Does Medi-Cal pay for board and care?

Not on its own. In California a "board and care" is a small Residential Care Facility for the Elderly, usually six beds in an ordinary house. Medi-Cal pays for care in one only through the Assisted Living Waiver (ALW), in fifteen counties, and only for the care: the resident pays the home from income, at most $1,444.07 a month in 2026 for someone on SSI/SSP ($706.07 room and board plus up to $738.00 care and supervision), and keeps at least $182. Of the 1,213 homes on the state's ALW list with an open licence, 821 are six-bed homes.

Check whether ALW may fit

What is a board and care home in California?

A board and care home is the everyday name for a small assisted-living home: a licensed Residential Care Facility for the Elderly (RCFE) with six beds or fewer, usually in a house on a residential street, run by a licensee who often lives there or nearby. The licence comes from the California Department of Social Services, Community Care Licensing. It allows non-medical care: meals, help with bathing, dressing and medications, supervision, and a safe place to live. The same licence type covers large assisted-living communities; the difference is size, not the law. You can look up any home's licence, inspections and citations in the CDSS facility search ↗.

Adult Residential Facilities (ARFs) are the same idea for adults 18 to 59. Both kinds can be on the ALW list.

Does Medi-Cal pay for board and care?

Through the Assisted Living Waiver, yes, for the care. Medi-Cal does not pay a board and care home directly, and a home cannot bill Medi-Cal for a resident who is not enrolled in the waiver. When a person is enrolled, DHCS pays the home a daily rate for care by tier, $95.69 to $270.80 a day in 2026, and pays the Care Coordination Agency $320 a month for coordination. The home has to be on the state's list of participating facilities, and the person has to qualify and enroll. How ALW works explains the steps; the rates by tier show the figures.

What do you pay in a board and care home under ALW?

Room and board, from your own income. In 2026 a resident who gets SSI/SSP receives $1,626.07 a month in a licensed home; the home may charge at most $1,444.07 of it for room, board and basic services, and the resident keeps at least $182.00 for personal needs. A home may charge up to $20 more a month only if the admission agreement says so. A resident with other income pays the home from that income under the same CDSS standard. The care itself is never billed to the resident: it is paid by Medi-Cal under the waiver. The full figures and who pays for what.

What is the "board and care deduction" for Medi-Cal?

People search this phrase. It refers to an income deduction in Medi-Cal's share-of-cost rules for someone who lives in a licensed board and care home and has a share of cost. It is not part of the Assisted Living Waiver: ALW requires full-scope Medi-Cal with no share of cost, so a waiver resident has no share of cost to deduct against. If you have a share of cost today, the county Medi-Cal office applies the deduction, and the Medi-Cal zero share of cost guide explains how a share of cost can be cleared before applying for ALW.

How do you find board and care homes that take the waiver?

Start with the state's list, not with a phone book. Every home that can be paid under ALW is on the DHCS list of participating facilities, and alwbeta.com shows that list by county with each home's licence status and size. These are the six-bed homes on it, county by county, with an open licence as of the October 17, 2026 licence file:

Open a county to see every home, then filter by size. A listing is not an open bed: whether a home has a waiver bed today is something only the home and your Care Coordination Agency can say, and Beta never ranks homes. The homes on the state's list.

Can a board and care home join the waiver if it is not on the list?

Yes. A licensed RCFE or ARF in a waiver county enrolls with DHCS as an ALW provider; the home applies, DHCS reviews it, and it appears on the list once approved. If a family has found a home it likes that is not on the list, the home can ask about enrolling, and the person stays on the waitlist meanwhile. How a home enrolls.

Choosing between a small home and a larger community? Board and care vs assisted living.

What people ask

Is board and care the same as assisted living?

In California, yes for licensing purposes: both are RCFEs. "Board and care" usually means a small home of six beds or fewer; "assisted living" usually means a larger community. The waiver treats them the same.

Does a board and care home have to accept Medi-Cal?

No. Taking the waiver is the home's choice; it enrolls with DHCS as a provider. A home that is not on the list cannot be paid under ALW, however willing it is.

Can my parent move into a board and care home before the waiver is approved?

They can move in as a private-pay resident, but nothing about the waiver is decided by the move. Enrollment needs DHCS's eligibility decision, an opening and the home's enrollment on the list. Moving in and then applying is one of the three starting points; already in assisted living explains it.

What if the home charges more than the SSI amount?

For a resident on SSI/SSP, the CDSS standard caps the charge for room, board and basic services at $1,444.07 a month in 2026, plus the optional $20. A home that asks for more, or for a "care fee" on top, is asking for something the waiver already pays. Say so, and tell your Care Coordination Agency.

Is there a waitlist?

Yes. DHCS keeps one statewide waitlist for the waiver, with priority for people leaving a nursing facility or hospital. How the waitlist works.

Not sure whether ALW could fit? Request a callback and Beta's ALW team will tell you which of the six requirements looks uncertain, and which counties have the small homes you are looking for.