Understanding the Medi-Cal Assisted Living Waiver Program

Sarah OrdoverApr 11th, 2023

Seniors with incomes of less than $1677 per month and $130,000 in assets may qualify for Medi-Cal and the Assisted Living Waiver (ALW) program. The Assisted Living Waiver (ALW) is a limited availability program that allows Medi-Cal to pay for some residential care facilities for the elderly (RCFEs). As of March, about 180 assisted living facilities and board and care homes in Los Angeles County are participating in the program.

There is a two-year waiting list to get the waiver with over 3,000 people on it. However, if your loved one already is in a medical facility such as a nursing home, you can be bumped to the top of the list. This happened recently for a client of ours. She was discharged to a skilled nursing facility from the hospital. Her family successfully applied for Medi-Cal. They then contacted Libertana, one of the care coordinating agencies we work with that manages ALW waivers. She immediately became eligible.

Here's the catch: We couldn't find an available bed in the LA Metro area, or at least, a bed that was appropriate for her level of care. So, getting the waiver was not a solution for her. The family had the choice of going way out of their chosen geographic area or moving their loved one into a board and care home that was, frankly, depressing. Her family ended up paying privately to place her in a board and care home we found that was relatively low-cost, clean and safe, and where we knew she would get proper oversight.

The ALW program is an important and much-needed benefit for low-income families. It is a blessing that it has expanded from just 78 participating RCFE facilities in 2020 to almost 200 now. There are some good ALW facilities out there. A number of the facilities we work with privately are now accepting the waiver.

But families should be aware that most assisted living facilities still do not accept the waiver, the waiver generally covers the cost of a shared room only, and that availability is limited.

You can see the current RCFE participating facilities by clicking here: https://www.dhcs.ca.gov/services/ltc/Documents/List-of-RCFE-facilities.pdf.

Assisted Living Locators Los Angeles owner Sarah Ordover is one of LA’s top senior living advisors. Certified in dementia care, Sarah is a trained aging specialist who holds an RCFE assisted living administrators license. Sarah thoughtfully guides families through the senior living decision-making process, helping them find the best solution for their loved ones. Call Sarah at 310-853-8282 for a consultation. Assisted Living Locators is free to clients.