The federal government usually pays states back for part of the cost when people with disabilities live in institutions. They approved Home- and Community-Based Services (HCBS) waivers to allow people to get Medi-Cal to pay for community services instead of institutional care.

The federal rules allow Medi-Cal waivers because people with disabilities are better off when they live at home and the community, instead of an institution. The waivers help keep people with disabilities out of institutions. Waivers recognize that many people at risk of being placed in medical facilities can be cared for in their homes and communities. This keeps their independence and ties to family and friends at a cost no higher than institutional care. The DD Waiver is the largest HCBS waiver in California and the nation.^[1]Home and Community-Based Services Waiver for the Developmentally Disabled (HCBS-DD) (ca.gov)