In March 2006, Medi-Cal began paying for assisted living care to select aged and disabled residents of Los Angeles, Sacramento and San Joaquin counties under the Assisted Living Waiver Pilot Project (ALW). The ALW was created by legislation that directed the California Department of Health Care Services (DHCS) to develop and implement the project. A key goal of the pilot project was to enable low-income, Medi-Cal eligible seniors and persons with disabilities, who would otherwise require nursing facility services, to remain in or relocate to the community. The program was approved by the Centers for Medicaid and Medicare and was converted into a five-year federal waiver program as of March 1, 2009. Pending final approval, the waiver program will be renewed through February 28, 2019.
A five year waiver renewal effective March 1, 2014 authorized expansion into Kern, Orange, Santa Clara and San Mateo counties.
Assisted Living Services: these services are provided in a Residential Care Facility for the Elderly (RCFE) or Assisted Care: which are provided by a licensed home health agency and provided to residents in public housing. The following is a list of some of the services of the assisted living program that must be provided to ALW participants: 
  • A care plan for each resident
  • Providing personal care and assistance
  • Laundry
  • Housekeeping
  • Maintenance of the facility
  • Providing intermittent skilled nursing care
  • Meals and snacks
  • Providing assistance with self-administration of medications
  • Providing or coordinating transportation
  • Providing recreational activities
  • Providing social services


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