Overview of Medi-Cal Community-Based Adult Services Program
California’s Community-Based Adult Services (CBAS) Program is an adult day health care program for seniors and adults who are disabled or have chronic medical, cognitive, or behavioral conditions. Intended to prevent and delay premature nursing home admissions, supportive services are provided in adult day health care centers that are certified as CBAS centers. This includes daytime supervision, nursing services, personal care assistance, and transportation to and from the CBAS center.
CBAS centers are not located in all CA counties. Currently, there are approximately 321 centers within 28 counties: Alameda, Butte, Contra Costa, Fresno, Humboldt, Imperial, Kern, Los Angeles, Madera, Merced, Monterey, Napa, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Shasta, Solano, Stanislaus, Tulare, Ventura, and Yolo. If there is not a CBAS center in one’s county, they may be able to attend a CBAS center in a neighboring county if it is within an hour drive from their home.
While many Home and Community Based Services (HCBS) Medicaid programs allow program participants to self-direct their own care, specifically allowing them to hire their own caregiver, this is not an option through the CBAS Program. However, program participants have a say in which CBAS center they would like to attend.
Community-Based Adult Services are not an entitlement. CBAS centers have limited capacity and when capacity is reached, a waitlist forms. CBAS centers are individually owned and operated, and therefore, any waitlist(s) that exist are CBAS center-specific.
The Community-Based Adult Services (CBAS) Program operates under an 1115 Medicaid Waiver called CalAIM (California Advancing and Innovating Medi-Cal). In 2012, CBAS replaced the Adult Day Health Care (ADHC) Program. CBAS is an available benefit for persons enrolled in CA’s State Plan Medicaid. In California, the Medicaid program is called Medi-Cal.
Benefits of Medi-Cal Community-Based Adult Services Program
Community-Based Adult Services are provided in adult day health centers that are certified as CBAS centers. The hours of operation vary based on the center. However, all centers must be open at least 5 days a week for a minimum of 6 hours / day. Centers cannot be open longer than 12 hours / day. While available benefits may include the following, an individual assessment determines the exact services and supports one receives.
– Care Coordination
– Meals
– Mental Health Services
– Personal Care Services
– Professional Nursing Services
– Registered Dietician Services (i.e., nutrition assessment, dietary education)
– Social Services
– Therapeutic Activities (individual or group)
– Therapies (physical, speech, occupational)
– Training / Support (for families and caregivers)
– Transportation (to / from home and CBAS center)
Eligibility Requirements for Medi-Cal Community-Based Adult Services Program
CBAS is for California residents aged 18+. Applicants must reside in a county in which there is a CBAS center or live within an hour drive from a CBAS center in a nearby county. Currently, there are CBAS centers located in the following California counties: Alameda, Butte, Contra Costa, Fresno, Humboldt, Imperial, Kern, Los Angeles, Madera, Merced, Monterey, Napa, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Shasta, Solano, Stanislaus, Tulare, Ventura, and Yolo. Additional eligibility criteria for CBAS follows.
Financial Criteria: Income, Assets & Home Ownership
Income
The applicant income limit is equivalent to 138% of the Federal Poverty Level (FPL), which increases annually in January. For Medi-Cal, however, the income limit increases in April. Effective 4/1/26, a single applicant can have a monthly income up to $1,836. When both spouses are applicants, the income limit is $2,490 / month. When only one spouse is an applicant, the income of the non-applicant spouse is not counted towards the income eligibility of their spouse. Only the applicant spouse’s income is considered, which is limited to $1,836 / month. Furthermore, up to $4,066.50 / month (in 2026) can be transferred from the applicant to their non-applicant spouse as a Spousal Income Allowance. Also called a Monthly Maintenance Needs Allowance, it is intended to ensure the non-applicant spouse has a minimum monthly income of this amount. Non-applicant spouses who have their own income equal to or greater than $4,066.50 / month are not entitled to a Spousal Income Allowance.
Assets
The asset limit is $130,000 for an individual and $195,000 for a couple (with both spouses as applicants). When only one spouse is an applicant, the couples’ assets are still considered jointly owned. The applicant spouse, however, can keep up to $130,000 in assets and the non-applicant is allocated a larger portion of the assets to prevent spousal impoverishment. This is called a Community Spouse Resource Allowance, and in 2026, will allow the non-applicant spouse to keep up to $162,660 in assets.
Some assets are not counted towards Medicaid’s asset limit. This generally includes one’s primary home, household furnishings and appliances, personal effects, and a vehicle.
There is a Look-Back Period, during which Medi-Cal scrutinizes past asset transfers of persons applying for Medicaid-funded nursing home care, but it is not applicable to persons applying for the Community-Based Adult Services Program. However, if one may require Nursing Home Medicaid in the near future, it may be applicable. Learn more about Medi-Cal’s “look-back”.
While Medi-Cal has a Medicaid Estate Recovery Program (MERP), it is not applicable to CBAS.
Home Ownership
The home is often the highest valued asset a Medicaid applicant owns, and many persons worry that Medicaid will take it. Fortunately, for Medi-Cal eligibility purposes, the home is considered exempt (non-countable) in the following circumstances.
– The applicant lives in the home or has Intent to Return home and indicates it in writing. California is set apart from the other states in that there is no home equity interest limit.
– The applicant has a spouse living in the home.
