Community-Based Adult Services – Formerly “Adult Day Health Care”

Community-Based Adult Services (CBAS) became effective on April 1, 2012, under the California Bridge to Health Care Reform waiver (search for Community-Based Adult Services related sections). CBAS was included in California’s Section 1115(a) Medicaid Waiver, entitled Medi-Cal 2020. The 1115(a) waiver was approved by the Centers for Medicare & Medicaid Services (CMS) on December 30, 2015, was effective through December 31, 2020. DHCS received approval from CMS for a 12-month waiver extension on December 29, 2020. Currently, the 1115(a) waiver is renewed for an additional 5-year term, entitled CalAIM, effective December 29, 2021 through December 31, 2026.

CBAS Authority Transition

DHCS is collaborating with the California Department of Aging (CDA) to transition and strengthen coverage of the CBAS benefit from the CalAIM Section 1115 demonstration to the 1915(i) State Plan Amendment (SPA) for the next waiver term.  

Based on DHCS’ assessment of available federal authorities, the Department determined that 1915(i) SPA authority is optimal because:

• Services covered under 1915(i) SPA authority are considered entitlements in the Medicaid State Plan. 

• Individuals currently eligible for CBAS under 1115 authority would remain eligible for CBAS covered under 1915(i) SPA authority. 

• There would be a seamless transition for managed care plans and providers as CBAS (through a CBAS provider or unbundled CBAS) would continue to be covered statewide and offered through Medicaid managed care and fee-for-service.  

• Continuation of federal home and community-based services (HCBS) requirements (e.g., settings rule, eligibility determination, person-centered treatment planning) that already apply under 1115 authority would be maintained. 

Stakeholder Engagement

To promote transparency and provide opportunities for input, DHCS and CDA will host informational webinars, as well as present the draft 1915(i) SPA application for a 30-day public comment and tribal notice period.  

DHCS will post slide decks to this webpage after each webinar. Please refer to this section to view the meeting materials. 

• September 23, 2026, PowerPoint Slides

Find a quick answer for frequently asked questions.

Transition Questions

Please feel free to send your questions regarding the CBAS authority transition to CBASTransition@dhcs.ca.gov. 

CBAS Services

CBAS offers services to eligible older adults and/or adults with disabilities to restore or maintain their optimal capacity for self-care and delay or prevent inappropriate or personally undesirable institutionalization.

CBAS services include:

• an individual assessment;
• professional nursing services;
• physical, occupational and speech therapies;
• mental health services;
• therapeutic activities;
• social services;
• personal care;
• a meal;
• nutritional counseling;
• transportation to and from the participant’s residence and the CBAS center.

CBAS replaced Adult Day Health Care (ADHC) services which were an optional benefit under the Medi-Cal Program through February 29, 2012.

CBAS is a Medi-Cal Managed Care benefit available to eligible Medi-Cal beneficiaries enrolled in Medi-Cal Managed Care. Eligibility to participate in CBAS is determined by the beneficiary’s Medi-Cal Managed Care Plan. Other Medi-Cal beneficiaries ineligible to enroll in Medi-Cal Managed Care may receive CBAS, if found eligible through the Los Angeles Medi-Cal Field Office, or it’s designee.

Contact us

Please feel free to send your questions regarding CBAS/ADHC to CBASCDA@aging.ca.gov