Assisted Living Waiver (ALW)

To be eligible an ALW Participant, an individual must meet all of the following ALW eligibility criteria:

• Age 21 or older
• Have full-scope Medi-Cal eligibility with zero share of cost; **If you have a Share of Cost (SOC), contact your local Medi-Cal office or an outside agency for assistance.
• Have care needs equal to those of Medi-Cal-funded resident living and receiving care in Nursing Facilities;
• Willing to live in an assisted living setting as an alternative to a Nursing Facility;
• Able to reside safely in an assisted living facility or public subsidized housing;
• Ability and willingness to pay the rental fee charged by ALW facility (through social security or another form of income)
• Willing to live in an assisted living setting located in one of the following 15 counties providing ALW services: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma counties

Yes, a social worker can submit the required paperwork to our office.

If the social worker will not be the point of contact after submission, an additional point of contact is required.

Visit the DHCS website to apply: https://www.dhcs.ca.gov/services/medi-cal/

Yes. Your Share of Cost must be cleared BEFORE enrollment.

Care coordination services for the waiver program are free of charge to the applicant or advocate assisting with the application. Participants are required to pay the ALW Room & Board Rate to Assisted Living Facility each month.

ALW Room & Board Rate as of January 2026 is $1,444.07 per month.

Room & Board cost is determined each year based on the federal Social Security Administration (SSA) published maximum SSI benefits available to beneficiaries in different living arrangements. Most ALW participants use their Social Security Income/State Supplementary Payment (SSI/SSP) to pay for rent.

LTC Ombudsman
Time until assessment: Approximately 1-2 months

Adult Protective Services
Time until assessment: Approximately 1-2 months

Community (Anywhere other than a SNF or Hospital)
Time until assessment: Approximately 36 months

Skilled Nursing Facility or Hospital
Time until assessment: Approximately 12 months
Eligible for discharge after 60 days.

Voluntary Discharge:
If you voluntarily discharge from your facility before completing a 60 day admission, you will be placed on the 36 month community waitlist

*Please note all waitlist timeframes are estimates and are subject to change without notice*

You can live in the assisted living residence of your choosing. The facility must be on the approved waiver list and must confirm that it can accommodate the care level before admission.

The full list is available on the DHCS website:
https://www.dhcs.ca.gov/services/ltc/Pages/List-of-Approved-RCFE-ARF.aspx

Please contact our office to update us of your admission and once you reach the 60th day of admission we will place you on the SNF/Hospital waitlist.

Under California Code Regulations and Title 22, § 80091 clients who require health services and/or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a Community Care Facility (CCF).

• Feeding Tube
• Active, communicable TB
• Conditions that require 24-hour nursing care and/or monitoring
• Stage 3 and 4 dermal ulcers

Any other condition or care requirements which would require the facility to be licensed as a health facility as defined by Sections 1202 and 1250 of the Health and Safety Code

Starting January 1, 2024, assets will no longer be counted to determine Medi-Cal eligibility!​​​​​​​​​

Per DHCS: An ALW participant is presumed competent to sign documents/consent to services on their own behalf. There is no authority that permits anyone other than a legal representative, conservator, or power of attorney to sign the initial applicant documents and or the biannual assessment/individual service plan for a participant. However, nothing forbids another person from assisting the participant to sign the necessary documentation on their own behalf.

If you have already had an assessment with another Care Coordinating Agency and would like to switch your services to our agency, please complete the CCA Change form linked below and send it to our office with the member’s Date of Birth and their Medi-Cal number.

Written requests are accepted by fax, email, or an uploaded form from the participant or their legally authorized representative. CCA changes without authorization from these two individuals will not be accepted.