New NCD Report on Aligning HCBS with the ADA & Olmstead
The National Council on Disability (NCD) recently released a report titled Home and Community-Based Services: Creating Systems for Success at Home, at Work and in the Community, which is intended to help guide state policy makers, service providers, people with disabilities and their advocates in efforts to align support systems with the Olmstead decision and the Center for Medicare and Medicaid Services (CMS) new regulations for Home and Community-Based Services (HCBS), which set limitations on the size and other certain characteristics of settings entitled to receive Federal Financial Participation (FFP) under the various Medicaid HCBS authorities. The report offers a number of recommendations for federal and state entities based on a thorough review of the legal and regulatory HCBS framework outlined by the Americans with Disabilities Act (ADA). Key findings outlined in the report include:
- 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, currently need information about setting type and size for informed decisions and guidance impacting people with disabilities.