At the same time, the number of full time staff increased by 55% (69,494 to 107,737). The "maintenance expenditures" increased by over 100% ($353 million to $764 million).

In 1965, changes to the Social Security Act created Medicare and Medicaid and with it another major source of funding for services to people with developmental disabilities, particularly those with severe disabilities.

Again, the initial effect was to increase institutionalization of various forms and create obstacles to community living options for people with severe disabilities.

It was not until the 1980s that Medicaid became a major source of support for the kind of community living arrangements we would recognize today.

President Lyndon Johnson
Photo courtesy of PCMR report, "MR-67"<

Initially, the Medicaid program provided federal matching funds ranging from 50% to 82%, including the admission of people into nursing homes.

Key developments in the Medicaid program and its role in American's health care system.