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HCBS

Home and Community-Based Services (HCBS) Waivers allow states that participate in Medicaid, known as Medi-Cal in California, to develop creative alternatives for individuals who would otherwise require care in a nursing facility or hospital. Medi-Cal has an agreement with the Federal Government, which allows for waiver services to be offered in either a home or community setting. The services offered under the waiver must cost no more than the alternative institutional level of care. Recipients of HCBS Waivers must have full-scope Medi-Cal eligibility.

 

Home and Community-Based Services (HCBS) were developed to offer support to individuals in community settings, as an alternative to institutional care. In 2014, new federal rules were released by the Centers for Medicare & Medicaid Services (CMS), requiring homes and programs where HCBS are delivered to meet new criteria. The Department and its partners are working to implement the requirements for home and community-based settings in accordance with this Final Rule.

 

Everyone who receives, or provides, HCBS services may be affected by the CMS Final Rule. Activities are happening now to help California meet these new requirements.

 

CMS issued guidance to states on July 14, 2020, indicating that the transition period for ensuring compliance with the HCBS Final Rule has been extended one year to March 17, 2023, in response to the COVID-19 pandemic. The guidance can be found here: https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/smd20003.pdf.


HCBS Final Rule Compliance Report VMRC