Assisted Living Waiver

    ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Assisted Living Waiver Program

    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. The current five-year waiver term is approved for March 1, 2019 – February 28, 2024.

      Please complete application and fax back to 530-895-1703 – Attention: ALW Department

      For questions, call: (800)400-0727 – ask for the ALW Department


        The following is a list of some of the services that can be provided to ALW participants. These services may be provided in a Residential Care Facilities for the Elderly (RCFE) or by a licensed Home Health Agency to residents in public housing.

        • Assisting in developing and updating an individualized care plan for each resident
        • Personal care and assistance with activities of daily living
        • Laundry
        • Housekeeping
        • Maintenance of the facility
        • Providing intermittent skilled nursing care
        • Meals and snacks
        • Providing assistance with self-administration of medications
        • Coordinating transportation
        • Providing recreational activities
        • Providing social services

        Care Coordination: These services include identifying, organizing, coordinating and monitoring services needed by participants.

        Nursing Facility Transition Care Coordination: These services help transition participants from a nursing home to the community.


          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.

          *Home and health Care Management is currently only offering ALW services in Sacramento county.


            While the Assisted Living Waiver itself has no income limits, one must be eligible for full-scope Medi-Cal with no Share of Cost. In limited circumstances, persons who exceed the Medi-Cal income limits can still be eligible for the Assisted Living Waiver. Applicants must have an income of atleast $1,000 per month to cover room and board fees.

            ALW Current Enrollment

              Current enrollment and waitlist information for the Assisted Living Waiver can be found on the enrollment dashboard, which is updated monthly. New applicants to ALW should be aware the number of available slots is limited and there is a waitlist. Open waiver slots are release to Care Coordination Agencies on a regular basis. Please contact the Care Coordination Agency of your choice for the information on enrollment details. A current listing of Care Coordination Agencies can be found here.

              Additional Program Resources

              Apply today AT NO COST by downloading the Application below!

              Please complete application and fax back to (530)895-1703 – Attention: ALW Department

              For questions, call: (800)400-0727 – ask for the ALW Department