People are talking a lot about potential Medicaid changes. This includes whether the federal government might give less money for it in the future. In New Jersey, people with disabilities need Medicaid to get important help from DDD services. Even though many people have protested and told the government, “No Cuts, No Caps” and “Hands off Medicaid,” we don’t know what will happen in the future. This can be scary because people don’t want to lose the services they need.
Medicaid was created in 1965, but it wasn’t immediately a major funding source for developmental disability services. Before this, people received support in large state-run facilities or in community programs funded by the state. Medicaid funding allowed for expansion of services and more personalized options. If we look at the past, we can see how things have changed and grown over time.
- 1980s – 1990s: NJ DDD services were paid for in a simple way. If someone needed help, their services were paid for through Medicaid contracted funding. Only a handful of different services were offered through this system. Medicaid and DDD prepaid the service provider for the whole year. This payment was made even if someone later missed a lot of days in the program or service. This was a one-size-fits-all model through Medicaid Home and Community Based Services (HCBS).
- 1998: A new Medicaid program called Real Life Choices (RLC) started under HCBS. People could decide how to use their budget to meet their needs. This could range from hiring their own caregivers to transportation and community activities. There weren’t a lot of services to choose from, but it showed that people have different needs. This was the beginning of self-directed services.
- 2000s: Real Life Choices then expanded into Self-Directed Day Services (SDDS) under Medicaid HCBS. It gave people more choices in how they spent their funding on services. People weren’t limited to going to a day program or living in a group home. More and different options for services increased a lot now.
- 2010s: A new system, called Fee for Service (FFS), started. This system gave people more control over how they used their funding for services. People could choose to use their budget to go to school, try new activities, get support to get a job, and enjoy life more. Medicaid became the primary source of pay for these services beginning in 2013.
- 2018: NJ DDD worked to make services better, help people join their communities, and make the system more flexible. Medicaid became the main way to pay for services. All services in DDD were fully funded by Medicaid through the Supports Program and the Community Care Program (CCP).
Disability services and the way they are funded have changed a lot over the years. Each time with the goal of improving services to meet the needs of people with disabilities. Reducing or capping Medicaid funding and services would be a step backwards.
Medicaid has been a vital source of services in New Jersey and nationwide. We are committed to sharing important information that helps the broader community to understand the importance of Medicaid funding. By highlighting how Medicaid has changed the lives of people with disabilities, together we can help to ensure that decisions are made to provide essential support.
You can get more information on Medicaid and share your story on how Medicaid has impacted your life by visiting the Boggs Center resource here.
No matter what happens with Medicaid, Values Into Action NJ will keep working to make things better. We will make sure people with disabilities get the support they need to live their life the way they want.