CBAS stands for Community-Based Adult Services, a California program that provides daytime health and social services to adults with chronic medical conditions, cognitive impairments, or disabilities. The program operates through 322 centers across the state, serving roughly 45,750 participants as of early 2026. Its core purpose is straightforward: keep people out of nursing homes and hospitals by giving them professional care during the day while they continue living at home.
Who CBAS Serves
CBAS is designed for adults 18 and older who have ongoing medical, cognitive, or mental health conditions serious enough that they’d otherwise be at risk of ending up in institutional care. Participants typically need some level of protective supervision throughout the day, and the program exists to stabilize or improve their condition so that a nursing facility stay can be delayed or avoided entirely.
To qualify, a person must fall into at least one of several eligibility categories. These include people who meet nursing facility level-of-care standards, people with brain injuries or chronic mental illness who need help with daily activities like bathing or managing money, people with moderate to severe Alzheimer’s or other forms of dementia, and people with developmental disabilities as determined by a Regional Center. A physician or nurse practitioner must request services, and the person’s Medi-Cal managed care plan makes the final eligibility decision.
What Happens at a CBAS Center
CBAS centers function like structured day programs staffed by health professionals. When someone first enrolls, a team of clinicians assesses their specific needs and builds an Individualized Plan of Care. This plan spells out each participant’s problems, the treatments or activities they’ll receive, how often they’ll get them, and measurable goals for progress. A physician, program director, and the rest of the care team all sign off on the plan.
The services available at each center cover a wide range:
- Nursing care from registered nurses
- Rehabilitation therapies including physical, occupational, and speech therapy
- Mental health services
- Social services and case management
- Personal care such as help with grooming or mobility
- Therapeutic activities designed around individual goals
- Hot meals and nutritional counseling
- Transportation to and from the participant’s home
The transportation piece is worth highlighting because it removes one of the biggest barriers for people with mobility challenges or cognitive impairment. Centers are responsible for getting participants door to door, not just to a bus stop or curb.
Staffing at CBAS Centers
California sets specific staffing ratios for CBAS centers based on how many people attend on a given day. For every 40 participants, a center must have at least one registered nurse and one social worker. A center serving 120 people daily, for example, needs a minimum of three nurses and three social workers on site. These ratios ensure that participants have regular access to clinical staff rather than relying on aides alone.
How CBAS Is Funded
CBAS is a Medi-Cal benefit, meaning it’s funded through California’s Medicaid program. Most participants access the program through their Medi-Cal managed care plan, which handles the eligibility determination and coordinates care with the CBAS center. The center receives an all-inclusive rate that covers every service in the participant’s care plan, from nursing to meals to transportation. There is no separate billing for individual services.
For the small number of Medi-Cal beneficiaries who aren’t enrolled in managed care, eligibility can be determined through the state’s Department of Health Care Services or a designated field office. The program currently operates under California’s CalAIM waiver, a federal Medicaid agreement that runs through December 2026.
How CBAS Differs From Other Adult Day Programs
California has various types of adult day programs, but CBAS is distinct because of its medical component. A standard adult day care center might offer social activities and supervision, but CBAS centers are required to provide clinical services like nursing, therapy, and mental health care. The eligibility requirements reflect this: you can’t simply sign up because you want daytime activities. You need to have a documented medical, cognitive, or mental health condition that puts you at risk of needing a higher level of care.
CBAS replaced California’s older Adult Day Health Care program, which was restructured and brought under the Medi-Cal managed care system. The transition tightened eligibility criteria and shifted oversight so that managed care plans play a central role in determining who qualifies and coordinating each participant’s broader health care.
What the Day-to-Day Experience Looks Like
For families, CBAS often serves a dual purpose. The participant receives professional health monitoring, therapy, and social engagement during the day, while family caregivers get reliable respite. A typical day might include a morning pickup, a group exercise or therapy session, a hot lunch, individual time with a nurse or social worker, and an afternoon activity before transportation home.
Because each person’s plan of care is individualized, the mix of services varies. Someone recovering from a stroke might spend more time in physical and speech therapy, while a person with moderate dementia might focus on structured cognitive activities and supervision. The care plan is reviewed periodically and adjusted as the participant’s condition changes, with measurable goals tracked over time to ensure the program is actually helping.