Home & Community‑Based Services (HCBS)
The primary goal of California’s Department of Developmental Services (“DDS”) is to help individuals with developmental disabilities access the care they need to live lives of dignity and independence. DDS Home & Community-Based Services (HCBS) is one key channels through which the DDS achieves its underlying goal.
The entire HCBS approach to providing care is grounded in the belief that individuals with developmental disabilities should have the same opportunities for independence and community life as anyone else. More specifically, HCBS is grounded in the idea that many people can be better served by receiving care in their homes rather than an institution. By shifting resources from institutions to home and community settings, HCBS enhances quality of life for individuals with developmental disabilities, as well as their families. Additionally, HCBS also respects the individual choice and dignity of those receiving care.
HCBS Waiver California DDS
There are two primary ways DDS participants can access HCBS care. The first is the HCBS waiver. Also known as a 1915(c) waiver, this funding allows individuals who receive Medicaid, also known as Med-Cal in California, to use their Medicaid to access care not typically available through Medicaid. Specifically, this waiver allows individuals with developmental disabilities to use Medicaid to pay for DDS services.
Along with a 1915(c) waiver, individuals can access HCBS care through 1915(i) care. Similar to a 1915(c) waiver, individuals accessing 1915(i) care do so through Medicaid.
In summary, the 1915(c) waiver and 1915(i) programs allow developmentally disabled individuals to access HCBS services through Medicaid. The key difference lies in eligibility. On the one hand, 1915(c) waivers are for those who would ordinarily require long-term institutional care. On the other hand, 1915(i) funding allows individuals with developmental disabilities to access HCBS even if their condition is not so serious to require institutional care.
How to Access Home and Community-Based Services
Because HCBS is funded through Medicaid, the primary eligibility requirement is that HCBS recipients must be eligible for Medicaid.
From there, the actual process is obtaining home and community services is relatively simple. The process begins with an assessment by the local regional center. During the assessment, case workers will evaluate each individual’s needs with the goal of developing a customized care plan that can be delivered entirely at home or in the community.
FAQ
Q: What is HCBS and how is it different from regular DDS services?
A: HCBS is not all that different from other types of DDS services. The primary distinction is that HCBS focuses on delivering care directly in a person’s home or community rather than an institutional setting.
Q: Who can qualify for the HCBS waiver?
A: Individuals with developmental disabilities who are eligible for Medicaid may qualify for HCBS services. The key here is Medicaid eligibility, since one way or another HCBS is funded by Medicaid.
Q: Does HCBS replace institutional care?
A: Not entirely. While HCBS emphasizes community living, some individuals may still require institutional care. HCBS, whether paid for by a 1915(c) waiver or through 1915(i) funding, gives people the choice to remain in the community.
Q: Can family members provide services under HCBS?
A: In some cases, yes. Certain types of support and care may be delivered by relatives if approved under the person-centered plan.
Q: Is there a waiting list for HCBS?
A: Availability of services can vary, so contact your regional center for the most current information. Your regional center can also start the process of securing funding and resources for your HCBS services.
Q: What is the cost to participants?
A: Eligible participants do not pay out of pocket for HCBS services. Rather, services are funded through Medicaid and administered by DDS through either a 1915(c) waiver or 1915(i) funding.