Home/Community Services

The Trump administration is proposing a reorganization and staffing cuts at HHS that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.

HCBS, Medicaid Home and Community-Based Services

The recently passed House budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (12.2 million) who are also enrolled in Medicaid.

This issue brief provides information about some of the services Medicaid provides in assisted living facilities from KFF’s most recent survey of state Medicaid HCBS home care programs.

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.

This issue brief describes states’ ongoing efforts to respond to shortages of home care workers and how they pay these workers, finding that increased payment rates are a key component of states’ efforts to address workforce shortages.

This issue brief provides new information about family caregivers from KFF’s most recent survey of state Medicaid HCBS programs, including a discussion of paying family caregivers, self-direction, and supports available for family caregivers.

This data note provides new information about waiting lists for Medicaid Home- and Community-Based Services, including a discussion of why waiting lists are an incomplete measure of unmet need and why they are not necessarily comparable across states or over time.

This issue brief presents findings from the focus groups including caregiver characteristics; physical, emotional, and mental caregiving demands of caregiving; their wages, finances, and opportunities for advancement; and what caregivers would like policymakers to know about their work.

Medicaid paid for more than half of the $415 billion that the US spent on long-term services and supports in 2022, most of which went to home and community-based services as well as to care in nursing homes and other institutional settings.