·Federal program
OBBBA Standalone HCBS Waiver (Non-Institutional LOC, 2028)
Future Medicaid waiver authority created by the One Big Beautiful Bill Act (P.L. 119-21, signed July 4, 2025) that will allow states to offer HCBS waivers — including respite and caregiver supports — to people who do NOT yet meet institutional level of care. Available starting July 1, 2028. CMS guidance issued November 2025; $50M FY2026 and $100M FY2027 in state infrastructure funding already appropriated. No state has adopted yet. Tracking stub: state-level adoptions should be recorded when states submit waiver amendments.
What it offers
From July 1, 2028, states may offer HCBS waivers under a new §1915(c)-style authority for people who do not yet require institutional level of care. Anticipated services: respite care, adult day health, personal care, caregiver training and support, and self-directed services where family members can be paid caregivers. $50M in FY2026 and $100M in FY2027 infrastructure funding has been appropriated to help states build waiver applications. CMS issued preliminary guidance (CIB 11-18-2025) November 2025. No state has adopted as of June 2026. This record is a tracking stub — check back after July 2028 for state adoption status and eligibility details.
Questions that decide eligibility
GiveCare prepares the questions; the program makes the decision. Bring these to the call or the application:
- 01
Does the VA disability rating meet the program’s minimum (our record lists null%)?
- 02
Do the work hours meet the minimum (our record lists null hours)?
- 03
Is there a caregiver-specific department, coordinator, or support line? Ask for it by name.
Many agencies have one that isn’t advertised on the website.
- 04
What documents do you need from us to start an application?
- 05
Is there a waitlist right now, and how long is it?