Assisted Living Waiver Program
Are you struggling financially and cannot afford to pay for Assisted Living Facilities?
Our goal is to make your life easy for our seniors and families searching for an assisted living environment. We frequently visit and check these communities making sure they meet our high standards for quality of care.
What is the Medi-Cal Assisted Living Waiver Program? Can’t afford private payment for Assisted Living accommodations – This program maybe for you?
The Assisted Living Waiver Program was developed to make affordable housing with personal and health-related services available to seniors and individuals with a disability. This program offers Assisted Living as an alternative to long-term placement in a nursing home. Assisted living bridges the gap between independent living and nursing home care. It provides personal support and services to provide more intensive care than is available through home care services.
Assisted living typically offers assistance with the activities of daily living and ensures residents have access to staff 24 hours a day. It also is less expensive and less restrictive than a nursing home. The
Assisted Living Waiver (ALW) program is one long-term care option for Medi-Cal recipients and offers an alternative to nursing facility placement. The program is a combination federal/state-funded program that allows eligible individuals to reside in and receive services from a California licensed Residential Care Facility.
They provide an alternative to long-term care placement in a nursing home, offering a quality of life in a home-like-setting!
More information is available through the DHCS ALW website: http://www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx.
What are the eligibility requirements?
- Have full-scope Medi-Cal with zero share of cost.
- Age 21 or older
- You require hands-on assistance such as mobility, bathing, using the bathroom, dressing, grooming, eating, and taking medications.
- You have care needs that can be safely met in a residential care facility setting.
- Your total monthly income must not be higher than approximately $1450, and your resources do not have a value higher than $2,000. If your funds are above this amount, you will have to spend them down before you are eligible for Medi-Cal with no share of cost and the ALW Program.
- You cannot be a Medi-Cal participant in Cal Medi-Connect, SCAN, or PACE plans.
What services are available for residents in Assisted Living?
Services that are required by state statutes and regulations to be provided or coordinated must include, but are not limited to:
- Providing personal care and assistance with ADLs sufficient to meet both the scheduled and unscheduled needs of the residents
- Washing, drying, and folding all laundry.
- Performing all necessary housekeeping tasks
- Maintaining the facility
- Providing three meals per day plus snacks
- Food must meet minimum daily nutritional requirements.
- Providing intermittent skilled nursing services as required by residents, and in accordance with State law
- Aid with the self-administration of medications or, as necessary, administering medications
- Providing or coordinating transportation
- Providing daily recreational activities
- Providing social services
- Providing a response system to summon assistance from personal care providers.
- Assisted living units may be private or shared accommodation
- A resident has the right to make choices and receive services in a way that will promote the resident’s dignity, autonomy, independence, and quality of life.
How do I know if my loved ones will be qualified?
- Must have Medi-Cal or be eligible for Medi-Cal benefits
- No Share of Cost (we can help with removing Share of Cost)
- Total monthly income under $1450/month -approximately
- Work with approved Care Coordination Agencies (CCA) from the State of California.
- Medi-Cal participant is responsible for paying room and board.
- Medi-Cal will cover the cost of daily care provided from approved ALW facilities.
- Community Assists will help you get approved!
What are the Room and Board fees?
As an Assisted Living Waiver member, you are responsible for paying for monthly room and board to the facility. You will keep a monthly personal needs allowance to use at your discretion.
As an Assisted Living Waiver member, you must be able to pay the established room and board payment. The room and board payment provide either a single or double occupancy living unit. You are responsible to pay the room and board fee directly to the facility each month.
2020 - Rates:
Income:
$1,173.37 or less
$1,193.37 or greater
Room & Board Fees:
$1069.37
$1,089.37
Where can I get assistance if my income is less than the room and board fees?
By contacting your local Social Security Administration Office and providing notification that you are now in an assisted living facility, it often will result in an increase to your monthly income. This will allow you to have enough income to cover the room and board fees. Although this is not a guarantee, it is an avenue worth pursuing.
Which counties participate in the waiver?
Currently, Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma counties participate in the Assisted Living Waiver Program.
You do not need to currently reside in these counties to be added to the waiting list, but once approved, you would need to be willing to reside in an assisted living setting located in one of the above counties.
Community Assists – Specializing in The Placement of Medi-Cal Eligible Members into The California Assisted Living Waiver Program (ALW)