Home- and Community-Based Services beyond Medicaid

This paper highlights promising practices of how state-funded home- and community-based services programs are supporting low-income older adults and/or people with physical disabilities and their family caregivers to live with maximum independence at home. Specifically, the paper profiles programs in nine states: Connecticut, Illinois, Massachusetts, Nebraska, New Jersey, North Dakota, Oregon, Pennsylvania, and Washington.

The paper also highlights Washington state’s emerging innovation: the Medicaid Transformation demonstration, which tailors support for near poor older adults and family caregivers.

The design, operation, and outcomes of these programs can provide useful insights for federal and state policy makers.

This paper aims to help administrators, policy makers, and advocates learn from each other and implement programs that will reach people who do not qualify for Medicaid or who are waiting to receive Medicaid services.