Progress with the 1915(i) Option

The Arc participated in a meeting with other advocates and DHHS staff to evaluate the potential of using the 1915(i) option to fund services for people with IDD. The “I” option is a federal program states can implement that would allow Medicaid funding to be used for Community Based Habilitation services. Currently, without the I option, the only ways to provide habilitative services through Medicaid are the Intermediate Care Facility program [state institutions and some group homes] and the Home and Community Base Waiver program [CAP / DD]. 

Click to read a letter from CMS describing the 1915(i) option

The Arc of NC has advocated strongly for the state to use this option for some time. It would allow the state to use funds spent to provide certain services for people with IDD as a match for federal Medicaid funds for the same type of services. Using this plan, the state may be able to extend services to people on waiting list with the additional federal funding., while continuing to fund all services originally provided. 

For example, if the state currently spends $10 million on a service that becomes a Medicaid service under the “I” option, that same $10 million would expand to $30 million due to the approximate 2 for 1 Medicaid match from the federal government.

Though there is a potential for expanded service, it is not guaranteed. Implementation of the I option is a complex process that will require very detailed financial modeling to avoid cost overruns and to assure that no one currently receiving state services will lose them because of this option. 

We anticipate the work group to meet several times in order for the Department to present a report mandated in House Bill 916 by the end of the year. We are encouraged by the openness of State officials to have an objective evaluation of the potential of the 1915i option, and we will work to assure that every possible avenue is examined to make this a successful reality. 

The Arc’s fundamental goal is to create a cost effective option that allows the state to expand service for people with IDD. Due to the state’s current budget situation, we recognize this must be cost-neutral with state money. As our economy improves we hope that additional funding will be available so that we could move closer to our ultimate goal of no waiting list for services for people with IDD. 

We will update members as this process continues. Thank you for your continued advocacy.