Luca Amine-Hadir, 5, looks out the window in his kitchen in Sebastopol, Calif. on Wednesday, Sept. 3, 2025. Luca lives with autism, cerebral palsy and intractable epilepsy, and his ability to live at home comfortably is supported by the In-Home Supportive Services program and Home-and-Community-Based Alternatives waiver, both funded by Medicaid.