Eligibility for Waiver Personal Care Services

The California Department of Social Services (CDSS) has provided information regarding Medi-Cal Home and Community Based Alternative (HCBA) Waiver through the Waiver Personal Care Services (WPCS) program. CDSS also clarifies new roles that the counties must adhere to regarding information sharing and referrals through the waiver program.

The HCBA Waiver provides care management assistance to people at risk for institutional or nursing home placement. With HCBA, a multidisciplinary team of registered nurses and social workers provide care management services to waiver beneficiaries. The waiver covers direct and indirect care services, including WPCS. Under the HCBA waiver, recipients may get up to 24 hours of direct care. The Department of Health Care Services (DHCS) administers the HCBA waiver program by contacting the HCBA Waiver agencies.

HCBA Waiver Services include:

  •     Private home health services/nursing
  •     Case management
  •     Habilitation
  •     Home and Family respite
  •     Community transition services
  •     Environmental accessibility adaptations
  •     Waiver Personal Care Services (WPCS) 

County In-Home Supportive Services (IHSS) Staff must:

-Notify DHCS/Waiver Agency staff of services hours approved by the recipient, and

-Determine eligibility for IHSS hours for those not authorized for WPCS services.

County staff must also share case file information to help DHCS/Waiver Agencies determine the number of WPCS hours to approve. County staff may request that the Waiver Agency supplies a list of mutual recipients in their county.

To be considered for the Waiver Personal Care Services Program candidates apply for enrollment in the HCBA waiver. A receipt will be sent for the candidate’s application. Then a representative from DHCS or relevant HCBA waiver agency will schedule a first in-home assessment to see if the candidate qualifies. Individuals must be currently receiving IHSS and have a maximum of 283 IHSS hours to be eligible for WPCS for specific tasks not covered by IHSS hours.

County IHSS staff will assess the recipient annually to determine IHSS service needs. This reassessment must include updating DHCS/Waiver Agency staff regarding any changes in services to the recipient.  (ACL 21-154, December 30, 2021.)