make changes in communities and outcomes are presented in Figure 1. These included changes in leadership, loss of funding, and loss of staff. Discussion Several of these challenges are presented below: Staff changes and leadership Changes in staffing affected CILs’ capacity to bring about community change. The addition of staff enabled the CILs to bring about new programs and policies; loss of staff limited their ability to do so. Data show that losses in staff occurred more frequently and had a greater impact on CILs’ capacity for change. CIL” experienced a “Smithville significant loss of employees described by staff as an including the loss of “exodus,” several directors during a one-year period. Staff time available to bring about community change suffered as the remaining employees struggled to maintain core services. Medicaid expansion (or not) State-level changes due to rejection of Medicaid expansion reduced funding for CIL services. Services such as case management were in some cases shifted from CILs to other organizations/ managed care organizations. In addition, states that engaged in aggressive reductions in state spending scrutinized and carefully reviewed spending by the CILs, leading them to become more risk-averse. Fewer community actions were taken as the focus narrowed to maintaining their ability to provide direct IL services. CILs responded to this threat by engaging communities through public education, awareness building, and voter registration. The health insurance requirements of the Affordable Care Act often led to extremely high caseloads and consumer demands for navigation assistance limited CILs’ ability to focus on new community programs and policies. Other state requirements, from Vocational Rehabilitation for example, concerning eligibility of consumers for IL support led to the loss of consumers of other IL services. Loss in funding preceded declines in implementation of community change. WIOA Law Enacted The Workforce Innovation and Opportunity Act (WIOA) was enacted in July 2014, with requirements for implementation taking place in July 2015. WIOA transferred independent living programs from the Department of Education to the Administration for Community Living within the Department of Health and Human Services. The enactment of WIOA led to some CILs increasing community changes, including by promoting voting registration efforts and disability awareness events in schools and the community. CILs are required to provide transition services (both to youth transition and from those in institutions back to community living). This new core service is required but not yet funded.
make changes in communities and outcomes are presented in Figure 1. These included changes in leadership, loss of funding, and loss of staff. Discussion Several of these challenges are presented below: Staff changes and leadership Changes in staffing affected CILs’ capacity to bring about community change. The addition of staff enabled the CILs to bring about new programs and policies; loss of staff limited their ability to do so. Data show that losses in staff occurred more frequently and had a greater impact on CILs’ capacity for change. “Smithville CIL” experienced a significant loss of employees described by staff as an “exodus,” including the loss of several directors during a one-year period. Staff time available to bring about community change suffered as the remaining employees struggled to maintain core services. Medicaid expansion (or not) State-level changes due to rejection of Medicaid expansion reduced funding for CIL services. Services such as case management were in some cases shifted from CILs to other organizations/ managed care organizations. In addition, states that engaged in aggressive reductions in state spending scrutinized and carefully reviewed spending by the CILs, leading them to become more risk-averse. Fewer community actions were taken as the focus narrowed to maintaining their ability to provide direct IL services. CILs responded to this threat by engaging communities through public education, awareness building, and voter registration. The health insurance requirements of the Affordable Care Act often led to extremely high caseloads and consumer demands for navigation assistance limited CILs’ ability to focus on new community programs and policies. Other state requirements, from Vocational Rehabilitation for example, concerning eligibility of consumers for IL support led to the loss of consumers of other IL services. Loss in funding preceded declines in implementation of community change. WIOA Law Enacted The Workforce Innovation and Opportunity Act (WIOA) was enacted in July 2014, with requirements for implementation taking place in July 2015. WIOA transferred independent living programs from the Department of Education to the Administration for Community Living within the Department of Health and Human Services. The enactment of WIOA led to some CILs increasing community changes, including by promoting voting registration efforts and disability awareness events in schools and the community. CILs are required to provide transition services (both to youth transition and from those in institutions back to community living). This new core service is required but not yet funded.