Special Needs Community Impact: Transition to Independence Act Legislative Update

 In Special Needs Planning
Texas State Capitol building located in Austin, Texas, USA.

Texas State Capitol building located in Austin, Texas, USA.

Last month, the Transition to Independence Act (S. 1604) was introduced by Senators Chuck Grassley (R-Iowa), Ron Wyden (D-Oregon), and Robert Casey (D-Pennsylvania.  This bipartisan bill aims to promote “self-determination, independence, productivity, and integration and inclusion” for persons with disabilities.  Let’s break it down for the highlights.


  • Medicaid is the largest program to support persons with disabilities by providing primary health care, home-based care, and community-based care.
  • We have a public policy of integration – specifically, to encourage individuals with disabilities to connect within their communities and have integrated employment.


We do not encourage this public policy because Medicaid funding to states is not linked whatsoever to providing better outcomes for individuals with disabilities.  Further, because investing in the necessary changes that will bring about better outcomes is quite costly, there is actually a financial disincentive for states to make improvements.  In addition, because the long-term result of achieving better outcomes for the individual actually saves Medicaid funds, a second financial disincentive exists because any unused monies from a state’s Medicaid funds must be returned to the federal government.


Incentivize the resources of the Medicaid Program for Medicaid Buy-In states in order to establish better outcomes for individuals with disabilities (As of April 2014, only Alabama, Florida, Hawaii, Tennessee & the District of Columbia do not have a Medicaid Buy-In program)


If passed, the program would be tested during a 5-year period in which 10 flagship states would be provided financial incentives if and when that state meets certain benchmarks for integration of disabled persons in their communities and in their employment opportunities.

The two mandatory benchmarks:

  • There must be a reduction of segregated programs, and
  • There must be increased participation in individual integrated employment.

Some examples:

  • The state agrees to cease new congregate housing placements (in congregate housing, an individual or family has a private room, but shares common areas with other residents)
  • The state grows the workforce that serves individuals with disabilities
  • The state improves interagency collaboration so that the healthcare services, long-term support services, housing services, education services, transportation services and workforce training services come together to maximize the outcome of the individual with a disability.


The bill aims to be “budget-neutral” for the federal taxpayer by essentially allowing the state to retain Medicaid funds that are saved by the state as a result of improvements the state has made in successfully implementing the policy of integration.


This legislation is already an important achievement because it has shined a light on the need for greater integration and better employment opportunities for people with disabilities.   However, this legislation to have an even greater and lasting impact on the Special Needs Community – but that can only happen if the Transition to Independence Act (S. 1604) passes. 

Click here if you would like to express your support for this bill, or call your state congressional leaders.

Community Support for the Transition to Independence Act includes:

American Association of People with Disabilities

American Association on Health and Disability

American Network of Community Options and Resources

  • Christian Opportunity Center
  • Hope Haven
  • Opportunity Village
  • Hills & Dales
  • New Hope Village
  • Exceptional Persons Incorporated

Autism Speaks

Autistic Self Advocacy Network

Muscular Dystrophy Association

National Adult Day Services Association

National Association of State Directors of Developmental Disabilities Services

National Association of States United for Aging and Disabilities

National Down Syndrome Congress

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