Lawmakers Hear Push for 'Be Home Soon' to Unify Medi‑Cal Home‑and‑Community‑Based Services

Senate Budget Subcommittee No. 3 on Tuesday examined Be Home Soon, a proposal that would create a coordinated, statewide Medi‑Cal home‑and‑community‑based services (HCBS) program intended to reduce long waits for care and help older adults and people with disabilities avoid costly institutionalization.

Supporters said the plan would centralize disconnected programs so people can get help earlier. "Be Home Soon creates a more coordinated, accessible and affordable system that delivers services when people need them, not when bureaucracy finally catches up," Justice in Aging advocate Hagar Dickman told the committee. Kate Myers of the California Health Care Foundation added that California’s aging population is growing rapidly and that the state’s existing HCBS delivery system is fragmented, with coverage and enrollment rules varying by county.

Why it matters: Advocates argued the proposal would prevent avoidable hospital stays, nursing‑home placements and homelessness by removing administrative barriers and expanding caregiver supports and home modifications. Bea Saki of East Bay Innovations described long transition delays and housing barriers that leave people institutionalized despite alternatives that could keep them safely in the community. "Under Be Home Soon, John's mother would not wait years for the services she needs," she said.

Cost and capacity questions: Department of Health Care Services Chief Deputy Tyler Sadwith told the committee the department supports the proposal’s goals but flagged substantial upfront general‑fund costs and uncertainty about when projected savings would materialize. "The Be Home Soon proposal estimates annual savings of $625,000,000 general fund when fully implemented," he said, "however it is unclear as to the timeline when those savings are expected to be realized, and it is unclear what assumptions were used to project those savings." The department also provided enrollment and wait‑list data: 11,254 enrollees in the HCBA waiver, 14,495 in the assisted‑living waiver, with wait lists of 6,674 and 17,886 respectively.

Providers and counties cautioned about workforce and administrative bottlenecks. Panelists described provider‑enrollment backlogs (certifications taking up to two years in some cases), care coordination agencies at capacity, and a shortage of registered nurses and social workers needed to expand services on the ground. DHCS said meaningful expansion would require investments in provider rates, workforce recruitment, enrollment‑processing technology and increased operational capacity.

What's next: Legislators pressed Department of Finance and LAO staff for analyses showing the proposal’s fiscal profile over the near and medium term. DOF officials said the proposal would challenge the state’s balanced‑budget structure in the budget year and noted the need to examine out‑year impacts. Committee members asked DHCS and LAO for more detailed timeline assumptions and a counteranalysis of when savings would occur.

Public comment and context: Supporters including LeadingAge California, IHSS consumer advocates and disability‑service providers urged lawmakers to prioritize consumers and preserve housing‑access components. Several county and provider speakers recommended targeted rate reform and administrative fixes—such as presumptive eligibility policies—so individuals can receive services while paperwork is finalized.

The committee did not take a vote. Lawmakers requested additional analyses from DOF and LAO and signaled they will continue oversight of the proposal before final budget decisions.