Costs and Affordability•Assisted Living
Understanding the Assisted Living Waiver (ALW) Program in CA
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Costs and Affordability•Assisted Living
Understanding the Assisted Living Waiver (ALW) Program in CA
The Assisted Living Waiver (ALW) program provides an alternative to nursing home care for eligible seniors and individuals with disabilities. It offers affordable housing with personal and health-related services, promoting dignity, privacy, and independence.
What is the ALW Program?
The ALW program helps Medi-Cal beneficiaries remain in their communities instead of moving into licensed healthcare facilities. While Medi-Cal covers specific services, residents must pay for their own room and board. In 2024, for those receiving Supplemental Security Income (SSI) of $1,575.07, room and board costs are $1,398.07. An additional $20 may be charged if the resident has other income, as the Admission Agreement specifies.
Eligibility and Enrollment
- Available in select California counties, including Alameda, Los Angeles, Orange, San Diego, and more.
- Open to beneficiaries residing in skilled nursing facilities or the community who require nursing-level care.
- Individuals with a Medi-Cal share of the cost are not eligible.
Eligibility Requirements:
- 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.
How to Determine Eligibility
- Medi-Cal enrollment is required; local county offices determine eligibility.
- Level of care assessment is conducted by registered nurses from Care Coordination Agencies (CCAs).
- A phone pre-screening is done before scheduling an in-person assessment.
Conclusion The ALW program provides an essential alternative for those needing long-term care while maintaining independence. For more details or to apply, contact a Care Coordination Agency in your county. Please refer to the extensive list on the Department of Health Care Services (DHCS) website here: List-of-Approved-CCAs**
FAQ
Will medicaid pay for assisted living?
Medicaid is a federal and state financial assistance program. People with limited income or resources may qualify for financial assistance through Medicaid. Unfortunately, not all assisted living communities accept payments from Medicaid or participate in the Medicaid waiver program. Participation varies from state to state so, check with your state health or welfare departments, your long-term care ombudsman, or the Area Office on Aging.
How much does medicaid pay for assisted living?
Medicaid benefits and eligibility are calculated differently from state to state because it is funded partially by the federal government and partially by each state.