Expanding Access to Assisted Living Services
Interested in learning about programs that help people access Assisted Living in California? Check out these programs related to Medi-Cal and support for Veterans.
Options for Individuals on Medi-Cal
The Assisted Living Waiver (ALW) program is available in 15 counties and helps transition older adults out of nursing facilities or keeps them from having to go into a nursing facility when they can be safely cared for in an Assisted Living community. Residents pay for their room and board with their Supplemental Security Income/State Supplementary Payment (SSI/SSP) Non-Medical Out of Home Care (NMOHC) Payment and the state Department of Health Care Services (DHCS) pays the Assisted Living community a daily rate for care and services. Assisted Living providers must become a Medi-Cal provider to participate in the program. DHCS has stated their intent to transition ALW residents into the CalAIM Community Supports program and to discontinue the ALW program over several years. Learn more about the ALW and signing up to become a provider here.
California Advancing and Innovating Medi-Cal (CalAIM) offers Community Supports Nursing Facility Transition/Diversion to Assisted Living Services, which is like the ALW. As with the ALW, residents pay for their room and board with their SSI/SSP NMOHC payment, but providers negotiate directly with managed care health plans (MCPs) for payment for care and services. This is currently an optional benefit for MCPs to offer but there is at least one option in most counties and beginning Jan. 1, 2027, MCPs will be required to offer this benefit.
CALA is helping members make the transition from the ALW to CalAIM CS and members who have never participated in a Medi-Cal program. We’re working to educate MCPs about the benefits of Assisted Living and help facilitate conversations between CALA members and interested health plans. There are also companies working to bring the two parties together and serve as the Medi-Cal provider and subcontract with the Assisted Living provider, which minimizes the complexities for the Assisted Living provider.
Resources:
- Comparison of ALW and CalAIM CS Nursing Facility Transition/Diversion to Assisted Living Services
- Contact MCPs in your county offering CalAIM CS
- Collaborative Planning and Implementation Group Directory: groups composed of stakeholders in a county or region that work together to identify, discuss and resolve topical implementation issues.
- SSI/SSP NMOHC rates
Options for Veterans
CalVet Veterans Homes operate throughout California with seven homes providing Assisted Living services, and four of the seven homes also providing Memory Care services. All CalVet homes serve California’s veterans and their eligible spouses and domestic partners. Veterans pay a specified percentage of their income as member fees to live in a CalVet home, and a lack of income will not make a veteran ineligible for admission.
The Aid & Attendance (A&A) benefit through the federal Veterans Affairs Department is a monthly benefit that qualified veterans and their surviving spouses can receive to help with the cost of care when they require assistance with certain activities of daily living (ADLs). Through the A&A, an increased monthly pension amount to pay for the cost of care for ADLs can be used to pay for Assisted Living in any community, including a CalVet home. For more information on A&A, please visit CALA’s Toolkits & Brochures webpage under Member Resources to download the brochure.
Share your Experience with CALA
If your company or community has participated in any of these programs, let us know about your experience. If your company or community has not participated in any of these programs but is interested in learning more, please let us know.
Email Selena Coppi Hornback to share your experiences or learn more about these programs.