A Compendium of Current Federal Initiatives in Response to the Olmstead Decision. NURSING HOME TRANSITIONS DEMONSTRATION PROGRAM


Funding Organizations:

  • Health Care Financing Administration (HCFA)
  • Department of Housing and Urban Development (HUD)

Implementing Organizations:

  • Health Care Financing Administration (HCFA)
  • Department of Housing and Urban Development (HUD)
  • Office of the Assistant Secretary for Planning and Evaluation (ASPE)


The purpose of the Nursing Home Transitions Demonstration Program is to provide direct grants to states to transition people of any age from institutional living arrangements to community settings. The objective is to provide assistance to states that will lead to sustainable infrastructures for identifying persons in institutional settings who want to transition to community settings, and for developing the supports and services required for such persons to successfully transition back into community life.


While there has been a significant expansion in services and supports for persons with disabilities of all ages living in community settings, there are still a significant number of persons who reside in nursing homes and other institutional settings due to the lack of community-based supports that meet their needs. Many of these persons require a broad range of supports in order to successfully transition back into community life, including placement planning, housing assistance, individual counseling, medical assistance, assistance with application for public benefits, home modifications, help with assistive devices, transportation assistance, employment assistance and assistance with establishing networks of informal supports of family and friends. Thus, in 1998, HCFA and ASPE implemented the Nursing Home Transitions Demonstration Program, which provides flexible funds to states to develop programs that have the specific goal of transitioning persons living in institutions back to community life.


Since 1998, HCFA and ASPE have awarded a small number of Nursing Home Transitions Demonstration grants to states on a competitive basis. In 1998, four grants of $150,000 each were awarded to Colorado, Michigan, Rhode Island, and Texas. In 1999, four additional grants of $500,000 each were awarded to New Jersey, New Hampshire, Vermont and Wisconsin. In the year 2000, four more grants of $500,000 each were awarded to Arkansas, Florida, Nebraska and Pennsylvania.

In 2001, Congress significantly increased the funding level for the program, which was also renamed the Nursing Facility Transitions Program, and expanded the program to include Independent Living Partnership (ILP) grants, which will provide funding directly to Independent Living Centers (ILCs) for establishing nursing home transition programs. As part of HCFA's Systems Change Grants for Community Living initiative, approximately $8-$13 million in HCFA funding will be awarded to 10-18 states for Nursing Facility Transitions programs, and another $1-$2 million in grants will be awarded to ILCs under the ILP component of the program.

In addition, HCFA and HUD are collaborating to develop mechanisms for linking HUD resources, such as HUD Section 8 vouchers, with the Nursing Home Facilities Demonstration grants. Additional information on the specific mechanisms by which housing assistance will be made available to persons with disabilities who are transitioning from institutional settings to community life through the Nursing Facility Transitions will be communicated to the FY 2001 grantees in the future.

Contact Information:

Thomas Shenk, Disabled and Elderly Health Program Group, Health Care Financing Administration, 7500 Security Boulevard, MailStop S2-14-26, Baltimore, MD 21244-1850, (410)786-3295

Gavin Kennedy, Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, H.H. Humphrey Building, Room 424E, 200 Independence Avenue, S.W., Washington, D.C. 20201, (202)690-6443

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