Home & Community-Based Alternatives Waiver

 Latest Updates:  

 The draft HCBA Waiver Policy Letter (PL), #19-001, available by clicking on the “DRAFT HCBA Waiver PL #19-001 – Under 21” hyperlink below, is being made available to the public for a two week comment period. All comments should be submitted to DHCS using the comment template available at the “Policy Letter Comment Template” hyperlink below.  Comments must be received by the Department by 4:00 p.m., Friday, May 17, 2019. Comment forms may be submitted to the HCBA Alternatives email inbox or by mail. , at: HCBAlternatives@DHCS.CA.gov, The subject line of the e-mail must include, “Public Comment on Draft PL 19-001.” All forms must include the name of the individual submitting the question and his or her email address.

 Responses may also be submitted by mail to the following address:
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 Agency
Service Area
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 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: 11/5/2019 12:01 PM