What Is the Assisted Living Waiver Program in California?

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Reviewed by Annalisa Hahn, senior care expert Annalisa Hahn is a regional manager at A Place for Mom and has worked in senior care or other medical organizations for more than 30 years.

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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Key Takeaways

  1. In California, the Assisted Living Waiver (ALW) can cover the cost of authorized assisted living care. Seniors who are eligible can find qualifying communities or caregivers through the state’s Medicaid provider, Medi-Cal.
  2. The Assisted Living Waiver helps seniors live in their homes and communities for as long as possible. The ALW covers costs of assisted living communities and home care agencies that provide personal support, assistance with activities of daily living, and skilled nursing care.
  3. Seniors must be willing to move to one of 15 counties where the program is available. This program is only available in a limited area, and there is often a waitlist to get into a community.
  4. Eligible seniors can easily apply for these waivers online or through the mail. Contact your county's Social Services office or one of A Place for Mom’s Senior Living Advisors if you have any further questions.

Medi-Cal’s assisted living waiver

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 ]