CA Home and Community-Based Services Waiver for the Developmentally Disabled

The Home and Community-Based Services Waiver for the Developmentally Disabled (HCBS-DD) is a program that was created by the California Department of Developmental Services (DDS) to provide an alternative to an intermediate care facility for individuals with intellectual disabilities (ICF-IID) or state developmental center placement for individuals who meet specific criteria and who are regional center consumers. In this blog post, we will explain the HCBS-DD waiver, how it works, and how it can benefit families.

Overview of Home and Community-Based Services Waiver for the Developmentally Disabled

The HCBS-DD waiver is a Medicaid waiver program established in 1982 and renewed in 2023 for a five-year period. The purpose of the HCBS-DD waiver is to provide home and community-based services (HCBS) to individuals with developmental disabilities who are at risk of institutionalization or who need help with activities of daily living or instrumental activities of daily living. The HCBS-DD waiver serves individuals who are eligible for full-scope Medi-Cal benefits, have a diagnosis of developmental disability, have a physician’s certification of the need for ICF-IID level of care, and meet other clinical and financial criteria. The DDS administers the HCBS-DD waiver in collaboration with 21 regional centers throughout California that buy and coordinate services for people with developmental disabilities.

Eligibility requirements

To qualify for the HCBS-DD waiver, you must meet the following eligibility requirements:

• Be a resident of California
• Be eligible for full-scope Medi-Cal benefits
• Have a diagnosis of developmental disability, which means having a disability that originates before age 18, is expected to continue indefinitely, and constitutes a substantial disability
• Have a physician’s certification of the need for ICF-IID level of care, which means having significant functional limitations in three or more areas of major life activity
• Have an unmet need for at least one HCBS-DD waiver service
• Have a monthly income of less than 300% of the Supplemental Security Income (SSI) federal benefit rate
• Have countable resources of less than $2,000 for an individual or $3,000 for a couple

Services and supports

The HCBS-DD waiver offers various services and supports tailored to your needs and preferences. These services and supports include:

• Respite: A service that provides temporary relief to your primary caregiver from the demands of caring for you
• Behavioral intervention: A service that helps you reduce challenging behaviors and increase positive behaviors through assessment, planning, training, and monitoring
• Supported living: A service that enables you to live in your own home or apartment with assistance from staff or other natural supports
• Transportation: A service that allows you access community resources, activities, or other waiver services
• Community integration: A service that helps you participate in social, recreational, educational, or vocational activities in the community
• Specialized medical equipment and supplies: A service that provides you with medically necessary equipment or supplies that are not covered by Medi-Cal or other sources
• Specialized therapeutic services: A service that provides you with physical therapy, occupational therapy, speech therapy, or other therapies that are not covered by Medi-Cal or other sources

Compensation for caregivers

One of the benefits of the HCBS-DD waiver is that it allows you to self-direct some or all of your services through the Self-Determination Program (SDP), which gives you an individual budget and the option to hire your service providers, including family members. You can also choose how much to pay your providers within the limits set by the program. The SDP pays your providers directly through a financial management service (FMS) that handles payroll, taxes, insurance, and background checks. The FMS also provides training and support to your providers. By self-directing your services, you can have more control over your care and reward your family members for their work.

A note from Givers

If you want to learn more about the HCBS-DD waiver or other programs that can compensate your family caregivers, please fill out this form, and we will contact you soon. We are here to help you find the best options for your situation and advocate for your rights as a caregiver.