Community Inclusion

The authors of this report conclude that in the 10 years since the Olmstead decision, there has been little national (though some individual state) progress moving people with disabilities out of nursing facilities and public institutions and into communities with supports. The report includes an overview of Olmstead, institutional data, and recommendations for improvement.

Are MIGs assisting individuals with disabilities to become employed? An annual GPRA report has been produced since 2007. This report builds on previous work, and shows the continued impact of MIG funding in 2008 on programs and services that facilitate employment among individuals with disabilities. As the MIG program approaches the end of its authorized period, many states are committing to evaluating the programs, documenting their impacts, and sustaining the efforts beyond 2011.

Forthcoming legislation provides an opportunity to improve specialized transportation services, particularly those funded by the Federal Transit Administration. This report recommends that policymakers take steps to strengthen coordinated planning, increase support for mobility management, and improve data collection and reporting on these services. Also included is a link to a table delineating key characteristics of the FTA Programs and some background papers.

What are the housing challenges facing older adults? Find out in this report that also explores strategies to better enable older adults to age in place or in their community. It discusses accessible, safe, and affordable housing, access to social services and transportation, and housing models that help to allow aging in place. Also included is a link to an online toolkit, and a series of fact sheets on housing for seniors.

Learn about innovative practices that aim to improve the recruitment, training, and retention of direct-care workers. This online collection of profiles was created to help providers learn from one another. The growing collection of practices profiled are among the best examples of the “quality care through quality jobs” school of thought.

Explore how this state deals with Assessments, Level of Care, Money Follows the Person and other policies through their comprehensive online HCBS Case Management Manual. Included are detailed information on services, units and rates, and forms. Find an online index to the manual, where each link loads a separate Word document with detailed information on the item.

According to the authors, transforming Medicaid’s LTC programs is an urgent priority given states’ challenging fiscal environment. Based on this paper’s model, more than 35 percent of a state’s budget will be needed for Medicaid by 2030, of which half will be for LTC services. The brief examines Medicaid expenditures for LTC, in both institutional and community settings, and presents ideas for consideration for states to transform their programs to help address budget constraints.

The Affordable Care Act (ACA) includes the extension of the MFP Demonstration Program for an additional 5 years. This letter provides background about the MFP Demonstration Program, explains improvements made by the ACA, details how the ACA will impact current MFP grantees, and provides preliminary information for non-participating States that may be interested in pursuing new funding.

Find useful tools to help you advocate for participant-directed services. This toolkit offers a “Budget Myths Chart” highlighting common myths, counter-arguments, and important facts to make your case, and other helpful tools including personal stories, reports on involving program participants, and tips and examples of opinion articles suggested by policymakers and advocates.

While 1915(c) waivers are a prominent vehicle for the delivery of HCBS, they are not the only mechanism available to States. CMS developed a technical assistance paper that outlines the enrollment authorities that States may consider when designing managed HCBS programs, the review and approval process for each, and rate setting techniques that may be useful. The appendix offers a useful chart outlining the authorities, including their key flexibilities and limitations.