Formal home health care services have been provided for clients and families since the late 19th century in this country. Although elderly persons have been a major group to receive such services, it was not until 1966 that government policy focused on facilitating home care of elderly persons. In 1966, home health care agencies became eligible for Medicare funds. In 1981, the Home Care Waiver allowed Medicare reimbursement for home health care which did not exceed the cost of institutional care.