Home and Community Based Services (HCBS) waivers
The Department of Health Care Services (DHCS) will be renewing, converting, or amending several Medi-Cal HCBS waivers during State Fiscal Year 2008-09. These processes generally take several months of planning, development and negotiation with the federal Centers for Medicare and Medicaid Services (CMS) before waiver approval. They involve DHCS waiver, fiscal forecasting, and budget staff as well as program management from departments involved in the specific waiver. The fiscal impact of the waiver must meet applicable federal requirements for cost neutrality, and comply with any additional fiscal or cost restrictions imposed through the State’s budget process or legislation authorizing the waiver.
Process for Getting Stakeholder Input
DHCS is working with the Olmstead Advisory Committee (OAC) and other external stakeholders to get input on HCBS waiver issues relating to what services are most critical, how to outreach to vulnerable populations, waiver caps and waiting lists, and evaluation of quality and effectiveness. The input received will be vetted with executive management, and, as appropriate, included in the final application to CMS.