Fulfilling the Vision of Accessible Home and Community-Based Services (HCBS)

States play a critical role in helping people with disabilities have a choice of where and how they live, work, and enjoy their lives, as required under the Olmstead vs. LC Supreme Court decision. We bring our deep expertise with HCBS policies, services, data, quality monitoring, and performance improvement to support development of responsive and actionable Olmstead Plans and compliance with Olmstead and other legal requirements.

Engaging people impacted by HCBS policies and programs is vital to inclusive, person-centered decision-making. We center input from people who use HCBS, their caregivers, guardians, and providers via town halls, workgroups, key informant interviews, and other forums to help states and federal policy makers co-create and implement transparent and lasting solutions.

People who use HCBS can have diverse and often complex needs, which can lead to duplication or gaps in care. We bring our knowledge of federal and state HCBS policies and programs to identify existing system strengths and gaps, and to support the design and implementation of programs, services, and trainings. We promote program integrity in every project, ensuring that programs comply with applicable requirements and efficiently use resources.

Choosing the right mix of home and community-based services can be challenging. We aim to empower people who use HCBS, their caregivers, guardians, providers, and policymakers with data and tools that support data-driven decision making. We develop toolkits, dashboards, and infographics for HCBS users, state staff, and other audiences that support informed decision-making and highlight key milestones.

HCBS systems are complex, and effective monitoring requires bringing together information about Medicaid enrollment and services, state mental health, housing, employment, experience of care, and other sources. We offer an established approach for identifying, validating, and integrating diverse data sources and calculating the metrics needed to monitor HCBS quality, including CMS’ HCBS Quality Measure Set. We work closely with our partners to help interpret results and support continuous quality improvement.

Understanding where HCBS policies and programs are or aren’t working, and why, is critical for achieving system goals and using resources wisely. From rapid, targeted assessments to comprehensive mixed methods evaluations, we have decades of experience generating and synthesizing the evidence needed to drive key decisions. We work closely with our partners to help interpret results, and communicate findings to key decision makers.