In response to a new Federal initiative to improve the U.S. long-term services and supports (LTSS) system, this commentary discusses an array of policies and practices that could potentially improve LTSS provision by shifting from institutional to community-based services, increasing equity across populations, offering consumers more choice and control, improving conditions for workers and caregivers, and promoting improved consumer-level outcomes.
Reports & Publications
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.
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.