Home & Community Based Services

NSCLC advocates for more use of home and community-based services versus institutionalization, especially for low-income older adults needing long term services and supports.

Darling et al v. Douglas, Ninth District, California, is a class action suit that challenged the State’s planned elimination of Adult Day Health Care (ADHC) as a Medi-Cal benefit. Read more about the suit.

• Policy Issue Brief: CMS Notifies States of Limited MOE Flexibility in HCBS Waiver Programs
  (9/19/11) Advocates in states that may be contemplating cuts to HCBS waiver programs should be aware of the limits of the states' authority to make changes, both under the Affordable Care Act and other sources of federal law. Policy Issue Brief.  



• Revisiting the Olmstead Ruling: Keeping More Older Adults Out of Nursing Homes
  A September 2010 NSCLC report,  10-Plus Years After the Olmstead Ruling: Progress, Problems, and Opportunities, calls on Congress and the states to give older adults and people with disabilities to expand the use of home and community based services a...



• California”s Little Hoover Commission Testimony
  On May 27, 2010, NSCLC attorney Eric Carlson testified at California’s Little Hoover Commission, an independent state oversight committee that is reviewing the state’s system of care for seniors and individuals with disabilities. Eric outlined the ...



• Advocacy to Protect Medicaid-Funded Home Health Care
  Federal law requires that each state's Medicaid program provide home health care services.  These home health services allow low-income older Americans to stay at home longer. Under federal law, a state Medicaid program is not allowed to impose a â...



• To be or not to be Homebound: The Limits of States’ Discretion in Medicaid’s Coverage for Home Health Services
  This issue brief provides an overview of the boundaries of a state’s home health service standard, including a discussion of the controversy in Missouri, in order to provide useful background for advocates trying to maximize the community-based optio...



• NSCLC Comments on HCBS Advance Notice of Proposed Rulemaking
  NSCLC writes to comment on the Advance Notice of Proposed Rulemaking relating to Medicaid home and community-based services (HCBS) waivers. Read comments (Aug. 20, 2009).



• NSCLC Requests Clarification on CMS Policy on Medicaid HCBS Waiver
  The District of Columbia operates a Medicaid home and community-based services waiver for individuals 65 years old or older or with disabilities. The waiver document it submitted to the Centers for Medicare & Medicaid Services (CMS), and for which ...



• Webinar: Medicaid’s New HCBS State Plan Benefit
  NSCLC Staff Attorney Gene Coffey recently led a webinar presenting an analysis of Medicaid’s new HCBS state plan option. The webinar was attended by more than 300 advocates from around the U.S. Topics included a discussion of the issues surroundin...



• AoA’s Nursing Home Diversion Program
  The Administration on Aging’s Nursing Home Diversion Modernization Grant Program hopes to transform the long-term care system by giving grants to states “to assist individuals at risk of nursing home placement...to receive home and community-based ...



• NSCLC’s Statement Regarding CMS’ Position on Spousal Impoverishment Protections in HCBS Waiver
  The Centers for Medicare & Medicaid Services (CMS) is taking an unfounded position regarding the applicability of the federal law’s spousal impoverishment protections in home and community-based care (HCBS) waiver programs. Read NSCLC Statement o...