How direct support is delivered in community services.
Practice · Deep dive
A 33-year-old autistic man died Oct. 23 after police found him unresponsive as staff restrained him at a QSAC group home in East Harlem. The medical examiner will determine the cause; NYPD is investigating.
October 24, 2026 · Man dies after being found unresponsive, restrained during Harlem shelter assault call · 4 min
Practice · Safety
Pennsylvania State Police launched a statewide Blue Envelope Program Oct. 16, 2026 to help people with autism, ID or dementia communicate at stops. Envelopes are available at local PSP stations.
October 16, 2026 · Pennsylvania State Police Launch Blue Envelope Program to Support Individuals with Disabilities During Law Enforcement Encounters · 1 min
NC Medicaid revised its Legally Responsible Individual paid-caregiver toolkit for CAP/C Consumer Directed services effective Sept. 22, 2026, and posted the update Oct. 12, adding a treating-practitioner letter option.
October 12, 2026 · Legally Responsible Individual Toolkit Updated · 1 min
HOPE NC opened three supportive housing pilots for adults with I/DD in Raleigh, Durham and Chapel Hill, with a Chapel Hill ribbon cutting Oct. 13, 2026, North Carolina Health News reported.
October 16, 2026 · Three Triangle-area housing pilots offer NC blueprints for adults with disabilities · 2 min
Practice · Abuse and neglect oversight
A New Hampshire oversight council wants one 24/7 abuse and neglect hotline, shared case tracking and public provider data for DD services. DHHS has 30 business days to answer the 17-page plan, which also tells DSPs no one may talk them out of a required report.
September 29, 2026 · Quality Council Systems Review Process and Recommendations · 2 min
Practice · Practice tools
ACL refreshed a free ZIP-code search tool that lists home modification programs, funding, and local providers.
September 28, 2026 · The New Home Modification Information Network · 1 min
Practice · How the system works
Federal rules require states to protect health and welfare in I/DD services, with new HCBS incident rules due July 9, 2027. Who oversees providers, how critical incidents and ICF/IID surveys work and what fraud units do, as of September 2026.
September 27, 2026 · 42 CFR 441.302, State assurances · 5 min
Practice · How the system works
More than 1.5 million people self-directed their home care in 2023, mostly through Medicaid, with FMS handling payroll. How employer and budget authority work, who the legal employer is, and when family can be paid, as of September 2026.
September 25, 2026 · Chapter 5: Self-Direction for Home- and Community-Based Services · 8 min
Practice · Self-direction
MACPAC’s Sept. 25, 2026, briefing found unclear Information and Assistance roles disrupt self-directed HCBS. Staff floated a policy option: Congress and CMS should streamline supports under one administratively contracted entity.
September 25, 2026 · Ensuring Health and Welfare in Self-Directed Home- and Community-Based Services: Findings and Policy Option · 1 min
Practice · Employment supports
GAO finds Georgia, Pennsylvania, and Washington usually fund I/DD employment supports through VR first, then Medicaid HCBS. Providers reported delays and confusion over whether a VR closure letter is required before HCBS job coaching can start.
September 23, 2026 · Disability Employment: Providers Cited Challenges with State Coordination of Federal Funds · 1 min
Practice · Federal audit
A federal audit found 70 of 101 critical incidents in Connecticut's DDS home supports were not properly reported or recorded. HHS OIG's report, posted Sept. 22, also found missing background and registry checks; the state agreed with all four recommendations.
September 22, 2026 · Health and Safety Audit of Connecticut's Individualized Home Support Services (OAS-25-01-072) · 2 min
Practice · How the system works
The medical model locates disability in the person; the social model locates it in barriers around them. WHO's ICF blends the two, and U.S. rules mix both as of September 2026. What each model means for eligibility, support plans and a DSP's daily work.
September 11, 2026 · Towards a Common Language for Functioning, Disability and Health: ICF (beginner's guide) · 5 min
Practice · North Dakota
A June 16, 2026 OIG audit found 182 compliance failures in North Dakota I/DD residential habilitation, from late background checks to broken alarms.
June 18, 2026 · North Dakota Could Better Ensure That Providers Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 44 Residential Settings · 1 min
Practice · Practice
On June 9, 2026, the National Alliance for Direct Support Professionals issued its first full rewrite of the DSP Code of Ethics in over 25 years.
June 9, 2026 · NADSP Releases Revised Code of Ethics · 1 min
Practice · Indiana
Indiana's Family Supports waiver amendment, announced Jan. 22, 2026, requires DSPs to be on the state registry for services from Jan. 1, 2026. It also adds hourly shift notes.
January 22, 2026 · IHCP Bulletin BT202612: CMS approves waiver amendment for Medicaid HCBS Family Supports waiver · 2 min
Practice · New Jersey
New Jersey launched START Services NJ in December 2025, a crisis program for people with I/DD and mental health needs, in 11 counties. YAI runs it under a $3.2 million contract.
December 22, 2025 · New Jersey Human Services Launches START Crisis Prevention & Intervention Program for Individuals with Intellectual and Developmental Disabilities and Mental Health Needs · 1 min