Home and Community-Based Services: Creating Systems for Success at Home, at Work and in the Community

NASDDDS, Center on Human Policy at Syracuse University, Institute on Community Integration at the University of Minnesota, and the Human Services Research Institute (2015) 

The National Council on Disability (NCD) released a paper entitled “Home and Community-Based Services: Creating Systems for Success at Home, at Work and in the Community”.  This paper, authored by NASDDDS staff, in collaboration with colleagues from the Center on Human Policy at Syracuse University, Institute on Community Integration at the University of Minnesota, and the Human Services Research Institute, provides a literature review of research related to the size and nature of settings in which individuals with disabilities receive HCBS and the implications of those settings on individual outcomes.  In addition, the paper reviews the broader context for HCBS policy and practice, examining developments stemming from civil rights litigation, federal legislative and regulatory changes and self-advocate perspectives.

 

As noted in the paper, “[s]etting size is but one of several variables that must be taken into consideration in any assessment and analysis of an individual’s quality of life. However, … the data make it clear that individual and family-scale settings are significantly more likely to be community-based, while larger and congregate settings are likely to be institutional in nature.”   The paper also notes that “[s]mall, personalized, settings increase opportunities for personal satisfaction, choice, self-determination, community participation, and feelings of well-being. Small settings are similarly associated with decreases in (1) the use of services, (2) feelings of loneliness, and (3) service-related personnel and other costs.”

 

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