OT Group Interventions at Adult Day Care Centers

Hi everyone, I’m learning about OT program development and I really love the idea of community-based interventions because elderly clients can gain so much from it! I was wondering: Is it realistic to rely on Medicaid as a funding source for OT group interventions at an adult day care center? I have read about the Home and Community-Based Service Waivers as well as grant funding, however, I’ve been told that many programs at ADCC also rely on out of pocket payment from clients. Is this true?