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Policymakers should enact and strictly enforce antidiscrimination and civil rights laws.

Ensuring the quality of services for home care is difficult because no quality measures can assess every service that is delivered daily in hundreds of thousands of private homes across the country

Federal regulations should promote home-care quality assurance standards that are guided by flexible consumer-oriented principles. The prin

States should be required to conduct annual scheduled in-home surveys that assess clients’ experience and involvement in care plans and outcomes.

States should extend the purview of their existing ombudsman programs to include long-term services and supports delivered in homes.

States should require agencies to establish grievance and appeals procedures and provide consumers with written notice of their right to voice grievances.

States should require that home-care providers adequately train family caregivers who agree to use technology (such as home dialysis, tube feeding, and continuous intravenous infu

States must demonstrate to CMS that their methods to ensure backup workers are available to all individuals who receive Medicaid-funded home and community-based servic