Protecting and Expanding California’s Home and Community-Based Services
Most Californians want to age in their homes and communities, rather than in institutional settings like nursing facilities. To remain living at home and active in their communities, many people need help with personal care and other assistance.
Medicaid, not Medicare, is the main payer for these types of supports, known as Home and Community-Based Services (HCBS). In California, Medi-Cal supports nearly a million older adults and people with disabilities living in the community through its HCBS programs.
The availability and extent of HCBS coverage, however, can be uncertain. This is because under federal law, states have the option to provide these services, but they are not required to do so. As a result, during budget shortfalls—whether caused by federal Medicaid funding cuts, a recession, or other financial challenges—states frequently consider reducing optional benefits like HCBS to balance their budgets.
These fact sheets provide an overview of HCBS in California and their vital role in supporting the health and well-being of older adults and disabled people.
