BACKGROUND
Long-term services and supports (LTSS) refer to the daily living supports that people with disabilities and older adults need. LTSS includes home and community-based services (HCBS), which are the overwhelming preference of service delivery for the disability community and older adults. Most LTSS is funded through Medicaid, called Medi-Cal in California. LTSS includes In-Home Supportive Services (IHSS), Medicaid Home and Community Based Services Waivers (Waivers), Community Based Adult Services (CBAS), and institutional settings such as nursing facilities.