Are you a California resident who is elderly and in need of long-term care assistance? If so, the Medi-Cal Assisted Living Waiver (ALW) program might be the solution you've been searching for. Learn the ins and outs of the ALW program, including eligibility requirements, the benefits it provides, and how to apply. To learn more about California Assisted Living Waivers read on below or reach out to the Sunbound team for more information.

What is the Assisted Living Waiver Program?

The Assisted Living Waiver program, also known as ALW, is a valuable resource for California seniors who require a Nursing Home Level of Care but prefer to live in an assisted living environment rather than a nursing home. The program provides personal care assistance, homemaker services, and home health aides in Adult Residential Facilities (ARFs), Residential Care Facilities for the Elderly (RCFE), and Public Subsidized Housing (PSH). The ALW program aims to delay or prevent nursing home placements by offering seniors the opportunity to receive the same level and quality of care in a more comfortable and home-like setting.

Eligibility for the Assisted Living Waiver Program

To be eligible for the Assisted Living Waiver program, applicants must meet certain criteria, including:

Age and Disability

Applicants must be a minimum of 65 years old or a minimum of 21 years old if disabled. This ensures that the program is available to both elderly individuals and younger individuals with disabilities who require long-term care assistance.

Nursing Home Level of Care

Participants must have a need for a specific level and type of care that is typically provided in a nursing home setting. The state and the assisted living facility will assess whether the resident's care needs can be adequately met within an assisted living environment.

Financial Restrictions

To qualify for the ALW program, individuals must meet certain financial requirements. Like many Medicaid programs, ALW has both income and asset level limits. 

Income Limits

As of 2023, the monthly income limit for a single applicant is set at $1,677, while for a married couple applying together, the limit is $2,269. These income limits are subject to change and are based on a percentage of the Federal Poverty Level figures. It's important to note that if only one spouse needs assisted living care, only their income will be counted towards the individual income limit.

Asset Limits

As of 2023, the asset limit for an individual is $130,000, and for a married couple applying together, the limit is $195,000. Certain assets, such as a primary residence, household furnishings, personal items, and a vehicle, are considered non-countable towards the asset limit. 

Medi-Cal Eligibility

To participate in the Assisted Living Waiver program, individuals must be eligible for Medi-Cal, which is California's Medicaid program. Full-scope Medi-Cal coverage with no share of cost (SOC) is required for participation in the ALW program.

Benefits of the Assisted Living Waiver Program

The Assisted Living Waiver program offers a range of benefits to participants. Here are some of the key advantages of enrolling in the program:

Alternative to Nursing Home Placement

The ALW program provides an alternative to nursing home placement for individuals who require a Nursing Home Level of Care. It offers the opportunity to receive the same level and quality of care in an assisted living environment, which is often preferred by seniors and their families.

Personal Care Assistance

One of the primary benefits of the ALW program is access to personal care assistance. This can include help with activities of daily living (ADLs) such as bathing, dressing, grooming, and mobility assistance. Having trained professionals available to assist with these tasks can greatly improve the quality of life for participants.

Homemaker Services

In addition to personal care assistance, the ALW program also provides homemaker services. These services can include light housekeeping, meal preparation, laundry, and other household tasks. By having these services available, participants can focus on enjoying their daily lives without the burden of managing household chores.

Home Health Aides

The ALW program also offers access to home health aides who can provide medical assistance and support. This can include medication management, wound care, monitoring of vital signs, and other healthcare services. Having skilled healthcare professionals available can provide peace of mind for participants and their families.

Memory Care Options

For individuals with Alzheimer's disease or related forms of dementia, some assisted living settings within the ALW program offer specialized memory care. These memory care units are designed to provide a safe and supportive environment for individuals with cognitive impairments. They often have trained staff and additional security measures in place to ensure the well-being of residents.

Applying for the Assisted Living Waiver Program

Before applying for the ALW program it’s important to consult with a senior care specialist such as a geriatric care manager or a Medi-Cal expert who can help you understand whether you or your senior loved one is eligible. Once you’ve confirmed your eligibility, steps for applying for the ALW program are:

Step 1: Gather Required Information

Before applying, make sure you have all the necessary information and documents. This may include:

• Full name and date of birth
• Medi-Cal number and issue date
• Address and telephone number
• Total monthly income and source
• Completed Physician's Report
• Power of Attorney documents, if applicable
• Choice of approved Assisted Living communities

Step 2: Contact a Care Coordination Agency

To begin the application process, reach out to a Care Coordination Agency (CCA) that is approved to provide assistance with the ALW program. They can guide you through the application process and help determine your eligibility.

Step 3: Complete the Intake Process

During the intake process, you will provide the necessary information and documents to the CCA. They will assess your eligibility and submit your application to the California Department of Health Care Services (DHCS).

Step 4: Wait for Assessment and Placement

Once your application is submitted, you will be placed on a waitlist for program participation. The wait times can vary, depending on the availability of slots. The CCA will keep in contact with you and notify you when a slot becomes available for you to finalize your move into an approved Assisted Living Facility.

The Assisted Living Waiver program offers a valuable opportunity for California residents to receive long-term care assistance in an assisted living environment. By meeting the eligibility requirements and going through the application process, individuals can access personal care assistance, homemaker services, and home health aides. The program provides an alternative to nursing home placement and allows participants to maintain their independence and quality of life. If you believe you or a senior loved one may qualify for the ALW program, don't hesitate to explore this option and take advantage of the benefits it offers.

To learn more about how Sunbound can help make senior care more affordable for you or your loved one, send us an email at info@sunboundhomes.com or request more information on Sunbound. Sunbound is the best way to pay for senior living and senior care and is on a mission to make senior living affordable for everyone.