Initiative ~ Executive Order ~ HHS Role ~ News & Additional Resources

Delivering on the Promise
Table of Contents

U.S. Department of Health and Human Services
[Complete Report: HTML = 315K / PDF = 426K]
Table of Contents ~ Chapter I ~ Chapter II ~ Chapter III
Appendix A ~ Appendix B ~ Appendix C ~ Timeline

Self-Evaluation to Promote
Community Living for People with Disabilities

Report to the President
on Executive Order 13217

A Year of New Freedom

Since President Bush announced the New Freedom Initiative in February 2001, the Department of Health and Human Services has supported a number of efforts to enhance and improve community integration for people with disabilities. Highlights of a few of these efforts follow:

HHS COMMUNITY INTEGRATION ACTIVITIES IN 2001

February

February 15, 2001 - $113 Million to States for Caregiver Support Programs: HHS announced the release of $113 million in grants to states under the new National Family Caregiver Support Program, which helps family members provide care for the elderly at home. The grants will be used by states to run programs that provide critical support, including home and community-based services, to help families maintain their caregiver roles.

February 25, 2001 - $50,000 per state for Community Integration "Starter Grants": HHS announced the availability of $50,000 "Starter Grants" to each state and territory on request. The grants were designed to pay for the development of public-private partnerships, including consumer task forces, to advise on the use of federal grants to develop systems to improve community-based services for people with disabilities. Fifty-four of 56 states and territories applied for and received a grant.

March

March 2001 - $20,000 per State to Develop Coalitions on Community-Based Care for Persons with Mental Illness: SAMHSA announced the availability of grants to support an initiative to develop state coalitions to promote community-based care for persons with mental illness. As of June 2001, 43 states received awards to assist them in developing and enhancing state coalitions addressing the Olmstead decision. The role of the National Coalition is to provide technical assistance to state coalitions on establishing guidelines and recommendations, identifying models, best practices and technical assistance resources, and disseminating information on Olmstead implementation and effective community integration plans.

March 26 and 27, 2001 - National Blueprint for Addressing Mental Health Discrimination and Stigma: SAMHSA sponsored "Spring to Action: A National Mental Health Symposium to Address Discrimination and Stigma." With more than 400 mental health experts and consumers attending, a blueprint for action was developed that states and local communities can use to address discrimination and the effects of stigma on lives of people with mental illness by fostering community acceptance and living.

April

April 2001 - New, More Flexible Eligibility Rule in Medicaid: A new rule went into effect allowing states greater flexibility in determining Medicaid eligibility and permitting states to disregard portions of an applicant's income, such as income necessary to pay for essentials such as food and housing. Under previous rules, people in institutions could qualify for Medicaid coverage at much higher income levels than if they lived in the community, creating an "institutional bias."

May

May 24-25, 2001 - Four New Grant Initiatives Announced at National Conference on Community Integration: CMS hosted a national conference to promote more integrated, community living for persons of all ages with disabilities. At the conference, four new grant initiatives, collectively entitled "Systems Change Grants for Community Living," were formally announced. More than 500 participants, including state and federal representatives, advocates and consumers, shared information and ideas in the common goal of reform of community long-term support systems.

June

June 2001 - National Conference Highlighting Pilot Programs for Consumer-Directed Care: ASPE sponsored a national conference, entitled "Independent Choices," in conjunction with the Robert Wood Johnson Foundation and AARP to highlight pilot programs for consumer-directed care.

June 2001 - Health Disparities and Mental Retardation Initiative: HHS launched a Surgeon General's Initiative on Health Disparities and Mental Retardation to identify critical challenges and develop a national action plan to promote the health of individuals with mental retardation so that such individuals can live, go to school and work in their communities. Elements of the initiative include: a dedicated Web site; a Surgeon General's Listening Session on Health Disparities and Mental Retardation on October 10, 2001; a national conference on December 5-6, 2001, in Washington, D.C.; and products that will include a national action plan, a report on the proceedings of the conference, and a monograph describing models of existing programs providing health care services to individuals with mental retardation.

