Strengthening Access to Community Living for People With Disabilities and Older Adults

By Kathleen Sebelius*

Every person should have a chance to live, work, and thrive as a part of their local community. The Obama administration has worked to create more opportunities for people with disabilities and older adults to access the benefits of community living — like living in a place of their own choosing with people they care about, having a job, and participating in community life.

At the Department of Health and Human Services, we recognize that Medicaid-funded home and community-based services are a critical part of our efforts to help people with disabilities and older adults live healthy and meaningful lives in the community. That is why I am pleased to share with you final rules that help more eligible Americans have full access to the benefits of community living and receive services in the most integrated setting. The rule clearly defines the qualities of home and community-based settings so that these Medicaid programs can serve as an alternative to institutional care for those who choose them.

The rule will help people like Marisa, a 29-year-old woman who uses a power wheelchair and requires assistance with nearly all her physical needs. Marisa used to rely on her mother to provide this daily care, and her independence in the community was limited. Through Medicaid-funded home and community-based services, Marisa now lives more independently and is able to do things such as volunteering and completing college.

The rule makes clear that home and community-based services should support the person’s choices for participation in the broader community, just as Marisa’s services do. The final rule is a result of robust input from the public and a wide range of stakeholders, states, as well as strong collaboration across multiple federal agencies. I look forward to continuing this successful, collaborative approach as we implement the rule.

As we mark the 15th anniversary of the Supreme Court’s Olmstead decision this year, I am proud of the progress we have made to strengthen the community living opportunities for people with disabilities and older Americans.

For more information about the rule, see

* Kathleen Sebelius, Secretary, Department of Health and Human Services


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