Medi-Cal: Home and Community-Based Alternatives Waiver.

Plain English Breakdown

The official source does not provide specific details about the exact number and type of services covered under the HCBA Waiver.

Medi-Cal: Home and Community-Based Alternatives Waiver

This bill changes Medi-Cal rules for home and community-based services, requiring an increase in available slots each year.

What This Bill Does

• Changes existing laws about home and community-based services (HCBS) under Medi-Cal to focus on the Home and Community-Based Alternatives (HCBA) Waiver.
• Requires the State Department of Health Care Services to add at least 10,000 new HCBA slots each year starting in 2027.
• Removes the requirement for federal cost neutrality when expanding HCBA services.
• Requires the department to submit annual reports about HCBA slot numbers and waiting lists to the Legislature.

Who It Names or Affects

• People who receive Medi-Cal services through home and community-based alternatives.
• The State Department of Health Care Services which administers Medi-Cal.
• Legislators who will receive annual reports about HCBA slots and waiting lists.

Terms To Know

Medi-Cal

A health care program for low-income Californians, funded partly by the federal government.

Home and Community-Based Services (HCBS)

Services that help people live at home instead of in a nursing facility or hospital.

Limits and Unknowns

• The bill does not specify how much funding will be provided for the new HCBA slots.
• It is unclear if federal approval will be needed to remove the cost neutrality requirement.
• The exact number and type of services covered under the HCBA Waiver are not detailed in this summary.

Official Summary Text

AB 2081, as amended, Stefani.
Medi-Cal: Home and Community-Based Alternatives Waiver.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions.
Under existing law, home- and community-based services (HCBS) approved by the United States Department of Health and Human Services are covered for eligible individuals to the extent that federal financial participation is available for those services under the state plan or waivers granted in accordance with certain federal provisions. Existing law authorizes the Director of Health Care Services to seek waivers for any or all approvable HCBS.
Existing law sets forth provisions for the implementation of the
Nursing Facility/Acute Hospital Transition and Diversion Waiver, which is the predecessor of the Home and Community-Based Alternatives (HCBA) Waiver, for purposes of providing care management services to individuals who are at risk of nursing facility or institutional
placement.
placement, subject to federal cost neutrality.
Existing law sets forth provisions authorizing the director to expand the number of waiver slots up to 5,000 additional slots.
This bill would recast the above-described waiver provisions to refer to the HCBA Waiver and would delete the provision relating to the 5,000 slots. The bill would require the department, beginning in 2027,
to ensure that the HCBA Waiver provides for an annual increase of not fewer than 10,000 waiver slots for each waiver year,
and for the HCBA Waiver period, to increase the total number of waiver slots by 10,000, in addition to any planned expansion of waiver slots federally approved as of January 1, 2026,
as specified.
The bill would require the department to prepare and submit an annual report to the Legislature that provides certain information about waiver slot numbers, waiting list numbers,
demographics, and departmental efforts, as specified.
The bill would require the department, by March 1, 2027, to seek any necessary amendments to the HCBA Waiver to ensure that there is sufficient capacity to enroll all individuals who are eligible for, and express an interest in, participating in the HCBA Waiver who are currently on a waiting list. The bill would require the department to continue to monitor the capacity of the HCBA Waiver and to expand capacity, as specified.
Existing law requires the department to implement the waiver only to the extent that it can demonstrate federal cost neutrality as required under the terms of the waiver, and only to the extent any necessary federal approvals are obtained and federal financial participation is available.
This bill would recast those conditions, removing the federal cost neutrality criterion. The bill would authorize the
department to seek amendments to the HCBA Waiver or take other actions as necessary to implement these provisions.

Current Bill Text

Download Bill PDF