Older adult Medicaid home and community based services in the American rescue plan: A window of opportunity for nursing

Published:September 22, 2022DOI:
      As reported in numerous studies, older adults report the desire to remain at home, expressing their preference to “age in place” and avoid institutionalization. As nurses, we recognize the challenges of attaining this goal given the lack of insurance coverage for routine chronic care at home, shortages of providers, and many older adults’ inability to self-pay for services that would enable them to remain in the community. Recent federal Medicaid policy provides states with funding to address these and other barriers to home-based services for older adults. The purposes of this paper are to alert nurses to this opportunity and suggest how nurses can provide their expertise in the implementation and evaluation of these efforts at the state level.


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      1. Centers for Medicare and Medicaid Services (2021a). State Medicaid director letter SMDL #21-003, Implementation of American Rescue Plan Act of 2021 section 9817: Additional support for Medicaid home and community-based services during the COVID-19 emergency, Retrieved May 13,2021 from and updated on June 3, 2022, as SMDL#22-002

      2. Centers for Medicare and Medicaid Services (2021b). Strengthening and investing in home and community based services for Medicaid beneficiaries: American Rescue Plan Act of 2021 section 9817 spending plans and narratives. Retrieved from Retrieved May 5, 2022

      3. Centers for Medicare and Medicaid Services (2022). Program of all-inclusive care for the elderly. Retrieved from Retrieved May 5, 2022

      4. Centers for Medicare and Medicaid Services (2022). American Rescue Plan Act of 2021 section 9817 states planned activities high -level overview infographic. Retrieved from

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