– The applicant has a dependent relative, such as a disabled child, living in the home.
– The applicant has a child under 21 years old living in the home.
Medical Criteria: Functional Need
While an applicant can require a Nursing Facility Level of Care (NFLOC), this high of a level of care need is not necessary to be eligible for Community-Based Adult Services. Other eligibility categories include persons with Alzheimer’s disease or related dementias, persons with Traumatic Brain Injury, and persons with chronic mental illness. To determine if one is functionally eligible, the CBAS Eligibility Determination Tool (CEDT) is used.
While the exact functional requirements vary based on the eligibility category, an applicant’s ability to complete their Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) is considered. Examples of ADLs and IADLs include bathing, mobility, dressing, medication management, meal preparation, and money management. Relevant to persons with Alzheimer’s disease or a related dementia, cognitive impairments (i.e., memory, decision making, and judgment), are also considered. A diagnosis of dementia in and of itself does not mean one is functionally eligible.
Qualifying When Over the Limits
Having income and / or assets over Medicaid’s limit(s) does not mean an applicant cannot still qualify for Community-Based Adult Services. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Some of these strategies are fairly easy to implement, and others exceedingly complex. Below are the most common.
For persons over the income limit, Medi-Cal has a Share of Cost Program. Also called a Medically Needy Program, an applicant with “excess” income has to pay towards the cost of their care services / medical expenses. This is their “share of cost” and is based on their monthly income. It can be thought of as a deductible and once it has been paid for the month, Medi-Cal will pay for Community-Based Adult Services for the remainder of the month. Professional Medicaid Planners can assist persons in lowering their “share of cost”.
When persons have assets over the limit, Irrevocable Funeral Trusts (IFTs) are an option. IFTs are pre-paid funeral and burial expense trusts that Medicaid does not count as assets. Another option are Medicaid-Compliant Annuities, which turn countable assets into a stream of income. There are many other options when the applicant has assets exceeding the limit.
Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of Medicaid benefits. Professional Medicaid Planners are educated in the planning strategies available in California to meet Medi-Cal’s financial eligibility criteria without jeopardizing Medicaid eligibility. Furthermore, there are additional planning strategies that not only help one meet Medicaid’s financial eligibility criteria, but can also protect assets for family as inheritance.
While these strategies often violate Medi-Cal’s Look-Back Period, the Look-Back Rule does not apply to the CBAS Program. Some persons, however, will go on to require Nursing Home Medicaid, and if this is the case, the Look-Back Period is relevant. Due to this, it is best to implement Medicaid planning strategies with careful planning and well in advance of the need for nursing home care. There are, however, some workarounds, and Medicaid Planners are aware of them. For these reasons, it is highly suggested one consult a Medicaid Planner for assistance in qualifying for Medicaid when over the income and / or asset limit(s). Find a Certified Medi-Cal Planner.
How to Apply for Medi-Cal Community-Based Adult Services Program
Before You Apply
Prior to submitting an application for CBAS, applicants need to ensure they meet the Medi-Cal eligibility criteria. Applying when over the income and / or asset limit(s) can be cause for denial of benefits. The American Council on Aging offers a Medicaid Eligibility Test to determine if one might meet Medicaid’s eligibility criteria.
As part of the application process, applicants need to gather documentation for submission. Examples include copies of Social Security cards, Medicare cards, life insurance policies, property deeds, pre-need burial contracts, prior bank statements, and proof of income. A common reason applications are held up is required documentation is missing or not submitted in a timely manner.
Since CBAS is not an entitlement program, some CBAS centers may have a waitlist for program participation. In the case of a waitlist, each CBAS center determines how their waitlist operates and if certain persons are prioritized. Applicants can be on a waitlist at multiple CBAS centers.
Application Process
To apply for the CBAS Program, one must complete an Application for Health Insurance and be determined eligible for Medi-Cal. It should be indicated on the application that long-term home and community based services is needed. Persons who require assistance with completing the application can call Covered California’s Customer Service Center at 1-800-300-1506. Persons can also apply online for Medi-Cal at CoveredCA.com or over the phone / in person at one’s Department of Health Care Services county office.
Generally, it is via one’s Medi-Cal managed care health plan through which CBAS is provided. Persons enrolled in Medi-Cal managed care should contact their health plan. As part of the CBAS application process, a functional needs assessment will be completed.
There are approximately 321 CBAS centers in CA. See a current list of centers or a service area map. Alternatively, persons can call the Senior Information Line at 800-510-2020.
Learn more about the Community-Based Adult Services Program.
The CBAS Program is administered by the California Department of Health Care Services (DHCS), the California Department of Aging (CDA), and the California Department of Public Health (CDPH). CBAS Centers must be licensed as Adult Day Health Care (ADHC) centers by CDPH. The CDA certifies ADHC centers as CBAS centers.
Approval Process & Timing
The Medi-Cal application process can take up to 3 months, or even longer, from the beginning of the application process through the receipt of the determination letter indicating approval or denial. Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. If the application is not properly completed, or required documentation is missing, the application process will be delayed. Based on federal law, Medicaid offices have up to 45 days to review and approve or deny one’s application (up to 90 days for disability applications). Despite the law, applications are sometimes delayed even further. Furthermore, as waitlists may exist, approved applicants may spend many months waiting to receive benefits.