Key Facts About Home and Community-Based Services

Millions of Americans living with disabilities rely on home and community-based services (HCBS) for essential supports that enable them to live independently in their homes and communities. Medicaid is the primary source of coverage for HCBS.

Here are key facts you need to know about the vital role of HCBS for the disability community, families, and caretakers:

1. Medicaid funds the majority (57%) of HCBS.
2. HCBS encompass services that address both medical and daily living needs. Medical services include home health nursing services, physical/occupational/speech therapies, and more, while daily living services include but are not limited to personal care, transportation, meal programs, and adult day centers.
3. HCBS serve a diverse population, including individuals with intellectual or developmental disabilities, physical disabilities, and/or mental illness.
4. Without the critical services provided by HCBS, patients’ family members often have to fill in the gaps to provide care. More than 1 in 5 Americans are caregivers who provide vital assistance to family members, including children or adults with disabilities, aging parents, and more.
5. Nearly 820,000 Americans remain on waitlists to receive HCBS, oftentimes for years.
6. The American Rescue Plan provided an additional 10 percentage point increase in federal matching funds for state spending on HCBS from April 2021 through March 2022, which will lead to an estimated $11.4 billion increasein federal spending on HCBS. Medicaid HCBS spending is estimated to be about $114 billion in FY 2021.
7. The COVID-19 crisis has been especially challenging for older adults and people with disabilities. At the time of publishing, more than 186,000 residents and workers in nursing homes and other congregate settings have died from COVID-19, representing nearly 1 in 3 deaths nationwide.
8. More than half of all states deliver some or all HCBS through Medicaid managed care.

Congress is currently considering providing additional funding for Medicaid HCBS. The Modern Medicaid Alliance and our partners will continue to advocate for these essential services and for a strong, sustainable Medicaid program.

For more information about how Modern Medicaid Alliance partners are raising awareness about the vital role HCBS play in the lives of people with disabilities, check out our latest Medicaid Spotlight piece on The Arc of the United States.