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Home and Community-Based (HCB) Alternatives Waiver

The HCB Alternatives 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 Home and Community-Based Services (HCBS) Waiver programs, including the HCB Alternatives 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.  HCBS Waiver programs manage the provision of home-based services to eligible Medi-Cal beneficiaries who would otherwise receive care in an intermediate care facility, a skilled nursing facility, a sub-acute facility, or an acute care hospital.

Current Waiver (2017 - 2021)

Waiver Renewal Approval Letter  

Waiver Renewal Application - Approved 5/16/2017 

Documents for Public Comment  

 Addendum to Proposal for the NF-AH Waiver

Summary of Second Public Comment

 Second Notice of 30 day Public Comment

 Summary of Public Comment

 Notice of 30 day Public Comment

 Waiver Proposal

 Calendar of Events


A. Timeline

B. Current Waiver

C. Transition Plan

Public Comment Form


Send public comments via email to the following address:


Written public comment should be sent to the following address:

ATTN: Gopinath Vijayalakshmi

Department of Health Care Services

Long-Term Care Division

1501 Capitol Avenue, MS 4502

P.O. Box 997437

Sacramento, CA 95899-7437

Stakeholder Meetings 

Stakeholder Meetings

Technical Experts Workgroup 

Technical Experts Workgroup Statement of Interest

Technical Experts Workgroup Overview

Save the Date: Technical Experts Workgroup Meeting

Legislative Q & A 

November 4, 2015

Stakeholder Input 

DHCS values your input.  Please e-mail questions and comments to: or send written correspondence to:

Department of Health Care Services
Long-Term Care Division
1501 Capitol Avenue, MS 4503
P.O. Box 997437
Sacramento, CA 95814


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Last modified on: 7/14/2017 12:40 PM