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New CMS Toolkit for Strengthening Home and Community-Based Services ("Rebalancing Toolkit")

November 3, 2020

This week the Centers for Medicare & Medicaid Services (CMS) launched a new toolkit designed for state Medicaid agencies to strengthen their infrastructure and develop robust home and community-based services (HCBS) for eligible beneficiaries. This toolkit is the latest in a series of CMS efforts to promote high quality, person-centered HCBS to safely transition older adults and individuals with disabilities back to their homes and communities, and decrease reliance on institutional care.  

The toolkit provides states with examples of innovative state models and best practices to rebalance their long-term services and supports (LTSS) programs to expand the use of HCBS over institutional services. LTSS enables millions of Americans, including children, individuals with disabilities, and older adults, to have their care needs met in a variety of settings, which are often more cost-effective than traditional institutional settings. As the primary funder of LTSS nationally, Medicaid plays an important role in supporting state efforts to achieve a more equitable balance between the share of spending and use of services and supports delivered in individuals’ homes and communities as compared to institutional care.

The toolkit identifies promising state models and practices for strengthening state infrastructure to increase transitions from institutional settings to community-based settings; prevent or delay institutionalization; and improve community living for individuals eligible for Medicaid HCBS.

The toolkit contains four modules that provide: 

  • State strategies to increase the share of LTSS provided in community-based settings;
  • Tools designed to assist states with policy and programmatic strategies;
  • Case studies of innovative programs and creative ways states are leveraging available federal authorities to transform LTSS systems; and
  • Links to relevant resources.

States continue to be at the forefront of innovation in designing new models for the delivery and financing of LTSS. CMS supports state efforts to help older adults and people with disabilities to access care and services at home and in other community settings, so they may live their lives with as much dignity and independence as possible. CMS is committed to helping states to strengthen and enhance their LTSS systems, and ensure that Medicaid beneficiaries receive high quality, cost-effective, person-centered services in the setting of their choice.

View the Long-Term Services and Supports Rebalancing Toolkit.

View the Long-term Services and Supports (LTSS) Rebalancing Toolkit Fact Sheet.

Last modified on 11/18/2020

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