The Medicaid Personal Care Services Option Part I: Cross-State Variations and Trends Over Time

The past decade or so has seen considerable growth in the number of Medicaid programs electing to cover personal care services--from only ten in FY 1979 to 29 in FY 1992. Substantial inter-state variation exists in Medicaid personal care services coverage. In 1988, participation rates per 1,000 aged/disabled Medicaid recipients ranged from a low of four (New Hampshire) to a high of 215 (South Dakota). Federal law and regulations place few limitations on states' discretionary authority. States that interpret federal requirements more liberally are ones that have consciously sought to develop "consumer-directed" models of service delivery. (ASPE Research Notes, Volume 7). [5 PDF pages]