Home & Community-Based Alternatives Waiver
Waiver Integration Amendment
The Department of Health Care Services (DHCS) is amending the Home and Community-Based Alternatives (HCBA) Waiver to integrate Assisted Living Waiver (ALW) services, in alignment with the end date of the current ALW term, February, 28, 2024. Information on the waiver integration amendment is available at the Home & Community-Based Alternatives Waiver and Assisted Living Waiver Integration page.
Fifth Temporary Extension of the 2017-2021 HCBA Waiver Term
On December 13, 2022, the Centers for Medicare & Medicaid Services (CMS) approved DHCS' request to extend the current term of the HCBA Waiver for an additional 90-day period. The previous Waiver extension was scheduled to expire on December 26, 2022. This temporary extension allows the HCBA Waiver to continue operating through March 26, 2023.
Fourth Temporary Extension of the 2017-2021 HCBA Waiver Term
On September 26, 2022, the CMS approved DHCS' request to extend the current term of the HCBA Waiver for an additional 90-day period. The previous Waiver extension was scheduled to expire on September 27, 2022. This temporary extension allows the HCBA Waiver to continue operating through December 26, 2022.
Third Temporary Extension of the 2017-2021 HCBA Waiver Term
On June 21, 2022, the CMS approved DHCS' request to extend the current term of the HCBA Waiver for an additional 90–day period. The second waiver extension was scheduled to expire on June 30, 2022. This temporary extension allows the HCBA Waiver to continue operating through September 27, 2022.
Second Temporary Extension of the 2017-2021 HCBA Waiver Term
On March 23, 2022, CMS approved DHCS' request to extend the current term of the HCBA Waiver for an additional 90–day period. The initial Waiver extension was scheduled to expire on March 31, 2022. This temporary extension allows the HCBA Waiver to continue operating through June 29, 2022.
Temporary Extension of the 2017-2021 HCBA Waiver Term
On December 22, 2021, 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, and the temporary extension allows the HCBA Waiver to continue through March 31, 2022. The extension provides CMS with additional time to review the HCBA Waiver renewal application, and allows the State time to respond to CMS' formal Request for Additional Information, and resubmit a revised Waiver renewal application.
HCBA Policy Letter #21-001: COVID-19 Vaccine Administration
DHCS is issuing HCBA Policy Letter #21-001 to notify HCBA Waiver Agencies about the update to California's vaccine administration prioritization, effective March 15, 2021, and to provide Waiver Agencies with instructions for the HCBA Waiver Agency participant notification plan, in advance of the March 15, 2021, effective date.
2022-2026 HCBA Waiver Renewal
The current HCBA Waiver term was set to end on December 31, 2021. CMS has approved multiple DHCS requests for temporary extensions to extend the 2017-2021 HCBA Waiver term and allow it to continue operating. On September 29, 2022, DHCS submitted a waiver renewal application to CMS to request reauthorization of the HCBA Waiver for a new five-year waiver term from January 1, 2022, through December 31, 2026.
The reauthorization process allows CMS to evaluate states' Medicaid waiver programs for compliance with Waiver assurances and federal requirements. In addition, the Waiver renewal process allows states to make changes to the Waiver to include best practices, respond to the changing needs of the population, address state and federal law and regulations, etc. DHCS is committed to engaging the public for input on the Waiver renewal and has created a webpage to provide information on the Waiver renewal process, including information on the ways in which the public can submit input to DHCS. Access the HCBA Waiver Renewal Webpage.
COVID-19 Response Guidance
In response to the COVID-19 public health emergency (PHE), DHCS has submitted requests to CMS to implement flexibilities to help protect the health and safety of the public. Approved requests, as well as guidance on the implantation of the temporary flexibilities is available on DHCS' COVID-19 Information for Providers & Partners webpage.
COVID-19 Hotspot Enrollment
On September 17, 2020, CMS authorized California’s request to
temporarily modify 1915(c) Waiver enrollment policy for the HCBA Waiver to
prioritize intake processing of Waiver applicants residing in hospitals and
skilled nursing facilities in areas of the state identified as “hotspots.” The
temporary enrollment flexibility is available Waiver-wide, but only applies to
individuals within counties with the highest rates of new COVID-19 infections.
