HCBS means home and community-based services. It is the Medicaid category for support delivered in a person's home or in the community, rather than in an institution. For intellectual and developmental disability services, that institution is often an ICF/IID. HCBS is the alternative: a place to live, a day, a job coach, personal care, respite, a home modification, or whatever else the state put in the program.
The benefit is largely optional. States decide whether to offer it, who can enroll, and which services are on the menu. That is why one state's waiver looks generous on housing and thin on employment, and the next state is the reverse. The federal government sets the frame, including a rule finalized in 2014 that expects these services to be delivered in integrated settings rather than settings that isolate people. People in the field call that the settings rule. It is about where a service happens, not about the wage.
HCBS is not one waiver. States use waivers, state-plan options, and sometimes broader demonstrations to pay for it. A news story that says "HCBS cuts" may mean a disability waiver, an aging waiver, or both. The rate, the waiting list, and the worker are different even when the acronym is the same.
Provider agencies live inside this category. They bill a fee schedule for units of service. When a legislature trims optional Medicaid, home and community-based lines are often where the cut shows up, because institutional benefits are harder to treat as optional. That is why a national brief about HCBS and a state memo about a disability rate are the same story at two altitudes.
If you see HCBS in a headline, the next words to find are the population and the authority. Disability or aging. Waiver or state plan. Without those, the acronym is only a direction of travel: community, not institution.