AIDS Medi-Cal Waiver Program
Local agencies, under contract with the California Department of Public Health, Office of AIDS, provide home- and community-based services as an alternative to nursing facility care or hospitalization.
The Medi-Cal Waiver Program (MCWP) provides comprehensive case management and direct care services to persons living with HIV/AIDS as an alternative to nursing facility care or hospitalization. Case management is participant centered and provided using a team-based approach by a registered nurse and social work case manager. Case managers work with the participant, their primary care provider, family, caregivers, and other service providers to determine and deliver needed services to participants who choose to live in a home setting rather than an institution.
The goals of the MCWP are to:
- Assist participants with disease management, preventing HIV transmission, stabilizing overall health, improving quality of life, and avoiding costly institutional care;
- Increase coordination among service providers and eliminate duplication of services;
- Transition participants to more appropriate programs as their medical and psychosocial status improves, thus freeing MCWP resources for those in most need; and
Enhance utilization of the program by underserved populations.
Clients eligible for the program must be Medi-Cal recipients: whose health status qualifies them for nursing facility care or hospitalization, in an “Aid Code” with full benefits and not enrolled in the Program of All-Inclusive Care for the Elderly (PACE); have a written diagnosis of HIV disease or AIDS with current signs, symptoms, or disabilities related to HIV disease or treatment; adults who are certified by the nurse case manager to be at the nursing facility level of care and score 60 or less using the Cognitive and Functional Ability Scale assessment tool, children under 13 years of age who are certified by the nurse case manager as HIV/AIDS symptomatic; and individuals with a health status that is consistent with in-home services and who have a home setting that is safe for both the client and service providers.
For further information refer to the
Office of AIDS.
AIDS Medi-Cal Waiver Program Waiver Renewal: 2022 - 2026
The California Department of Health Care Services (DHCS), in collaboration with the California Department of Public Health (CDPH), must renew its MCWP Waiver, authorized under section 1915(c) of the Social Security Act, every five years. The current waiver term ends on December 31, 2021. The new waiver term will be January 1, 2022, through December 31, 2026. DHCS submitted the MCWP renewal application to the Centers for Medicare & Medicaid Services (CMS) on September 29, 2021.
The renewal application includes new and revised content based on input DHCS received from stakeholders during the 30-day Public Comment Period held August 13 – September 13, 2021. All changes to the MCWP Waiver program must be approved by CMS before they can be implemented.
Third Temporary Extension of the 2017-2021 HIV/AIDS Waiver Term
On June 21, 2022, the Centers for Medicare & Medicaid Services (CMS) approved DHCS' request to extend the current term of the HIV/AIDS waiver for an additional 90–day period. The previous temporary waiver extension was scheduled to expire on June 29, 2022. This temporary extension allows the HIV/AIDS Waiver to continue operating through September 27, 2022.
Second Temporary Extension of the 2017-2021 HIV/AIDS Waiver Term
On March 23, 2022, the Centers for Medicare and Medicaid Services (CMS) approved DHCS' request to extend the current term of the HCBA Waiver for 90 days. This waiver is currently scheduled to expire on March 31, 2022. This temporary extension allows the HIV/AIDS Waiver (to continue operating through June 29, 2022. The extension provides the state with additional time to finalize its responses to the CMS formal request for additional information (RAI) and resubmit a revised waiver renewal application.
Temporary Extension of the 2017-2021 HIV/AIDS Waiver Term
On December 22, 2021, the Centers for Medicare and Medicaid Services (CMS) approved DHCS' request to extend the current term of the HCBA Waiver for 90 days. The waiver was scheduled to expire on December 31, 2021. This temporary extension allows the HIV/AIDS Waiver to continue operating through March 31, 2022. The extension provides the state with additional time to finalize its responses to the CMS formal request for additional information (RAI) and resubmit a revised waiver renewal application.
2022-2026 AIDS Waiver Renewal - Public Comment Period
DHCS posted the 2022 MCWP Waiver renewal application for a 30-day Public
Comment Period, from August 13 through September 13, 2021, prior to submitting
the Renewal Application to the Centers for Medicare and Medicaid Services (CMS)
for reauthorization.