For more information on the Appendix K temporary authorization of prioritized
enrollment of applicants in COVID-19 “hotspots,” please visit DHCS’ COVID-19
Information for Providers & Partners webpage.
|County||Designated COVID-19 “hotspot" as of||Waiver Agency|
|Alameda||12/01/2020||Center for Elders' Independence|
|Amador||11/04/2020||Libertana Home Health|
|Butte||11/16/2020||Home Health Care Management|
|Calaveras||11/24/2020||Libertana Home Health|
|Colusa||11/10/2020||Home Health Care Management|
|Contra Costa||11/16/2020||Center for Elders' Independence|
|Del Norte||11/16/2020||Home Health Care Management|
|Fresno||10/13/2020||Libertana Home Health|
|El Dorado||11/16/2020||Home Health Care Management|
|Glenn||10/13/2020||Home and Health Care Management|
|Humboldt||12/01/2020||Home Health Care Management|
|Kern||10/13/2020||Libertana Home Health|
|Kings||10/13/2020||Libertana Home Health|
|Lake||10/13/2020||Home Health Care Management|
|Lassen||11/24/20||Home Health Care Management|
- Access TLC
- Libertana Home Health
- Partners in Care
|Madera||10/13/2020||Libertana Home Health|
|Merced ||10/13/2020||Libertana Home Health|
|Modoc||11/04/2020||Home and Health Care Management|
|Monterey||10/13/2020||Libertana Home Health|
|Nevada||11/16/2020||Home Health Care Management|
- Access TLC
- Libertana Home Health
|Placer||11/10/2020||Home and Health Care Management|
|Plumas||11/04/2020||Home and Health Care Management|
|Riverside||10/13/2020||Institute on Aging|
|Sacramento||11/10/2020||Home and Health Care Management|
|San Benito||11/16/2020||Libertana Home Health|
|San Bernardino||10/13/2020||Institute on Aging|
|San Diego||11/10/2020||San Ysidro Health|
|San Francisco||12/15/2020||Institute on Aging|
|San Joaquin||10/13/2020||Home and Health Care Management|
|San Luis Obispo||11/16/2020||Libertana Home Health|
|San Mateo||12/01/2020||Institute of Aging|
|Santa Barbara||12/01/2020||Access TLC|
|Santa Clara||12/01/2020||Libertana Home Health|
|Santa Cruz||11/16/2020||Libertana Home Health|
|Shasta||10/13/2020||Home and Health Care Management|
|Sierra||11/16/2020||Home Health Care Management|
|Siskiyou||11/10/2020||Home and Health Care Management|
|Solano||11/10/2020||Home and Health Care Management|
|Sonoma||10/13/2020||Sonoma Co. Human Services Dept.|
|Stanislaus||10/13/2020||Libertana Home Health|
|Sutter||11/10/2020||Home Health Care Management|
|Tehama||10/13/2020||Home Health Care Management|
|Trinity||11/10/2020||Home Health Care Management|
|Tulare||10/13/2020||Libertana Home Health|
|Tuolumne||11/16/2020||Libertana Home Health|
|Ventura||11/16/2020||Ventura County Agency on Aging|
|Yolo||11/16/2020||Home Health Care Management|
|Yuba ||11/10/2020||Home Health Care Management|
HCBA Waiver Overview
The HCBA Waiver (formerly the Nursing Facility/Acute Hospital (NF/AH) Waiver) was approved by CMS on May 16, 2017. Medicaid's 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 for 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 available 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.
HCBA Waiver Current 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 number of available slots is limited. Waiver Agencies in areas with waitlists are working diligently to enroll as many new participants as their capacity allows. Waiting periods for Waiver enrollments are expected to decrease over time. Special circumstances may qualify an applicant for priority enrollment; please contact the Waiver Agency in your area for more information.
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.
Santa Barbara County, and sections of Los Angeles and Orange Counties
Alameda and Contra Costa Counties
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
San Francisco, San Mateo, San Bernardino, and Riverside Counties
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
Sections of Los Angeles County
San Diego County
Participant Enrollment Information
How to submit an applications 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.
Other Participant Enrollment Information and Documents
Waiver Personal Care Services Resources
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.