The immediate goal of any depression intervention in home health care is recovery from depression and reduction of depressive symptoms. Data from other populations suggest that treating depression may reduce the risk of negative functional outcomes as well. Functional outcomes are especially important in home health care, both because good functional status is critical in allowing older adults to remain in their own homes and because Medicare’s prospective payment system bases reimbursement on functional outcomes. Despite the availability of efficacious treatments for depression, however, only nine (12%) of our depressed home care patients received adequate antidepressant treatment. This magnitude of untreated major depression underscores the critical need for effective strategies to reduce the burden of depression in older home health care patients.