A Compendium of Current Federal Initiatives in Response to the Olmstead Decision. HEALTH CARE FINANCING ADMINISTRATION SYSTEMS CHANGE GRANTS

07/10/2001

Funding Organization:

  • Health Care Financing Administration (HCFA)

Implementing Organization:

  • Health Care Financing Administration (HCFA), Disabled and Elderly Health Program Group (DEHPG)

Purpose:

As part of the FY 2001 Department of Health and Human Services budget, Congress specifically appropriated $70 million for "Systems Change for Community Living" grants that will assist states and others, in partnership with their disability and aging communities, to design and implement effective and enduring improvements in community long-term support systems. These systemic changes will be designed to enable children and adults of any age who have a disability or long-term illness to:

  • Live in the most integrated community setting appropriate to their individual support requirements and their preferences.

  • Exercise meaningful choices about their living environment, the providers of services they receive, the types of supports they use and the manner by which services are provided.

  • Obtain quality services in a manner as consistent as possible with their community living preferences and priorities.

Background:

Medicaid home and community-based services play an increasingly critical role in enabling individuals of all ages who have a significant disability or long-term illness to live fuller, more self-directed lives in their own homes and communities than ever before. Despite continuing progress on this front, however, states wishing to improve the availability and quality of these services still face significant challenges. Accordingly, Congress and the Administration have envisioned a new grant program to assist states and the disability and aging communities to work together to find viable ways to expand such services and supports. The Systems Change grant funds are meant to be used to bring about enduring system improvements in providing long-term services and supports, including attendant care to individuals in the most integrated settings appropriate to their needs.

Description:

Four distinct grant solicitations comprise the "Systems Change for Community Living" grants that are the subject of this coordinated invitation. They are:

  • "Nursing Facility Transitions" grants: HCFA is making available between $10-$14 million to help states transition eligible individuals from nursing facilities to the community. Two types of grants are offered: "State Program" grants will be made to support state program initiatives; "Independent Living Partnership" grants will be made to selected Independent Living Centers (ILCs) to promote partnerships between ILCs and states to support nursing facility transitions.

  • "Community-Integrated Personal Assistance Services and Supports" grants: Personal assistance is the most frequently used service that enables people with a disability or long-term illness to live in the community. Grants totaling $5-$8 million are available to support states' efforts to improve personal assistance services that are consumer-directed or offer maximum individual control.

  • "Real Choice Systems Change" grants: The goal is to help design and implement effective and enduring improvements in community long-term support systems to enable children and adults of any age who have a disability or long-term illness to live and participate in their communities. Approximately $41-$43 million is available in direct grants to states.

  • "National Technical Assistance Exchange for Community Living" grants: This national technical assistance initiative will provide technical assistance, training, and information to states, consumers, families, and other agencies and organizations. Funding for the technical assistance will range from $4-$5 million. Grant applications are due to HCFA in July 2001.

Grant awards will be made prior to October 1, 2001. States will have up to 36 months to expend their funds.

Contact Information:

Additional background information on the Systems Change grants is available on the HCFA website at: http://www.hcfa.gov/medicaid/systemschange.

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