Home and Community-Based Alternatives (HCBA) Waiver Program
HCBA Hotline: 1-800-251-6764
The Home and Community-Based Alternatives (HCBA) Waiver allows Medi-Cal beneficiaries with high-level care needs to continue to live at home or in the community by identifying and ensuring they receive services that will sustain their health and safety outside of an institution.
The HCBA Waiver provides care management services to persons at risk for nursing home or institutional placement. Care management services are provided by a multidisciplinary care team comprised of a nurse and social worker, which 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.
Comprehensive Care Management (CCM):
- Provided by a Care Management Team (CMT) comprised of a Nurse and a Social Worker with at least a master’s degree.
- Coordinate / monitor medically necessary state plan and Waiver services, and other non Medi-Cal services available from across delivery systems, regardless of the funding source.
- Conduct assessments to determine participants’ Level of Care (LOC).
- Review / approve person-centered Plans of Treatment.
- Conduct on-site home visits based on participants’ acuity levels.
- Contact participants, in-person or by phone, at least once a month.
- Report / manage health and safety issues, and critical incidents.
Services that may be provided to support Waiver Participants in the community:
- In-home Nursing Services
- Waiver Personal Care Services (WPCS)
- Family/Caregiver Training
- Home or Facility Respite
- Habilitation Services
- Community Transition Services
- Environmental Accessibility Adaptation
- Medical Equipment Operating Expenses
- Personal Emergency Response System (PERS) – Installation, Testing and Operation
This 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.