Home & Community-Based Alternatives Waiver

Latest Updates:  

HCBA Waiver Amendment Notice of 30-Day Public Comment Period is August 12 - September 10, 2019.

The Department of Health Care Services (DHCS) intends to submit an amendment of the HCBA Waiver to the Centers for Medicare and Medicaid Services (CMS) for approval to modify the prioritization of entrants into the waiver.

The full text of the proposed amendment to the HCBA Waiver is available by clicking on the following hyperlink: Proposed HCBA Waiver Amendment

Written Public Comment Period

Public comments will be accepted from August 12, 2019 through 5:00 pm on September 10, 2019.

Any interested person, or his or her authorized representative, may submit written comments to DHCS relevant to the amendment. All comments and input received during the 30-day public comment period will be considered for incorporation into the HCBA Waiver amendment.

All comments are to be submitted to DHCS using the comment template available at the following hyperlink: Public Comment Template

Comments must be received by the Department, or post-marked, no later than 5:00 p.m., Tuesday, September 10, 2019. Comments may be submitted to the HCBA Alternatives email inbox, at: HCBAlternatives@DHCS.CA.gov; please include “HCBA Amendment Public Comment" in the Subject line.

Or by mail, to:

Department of Health Care Services

Integrated Systems of Care Division, MS 4502

P.O. Box 997437

Sacramento, CA 95899-7437

Attention: HCBS Section

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 AgencyService Area
Access TLC

Santa Barbara County, and sections of Los Angeles and Orange Counties


(service area defined by zip codes)

Centers for Elders' IndependenceAlameda and Contra Costa Counties
Home Health Care ManagementButte, 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 AgingSan 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 HealthSan Diego County
Sonoma County Human Services DepartmentSonoma County
Ventura County Agency on AgingVentura County

Authorized Waiver

Participant Enrollment Information

How to Submit 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: 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.   

Last modified date: 8/16/2019 2:24 PM