How can I get sendmail to deliver local mail to $HOME/.mail instead of into /usr/spool/mail (or /usr/mail)?
This is a local mailer issue, not a sendmail issue. Either modify your local mailer (source code will be required) or change the program called in the "local" mailer configuration description to be a new program that does this local delivery. One program that is capable of doing this is procmail, although there are probably many others as well.