Advocating for Home and Community-Based Services

For millions of Americans living with disabilities, home and community-based services (HCBS) provide essential services that vastly improve their lives and enable them to live independently in their communities. As one of the key sources of funding for HCBS outside of private long term care coverage, Medicaid helps ensure that people with disabilities have the support they need to live independently in their homes and communities.

Medicaid and private health insurance provide coverage meet medical needs like skilled nursing care, dietary management, and case management. But HCBS encompass other services that address daily living needs, such as personal care, transportation, and meal programs. Without the critical services provided by HCBS, patients’ family members often have to fill in the gaps to provide care, or patients may unwillingly end up in an institution.

The Arc of the United States, a Modern Medicaid Alliance partner, is currently leading Medicaid Can’t Wait, a nationwide campaign to raise awareness about the vital need for HCBS for people with disabilities. As part of this campaign, The Arc is providing resources to help educate lawmakers on the importance of investing in HCBS. Some of those resources include testimonials from people with disabilities explaining why living in their communities matters to them.

While Medicaid covers HCBS for millions of Americans, over 800,000 individuals remain on waiting lists — often as long as 8 to 10 years — before they can receive HCBS.

The COVID-19 pandemic has reinforced how essential HCBS are for millions of Americans with disabilities. In response to the COVID-19 crisis, changes to state Medicaid programs across the country have helped expand and strengthen HCBS, allowing individuals with disabilities to remain at home instead of in nursing homes, minimizing their exposure to the virus.

Ensuring that people with disabilities continue to live independently in their chosen community setting is a top priority for The Arc as they work to strengthen and expand HCBS. Learn more about how The Arc is raising awareness on the importance of HCBS through Medicaid Can’t Wait.

Fast Facts on HCBS

  • Around 5 million people rely on HCBS through Medicaid.
  • HCBS recipients are diverse and include individuals with intellectual or developmental disabilities, individuals with physical disabilities, individuals with mental illness, and seniors.
  • Medicaid HCBS spending totaled $92 billion in 2018.
  • HCBS support daily living needs including services like personal care, transportation, and home-delivered meals.