Assisted Living Waiver Member Enrollment
Eligibility
Assisted Living Waiver (ALW) eligible individuals are those who are enrolled in Medi-Cal and meet the level of care provided in a nursing facility due to their medical needs. Individuals with Medi-Cal benefits that include a share of cost may not enroll in the ALW. The state does not determine eligibility for Medi-Cal benefits. Please contact your local county office to obtain information about how to apply for Medi-Cal benefits.
How To Enroll
Medi-Cal members do not submit applications. Medi-Cal members are enrolled through Care Coordination Agencies, which are providers within the ALW program. Medi-Cal members must contact a Care Coordination Agency, who determine each individual's care needs. Assessments are done by registered nurses employed by a Care Coordination Agency (CCA). Click on the Care Coordination Agencies link below and contact one of the CCAs in your county of residence to request an assessment. A pre-screening "assessment" will be done over the phone before an appointment is set up for the actual assessment.
Program Services
Participants in the ALW program will have access to three waiver benefits:
Assisted Living Services
These services are called the Assisted Living Services when they're provided in an Residential Care Facility or an Adult Residential Care Facility. The services are called Assisted Care when they are provided by a licensed Home Health Agency and delivered to residents of publicly-funded housing.
Care Coordination
These services include identifying, organizing, coordinating, and monitoring services needed by a participant. Care Coordinators conduct assessments to assist in determining eligibility, develop individualized Service Plans (ISPs), arrange for services, maintain contact with participants, and monitor service delivery on a monthly basis.
Nursing Facility Transition Care Coordination
This benefit helps to transition residents from nursing facilities to the community.
Additional Resources:
