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The institutional long-term care sector urgently requires reforms to finally become a top-quality model of person-directed living. These solutions exist today in pockets of the sector, developed over decades of work by leaders who have long experience in designing and implementing cost-effective change. Some of these leaders are involved with the Gray Panthers, the Live Oak Project, the Center for Innovation’s Green House Project and other initiatives.

To accelerate transformation of outdated institutional models, we are proposing that HHS undertake a well-organized, 3-year national demonstration designed to transform traditional nursing facilities into vibrant homes serving individuals living with disabilities – in community settings where residents and staff can live, work and thrive.


Total funding for this request is $600,000,000. Current legislative authority for this project resides in Section 6114 and Sec. 3021 of the Affordable Care Act, enacted in 2010.

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