LAUSR

•Though youth with severe emotional disturbance (SED) require intensive home and community-based mental health services to be maintained in their home, such treatment is often unavailable to youth who are privately insured and ineligible for Medicaid.•Medicaid Home and Community-Based Service (HCBS) Waivers and State Plan Amendment Options are federal policies that allow states to extend Medicaid coverage to persons with special healthcare needs whose incomes are beyond Medicaid eligibility criteria. Some states use these policies to serve youth with SED.•Several HCBS policies are described and compared. Waiver programs for youth with SED in nine states are described.•Little research exists about states' use of these HCBS Medicaid policies. Future inquiry should focus on descriptive research and treatment and cost effectiveness studies.