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California has renewed its Medicaid 1915(i) State Plan Home and Community-Based Services (HCBS) program for another five years. State Plan Amendment (SPA) 26-0009 is effective October 1, 2026 and continues through September 30, 2031. California’s Department of Developmental Services (DDS) says the renewal allows the state to continue accessing federal funding for certain community-based services, including services for individuals who do not meet the eligibility criteria of the current 1915(c) HCBS waiver.
The terminology can sound complicated, especially for families who are simply trying to understand how a loved one can continue living safely and meaningfully at home and in the community.
The practical takeaway is this: the renewal continues an important funding pathway for home and community-based services. It does not automatically determine who qualifies for a service or what services an individual will receive.
Medicaid is known as Medi-Cal in California. Federal Medicaid law provides several pathways that states can use to offer Home and Community-Based Services (HCBS).
One of those pathways is Section 1915(i) of the Social Security Act. Unlike the 1915(c) HCBS waiver, which has different eligibility requirements and structures, 1915(i) allows states to provide certain HCBS through the Medicaid State Plan.
A key feature of 1915(i) is that its eligibility criteria must be less stringent than the institutional level-of-care criteria used for waiver programs. This can provide another pathway for eligible individuals to receive services in home and community settings.
For families, this matters because support does not have to be viewed only through the lens of institutional care. Home and community-based services are intended to help eligible people receive support while participating in everyday life in their homes and communities.
California’s renewal of SPA 26-0009 provides continuity for the state’s 1915(i) State Plan HCBS program for five years, from October 1, 2026, through September 30, 2031. DDS identifies the program as a way to access federal funding for community services for individuals who do not meet the eligibility criteria of the current 1915(c) HCBS waiver.
The renewal is important at the program and funding level. It does not mean that every person receiving Regional Center services will automatically receive new services or that an existing Individual Program Plan (IPP) will automatically change.
Eligibility, assessments, prior authorization, service plans and other program decisions remain part of the applicable state and Regional Center processes. The approved California SPA identifies DDS and Regional Centers as responsible for areas including eligibility evaluation, review of participant service plans, prior authorization and utilization management.
A statewide program renewal can sound like a major change for families, but it is important not to read more into the announcement than it says.
The renewal does not automatically:
These decisions depend on the individual’s circumstances and the requirements of the applicable programs.
Families with questions about an individual’s eligibility or services should work with their Regional Center Service Coordinator or the appropriate DDS resource. Questions involving benefits, appeals, or legal rights may also require assistance from a qualified advocate or legal professional.
When families hear about changes to Medicaid or HCBS programs, it can be tempting to focus immediately on eligibility rules, funding categories and program names.
Those details matter. But the starting point can be much simpler:
What does this person want their everyday life to look like?
Home and community-based support can be connected to many aspects of daily life, including:
CMS notes that 1915(i) services are provided through a person-centered service plan and can include different types of long-term services and supports depending on how a state designs its benefit.
The goal is not simply to provide a service. The goal is to connect appropriate support with the person’s needs, preferences, strengths and desired outcomes.
Person-centered support means recognizing what someone can do, what they wants to do and where assistance can make participation easier.
For example, a person may be able to prepare part of a meal but need help organizing ingredients. Someone who wants to use public transportation may need assistance practicing a route rather than having someone make every trip for them. Another person may need reminders and encouragement to follow a familiar routine.
Small differences like these can have a meaningful effect on independence and confidence.
Support should also respect communication preferences. A person may communicate through speech, gestures, technology, visual supports, or other methods. Their preferences and choices should remain part of the conversation whenever possible.
If the 1915(i) renewal prompts a conversation about services or future planning, families can start with everyday needs rather than the funding terminology.
Consider asking:
These questions help keep planning centered on the individual rather than on a diagnosis, disability, or list of limitations.
Medicaid and Regional Center policies can be complicated, and program updates can easily be misunderstood.
The renewal of California’s 1915(i) HCBS program is best understood as a continuation of a state funding pathway, not as a blanket change in eligibility or a guarantee of services for every individual.
For families, the most useful approach is to combine accurate information about available programs with a clear understanding of the person’s own goals, needs, preferences and daily life.
Community living looks different for everyone. For one person, independence may mean preparing breakfast with minimal assistance. For another, it may mean participating in a community activity, developing employment skills, maintaining relationships, or having more choice in how their day unfolds.
The right support should help make those goals more achievable while respecting the person’s dignity and choices.
ComForCare Home Care North San Diego supports individuals and families with everyday routines and in-home support designed around each person’s needs and preferences.
Our role is to provide practical support while respecting independence, dignity and the individual’s way of doing things.
For questions about 1915(i) eligibility, Regional Center authorization, Medi-Cal coverage, or an individual’s IPP, families should rely on the appropriate official source, Regional Center Service Coordinator, or qualified benefits professional.
This article provides general educational information and is not a determination of eligibility, coverage, or authorization for any individual. Program rules and individual circumstances may vary.
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