Individuals with disabilities and older adults have the right to live as independently as possible within their home and community. Most people want to stay in their home and community as their support needs increase. But for some individuals with disabilities and older adults the freedom to live where and with whom they choose is lost due to barriers that prevent them from being supported in their homes and communities. These barriers include lack of affordable and accessible housing, access to transportation, employment supports, an adequate workforce to provide personal care, healthcare, and funding, as well as attitudinal and public policy barriers.
In June 2001, President Bush launched the New Freedom Initiative outlining his clear intent "to help ensure that all Americans have the opportunity to live close to their families and friends, to live more independently, to engage in productive employment, and to participate in community life." As part of this initiative, the president authorized funds for Real Choice System Change Grants to help design and implement improved ways of providing community supports and services to enable children and adults of any age who have a disability or long-term illness to live and participate in their communities. Since 2001, New Hampshire has received eleven Real Choice grants to support its efforts to support all people to live full and meaningful lives in their communities. A broad cross-disability coalition of individuals with disabilities, older adults, families, professionals and others in need of long-term services and supports has been developed to guide the work of New Hampshire's Real Choice projects.
The Real Choice Systems Transformation project is designed to create and implement improvements in community-based care systems in order to improve health and long-term care services and supports that assist people with disabilities and long-term illnesses to live in the community. This project has been structured to
- Support NH's Medicaid Reform efforts to substantially expand access to community based consumer directed services and supports.
- Increase the percentage of people referred to and enrolled in home and community based as opposed to institutionally based services.
- Develop nationally relevant and innovative community practices that can be replicated by other states.