Home and Community Based Services

Home and Community-Based Services (HCBS) are an integral part of the “aging-in-place” philosophy. HCBS includes Adult Day Services, Home Care/Home Health, and Hospice, Programs for All-Inclusive Care for the Elderly (PACE), Senior Centers, and transportation services. A number of services programs in California assist seniors, enabling them to remain in their homes.

Find out more by clicking on a link below.

• Federal resources
• State resources
• Home and Community Based Subcommittee agenda
• Additional resources

Federal Resources

HUD's Service Coordinator Program
The HUD Service Coordinator Program funds social service staff for elderly and disabled properties to help residents find supportive services within their community. Service Coordinators arrange program referrals that may assist with meals, transportation, health and wellness, advocacy, and counseling. In addition, Service Coordinators educate residents on their rights, establish links with the local community and educate housing staff about the resident needs and "aging-in-place." 

Visit the  American Association of Service Coordinators website for more information.

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State Resources

• California Department of Aging
• California Department of Health Care Services
• California Department of Public Health
• California Department of Social Services

MediCal Assisted Living Waiver Pilot Progam
In 1999 Assemblymember Dion Aroner introduced AB 499, an Aging Services of California sponsored bill to establish a MediCal assisted living waiver pilot program in California. The bill was signed into law in 2000. Aging Services of California members were instrumental in developing the scope of this project and as a result, the pilot is being tested in both publicly funded housing and residential care facilities for the elderly. The ALWPP is being administered through the Department of Health Services (DHS), which has contracted with the NCB Development Corporation to implement the program.

The pilot is being tested in Sacramento, San Joaquin and part of Los Angeles counties. To view the project website visit www.californiaassistedliving.org. The website has been updated to include a roster of participants and consumer information.

Program of All-Inclusive Care for the Elderly (PACE)
PACE is a comprehensive managed care system for nursing home eligible seniors age 55 and over. This program offers a full range of long term care services to recipients and receives payment from Medicare and Medicaid for low-income participants. The program is administered through the California Department of Health Services and provides a substantial cost savings to the state and federal government compared over 24- hour skilled nursing care.

Although PACE originated in California the state falls far short of the number of sites needed to serve our frailest seniors. Aging Services of California continues its effort to collaborate and promote expansion of the number of PACE programs in California.

The following are PACE sites in California:
• AltaMed Senior BuenaCare (Los Angeles)
• Center for Elders Independence (Oakland)
• On Lok Lifeways (San Francisco)
• St. Paul's PACE (San Diego)
• Sutter SeniorCare (Sacramento)

For more information visit the newly launched California PACE Association or CalPACE website.

For additional information visit the National PACE Association website.

In-Home Supportive Services (IHSS)
The In-Home Supportive Services program provides in-home personal care and domestic services to low- income persons who are elderly or have a disability to help them remain safely in their own home and avoid moving to an institutioanl setting.  IHSS services include meal preparation, laundry, shopping, non-medical pesonal care services, assistance traveling to medical appointments, and acertain paramedical services.  Costs for the program are shared by federal, state, and county governments, but the program is administered at the county level.

Visit www.cdss.ca.gov for more information.

Adult Day Services
Adult day service centers are community-based group programs designed to meet the needs of functionally and/or cognitively impaired adults through an individual plan of care. These programs are designed to provide social and health services to adults who need supervised care in a safe place outside the home during the day. They also offer caregivers respite from the demanding responsibilities. There are three types of adult day centers:

• Social: Social center provides participants with meals, recreation and some health-related services.
• Medical/Health: This type of center offers social activities as well as more intensive health and therapeutic services.
• Specialized: A specialized center only provides services to specific care recipients, such as those with diagnosed dementias or developmental disabilities.  

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Christin Hemann Public Policy Analyst