Medicaid Home Modification Assistance in California

California offers Medi-Cal-funded help with home modifications through two distinct waiver programs, both administered by the state Department of Health Care Services (DHCS).

Home and Community Based Alternatives (HCBA) Waiver

The HCBA Waiver (opens in a new tab) is the program most directly relevant to modifying an existing home. It’s designed to help Medi-Cal-eligible individuals who would otherwise need nursing-facility-level care remain in their own home, a relative’s home, or an adult foster or family care setting instead. Covered home modifications commonly include wheelchair ramps, grab bars, and bathroom accessibility changes.

Assisted Living Waiver (ALW)

The Assisted Living Waiver (opens in a new tab) is a separate HCBS waiver created to test Medi-Cal coverage of assisted living as a benefit. It’s currently available in 15 California counties, with the current five-year waiver term approved through February 2029. This program is more relevant if the goal is supporting a move to a licensed assisted living setting rather than modifying an existing private home.

How to apply

Both waivers are administered through DHCS. Since eligibility involves both financial (Medi-Cal) qualification and a clinical level-of-care determination, the practical starting point is usually your local county social services or aging services office, which can help identify which waiver applies and begin the application process. Los Angeles County residents, for example, can start through the county’s Department of Public Social Services HCBS program page.

What to have ready

• Proof of Medi-Cal eligibility, or documentation to apply for it alongside the waiver application
• Medical documentation supporting the need for home modifications or a higher level of care
• Information about your current living situation and the specific modifications needed

Other assistance to check alongside Medi-Cal

If you’re a veteran, the VA HISA grant (opens in a new tab) is a separate federal benefit worth checking regardless of Medi-Cal status. Local nonprofit programs, covered in our nonprofit and local grants guide (opens in a new tab), may also help, particularly for smaller or more urgent modifications while a waiver application is pending.