Abstract：
People with intellectual and developmental disabilities (IDD) often have higher rates of comorbid mental health conditions compared to the general population. Yet, many people with IDD also have unmet needs for mental and behavioral health services. The aim of this study was to examine how states provided mental and behavior health, and crisis services to people with IDD in their Home- and Community-Based Services (HCBS) programs, the largest funding mechanism for Long-Term Services and Supports (LTSS) for people with IDD in the United States. We analyzed fiscal year (2021) Medicaid HCBS waivers for people with IDD from across the United States to examine if and how they provided mental and behavior health, and crisis services. States projected spending $968.9 million for mental and behavior health, and crisis services for 190,299 people with IDD. Applied behavior analysis services were provided at greater rates than positive behavior supports and other forms of behavior interventions. While most states provided mental and behavior health, and crisis services in their waivers, there were vast inconsistencies in how they did so, across states, waivers, and services. HCBS are a crucial safety net to ensure people with IDD, especially those who also have mental health disabilities, can live and thrive in their communities.
摘要：
与普通人群相比，患有智力和发育障碍（IDD）的人通常具有更高的合并症精神健康状况。然而，许多IDD患者对精神和行为健康服务的需求也未得到满足。这项研究的目的是研究国家如何提供精神和行为健康，以及在家庭和社区服务（HCBS）计划中为患有IDD的人提供危机服务，为美国IDD患者提供长期服务和支持（LTSS）的最大筹资机制。我们分析了来自美国各地的IDD患者的医疗补助HCBS豁免，以检查他们是否以及如何提供精神和行为健康。危机服务。各州预计将在精神和行为健康方面花费9.689亿美元，为190,299名IDD患者提供危机服务。应用行为分析服务的提供率高于积极行为支持和其他形式的行为干预。虽然大多数州提供精神和行为健康，和危机服务在他们的豁免中，他们这样做的方式存在巨大的矛盾，各州之间,弃权,和服务。HCBS是确保患有IDD的人的重要安全网，尤其是那些有心理健康障碍的人，可以在他们的社区中生活和茁壮成长。