June 28, 2001 - $8 Million in Alzheimer's Disease Demonstration Grants: HHS announced the award of more than $8 million in grants to 25 states to develop effective models of care for people with Alzheimer's disease and their families. The Alzheimer's Disease Demonstration Grants to States Program, administered by AoA, seeks to expand the availability of diagnostic and support services for people with Alzheimer's disease, their families and caregivers, as well as to improve the responsiveness of the home- and community-based care system to people with dementia.

July

July 11-13, 2001 - National Olmstead Policy Workshop: AHRQ held a national workshop for state and local policymakers entitled "Beyond Olmstead: Making Community Based Services Work for All Persons with Disabilities." The workshop provided participants with tools to improve their ability to work collaboratively with consumers, providers, advocates and others on accurately assessing consumer needs and planning for successful transitions from institutions or increasing the types and level of support for persons already living in the community.

July 16, 2001 - Section 8 Vouchers National Teleconference: OCR and HUD sponsored a toll-free, nationwide conference call on "Understanding HUD's Section 8 Vouchers." The conference call, which attracted 681 participants, was designed to assist states, consumers and others involved in Olmstead implementation with information that can help address the critical shortage of accessible, affordable rental housing for people with disabilities, best practices for maximizing choice and consumer control, and strategies for expanding access to Section 8 vouchers for people with disabilities.

July 25, 2001 - Creation of Interagency Council on Community Living: Secretary Thompson convened representatives from seven federal agencies to celebrate the 11th anniversary of the ADA. At an event in the HHS Great Hall, at which Department of Labor Secretary Elaine Chao, Department of Education Secretary Rod Paige, and other high-ranking officials participated, Secretary Thompson announced the creation of the Interagency Council on Community Living. Following the event, HHS' Deputy Secretary Claude Allen convened the council's first meeting.

July 25, 2001 - $9 Million in Grants to Support Employment of People with Disabilities: HHS announced $9 million in grants to 18 states to help people with disabilities to become and stay competitively employed. The grants enable states to increase services and supports to workers and help others return to work without fear of losing health coverage. States can use the funds to build systems that provide personal assistance and supports, to reach out to people with disabilities, to train staff in new employment possibilities and to improve transportation or other support programs.

August

August 5-7, 2001 - Conference on Community-Based Care for Persons with Mental Illness: SAMHSA convened the 2001 National Technical Assistance Annual Mental Health Block Grant Conference for state mental health planners. The conference, "Partnerships for Integration: Strategies for Serving Individuals and Families," included topics on the Olmstead decision and National and State Coalitions to Promote Community-Based Care for Persons with Mental Illness.

August 13, 2001 - Promising Practices for Children with Serious Emotional Disturbances: SAMHSA released three new volumes of promising practices for families, communities and caregivers to help build exemplary systems of care for children with serious emotional disturbances and their families.

August 23-24, 2001 - Product Standards and People with Disabilities: FDA undertook an initiative to develop and revise guidelines to address the needs of older persons and persons with disabilities when developing standards.

September

September 6-7, 2001 - National Conference on Family Caregiver Support Program: The Assistant Secretary for Aging of HHS hosted "The National Family Caregiver Support Program: From Enactment to Action" conference to highlight the exciting new federal program that provides grants to states to serve the family caregivers of the growing population of older persons. More than 700 representatives of the nationwide network of state and area agencies on aging, tribal organizations and service providers attended the conference.

September 10-12, 2001 - Promoting Community Integration via PACE: CMS unveiled a new format to help states adopt Program for All-Inclusive Care for the Elderly (PACE). CMS hosted a conference to enable the sharing of information as to how states may adopt PACE to promote community living. In November 2001 CMS approved the nation's first application for permanent provider status under Medicaid and Medicare.

