In 2001, the federal government embarked on the New Freedom Initiative, a multi-agency effort to "remove barriers to community living for people of all ages with disabilities and long-term illnesses. It represents an important step in working to ensure that all Americans have the opportunity to learn and develop skills, engage in productive work, choose where to live and participate in community life."
By 2005, the Center for Medicaid and Medicare Services was describing the following types of accomplishments:
- $158 million from 2001-2003 in Real Choice Systems Change grants to 49 states, D.C. and two territories to help states develop programs.
- These grants included the "Money Follows the Person" demonstration projects in 8 states. The intent of these grants was to help states "re-balance their long-term support systems (institutional and community-based options) and permitting funding to follow the individual to the most appropriate and preferred setting."
- The Independence Plus Initiative to make it easier for States to request waives or demonstrations that offer families or individuals greater opportunities to take charge of their own health and direct their own services.
- Transitions from Institutions – the use of HCBS waivers to cover one-time expenses in the transition from institutions to "their own home in the community."
- Promising Practices repository of activities related to NFI initiatives.