Who qualifies for the HCBA waiver?

The HCBA waiver lets children who don't qualify for Medi-Cal based on income still access long-term care services through Medi-Cal. The waiver is intended for medically fragile, technology-dependent individuals.

The term “medically fragile” refers to a person who has a medical condition that requires round-the-clock medical supervision. For example, a child who has a seizure disorder may need to be supervised by a nurse or a person who has been trained to give them emergency medications. “Technology dependent” refers to a person who depends on a machine to do something that the body normally does on its own. A child who has a feeding tube and gets nutrition from a feeding pump is technology dependent, and so is a child who uses a ventilator for breathing.

A child does not need to have a developmental disability or be a Regional Center client to qualify for the HCBA waiver. The HCBA waiver looks at a child’s need for nursing care at home, not at the child’s developmental milestones. For example, a child who has a kidney condition and uses at-home peritoneal dialysis would qualify for the HCBA waiver because the child has a medical condition that requires nursing care at home.

A child doesn’t have to actually get home nursing care in order to be enrolled in the HCBA waiver; they just have to have a medical condition that qualifies them to get nursing care.

For more information, see our full article Home and Community Based Alternatives Waiver (HCBA) 101.