Advocacy in Action: Why Home and Community-Based Services Matter More Than Ever

posted by Maghan Bowman on Monday, April 27, 2026

At EPI, advocacy is an essential part of our work year-round. We engage at both the federal and state levels to strengthen disability services, support the direct care workforce and improve access to mental health services. As policies continue to evolve, staying engaged helps ensure real experiences and community needs remain central to decision-making.

This spring, discussions around Medicaid and home and community-based services (HCBS) have taken on renewed urgency at both the state and federal levels. HCBS allows people with differing abilities to live safely in their homes and communities while using public resources responsibly. These services support independence, stability, and dignity, and they do so at a significantly lower cost than institutional care.

Across the country, providers and advocates continue to emphasize that HCBS are both person-centered and cost-effective. Investments in community-based care reduce reliance on emergency and institutional settings, support workforce participation for individuals and family members alike, and strengthen local economies.
 

EPI continues to advocate for policies that:

• Protect access to Medicaid-funded HCBS
• Sustain and strengthen the direct care workforce
• Reflect growing community need
• Ensure oversight and accountability enhance services rather than disrupt them

As federal budget and Medicaid conversations continue, it remains critical that policymakers understand the real-life impact of these services and the people who rely on them every day.

Federal Advocacy: A Critical Moment for Community-Based Services
At the federal level, conversations around budget priorities, reconciliation, and Medicaid funding continue to evolve. These discussions carry real implications for people with disabilities, families, and the providers who support them. As policymakers weigh complex fiscal decisions, it remains essential that the value and impact of home and community-based services are clearly understood.

National advocacy partners continue to emphasize that HCBS are both person-centered and cost-effective, supporting people to live, work, and grow in their communities while avoiding far more expensive institutional care. As these federal conversations continue, EPI remains engaged alongside provider coalitions to ensure the voices of people with differing abilities and direct support professionals are included in the process.

Strengthening the Case for HCBS
Recent national discussions have further highlighted what providers and families have long known: home and community-based services are not optional, they are foundational. Across the country, more than half a million individuals remain on waiting lists for HCBS, even before potential funding pressures are considered.

Beyond improving quality of life, HCBS strengthen local economies by supporting a workforce of direct support professionals and enabling family members to remain employed. Investments in these services reduce reliance on emergency rooms and institutional care, improve long-term outcomes, and allow people with disabilities to remain in their homes and communities.

Advocacy efforts at both the state and federal levels continue to focus on protecting these outcomes and ensuring policies reflect real-world impact.

Looking Ahead
Advocacy remains essential as policies continue to take shape. Whether at the statehouse or in national conversations, EPI is committed to promoting thoughtful, person-centered solutions that strengthen services and expand opportunity.

If you’re interested in staying informed or getting involved, we invite you to learn more and lend your voice alongside ours. Visit our advocacy page to learn more and get involved.

Together, we can continue advocating for systems that support people, families, and communities across Iowa.