Summary: Over 100,000 people with developmental disabilities live in Medicaid funded institutions and group homes across the United States. State Medicaid policies determine group home residents’ ability to take leave for overnight family visits and other purposes. Overnight home and community visits improve quality of life, strengthen family ties, and are consistent with provisions of the federal Americans with Disabilities Act of 1990 that uphold individuals’ rights to receive services in the most inclusive setting.
The Arc of the District of Columbia undertook a review of state leave policies for Medicaid funded group homes in response to requests for help by parents of adult DC residents with developmental disabilities. These parents were finding the District’s current policy, which only permits up to 18 leave days per year, to be woefully inadequate. The Arc of DC found that the District has one of the most restrictive, least family-friendly leave policies in the nation, ranking 46 th among states. Unlike the District, most states either place no limits on home visits or cap home visits at a much higher level, permitting an average of up to 44 days of leave per resident per year. States typically reimburse for up to 14 days in a row when a resident is hospitalized (with no annual limit on hospital stays).
District of Columbia officials can support residents with disabilities and their families in a cost-neutral manner by expanding DC’s leave policies to conform with state standards. Although the District plans to offer Medicaid group homes residents more individualized, community living, the Medicaid waiver that will fund this new model is currently being rewritten. It will be several years before the waiver has the capacity to assist all of the 838 District residents currently living in Medicaid group homes. Providing more leave days now will improve the quality of life of group home residents immediately and will also support transition to community living by giving residents opportunities to spend time with their families in the community.
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