $3.8 million in 1982 to more than $8.1 billion in 1997. Emerging, as well as long-standing, policy issues related to the waiver program include concerns with access, variation in availability by disability group, State decisions related to the provision of community-based LTC, and evidence on effectiveness.
authors.affiliation: Policy Sciences Graduate Program, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA. nanmille@umbc.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Ramsland
authors.forename: C
authors.initials: C
authors.lastname: Harrington
mesh_terms: D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000458:organization & administration* / Q000639:trends; D008484:Medicaid / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000639:trends; D009936:Organizational Innovation; D013221:State Health Plans / Q000458:organization & administration* / Q000639:trends; D014481:United States