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Americans with Disabilities - State & Local Financing & Systems Reform (Paperback)
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Americans with Disabilities - State & Local Financing & Systems Reform (Paperback)
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The current picture of long-term services and supports (LTSS)
documented by families, policymakers, researchers, and service
providers is complex, confusing, and frustrating. It is a ship
struggling with the weight of escalating costs and an increasing
number of passengers seeking access and safe passage. Services and
supports are scattered throughout numerous federal programs, with
uncertain points of entry and different rules of eligibility
defined by geography, income level, age, and nature and type of
disability. There is no comprehensive national policy focused on
LTSS that is free from the medical model and institutional bias of
long-term care (LTC). However, at the state and local levels, there
is a push to move forward: setting new policies, reallocating
resources, testing new service delivery approaches, and engaging
individuals with disabilities and families in a public dialogue to
redesign the ship to support a consumer-responsive system that
encourages choices, seeks flexibility in service delivery, invests
in public-private colLabouration, and values the role of formal and
informal caregivers. None of the highlighted activities can offer a
comprehensive roadmap to reform of existing systems. However, each
highlighted state or local system focuses a spotlight on innovative
thinking, including policies, processes, and methods of
administration to help guide the redesign efforts for the future.
This book identifies and highlights selected activities at the
state and local levels that are leading toward increased access to
LTSS with federal and state dollars. A growing number of states are
re-evaluating their current systems to identify a range of options
for consumers to remain in their own homes or communities rather
than be forced into more restrictive environments and skilled
nursing facilities. Researchers selected five states to profile and
analysed current activities that are in different stages of
development toward the goal of comprehensive, person-centred
service and support programs.
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