Why HCBS Matters

Save Medicaid Kentucky is a statewide coalition working to protect and strengthen Home and Community-Based Services (HCBS) for Kentuckians of every age—children, adults, and older adults living with intellectual and developmental disabilities, physical disabilities, and complex medical needs.

HCBS is not simply health insurance. It is the network of Direct Support Professionals (DSPs), personal care, nursing, behavioral supports, therapies, transportation, and respite that make life at home possible. When these supports are stable, Kentuckians stay in their communities. When they falter, families are pushed toward crisis and costly institutional care.

Our mission is to educate the public, elevate Kentucky voices, connect advocates, and encourage respectful, bipartisan solutions that protect access to care. Policymakers across the aisle share a common goal: ensuring Kentuckians can live safely in their communities.

• Children and adults with disabilities living safely at home with their families.
• Older adults aging in place with dignity instead of moving to institutional care.
• Medically complex Kentuckians receiving nursing and therapies where they live.
• Direct Support Professionals earning a living doing essential work.
• Family caregivers able to keep working, parenting, and holding their households together.
• Providers sustaining services in rural counties where options are already limited.

Kentucky's HCBS system is under real pressure. Waitlists for waiver slots and DSP staffing remain long in many parts of the state, and provider reimbursement has not kept pace with the true cost of care. When reimbursement lags, providers close programs or leave Medicaid—and rural counties feel it first.

Recent state budget conversations have raised questions about whether Kentucky's Medicaid program can maintain current HCBS service and reimbursement levels. We are asking for collaboration, transparency, and sustainable solutions before more Kentuckians lose access to the care that keeps them safely at home.

Protecting HCBS is not a partisan issue. It is a shared commitment to Kentucky's most vulnerable neighbors.

• Direct Support Professionals who took months or years to find.
• Specialty medical, dental, and behavioral care with waitlists that already stretch long.
• Continuity of care during transitions—including turning 18 and aging into adult services.
• Access to providers, especially in rural counties hit hardest by workforce shortages.
• Caregiver stability, when family members must leave jobs to provide round-the-clock care.
• Long-term cost savings that HCBS delivers by keeping people out of institutional settings.

Solutions require everyone at the table. We are asking the Governor's Office, the Cabinet for Health and Family Services, and members of the General Assembly, alongside providers, advocacy organizations, and families, to work together on sustainable funding, a stronger DSP workforce, and clear communication with the Kentuckians who rely on HCBS.

Families, self-advocates, providers, caregivers, healthcare professionals, and community members are all part of this movement. Together, we can ensure Kentucky's most vulnerable neighbors are supported at home and in their communities.

Explore Kentuckians across the Commonwealth on the interactive map or read personal accounts from every region.