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June 2009 Symposium

Home and Community-Based Services:
Examining the Evidence Base for State Policymakers

A one-day symposium convened on
Thursday, June 11, 2009

The Hilltop Institute sponsored its sixth day-long symposium at which national experts discussed the measures and evidence to examine whether the expansion of home and community-based services (HCBS) has produced desired outcomes (quality, choice, cost, satisfaction, and safety) in the long term for older adults and persons with physical disabilities. This symposium moved beyond widespread praise for HCBS in order to assess the breadth and depth of evidence that HCBS is effective. For all supporters of HCBS, this type of clear-eyed focus is necessary to confront the reality that HCBS continues to be underfunded (relative to institutional care), at least in part, because many state policymakers remain unconvinced that the evidence base exists to support further transformative state investments in broad rebalancing efforts. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. More than 130 policymakers, health services researchers, and health care practitioners from across the country participated in the event.

Symposium Proceedings

Symposium Brochure

Speaker Biographies

Symposium Pictures

Keynote: Creating the Analytic Framework. to Understand and Evaluate. Home and Community-Based Services (HCBS)


Susan Reinhard



Martha Roherty
Session 1: Effectively Assessing Quality in HCBS


Gale Arden

  Walter Leutz Presentation


Cynthia Woodcock
Session 2: Assessing the Performance of Consumer-Directed and Tailored Service Initiatives within HCBS


William A. B. Ditto

  Randall Brown Presentation


Stephanie Cannon-Jones
Luncheon: The Evolving HCBS Landscape: Challenges, Solutions and Recommendations
Speaker: Carol Raphael Presentation
Session 3: Effectively Targeting Candidates for HCBS


Leslie Hendrickson

  Kathy Leitch Presentation


Anthony Tucker

Session 4: Determining whether HCBS is Cost-Effective


H. Stephen Kaye

  David Grabowski Presentation
  Peter Arno Presentation


Stacey Mazer


Henry Claypool