Home Services Long-Term Care Alternatives (Home and Community-Based Service Options) Home and Community-Based Alternatives Waiver

Home and Community-Based Alternatives Waiver

**DHCS is experiencing longer than normal processing times for WPCS requests and phone calls due to a high volume of
requests. Please allow additional time for processing and continue to work with the HCBA Waiver Agency assigned to your service area.**

HCBS Provider Minimum Wage Increase

Due to the enactment of Senate Bill 3, California’s statewide minimum wage will increase from $16.50 to $16.90 for all employers on January 1, 2026. As a result of California’s minimum wage increase, the 2026 Home and Community-Based Services reimbursement rates for specific provider types and procedure codes will also increase. Below is a list of the 2026 maximum payable rates that are applicable to HCBS programs.

Procedure Code	Provider Type	2026 Maximum Payable Rate	Unit	Impacted Waivers/ Programs
T1019	HHA (14)	$5.28	15 Minutes	HCBA Waiver, ALW, CCT
T1019	Personal Care Agency (66)	$5.28	15 Minutes	HCBA Waiver, ALW
T1019	HCBS Benefit Provider	$5.28	15 Minutes	HCBA Waiver
T1019	Employment Agency (64)	$5.28	15 Minutes	HCBA Waiver, ALW
T1019	Professional Corporation (95)	$5.28	15 Minutes	HCBA Waiver, ALW, CCT
T1005	Personal Care Agency (66)	$5.28	15 Minutes	HCBA Waiver, ALW
T1005	Personal Care Agency (66)	$5.28	15 Minutes	HCBA Waiver
T1005	Employment Agency (64)	$5.28	15 Minutes	HCBA Waiver

In order to be reimbursed at the new rate, agencies will need to submit claims using the higher rates listed above for all services provided effective January 1, 2026. This will allow your agency to be reimbursed at the new rates immediately, as opposed to needing to resubmit claims.

Please email iscd-cmu-wa@dhcs.ca.gov with any additional questions.

Overview

The Home and Community-Based Alternatives (HCBA) Waiver is approved by the Centers for Medicare & Medicaid Services (CMS) in five year increments and was most recently approved on February 2, 2023 for the 2023-2027 waiver period. 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 of nursing home or institutional placement. The care management services are provided by a multidisciplinary Care Management Team (CMT) comprised of a nurse and social worker. The CMT coordinates Waiver and State Plan services (such as medical, behavioral health, In-Home Supportive Services, etc.), and arranges for other 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.

Enrollment

Current enrollment and waitlist information for the HCBA Waiver can be found on the enrollment dashboard, which is updated monthly.

New applicants to the HCBA Waiver should be aware that the program has reached maximum capacity and a waiting list has been implemented effective July 12, 2023.

New applicants are encouraged to apply and secure a placement on the waiting list with the assigned Waiver Agency in their area of residence. When a slot becomes available, applicants on the waiting list who meet Reserve Capacity criteria will be prioritized for intake processing. Reserve Capacity criteria includes applicants transitioning from similar Home and Community Based Services (HCBS) Waivers because their needs can no longer be met, applicants under 21 years of age, or applicants who have been residing in a health care facility for at least 60 days at the time the HCBA Waiver application is submitted.

Complete applications submitted to DHCS for enrollment review prior to July 12, 2023 will continue to be processed with priority given to Reserve Capacity eligible applicants. DHCS is currently taking steps necessary to request an increase in waiver capacity as soon as possible. If you have questions about the status of your application, please contact your assigned Waiver Agency.

HCBA Waiver Renewal

HCBA Waiver Approval Letter
2023-2027 HCBA Waiver

Approved Amendments

Updated Telehealth and Early Periodic Screening, Diagnostic, and Treatment (EPSDT) Language (Effective December 1, 2025)
Waiver Personal Care Service (WPCS) Providers Sick Leave Amendment (Effective July 1, 2024), this amendment increases the number of paid sick leave hours available for WPCS providers.
Corrective Slot Increase Amendment (Effective January 1, 2024), this corrective amendment removes Waiver Personal Care Services (WPCS) as an approved telehealth service. This amendment also removes a duplicative performance measure.
Waiver Slot Increase (Effective January 1, 2024), this amendment increases the number of participants served for waiver years 2-5.
Corrective Telehealth Amendment (Effective November 12, 2023), this corrective amendment removes Waiver Personal Care Services (WPCS) as an approved telehealth service.
Telehealth Amendment (Effective November 12, 2023), this amendment adds telehealth as a permanent service delivery option for the following waiver services: Case Management; Community Transition Service; Comprehensive Care Management; Family/Caregiver Training; and Transitional Case Management.

