Assisted Living Waiver
HCBS Tus Muab Kev Pab Cuam Tshuam Yam Ntxim Saib Ntxim Ua Ntxiv
Vim yog tsab cai lij choj Senate Bill 3 tau tsim, cov nyiaj hli tsawg kawg nkaus thoob plaws lub xeev California yuav nce ntxiv ntawm $16.50 mus rau $16.90 rau txhua tus tswv haujlwm rau lub Ib Hlis 1, 2026. Vim yog California txoj kev nce nqi zog tsawg kawg nkaus, cov nqi them rov qab rau Cov Kev Pabcuam Hauv Tsev thiab Hauv Zej Zog xyoo 2026 rau cov hom kev pabcuam thiab cov lej txheej txheem tshwj xeeb kuj yuav nce ntxiv. Hauv qab no yog daim ntawv teev cov nqi them siab tshaj plaws xyoo 2026 uas siv tau rau ALW.
| Kev piav qhia | Service Code thiab Modifier | Tus Nqi Them Siab Tshaj Plaws Xyoo 2026 | Chav tsev | kev zam |
|---|---|---|---|---|
| Tier 1- Kev Pabcuam Nyob Hauv Tsev - Tus Tsim Tsev; Kev Pabcuam Hauv Tsev; Kev Kho Tus Kheej | T2031 U1 | $ 95.69 | Per Diem | ALW |
| Tier 2- Kev Pabcuam Nyob Hauv Tsev - Tus Tsim Tsev; Kev Pabcuam Hauv Tsev; Kev Kho Tus Kheej | T2031 U2 | $ 114.33 | Per Diem | ALW |
| Tier 3- Kev Pabcuam Nyob Hauv Tsev - Tus Tsim Tsev; Kev Pabcuam Hauv Tsev; Kev Kho Tus Kheej | T2031 U3 | $ 132.97 | Per Diem | ALW |
| Tier 4- Kev Pabcuam Nyob Hauv Tsev - Tus Tsim Tsev; Kev Pabcuam Hauv Tsev; Kev Kho Tus Kheej | T2031 ua 4 | $ 179.58 | Per Diem | ALW |
| Qib 5- Kev Pabcuam Nyob Hauv Tsev – Tus Tsim Tsev; Kev Pabcuam Hauv Tsev; Kev Kho Tus Kheej | T2031 ua 5 | $ 270.80 | Per Diem | ALW |
Yuav kom tau txais nyiaj rov qab ntawm tus nqi tshiab, cov koom haum yuav tsum xa cov ntawv thov siv cov nqi siab dua teev saum toj no rau txhua qhov kev pabcuam uas tau muab txij li Lub Ib Hlis 1, 2026. Qhov no yuav tso cai rau koj lub koom haum kom tau txais nyiaj rov qab ntawm cov nqi tshiab tam sim ntawd, es tsis txhob yuav tsum xa cov ntawv thov dua.
Thov xa email rau ALW vanity inbox nrog rau cov lus nug ntxiv.
Assisted Living Waiver Kev Tsim Nyog
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 program to test the efficacy of assisted living as a Medi-Cal benefit. Additional information about this legislation can be found on the Social Security Administration website. The Centers for Medicare and Medicaid Services (CMS) approves waiver renewals in five-year increments, and expansion of the program into additional counties. Currently, the ALW is available in 15 counties and the current five-year waiver term is approved for March 1, 2024 – February 28, 2029.
