Medicaid Home & Community Based Services (HCBS): Programs & Waivers by State

Last updated: September 28, 2022

 

What are Home & Community Based Services (HCBS)?

Home & Community Based Services are services paid for by Medicaid that provide assistance to individuals in their homes or in the community at large instead of in a nursing home.

The types of services provided are not limited to health care. Instead, they include non-medical personal care, assistance with activities of daily living, home modifications to support aging in place and many other types of assistance.

The locations in which individuals can receive these services is not limited to just their homes. Instead, services can be provided in the “community” such as at an adult day care center, or in senior living such as assisted living residences or memory care communities. Adult foster care homes, homes of family members and friends are also options. It is perhaps easier to define the one location in which one cannot receive HCBS, and that is in a nursing home.

 

State-by-State List of HCBS Programs & Waivers

The table below contains the state and program names. In the months ahead, each program will link to page with complete details about that program’s benefits, eligibility requirements and application process. In the interim, should the program name not be linked, simply click on the state name in the left column for eligibility requirements and a program overview.

 Note: This list is intended to be comprehensive. However, certain programs may have been omitted in this first draft.
Medicaid Programs & Waivers that Provide Home & Community Based Services (Updated Sep. 2022)
State Program / Waiver Name
Alabama Elderly and Disabled (E&D) Waiver / Personal Choices Program
Alabama’s Community Transition (ACT) Waiver / Personal Choices Program
State of Alabama Independent Living (SAIL) Waiver / Personal Choices Program
Alaska Alaskans Living Independently (ALI) Waiver
Community First Choice (CFC) Program
Personal Care Services (PCS) Program
Arizona Arizona Long Term Care System (ALTCS) Agency with Choice  / Self-Directed Attendant Care
Arkansas ARChoices in Homecare Waiver / Independent Choices
Living Choices Assisted Living Waiver
Personal Care Program / Independent Choices
California In-Home Supportive Services (IHSS) Program
Assisted Living Waiver (ALW)
Multipurpose Senior Services Program (MSSP)
Home and Community Based Alternatives (HCBA) Waiver
Community-Based Adult Services (CBAS) Program
Enhanced Care Management Benefit
Colorado Elderly, Blind & Disabled Waiver CDASS & IHSS
Connecticut Community First Choice (CFC) Program
Connecticut Home Care Program for Elders (CHCPE)
District of Columbia Elderly and Persons with Physical Disabilities (EPD) Waiver / Services my Way
State Plan Personal Care Aide Services Program
Adult Day Health Program (ADHP) Services
Delaware Diamond State Health Plan Plus (DSHP-Plus) Program
Florida Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC) Program
Georgia Community Care Services Program (CCSP)
Services Options Using Resources in Community Environments (SOURCE)
Hawaii QUEST Integration (QI) Program
Idaho Medicare Medicaid Coordinated Plan (MMCP)
Idaho Medicaid Plus (IMPlus)
Aged & Disabled (A&D) Waiver
Personal Care Services (PCS) Program
Illinois Supportive Living Program (SLP)
HCBS Waiver for Persons who are Elderly
HealthChoice Illinois / Managed Long Term Services and Supports (MLTSS)
Medicare-Medicaid Alignment Initiative (MMAI)
Indiana Aged and Disabled (A&D) Waiver / Consumer Directed Attendant Care (CDAC) Program
Iowa HCBS Elderly Waiver
Kansas Frail Elderly (FE) Waiver
Kentucky Home and Community Based (HCB) Waiver
Louisiana Adult Day Health Care (ADHC) Waiver
Long-Term Personal Care Services (LT-PCS) Program
Community Choices Waiver (CCW)
Maine Elderly and Adults with Disabilities Waiver
Consumer Directed Attendant Care Services (CDAS) Program
Maryland Home and Community Based Options Waiver (HCBOW)
Community Personal Assistance Services (CPAS) Program
Community First Choice (CFC) Program
Medical Day Care Services Waiver (MDCSW)
Maryland HealthChoice Demonstration Waiver – Increased Community Services Program
Massachusetts Senior Care Options (SCO) Program
Frail Elder Waiver (FEW)
Adult Day Health (ADH) Program
Personal Care Attendant (PCA) Program
Adult Foster Care (AFC) Program
Group Adult Foster Care (GAFC) Program
Michigan MI Choice Waiver
MI Health Link Waiver
Home Help Services Program
Minnesota Personal Care Assistance (PCA) Program / Community First Services and Supports (CFSS) Program
Elderly Waiver
Minnesota Senior Care Plus (MSC+) Program / Minnesota Senior Health Options (MSHO) Program
Mississippi Assisted Living (AL) Waiver
Elderly and Disabled (E&D) Waiver
Independent Living (IL) Waiver
Missouri Aged and Disabled Waiver (ADW)
Structured Family Caregiving Waiver (SFCW)
Supplemental Nursing Care (SNC) Program
Consumer Directed Personal Care Assistance
Montana Big Sky Waiver (BSW)
Community First Choice / Personal Care Assistance Programs
Nebraska Aged & Disabled (AD) Waiver
Personal Assistance Services (PAS)
Nevada Waiver for the Frail Elderly (FE)
Personal Care Services (PCS) Program
Adult Day Health Care (ADHC)
New Hampshire Choices for Independence (CFI) Waiver
Personal Care Attendant Services (PCAS) Program
New Jersey Personal Preference Program (PPP) / Personal Care Assistant Services
Medicaid Managed Long Term Services and Supports (MLTSS) Program
New Mexico Community Benefit (CD) Program
New York Managed Long Term Care / Consumer Directed Personal Assistance Program (CDPAP)
Community First Choice Option (CFCO) / Consumer Directed Personal Assistance Program (CDPAP)
Assisted Living Program (ALP)
North Carolina Personal Care Services (PCS) Program
Community Alternatives Program for Disabled Adults (CAP/DA)
North Dakota Home and Community Based Services (HCBS) Waiver
Medicaid State Plan Personal Care (MSP-PC)
Ohio PASSPORT Waiver
Assisted Living Waiver
MyCare Ohio Plan
Oklahoma ADvantage Waiver Program
State Plan Personal Care (SPPC) Program
Oregon Aged and Physically Disabled (APD)Waiver
Independent Choices Program (ICP)
Consumer-Employed Provider Program
Spousal Pay Program
Oregon K Plan (Community First Choice)
State Plan Personal Care (SPPC) Program
Oregon Project Independence (OPI)
Pennsylvania Community HealthChoices (CHC) Program / Services My Way (SMW) Program
Rhode Island Medicaid Long Term Services and Supports (LTSS)
Medicaid Preventive Services
RIte at Home (Shared Living)
South Carolina Community Choices Waiver
South Dakota Home and Community-Based Options and Person Centered Excellence (HOPE) Waiver
Personal Care Services (PCS)
Tennessee TennCare CHOICES
Texas STAR+PLUS Home and Community Based Services (HCBS) Program
Community First Choice (CFC)
Primary Home Care (PHC) Program
Day Activity and Health Services (DAHS)
Community Attendant Services (CAS)
Dual Demonstration Project / Dual Eligible Project
Utah Aging Waiver (formerly Utah Waiver for Individuals Age 65 or Older)
New Choices Waiver (NCW)
State Plan Personal Care Services
Vermont Choices for Care
Choices for Care Moderate Needs Group (CFC MNG)
Attendant Services Program (ASP)
Adult Day Services Program / Day Health Rehabilitation Services
Adult High Technology Program
Assistive Community Care Services (ACCS)
Virginia Commonwealth Coordinated Care Plus (CCC Plus) Waiver Program
Washington Specialized Dementia Care Program (SDCP)
Community Options Program Entry System (COPES) Waiver
Community First Choice (CFC) Program
Medicaid Alternative Care (MAC) Program
New Freedom (NF) Waiver
Medicaid Personal Care (MPC) Program
Tailored Supports for Older Adults (TSOA) Program
West Virginia Medicaid Personal Care Program
Aged & Disabled Waiver (ADW)
Wisconsin Family Care & Family Care Partnership Programs
Include, Respect, I Self Direct (IRIS) Waiver Program
Medicaid Assistance Personal Care (MAPC)
Wyoming Community Choices Waiver (CWW)

