By Kindel Holloman, Marketing Manager
The 2026 Home and Community-Based Services Conference, held August 23-27, 2026, at the Baltimore Marriott Waterfront in Baltimore, Maryland, brought together policymakers, program administrators, providers, and advocates to share ideas, discuss emerging trends, and identify ways to strengthen home- and community-based services (HCBS) across the country.
The sessions covered a wide range of topics, but several themes surfaced repeatedly. Together, they pointed to five useful questions for understanding the opportunities and challenges shaping the future of HCBS.
1. How can states meet growing HCBS demand with a limited workforce?
The long-term success of home- and community-based services depends on a stable, skilled, and well-supported direct care workforce. Throughout the conference, discussions focused on moving beyond short-term staffing challenges and developing sustainable workforce strategies that address recruitment, retention, training, career advancement, and leadership development.
Speakers highlighted efforts by states, providers, and managed care organizations to strengthen workforce pipelines while preparing for increased demand driven by demographic changes and growing service needs. Many also emphasized that retaining experienced workers requires more than competitive wages and training opportunities. Flexible schedules, compressed workweeks, and work-from-home arrangements, when appropriate, were frequently discussed as ways to help employees balance work and caregiving responsibilities.
A clear theme emerged: workforce sustainability depends on a growing understanding that retaining experienced workers requires policies that support employees both on and off the job. Without that support, workforce gains can be difficult to sustain.
2. How can states better recognize, support, and sustain family caregivers so individuals can remain in their homes and communities?
Family caregivers play a vital role in helping individuals live independently in their homes and communities. Conference discussions acknowledged the increasing pressures facing family caregivers and the connection between caregiver well-being and the effectiveness of HCBS programs.
Sessions explored approaches ranging from respite services, caregiver education, support groups, and data-informed methods that help identify caregiver burden before it becomes a crisis. Many presenters emphasized that family caregivers should be viewed as an essential part of the broader care continuum rather than a supplemental source of support.
The message was consistent: supporting family caregivers is critical to sustaining HCBS and helping more individuals remain safely in their homes and communities.
3. How can HCBS expand access and flexibility while maintaining accountability, quality, and long-term sustainability?
Conference discussions covered waiver authorities, self-direction, quality oversight, participant protections, program integrity, and evolving federal requirements. Rather than presenting oversight and innovation as competing priorities, speakers described them as complementary goals that must advance together.
Attendees also shared examples of improving consumer access through upgraded systems, streamlined processes, and stronger coordination among state agencies, Area Agencies on Aging, and community partners.
These examples reinforced an important point: policy changes alone do not improve access. Individuals and families must also be able to navigate and use the systems designed to support them.
4. How can technology and artificial intelligence (AI) strengthen HCBS without losing the human connection?
Technology was one of the conference's most visible themes, with discussions focused on how innovation can improve services while preserving person-centered care.
Sessions covered AI, care management, digital access, home safety, and program administration. Presenters highlighted practical applications that can reduce administrative burden, improve care coordination, expand access to services, strengthen workforce capacity, and support greater independence for people receiving HCBS.
Speakers emphasized that technology should enhance, rather than replace, the human relationships at the center of person-centered care.
Interest in AI extended beyond formal sessions. Attendees identified opportunities to use AI for data collection, analysis, administrative efficiency, consumer assistance, and decision support. They also emphasized the need for training, governance, security, privacy protections, and regulatory compliance.
The discussion has moved beyond what AI might do. Increasingly, the focus is on how to implement these tools responsibly, effectively, and at scale.
5. How can organizations break down silos across aging, disability, healthcare, housing, and community systems to improve outcomes?
The importance of collaboration was evident throughout the conference. Sessions addressing aging services, disability services, healthcare, housing, public health, workforce development, and innovation all reinforced the same point: many HCBS challenges extend beyond the scope of any single organization.
Presenters underscored the need for stronger coordination among state agencies, community organizations, providers, managed care entities, and other stakeholders. Attendees shared examples of successful partnerships supported by data-sharing agreements, business associate agreements, and targeted grants designed to improve coordination and expand access to long-term services and supports.
A common message emerged: better outcomes depend on integrated approaches that address the full range of factors affecting individuals' lives.
As one attendee observed, “The most effective partnerships have clear accountability, shared outcomes, and the flexibility to respond to what communities actually need. When we move from simply coordinating organizations to truly integrating the experience for the person receiving services, that's where partnership has the greatest impact.”
Looking Ahead
Each of these five questions reflects a different aspect of HCBS transformation, yet the conversations throughout the conference pointed to the same reality: progress depends on turning ideas into practical action. Workforce development, caregiver support, program integrity, technology, and cross-sector collaboration are deeply connected. Advances in one area often depend on progress in another.
The questions raised during the conference do not have simple answers. Together, however, they highlight the priorities shaping policy decisions, program design, and service delivery as HCBS evolves. The organizations that make the greatest progress will be those that pair new ideas with implementation strategies that improve outcomes for the people and communities they serve.
