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The Assisted Living Waiver is not in your county. Here are the options
The Assisted Living Waiver runs in 15 California counties. If yours is not one: move to a waiver county, or look at HCBA, IHSS, MSSP, PACE and CalAIM.
The Assisted Living Waiver (ALW) runs in 15 of California's 58 counties. If the person lives in one of the other 43, such as Ventura, Santa Barbara, Stanislaus or Placer, there are two paths: move to an assisted-living home in a waiver county, which the rules allow (a person only has to be willing to live in one), or use a program that runs where they are now: the HCBA waiver, IHSS, MSSP, PACE where it operates, or a Medi-Cal plan's Community Supports.
Which counties have the waiver?
The fifteen waiver counties, according to the Department of Health Care Services (DHCS): Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, Sonoma. Homes on the state list, by county.
Which counties do not?
The other 43: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Imperial, Inyo, Kings, Lake, Lassen, Madera, Marin, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumas, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Stanislaus, Sutter, Tehama, Trinity, Tulare, Tuolumne, Ventura, Yolo and Yuba.
Can you move to a waiver county to get ALW?
Yes. One of the six requirements is being willing to live in an assisted-living setting in a waiver county; the person does not have to live there already when they ask. A Care Coordination Agency in the waiver county sends the waitlist request, and the move happens when DHCS releases an opening and a participating home admits the person. Until then, keep the person safely where they are. Families usually look at the nearest waiver county:
| If the person lives in | The nearest waiver counties are usually |
|---|---|
| Ventura, Santa Barbara, San Luis Obispo | Los Angeles, Kern |
| Imperial | San Diego, Riverside |
| Kings, Tulare, Madera, Merced | Fresno, Kern |
| Stanislaus, Calaveras, Tuolumne, Amador | San Joaquin |
| Placer, El Dorado, Yolo, Sutter, Yuba, Nevada | Sacramento |
| Solano, Napa | Contra Costa, Sacramento, Sonoma |
| Marin, Lake, Mendocino | Sonoma, San Francisco |
| Santa Cruz, Monterey, San Benito | Santa Clara |
| Inyo, Mono | Kern, San Bernardino |
| The far north (Butte, Shasta, Tehama, Glenn, Colusa and the counties above them) | Sacramento |
The table is geography, not a rule: the person chooses any waiver county. Who qualifies.
What runs where the person lives now?
| Program | What it is | Who it is for | Where to start |
|---|---|---|---|
| Home and Community-Based Alternatives (HCBA) waiver | Care management by a nurse and a social worker, and waiver services, at home; DHCS has kept a waiting list since July 12, 2023 | Medi-Cal members at risk of nursing home placement | DHCS HCBA waiver page · HCBA or ALW |
| In-Home Supportive Services (IHSS) | Hours of a caregiver's help at home, paid through the county; a family member can be the caregiver | Medi-Cal members who need help to stay safely at home | DHCS IHSS page · IHSS or ALW |
| Multipurpose Senior Services Program (MSSP) | Care management and some purchased services to help a person stay at home | People 60 and over with Medi-Cal who are certifiable for a skilled nursing facility, where an MSSP site serves the county | California Department of Aging: MSSP |
| PACE (Program of All-Inclusive Care for the Elderly) | All of a person's Medicare and Medi-Cal care through one organization, where a PACE organization operates | People 55 and over who need a nursing-home level of care and live in a PACE service area | DHCS PACE page · PACE or ALW |
| CalAIM Community Supports | Some Medi-Cal plans offer help moving from a nursing facility into assisted living, or staying out of one | Members of a plan that offers it; it varies by plan and county | DHCS Community Supports search tool |
Which program fits? asks six questions and names the one to look at first. None of these pays an assisted-living home's room and board. For the room and board, SSI/SSP is the same in every county. How to pay for assisted living in California.
What people ask
Is there an Assisted Living Waiver in Ventura County?
No. Ventura is not one of the fifteen waiver counties. A Ventura resident can ask an agency in a waiver county, Los Angeles or Kern are the nearest, to send a waitlist request, as long as they are willing to live in that county.
Will ALW come to more counties?
DHCS sets the counties in the waiver it files with the federal government; the current waiver runs from March 1, 2024 to February 28, 2029. Any change would come through DHCS. Until then, the fifteen counties are the ones that apply.
Can I stay on the waitlist while living in a county without ALW?
Yes. The waitlist request can be sent while the person lives anywhere in California, as long as they are willing to move to a waiver county when an opening comes.
Can Beta help if I live outside the waiver counties?
Beta's ALW team can send the waitlist request and coordinate the move into a waiver county. For HCBA, IHSS, MSSP or PACE where you live, the program's own agency is the place to start.
Request a callback and Beta's ALW team will tell you whether moving to a waiver county could work, and which waiver county is closest.
About this informationReviewed October 19, 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 19, 2026. Where this page and an official source differ, the source controls.
County pages are planning resources. 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.