This chapter introduces the reader to home- and community-based services (HCBS) as an alternative for consumers who want to avoid leaving their homes to reside in assisted living—that is, communities that provide a combination of care and housing in a group setting. To understand the benefits of HCBS, the chapter first reviews the broad spectrum of long-term care services. Next, it provides the historical evolution of HCBS to help the reader understand the background and development of today’s supportive services. It then examines in more detail three existing HCBS programs. Closing the chapter is a discussion of the need for expansion of HCBS programs in light of the challenges experienced by consumers in accessing services. The chapter helps the reader to explain the structure of three HCBS programs (State Plan, 1915c, and PACE [Program of All-inclusive Care for the Elderly]).