Yuav kom tsim nyog tau txais cov kev pabcuam ua tus neeg koom nrog ALW, tus neeg yuav tsum ua tau raws li cov qauv tsim nyog ALW hauv qab no:
- Hnub nyoog 21 lossis tshaj saud;
- Muaj kev tsim nyog tau txais Medi-Cal tag nrho nrog xoom feem ntawm tus nqi;
- Muaj cov kev xav tau kev saib xyuas zoo ib yam li cov neeg nyob hauv Medi-Cal-nyiaj pab uas nyob thiab tau txais kev saib xyuas hauv cov tsev laus;
- Txaus siab nyob rau hauv ib qho kev pab nyob ua ib qho kev xaiv rau lub tsev laus;
- Muaj peev xwm nyob nyab xeeb nyob rau hauv ib qho chaw pab nyob los yog pej xeem cov nyiaj pab vaj tse;
- 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 tsuas yog txwv rau cov tib neeg uas tsim nyog tau txais Medi-Cal, yam tsis muaj Medi-Cal feem ntawm tus nqi, uas yuav tsum tau muaj kev saib xyuas hauv tsev laus thiab xav tau nyob hauv qhov chaw saib xyuas hauv tsev lossis hauv zej zog cov neeg laus thiab / lossis cov neeg xiam oob qhab. ALW cov neeg koom yuav tsum muaj nyiaj txaus los them rau lawv chav tsev thiab lub rooj tsavxwm, nrog rau qee cov nyiaj seem kom tau raws li qhov xav tau ntawm tus kheej thiab qhov xwm txheej. Hauv kev txiav txim siab txog kev tsim nyog tau txais Medi-Cal rau cov tib neeg uas tab tom thov kev tso npe nkag rau hauv ALW, cov cai tswj kev tiv thaiv kev txom nyem ntawm tus txij nkawm thiab tsev neeg tau raug siv.
Lub hom phiaj ntawm ALW yog:
- pab txhawb kev hloov pauv nyab xeeb thiab raws sijhawm ntawm Medi-Cal-tsim nyog cov neeg laus thiab cov neeg xiam oob khab los ntawm lub tsev laus mus rau lub zej zog zoo li qhov chaw nyob hauv Chaw Kho Mob Rau Cov Neeg Laus (RCFE), Lub Chaw Saib Xyuas Neeg Laus (ARF), lossis nyiaj pab rau pej xeem vaj tse, siv ALW cov kev pab cuam; thiab
- muab cov neeg laus tsim nyog thiab cov neeg xiam oob qhab, uas nyob hauv zej zog, tab sis muaj kev pheej hmoo ntawm kev ua haujlwm, kev xaiv ntawm kev siv ALW cov kev pabcuam los tsim ib txoj haujlwm uas yuav ua tau raws li nws cov kev xav tau kev saib xyuas thaum tseem nyob hauv RCFE, ARF , los yog pej xeem cov nyiaj pab vaj tse.
ALW Kev Tsis Txaus Siab
Yog tias koj yog ib tus neeg koom nrog ALW thiab tsis txaus siab rau koj lub chaw ALW, Lub Chaw Haujlwm Saib Xyuas Kev Saib Xyuas Kev Noj Qab Haus Huv (CCA), lossis ALW cov kev pabcuam uas koj tau txais, koj tuaj yeem xa daim ntawv tsis txaus siab rau ALW raws li hauv qab no:
- Grievances regarding the quality or receipt of ALW services must be submitted to your CCA via email, mail, or telephone. Find your CCA’s contact information.
- Kev tsis txaus siab hais txog kev sib koom tes ntawm kev saib xyuas los ntawm koj CCA yuav tsum xa mus rau Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv ntawm email ntawm: ALWGrievances@dhcs.ca.gov
- All other grievances not listed above must be submitted to the California Department of Social Services, which will direct your grievance to your local ombudsman. Grievances can be submitted via telephone at (844) LET-US-NO ((844) 538-8766), via email at letusno@dss.ca.gov, or online at the California Department of Social Services Community Care Licensing Division webpage.
Yog xav paub ntxiv txog ALW cov lus tsis txaus siab, thov saib daim ntawv qhia txog kev tsis txaus siab ntawm ALW.
Tam sim no Waiver
Pom zoo ALW Amendments
- ALW Slot Expansion Amendment WY 1 (Effective October 1, 2024), CMS approved DHCS’ amendment to the ALW to increase the waiver capacity for waiver year 1 of the 2024-2029 ALW.
