Organizations that support people with disabilities are operating in a stable environment. The 1983 Section 1915(c) of the Social Security Act established the first Home and Community Based Services Waiver as a voluntary alternative to institutionalization. Consistent with that section: Eligibility is based on an individual having an institutional, nursing home, or hospital level of Eligibility that is reviewed annually. Service plans provide medical assistance consistent with written plans of care for case management services, homemaker/home health aide and personal care services, adult day health services, habilitation services, and respite care.

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