What is the Assisted Living and the Waiver Program (ALW)?

Assisted living presents numerous advantages for seniors living independently. Apart from enjoying the camaraderie of fellow residents, they benefit from personalized care delivered by skilled and compassionate staff. However, these perks often come with a considerable price tag, which may pose challenges for low-income seniors.

Enter the Assisted Living Waiver program, a healthcare initiative aimed at addressing this gap. This program enables seniors to access necessary care within a homely setting, steering clear of the institutional feel of nursing homes. Tailored for seniors requiring nursing home-level care, it offers an alternative by facilitating their residence in assisted living communities. The primary objective is to enhance seniors’ quality of life by providing a more comfortable, home-like environment while ensuring they receive essential medical care and support.

What are the benefits of the program?

The ALW program offers a comprehensive range of services tailored to support seniors in maintaining independence. These include:

• Personal Care: Assistance with daily tasks like eating, grooming, bathing, and toileting to ensure comfort and hygiene.
• Mobility Support: Help with moving around safely to navigate the environment with confidence.
• Medication Management: Administration of prescribed medications to reduce the risk of errors and ensure proper healthcare.
• Transportation: Arrangement of transportation for medical appointments and other needs, alleviating travel concerns.
• Health Services: Access to various healthcare services, including nursing care as needed, to address medical needs effectively.
• Social and Recreational Activities: Engagement in age-appropriate social and recreational activities to promote mental well-being and community involvement.
• Housekeeping and Laundry: Assistance with household chores to free up time for enjoyable pursuits.
• Nutritious Meals: Provision of balanced meals to support seniors’ nutritional needs and overall health.
• Transition Support: Assistance with transitioning from nursing homes to ensure a smooth adjustment to the new living environment.
• These services collectively empower seniors to lead fulfilling lives while receiving the necessary support for independent living.

What are the eligibility requirements for the program?

To be eligible for the ALW program, individuals must satisfy the following criteria:

• Age Requirement: Applicants must be at least 21 years old.
• Medical Eligibility: Candidates must demonstrate full-scope Medi-Cal eligibility without any share of the cost obligation. This indicates eligibility for Medi-Cal coverage without the need to allocate a portion of their income towards medical expenses before Medi-Cal benefits commence.
• Care Needs Assessment: Prospective participants must exhibit care needs equivalent to those of residents in nursing facilities funded by Medi-Cal. These needs typically encompass assistance with activities of daily living such as bathing, dressing, eating, and mobility.

It’s crucial to recognize that the program aims to cater to individuals who would otherwise necessitate nursing home care. As such, the eligibility criteria are structured to ensure that only those with substantial care requirements are eligible for enrollment.

What are the out-of-pocket expenses and financial aid options available?

Despite the comprehensive services offered by the ALW program, participants are still responsible for contributing to their room and board expenses. In 2024, for participants with monthly SSI income of $1,575.07, the room and board rate is $1,398.07. For participants with income over $1,575.07, the room and board rate is $1,418.07.

For seniors with limited incomes, various financial assistance avenues are available:

Social Security: While not covering assisted living costs directly, some benefits may be accessible, varying by state. Local Social Security offices can provide eligibility information.
HUD’s Section 202 Program: Offers subsidized housing with services like housekeeping and transportation.
Veteran’s Benefits: The Aid & Attendance program provides need-based financial aid in addition to the VA pension for long-term care expenses.
Medicaid: State-specific programs offer financial aid for assisted living, with details varying by state.
Non-Medicaid State Assistance: Some regions offer local benefit programs for assisted living costs.
Long-Term Care Insurance: Depending on coverage, insurance may support assisted living expenses.

How to Apply

To begin the application process, contact the Care Coordination Agency in your county:

https://www.dhcs.ca.gov/services/ltc/Documents/Care-Coordination-Agencies.pdf

For more information about the ALW program, contact:

www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx

Assisted Living Waiver
Department of Health Care Services
Long-Term Care Division

1501 Capitol Avenue, MS 4503
PO Box 997437
Sacramento, CA 95899-7437

ALW Hotline – 916-552-9322