Reflections on the NASUAD 2014 HCBS Conference

As population demographics continue to shift, long term services and supports are increasingly important to improve health and quality of life for individuals of all ages and abilities. A key component of long term services and supports are home and community-based services (HCBS), which provide opportunities for individuals, including people with disabilities and chronic conditions, to receive services in their own homes or communities.

As a member of the New Editions Money Follows the Person (MFP) Technical Assistance (TA) Center, I work to support states as they focus on improving and expanding HCBS through Medicaid waivers. In September, I joined several other MFP TA Center team members at the 2014 National Association of States United for Aging and Disabilities (NASUAD) HCBS conference in Crystal City, VA. The annual conference is a not-to-be missed learning opportunity where colleagues at the federal, state and local levels come together to discuss innovations, successes, strategies, and challenges in the field of HCBS. I left the 2014 HCBS Conference feeling energized with a boatload of good ideas to help propel my work forward.

I attended many excellent workshops and was particularly interested in how presenters addressed the role of technology in helping people live more independently. Advances in technology and its innovative use to address a wide variety of challenges can improve health outcomes while decreasing the cost and resource intensity of services and supports traditionally associated with HCBS. For example, monitoring devices requiring individuals to check in each day can now send alerts to a designated circle of contacts.  This is a proactive approach that accomplishes the goal of ensuring an individual is safe, without the stigmatization of other systems (“I’ve fallen and can’t get up” has become a punchline).  Staff in Georgia said for less than the cost of providing traditional HCBS to two people, they can now monitor over 20,000 individuals using an app that piggy backs on phone systems that many seniors already have. 

Investments in telehealth and telecare systems and devices can extend the capacity of our current health care workforce and provide people in rural areas with expertise that in the past has only been available in major metropolitan areas. Furthermore, services and supports can be provided without the travel expense and fatigue associated with traditional interventions. The quantity and quality of assistive technology increase daily. Many of these advances improve the ability of programs to provide services and supports to individuals with increased discretion and dignity, contributing to a larger sense of social participation and community integration. From utensils that allow people with tremors to feed themselves and participate in shared meals to assistive devices that help people who are unable to talk converse using voice output activation aids making conversation and community integration more achievable, the creativity of the inventors of these items is amazing.

Prior to my current role, I served as Michigan’s MFP Project Director and Project Manager for the Michigan State Planning Project for the Uninsured. Over the course of my career, I have been dedicated to improving the ability of individuals to receive high quality services and supports in settings of their choosing, not limited to the confines of institutional care. I encourage you to become aware of technology advances and take advantage of these resources to help the people you serve.  Because of technology, people continually have more options and choices.

To learn more about assistive technology, visit

To learn more about NASUAD, visit:

To learn more about HCBS, visit:

Ellen Speckman-Randall is as a Policy Analyst at New Editions and a member of the MFP Technical Assistance Center.  She previously served as Michigan’s MFP Project Director and Project Manager for the Michigan State Planning Project for the Uninsured.  Ellen has also worked in the non-profit sector as Executive Director of various associations, including the Michigan County Social Services Association and their affiliate council the Michigan County Medical Care Facilities Council, Michigan Interfaith Impact for Justice and Peace, Michigan Association of Professional Psychologists, and the American Society of University Professors, Michigan Chapter.