Compare your options
MSSP or ALW: which fits?
MSSP brings care management and some purchased services to a person 60 and over at home. ALW pays an assisted-living home for care. Where care happens is the difference.
The Multipurpose Senior Services Program (MSSP) brings care management and some purchased services to a person 60 and over who wants to stay at home. The Assisted Living Waiver (ALW) pays a licensed assisted-living home for care, for adults 21 and older. Both need Medi-Cal and the level of care a nursing facility gives; where the care happens is the difference. Beta ALW is a Care Coordination Agency for the ALW side.
Important: MSSP is reached through the MSSP site that serves the person's county. ALW is reached through a Care Coordination Agency (CCA), the state-listed organization that sends the waitlist request to the California Department of Health Care Services (DHCS). Beta's ALW team is a CCA. It can't promise eligibility, an opening, a date or a room, in either program.
MSSP and ALW, side by side
The MSSP column comes from the California Department of Aging's MSSP page, the ALW column from DHCS's ALW pages. "Your agency" means your CCA.
| Question | MSSP | ALW |
|---|---|---|
| Who it's for | People 60 and over with Medi-Cal who are certifiable for a skilled nursing facility, where an MSSP site serves the county. | 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 | Care management, and some purchased services that help the person stay at home. | Care in the home, and care coordination. You pay room and board (the room and meals). |
| Where you live | Your own home. | 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 MSSP site for your county. | A CCA, which sends the request to DHCS. |
| Is there a waitlist? | Ask the MSSP site. | Yes. DHCS keeps one master waitlist and releases openings (the state calls them slots) in priority order, when the state releases capacity. |
Can you have both?
Not in the way the two are built. MSSP's services go to the person's own home, and a licensed assisted-living home is not the person's own home, which is the same reason In-Home Supportive Services ends on an ALW move-in. DHCS also 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). A place on the ALW waitlist is not enrollment, so a person can keep MSSP while waiting. Ask the MSSP site and your agency before changing programs, so the end date of one and the start date of the other line up.
Which fits when
MSSP fits someone 60 or over who wants to stay in their own home with a care manager arranging help, where an MSSP site serves the county. ALW fits someone 21 or older who will live in an assisted-living home, or already does, and who meets the six ALW requirements. Read the six requirements. MSSP's age is 60; ALW's is 21, so a younger adult with a disability looks at ALW or at the HCBA waiver, not MSSP.
Ask the MSSP site what it would arrange at home. Ask your agency what ALW would cover. You decide which fits. Not sure? Request a callback. See the other alternatives to ALW, or try the program-fit tool, which asks about MSSP as well.
Before anyone moves
Keep MSSP in place until the ALW side is confirmed in writing: eligibility from DHCS, the enrollment date from your agency and the home's agreement to admit your family member under ALW. Ask the MSSP site how and when leaving takes effect, so the dates line up.
If you're a case manager
Confirm the MSSP end date with the site and the ALW enrollment date with the CCA before advising a change. 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
Is MSSP in every county?
No. MSSP works where an MSSP site serves the county; the California Department of Aging lists the sites. ALW runs in fifteen counties, and a person only has to be willing to live in one of them. Which counties have ALW.
Can someone under 60 use MSSP?
No. MSSP is for people 60 and over. ALW is for adults 21 and older, and the HCBA waiver has no minimum age.
Can I stay on MSSP while I wait for ALW?
A place on the ALW waitlist is not enrollment, so MSSP can continue while the person waits. Tell the MSSP site and your agency when an ALW opening is offered, so the dates line up.
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.