Assisted the Centers for Medicare & Medicaid Services (CMS) in accelerating its understanding of the challenges that states face related to the HCBS direct service workforce and offered potential strategies and solutions to address those challenges, including for individuals/family members hiring and managing their own direct service workers. The project also helped CMS understand and delivery HCBS to specific Medicaid-eligible populations, including youth with disabilities who are transitioning out of the foster care system, and adults with intellectual and developmental disabilities living with and cared for by aging parents and guardians.

Barbara A Kleist
Barbara A Kleist
Subcontract from
Lewin Group [Falls Church, VA]
U.S. Department of Health and Human Services


Barbara A Kleist :: Director, Entrepreneurial and Development Programs

Amy S Hewitt :: Director, Institute on Community Integration

Danielle C Mahoehney :: Community Living and Employment Specialist


Lynda Lahti Anderson :: Research Associate

Kristin Dean :: Director of Information Technology

Shawn C Lawler :: Web Developer


Amanda W Ryan :: Academic Technologist


  • Direct support workforce
    • Retention and recruitment
  • Community life
    • Consumer/self-directed services
  • Housing and residential services
    • Medicaid services (residential)