Title: A Review of Extended Home- and Community-Based Services (HCBS) in Section 1115 Waiver Programs

Publication date: February 2024

Section 1115 demonstrations in the Medicaid program are an avenue for states to test innovations in long-term services and supports (LTSS) and home- and community-based services (HCBS) delivery. Several states are using Section 1115 waivers to expand access to HCBS to beneficiaries who do not yet meet functional or financial eligibility requirements but are deemed “at risk” of future LTSS use or institutionalization. The purpose of this report is to examine those 1115 waiver programs that expand access to HCBS services, particularly to older adults.