Understanding and navigating the intricacies of healthcare initiatives and services can often be a daunting task. This guide aims to simplify one such initiative, the Assisted Living Waiver (ALW) program, for residents of Orange County. The ALW program is designed to provide seniors who require nursing home-level care with the financial assistance they need to live in an assisted living community instead. 

 Assisted living offers many benefits to seniors who live alone. Besides the enjoyment of the company of other seniors in the community, they can also appreciate personalized care and attention provided by highly trained caring staff. However, these advantages often come at a hefty price, potentially out of reach for many low-income seniors.

This is where the Assisted Living Waiver program comes in. This healthcare initiative allows seniors to receive the care they need in a more home-like environment, avoiding the institutional atmosphere of a nursing home.

The program is designed for seniors who require nursing home-level care, offering them an opportunity to live in assisted living communities instead. The main goal is to improve the quality of life for seniors by providing them with a more comfortable, home-like environment while ensuring they receive the medical care and assistance they need.

 The ALW program encompasses a wide array of services crucial for seniors striving for independent living. Some of the primary services covered by the program include:

• Personal Care: Help with everyday activities and chores like eating, grooming, bathing, and toileting. This enables seniors to maintain personal hygiene and carry out daily routines with comfort and ease.
• Mobility Assistance: Support with mobility-related activities, ensuring seniors’ safety as they navigate their environment.
• Medication Administration: The program covers the administration of prescribed medication, reducing the risk of medication errors and ensuring proper healthcare management.
• Transportation Services: Provision of transportation for medical checkups or other purposes, removing the worry about travel logistics.
• Health-Related Services: A wide range of health-related services, including nursing at the required level, are included. This ensures that seniors have access to appropriate medical care when necessary.
• Social and Recreational Activities: Organization of various age-appropriate social and recreational activities, fostering community engagement and promoting mental health.
• Housekeeping and Laundry Services: Help with housekeeping and laundry relieves seniors of these chores, allowing them more time to engage in enjoyable activities.
• Meals: Provision of meals ensures seniors receive adequate nutrition, contributing to overall health.
• Nursing Home Transition Care: The program also provides transition care for those moving from nursing homes, guaranteeing smooth integration into their new living environment.

These benefits ensure seniors participating in the ALW program enjoy a high quality of life while receiving the care they need.

 To qualify for the ALW program, individuals must meet the following requirements:

• Age: The applicant must be aged 21 or older.
• Medical: Applicants must have full-scope Medi-Cal eligibility with zero share of the cost. This means they must be eligible for Medi-Cal and not required to spend a portion of their income on medical care before Medi-Cal starts to pay.
• Care Needs: Applicants must have care needs equal to those of Medi-Cal-funded residents living in nursing facilities. This typically includes the need for help with activities of daily living, such as bathing, dressing, eating, and moving around.

It’s important to note that the program is intended to serve individuals who would otherwise require nursing home care. Therefore, the criteria are designed to ensure that only those with substantial care needs qualify.

In addition, to be eligible, you must be willing to live in an assisted living setting as an alternative to a nursing facility. You should be capable of residing safely in an assisted living facility or public subsidized housing. You should also be willing to live in an assisted living setting located in one of the following counties providing ALW services: Alameda, Contra Costa, Fresno, Kern, Orange, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma counties.

 Even though the ALW program covers various services, the participant must still contribute to their room and board costs. In 2019, the “room and board rate” was approximately $1,039 per month or $1,059 per month, depending on one’s income. Those who cannot afford this minimum monthly expense may be able to find a spot in publicly subsidized housing. 

For low-income elders who find it challenging to cover their living expenses, there are several financial assistance options available. Some of these include

• HUD’s Section 202 Program: This program offers subsidized housing for seniors who qualify. It is a rent-assisted housing program that offers various services like housekeeping, transportation, and dining, all aiming to enable elders to live as independently as possible.
• Veteran’s Benefits: The Aid & Attendance program established by the US Department of Veterans Affairs offers eligible seniors need-based financial assistance, in addition to the VA pension. These funds can be used to cover the cost of long-term care.
• Medicaid: Medicaid has several different programs designed to provide financial assistance to elders for assisted living. However, the specifics of these programs vary from state to state.
• Non-Medicaid State Assistance: Long Beach and other areas in Orange County have their own benefit programs designed to help residents cover the cost of assisted living. It’s worth investigating the details to determine if you’re eligible.
• Long-Term Care Insurance: Depending on the type of insurance you have, you may or may not be able to benefit from long-term care insurance. It’s worth discussing this with your insurance company to ascertain if there is any financial advantage for you.
• Social Security: Although Social Security does not cover the cost of assisted living directly, there are ways that individuals and their families may enjoy some benefits. This varies from one state to another. Speaking to your local Social Security office will provide more clarity on the eligibility requirements and benefits.

