Medicaid Home and Community Based Services (HCBS)

You may have heard the term HCBS before. It stands for Home and Community-Based Services. HCBS are Medicaid-funded services that help people with disabilities live and receive support in their homes and the communities they choose. Many people with disabilities wait years for the home- and community-based services they need. Without adequate personal care, direct-support workers, and family-caregiver supports, people may be unable to get out of bed, eat, bathe, use the bathroom, work, or participate in community life. At the same time, institutional care, including nursing-home placement, is often easier to access.

The new DOJ opinion says that federal disability laws may not require states to provide the services people need to live in their communities. That could make it harder for people with disabilities to get the support they need to stay in their homes and avoid being placed in institutions.

Community-based services offer important benefits, including:

• Lower costs: HCBS are usually less than half the cost of residential care.
• Culturally responsive: People can continue to take part in spiritual and cultural activities that matter to them.
• Familiarity: People can receive support in their own home or small residential facility in the community.
• Support from family: Some waivers permit family members to be paid caregivers. Check with your state agency and its Medicaid office for more info.

Community-based services are about more than where someone receives care. They help people make their own choices and stay connected to the people and places that matter to them.