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AB 315

Medi-Cal: Home and Community-Based Alternatives Waiver.

2025-2026 Regular Session Introduced by Mia Bonta and 1 co-sponsor

AB 315 expands California's Medi-Cal waiver program to shift long-term care from nursing homes to home and community-based services for eligible beneficiaries.

In committee: Held under submission.
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Bill Summary · AB 315

Legislative bill overview

AB 315 would establish or expand Medi-Cal's Home and Community-Based Alternatives (HCBA) Waiver program in California, which allows eligible beneficiaries to receive long-term care services in home and community settings rather than institutional facilities like nursing homes. The bill aims to shift care delivery toward less restrictive, community-integrated environments while maintaining or improving access to necessary services for vulnerable populations.

Why is this important

This legislation directly affects how California delivers long-term care to elderly, disabled, and chronically ill Medi-Cal beneficiaries—potentially improving quality of life and independence for tens of thousands of people. The shift from institutional to community-based care can reduce costs to the state while allowing individuals to remain in their homes and communities, though implementation and funding mechanisms are critical to actual outcomes.

Potential points of contention

  • Funding and fiscal impact: Whether state and federal resources are sufficient to support expanded HCBA services without reducing other Medi-Cal programs or creating waitlists for care
  • Provider capacity: Whether adequate home care workers, agencies, and support services exist in all regions to meet demand, especially in rural areas
  • Quality assurance and oversight: How the state will monitor care quality and protect vulnerable beneficiaries in less-regulated home settings compared to licensed facilities
  • Institutional care workforce: Impact on nursing home employees and facilities, and whether transition planning protects workers during industry shift

Compiled from official sources — confirm details with the bill’s official record.

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