Bureaucracy of Residency, Domicile, and Disability Services While Traveling

Wouldn't it be nice if you only had to worry about the challenges of circumnavigating 6000 miles of the Eastern continental United States and Canada in a boat?

And not how to survive more challenging bureaucracies that would rather you stayed in a nursing home and never ever ever left it, because then their paperwork is easier! As a mobility impaired disabled wheelchair user requiring Home Care, how do you leave the state for a period of time while maintaining access to absolutely fundamentally required home care?