This report provides an overview of 35 states’ initiatives to improve their LTC systems and includes lessons learned and recommendations that can guide states undertaking similar initiatives. Despite accomplishments and improvements, Grantees described continuing barriers including insufficient funding for home and community services; workforce shortages; lack of affordable and accessible housing and transportation; and outdated or inflexible administrative, statutory, and regulatory provisions. 

O’Keeffe, Janet; O’Keeffe, Christine; Coleman, Barbara; Greene, Angela; Brown, David; Anderson, Wayne; Osber, Deborah 

Assistive Technology; CPASS; Information and Referral; Nursing Facility Transition; Real Choice Systems Change; Stakeholder Involvement; Lack of Home and Community Services; Workforce Shortages; Consumer-Direction Program Issues; Administrative and Bureaucratic Barriers; Statutory and Regulatory Barriers; Lack of Affordable Accessible Housing and Transportation; 

Aging Issues, Consumer/Participant Direction, Developmental/Intellectual Disabilities, Physical Disabilities, Transition/Diversion from Institutions 

Promising practices, Reports 

RTI - Systems Change Evaluation 

Alabama, Arkansas, Delaware, Florida, Guam, Hawaii, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Vermont, Virginia 

04/27/2007 

Janet O’Keeffe
RTI International

jok@rti.org