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Barragán Leads California Colleagues in Letter Urging California to Expand Home- and Community-Based Alternatives Waiver

FOR IMMEDIATE RELEASE                                     

13 November 2023

Contact: Kevin McGuire, 202-538-2386 (mobile)

WASHINGTON, D.C. – Today, U.S. Representative Nanette Barragán (CA-44) led 22 Members of the California Congressional Delegation in a letter to California Governor Gavin Newsom to recommend the expansion of the Home-and Community-Based Alternatives (HCBA) Waiver. 

The HCBA Waiver allows Californians to use federal, Medicaid-funded Home and Community-Based Services (HCBS) as an alternative to nursing homes and other institutional care facilities. The program serves children, adults, and older Americans with disabilities who qualify for an institutional level of care, and who need home and community-based services to continue to live at home.

In 2021, Rep. Barragán led members of the California Congressional Delegation in a letter to the California Department of Health Care Services (DHCS) urging the State to increase the number of people served by the HCBA Waiver. DHCS responded by increasing the number of waiver slots in 2021. However, current waiver capacity is not sufficient to meet the growing demand of the program. Currently, the HCBA Waiver is capped at 8,974 slots and as of October 2023, the Waiver is full, with more than 3,000 people on the waiting list.

“Now that the HCBA Waiver cap has been reached, we understand that DHCS plans to submit an amendment to CMS to increase the limit as of January 2024 to 10,081 slots because there is an existing California budget allocation for that number of slots,” wrote the Members. “We do not believe this modest increase will provide immediate access to Medi-Cal for medically fragile children, clear the waiting list, or accommodate the obvious increase in consumer need for the program. If the state does not request a meaningful increase in slots, we are concerned that thousands of Californians will languish on an ever-growing waitlist and suffer unnecessary institutionalization.”

This letter recommends California allocate funding for an increase in the number of HCBA Waiver slots sufficient to clear the current waiting list, with the ability to raise the cap as needed to meet demand for this program. California can do this in the same way that it operates two other HCBS Waivers that do not have functional caps.

The letter was signed by Reps. Julia Brownley, Salud Carbajal, Tony Cárdenas, Judy Chu, Lou Correa, Mark DeSaulnier, Anna Eshoo, Jimmy Gomez, Ro Khanna, Barbara Lee, Ted Lieu, Zoe Lofgren, Doris Matsui, Kevin Mullin, Katie Porter, Linda Sánchez, Adam Schiff, Brad Sherman, Mark Takano, Mike Thompson, Norma Torres, and Maxine Waters.

The letter was endorsed by Disability Rights California.

The full text of the letter can be found here.