Assisted Living Waiver
Assisted Living Waiver
The Assisted Living Waiver (ALW) helps eligible Medi Cal members who need a high level of daily support receive care in licensed assisted living settings instead of nursing facilities. It is a Home and Community-Based Services (HCBS) waiver approved by the federal Centers for Medicare and Medicaid Services. Waivers operate in five-year cycles, and the current ALW term is approved from March 1, 2024, through February 28, 2029. The program is available in 15 counties in California.
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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 no share of cost.
- Have care needs equal to those of Medi-Cal-funded residents living and receiving care in nursing facilities.
- Be 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: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.
ALW participants must pay the facility directly for their room and board, with some funds remaining to meet personal and incidental needs. In determining Medi-Cal eligibility for individuals who are applying for enrollment into ALW, institutional and spousal impoverishment prevention rules are applied.
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The ALW helps members:
- Transition from a nursing facility to a community home-like setting in a Residential Care Facility for the Elderly (RCFE), Adult Residential Care Facility (ARF), or subsidized public housing, utilizing ALW services, when safe and appropriate.
- Stay in the community with support if they are at risk of being institutionalized.
ALW Program Integrity
DHCS routinely monitors ALW claiming to confirm proper payments, safeguard federal and State funds, and ensure compliance with waiver requirements. As part of this oversight, DHCS has identified issues requiring CCAs and ALW facilities to take corrective action to avoid claim denials. For more information, review the latest policy letter.
ALW Kev Tsis Txaus Siab
If you have concerns about your ALW services or facility, you can file a grievance:
- About your ALW services: Contact your Care Coordination Agency (CCA) via email, mail, or telephone. Find your CCA’s contact information.
- About the coordination of care by your CCA: Email DHCS at ALWGrievances@dhcs.ca.gov.
- All other grievances: Contact the California Department of Social Services:
- Phone: (844) LET-US-NO (538-8766)
- Email: letusno@dss.ca.gov
- Online: CDSS’ Community Care Licensing Division webpage.
For more information, see the ALW Grievance Fact Sheet.
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 raws li tus nqi tshiab, cov koom haum yuav tsum xa cov ntawv thov siv cov nqi siab dua uas 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.
Please email ALWP.IR@dhcs.ca.gov with any additional questions.
Tam sim no Waiver
Cov Kev Hloov Kho ALW Tam Sim No Uas Tau Pom Zoo
- 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.
Kev Hloov Kho Thaum Muaj Xwm Ceev (Cov Ntaub Ntxiv Ks)
- Ntxiv K Kev Nchuav Tshuaj Lom Hauv Orange County (Siv Tau Lub Tsib Hlis 21, 2026), CMS tau pom zoo rau DHCS qhov kev thov kom hloov kho ALW kom ntxiv tau App K los teb rau kev nchuav tshuaj lom hauv Orange County. Cov kev hloov kho ntawm Appendix K tso cai rau kev ywj pheej ib ntus rau cov neeg koom nrog Assisted Living Waiver thiab cov neeg thov uas raug cuam tshuam los ntawm qhov xwm txheej ceev ntawm cov tshuaj lom neeg xau hauv Orange County. Cov kev hloov no tso cai rau lub xeev txuas ntxiv lub sijhawm rov sau npe dua ntawm 30 mus rau 60 hnub rau cov neeg koom nrog uas tsis tuaj yeem rov qab mus rau lawv qhov chaw pabcuam neeg laus, xyuas kom meej tias cov kev pabcuam Pabcuam Neeg Laus thiab Kev Pabcuam Neeg Laus tuaj yeem muab tau rau lwm qhov chaw, thiab ncua lub sijhawm sau npe 60 hnub rau cov neeg thov uas ua tsis tau cov kauj ruam uas yuav tsum tau ua lossis tsis tuaj yeem nrhiav chaw nyob ruaj ntseg vim muaj xwm txheej ceev. Tsis tas li ntawd xwb, cov neeg thov uas tau muab lub sijhawm zam tab sis tseem tsis tau txais qhov chaw nyob hauv chaw ua haujlwm yuav khaws lawv lub sijhawm kom txog thaum cov xwm txheej tso cai rau kev sau npe ua tiav.
Kev Hloov Kho tas sij hawm
Kev Tso Cai Rau Kev Nyob Uas Muaj Kev Pabcuam Cov Kev Hloov Kho Uas Tas Sij Hawm Lawm
ALW Current Enrollment
Current ALW enrollment and waitlist information is available on the enrollment dashboard, which is updated monthly. New applicants to the ALW should know that the number of available slots is limited, and there is currently a waitlist. Open waiver slots are released to Care Coordination Agencies on a regular basis. Please contact the Care Coordination Agency of your choice for more information.
Cov Ntawv thiab Cov Lus Qhia Txog Txoj Cai Tam Sim No
- Assisted Living Waiver Capacity Memorandum
- ALW PL #24-001 Telehealth Policy
- ALW PL #24-002 Kev Tso Tawm ntawm ALW Qhov Chaw thiab Kev Tswj Xyuas Daim Ntawv Tos
- ALW PL #26-001 Kev Piav Qhia Txog Kev Xa Mus Rau Tus Neeg Saib Xyuas Kev Kho Mob Mus Ntev Rau ALW
- ALW PL #26-002 Kev Thov Nyiaj Pab Rau Kev Nyob Hauv Tsev (ALW)
Cov Kev Pabcuam Ntxiv:
- ALW 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
- ALW Renewal Approval Letter
- ALW – Approved 3/1/19 to 2/29/24
- ALW Enrollment and Waitlist – January 2019 through April 2026 – updated 7/2026
- 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
- Lub vas sab ntawm Social Security Administration
Thov xa koj cov lus tawm tswv yim thiab cov lus nug ntawm ALW mus rau: ALWP.IR@dhcs.ca.gov