http://goo.gl/MQBw7S
In this report, NCD reviews the research on outcomes since Olmstead, and finds that strong trends indicate that smaller, more dispersed and individualized community settings further integration and positive outcomes for individuals with disabilities. Specifically, greater individual choice, satisfaction, housing stability, and higher levels of adaptive behavior and community participation are associated with living in residential settings of smaller size. This research tends to support the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (HHS/CMS) decision to promulgate final regulations impacting all Medicaid Home and Community Based Services authorities which establish that only settings of limited size and with certain characteristics will be entitled to receive Federal Financial Participation under the various Medicaid HCBS authorities.