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Home and Community-Based Services Programs
Medicaid, known as Medi-Cal in California, is a jointly-funded, federal-state health insurance program for certain low income and needy people that includes long-term care benefits. In 1981, President Reagan signed into law the Medicaid Home and Community-Based Services Waiver (Waiver) program, section 1915(c) of the Social Security Act. The legislation provided a vehicle for California to offer services not otherwise available through the Medi-Cal program to serve people (including the developmentally disabled) in their own homes and communities. The Waiver program recognizes that many individuals at risk of being placed in medical facilities can be cared for in their homes and communities, preserving their independence and ties to family and friends at a cost no higher than that of institutional care.
This manual provides additional information on California’s Waiver for individuals with a developmental disability.
1915i State Plan Amendment:
Established as part of the Deficit Reduction Act of 2005, section 1915(i) of the Social Security Act gives states the option to provide Home and Community Based Services (HCBS) without a waiver. One of the key provisions of Section 1915(i) is that eligibility criteria for these services must be less stringent than the institutional level of care criteria required under waivers. Therefore, approval of the 1915(i) SPA allows DDS to access federal funding for community services provided to individuals who do not meet the eligibility criteria of the current Waiver.