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

Last updated: March 22, 2021

 

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 Mar. 2021)
State Program / Waiver Name
Alabama Elderly and Disabled Waiver / Personal Choices Program
Community Transition Waiver / Personal Choices Program
Alaska Alaskans Living Independently
Community First Choice
Personal Care Services Program
Arizona Arizona Long Term Care System (ALTCS) Agency with Choice  / Self-Directed Attendant Care
Arkansas AR Choices in Homecare / Independent Choices
Living Choices Assisted Living Waiver
Personal Care Program / Independent Choices
California In-Home Supportive Services Program
Assisted Living Waiver
Multipurpose Senior Services Program
Home and Community Based Alternatives Waiver
Colorado Elderly, Blind & Disabled Waiver CDASS & IHSS
Connecticut Community First Choice
Connecticut Home Care Program for Elders
District of Columbia Elderly and Persons with Physical Disabilities Waiver / Services my Way
State Plan Personal Care Program
Adult Day Health Program Services
Delaware Delaware State Health Plan Plus
Florida Statewide Medicaid Managed Care Long-Term Care Program
Georgia Community Care Services Program (CCSP)
Services Options Using Resources in Community Environments (SOURCE)
Hawaii Med QUEST
Idaho Medicare Medicaid Coordinated Plan (MMCP)
Idaho Medicaid Plus (IMPlus)
Aged & Disabled (A&D) Waiver
Personal Care Services Program (PCSP)
Illinois Community Care Program (CCP)
Supportive Living Program (SLP)
HCBS Waiver for Persons who are Elderly
HealthChoice Illinois
Medicare-Medicaid Alignment Initiative (MMAI)
Indiana Aged and Disabled Waiver / Consumer Directed Attendant Care (CDAC) Program
Iowa HCBS Elderly Waiver
Kansas HCBS for the Frail Elderly
Kentucky Home and Community Based (HCB) Waiver
Louisiana Adult Day Health Care 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
Community Personal Assistance Services
Community First Choice
Medical Day Care Services Waiver
Maryland HealthChoice Demonstration Waiver – Increased Community Services Program
Massachusetts Senior Care Options (SCO)
Frail Elder Waiver
Adult Day Health Program
Personal Care Attendant (PCA) Program
Adult Foster Care Program
Group Adult Foster Care Program
Michigan MI Choice Waiver
MI Health Link Waiver
Home Help Services Program
Minnesota Personal Care Assistance Program
Elderly Waiver
Minnesota Senior Care Plus (MSC+) / Minnesota Senior Health Options (MSHO)
Mississippi Assisted Living Waiver
Elderly and Disabled Waiver
Missouri Aged and Disabled Waiver (ADW)
Structured Family Caregiving Waiver
Supplemental Nursing Care Program
Missouri Care Options (MCO)
Consumer Directed Personal Care Assistance
Montana Big Sky Waiver
Community First Choice / Personal Care Assistance Programs
Nebraska Aged & Disabled Waiver
Personal Assistance Services
Nevada Waiver for the Frail Elderly
Personal Care Services (PCS) Program
New Hampshire Choices for Independence Waiver
Personal Care Attendant Services (PCAS) Program
New Jersey Personal Preference Program (PPP)
Medicaid Managed Long Term Services and Supports (MLTSS)
New Mexico New Mexico Centennial Care 2.0 Community Benefit
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 Aged & Disabled Waiver
Medicaid State Plan Personal Care (MSP-PC)
Ohio PASSPORT Waiver
Assisted Living Waiver
MyCare Ohio Plan (MCOP)
Oklahoma ADvantage Program Waiver
Personal Care Program
Oregon Aged and Physically Disabled Medicaid Waiver
Independent Choices Program
Client-Employed Provider Program
Spousal Pay Program
Oregon K Plan (Community First Choice)
Pennsylvania Community HealthChoices Program / Services My Way (SMW) Program
Rhode Island Global Consumer Choice Compact Waiver
RIte at Home (Shared Living)
South Carolina Community Choices Medicaid Waiver
South Dakota Home and Community-Based Options and Person Centered Excellence (HOPE) Waiver
Personal Care Services
Tennessee TennCare CHOICES
Texas STAR+PLUS
Community First Choice (CFC)
Primary Home Care (PHC) Program
Day Activity and Health Services (DAHS)
Community Attendant Services (CAS)
Utah Utah Waiver for Individuals Age 65 or Older
New Choices Waiver (NCW)
Personal Care Services
Vermont Choices for Care
Choices for Care Moderate Needs Group (CFC MNG)
Global to Commitment to Health Waiver
Attendant Services Program (ASP)
Adult Day Services Program / Day Health Rehabilitation Services
Adult High Technology
Assistive Community Care Services (ACCS)
Virginia Commonwealth Coordinated Care Plus (CCC Plus)
Washington Specialized Dementia Care Program
Community Options Program Entry System (COPES)
Community First Choice Option (CFCO)
Medicaid Alternative Care (MAC)
New Freedom Waiver
Medicaid Personal Care (MPC)
West Virginia Medicaid Personal Care Program
Aged & Disabled Waiver
Wisconsin Family Care & Family Care Partnership Programs
Include, Respect, I Self Direct (IRIS)
Medicaid Assistance Personal Care (MAPC)
Wyoming Community Choices Home and Community Based Services Medicaid 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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