Home and Community-Based Services (HCBS) Waivers
HCBS Waivers allow states that participate in Medicaid, known as Medi-Cal in California, to develop creative alternatives for individuals who would otherwise require care in a nursing facility or hospital. Medi-Cal has an agreement with the Federal Government, which allows for waiver services to be offered in either a home or community setting. The services offered under the waiver must cost no more than the alternative institutional level of care. Recipients of HCBS Waivers must have full-scope Medi-Cal eligibility.
WHAT SERVICES ARE OFFERED UNDER THESE HCBS WAIVERS?
The services available under these HCBS Waivers include case management, community transition services, private duty nursing, family training, home health aides, life-sustaining utility reimbursement, habilitation services, and respite care.
WHO PROVIDES THE SERVICES?
There are a variety of HCBS Waiver providers, including the following:
- Licensed and certified Home Health Agencies;
- Individually licensed HCBS Waiver Providers; or
- Unlicensed caregivers.
HOW LONG CAN ONE RECEIVE THESE SERVICES?
The beneficiary may receive these home- and community-based services as long as they are medically necessary, cost-neutral, and he/she meets the nursing facility or acute hospital level of care.
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HOW DO I BECOME A HCBS WAIVER PROVIDER?
For information on becoming one of the following HCBS waiver providers or to request an application, please contact In-Home Operations (IHO) at (916) 552-9105 or email: IHOwaiver@dhcs.ca.gov.
- HCBS Waiver Nurse Provider – RN and LVN
- Marriage and Family Therapist
- Licensed Psychologist
- Professional Corporation
- Licensed Clinical Social Worker
- Non-Profit Organizations
- Employment Agency
- Personal Care Agency
- Home and Community-Based Services Nursing Facility (Congregate Living Health Facility)
- Public Authority - In Home Supportive Services
HOW DOES ONE REQUEST HCBS WAIVER SERVICES?
The beneficiary or their legal representative must contact (IHO) and request a HCBS Waiver application. Based upon the information on the Waiver application, the Nurse Evaluator II will determine if the individual meets the criteria for the HCBS waiver and schedule a home visit to discuss the waiver and waiver services that are available. Each HCBS waiver can only serve a limited number of individuals. Once that limit is reached, the names of individuals requesting waiver services will be placed on a waiting list based upon the date IHO received their completed HCBS Waiver application.
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FOR MORE INFORMATION ABOUT IHO:
- Northern California (916) 552-9105
- Southern California (213) 897-6774