Home and Community-Based Services (245D & 245G)

Home and Community-Based Services (HCBS) are healthcare and supportive services provided to individuals in their homes or community settings rather than institutional environments like nursing homes or hospitals. These services are designed to help people with disabilities, chronic illnesses, or aging-related challenges maintain their independence, improve their quality of life, and participate in their communities.

Key Features of HCBS

1. Personalized Care: Services are tailored to the specific needs of each individual, promoting autonomy and personal choice.
2. Community Integration: HCBS helps individuals engage with their community by supporting activities like employment, education, and social participation.
3. Cost-Effective: By avoiding institutional care, HCBS can often be more affordable for both individuals and the healthcare system.
4. Wide Range of Services: Services can include assistance with daily activities, medical care, therapy, and emotional support.

Types of HCBS

• Help with activities of daily living (e.g., bathing, dressing, eating).
• Support for instrumental activities (e.g., meal preparation, managing medications).

Homemaker Services:

• Light housekeeping, laundry, and meal preparation.

• Temporary relief for caregivers, allowing them time to rest or handle other responsibilities.

• Daytime programs that provide social and therapeutic activities.

• Medical services provided at home, such as wound care or administering medications.

• Assistance with non-emergency transportation to medical appointments or community activities.

Eligibility and Funding

• HCBS is often funded through Medicaid waivers, which allow states to use federal funds to provide non-institutional care.
• Private pay, long-term care insurance, or state-specific programs may also cover HCBS.

Goals of HCBS

• Encourage independence.
• Support people in staying connected to their families and communities.
• Delay or prevent institutionalization.
• Provide holistic care that includes physical, emotional, and social well-being.