Hawaii Medicaid Waivers & Home and Community Based Programs Overview

Hawaii, known as The Aloha State, has a unique Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the Hawai‘i Department of Human Services (DHS), Med-QUEST Division (MQD), the state’s Medicaid program, Hawai‘i QUEST Integration (QI), consolidates both traditional Medicaid and long-term services under a managed care model. Key waiver programs include the Hawai‘i Home and Community-Based Services Waiver for Individuals with Intellectual and Developmental Disabilities (HCBS I/DD Waiver), which provides habilitation, employment, and personal assistance services for individuals with developmental disabilities, and the Community Care Services (CCS) Program, which supports Medicaid beneficiaries with serious mental illness.

Hawai‘i also emphasizes self-directed services and culturally responsive care models, ensuring that participants have greater flexibility in managing their services while incorporating Native Hawaiian cultural values into long-term care planning.

Regulatory oversight in Hawai‘i is managed through Med-QUEST (MQD) and the Developmental Disabilities Division (DDD) of the Hawai‘i Department of Health (DOH), with additional licensing and provider compliance requirements enforced by the Office of Health Care Assurance (OHCA). Hawai‘i's Managed Care Organizations (MCOs) play a central role in coordinating HCBS services, ensuring that Medicaid participants receive comprehensive, community-based care while promoting cost-effective service delivery.

The state has also implemented Electronic Visit Verification (EVV) for personal care services, reinforcing accountability in home-based care programs. Given Hawai‘i’s island geography and rural healthcare challenges, the Medicaid system places a strong emphasis on telehealth expansion, integrated behavioral health services, and community-based aging supports.

With a focus on person-centered planning, cultural competency, and managed care efficiency, Hawai‘i’s Medicaid waiver system ensures that participants receive high-quality, sustainable long-term care services while maintaining independence, dignity, and connection to their communities.

---

Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

Browse Policy & Procedure Manual for This State's Programs and Services