Medi-Cal Assisted Living Waiver (ALW) Program – Sacramento County
Expert Care Coordination with Elder Options
Elder Options is California’s most experienced Care Coordination Agency, providing expert support for the Assisted Living Waiver (ALW) Program since its inception in 2006. With credentialed care managers, our knowledgeable team helps Sacramento-area clients, families, assisted living communities, and community partners navigate the ALW program with confidence.
What Is the Medi-Cal Assisted Living Waiver (ALW) Program?
Administered by the California Department of Health Care Services (DHCS), the ALW program offers eligible individuals placement in an approved assisted living community as an alternative to skilled nursing home care. This program is available in specific counties throughout California.
Elder Options is an approved Care Coordination Agency (CCA) serving Sacramento County, helping individuals transition into qualified assisted living communities while ensuring they receive the care and services they need.
Program History
The ALW program was established in 2006 as a pilot project through federal funding from CMS (Centers for Medicare & Medicaid Services) and the State of California. Elder Options was among the first CCAs to participate and has been actively supporting the program ever since.
As a Care Coordination Agency, Elder Options:
- Conducts intakes and assesses preliminary eligibility.
- Performs initial R.N. assessments.
- Assists Sacramento-area families in finding an appropriate assisted living placement.
- Provides advocacy and monthly face-to-face care coordination to ensure quality care.
ALW Program Eligibility Requirements
To qualify for the Assisted Living Waiver (ALW) Program in Sacramento County, applicants must meet the following criteria:
- Full-scope Medi-Cal enrollment.
- Verified income source (Social Security, Pension, SSI).
- Medi-Cal with no Share of Cost (SOC).
- Meet ADL/IADL requirements (Activities of Daily Living/Instrumental Activities of Daily Living).
- Be willing to transition from a skilled nursing facility to an approved assisted living community.
- Currently live in the community but desire/require assisted living care.
Important Note: ALW Program Waitlist
The ALW program currently operates on a waitlist system. Wait times vary but may be 6 months for individuals in a skilled nursing facility and 12 months for those in a community setting. Wait times in Sacramento County are subject to change depending on availability.
Payment & Financial Assistance
The California Department of Health Care Services (DHCS) sets fixed fees and tier levels based on the level of care required. Payments are structured as follows:
- The client’s Social Security/pension covers a portion of the assisted living costs, with a small allowance retained for personal needs.
- Medi-Cal funds the remaining balance through the ALW program.
- Monthly care coordination and client follow-ups are covered by ALWP payments to the contracting CCA.
Required Documents for ALW Application
To begin the application process, you will need:
- Individual’s full name and date of birth.
- Medi-Cal number and issue date (must be active, not pending).
- Proof of no Share of Cost (SOC).
- Current address and phone number.
- Total monthly income and source (e.g., Social Security, pension).
- Completed Activities of Daily Living (ADL) questionnaire.
- Physician’s Report (Form 602a).
- Power of Attorney documents (if applicable).
- E-Tar and Face Sheet (if currently in a skilled nursing facility).
- Preferred choice of two approved assisted living communities in Sacramento. (We strongly recommend visiting multiple facilities to find the best fit.)
How to Apply: Step-by-Step Process
1. Initial Call & Intake
- Contact Elder Options to express interest in the ALW program in Sacramento.
- The current waitlist status will be explained.
- If you choose to proceed, an ALW coordinator will assist with the intake process.
2. Eligibility Verification
- The client/family/POA will receive an email with required information.
- Elder Options will verify Medi-Cal eligibility and submit the waitlist form to DHCS.
- A confirmation letter will be sent to the client/family/POA.
3. Waitlist & Ongoing Monitoring
- Elder Options staff will check Medi-Cal eligibility monthly and stay in regular contact.
- Once a placement slot opens, Elder Options will immediately notify the top waitlisted individuals.
- The move into an approved assisted living facility must be completed within 60 days of notification.
Current estimated waitlist times in Sacramento County are 6 months for individuals presently in a skilled nursing facility (SNF) and 12 months for individuals living in a community setting.
Get Started Today
If you or a loved one qualify for the Medi-Cal Assisted Living Waiver (ALW) Program in Sacramento, Elder Options is here to help. Contact us today to begin the intake process and secure the care and support you deserve.