Home and Community-Based Alternatives Waiver
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
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
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.
Access TLC | Santa Barbara County, 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, Glenn, Sacramento, San Joaquin, Shasta, Solano, Sutter, Tehama, Yolo, Yuba, Colusa, Del Norte, El Dorado, Humboldt, Lake, Lassen, Modoc, Nevada, Placer, Plumas, Sierra, Siskiyou, and Trinity Counties |
Institute on Aging | San Francisco, San Mateo, San Bernardino, and Riverside Counties |
Libertana Home Health | Kern, Fresno, Kings, Tulare, Madera, Mariposa, Merced, Stanislaus, Tuolumne, San Luis Obispo, Amador, Calaveras, Santa Clara, Santa Cruz, San Benito, Monterey, 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 | San Diego County |
Sonoma County Human Services Department
| Sonoma County |
Ventura County Agency on Aging
| Ventura 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
If you live in one of the seven counties listed below, you will submit your application to the State. Use the HCBA Waiver Participant Application and follow the instructions on the application to mail it to DHCS.
DHCS Counties:
- Alpine
- Imperial
- Inyo
- Marin
- Mendocino
- Mono
- Napa
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.
- If you reside in: Alpine, Imperial, Inyo, Marin, Mendocino, Mono, or Napa counties, your grievance must be submitted to DHCS via email at: ISCDCompliance@dhcs.ca.gov.
- 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, here.
Other Participant Enrollment Information and Documents
Spanish translation of HCBA Waiver Participant Application/Solicitud del Programa de Exención de Alternativas Basadas en el Hogar y la Comunidad (HCBA)
Additional Resources
Waiver Personal Care Services Resources
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.
