Several ongoing efforts address the problem of measuring quality in home- and community-based services (HCBS), but there is no consensus as to what aspects of HCBS are essential to improve quality, compare service delivery models, settings, or providers, or ensure equity in service provision. In this brief, we propose a conceptual framework for quality and outcome measurement in long-term services and supports.
Reports & Publications
June 2014 marked the 15th anniversary of the United States Supreme Court’s landmark civil rights decision in Olmstead v. L.C., finding that the unjustified institutionalization of people with disabilities is illegal discrimination. While many cases are resolved without involving the courts, during the last 15 years, the lower courts have had the opportunity to apply Olmstead in a number of contexts, resulting in decisions furthering community integration for people with disabilities.
On June 27, 2013, the Senate passed a comprehensive immigration reform bill with strong bipartisan support: The Border Security, Economic Opportunity, and Immigration Modernization Act of 2013 (S.744). In the House, leadership has outlined principles for reform and considered several piecemeal bills in relevant committees. However, it remains uncertain whether legislation will move forward in this Congress and, if so, what path it may take.
The story of the rise, passage, and repeal of the Community Living Assistance Services and Supports (CLASS) Act has, to a large extent, neglected political context. Most accounts have focused on perceived flaws in the design of the program, such as its voluntary nature or absence of underwriting.
Over the past two decades, major efforts have been undertaken to expand access to Medicaid home and community-based services (HCBS) for the elderly and disabled. Despite this, many states still have long waiting lists for HCBS. Using data collected, this study examined the trends in Olmstead and related cases against states between 1999 and 2011. The findings show there were 131 cases filed during the period, and 90 cases were resolved through court rulings and settlements.