Home Care Wasn’t Ready For the Climate Crisis—Even Before Trump’s Cuts

The Home and Community-Based Services (HCBS) program, established via a 1981 amendment to the Social Security Act, currently allows approximately 7 million Medicaid recipients to receive care in their homes rather than in institutions. However, investigative findings suggest this decentralized care model lacks the robust emergency protocols and infrastructure necessary to protect disabled and elderly populations during extreme weather events. The situation is reaching a critical point as the Trump administration proposes significant cuts to Medicaid and shifts in FEMA's disaster response mandates, which would further erode the safety net for home-bound individuals during climate-induced crises.