Home and community-based services are support and long-term care services that offer an alternative to institutional care for those who need assistance with life's daily activities. For Lois Curtis of Atlanta, one of the plaintiffs in the Olmstead v. L.C.1 who spent most of her life in mental institutions, it means a live-in companion who helps her with the day-to-day activities of living in her own home, like managing finances, cooking meals, and keeping track of medications.2 For Larry McAfee, another Georgian who was quadriplegic, community-based services involved round-the-clock personal care, wheelchair accessible bathrooms and kitchens, a specialized computer, and a specially adapted van.3
Sidney D. Watson, From Almshouses to Nursing Homes and Community Care: Lessons from Medicaid's History, 26 Georgia State University Law Review, vol. 26, no. 3, pp. 937-969, (2010).