- ALW Slot Expansion Amendment WY 2-5 (Effective March 1, 2025), CMS approved DHCS’ amendment to the ALW to increase the waiver capacity for waiver years 2-5 of the 2024-2029 ALW.
- ALW Slot Expansion Amendment (Effective January 1, 2024), CMS approved DHCS’ amendment to the ALW to add 1,800 slots to year 5 of the 2019-2024 ALW.
- Telehealth Amendment (Pib Lub Kaum Ib Hlis Ntuj 12, 2023, qhov kev hloov kho no ntxiv telehealth raws li qhov kev xaiv xa mus tas li rau cov hauv qab no: Kev Sib Koom Tes, Kev Npaj Txhim Kho Kev Txhim Kho thiab Kev Ua Raws, NF Kev Hloov Kho Kev Kho Mob.)
- ALW Slot Expansion Amendment (Effective July 1, 2021, CMS approved DHCS’ amendment to the ALW to add 7,000 slots to eliminate the current waitlist and expand waiver capacity.)
- ALW Txoj Cai Tsab Ntawv #24-002 ALW Slots thiab Waitlist Management
Pom zoo Kev Hloov Kho Xwm Ceev
- Approved Appendix K Southern California Wildfires (Effective January 7, 2025), in response to the Los Angeles and Ventura Counties Fire, which has burned over 70,000 acres, prompted evaluation orders and road closures, and continues to threaten structures, homes, and critical infrastructure. This amendment, temporarily expands the settings in which services can be provided and permits retainer payments for certain services. Additionally, the amendment authorizes a temporary suspension of the enrollment period and extension of the reenrollment period.. The listed flexibilities are authorized under this amendment apply to waiver participants impacted by the State of Emergency in Los Angeles and Ventura Counties.
DHCS obtained approval for flexibilities accepted under the federal 1135 waiver authority which will expire January 7, 2026, for Los Angeles and Ventura Counties. The following flexibilities are available immediately.
Permit evacuating facilities (such as ICF-DDs, SNFs) to be fully reimbursed for services rendered to affected beneficiaries in alternative physical settings, such as temporary shelters or other care facilities.
Permit some services to continue to be provided without a requirement for a new or renewed prior authorization.
Temporarily allow services to be provided in settings that have not been determined to meet the HCBS Settings Rule criteria.
Temporarily extend the timeframe to reinstate services and benefits to an individual who files a fair hearing request.
Assisted Living Waiver Kev Sau Npe Tam Sim No
Current enrollment and waitlist information for the Assisted Living Waiver can be found on the enrollment dashboard, which is updated monthly. New applicants to the 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.
Lub Sijhawm Waiver
Ntxiv Program Resources:
- ALW PL #24-001 Telehealth Policy
- Assisted Living Waiver Description and Eligibility Information
- Daim ntawv teev npe ntawm RCFE & ARF Facilities
- Daim ntawv teev cov koom haum saib xyuas kev sib koom tes
- Kev piav qhia ntawm Public Subsidized Housing
- Daim ntawv teev npe ntawm Public Subsidized House Agencies
- Daim Ntawv Pom Zoo Tshaj Tawm Txog Kev Ua Neej Nyob
- Assisted Living Waiver – Approved 3/1/19 to 2/29/24
- Kev Sau Npe thiab Daim Ntawv Tos ntawm ALW - Lub Ib Hlis 2019 txog Lub Kaum Ob Hlis 2025 - hloov kho tshiab 2/2026
- Cov ntaub ntawv sau npe rau tus kws kho mob
- Muab Kev Pabcuam, Cov Ntawv, thiab Memorandums
- Xyoo 2026 ALW Cov Nqi Them Rov Qab
Please submit your ALW comments and questions to: ALWP.IR@dhcs.ca.gov