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Services and supports for people with mental retardation and related
disabilities are configured somewhat differently in every state.
However, there is a framework of federal laws and programs that help
shape state programs.
Most states have adopted Part C of The Individuals with Disabilities
Education Act (IDEA). IDEA Part C provides early intervention
services for children from birth until age three. Each governor
selects the program that hosts Part C. In some states it is public
education, in some the health department, in others the agency that
provides disability services, and other
variations. This program is family centered and designed to work with
infants, toddlers and their parents.
Part B of IDEA carries on from age three to when school starts. It
continues the Part C program, with a more formal education component
and is almost always part of the education system. For both programs,
there are federal funds as well as state and sometimes local funds
involved. Services are at no cost to families.
IDEA itself covers education from when school starts to (usually) 22
years of age. Each student is to receive an individualized program of
education in the least restrictive setting possible.
Services for adults are mostly funded through Medicaid. Medicaid has
two basic types of services. For both, the State must submit a plan
to the Health Care Financing Administration. Services are provided
with a combination of state and federal funds.
Services like Intermediate Care Facility for Mentally Retarded
Persons (ICF/MR), basic health and prescription coverage, etc., can
be covered under the basic state plan. Few states cover dental care
for adults, except in emergencies.
Medicaid Waiver services are now the most prevalent form of financing
for services to adults. They vary greatly between states and are
usually administered by the state MR or MR/DD agency. They provide
for everything from group homes to supported living to supported
employment.
Also, Vocational Rehabilitation Services, funded in part by the US
Department of Education, provide for evaluations, some equipment
necessary to work, and work training and supported employment.
There are dozens of other specific programs that are available in
every state. Many have a federal source of funds and criteria.
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