Waiver Agency HCBA Application Fillable Form

The Home and Community Based Alternatives Waiver provides care management services to persons at risk for nursing home or institutional placement. The care management services are provided by a multidisciplinary care team comprised of a nurse and social worker. The care management team coordinates Waiver and State Plan services (e.g., medical, behavioral health, In-Home Supportive Services, etc.), and arranges for other available long-term services and supports available in the local community. Care management and Waiver services are provided in the Participant’s community-based residence. This residence can be privately owned, secured through a tenant lease arrangement, or the residence of a Participant’s family member.

Home and Community-Based Alternatives (HCBA) Waiver Application

Authorization for Release of Protected Health Information

Nondiscrimination and Language Access


You must submit a completed Authorization to Release Medical Records with your HCBA application

Fill out the form, download and save it. Once that is completed, please email it directly to one of our onsite representatives at HCBA@ACCESSTLC.COM. Please note: This waiver for Access TLC is for Santa Barbara County, and sections of Los Angeles and Orange Counties.

Our Mission

Access TLC is to provide unparalleled quality of service that allows patients to have a better quality of life. Our caregivers have decades of combined experience in hospice and home healthcare, and we utilize state-of-the-art equipment to guarantee the utmost comfort and peace of mind as our patients navigate the home healthcare process.


Our home health care service is for patients who need care from highly trained, highly skilled providers. Our goal is to help patients to function independently at home, to increase their comfort and to improve their overall health. Patients are eligible if they are homebound and under the care of a physician who certifies that they need one of more of the following:

  • Intermittent Skilled Nursing Care
  • Physical Therapy Services
  • Speech/Language/Occupational/Therapy
  • Pathology Service

Our home health care services include but are not limited to:

  • Nursing Assessment
  • Medication Management
  • Home Health Aide Services
  • Bathing & Dressing
  • Rehabilitation Therapy
  • Home Safety Evaluation
  • Medical Social Services
  • Treatments & Injections
  • Dressing Changes & Wound Care
  • Post-Op Care
  • Incontinence Care
  • Restorative Care
  • Patient & Family Education

Home Hospice is a program of care designed to relieve and manage symptoms related to a terminal illness and to help the patient and family with emotional and spiritual support during the end of life. Hospice provides extra care and comfort in the patient’s home, hospital, long-term care facility or wherever the patient resides.
Hospice offers:

  • Palliative & Support Care
  • Bereavement Grief Counseling

The services offered include:

  • Physician Services
  • Skilled Nursing Services
  • Physical/Speech Therapy
  • Medical Supplies & Equipment
  • Dietary Counseling
  • Bereavement Counseling

Seniors step out of the house less often as they get older. Many of them rely on visitors to socialize and seek companionship. Companionship is correlated to their health and overall well being. We provide caring, competent and dedicated professionals to care for those who need it. We work with patients and their families to design a program of care, and hourly shifts based on their needs.

Private pay services include:

  • Bathing/Showering Assistance
  • Continence Care/Toileting Assistance
  • Personal Hygiene Care/Skin
  • Care/Grooming
  • Companion Services for Recreational
  • Activities
  • Dressing Assistance/Clothing Selection
  • Errand Running/Groceries/Shopping
  • Eating Assistance/Meal Preparation
  • Transferring/Repositioning Assistance
  • Wake Up/Tuck-In Services
  • Linen Changes/Laundry Services
  • Washing/Drying Dishes
  • Appointment Reminders
  • Vacuuming/Dusting
  • Personal Care Services

All Transport Care provides professional, comfortable and dependable non-emergency transportation services. We are a reliable service with over 20 years of experience providing Continuum of Care Services.

We are proud of our excellent relationships we maintain in the community with Physicians, Medical Groups, Hospitals, as well as the major Health Plans. Our services are designed to fit common and special-needs situations which include bariatric, inaccessible areas, staircases, and long distance transports.

We help clients who are bed-bound, or have limited body flexibility and need to transport in a stable and lay-down position throughout the entire trip. Perfect for individuals who are wheelchair bound and unable to transfer safely to a passenger vehicle.

The transport services we offer include but are not limited to:

  • Stretcher/Gurney transport
  • Wheelchair lift service
  • Specialty transit
  • Medical appointments
  • Bariatric transport
  • Dialysis treatments
  • Discharge to home or facility
  • Dental appointments
  • Transferring to the facility


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CALL 800-TLC-9887