Combined 1915 (b)/(c)
States can provide traditional long-term care benefits (like home health, personal care, and institutional services), as well as non-traditional home and community-based "1915(c)-like" services (like homemaker services, adult day health services, and respite care) using a managed care delivery system, rather than fee-for-service. They accomplish this goal by combining a 1915(c) waiver with a 1915(b) waiver (or any of the Federal authorities outlined in the Managed Care Delivery System section. The managed care delivery system authority is used to either mandate enrollment into a managed care arrangement which provides HCBS services or simply to limit the number or types of providers which deliver HCBS services.