首頁服務長期照護替代方案（居家與社區服務選項）生活輔助豁免​​ 

輔助生活豁免​​ 

輔助生活豁免​​ 

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.​​ 

目標​​ 

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 申訴​​ 

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 提供者最低工資增加​​ 

由於參議院第 3 號法案的頒佈，加州全州所有雇主的最低工資將於 1 月1 ，2026 ，從 16.50 美元提高到 16.90 美元。由於加州最低工資上調，2026 年特定醫療服務提供者類型和程序代碼的居家和社區服務補償費率也將上調。以下是適用於 ALW 的 2026 年增加的最高應付費率清單。​​ 

服務說明​​ 服務代碼和修正因子​​ 2026 年最高應付費率​​ 單位​​ 放棄​​ 
第一級-輔助生活服務-家庭主婦; 家庭健康援助; 個人護理​​ T2031 U1​​ 美元 95.69​​ 每日​​ 永遠​​ 
第 2 級-輔助生活服務-家庭主婦; 家庭健康援助; 個人護理​​ 第 2031 歲以下​​ 美元 114.33​​ 每日​​ 永遠​​ 
第三級-輔助生活服務-家庭主婦; 家庭健康援助; 個人護理​​ 第 2031 歲以下​​ 美元 132.97​​ 每日​​ 永遠​​ 
第 4 級-輔助生活服務-家庭主婦; 家庭健康援助; 個人護理​​ 第 2031 歲以下​​ 美元 179.58​​ 每日​​ 永遠​​ 
第 5 級-輔助生活服務-家庭主婦; 家庭健康援助; 個人護理​​ 第 2031 歲以下​​ 美元 270.80​​ 每日​​ 永遠​​ 

為了以新費率獲得報銷，各機構需要使用上述較高費率提交自 1 月 1、2026 日起提供的所有服務的索賠。這樣一來，您的機構就可以立即以新費率獲得報銷，而無需重新提交索賠。​​ 

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

目前的豁免​​ 

目前已獲批准的《酒精飲料法》修正案​​ 

緊急修正案（附錄 Ks）​​ 

  • 附錄 K Orange化學品洩漏（自 5 月21 、 2026起生效），CMS 批准了DHCS的請求，修改 ALW，以增加附錄 K，以應對Orange化學品洩漏事件。 附錄 K 修正案授權對受Orange郡化學品洩漏緊急狀態影響的輔助生活豁免參與者和申請人採取臨時靈活措施。 這些變化使得該州能夠將無法返回輔助生活設施的參與者的重新註冊期限從 30 天延長至 60 天，確保輔助生活和住宅康復服務可以在其他場所提供，並暫時中止因緊急情況而無法完成必要步驟或獲得安置的申請人的 60 天註冊期限。此外，已獲得豁免名額但尚未獲得安置的申請人可以保留其名額，直到條件允許完成入學要求為止。​​ 

已過期修訂​​ 

輔助生活豁免條款到期修正案​​ 

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.​​ 

現行政策函件和備忘錄​​ 

其他Program資源：​​ 

請將您的ALW意見和問題提交至： ALWP.IR@dhcs.ca.gov​​