Home & Community-Based Alternatives Waiver
2022-2026 HCBA Waiver Renewal
The HCBA Waiver term ends December 31, 2021 and DHCS and has begun efforts to develop a waiver renewal application to submit to the Centers for Medicare and Medicaid Services (CMS) for reauthorization. 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 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, a 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, the
Centers for Medicare and Medicaid Services (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|
|Fresno||10/13/2020||Libertana Home Health|
|Glenn||10/13/2020||Home and Health Care Management|
|Kern||10/13/2020||Libertana Home Health|
|Kings||10/13/2020||Libertana Home Health|
|Lake||10/13/2020||Home and Health Care Management|
|Los Angeles||10/27/2020||1. Access TLC|
|3. Partners in Care|
|Madera||10/13/2020||Libertana Home Health|
|Merced ||10/13/2020||Libertana Home Health|
|Monterey||10/13/2020||Libertana Home Health|
|Riverside||10/13/2020||Institute on Aging|
|San Bernardino||10/13/2020||Institute on Aging|
|San Joaquin||10/13/2020||Libertana Home Health|
|Shasta||10/13/2020||Home and Health Care Management|
|Sonoma||10/13/2020||Sonoma Co. Human Services Dept.|
|Stanislaus||10/13/2020||Libertana Home Health|
|Tehama||10/13/2020||Home and Health Care Management|
|Tulare||10/13/2020||Libertana Home Health|
HCBA Waiver Overview
The HCBA Waiver (formerly the Nursing Facility/Acute Hospital (NF/AH) Waiver) was approved by the Centers for Medicare and Medicaid Services (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 team comprised of a nurse and social worker. The care management team coordinates Waiver and State Plan services (e.g., 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 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 enrolments 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 your 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 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.
Alpine, Imperial, Inyo, Marin, Mendocino, Mono, Napa
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 1-833-388-4551.
WPCS participants and providers can call the WPCS Hotline