Compare your options
How PACE differs from the Assisted Living Waiver (ALW)
PACE provides all of a person's Medicare and Medi-Cal care through one organization. ALW pays for care in an assisted-living home. You cannot be in both.
PACE and the Assisted Living Waiver (ALW) both serve people who need the level of care a nursing home gives. PACE is the Program of All-Inclusive Care for the Elderly. PACE provides all of a person's Medicare and Medi-Cal services through one PACE organization. ALW pays for care in an assisted-living home. A person can't be in both at the same time.
Important: Leaving PACE is a decision you make with the PACE organization, not with Beta. ALW pays the home for care and pays for care coordination. It does not pay 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.
PACE and ALW, side by side
The PACE column comes from the DHCS page on PACE and the federal PACE rules (42 CFR 460.90). 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 | PACE | ALW |
|---|---|---|
| Who it's for | People 55 or older who live in a PACE service area and need nursing-home level of care, as DHCS determines it. They must be able to live safely in their home or community when they enroll. | 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 | All covered Medicare and Medi-Cal services, through the PACE organization and its team. | Care in the home, and care coordination. You pay room and board. |
| Where you live | At home or in the community, inside the PACE service area. | 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 local PACE organization. | 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. While enrolled in PACE, a person must receive Medicare and Medi-Cal benefits solely through the PACE organization (42 CFR 460.90(b)). PACE has to be the single source of all Medi-Cal and Medicare services, so ALW can't pay alongside it. You can be on the ALW waitlist while you decide. Confirm the dates with the PACE organization and your agency before changing programs.
ALW also requires Medi-Cal with no monthly share of cost. If your family member has a share of cost today, that rules out ALW enrollment, in PACE or not. How to check the kind of Medi-Cal ALW needs.
Which fits when
PACE fits someone 55 or older in a PACE service area who wants all care from one team, at home or in the community. ALW fits someone who will live in an assisted-living home, or already does, and who meets the six ALW requirements. Someone under 55 can't use PACE. Read the six requirements.
Ask the PACE organization which doctors and services you would use under PACE. Ask your agency what ALW would cover. You decide which fits. Not sure which fits? Request a callback.
See the other alternatives to ALW, with a comparison page for each.
Before anyone moves
Stay enrolled in PACE 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 admit your family member under ALW. Ask the PACE organization how and when leaving PACE takes effect, so the dates line up. While you wait, tell your agency about any change in health, address or Medi-Cal.
If you're a case manager
A PACE participant receives all Medicare and Medi-Cal services through the PACE organization (42 CFR 460.90(b)), so enrollment in PACE and ALW can't overlap. Confirm the PACE disenrollment date and the ALW enrollment date with the PACE organization and 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.
About this informationReviewed 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.