State Medicaid Waiver Directory

California does not have a Katie Beckett or TEFRA program by name. However, the HCBA Waiver functions similarly for medically complex individuals who need nursing-facility level of care but can be served at home, and children with developmental disabilities access Medi-Cal and Regional Center services regardless of parental income through DDS eligibility.

The Home and Community-Based Alternatives (HCBA) Waiver is the primary route for individuals at risk of nursing facility placement, including medically complex children. The HCBA Waiver requires Medi-Cal eligibility, a level-of-care determination, and a referral through the local HCBA Waiver agency. Separately, the Department of Developmental Services (DDS) Regional Center system provides services to children and adults with developmental disabilities through 21 regional centers statewide — this is independent of Medi-Cal waiver eligibility. For adults with physical disabilities, In-Home Supportive Services (IHSS) is one of the largest Medicaid-funded personal care programs in the country and does not have a waitlist.

HCBA Waiver: Must have full-scope Medi-Cal, need nursing-facility level of care, and be at risk of institutionalization. Regional Center: Must have a developmental disability (intellectual disability, cerebral palsy, epilepsy, autism, or related condition) that began before age 18. CCS: Children under 21 with certain chronic or complex medical conditions, regardless of income. IHSS: Medi-Cal-eligible adults and children who need help with daily activities due to a disability.

For the HCBA Waiver, standard Medi-Cal financial eligibility applies. Regional Center services through DDS do not require Medi-Cal and are available to families across income levels for core eligibility. CCS has no income limit for the Medical Therapy Program component. IHSS uses Medi-Cal financial rules. California expanded Medi-Cal to all income-eligible adults regardless of immigration status.

HCBA Waiver requires nursing-facility level of care. Regional Center eligibility is based on functional and diagnostic criteria, not institutional level of care. CCS has its own medical eligibility criteria based on diagnosis.

CCS serves children under 21. Regional Center serves individuals from birth (Early Start program serves birth to age 3 under IDEA Part C). HCBA Waiver serves all ages. IHSS serves eligible individuals of all ages.

California has 21 DDS-funded Regional Centers statewide, each serving a specific geographic region. They provide intake, eligibility, case management, and service coordination for individuals with developmental disabilities. Use the county lookup at dds.ca.gov/rc/lookup-rcs-by-county/ to find the one serving your area.

CCS is a Medi-Cal program that provides diagnostic and treatment services for children under 21 with certain qualifying medical conditions including cerebral palsy, epilepsy, cystic fibrosis, heart disease, cancer, and others. The Medical Therapy Program component has no income limit. Contact your county CCS program through DHCS.

ECM is a free Medi-Cal benefit for people with complex needs that assigns a single lead care manager to coordinate medical, behavioral health, and social service needs. Children with serious illnesses or complex disabilities may qualify. Ask your Medi-Cal managed care plan about ECM enrollment.

Disability Rights California (disabilityrightsca.org) is the state's federally mandated Protection and Advocacy (P&A) agency. They provide free legal assistance, advocacy, and educational resources to people with disabilities across the state, including help with Medi-Cal denials, Regional Center disputes, IHSS issues, and education rights.

Family Voices of California (familyvoicesofca.org) is a family-led advocacy organization focused on children and youth with special health care needs. They provide information, navigation support, and advocacy around Medi-Cal, IHSS, HCBA Waiver, and related programs.

Parents of minor children with disabilities may qualify to be paid as IHSS providers. To apply: (1) get the child authorized for IHSS through the county, (2) complete the IHSS provider enrollment process at the county IHSS office, (3) complete required provider orientation and registry enrollment. Once enrolled, you receive an hourly wage directly. Rates vary by county. Contact your county IHSS office to begin.

DOR administers the largest vocational rehabilitation (VR) and independent living program in the country. Free services include career counseling, job training, assistive technology, college support, and job placement for people with disabilities. Transition-age youth (16+) can connect with DOR before leaving high school. There are over 100 DOR offices statewide. Visit dor.ca.gov or call 1-800-952-5544.

Ability Tools (abilitytools.org) is California's state assistive technology program. It offers free short-term device loans through Device Lending and Demo Centers statewide, durable medical equipment reuse programs, a wheelchair repair fund (Keep the Wheels Rolling — grants up to $450), and the FreedomTech Financial Loan Program for low-interest loans to purchase assistive technology. No Medi-Cal required.

California has 11 regional Caregiver Resource Centers (caregivercalifornia.org) that provide free support to family caregivers of adults with brain-impairment disabilities including brain injury, stroke, and other neurological conditions. Services include caregiver assessment, counseling, respite, legal consultations, and care management — all at no cost to the caregiver. Not limited to Medi-Cal enrollees.

California's SDI program (edd.ca.gov/Disability) provides partial wage replacement (70–90% of wages, up to ~$1,765/week) when a worker cannot work due to disability or illness. PFL provides up to 8 weeks of pay to care for a seriously ill family member, bond with a new child, or address a military qualifying event. Both are available to workers who paid into CASDI through payroll — not income-based. Apply through myEDD.

California has 48 Early Start Family Resource Centers (frcnca.org) statewide, staffed by parents of children with special needs. They provide one-on-one support, information, referrals, and parent-to-parent connection — at no cost and with no income or Medi-Cal requirement. FRCs are especially helpful for families newly navigating the system for children ages 0–5. Call 800-515-BABY (2229) or visit frcnca.org to find your local center.

California has statewide Family Empowerment Centers (californiafamilyempowermentcenters.org) funded by the California Department of Education to provide free training, information, and advocacy for families of children with disabilities ages 3–22. FECs help families understand IEPs, 504 plans, transition planning, and special education rights. They operate independently from school districts and are a free resource for any family.