How to apply for Home and Community-Based Alternatives (HCBA) Waiver

Who it's for

The HCBA Waiver is California's Medi-Cal waiver for people with the highest level of medical need — those who would otherwise require ongoing care in a hospital or a nursing facility but can be safely served at home with intensive support. A waiver-agency registered nurse builds and manages an individualized care plan that can include in-home skilled nursing (including shift nursing for medically fragile people), care management, personal care, habilitation, family/caregiver training, medical equipment operating expenses, communication devices, environmental accessibility adaptations (wheelchair ramps, widened doorways, roll-in showers), and private-duty nursing. It is the most intensive of California's home-care alternatives and is intended to prevent or reverse institutional placement for medically complex individuals.

What you'll need

• Medi-Cal card or Medi-Cal application confirmation showing full-scope coverage
• Recent hospital or physician records documenting hospital- or nursing-facility-level of care need
• Care needs assessment by an enrolled HCBA waiver agency registered nurse (scheduled after referral)
• Documentation of current providers, medications, and equipment

Where to apply

Renewals

annual (re-assessment of level-of-care and Medi-Cal eligibility)