Home & Community-Based Alternatives Waiver
Latest Updates:
The final HCBA Waiver Policy Letter (PL) #19-001 is available by clicking the "HCBA Waiver PL#19-001" hyperlink below, and on the "HCBA Policies" page under Additional Resources. The Policy Letter outlines DHCS policies regarding prioritized intake screening and enrollment of applicants under the age of 21.
HCBA Waiver PL#19-001
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 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.
Waiver Agency |
Service Area |
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Santa Barbara County, and sections of Los Angeles and Orange Counties
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Alameda and Contra Costa Counties |
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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 |
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San Francisco, San Mateo, San Bernardino, and Riverside Counties |
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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
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Sections of Los Angeles County
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San Diego County |
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Sonoma County |
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Ventura County |
Authorized Waiver
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
Participant Information
Additional 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 1-833-388-4551.
