主页服务长期护理替代方案（以家庭和社区为基础的服务选择）生活辅助豁免​​ 

辅助生活豁免​​ 

辅助生活豁免​​ 

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.​​ 

合格​​ 

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.​​ 

目标​​ 

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 申诉​​ 

If you have concerns about your ALW services or facility, you can file a grievance:​​ 

For more information, see the ALW Grievance Fact Sheet.​​ 

HCBS 提供商最低工资上涨​​ 

由于参议院第 3 号法案的颁布，加州全州所有雇主的最低工资将从 1 月1 增至 16.90 美元，2026 。由于加州提高了最低工资标准，2026 年特定服务提供者类型和程序代码的家庭和社区服务补偿标准也将提高。以下是适用于 ALW 的 2026 年增加的最高应付费率清单。​​ 

服务说明​​ 服务代码和修饰符​​ 2026 年最高支付率​​ 单元​​ 放弃​​ 
第 1 级 - 辅助生活服务 - 家庭主妇；家庭健康援助；个人护理​​ T2031 U1​​ $ 95.69​​ 每日津贴​​ 轻武器​​ 
第 2 级 - 辅助生活服务 - 家庭主妇；家庭健康援助；个人护理​​ T2031 U2​​ $ 114.33​​ 每日津贴​​ 轻武器​​ 
第 3 级 - 辅助生活服务 - 家庭主妇；家庭健康援助；个人护理​​ T2031 U3​​ $ 132.97​​ 每日津贴​​ 轻武器​​ 
第 4 级 - 辅助生活服务 - 家庭主妇；家庭健康援助；个人护理​​ T2031 U4​​ $ 179.58​​ 每日津贴​​ 轻武器​​ 
第 5 层 - 辅助生活服务 - 家庭主妇；家庭健康援助；个人护理​​ T2031 U5​​ $ 270.80​​ 每日津贴​​ 轻武器​​ 

为了按新费率获得报销，各机构需要使用上述较高费率提交自 1 月 1、2026 日起提供的所有服务的索赔。这样一来，您的机构就可以立即按新费率获得报销，而无需重新提交索赔。​​ 

Please email ALWP.IR@dhcs.ca.gov with any additional questions.​​ 

当前豁免​​ 

当前已批准的ALW修订案​​ 

紧急修正案（附录Ks）​​ 

  • 附录 K Orange化学品泄漏（自 5 月21 、 2026起生效），CMS 批准了DHCS的请求，修改 ALW，以增加附录 K，应对Orange化学品泄漏事件。 附录 K 修正案授权对受Orange县化学品泄漏紧急状态影响的辅助生活豁免参与者和申请人采取临时灵活措施。 这些变化使得该州能够将无法返回辅助生活设施的参与者的重新注册期限从 30 天延长至 60 天，确保辅助生活和住宅康复服务可以在其他场所提供，并暂时中止因紧急情况而无法完成必要步骤或获得安置的申请人的 60 天注册期限。此外，已获得豁免名额但尚未获得安置的申请人可以保留其名额，直到条件允许完成入学要求为止。​​ 

已过期的修正案​​ 

辅助生活豁免到期修正案​​ 

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.​​ 

现行政策函件和备忘录​​ 

其他Program资源：​​ 

请将您的ALW意见和问题提交至： ALWP.IR@dhcs.ca.gov​​