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The Evolution of HCBS

Hello Friends,


As we close out this year and look ahead to the new one, it's a time for reflection.


We’re in the business of caring for those with disabilities because we’re passionate about helping our clients live the best lives possible. We hope sharing the history of HCBS is a reminder of how important Service Providers and DSPs are to the community, and ultimately serve as a thank you for doing all you do!


Before HCBS

Before the 1980s when states started providing waiver services, individuals with developmental disabilities or chronic illnesses were often institutionalized in large facilities. Home and community-based services were designed to keep people, healthy and safe. This was necessary to ensure a safe transition from institutional care to home and community-based care.


Medicaid Waivers

Medicaid Waivers were introduced in 1981, which allowed federal Medicaid funds to support individuals who would traditionally be institutionalized in nursing homes or other facilities, to receive care in their homes or communities. As client needs progressed, so did the waivers. The original MRDD waiver was replaced by the NOW waiver. There's the ROW waiver, EDA waivers, Children's Choice waiver, and others. Over the years we have seen the language, become more inclusive.


Americans with Disabilities Act (ADA)

In 1990, the Americans with Disabilities Act was passed. The goal was to eliminate discrimination against people with disabilities and promote their full participation in society. This legislation not only paved the way for greater inclusivity in various aspects of life but also influenced the development of HCBS by emphasizing the importance of community integration.


Balancing Choice with Independence

Over the last 40 years we have seen the transition of individuals living in institutions and being hidden from society, to being loved and contributing members of our communities. This will continue with person-centered care, evolves support and assistance to include the individual's preferences, aspirations, and goals.


The Future of HCBS

Efforts are being made daily to strike a balance between ensuring safety and autonomy to finding dignity in risk by empowering individuals to make choices so they can live their best lives. Looking ahead, this will continue and be easier with advances in technology, personalized medicine, and measured outcomes, which hold the potential to tailor care plans to individual needs more effectively. Policymakers, healthcare professionals, and advocates continue to collaborate to address systemic challenges and ensure that HCBS remains a cornerstone of person-centered, community-based care.


The Challenge

A few challenges remain.

  • How can we ensure our clients are meeting their goals?

  • Are they learning and moving forward in life the way they desire?

  • If a client wants to go to college or learn to water ski, or do something thought difficult, how do we ensure they are helping the client achieve?


The Solution

Using better tools and technology in a positive, inclusive way that builds team awareness will ensure continued success. Electronic Progress Notes made specifically for Service Providers is a must for streamlining administrative tasks and delivering person-centered care.


Let Cura show you how to succeed as a provider in 2024 with Cura OS.

  • Reduce paper-heavy overhead and compliance.

  • Streamline admin processes, automate compliance tasks, and

  • Ensure accuracy, improve employee retention and person-centered care.

Wishing you an amazing week and a Happy New Year!

Curtis & Your Cura Team

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