NCD: Creating Systems for Success at Home, at Work and in the Community

The National Council on Disability (NCD), an independent federal agency, in a cooperative agreement with the National Association of State Directors of Developmental Disabilities Services (NASDDDS), released "Home and Community-Based Services: Creating Systems for Success at Home, at Work and in the Community" online Tuesday, February 24, 2015.

Main Content

The new report offers a number of recommendations for federal and state entities from a thorough review of the legal and regulatory home and community-based services framework outlined by the Americans with Disabilities Act and the new HCBS regulations.

The bearing of setting size and configuration on the quality of supports and services received by people with intellectual and developmental disabilities and individuals with mental health disabilities in home and community-based arrangements is the focus of the findings.

"The legal mandate shifting service delivery for people with disabilities away from institutions to home and community settings is unequivocal," said Joan Durocher, NCD's Director of Policy.

"Yet, transitioning from institutional to more individualized, person-centered settings integrating people with disabilities into the community continues to challenge policymakers, providers, and stakeholders alike. Ensuring that the size of, and type of, supports and services for people with disabilities are aligned with best practices is essential. 'Home and Community-Based Services: Creating Systems for Success at Home, at Work and in the Community' details factors that can make a crucial difference between meaningful integration or segregation in the delivery of HCBS."

Key Findings:

• States have been offered federal financial incentives to shift away from institutional services and towards HCBS;
• Many states continue to deliver services through HCBS funding authorities that are not meaningfully integrated into their communities and do not meet the new federal standards;
• HCBS systems should provide clear incentives to providers to deliver residential, day and employment services within small or individual settings scattered throughout the community;
• Under the new rule, states will need to shift funding away from settings currently funded as HCBS that are institutional in nature; and
• Stakeholders, including state legislators and policy makers current need information about setting type and size for informed decisions and guidance impacting people with disabilities.

To read the full report, visit NCD online at: www.ncd.gov/publications/2015/02242015