Home and Community Based Service (HCBS) clients are growing in number as states increasingly provide care in non-institutional settings. In some states, like the one in which the present study was conducted, HCBS clients can choose to hire family members, friends or unfamiliar agency workers as paid caregivers of interest was HCBS clients’ choice of paid caregivers and how their choices were related to the social networks in which they were embedded, their well-being and loneliness.