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Access to Home- and Community-Based Services

In this session, staff presented a draft chapter on access to Medicaid home- and community-based services (HCBS). The chapter draws on Commission discussions as well as findings from stakeholder interviews, a roundtable, two panels, an environmental scan, and a literature review. It provides an overview of Medicaid coverage of HCBS and describes findings in two areas—access barriers for beneficiaries and state challenges in administering HCBS programs—mapped to MACPAC’s HCBS access framework. The chapter concludes with areas for further work and next steps aimed at identifying policies that drive toward a more streamlined HCBS delivery system with increased access for beneficiaries and reduced administrative burden for states.