Compare your options
CCT or ALW: which helps you leave a nursing home?
California Community Transitions (CCT) helps Medi-Cal members move out of a facility into the community. ALW pays an assisted-living home for care, with waitlist priority after 60 days in a facility.
Both are about leaving a facility, in different ways. California Community Transitions (CCT) is the program DHCS describes on its CCT page. California takes part in the federal Money Follows the Person demonstration (CMS lists a DHCS project director for it), which exists to move long-term care from institutions to the community. The Assisted Living Waiver (ALW) pays a licensed assisted-living home for care, and a person in a nursing facility for at least 60 days gets first priority on the ALW waitlist. Beta ALW is a Care Coordination Agency for the ALW side.
Important: What CCT covers, who qualifies and who runs it locally are on the California Department of Health Care Services (DHCS) CCT page; this page does not restate them. ALW is reached through a Care Coordination Agency (CCA), the state-listed organization that sends the waitlist request to DHCS. Beta's ALW team is a CCA. It can't promise eligibility, an opening, a date or a room, in either program.
CCT and ALW, side by side
The CCT column says only what the federal Money Follows the Person page states; the DHCS CCT page has California's rules. The ALW column comes from DHCS's ALW pages. "Your agency" means your CCA.
| Question | CCT | ALW |
|---|---|---|
| What it is for | Moving people who are eligible for Medicaid long-term services and supports out of an institution and into the community, under the federal Money Follows the Person demonstration. | Medi-Cal paying a licensed assisted-living home for care, plus care coordination, for someone who would otherwise need a nursing home. |
| Who it's for | Ask the DHCS CCT page and the local lead organization. | 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. |
| Where you go | The community, as the program defines it; the DHCS CCT page says which settings. | 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). |
| Who you apply through | The DHCS CCT page names the way in. | A CCA, which sends the request to DHCS. |
| Priority for people in a facility | Ask the program. | First priority on the ALW waitlist for a person in a nursing facility or other institutional setting for at least 60 days when the request is submitted. |
Leaving a nursing home through ALW
The ALW path from a nursing facility has its own guide: the 60-day rule, who sends the request, what the discharge planner does and what the home needs before admission. The nursing-home transition guide. Who gets priority on the ALW waitlist. The home's agreement to admit is a separate decision from ALW eligibility.
Can you have both?
Ask both programs before assuming either answer. DHCS says a person with Medi-Cal may be enrolled in only one home and community-based services waiver at a time (the DHCS policy letter on dual enrollment); whether CCT counts as one for that rule is a question for DHCS, and this page does not answer it. A place on the ALW waitlist is not enrollment. Tell your agency if CCT starts, and tell the CCT lead organization when an ALW opening is offered, so the dates line up.
Which fits when
If the person wants to live in an assisted-living home, ALW is the program built for that, and the 60-day facility stay gives first priority. If the person wants another community setting, or needs help with the move itself that ALW does not pay for, ask the DHCS CCT page what CCT covers. See the other alternatives to ALW, including the HCBA waiver for care at home and staying in a nursing facility.
If you're a discharge planner
Confirm the days in the facility, because the 60-day count is what sets ALW priority, and send the ALW waitlist request through a CCA without waiting for the CCT answer. 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.
What people ask
Does ALW pay for the move out of the nursing home?
ALW pays the home for care by care tier and the agency for care coordination, from enrollment. It never pays room and board. What CCT pays for around a move is on the DHCS CCT page.
Do I lose ALW priority if I leave the nursing home first?
The first priority group is for people in a nursing facility or other institutional setting for at least 60 days when the waitlist request is submitted. Send the request before leaving; ask your agency how a move before an ALW opening affects the request.
Is CCT the same as the ALW?
No. CCT is DHCS's program for leaving an institution, and California is one of the states in the federal Money Follows the Person demonstration; ALW is a Medi-Cal waiver that pays an assisted-living home for care. They are run by DHCS under different rules.
About this informationReviewed October 26, 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 October 26, 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.