Administration for Community Living

Last week I posted an audio interview with colleague and industry thought leader, Rob Hilton, President & CEO of the A M McGregor Group.  It is my intention (or at least strong hope) that will be the first of many such informative Pub Chats in the future.  My goal is to post two-to-three interviews per month.

As a follow on to the topic Rob discussed with us – Affordable Housing Plus Services – I wanted to make sure patrons of the Policy Pub are aware of the new Administration for Community Living (ACL), as well as provide some general information and background on this new division within the Department of Health and Human Services.

In her April 16, 2012 news release, HHS Secretary Kathleen Sebelius shared the following statement:
The Administration for Community Living will bring together the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency that supports both cross-cutting initiatives and efforts focused on the unique needs of individual groups, such as children with developmental disabilities or seniors with dementia. This new agency will work on increasing access to community supports and achieving full community participation for people with disabilities and seniors.

Key objectives of the ACL include:
1. Reduce the fragmentation that currently exists in
    Federal programs addressing the community living
    service and support needs of both the aging and
    disability populations.
2.  Enhance access to quality health care and long-term
     services and supports for all individuals.
3.  Promote consistency in community living policy across
     other areas of the Federal government.
4.  Complement the community infrastructure, as
      supported by both Medicaid and other Federal
      programs, in order to better respond to the full
      spectrum of needs of seniors and persons with

At a conceptual level, these objectives should be supportive of new public policy efforts designed to integrate affordable housing, community-based services and healthcare: acute, post-acute and long-term.  Taken together, they represent a paradigm shift from a policy perspective that focuses on the “who” to the “what.”  Rather than a top down approach to providing for the variety of needs for distinct populations (e.g., elderly with chronic conditions, adults with behavioral health needs, children with disabilities), the ACL’s purpose is to transcend programmatic assistance across demographic characteristics.

If – and it is quite admittedly a very big if – the ACL can be successful in facilitating greater cooperation and improved communication by, between and among various federal, state and local agencies responsible for providing home and community based services (HCBS), the opportunities for the social integration of the populations served by those organizations is tremendous.  More importantly, the potential to develop local, community-based solutions that reflect a holistic view of individual health and wellness should – at least initially – merit our strong support, rather than a inclination to dismiss, “just another federal agency,” as I believe most of us have been prone to do.

But I will wager this: the ultimate success of the ACL will depend critically upon its ability to build productive knowledge exchanges with private sector organizations.  If successful in its mission, the ACL can help to knock down walls of bureaucratic obstruction that have historically impeded the efficient creation of community-based solutions that provide integrated services and care.  It will be the role of organizations having real world experience in planning, developing and providing HCBS, however, to work with the ACL in crafting public policy that aligns with and supports those solutions.

I think the Administration for Community Living has the potential to be a very positive step forward in addressing the tremendous challenges we face in providing affordable housing, community-based services and healthcare to our seniors.  I think it has the potential to create the type of excitement Rob Hilton shared with us in last week’s Pub Chat.  What do you think?

  ~ Sparky

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