Written by a parent, not a doctor. Nothing here is medical advice.

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California program

Medi-Cal through a home-care waiver (HCBA)

Help arranging hospital-level, nursing-facility or subacute care safely at home through the HCBA waiver.

What it is

Help arranging hospital-level, nursing-facility or subacute care safely at home through the HCBA waiver.

HCBA may help when your child needs a high level of care at home. The waiver agency checks the care and the county checks the financial route. Chemotherapy or equipment alone does not mean your child qualifies.

Who can get it
  • HCBA serves people of any age who need a qualifying hospital, nursing-facility or subacute level of care. That care must fit an approved, safe home plan under the waiver’s rules. A diagnosis or need for help at home alone is not enough. The waiver agency assesses the care and coordinates the right Medi-Cal financial review.
  • The waiver counts only your child's own income and savings; the county tells you the current limit.
With other insurance
  • The waiver’s child-only financial review does not replace the clinical level-of-care assessment.
Before changing coverage
  • The waiver team and hospital need to check service arrangements and treatment access alongside any existing plan.
What you get
  • Approved waiver services, with any Share of Cost confirmed through the child’s eligibility review.
  • Care management, nursing, respite, equipment and home accessibility changes under the service plan.
  • Possible additional personal-care hours through WPCS after enrollment.
If you decide to apply
  1. Ask the regional HCBA waiver agency for an assessment and help with form DHCS 1320.
  2. Have ready: nursing orders, a seven-day care log, discharge records and your child’s financial information. Ask the county which other financial records it needs.

(833) 388-4551 · Official page ↗

What happens next
  • Assessment and the waiting list precede enrollment. The agency can give current queue information and reevaluation dates.
  • Approval names the service plan and an aid code: 6X without a share, or 6Y with a share based on the child’s income.
Good to know

There is a waiting list, and applicants under 21 have priority. Regular Medi-Cal home nursing has a separate route.

What else to know
  • Intensive needs such as IV nutrition, a tracheostomy or ventilation can warrant a clinical assessment. These examples do not guarantee qualification.
  • There is a waiting list, and children under 21 go ahead of adults. Ask the waiver agency where your child stands and how long the wait usually is.
  • Fundraising money held in the child’s name may affect the asset review. The county can explain ownership and exemptions before any account change.

Federal background: Medicaid home-care programs (waivers).

Official sources
Ask your social worker

“Do our child’s needs warrant an HCBA assessment? What help, costs and waiting time should we understand before deciding whether to apply? If we apply, could you help with the assessment and other care during any wait?”

Why I’m asking: I want to understand whether my child’s home-care needs warrant a waiver assessment.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Call the home-care waiver line, file the application, keep a seven-day log of every nursing task, and ask for the under-21 priority assessment.

Your social worker

The social worker or discharge planner gathers nursing orders and records describing daily care. They request medically needed home nursing at the same time.

The care team

The oncologist and nurses write the description of daily skilled care. That description, not the diagnosis, decides the level of care.

Who decides
The waiver agency assesses clinical requirements and enrollment availability; the county confirms the applicable Medi-Cal financial budget.
Ask your social worker
“Does my child's daily care meet the home-care waiver's requirements, and who writes that up? Can we ask Medi-Cal for home nursing now?”

How to apply

First step: Call (833) 388-4551 and ask which home-care waiver agency covers your area. Ask for under-21 priority. Ask the discharge team to request Medi-Cal home nursing too, without waiting for the waiver.

  1. Call (833) 388-4551 to find the waiver agency and file the application.
  2. Ask for the under-21 priority assessment.
  3. Ask the discharge team for EPSDT private-duty nursing at the same time.

Where it starts: Send the home-care waiver application to the regional agency

What to gather

  • Form DHCS 1320
  • Nursing orders with tasks, frequency and hours
  • A seven-day care log
  • Hospital discharge records
  • The financial records requested by the county for the applicable eligibility route.

How long: Assessment first, then the wait list. Ask the waiver agency for the current position and the annual re-evaluation date.

What a yes looks like

A waiver service plan, an aid code 6X (no share) or 6Y (share on the child's own income), and named agencies for each service.

What a no looks like, and the next move

A letter naming level of care, finances, safety or capacity. For level of care, correct the care description with the nurses and re-apply when the care changes. For capacity, stay on the list and use medically needed home nursing meanwhile.

Watch out

  • Diagnosis alone does not establish the qualifying hospital, nursing-facility or subacute level of care. The waiver agency assesses the actual care needs.
  • HCBA has CMS-approved enrollment limits and has operated a waiting list since July 12, 2023. Reserved-capacity and priority rules can help some applicants, including children under 21, but do not guarantee an immediate opening. The waiver agency can explain current status; an old statewide waiting-list count does not show this child’s place or expected wait.
  • The county confirms the child’s applicable resource rules, affected eligibility category and effective date of any scheduled change. No unverified July 2027 amount is stated.
  • The county confirms the applicable child-only route, income and resource rules and effective dates. No waiver-population limit is inferred from the ordinary child income screen.

Dates that change this

2026-04: HCBA has CMS-approved enrollment limits and has operated a waiting list since July 12, 2023. Reserved-capacity and priority rules can help some applicants, including children under 21, but do not guarantee an immediate opening. The waiver agency can explain current status; an old statewide waiting-list count does not show this child’s place or expected wait. (not yet confirmed against the final rule)

2027-07-01: The county confirms the child’s applicable resource rules, affected eligibility category and effective date of any scheduled change. No unverified July 2027 amount is stated.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Approved HCBA services can include care management, nursing, respite, equipment and home changes. The county confirms the applicable financial route and any Share of Cost; a child-only budget or $0 share is not automatic.

Covers: Care management · Private-duty nursing · Home health aide · Respite · Family training · Medical equipment · Home accessibility changes · Waiver Personal Care Services

Legal protection: Institutional deeming may permit a child-only financial route when its requirements are met. The county confirms the applicable budget and excluded income or assets.

What it costs the family: No premium. Aid code 6X (no share of cost) or 6Y (share of cost on the child's own income).

The eligibility facts, as published

Level of care
Qualifying hospital, nursing-facility or subacute level of care and an approved safe home-care plan. Diagnosis or home help alone does not establish eligibility.
Financial
The county and waiver agency assess the applicable financial route, including child-only budgeting and any Share of Cost. The questionnaire does not establish the actual waiver budget.
Asset test
The county confirms the child’s applicable resource rules, affected eligibility category and effective date of any scheduled change. No unverified July 2027 amount is stated.
Age
any. Under-21 applicants have wait-list priority
Reevaluation
annual

Decisions this site cannot make: Level of care · Medical necessity · Waiver capacity and wait-list position · Child-only Medi-Cal budget

Expect friction on: Waiting list and CMS-approved capacity; the waiver agency confirms current status. · Waiver agency assessment · Nursing agencies to staff the hours

The trap: Waiting for the home-care waiver for nursing. A child already on Medi-Cal has a right to medically needed home nursing now. Ask for that first.

Where I read this

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