Cutler Institute

Home and Community-Based Services: Quality Management Roles and Responsibilities. Discussion Paper


This is the first in a series of papers synthesizing the ideas and practices of states as they improve the quality of home and community based services (HCBS) and supports for older persons and persons with disabilities. Building on the experiences and challenges of the QA/QI Systems Change grantees, the paper addresses four fundamental questions about quality management. The intent is to provide an account of current practice, and a structure for how states view their options. There are two parts to this document, a Discussion Paper and the Appendices, each contained in separate pdf files. The Appendices may be downloaded at

Publication Type: 
Publish Date: 
January 30, 2005