Developing Programs and Restructuring Systems

Restructuring systems and developing programs are complex tasks that require knowledge about federal program and fiscal rules, the characteristics and needs of the individuals to be served and best practice models. Reform and development initiatives do not occur in a vacuum. Such efforts require sensitivity to fiscal realities and the points of view held by self-advocates, families, and advocates, providers, other state agencies and elected officials.

NASDDDS staff brings many years of experience from multiple states and a wide variety of systems to assist states in the design and restructuring of programs and services.

Support Is Available For

  • Restructuring and developing Medicaid HCBS waiver programs under 1915(c), (i), (j), (k) that comport with existing CMS policies and meet the state’s need
  • Developing managed care long term services and supports for people with I/DD
  • Designing self-directed services
  • Developing programs for people with co-occurring disabilities
  • Planning and execution of a facility closure initiative
  • Building person-centered practices into service system functions
  • Developing support-coordination systems
  • Developing an employment program
  • Designing a quality management system and practices
  • Reviewing documents; e.g. program proposals, policies, and waiver applications

To Request Technical Assistance

Members may contact any of the NASDDDS staff to discuss your need for assistance.

Telephone and email support is available to all member states at any time you need information, an opportunity to sound out ideas, to learn about innovative practices in other states, or to seek clarification on federal rules and policies.

Onsite technical assistance is available and can be arranged through any NASDDDS staff member. To discuss the need for technical assistance and how NASDDDS staff may be most helpful, contact Nancy Thaler, Executive Director at or 703-683-4202 or Robin Cooper, Director of Technical Assistance at or 608-231-2121.