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Home & Community-Based Services: State-Only Funded Programs in California

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Linkages⁴,⁷,⁴⁵

Administrative Agency: Dept of Aging

Population Served: Elderly & physically disabled adults (18+)

Annual Expenditure: $8,458,387 FY05-06

Funding Source: General Revenue

Number of People Served: 5,048 FY05-06

Eligibility Criteria: People who need assistance with ADLs. No asset limit.

Further Information: Other information This program aims to fill gap for individuals not eligible for other care management programs. There was a state-funded in-home support service for seniors & adults with disabilities (In-Home Support Service Residual Program), this is now funded by a Medicaid HCBS waiver..

Program Name: Adult Day Health Care Program³,⁷,⁴⁵

Administrative Agency: Dept of Aging

Population Served: Adults (18+)

Annual Expenditure: $408,688,000 FY05-06

Funding Source: General Revenue, Clients contribute + Federal Funds (Foundation, Title XIX (Medicaid).

Number of People Served: 47,500 FY05-06 (may include federally funded clients)

Eligibility Criteria: N/A

Further Information: Other information Statewide. No consumer direction

Program Name: Alzheimer's Day Care Resource Center³,⁴,⁷,⁴⁵

Administrative Agency: Dept of Aging

Population Served: Adults (18+) with Alzheimer's or related disorder

Annual Expenditure: $4,181,200 FY05-06

Funding Source: General revenue, local/county funds

Number of People Served: 2,627 FY05-06

Eligibility Criteria: Diagnosis of dementia or related disorder. No income or asset limits.

Further Information: Other information Statewide. No consumer direction

Program Name: Caregiver Respite Center³,⁷

Administrative Agency: Dept of Mental Health

Population Served: Adults (18+)

Annual Expenditure: $11,747,000 FY03

Funding Source: General Revenue, Clients contribute + Federal Funds (OAA TitleIIIE)

Number of People Served: 14,475 FY02 (may include federally funded clients)

Eligibility Criteria: Adult onset cognitive disorder

Further Information: Cost control Respite cap of $3600/year. Other information Statewide. Can be consumer directed, including payment to family members.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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