The Assisted Living Waiver (ALW) program in California is a home and community based services waiver (HCBS) available to Medicaid eligible seniors. The ALW allows seniors who qualify for nursing home care to instead receive the same level of care in an assisted living community. However, seniors wishing to take advantage of the assisted living waiver program need to be aware of several conditions of the program when they apply. Learn more about California’s Medicaid program, Medi-Cal, and how to apply for the ALW.
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The Assisted Living Waiver allows Medi-Cal-eligible seniors to choose an assisted living community as an alternative to a nursing facility. California created this experimental waiver to test the efficacy of assisted living as a Medi-Cal benefit. The ALW is currently available through 2029, though it is being offered to a limited number of participants.[01]
The ALW allows seniors and persons with disabilities to live in their home or community for as long as possible. This waiver covers the costs of care for seniors who are eligible for a nursing facility but would prefer to receive services through an assisted living community or home health care agency.
Accepted applicants need to live in one of the communities covered by the waiver. These include a list of options classified as Residential Care Facilities (RCFs), Adult Residential Care Facilities (ARFs), and publicly subsidized housing options covered by the waiver. The state also authorizes Care Coordination Agencies (CCAs) to develop personalized care plans and coordinate care services. Eligible seniors may use a CCA to develop a care plan while living in their current RCF, ARF, or subsidized housing arrangement.[02]
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Care services covered by the ALW include:[02]
These services are administered by the community staff or by a licensed home health agency, based on the participant’s choice of a residential setting. Every six months, participants receive an assessment from a registered nurse to determine their required level of care.
Medi-Cal is the state of California’s Medicaid health care program. The program covers various medical services for children and adults with limited income and resources. Federal and state taxes support Medi-Cal, and program recipients can receive services for as long as they meet the eligibility requirements for Medicaid.
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To participate in the Assisted Living Waiver program, seniors must be eligible for Medi-Cal and meet all of the program’s criteria:[01]
Currently, the counties offering the ALW are:
Seniors with Medi-Cal benefits that have partial Medicaid coverage and share in the cost of their care aren’t eligible to apply for the ALW program.
To qualify for the Assisted Living Waiver, seniors must first apply for Medi-Cal coverage. To apply online, visit the Covered California website. Seniors can also apply through the mail with the Single Streamlined Application, or in-person at a county’s Social Services office. To qualify for residential habilitation, seniors must receive prior approval from a Department of Health Care Services’ nurse evaluator, who will decide which level of care best meets a given senior’s needs. From there, the senior can be added to a waiting list for an assisted living community covered by the ALW.[02]
To view the current providers or additional waitlist information, visit the Department of Health Care Services website.
Finding the right assisted living community can take time. For assisted living options tailored to your needs, location, and budget, consider reaching out to A Place for Mom’s Senior Living Advisors. They can help you navigate the complexities of finding senior living services and even help schedule community tours. Talk with one of our experts today to learn more about California’s assisted living and home care services.
California Department of Health Care Services. (2022). Assisted Living Waiver.
California Department of Health Care Services. (2022, March). Application for a §1915(c) Home and Community Based Services Waiver.
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