HCBS/LTSS

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February 17, 2026
New 1915(c) Waiver Opportunity under OBBBA
Elizabeth Zirker and Jennifer Lav Fact Sheet
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December 3, 2025
Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements
David Machledt and Jennifer Lav Issue Brief
*** Co-Authored with Natalie Kean, Jennifer Mathis, and Gelila Selassie The One Big Beautiful Bill Act (OBBBA) establishes unprecedented work requirements in Medicaid expansion. Prior experience has shown that people with disabilities, older adults, and caregivers who should be exempted from work requirements often lose coverage or are denied…
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December 1, 2025
Improving Your HCBS Waiver Through Public Comment
Elizabeth Edwards Issue Brief
This explainer, targeted toward people who use Medicaid Home and Community-Based Services (HCBS), encourages people to get involved in shaping on their state Medicaid HCBS programs through commenting on Medicaid waiver changes. It explains what makes an effective comment and where to find information about each HCBS program within…
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December 1, 2025
Strengthening the Home and Community-Based Services (HCBS) Grievance Process
David Machledt Issue Brief
In May 2024, the Centers for Medicare & Medicaid Services (CMS) finalized regulations meant to improve access to key Medicaid services for people with disabilities. Parts of the new regulations requires states to revamp how they receive and resolve issues that people using Home and Community Based Services experience…
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September 24, 2025
Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce
Jennifer Lav, Brit Vanneman, and Syd Pickern Issue Brief
NHeLP in partnership with The Community Living Policy Center (CLPC) developed the following policy brief titled, “Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce." The Interested Parties Advisory Group (IPAG) requirement, established under the Medicaid Access Rule,…
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September 17, 2025
Medicaid Financing after OBBBA: State Directed Payments and Provider Taxes
Geraldine Doetzer Issue Brief
The so-called "One Big Beautiful Bill Act" (OBBBA) makes changes to complex but crucial Medicaid financing mechanisms that are likely to force states to reduce provider payments and limit benefits. This issue brief provides an overview of state directed payments and provider taxes and explains how they interact; how…
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New 1915(c) Waiver Opportunity under OBBBA

Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements

Improving Your HCBS Waiver Through Public Comment

Strengthening the Home and Community-Based Services (HCBS) Grievance Process

Interested Parties Advisory Groups: Meaningful Stakeholder Engagement to Ensure Adequate HCBS Payment Rates and Help Strengthen the Direct Care Workforce

Medicaid Financing after OBBBA: State Directed Payments and Provider Taxes