A Guide to Home- and Community-Based Services (HCBS): Funding Your Center-Based Care
A Guide to Home- and Community-Based Services (HCBS): Funding Your Center-Based Care
When families begin navigating long-term care options for their loved ones, the maze of acronyms, funding sources, and eligibility requirements can feel overwhelming. One of the most common questions we hear at A Plus Home Health is: “What exactly are Home- and Community-Based Services (HCBS), and how do they work?”
If you’ve ever found yourself asking this, you’re not alone. Many families exploring healthcare beyond private pay quickly discover that HCBS is the backbone of care programs that allow individuals to remain in their homes or community settings rather than moving into an institutional facility.
In this guide, we’ll break down HCBS in simple terms, explain how funding works, share insights from real family experiences, and show how our center-based community care model at A Plus Home Health fits into this framework.
What Are Home- and Community-Based Services (HCBS)?
At its core, Home- and Community-Based Services (HCBS) are a collection of health and human services designed to support individuals who need assistance with daily living, skilled healthcare, or rehabilitation.
The key is in the name: home and community. HCBS is about helping people remain where they’re most comfortable—at home or in a familiar community environment—while still receiving professional support.
HCBS can include:
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Skilled nursing care (medication management, chronic condition support, wound care)
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Rehabilitative therapies like physical, occupational, and speech therapy
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Personal care services, such as bathing, grooming, and mobility assistance
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Case management to coordinate care and connect families to resources
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Social services and respite care to support caregivers and reduce isolation
According to the Centers for Medicare & Medicaid Services (CMS), HCBS programs are often offered through state Medicaid programs and are structured to provide care outside of institutional settings.
This model recognizes that people thrive better when they remain connected to their communities, surrounded by family and support systems.
Why HCBS Matters
When we speak with families walking through our doors at A Plus Home Health, the same theme comes up over and over again: “We want Mom to get the care she needs, but we don’t want to uproot her from her life.”
That’s the beauty of HCBS. It’s not just about healthcare—it’s about dignity, independence, and quality of life.
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For seniors, HCBS can mean staying in their homes while still receiving therapy to prevent falls, nursing support to manage diabetes, or opportunities for social connection in a community setting.
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For children with developmental delays, HCBS provides access to therapies and educational support that help them thrive without requiring residential placement.
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For adults with chronic conditions, HCBS offers care coordination, medical oversight, and personal support that makes living independently possible.
At A Plus Home Health, we’ve seen firsthand how HCBS transforms lives. One of our patients, a stroke survivor in her late 60s, told us that being able to continue therapy in our center while still going home to her family every night gave her “the strength to keep fighting.” That’s the essence of HCBS—care that meets medical needs while protecting personal freedom.
How HCBS Is Funded
Each state manages its own HCBS programs under guidelines set by CMS. States can apply for waivers that allow Medicaid funds to cover services normally excluded from traditional institutional care coverage.
For example, Medicaid.gov outlines programs such as:
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Section 1915(c) Waivers – The most common type, allowing states to fund long-term care in home and community settings.
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1915(i) State Plan HCBS – Lets states add HCBS as part of their standard Medicaid plan.
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Program of All-Inclusive Care for the Elderly (PACE) – Combines Medicare and Medicaid funding to provide integrated services.
The Kaiser Family Foundation (KFF) notes that eligibility, benefits, and availability vary widely by state. Some states may have waiting lists due to high demand.
Key Takeaway
If your loved one may qualify for Medicaid, HCBS could be a game-changer. It can cover therapies, nursing, and personal care that would otherwise fall on families to fund out of pocket.
Eligibility for HCBS
Eligibility depends on several factors, including:
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Medical necessity (a physician’s recommendation)
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Level of care (the individual would otherwise require a nursing home or similar setting)
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Financial qualifications (income and asset limits under Medicaid rules)
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State-specific criteria
The National Association of Medicaid Directors (NAMD) emphasizes that HCBS is not a “one-size-fits-all” program. States design their programs based on population needs, so understanding your local state Medicaid website is key.
At A Plus Home Health, part of our role is guiding families through this process. We help you determine whether you or your loved one qualify and how to apply for waiver programs that support center-based or in-home care.
How HCBS Works in Practice
Here’s what typically happens when families pursue HCBS:
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Initial Assessment – A physician or state case manager evaluates the patient’s needs.
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Eligibility Determination – Financial and medical criteria are reviewed.
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Care Plan Development – If approved, a team creates a care plan that may include nursing, therapy, and social services.
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Care Delivery – Services are provided in the home or at a care center like ours.
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Ongoing Monitoring – Progress is tracked, and the plan is adjusted as needed.
This collaborative model ensures families aren’t navigating care alone.
Why Center-Based Care Matters Within HCBS
Many families assume HCBS only applies to home visits. While that’s often true, center-based care—like what we provide at A Plus Home Health—is an essential part of HCBS.
Here’s why:
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Team Collaboration – Our multidisciplinary staff (nurses, therapists, social workers) work together under one roof, ensuring seamless communication.
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Specialized Equipment – Therapy rooms and medical tools in our center can’t always be replicated at home.
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Social Connection – Patients engage with peers, reducing isolation and boosting mental health.
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Family Relief – Caregivers get scheduled respite while knowing their loved one is in professional hands.
In other words, our care center acts as a hub within the HCBS model—blending medical expertise with the human touch of community.
A Plus Home Health: Your Partner in HCBS
We understand the anxiety that comes with exploring care options. Medicaid waivers, state rules, and funding structures can sound intimidating, but you don’t have to figure it out alone.
At A Plus Home Health, we:
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Educate families about funding options and Medicaid eligibility
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Provide comprehensive center-based services covered under many HCBS programs
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Advocate for patients by coordinating with case managers and state agencies
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Focus on whole-person wellness, not just medical care
When families work with us, they aren’t just getting services—they’re gaining a partner who understands the system, fights for their loved one’s needs, and delivers compassionate, evidence-based care every day.
Final Thoughts
HCBS is more than a healthcare program—it’s a lifeline for families who want to balance professional support with independence and dignity.
By leveraging Medicaid-funded services, families can access high-quality care without bearing the crushing costs of private-pay models. And when paired with center-based care like what we provide at A Plus Home Health, HCBS becomes more than a program—it becomes a pathway to wellness, connection, and peace of mind.
If you’re exploring HCBS for yourself or a loved one, we invite you to connect with us at A Plus Home Health. We’ll walk you through eligibility, care planning, and the services that best fit your family’s journey.
Because at the end of the day, healthcare isn’t just about treatment—it’s about living fully, right where you belong: in your home and community.