Compare your options
PACE or ALW? One changes your doctors; the other changes your address.
PACE puts all of someone's care with one team and its doctors; ALW pays for care in an assisted-living home and keeps your doctors. How to tell which fits.
The Program of All-Inclusive Care for the Elderly (PACE) and the Assisted Living Waiver (ALW) both serve people who need nursing-home-level care, but they solve different problems. PACE wraps all medical and daily care into one team, generally for people 55 and older, who usually switch to PACE's doctors. ALW pays for care in an assisted-living home; the person keeps their doctors.
Need a place to live with help around the clock? Start with ALW. Need a lot of medical care coordinated at home? Ask about PACE.
Important: ALW pays for care and coordination inside the assisted-living home, not room and board; the person still pays for their room, meals and personal expenses. The California Department of Health Care Services (DHCS) keeps the master waitlist and decides when an opening (the state calls it a slot) is released; nobody can promise how long that takes. A home that takes ALW is not the same as a home with an open bed that will accept your family member. Beta's ALW team can't guarantee eligibility, enrollment, an opening, a placement or a date; what we can do is help you work out which fits and get the ALW steps right.
PACE and ALW, side by side
| PACE | ALW | |
|---|---|---|
| Who it's for | Generally adults 55+ who need nursing-home-level care, live in a PACE service area and can be safe in the community with PACE's support | Adults 21+ with full-scope Medi-Cal and no monthly share of cost who need nursing-home-level care and can be safe in assisted living |
| What it pays for | All covered medical, social and long-term care through the PACE team; housing is the person's own | Care and coordination in the home; the person pays room and board |
| Where you live | In the community, within the PACE area; PACE isn't a room-and-board benefit | An assisted-living home (licensed as an RCFE or ARF) that takes ALW, or qualifying public subsidized housing, in an ALW county |
| Waitlist? | No; enrollment goes through the local PACE organization | Yes; the statewide waitlist run by DHCS |
| Can you have both? | Not at the same time; Medi-Cal won't pay for the same care twice. You can be on the ALW waitlist while you decide; confirm with the PACE organization and your CCA before changing programs |
Which fits when
ALW fits when assisted living is the goal, the person is 21 to 54, or they want to keep their doctors. PACE fits when the person is 55 or older, lives in a PACE service area, and is comfortable moving to the PACE team. Ask which doctors would change; that's often the deciding fact.
A Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork and care planning with you (Beta is one), can help you decide.
Before anyone moves
Don't cancel or leave an existing program, provider or living arrangement until the new one is confirmed in writing: eligibility, the effective date, where the person will live, and how medications, equipment and records carry over. The person, or whoever speaks for them, should understand and agree. We can help you line these up so there's no gap in care.
If you're a case manager
PACE additionally requires age 55+ and a PACE service area, and applies its own provider network. Nonduplication rules govern overlapping enrollment; confirm with the PACE organization and CCA before advising a switch. Send records through the secure referral form.
Your next step
Tell us what your family member needs most; no decision required before you call.
Official sourcesChecked against the official sources
Use the official sources below to confirm time-sensitive program details.
This page provides general California ALW information. It is not an eligibility decision or a promise of enrollment, and it is not a guarantee of facility placement. You may choose any Care Coordination Agency listed by DHCS and any participating facility.