https://doi.org/10.1177/0733464820919184 Journal of Applied Gerontology 2020, Vol. 39(7) 700–701 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0733464820919184 journals.sagepub.com/home/jag Special Issue Introduction Amid an increasing number of older adults globally and a growing recognition that most older adults prefer to “age in place,” home- and community-based services (HCBS) play a key role in allowing older adults to live longer in their homes and communities. HCBS are more than the meals delivered to a homebound older adult or the transportation service provided to someone who is visually impaired. The realities of HCBS include micro- to macro-level consider- ations that involve the people receiving the HCBS as well as the individuals who provide the services, the programs designed to assure access to HCBS, and the policies that impact the services. This Special Issue on HCBS policy and practice highlights empirical work across a range of timely issues: HCBS use and need, the impact of HCBS policy changes, workforce education and training, and work envi- ronment and experience. HCBS Use and Need Hirschman and colleagues looked at predictors of health care transitions for older adults new to long-term services and supports (LTSS). Both acute and nonacute care transitions were explored, making this article a particularly unique con- tribution to the literature. Using the Anderson Behavioral Model of Health Service Use, 470 individuals were followed for 24 months. Among many important findings, this research demonstrated that LTSS recipients commonly experience health care transitions to and from both acute and nonacute settings of care. The nonacute care transitions (e.g., transi- tions to Skilled Nursing Facilities/Inpatient Rehab Facilities [SNF/IRF], to hospice, between LTSS settings) accounted for 17% of transitions during the study period. The article by Yu et al. explores the relationships between care recipients’ descriptive profile factors and HCBS use pat- terns in Taiwan. Guided by the Andersen model and using latent class analysis and multinomial logistic regression, the authors found that care recipients who live in areas with a lower degree of urbanization are less likely to use multiple services, which show inequality in long-term care service accessibility. The authors recommend a flexible long-term care policy that promotes use of integrated services and alle- viates barriers to accessing multiple types of services. Finally, Fu and Chui explored the role of living arrange- ment and filial piety in HCBS service need patterns in Beijing, China. Three classes of HCBS need patterns were identified: high-needs group, moderate-needs group, and low-needs group. Living arrangement, number of children, and number of diseases were found to be significantly asso- ciated with HCBS need patterns. Compared with the high- needs group, those living with at least two family members were more likely to express low needs or moderate needs. Living arrangement was a moderator for the effect of filial piety on HCBS needs. HCBS Policy Changes Although all of the articles in this special edition address policy issues, three articles focus directly on HCBS policy changes. The article by Goncalves, Weaver, and Konetzka measured Medicaid home care Participation and Intensity to describe changes in Medicaid home care policy generosity over time and across states. Yearly state-level data from the Medicaid Statistical Information System (1999–2012) were analyzed using exploratory and confirmatory factor analy- ses. During the study time frame, 29 states expanded both Participation and Intensity of services, whereas six states reduced both. Results suggest that the Participation and Intensity dimensions exist and are independent. Although some states increased or decreased both Participation and Intensity over time, others increased generosity in one dimension at the expense of the other. The findings are important because expansions along these two dimensions could have different implications for beneficiaries. Burgdorf and coauthors interviewed stakeholders in Maryland, one of the first states to adopt Community First Choice (CFC), a Medicaid state plan option authorized through the Affordable Care Act. The study goal was to assess challenges, benefits, and potential implications of this Medicaid option for state and federal policy makers. Findings suggest that expanding coverage for HCBS through CFC in Maryland was financially feasible, expanded the personal care workforce, and supported a more equitable approach to personal care services. Using a mixed-methods approach, Arora and colleagues evaluated the 2013 consolidation of Iowa’s Area Agencies on Aging (AAA), from 13 AAAs to six, on the delivery of HCBS to older adults in the state. No detectable impact was found on the proportion of older adults served by the AAAs 919184JAG XX X 10.1177/0733464820919184Journal of Applied GerontologyGruman and Menne editorial 2020 Strengthening the Research Evidence for HCBS Policy and Practice