Impacts of Waiting Periods for Home and Community-Based Services on Consumers and Medicaid Long-Term Care Costs in Iowa

This report compares the risk of nursing home entry, hospitalization rates, and Medicaid long-term care costs, among people with disabilities who faced widely-varying waiting times (ranging from 3 to 25 months), depending on when they applied for home and community-based services (HCBS) though Iowa Medicaid 1915(c) waivers. The three waivers--Brain Injury, Health and Disability, and Physical Disability--provide HCBS to non-elderly adults with disabilities on a first-come, first-served basis. The report examines the effects of waiting periods for all applicants, as well as for the roughly half of applicants who, due to their older age, were at higher risk of entering a nursing home. [43 PDF pages]