Home and community-based care: recent accomplishments and new challenges

This article traces the development of home and community-based care to its current place in the worlds of health and social policy. An argument is developed to the effect that such services have by now gained both heightened policy legitimacy and organizational capacity. Building on these contentions, the article goes on to suggest that such services should continue to gain a more prominent place within long-term care policy, and that long-term care issue deserve a more central place within social insurance policy more generally. The article concludes by suggesting that demonstrations of policy efficacy such as those that are taking place in home and community services might help to at least modestly offset the frontal assault which is currently taking place across the range of American social policy.