We are happy to present a two-part series with Melissa Harris, Deputy Director, Disabled and Elderly Health Programs Group, Centers for Medicare and Medicaid Services (CMS). Her role is to develop and implement policies to advance Home and Community Based Services (HCBS).  Here in Part 1 we discuss Medicaid generally as it relates to adults with disabling autism. HCBS waivers are intended to serve those with developmental disabilities in need of an institutional level of care, but waitlists in many states are very long, and providers willing to serve those with complex needs can be very scant. We discuss the staffing crisis, the availability of extra funds ot the states under the Rescue Plan, the issue of "waiver on paper" that does not translate into actual services, ICF availability or lack thereof, the rising rates of autism in the Medicaid system, and more. ••• Please pardon the technical difficulties, Ms. Harris had some difficulties with her connection but in almost all cases the audio can be understood.