Home & Community Based Services Authorities

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Home & Community Based Services Authorities

Home and Community Based Services (HCBS) first became available in 1983 when Congress added section 1915(c) to the Social Security Act, giving States the option to receive a waiver of Medicaid rules governing institutional care. In 2005, HCBS became a formal Medicaid State plan option. Several States include HCBS services in their Medicaid State plans. Forty seven states and DC are operating at least one 1915(c) waiver.

State Medicaid agencies have several HCBS options:

1915(c) Home and Community-Based Waivers 1915(i) State Plan Home and Community-Based Services 1915(j) Self-Directed Personal Assistance Services Under State Plan 1915(k) Community First Choice

The Centers for Medicare & Medicaid Services (CMS) works with states to assure and improve quality in Medicaid HCBS waiver programs.