Assisted Living Waiver

The Assisted Living Waiver (ALW) is a Home and Community-Based Services (HCBS) waiver that was created by legislation that directed the California Department of Health Care Services (DHCS) to develop and implement the project to test the efficacy of assisted living as a Medi-Cal benefit. The pilot program was determined to be successful during the first three years in a limited trial in three counties.  In March 2009, the Centers for Medicare and Medicaid Services (CMS) approved a waiver renewal for an additional five years and expansion of the program into additional counties.

To be eligible to receive services as an ALW Participant, an individual must meet the following ALW eligibility criteria:

• Age 21 or older
• Have full-scope Medi-Cal eligibility with zero share of cost
• Have care needs equal to those of Medi-Cal-funded residents 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
• Willing to live in an assisted living setting located in one of the following 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 

ALW is limited to individuals eligible for Medi-Cal, without a Medi-Cal share of cost, who require a nursing facility level of care and wish to live in a residential care setting or in publicly funded senior and/or disabled housing. ALW participants must have sufficient funds to pay for their room and board, with some funds remaining to meet personal and incidental needs. In determining Medi-Cal eligibility for individuals who are applying for enrollment into ALW, institutional and spousal impoverishment prevention rules are applied.