Assisted Living Waiver: A Program for Senior Assisted Living in California

Beginning in 2006 the ALW, or Assisted Living Waiver, allowed elder residents and those with disabilities access to assisted living care through Medi-Cal. This was available to those Californians living in San Joaquin, Sacramento and Los Angeles counties.

The purpose of the law is to allow those with minimal incomes, who are already in the Medi-Cal program and who would previously have needed to receive services from nursing facilities, to stay in their current living situation, or move to an RCFE, a Residential Care Facility for the Elderly.

On March 1, 2009, three years after the program began, it was changed to a federal waiver program, with a span of five years. Now, approval is expected for the ALW to be extended to at least the end of February, 2019.

In addition to the time extension, the Assisted Living Waiver has been extended geographically beyond the original three counties to include San Diego, Orange, Riverside, San Bernardino, Contra Costa, Santa Clara, San Mateo, Alameda, Fresno, Kern and Sonoma counties.

There are two requirements for inclusion in the program: the most import is that participants must need care at the level of a nursing facility; also, anyone receiving assistance through the ALW must already be eligible for and enrolled in full-scope Medi-Cal. While disabled residents can receive help through the Assisted Living Waiver at a younger age then 65, 21 years is the minimum age for participants in this program.

Those enrolled in the program provide payment for room and board, but at lower rates established by the facilities where they live. Medi-Cal provides all payments to the Residential Care Facility for the Elderly for medical services and care extending to five legally defined tiers of care. Usually, the cost is up to $200 a day for the top level of care, and in the range of $50 daily for the first level.

Go to for further facts concerning the ALW, or write to them at: Assisted Living Waiver, Department of Health Care Services Long-Term Care Division , 1501 Capitol Avenue, MS 4503, PO Box 997437, Sacramento, CA 95899-7437. You can also call 916-552-9105.


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