Limited housing options are among the most vexing dilemmas facing adults as they age and acquire disabilities.  Before the advent of Assisted Living, the choice boiled down to staying at home if you had an adequate social and financial support system or going to a nursing home.  Many people are in nursing homes because they can't care for themselves independently and because they don't have the family/friends network required to keep them in their own homes semi-independently.  
   Over the last several years there has been a movement toward improving home and community-based services to support more people in their quest to remain as independent as possible.  Community-based simply means that the source of assistance comes from an organization of groups of individuals that are based in a particular community rather than being provided in a facility such as a nursing home. 
   The June 18, 2009 newsletter from the National Council on Aging (www.ncoa.org) reports that legislation has been reintroduced in Congress to improve access to home and community-based services for Medicaid recipients. House and Senate bills both would enable seniors and younger adults with disabilities to live in their own homes while receiving the services and support they need by giving states more flexibility in determining eligibility, boosting the federal matching rate by 10%, ensuring spousal impoverishment protections and excluding at least six months of personal living expenses from eligibility calculations.  It looks as though there's a glimmer of hope that home and community-based services are on the rise.  One good thing about that is that it's much more cost effective than institutional care.