United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1999-05-14 monographic deposited born digital 91 p. GA 1.13:HEHS-99-101 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-101 P0b002ee18039394a f:he99101 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-99-101 machine generated eng fdlp REPORT GAOREPORTS-HEHS-99-101 HEHS-99-101 Health care programs Home health care services Disability benefits Persons with disabilities State-administered programs Disadvantaged persons Waivers Health surveys Aid for the disabled Long-term care Oregon Maine California Kansas Social Security Disability Insurance Program Supplemental Security Income Program Medicare Program Medicaid Program National Health Interview Survey VA Aid and Attendance Benefit Program Letter Report HEHS

According to a national survey done in 1994 and 1995, 2.3 million adults living in home- or community-based settings require considerable assistance with basic daily activities, such as bathing and dressing, to avoid institutionalization. Affording such help was a problem, however. Disabled adults were more likely than the general population to live in a family with an income of less than $20,000 and were almost twice as likely to live below the U.S. poverty threshold. Eighty-four percent of those aged 18 to 64 were jobless. More than 80 percent of severely disabled adults had public health insurance, primarily Medicare or Medicaid or both. At least 70 different federal programs assist individuals with disabilities. An estimated $79 billion in benefits will be paid in fiscal year 1999, primarily through Social Security Disability Insurance and Supplemental Security Income. Other programs provide a mixture of cash and services. Medicaid's fastest-growing outlays are for home- and community-based services waivers. The states are increasingly taking advantage of the flexibility these waivers allow to design and target programs that meet unique state needs. Personal care programs in California, Kansas, Maine, and Oregon reflect diverse approaches and can serve as models for other states to expand service delivery in noninstitutional settings and emphasize consumer participation in directing services to meet their own care needs. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-101/html/GAOREPORTS-HEHS-99-101.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-101/pdf/GAOREPORTS-HEHS-99-101.pdf GAO/HEHS-99-101 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-101 Letter Report GAO/HEHS-99-101; Adults With Severe Disabilities: Federal and State; Health care programs Home health care services Disability benefits Persons with disabilities State-administered programs Disadvantaged persons Waivers Health surveys Aid for the disabled Long-term care Oregon Maine California Kansas Social Security Disability Insurance Program Supplemental Security Income Program Medicare Program Medicaid Program National Health Interview Survey VA Aid and Attendance Benefit Program Title 2042 Section 12131 2042 U.S.C. 12131