For many, home and community-based services (HCBS) represent the difference between living independently and facing institutionalization. These Medicaid-funded programs cover personal care, transportation, and employment support, acting as a bridge to schools and workplaces. However, the path to securing this assistance is rarely straightforward. Because many of these programs are optional at the state level, access remains fragmented by varying eligibility requirements, enrollment caps, and persistent provider shortages.
In section Releases
Advocacy Groups Push Home-Based Care Awareness Amid Medicaid Funding Cuts
As October marks National Special Needs Law Month, the National Academy of Elder Law Attorneys and the Special Needs Alliance are issuing a new guide on home and community-based services, aiming to bolster independence for people with disabilities at a time when federal funding for these critical programs faces contraction.

NAELA President Marielle F. Hazen noted that while these services are transformative, they are not universally accessible. This instability is further compounded by the One Big Beautiful Bill Act (OBBBA), which introduced significant reductions in federal Medicaid funding. These budget shifts threaten to force states into difficult decisions regarding the availability of optional services. Robert F. Brogan, president of the Special Needs Alliance, emphasized that families must grasp the complexities of these systems before a crisis occurs, as understanding the current landscape is the primary defense in protecting long-term access to care.
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