State Medicaid HCBS Database

The Center for Retirement Research at Boston College, with support from the Sloan Foundation, is creating a publicly available Medicaid HCBS database drawing directly from state plan documents, HCBS waiver applications, and CMS-372(S) reports for all 50 states. This multi-state longitudinal database will enable users to identify the specific HCBS covered by Medicaid in each state, the generosity of coverage, and when policy changes occur – providing a foundation for rigorous research on HCBS policy.

Below are data for nearly 100 1915(c) waiver programs spanning 45 states and the District of Columbia, dating back to 2006.  These data have been extracted directly from .pdf copies of over 750 waiver applications submitted through the CMS Waiver Management System.  Please send your questions or comments to crr@bc.edu.

Stay tuned for future data releases containing more states, years, and types of HCBS policy data. An interactive database tool will debut later in 2026.

1915(c) Waiver Applications (45 states and DC; 2006-2025)

Complete Data | Excel Codebook

Visual Codebooks:
Request for Amendment | Main Application and Appendices B, C, E, I, J | Appendix C-1_C-3 (by service) | Appendix J (by service)

Each waiver application contains multiple sections, each focused on a different aspect of the waiver program.

Request for Renewal

If the application is to renew an existing program, the “Request for Renewal” section will briefly describe – in prose – any major changes to the program that are being proposed as part of the renewal request.

Request for Amendment

If the application is to amend a new or renewed waiver program, the “Request for Amendment” section will briefly describe any major changes to the program that are being proposed under the amendment request.

Main Application

In each waiver application, the main section will provide basic information on the waiver’s effective date, duration, basic purpose (in prose), basic level of care threshold for eligibility, any geographic limitations, any associated waiver authorities, and when the application was submitted to CMS.

Appendix B

In each waiver application, Appendix B describes participant access and eligibility.  It describes the waiver’s target population, individual cost limits, and the maximum number of waiver participants (if any).   It also describes the Medicaid eligibility groups served by the waiver and the post-eligibility treatment of income for the participant and their spouse.  Finally, it describes – in prose – the level of care criteria used to determine participants’ functional eligibility and how often it is to be reevaluated.

Appendix C

In each waiver application, Appendix C details the rules around waiver service provision.  It describes the basic rules regarding payment for services furnished by relatives/legal guardians, and any additional limits on the amount of wavier service that can be provided. Appendix C-1/C-3 lists the specific HCBS services provided through the waiver, who can provide each service, and any specific limitations regarding the provision of each service.

Appendix E

If the waiver allows participant direction, Appendix E details the specific elements of budgetary and/or employer authority that are vested in the participant.  Section E-1-g of the waiver details the specific services for which budgetary and employer authority are vested in the participant.

Appendix I

In each waiver application, Appendix I describes the financial responsibility for payments – detailing the non-federal funding sources (e.g., state-local governments) and the extent to which waiver participants may bear some portion of the service costs through co-payments or some other form of cost-sharing.

Appendix J

In each waiver application, Appendix J details the calculations underling the waiver’s estimated costs and cost-neutrality demonstrations.  Section J-2-d-i details the service-specific calculations.