 If you meet the eligibility requirements and are interested in the benefits the ALW program offers, the first step towards applying for the waiver is to submit a Medi-Cal application to your county’s Department of Human Services. It’s crucial to note that the state does not determine eligibility for Medi-Cal benefits. Contact your local county office to obtain information about how to apply for Medi-Cal benefits.

If this application is successful, you can then contact one of the listed care coordinating agencies and request an assisted living waiver. The entire process, from the time you submit your application to the time you receive confirmation can take anywhere from three to six months.

Although the Assisted Living Waiver Program is available in 15 California counties, including Orange, you don’t necessarily have to live in any of these counties to qualify for the waiver. This means you can take advantage of the waiver benefits by moving into an assisted living facility located in any of the counties that offer the ALW program.

Don't let financial constraints hinder you from the quality care and vibrant community you deserve. Find out if you qualify for the Assisted Living Waiver program and discover life at Westminster Terrace.

Remember that assisted living communities differ significantly in terms of their payment methods and the forms of assistance that are acceptable. When considering a move to an assisted living facility, it’s vital to speak to representatives from each facility you’re considering. They can provide specific information about the costs associated with living in their community, as well as the financial assistance options they accept.

This information will help you make a more informed decision that aligns with your budget restrictions and care needs. Don’t shy away from asking for specific details about everything that the cost covers – from meals and room services to personal care and medical assistance.

Remember, the aim is not only to find an affordable option but also to ensure that you or your loved ones can enjoy a good quality of life and receive the necessary care.

While the ALW program and assisted living facilities provide an excellent option for many seniors, they’re not the only choice available. For some individuals, home care might be a more comfortable or affordable option. Others might find that a residential care home, also known as a board and care home, better suits their needs.

Each of these options has its own set of benefits and drawbacks, and what’s best will depend on an individual’s specific circumstances and needs. It’s important to explore all available options before making a decision. Social workers, care managers, and other professionals can provide valuable guidance during this process.

As mentioned before, while this guide aims to provide a comprehensive overview of the Assisted Living Waiver program, it’s always a good idea to consult with a qualified financial representative for more information and professional advice.

Planning for elder care is a long-term decision. Consider future needs and possible changes in health status. An assisted living facility that meets an individual’s needs now might not be the best fit in the future. Planning ahead, with the help of professionals, can make transitions easier when they become necessary.

Assisted living facilities, and particularly those accepting the Assisted Living Waiver, can fill up quickly. Therefore, it’s crucial to start the application process early and to consider potential wait times.

 The Assisted Living Waiver program is a valuable resource that can help seniors in Orange County and across California access the care they need in a setting they prefer. By understanding the eligibility requirements, financial obligations, and application process, seniors and their families can make informed decisions about their care.

We hope this guide has provided you with valuable information to help you navigate the Assisted Living Waiver Program. Remember, you’re not alone in this process.

Numerous resources are available to help you along the way, from care coordinators to social workers and financial advisors. The journey might be challenging, but with the right information and support, you’ll find the best care option that suits your needs and ensures a comfortable and healthy life.

  1. What is ALW?

ALW stands for Assisted Living Waiver. It’s a program offered by California’s Department of Health Care Services to provide a home-like environment for Medi-Cal beneficiaries who need care services that are typically offered in a nursing facility.

2. Who can apply for the Assisted Living Waiver (ALW) Program?

To apply for the ALW program, an individual must meet the following eligibility criteria:

• Age 21 or older
• Have full-scope Medi-Cal eligibility with zero share of the cost
• Have care needs equal to those of Medi-Cal-funded residents living and receiving care in Nursing Facilities 

3. What services are covered under the Assisted Living Waiver program?

The ALW program covers a wide range of services, such as help with everyday activities and chores (including eating, grooming, bathing, and toileting), help with mobility-related activities, administering prescribed medication, providing transportation for medical checkups, organizing various social and recreational activities, and help with housekeeping, laundry, and meals.

4. What costs are not covered by the Assisted Living Waiver?

The ALW program does not cover the cost of room and board. However, there may be other financial assistance options that can help to cover these costs.

5. How do I apply for the Assisted Living Waiver Program in Orange County?

To apply for the ALW program, first, submit a Medi-Cal application to the Orange County Department of Human Services. Once this application is approved, contact a care coordinating agency and request an assisted living waiver. The entire application process can take anywhere from three to six months.

6. Is the Assisted Living Waiver program only available in Orange County?

No, the Assisted Living Waiver program is available in 15 counties in California. However, you don’t necessarily have to live in any of these counties to qualify for the waiver. You can still take advantage of the program by moving into an assisted living facility located in a county that offers the ALW program.

