This part of the PAS Center website reports ways in which states have obtained grant funding to reform Medicaid home and community-based services (HCBS). This report compliments information on Systems Change Grants ('Federal Systems Change Grants to States and Territories: 2001-2004') because it describes other funding opportunities for states from Federal sources, either within the Health and Human Services Department or in other Government departments. The funding mechanisms in this report either supplement HCBS developments (e.g. housing initiatives) or have been designed to support a specific population group (e.g. older people) to live in the community. Funding mechanisms that focus on other aspects of supporting people to live independently (e.g. employment) are not included in this report.

The support to facilitate community integration provided by Federal sources may pre-date the Supreme Court Olmstead ruling in 19991 although there has been an increase in activity post-Olmstead, largely due to the establishment of the New Freedom Initiative in 2001 (see 'Federal Policy Context', below). Federal government departments are also providing assistance to states in other ways, such as technical assistance, training and information. The extent of federal support differs so progress in areas that are key to community integration (e.g. transport) or for some population groups (such as people with mental illness) varies across states. The National Council on Disability has criticized this variation in progress.