People with developmental disabilities in California have important resources to ensure they receive the care and support they need. Medi-Cal and the Home and Community-Based Services (“HCBS”) waiver are two important channels through which the state provides healthcare and other support services to Californians. While both programs are essential, they serve different purposes and cover different types of services. Understanding these distinctions can help families and individuals make the most of the vital resources available to them.
What is Medi-Cal?
Medi-Cal is California’s version of Medicaid, providing comprehensive health coverage for eligible low-income residents. For individuals with developmental disabilities, Medi-Cal covers standard medical needs such as doctor visits, hospital care, prescription medications, mental health treatment, and dental services. In other words, Medi-Cal focuses on healthcare and medical treatment, ensuring individuals can maintain their physical and mental well-being.
What is the HCBS Waiver?
HCBS waiver services, administered by the Department of Developmental Services (“DDS”), go beyond medical care. In essence, the HCBS waiver fills in the gaps that regular Medi-Cal does not cover.
More specifically, HCBS allows developmentally disabled individuals to receive care in their community or at home, rather than in institutional settings. The waiver allows the state to access federal funds that can be used to reimburse the cost of community and home based care.
Services covered by the waiver may include respite services to assist family members and in-home caregivers, day programs, a variety of therapeutic services, and in some cases, may help with the costs of medical equipment and home modifications.
The Key Differences
To summarize, Medi-Cal provides the foundation of medical care by covering healthcare-related services. The HCBS waiver adds a key supportive framework specifically for individuals with developmental disabilities. The HCBS waiver helps cover the cost of non-medical care and support. Importantly, the HCBS waiver prioritizes care in the community and home, helping individuals with developmental disabilities thrive in their homes, families, and communities.