Funding

How are services for people with intellectual and developmental disabilities funded in your state? In other states? Across the country? How is this changing and evolving? Learn about funding in the resources below.

Partnerships in Employment: Summary of Section 1915(c) Home and Community Based Services Waivers and Section 1915(i) State Plan Home and Community Based Services

This is a resource document prepared for a Community of Practice (COP) on using Medicaid funds as a resource to support individual integrated employment. The COP is hosted by the Partnerships in Employment Training and Technical Assistance Center for Partnerships in Employment grantees. The goal of the COP will be to provide opportunities to learn about the ways in which 1915(c) Home and Community Based Waivers and 1915(i) State Plan Home and Community Based Services have been used to support integrated employment in federal statue and in states with PIE grants.

Emerging Practices, Transition: Funding Mechanisms

In October 2011, the Administration on Developmental Disabilities awarded grants to lead agencies in six states: California, Iowa, Mississippi, Missouri, New York, and Wisconsin. Two additional states, Alaska and Tennessee, received grants in October 2012. These states proposed activities to spur improved employment and post-secondary outcomes for youth with intellectual and developmental disabilities (IDD).

The Extent of Consumer-Directed Funding by MR/DD State Agencies in Day and Employment Services

Individual control over service delivery and life choices is well established as a value in supports for individuals with developmental disabilities. One policy-based strategy for expanding individual control is the use of mechanisms that provide for consumer direction of funding resources. This manuscript reports on the prevalence of consumer-directed funding for day and employment services, and the mechanisms that states are using to implement consumer-directed funding.

Oklahoma’s Outcomes-based Rate Setting System

Oklahoma’s Developmental Disabilities Services Division (DDSD) realized the need for increased attention towards the goal of community-based employment for individuals they served. Initially, rates were based on a vendor’s costs of providing direct services such as job development and job coaching. It became increasingly apparent that claims for vocational services oftentimes reflected staff activities (e.g., job development, client assessment, and service delivery documentation), which may have been occurring without the direct involvement of the service recipient.

Using an Outcomes-based Long-Term Vocational Services Funding Model in North Carolina

In North Carolina, counties have been consolidated into Local Management Entities (LMEs). These entities contract for services with community providers and provide oversight on access, utilization, best practices, and community collaborations. The Mecklenberg County LME established the Best Practices Community Committee, comprising service providers, individuals and family members, advocacy agencies, community partners, interested community volunteers, and LME staff. Sub-committees addressed several areas, including employment.

Michigan’s Job Development Incentive

Michigan's Department of Community Health, Mental Health and Substance Abuse Administration (MDCH) has expressed a strong desire to improve the state's employment outcomes among people with intellectual and developmental disabilities (IDD). Set against this desire is a major obstacle: Michigan is among the states hardest hit by the continuing economic recession, with the highest unemployment rate in the nation.

Contracting with Industry for the Provision of Job Coaching Supports in Oklahoma

Contracts with Industry, implemented in the 1990s as the Natural Supports Initiative, is a program option that allows the Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services Division (DDSD) to contract directly with businesses to provide job coaching supports that become a part of the natural workplace. Individuals participating in this program are employed by a business and are paid minimum wage or better.

Project GATE: Creative Sequencing of Funding

Alabama has piloted the Gaining Access To Employment project, a collaborative effort between the state’s Department of Mental Health/Developmental Disabilities (MH/DD) and its Department of Vocational Rehabilitation (VR). Through this project, known as Project GATE, the two agencies work together to help local service providers use funds to support integrated employment opportunities. MH/DD and VR have a long history of partnering, including joint efforts on a supported employment workgroup, due to the strong relationships between colleagues at each department.