Trends in the States:
Managed Care & Expanded Competitive Employment

This year’s Case for Inclusion looks at two key trends affecting those with intellectual and developmental disabilities.  As always, states are the laboratories of democracy and state leaders are looking at how they can help those with disabilities improve as well as save tax dollars in the Medicaid program.  To that end, states are looking at comprehensive managed care for those with ID/DD and also expanded Employment First initiatives to increase competitive employment for those with ID/DD.

In this report, managed care efforts in Kansas and Massachusetts are highlighted in case studies below.  In addition, the nationally inspiring success of Washington State’s Employment First initiative is studied with model legislation and state-specific projections of what similar efforts would mean for the other 49 states and Washington, D.C.

Kansas: KanCare represents one of the most aggressive and comprehensive Medicaid reforms affecting those with ID/DD, directly integrating work, health and community; broadening the scope of benefits; and prioritizing competitive employment and improving health outcomes. As of January 1, 2014, individuals with ID/DD will be able to chose from the three private plans currently offered to Medicaid enrollees, all of which fully integrate medical and behavioral health benefits and home and community-based services. KanCare will focus on specific outcomes to determine success, including: increased competitive employment; improved life expectancy; integration of physical health, behavioral health and home and community based services; and improved health. Learn more about Kansas’s efforts in managed care

Read the full Case Study

Massachusetts: The first state to implement a statewide pilot program (called a demonstration) for all dually eligible individuals, including those with ID/DD, Massachusetts aims to improve coordination of care, actual health outcomes, and overall quality of life for Americans with developmental disabilities.  Individuals with ID/DD will have new benefits available through the ICO plans, including restorative dental services, expanded personal care assistance, and greater access to durable medical equipment, and the program defines its success on actual outcomes. Although the actual outcomes tracked have yet to be determined, some of the possible measures to be included include access, person-centered care, integration of services and enrollee outcomes. Learn more about Massachusetts’s efforts in managed care.

Read the full Case Study

Washington: Washington State’s Employment First policy supports employment and day program funds targeted for working-age adults and ensures that after nine months of employment services the individual may choose community access programs. By focusing its efforts on this narrow window of time, Washington’s leaders and advocates addressed the difficult goal of finding a job directly through leadership, training and innovation, and clearly defined goals. The impact of this was profound: in seven years, the number of individuals competitively employed rose from 4,440 in 2004 (before the policy) to 5,562 by 2011. Learn more about Washington’s Employment First efforts.

Read the full Case Study


An Analysis of Medicaid Outcomes for Americans with Intellectual & Developmental Disabilities

United Cerebral Palsy (UCP) releases The Case for Inclusion each year, tracking the progress of community living standards for Americans living with intellectual and developmental disabilities (ID/DD). The report examines data and outcomes for all 50 states and the District of Columbia (DC), ranking each on a set of key indicators, including how people with disabilities live and participate in their communities, if they are satisfied with their lives, and how easily the services and supports they need are accessed. By taking these factors into account, UCP is able to develop a comprehensive analysis of each state's progress or failures in providing critical services to individuals living with disabilities.

The findings for 2013 reveal that: 1) All states have room for some improvement, but some have consistently remained at the bottom of the rankings; 2) Despite economic strains, many states have made real improvements in the quality of services being provided; 3) There is still work to be done in ensuring that people with ID/DD can enjoy the same freedoms and quality of life as all Americans.

P: 800.872.5827 | F: 202.776.0414 |

United Cerebral Palsy
1825 K Street, NW | Suite 600
Washington, DC 20006

Copyright © 2013