Assisted Living Waiver
- Listed: December 12, 2018 7:33 pm
- Expires: 998047 days, 17 hours
Description
Assisted Living Waiver
The Assisted Living Waiver (ALW) is a Home and Community-Based Services (HCBS) waiver that was created by legislation that directed the California Department of Health Care Services (DHCS) to develop and implement the project to test the efficacy of assisted living as a Medi-Cal benefit.
The pilot program was determined to be successful during the first three years in a limited trial in three counties. In March 2009, the Centers for Medicare and Medicaid Services approved a waiver renewal for an additional five years and expansion of the program into additional counties. A five year waiver renewal was effective March 1, 2014.
To be eligible to receive services as an ALW Participant, an individual must meet all of the following ALW eligibility criteria:
- Age 21 or older;
- Have full-scope Medi-Cal eligibility with zero share of cost;
- Have care needs equal to those of Medi-Cal-funded residents living and receiving care in Nursing Facilities;
- Willing to live in an assisted living setting as an alternative to a Nursing Facility;
- Able to reside safely in an assisted living facility or public subsidized housing;
- Willing to live in an assisted living setting located in one of the following counties providing ALW services: 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.
The goal of the ALW is to:
1) facilitate a safe and timely transition of Medi-Cal eligible seniors and persons with disabilities from a nursing facility to a community home-like setting in a Residential Care Facility (RCF), an Adult Residential Care Facility (ARF), or public subsidized housing, utilizing ALW services; and
2) offer eligible seniors and persons with disabilities, who reside in the community, but are at risk of being institutionalized, the option of utilizing ALW services to develop a program that will safely meet his/her care needs while continuing to reside in a RCF, ARF, or public subsidized housing.
Medi-Cal Member Enrollment Information
Eligibility
Assisted Living Waiver (ALW) eligible individuals are those who are enrolled in Medi-Cal and meet the level of care provided in a nursing facility due to their medical needs. Individuals with Medi-Cal benefits that include a share of cost may not enroll in the ALW. The state does not determine eligibility for Medi-Cal benefits. Please contact your local county office to obtain information about how to apply for Medi-Cal benefits.
- READ BEFORE ENROLL
Apply for Medi-Cal
You must apply for Medi-Cal in order to receive HCBS waiver and program services.You may apply for Medi-Cal before or after you have requested HCBS waiver and program services.On your Medi-Cal application you must indicated that you need long term care services and support.More information on how to apply please go to Ways to Apply for Medi-Cal.Special Medi-Cal Eligibility Rules
If you are currently on a waiting list for the HCBS waiver or program, special Medi-Cal eligibility rules may apply to you if you are:- Married or in a registered domestic partnership and
- Meet the medical requirement as verified by your doctor’s verification form.
More information regarding these special rules can be found on the Spousal Impoverishment flyer.
How To Enroll
Medi-Cal members do not submit applications. Medi-Cal members are enrolled through Care Coordination Agencies, which are providers within the ALW program. Medi-Cal members must contact a Care Coordination Agency, who determine each individual’s care needs. Assessments are done by registered nurses employed by a Care Coordination Agency (CCA). Click on the Care Coordination Agencies link below and contact one of the CCAs in your county of residence to request an assessment. A pre-screening “assessment” will be done over the phone before an appointment is set up for the actual assessment.
Program Services
Participants in the ALW program will have access to three waiver benefits:
Assisted Living Services
These services are called the Assisted Living Services when they’re provided in an Residential Care Facility or an Adult Residential Care Facility. The services are called Assisted Care when they are provided by a licensed Home Health Agency and delivered to residents of publicly-funded housing.
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ALW Services
Care Coordination
These services include identifying, organizing, coordinating, and monitoring services needed by a participant. Care Coordinators conduct assessments to assist in determining eligibility, develop individualized Service Plans (ISPs), arrange for services, maintain contact with participants, and monitor service delivery on a monthly basis.
Nursing Facility Transition Care Coordination
This benefit helps to transition residents from nursing facilities to the community.
Additional Resources:
- Assisted Living Waiver Fact Sheet
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List of RCFE Facilities: Updated 11/02/18
- Description of Public Subsidized Housing
Provider Enrollment Information
Provider Resources, Forms, and Memorandums
Disclaimer: The community resource directory information is deemed accurate and up-to-date, however, you should always contact the agency or provider to confirm this information and make an appointment. Be sure to confirm payment information with the provider, if payment is required. We are not affiliated to any of the organizations listed in this app/website. The information provided in this app/site is for the benefit of the community and and we are not liable for any information changed from the date we published this information. Please contact us if you like to make any changes in the information by emailing beracahsites@gmail.com1907 total views, 2 today
Listing ID: 2915c115cb1d2041
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- Member Since: March 11, 2018
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