ANCOR members provide an array of long term services and supports (LTSS) to people with disabilities and their families in a variety of settings in communities throughout the country.
LTSS can include services such as employment supports, vocational training, day habilitation, family and individual supports, care coordination, service coordination, and transportation. It can also include residential supports provided in a variety of settings such as one’s own home or apartment, very small homes with staff support, adult foster care and shared living arrangements, and community Intermediate care facilities (ICF-ID).
Medicaid also funds long term services and supports in large congregate settings such as state operated institutions and nursing homes. However, class action lawsuits dating back to the 1970s, the integration mandate of Americans with Disabilities Act and Supreme Court ruling in the landmark Olmstead decision have resulted in LTSS provided in community settings for most people with disabilities.
ANCOR is at the forefront of the development of Home and Community-Based Services (HCBS) waivers and state plan options that provide people with disabilities quality alternatives to institutional services.
HCBS first became available in 1983 when Congress added section 1915(c) to the Social Security Act, giving states the option to receive a waiver of Medicaid rules governing institutional care. In 2005, HCBS became a formal Medicaid State plan option. Several states include HCBS services in their Medicaid state plans. Forty-seven states and the District of Columbia are operating at least one 1915(c) waiver.
Federal authorities for State home and community based services options include: