Compare your options
CalAIM Assisted Living Facility Transitions compared with ALW
Some Medi-Cal plans offer a Community Support for assisted living. How it differs from ALW, what to ask your plan, and the DHCS rule on having both.
Some Medi-Cal managed-care plans offer help moving into or staying in assisted living as a CalAIM Community Support. Its current name is Assisted Living Facility Transitions. It is not the Assisted Living Waiver (ALW), and not every plan offers it. Under DHCS policy a person can be eligible for both, but cannot receive the plan support and ALW at the same time.
Important: What each plan offers can change. Confirm with your family member's own plan. Neither the plan support nor ALW pays room and board (the room and meals). The California Department of Health Care Services (DHCS) keeps the master ALW waitlist. It releases openings (the state calls them slots) in priority order, when the state releases capacity. No one can promise how long that takes. Beta's ALW team can't guarantee eligibility, enrollment, an opening, a placement or a date.
What to ask your health plan
Call the member-services number on the plan card. Ask for Community Supports or Enhanced Care Management (ECM). Note who you spoke to and when. Ask:
- Does the plan offer Assisted Living Facility Transitions in our county, and does my family member meet its rules?
- Is the support for the move only, or ongoing? What would we still pay?
- Can my family member stay on the ALW waitlist, and what happens if an ALW opening comes first?
- How do we appeal if the plan says no?
Find which plans offer Community Supports in your county (DHCS search tool). The tool may still show the older name, Nursing Facility Transition/Diversion to Assisted Living Facilities.
The plan support and ALW, side by side
The plan column comes from the DHCS Community Supports Policy Guide (volume 1, April 2025). The ALW column comes from DHCS's ALW pages. "Your agency" means your Care Coordination Agency, the state-listed organization that does the ALW paperwork and care planning with you. Beta is one. Read what the agency does.
| Question | Plan support (Assisted Living Facility Transitions) | ALW |
|---|---|---|
| Who it's for | Members of a Medi-Cal managed-care plan that offers it in their county, who meet the plan's rules. | Adults 21 or older with full-scope Medi-Cal and no monthly share of cost. They need the level of care a nursing home gives and can live safely in an assisted-living home. |
| What it pays for | Help with the move into assisted living or with staying there, as the plan defines it. Room and board is not included. | Care in the home, and care coordination. You pay room and board. |
| Where you live | An assisted-living home. Ask the plan which homes it works with. | A licensed assisted-living home that takes ALW, in one of the fifteen ALW counties. The state licenses these homes as a Residential Care Facility for the Elderly (RCFE) or an Adult Residential Facility (ARF). |
| Is there a waitlist? | Ask the plan how it decides and how long that takes. | Yes. DHCS keeps one master waitlist and releases openings in priority order, when the state releases capacity. |
Can you have both?
Not at the same time. DHCS policy says a person can be eligible for both ALW and this support but cannot receive both at once. A person on the ALW waitlist may be offered the support. DHCS tells plans to coordinate with ALW providers and with Care Coordination Agencies. Ask the plan how it handles an ALW opening, and tell your agency if the plan support starts.
See the other alternatives to ALW, with a comparison page for each. For the plan's care management rather than its housing support, see Enhanced Care Management (ECM) and ALW.
If your plan ends the support
Plans can change what they offer. If your plan ends or changes the support, ALW is a separate program and does not depend on the plan. A Care Coordination Agency sends the waitlist request to DHCS. The state decides eligibility and releases openings in priority order. Ask the plan, in writing, what it will do for members already receiving the support and how to appeal. Not sure what to do next? Request a callback.
Asking about IEHP, L.A. Care, CalOptima Health or another plan? Your Medi-Cal plan and assisted living, plan by plan.
Before anyone moves
Keep the plan support in place until the ALW side is confirmed in writing. That means eligibility from DHCS, the enrollment date from your agency and the home's agreement to keep your family member under ALW. Tell the plan the ALW start date, and tell your agency the date the plan support ends, so the two don't overlap.
If you're a case manager or ECM provider
Verify the member's plan and the current Community Supports policy first. A member cannot receive the support and ALW at the same time. If an ALW slot is released for a member receiving the support, tell the plan and Beta and confirm the effective dates. To refer someone, call with professional context only: your organization and role, a callback number, the person's county and setting, and the general need. Send no records. Beta's ALW team names the route for records once you are in touch.
About this informationUpdated October 26, 2026. Reviewed August 27, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and reviewed by Sergio B., Program Coordinator, against the official sources this page lists; facts checked through August 27, 2026. Where this page and an official source differ, the source controls.
This page gives general California ALW information. DHCS decides eligibility after the nurse assessment and releases openings. Each home decides its own admissions. Nothing here is an eligibility decision or a promise of enrollment, and it does not guarantee a place in a home. You may choose any Care Coordination Agency listed by DHCS and any participating home.
Something out of date? Tell Beta's ALW team.