Living Well 

Cross Site Evaluation

Volume IV 

Conclusion and Next Steps

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Living Well Cross Site Evaluation Volume IV: Conclusion and Next Steps 2

I. Conclusion

Grantees demonstrated higher levels of development during this early stage of the grant in two key areas: (1) engagement 

with self-advocates and families of individuals with individuals with intellectual and developmental disabilities (I/DD), and 

(2) building competencies and capacities of direct support professionals (DSPs).

All grantees are actively consulting and collaborating with self-advocates and families through a number of diverse 

strategies, such as surveys, in-person meetings, and leadership team positions. The evaluation team observed emerging 

practices surrounding outreach to individuals with dual I/DD and mental health diagnoses and marginalized groups, such 

as tribal populations, rural inhabitants, non-English speakers, and immigrant communities.

All grantees are developing trainings for DSPs and implementing the trainings through various methods, often with the 

use of technology and social media outlets. This demonstrates the variety of potential solutions to a systemic problem 

acknowledged across all sites. Grantees are also developing and implementing other initiatives to evaluate provider 

agencies, build DSP competencies, and develop capacities. Strategies used by grantees to build capacity within their 

states include soliciting feedback from DSPs and provider agencies to improve trainings, improving the recruitment and 

retention of DSPs in the workforce, and engaging with specialized partners to reach marginalized populations. 

While all grantees spent time during this evaluation year discussing their states’ data collection policies and methods, 

most grantees are still gathering and analyzing the appropriate data to determine baseline measures and begin developing 

strategies to address those key features. Although each of the grantees began their project work to address the key features 

from different pre-existing contexts, each has made demonstrable progress towards grant goals in the development and 

implementation of new and innovative strategies. Exhibit 1 illustrates key activities by grantee during year one of the 

evaluation.

II. Evaluation Limitations

The evaluation team acknowledges some complicating factors of the annual evaluation: 

• Early Stage in Grant Cycle. This is the second year of the grant for Cohort One (Georgia, New Hampshire, and

Virginia) and the first year of the grant for Cohort Two (Alaska, Idaho, Indiana, Missouri, and Wisconsin) out of

five total grant years. The projects are in early stages and the evaluation team acknowledges that grantees may not

fully address key features until later in the grant cycle. Additionally, the reported findings represent a point-in-time

snapshot of each grantee’s project work, and grantees likely have progressed since the information was reported or

observed by the evaluation team.

• Self-Reported Data. Data collected for this evaluation were largely self-reported by grantees based on questions

identified by the evaluation team. Therefore, the data collected may be subjective in nature and may not be exhaustive

of all activities conducted by grantees.

• Varying project design and state context. Grantees designed Living Well models that address the unique set of

factors in their state. There is variability within the ability of each grantee to leverage existing initiatives, partnerships,

and sources of funding. A range of external factors influence how grantees implement their grants, which are beyond

the scope of this evaluation.

• Multiple cohorts. Lewin is using a consistent set of data collection and analysis methods across all eight grantees

representing Cohorts One and Two. This approach may lack detailed analysis of differences between the two cohorts.

III. Next Steps

Lewin will continue to collect data from grantees across multiple methods during year two of the evaluation. The 

evaluation team will assess and refine the evaluation methods used to improve future data collection and analysis. In 

particular, the evaluation team anticipates gathering additional data from grantees and their partners related to the 

implementation of grant initiatives during subsequent evaluation years. The evaluation team will continue to collaborate 

with the technical assistance contractor and share findings with grantees to inform ongoing efforts. 
Living Well Cross Site Evaluation Volume IV: Conclusion and Next Steps 3

Exhibit 1. Key Activities by Grantee

Capacity 

Building

Partnerships

Engage new state partners

Engage specialized partners

Engagement and 

self-advocates 

and families

Reach marginalized populations

Improve supports for individuals with dual 

diagnoses and other disability types

Develop and implement trainings for 

self-advocates and families

Building 

competencies of 

DSPs and HCBS

Design and implement DSP trainings

Use technology and social media

Improve DSP recruitment and retention

Solicit DSP and provider feedback

Data Collection, 

Dissemination, 

and Monitoring

Reducing abuse 

and neglect

Use software to collect and analyze data

Monitor, certify, and improve group homes

Addressing health 

and safety Implement Medicaid waivers and statutes

Implementation, 

Evaluation, 

Sustainability

Evidence based 

practices 

for service 

improvements

Improve incident reporting system

Implement frameworks for culture change

Program and 

outcome 

evaluation

Use tools to evaluate project outcomes

Sustainability

Leverage existing grants and initiatives

Secure funding

Key Feature Activity

Cohort 1 Cohort 2 Georgia New Hampshire Virginia Alaska Idaho Indiana

Missouri

Wisconsin

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