The Education and Inreach Team (E&I) refer individuals currently living in private Intermediate Care Facilities (ICFs) to the Community Transitions Waiver Team. That team then works with the individual and their guardian(s) to transition into Home and Community Based Services (HCBS). This measure is a ratio between the number of people E&I refers over to the waiver team and the amount of people who actually decide to enter HCBS.

E&I referrals include people who want to leave private ICFs, want to stay, or are simply considering their options. Many E&I referrals come from the complete closure of a private ICF, in which case all clients are referred. Respecting client choice means this measure fluctuates depending on the attitudes of E&I's referrals. Ideally, 80% of E&I referrals are people wanting to move to HCBS. 

This measure is tracked twice a year, once at the end of Q1/Q2 and again at the end of Q3/Q4.

In 2019,  the Disability Law Center and the Department of Health and Human Services began a settlement agreement in regards to private ICFs in the state. This agreements includes stipulations about decreasing the number of authorized beds in private ICFs, educating people about community-based services, and moving people into community based services. This agreement was reached at the end of 2024. The Division of Services for People with Disabilities (DSPD) continues educating and transitioning clients into home and community based services. 

One private ICF closed in 2023, four in 2024, and one in 2025.

The decrease during 2025 can be explained by patient choice and ICF closures. When a private ICF closes, those cases are referred to DSPD and the majority transition into HCBS. However, only one ICF closed in 2025. So a larger portion of the referrals sent over by E&I during fiscal year 2025 where individuals that were simply curious about HCBS but ultimately decided not to transition from their current ICF.