Recent policy initiatives promote home- and community-based services (HCBS) to reduce the need for institutional care because most older adults prefer to remain at home and in their community. The desire to live at home, though, may be an elusive dream, given certain states’ resistance to bolstering options in Medicaid community-based care, and nonpartnered adults—and especially never married adults with few economic resources—have the most limited options. Thus, we argue that future policy efforts should focus on expanding HCBS options for nonpartnered older persons. Some of the potentially important options include extending the Family and Medical Leave Act coverage to smaller employers and expanding selfdirected Medicaid services, including budget and employer authority, to facilitate the provision of long-term care by family and friends.
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