INDEPENDENT CHOICES: A National Symposium on Consumer-Direction and Self-Determination for the Elderly and Persons with Disabilities. Coordinated Invitation to Apply for "Systems Change Grants for Community Living": Improving Community Services for Children and Adults of Any Age Who Have a Disability or Long Term Illness

Health Care Financing Administration
CFDA No.93.779, May 17, 2001


The Health Care Financing Administration (HCFA) is inviting proposals from 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:

  1. Live in the most integrated community setting appropriate to their individual support requirements and their preferences;
  2. 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; and
  3. Obtain quality services in a manner as consistent as possible with their community living preferences and priorities.

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" grant: 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 will be due in July 2001. We expect all grant awards to be made prior to October 1, 2001. States will have up to 36 months to expend these funds. Grantees are not required to provide a financial match, but a small non-financial recipient contribution from Grantees and/or a third-party "in-kind" contribution is required.

For more details and news about events relevant to these grant invitations, please periodically consult our web site at

Milestone Date Content
"New Tools" Letter January 10 This letter, addressed to State Medicaid Directors, was intended as an early alert to the new grant opportunities.
"Starter Grants" Announced February 25; Deadline June 1, 2001 These non-competitive, $50,000 grants available to each State were intended to support consumer task forces, public-private partnerships, and initial planning for the "Systems Change" grants.
Grant Solicitations Issued May  
New Opportunities for Community Living: A Systems Change Conference May 24 and May 25 This national conference is targeted towards States, consumers, providers, and advocates to share information and ideas on home and community based system initiatives.1
Letter of Intent to Apply Due June 8, 2001  
Applicant's Teleconference TBD Additional information regarding registration for this teleconference will be posted on the HCFA web site at
Application Due Dates
- Technical Assistance Exchange
- Nursing Facility Transitions
- Community PASS
- Real Choice Systems Change
July 16
July 20
July 20
July 20
Grant Period Start Date Prior to October 1, 2001
1. Information on this conference was previously distributed through the Home and Community Based Services Resource Network. For additional information go to:


The Full PDF Report available at, or can be ordered from the HHS Centers for Medicare and Medicaid Services (formerly HCFA), Web site: You will need a copy of the Acrobat Reader in order to view this Portable Document Format (PDF) report.