Expired Amendments

Home and Community-Based Alternatives Waiver Expired Amendments

Approved Emergency Amendments

Approved Appendix K Southern California Fires in Los Angeles and Ventura Counties (Effective January 7, 2025) which temporarily allows authorized direct care waiver services to participants in alternative settings. The listed flexibilities are authorized under this amendment apply to waiver participants impacted by the State of Emergency in Los Angeles and Ventura Counties.

DHCS obtained approval for flexibilities accepted under the federal 1135 waiver authority which will expire January 7, 2026, for Los Angeles and Ventura Counties. The following flexibilities are available immediately.
Permit evacuating facilities (such as ICF-DDs, SNFs) to be fully reimbursed for services rendered to affected beneficiaries in alternative physical settings, such as temporary shelters or other care facilities.
Permit some services to continue to be provided without a requirement for a new or renewed prior authorization.
Temporarily allow services to be provided in settings that have not been determined to meet the HCBS Settings Rule criteria.
Temporarily extend the timeframe to reinstate services and benefits to an individual who files a fair hearing request.

HCBA Waiver Agencies

Most service areas are identified by county and include all of the zip codes within the county. However, individuals residing in Los Angeles and Orange Counties should refer to the links below to identify the Waiver Agency that covers their zip code.

Waiver Agency	Service Area
Access TLC	Santa Barbara, Ventura, and sections of Los Angeles and Orange Counties (service area defined by zip codes)
Centers for Elders’ Independence	Alameda and Contra Costa Counties
Home Health Care Management	Butte, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Nevada, Placer, Plumas, Sacramento, San Francisco, San Joaquin, Shasta, Sierra, Siskiyou, Solano, Sutter, Tehama, Trinity, Yolo, and Yuba Counties
Institute on Aging	Riverside and San Bernardino Counties
Libertana Home Health	Alpine, Amador, Calaveras, Fresno, Inyo, Kern, Kings, Madera, Mariposa, Merced, Mono, Monterey, San Benito, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz, Stanislaus, Tulare, Tuolumne and sections of Los Angeles and Orange Counties (service area defined by zip codes)
Partners in Care	Sections of Los Angeles County (service area defined by zip codes)
San Ysidro Health	Imperial, San Diego Counties
Sonoma County Human Services Department	Sonoma County

Participant Enrollment Information

How to submit an application for the HCBA Waiver:

Refer to the table above to see which Waiver Agency serves your county/zip code. Click on the Waiver Agency name to be directed to their webpage
Contact the Waiver Agency to request an application
Complete the application and submit it to the Waiver Agency

HCBA Grievances

If you are dissatisfied with your HCBA Care Management Team, or the HCBA services you receive, you may submit a grievance in the following ways:

Grievances regarding the quality or receipt of HCBA services must be submitted to your Waiver Agency via email, mail, or telephone. Your Waiver Agency’s contact information can be found linked in the “HCBA Waiver Agencies” section above.
Grievances regarding the coordination of care by your Waiver Agency must be submitted to DHCS via email at: ISCDCompliance@dhcs.ca.gov.
Grievances regarding your Congregate Living Health Facility must be submitted to DHCS via email at: ISCDCompliance@dhcs.ca.gov.

For more information about HCBA grievances, please review the HCBA Grievance Fact Sheet.

For more information about HCBS grievances and Hearings, please reference the website Home-and-Community-Based-Services-(HCBS)–Grievance-and-Hearings.

Additional Resources

DHCS is experiencing longer than normal processing times for WPCS requests and phone calls due to a high volume of requests. Please allow additional time for processing and continue to work with the HCBA Waiver Agency assigned to your service area.

Waiver Personal Care Services Resources

Waiver Personal Care Services (WPCS) Webpage

Contact Us

Waiver participants and providers, please email your comments and questions regarding the HCBA Waiver to: HCBAlternatives@dhcs.ca.gov or call toll-free (833) 388-4551.

WPCS participants and providers can call the WPCS Hotline (916) 552-9214.