An analysis of Medicaid home- and community-based services (HCBS) programs in five states (Arizona, Florida, Mississippi, Montana, and Oregon) found that the states and managed care organizations (MCOs) reported challenges recruiting and training direct care workers, due in part to low wages. The states also faced challenges due to the complexity of consumer care needs and state funding limitations. Officials from all five states and three of the four MCOs interviewed as part of the analysis cited challenges recruiting and retaining HCBS direct care workers, particularly given the low wages these professionals typically receive. Officials from Montana and Oregon . . .