Expand home and community-based services (HCBS) for aging adults and people with disabilities — before they reach an institutional level of care. Public Consulting Group’s Aging & Disability Services experts are here to help states plan, design, model, and submit 1915(c)(11) waivers with confidence.
Trusted Expertise in Waiver Design and HCBS Expansion
Starting July 2028, CMS is expected to approve a new pathway to Medicaid HCBS coverage for individuals who don’t yet meet institutional level-of-care criteria. Funding to support states pursuing these waivers begins in the federal fiscal year 2027. In a July 2026 webinar, CMS indicated they planned to distribute this funding in the next few months.
States face a familiar challenge: building a compliant, financially sound waiver program that meets CMS requirements, remains operationally viable after launch, and meets the needs of participants, stakeholders, providers, and families.
Public Consulting Group (PCG) designs, drafts, and implements HCBS waivers for state Medicaid, Aging, and Developmental Disabilities agencies. Our team recently partnered with a state to design a new 1915(c) waiver and received approval under the current administration in three months. We did so by leveraging deep expertise in both new waiver development and amendment processes.
We help states:
- Assess whether and how new waiver programs can support their priorities
- Define needs-based eligibility criteria and covered services
- Establish provider qualifications and participant safeguards
- Prepare for CMS review — including cost neutrality and annual reporting
- Navigate the CMS review process from submission to approval
Our approach combines HCBS policy expertise, stakeholder engagement, waiver application development, rate and cost modeling, assessment design, and analytics. This approach allows states to assess options before submission, understand impacts on existing waivers and waitlists, and build the infrastructure to sustain the program long after approval.
Click here to learn more about the new 1915(c)(11) waiver.
1915(c)(11) Waiver Services with PCG
- Population, eligibility, and service package design
- Cost benefit analysis
- Assessment and screening tool development
- Stakeholder engagement and advisory groups
- Cross-waiver business process review
- Communications, outreach, and training
- Provider qualifications and monitoring design
- Rate studies and cost neutrality analysis
- Federal reporting, dashboards, and CMS readiness