Home and Community Based Services Impacts Tracker Project
Home and Community-Based Services Impacts Tracker Project
Tracking state Medicaid policy changes affecting Home and Community-Based Services for older adults and people with disabilities.
Explore the HCBS Impacts Tracker
Follow proposed and implemented Medicaid policy changes across states, including changes to funding, provider capacity, program requirements, and other policies affecting HCBS.
Last updated August 28, 2026 · Updated biweekly
What are Home and Community-Based Services?
Home and Community-Based Services (HCBS) help older adults and people with disabilities live in their own homes and communities rather than in institutional settings. Services can include personal care, home health, transportation, respite, and other supports that help people live independently in their communities.
Understanding how policy changes affect HCBS
Medicaid is a major source of funding for HCBS. As states face increased budget pressure from federal policy changes, they may consider changes to optional Medicaid services, including HCBS. Tracking these changes can help policymakers, advocates, researchers, and people with lived experience understand how Medicaid policy shifts are affecting access to services and supports in communities.
Explore & Contribute
Explore current HCBS policy developments or help keep the tracker up to date by sharing information about changes we may be missing.
HCBS Impacts Tracker
Review proposed and implemented state policy changes, including changes to funding, provider capacity, services, enrollment, and other Medicaid HCBS policies. The tracker is currently in a pilot phase.
Explore the Tracker →HCBS Information Collection Form
If we are missing a state policy change or information is incorrect, please let us know.
Submit an Update →About the Project
The HCBS Impacts Tracker Project tracks proposed and implemented state policy changes that may affect Medicaid Home and Community-Based Services. The tracker brings together information from state documents, agency actions, legislation, executive orders, budgets, and other sources to provide a centralized view of HCBS policy developments across states.
The project is being developed as a national resource for policymakers, advocates, researchers, and people with lived experience. During this initial phase, the project is developing and piloting the methodology and tracking tool that will support ongoing monitoring of state HCBS policy changes and their potential impacts.
What We Track
Where does the change occur?
Each entry identifies the state and the relevant legal or administrative authority, such as a state budget, agency action, executive order, or legislation, as well as the Medicaid authority when applicable.
What is changing?
The tracker describes the type of policy change, including changes to program spending, provider capacity, enrollment, services, or other aspects of Medicaid-funded HCBS. Entries also identify the populations that may be affected.
What is the status and when does it take effect?
Each entry records whether a change is proposed or enacted, when it was proposed, and when it takes effect when an effective date is available. Entries also include brief descriptions and links to state documents and other relevant sources.
How It Works
Identify
Monitor state policy developments that may affect Medicaid HCBS programs and services.
Document
Record the state, legal and Medicaid authorities, type of change, affected populations, status, dates, and a brief description.
Source
Link to relevant state documents and other articles or sources that provide additional information about the policy change.
Update
Continue monitoring entries as policies develop and invite partners to share information that may be missing or need correction.
Questions & Comments
For questions, feedback, or information about the HCBS Impacts Tracker, please contact [email protected].
Project Partners
The HCBS Impacts Tracker Project is led by the George Washington University Milken Institute School of Public Health Hirsh Health Law and Policy Program, together with Human Services Research Institute, LeadingAge LTSS Center @UMass Boston, and ATI Advisory.
This project is funded by The SCAN Foundation with collaborating support from the WITH Foundation .