Across the country, policymakers and community partners are grappling with how to support older adults, people with disabilities, and family caregivers in a changing policy environment. Home and community-based services (HCBS) are central to that conversation, as federal policy changes, state budget pressures, and delivery system reforms raise new questions about access, community living, and long-term system sustainability.

As stakeholders navigate this changing landscape, Aurrera Health has been approaching these issues from several angles: analyzing new federal policy, identifying practical options for preserving HCBS access, explaining the systems and funding streams that support older adults and people with disabilities, and examining the role of community-based partners. We pulled together several recent resources in one place for those tracking these issues.

How is federal policy changing HCBS access?

How H.R. 1 Reshapes Healthcare for Older Adults
With West Health Policy Center

This issue brief summarizes key provisions of H.R. 1 affecting older adults and the systems that serve them. It includes Medicaid eligibility and enrollment changes, Medicare Savings Program delays, HCBS-related provisions, rural health transformation funding, Medicare payment issues, and Supplemental Nutrition Assistance Program changes.

Preserving HCBS Access Amid Budget Uncertainty: A Framework for Decision Making
By Aurrera Health Group

Aurrera Health developed this framework to help policymakers think through options for preserving HCBS access when budgets are constrained. The resource walks through a three-step approach: assessing existing HCBS programs and engaging stakeholders, identifying criteria to guide decision-making, and weighing potential HCBS program changes.

What programs support older adults and people with disabilities?

Healthcare Service Delivery for Older Adults: A Landscape of Programs and Funding
With West Health Policy Center

This issue brief provides a high-level map of the major programs and funding streams supporting older adults, including Medicare, Medicaid long-term services and supports, Older Americans Act services, State Health Insurance Assistance Programs, Adult Protective Services, Veterans Affairs long-term care, Aging and Disability Resource Centers / No Wrong Door systems, and related federal programs.

What Are Home and Community-Based Services?
With California Health Care Foundation

This fact sheet series provides an accessible introduction to Medi-Cal HCBS, including what HCBS are, the major Medi-Cal HCBS programs, how people access and enroll in services, and the providers and organizations that deliver HCBS in California.

How can the aging services network support integrated care?

From Local Expertise to Statewide Implementation: How Ohio’s AAA Network Supports Integrated Care
With Ohio Association of Area Agencies on Aging

This white paper looks at Ohio’s experience engaging Area Agencies on Aging as key partners in Medicare-Medicaid integration. Drawing on the transition from MyCare Ohio to Next Generation MyCare, it describes how AAAs can help connect managed care infrastructure with on-the-ground HCBS expertise, local provider relationships, person-centered planning, and member needs. It also highlights how Ohio’s coordinated AAA network strengthened readiness through statewide collaboration, peer learning, and engagement with the Ohio Department of Medicaid and managed care partners.

Why do eligible older adults miss out on Medicare Savings Programs?

Rising MSP Participation Signals Progress, but Significant Enrollment Gaps Remain
With West Health Policy Center and Urban Institute

This issue brief summarizes a new Urban Institute analysis showing evidence that Medicare Savings Program participation has improved, but many eligible individuals remain unenrolled. The brief highlights opportunities for states to reduce administrative burden, streamline enrollment, align with other benefit programs, and target outreach to older adults.

What Does This Mean for HCBS Policy Going Forward?

Taken together, these resources reflect how interconnected aging, disability, and HCBS policy have become. Decisions about federal financing, Medicaid eligibility, HCBS program design, Medicare affordability, aging services infrastructure, and community-based partnerships all shape whether older adults and people with disabilities can access the care and services they need.

For more information about these resources or to discuss how Aurrera Health can support your organization on aging, disability, and HCBS policy issues, please contact Kristal Vardaman.

Authors

Sara Bovat [Deputy Director]

Kristal Vardaman [Managing Principal]

HCBS and Aging Policy Resource Roundup