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California’s Assisted Living Waiver (ALW) Program: How Medi-Cal Can Help Pay for Assisted Living

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Assisted Living•Costs and Affordability

California’s Assisted Living Waiver (ALW) Program: How Medi-Cal Can Help Pay for Assisted Living

Posted 06/23/2026•By Christina Bremner•4 min read
For many California families, paying for assisted living is one of the biggest concerns when a loved one begins to need daily care. The good news is that California’s Assisted Living Waiver (ALW) Program may help eligible Medi-Cal recipients receive assisted living services while avoiding placement in a nursing home. If you’ve heard of the ALW program but aren’t sure how it works, this guide will explain who qualifies, what it covers, and how to apply.

What Is the Assisted Living Waiver (ALW)?

The Assisted Living Waiver (ALW) is a Medi-Cal Home and Community-Based Services (HCBS) program administered by the California Department of Health Care Services (DHCS). Its purpose is to help seniors and adults with disabilities receive the care they need in a licensed assisted living community rather than in a skilled nursing facility.
The program helps eligible individuals remain in a more home-like environment while receiving assistance with daily activities such as:
·         Bathing and dressing
·         Medication management
·         Personal care
·         Housekeeping
·         Meals
·         Care coordination
·         Limited skilled nursing services when needed
·         Social and recreational activities

What Does the ALW Program Pay For?

One of the biggest misconceptions is that Medi-Cal pays the entire assisted living bill.
It doesn’t.
The ALW program pays for the care services provided in participating assisted living communities. Residents are still responsible for paying their room and board, although many use their Social Security, SSI, or other income to cover those housing costs.

Who Is Eligible?

To qualify for the Assisted Living Waiver, applicants generally must:
·         Be 21 years of age or older
·         Have full-scope Medi-Cal with no Share of Cost
·         Require a nursing-facility level of care
·         Be able to live safely in an assisted living community
·         Be willing to live in a participating assisted living community located in a county that offers the ALW program
A registered nurse will perform an assessment to determine whether the applicant meets the required level of care.

ALW Program Counties
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Which California Counties Participate?

Currently, the Assisted Living Waiver is available in the following counties:
·         Alameda
·         Contra Costa
·         Fresno
·         Kern
·         Los Angeles
·         Orange
·         Riverside
·         Sacramento
·         San Bernardino
·         San Diego
·         San Francisco
·         San Joaquin
·         San Mateo
·         Santa Clara
·         Sonoma
Even if you don’t currently live in one of these counties, you may qualify by moving into a participating assisted living community located there.