Workforce Challenges & DDS Waiver Services Analysis
Understanding Home & Community Based Services (HCBS) Waivers
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Medicaid is the primary funder of long-term services and supports (LTSS) in the
United States. It provides those services and supports either through institutional
care (i.e., intermediate care facilities or nursing facilities) or home- and community-
based services (HCBS).
States develop home and community-based services waivers (HCBS Waivers) to
meet the needs of people who prefer to get long-term care services and supports in
their home or community, rather than in an institutional setting.
States can offer a variety of unlimited services under an HCBS Waiver program,
including medical services and non-medical services. Examples include service
coordination, in home supports, respite, habilitation services, employment supports,
and more.
HCBS Waiver programs must:
Demonstrate that providing waiver services won't cost more than providing these
services in an institution
Ensure the protection of people's health and welfare
Provide adequate and reasonable provider standards to meet the needs of the
target population
Ensure that services follow an individualized and person-centered plan of care
HCBS
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ALVAREZ & MARSAL
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