 

Types of Medicaid that Pay for HCBS

There are multiple types of Medicaid programs that pay for Home and Community Based Services for the elderly.

Medicaid HCBS Waivers
Waivers are state-specific programs that are intended to prevent or delay the placement of elderly, frail, or disabled persons in nursing homes. To that end, waivers provide many services to beneficiaries in their homes, or places of residence including assisted living or the home of family members with whom they reside.

Medicaid waivers typically have the same eligibility requirements as nursing home Medicaid. States apply for waivers to the Centers for Medicare & Medicaid Services and receive approval typically for a 5-year period. Each waiver is approved for a specific target group (such as the elderly) and with a specific number of available slots. Consequently, there are often more applicants than there are available slots and wait-lists are common.

Aged, Blind and Disabled Medicaid
ABD Medicaid (this name varies by state) can be thought of as regular Medicaid. There are financial eligibility criteria, but not medical criteria to be eligible for the program. However, there are medical criteria to be eligible for specific benefits. Regular Medicaid is an entitlement. Therefore, persons who are eligible for HCBS under regular / ABD Medicaid are guaranteed to receive those services compared to HCBS under Waivers where persons can be wait-listed.

 

Services Provided under HCBS

The types of services that can be provided under Home and Community Based Service is quite broad. From care to home modifications to assistive technology, anything that a state determines can help an individual to live independently can be included as a possible benefit. One cost that cannot be paid for under HCBS is room and board in assisted living. A list of typical services follows but this is by no means a comprehensive list. Note that these services vary by state and the names of the benefits also vary. For example, what may be called a “home modification” in one state may be called an “environmental adaption” in another state.

  • Assistive Technology and Devices
  • Attendant Care / Personal Care
  • Care / Case Management
  • Caregiver Training
  • Chore Services
  • Community Transition Services
  • Companion Services
  • Durable and Home Medical Equipment
  • Environmental Accessibility Adaptations (Home Modifications)
  • Financial Management Services
  • Home Delivered Meals
  • Home Health Care
  • Homemaker Services
  • Non-Medical Transportation
  • Nursing Services
  • Personal Emergency Response Systems (PERS)
  • Respite Care
  • Transportation

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