​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​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.

CountyDesignated COVID-19 “hotspot" as ofWaiver Agency
​Alameda​12/01/2020​Center for Elders' Independence
​Alpine​11/10/2020DHCS
​Amador​11/04/2020​Libertana Home Health
​Butte​11/16/2020​Home Health Care Management
​Calaveras11/24/2020​Libertana Home Health
​Colusa​11/10/2020Home Health Care Management
​Contra Costa​11/16/2020​Center for Elders' Independence
​Del Norte​11/16/2020​Home Health Care Management
Fresno10/13/2020Libertana Home Health
​El Dorado​11/16/2020​Home Health Care Management
Glenn10/13/2020Home and Health Care Management
​Humboldt​12/01/2020​Home Health Care Management
Imperial10/13/2020DHCS
​Inyo​10/27/2020​DHCS
Kern10/13/2020Libertana Home Health
Kings10/13/2020Libertana Home Health
Lake10/13/2020Home Health Care Management
​Lassen11/24/20​Home Health Care Management
Los Angeles10/27/2020
  1. ​Access TLC
  2. Libertana Home Health
  3. Partners in Care
Madera10/13/2020Libertana Home Health
​Marin​12/08/2020​DHCS
​Mariposa​12/01/2020​Libertana

Mendocino10/13/2020DHCS
Merced 10/13/2020Libertana Home Health
​Modoc​11/04/2020​Home and Health Care Management
​Mono​11/04/2020​DHCS
Monterey10/13/2020Libertana Home Health
​Napa​11/16/2020​DHCS
​Nevada​11/16/2020Home Health Care Management
​Orange​11/16/2020
  1. ​Access TLC
  2. Libertana Home Health
​Placer​11/10/2020​Home and Health Care Management
​Plumas​11/04/2020​Home and Health Care Management
Riverside10/13/2020Institute on Aging
​Sacramento​11/10/2020​Home and Health Care Management
​San Benito​11/16/2020​Libertana Home Health
San Bernardino10/13/2020Institute on Aging
​San Diego​11/10/2020​San Ysidro Health
​San Francisco​12/15/2020​Institute on Aging
San Joaquin10/13/2020Home 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
Shasta10/13/2020Home 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
Sonoma10/13/2020Sonoma Co. Human Services Dept.
Stanislaus10/13/2020Libertana Home Health
​Sutter​11/10/2020Home Health Care Management
Tehama10/13/2020Home Health Care Management
​Trinity​11/10/2020​Home Health Care Management
Tulare​10/13/2020​Libertana Home Health
Tuolumne11/16/2020Libertana Home Health
​Ventura​11/16/2020​Ventura County Agency on Aging
​Yolo​11/16/2020Home Health Care Management
​Yuba ​11/10/2020Home 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 dashboa​r​​d​, 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.

Waiver Agency
Service Area
Access TLC​​​
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
Sonoma County
Ventura County

Authorized Waiver

Participant Enrollment Information

How to submit an applications for the HCBA Waiver:
  1. 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
  2. Contact the Waiver Agency to request an application
  3. 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  

Other Participant Enrollment Information and Documents

 

Participant Information

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.​

Last modified date: 1/13/2023 10:20 AM