Home and Community-Based Alternatives Waiver
Solicitation for Application (SFA)
The Department of Health Care Services (DHCS) has released a Solicitation for Application (SFA) to invite eligible organizations to apply to become Home and Community-Based Alternatives (HCBA) Waiver “Waiver Agencies.”
Applicants selected to become Contracted Waiver Agencies will receive funding to perform waiver administrative functions within a defined service area and to provide Comprehensive Care Management services to Waiver participants.
Waiver Agencies will be responsible for local waiver administration functions including, but not limited to:
Reviewing person-centered Plans of Treatment (POT)
Establishing an adequate network of service providers
Authorizing requests for services based on medical necessity
Billing the Medi-Cal Fiscal Intermediary for authorized services
Reimbursing contracted home- and community-based service provider within their service area
Monitoring provider performance, and
Ensuring the health and safety of participants receiving waiver services in the community.
HCBA Waiver Overview
The HCBA Waiver (formerly the Nursing Facility/Acute Hospital (NF/AH) Waiver) was approved by the Centers for Medicare and Medicaid Services (CMS) on May 16, 2017. Medicaid's Home and Community-Based Services (HCBS) Waiver programs, including the HCBA Waiver, are authorized under Section
1915(c) of the Social Security Act; governed by Title 42, Code of Federal Regulations (CFR); and administered by CMS.
The HCBA Waiver provides care management services to persons at risk for nursing home or institutional placement. The care management services are provided by a multidisciplinary care team comprised of a nurse and social worker. The care management team coordinates Waiver and State Plan services (e.g., medical, behavioral health, In-Home Supportive Services, etc.), and arranges for other available long-term services and supports available in the local community. Care management and Waiver services are provided in the Participant’s community-based residence. This residence can be privately owned, secured through a tenant lease arrangement, or the residence of a Participant’s family member.
HCBA Waiver Application
Please email your comments and questions regarding the HCBA Waiver to: HCBAlternatives@dhcs.ca.gov