What is the HIV/AIDS Medi-Cal Waiver Program?

The HIV/AIDS Medi-Cal Waiver Program (the “AIDS Waiver”) provides case management and direct care services to persons living with HIV/AIDS as an alternative to nursing facility care or hospitalization. You can use this service to help you stay at home, or to go home from a facility.

Who is eligible?

Eligible individuals must:

• Have a written diagnosis of HIV disease or AIDS from his/her primary care provider; and
• Have a qualifying health status to make home care appropriate; and
• Be Medi-Cal eligible on the date of enrollment and each month thereafter; and
• Be certified to meet the Nursing Facility Level of Care or higher and score 60 or less using the Cognitive and Functional Ability Scale Assessment tool.

What types of services are available under this waiver?

• Nurse and social work case management
• Homemaker services such as meal preparation and routine household care, grocery shopping, etc.
• Attendant care
• Minor physical adaptations to the home such as ramps, grab bars, widening of doorways, etc.
• Specialized medical equipment/medical supplies
• Skilled nursing – RN/LVN
• Psychotherapy
• Financial assistance for children/infants in foster care
• Nutritional counseling
• Non-emergency medical transportation
• Meals delivered to your home

Additional Information:

AIDS Waiver services are provided at no cost to the client, however individuals with a Medi-Cal share of cost must meet that share of cost each month to be eligible for services. There is a $25,727 per year cost limit effective January 1, 2017.

Individuals MAY NOT be simultaneously enrolled in or receive services from any of the following programs: Medi-Cal Hospice Program; State Plan case management services; Targeted case management to supplement AIDS Waiver; or another Medi-Cal Home and Community-Based Services Waiver.

Individuals MAY be simultaneously enrolled in Medicare Hospice.

AIDS Waiver agencies can provide additional information regarding eligibility and program services, enrollment, and the direct provision of case management services by a nurse and social worker. If you are not eligible for the AIDS Waiver, you may be eligible for other programs within the same agency or its parent agency. For a list of agencies by county see below.  For other resources see https://www.cdph.ca.gov/Programs/CID/DOA/Pages/OA_care_mcwp.aspx.

For Information about getting AIDS Waiver Services, you can call your county agency, listed below.  If you need information about applying for Medi-Cal, you can go to http://www.dhcs.ca.gov/services/medi-cal/Pages/ApplyforMedi-Cal.aspx.

AIDS WAIVER PROVIDERS

California Department of Public Health
Office of AIDS, HIV Care Branch