September 24-26, 2001 - Training for State Olmstead Coordinators: SAMHSA held the first annual Training Institute for State Mental Health Olmstead Coordinators. Technical assistance on coalition-building strategies to promote consumer and family involvement in Olmstead-related planning and incorporation of evidence-based practices was provided to participants.

September 25, 2001 - $5 million in Native American Caregiver Support Program Grants: HHS announced nearly $5 million in grants to 119 tribal organizations to implement the new Native American Caregiver Support Program. Grants were awarded to 110 tribal organizations to provide families of Native American and Native Hawaiian elders with access to information, respite care, counseling, training and supplemental services to help them meet their real-life caregiving challenges. In addition, nine tribal organizations each received $100,000 demonstration grants to develop and evaluate model caregiver support programs.

September 28, 2001 - $64 Million for States to Undertake Systems Change for Community Living: HHS announced approximately $64 million in new grants to 37 states and one territory to develop systems to change community-based reform programs for people with disabilities or long-term illnesses. The funds are part of four grant programs:

• $40.8 million in "Real Choice Systems Change" grants to help states design and implement effective and enduring improvements in community long-term support systems to enable children and adults with disabilities or long-term illnesses to live and participate in their communities;
• $7.6 million in "Community-Integrated Personal Assistance Services and Supports" grants to support states' efforts to improve personal assistance services that are consumer-directed or offer maximum individual control;
• $11.1 million in "Nursing Facility Transitions" grants to help states transition eligible individuals from nursing facilities to the community; and
• $4.9 million in "National Technical Assistance Exchange for Community Living" grants to provide technical assistance, training and information to states, consumers, families and other agencies and organizations.

October

October 1, 2001 - Children with Special Health Care Needs: National Child Health Day focused on the theme: All Aboard the 2010 Express: A 10-Year Action Plan to Achieve Community-Based Service Systems for Children and Youth with Special Health Care Needs and their Families. HHS mailed more than 5,000 kits to states and communities to help them plan events around this theme. On November 19, 2001, a national event in Broward County, Fla., for Child Health Day showcased the efforts of one Community of Excellence to put in place a family-centered, comprehensive, coordinated system of care for children and youth with special health care needs.

October 1, 2001 - $6 Million for Innovative Approaches to Family Caregiver Support Program Grants: HHS announced, as part of the National Family Caregiver Support Program, approximately $6 million in grants for 34 projects to develop innovative approaches to assist families and informal caregivers of older persons as well as grandparents and older relatives who are caregivers of children. Grants were awarded to state and area agencies on aging, nonprofit community service providers, institutions of higher learning and national organizations with demonstrated expertise in aging and caregiving issues. The five priority areas that grants focus on are: systems development; service components; linkages to special populations and communities; field-initiated demonstrations to develop and test new approaches to support caregivers; and national projects that enhance the development of caregiver programs.

October 22, 2001 - $5 Million to Enhance Community Living through Prevention of Secondary Conditions: HHS announced the availability of $5 million in competitive funds to develop and enhance the capacity of states to address the health and wellness of people with disabilities to prevent secondary conditions. These awards will enable states to enhance access for people with disabilities to preventative health and social programs, increase participation in community services and enhance independent living through elimination of environmental barriers.

November

Nov. 29-Dec. 1, 2001 - Emotional Health for Persons with Mental Retardation/Developmental Disabilities: HHS held a workshop on Emotional and Behavioral Health in Persons with Mental Retardation/Developmental Disabilities: Research Challenges and Opportunities. The workshop was designed to address key questions that arise in the inclusion of persons with mental retardation in federally funded research in the United States.

December

December 12 and 13, 2001 - Summit on Children with Special Health Care Needs: A National Summit in Washington, DC, showcased community and state successes, models and best practices related to building community systems for children and youth with special health care needs. The Summit was co-sponsored by HRSA/Maternal and Child Health Bureau, Family Voices, the American Academy of Pediatrics, the March of Dimes and other organizations.

Last revised: April 21, 2002