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, parallel to the renewal of the ALW for a final five-year term. Information on the waiver integration amendment is available on the Home & Community-Based Alternatives Waiver and Assisted Living Waiver Integration page.
2023-2027 HCBA Waiver Renewal
On February 2, 2023, the Centers for Medicare & Medicaid Services (CMS) approved the renewal of the HCBA Waiver for individuals who are medically fragile and technologically dependent. The waiver has been approved for a five-year period with a retroactive start date of January 1, 2023.
Authorized Waiver
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.
HCBA PL #21-001: COVID-19 Vaccine Administration[KN1] is also posted to DHCS' COVID-19 response page to provide HCBA Waiver Agencies with information about vaccine administration, testing requirements, and health care worker vaccine requirements.
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, and was applied in all 58 counties by December 2020. For more information on the Appendix K temporary authorization of prioritized enrollment of applicants in COVID-19 “hotspots,” please visit
COVID-19 Information for Providers & Partners webpage.
HCBA Waiver Overview
The HCBA Waiver (formerly the Nursing Facility/Acute Hospital (NF/AH) Waiver) was approved by CMS on February 2, 2023. 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
dashboard, 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.
Access TLC | Santa Barbara County, and sections of Los Angeles and Orange Counties
(service area defined by zip codes)
|
Centers for Elders’ Independence | Alameda and Contra Costa Counties |
Home Health Care Management | 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 |
Institute on Aging | San 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 Health | San Diego County |
Sonoma County Human Services Department
| Sonoma County |
Ventura County Agency on Aging
| Ventura County |
Participant Enrollment Information
How to submit an application 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.
DHCS Counties:
- Alpine
- Imperial
- Inyo
- Marin
- Mendocino
- Mono
- Napa
Other Participant Enrollment Information and Documents
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.
