Home and Community-Based Long-Term Services and Supports for Older People

More than 5 million older people need services and supports to remain living in their homes and communities. Most receive help exclusively from family caregivers, but others pay for services through public programs, out-of-pocket spending, or private insurance. The primary source of public funding is Medicaid, but other sources include the Older Americans Act and state funds. Residential alternatives that deliver supportive services in a home-like environment also play a role in helping older people avoid more institutional settings.