7. Are there other financial assistance options for low-income seniors?

Yes, there are several financial assistance options available for low-income seniors, such as HUD’s Section 202 Program, Veteran’s Benefits, Medicaid, Non-Medicaid State Assistance, Long-Term Care Insurance, and Social Security. The eligibility and benefits of these programs can vary, so it’s best to check with each program directly or consult with a financial advisor.

8. What alternatives are there to assisted living?

Alternatives to assisted living include home care services, adult day care services, residential care homes (also known as board and care homes), and nursing homes. The best option depends on an individual’s specific care needs, budget, and personal preferences.

Several organizations provide resources and advocacy for seniors and their families. These may include:

• AARP: AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. They provide resources on a variety of topics, including health, money, leisure, and family.
• The National Council on Aging (NCOA): NCOA is a respected national leader and trusted partner to help people aged 60+ meet the challenges of aging. They offer community programs, services, and effective advocacy.
• The Alzheimer’s Association: This is the leading voluntary health organization in Alzheimer’s care, support, and research. It’s a helpful resource if your loved one has Alzheimer’s or other dementias.
• Area Agencies on Aging (AAA): These agencies provide a range of options that help older adults choose the services and living arrangements that suit them best.
• Eldercare Locator: This public service connects you to services for older adults and their families. It can also provide you with resources on a variety of topics, including care planning, housing options, and legal issues.

In addition to these resources, our facility offers continued support for our residents and their families, ensuring that the transition to assisted living is as smooth and stress-free as possible. We are committed to being a partner in your care journey, always prioritizing your comfort and well-being.

Selecting the right assisted living facility is a crucial decision that requires meticulous consideration of several factors. Here are some key aspects to consider when choosing such a facility, and how our facility is the perfect fit in our area:

The level of care offered varies across different facilities. Some provide basic help with daily activities such as bathing, dressing, and meal preparation, while others offer extensive medical care. The level of care needed will depend on the individual’s health status and needs.

Our Facility: We provide a comprehensive and personalized level of care. We cater to both individuals who need assistance with daily activities and those who need more specialized medical attention. Our staff includes registered nurses available 24/7, ensuring that residents’ healthcare needs are met promptly and professionally.

The location of the facility is a crucial factor, especially if the individual would like frequent visits from family and friends. It’s also important to consider the proximity to medical facilities, local amenities, and the general environment and ambiance of the area.

Our Facility:  We’re conveniently located close to town, with easy access to medical facilities, shopping centers, parks, and cultural attractions. The facility itself is in a peaceful, green, and quiet neighborhood, providing a calming and pleasant environment for our residents.

 Assisted living facilities can offer a range of amenities such as fitness centers, swimming pools, in-house restaurants, and more. The types of amenities offered can significantly impact the resident’s lifestyle and enjoyment of their time at the facility.

Our Facility:  Our residents enjoy a wide variety of amenities, including a state-of-the-art fitness center, an onsite restaurant offering nutritious and delicious meals, beautiful communal spaces for socializing, and a comprehensive program of activities to keep our residents engaged and entertained.

 It’s essential to consider the quality of the staff and the overall community in the facility. The staff should be professional, friendly, and caring, while the community should be welcoming and inclusive.

Our Facility:  We take pride in our highly trained, compassionate, and dedicated staff who prioritize our residents’ well-being and comfort. Our facility fosters a close-knit community with a warm and inclusive atmosphere. We frequently organize events and activities that encourage social interaction and foster strong bonds among residents.

 Cost is often a significant factor. Different facilities have different pricing structures, so it’s crucial to understand what the costs cover and if any additional services may incur extra charges.

Our Facility:  We maintain transparency with our pricing, ensuring residents and their families understand the cost of care. We offer different packages to accommodate various budgets without compromising the quality of care.

 Care coordinators are a crucial part of the team, helping to navigate the complexities of senior care. They can answer questions, provide information about services and amenities, and assist with the admission process.

Our Facility:  Our experienced care coordinators are available to guide you through the application process and to continue assisting with any concerns or needs during your stay. They can be reached at  (714) 891-6608.

 Social workers provide emotional support and help address various social issues. They can assist with everything from facilitating communication between residents and their families to providing counseling.

Our Facility: We have an in-house team of social workers ready to provide support and assistance to our residents and their families. They can help you navigate through any emotional or social challenges you may encounter. You can schedule a meeting with them via our main office at (714) 891-6608.

 Start your journey towards a worry-free, engaging, and supportive living environment. Contact Leisure Vale today and learn how the Assisted Living Waiver program can make this possible!