This study examined service utilization and expenditures for individuals with ID living at home and in the community in California in 2004-05. The Anderson model was used to examine the effects of need, predisposing and enabling factors, provider supply, population characteristics and geographical variation. State client assessment, supply, and population data were used to examine client utilization and expenditues. Using logit regression analysis of secondary data on 175,595 individuals assessed by state regional centers, 21 percent did not receive any services. Controlling for client needs, individuals age 3-21 and all racial and ethnic minority groups were less like to receive any home and community based services. The supply of intermediate care facilities for habilitation and residential care reduced the likelihood of service use. OLS regression models on expenditures for those who received services found that younger individuals and all racial and ethnic minority groups had significantly lower expenditures. Provider supply, area population characteristics, and regional centers predicted variation in service use and expenditures. The wide variation both the access to services and expenditures for services by region was a concern. The disparities by age, race/ethnicity and geographic area need to be addressed in future studies and by state policy makers.

Benefits and Learning Objectives
Understand age and race disparities for the developmentally disabled