Who gets priority on the ALW waitlist, and how it is proved

The California Department of Health Care Services (DHCS) keeps one statewide waitlist for the Assisted Living Waiver (ALW) and releases openings in priority order under Policy Letter 24-002, as amended. The priority groups below go first, then everyone else in the order their requests were received. A priority group is documented, not claimed. No agency, including Beta, can move anyone up the list.

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Important: DHCS controls the waitlist and decides when openings (the state calls them slots) are released. Beta's ALW team is a Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork with you. It records what is true and submits it. It cannot change the priority rules or promise eligibility, a slot, a date or a bed.

The priority groups

Policy Letter 24-002 (dated October 7, 2024) lists the groups in this order:

1. People who have been in a nursing facility (a nursing home) or other institutional setting for at least 60 days when the waitlist request is submitted.
2. People whose urgent need is documented by Adult Protective Services (APS).
3. People whose urgent need is documented by the Long-Term Care Ombudsman.
4. Everyone else living in the community, in the order their requests were received.

How the waitlist works has the current split of each release between the groups.

The 60-day rule and the dates that prove it

The first group depends on two dates: the admission date to the nursing facility or other institutional setting, and the date the waitlist request is submitted. At least 60 days have to separate them. Policy Letter 24-002 gives an SNF face sheet and an admission record as examples of proof.

The CCA confirms the at least 60 days when a slot is released, so record exact dates, any moves between settings and who verified them. "About two months" does not establish 60 days. A person who met the rule when the request was submitted keeps that priority after going home, and proof of the stay is still required.

Ombudsman referrals under Policy Letter 26-001

Policy Letter 26-001 is dated June 22, 2026 and took effect at once. It limits Long-Term Care Ombudsman referrals to people who live in a nursing facility and meet its criteria. The criteria are in the letter, linked below.

An Ombudsman referral is not a shortcut through the waitlist. It places a person in a priority group only when it meets the letter's criteria, and a person at the agency has to review it.

What priority does not do

Priority is not enrollment, not a bed and not a date. It only affects the order in which DHCS releases openings. It is not eligibility either: the six requirements still have to be met when your turn comes, and DHCS decides after a nurse assessment. When an opening is released, current policy generally gives the agency 60 days to submit a complete application.

If you are not in a priority group

Most people are in the community group, in the order their requests were received. What you can do is be ready when your turn comes.

• Stay reachable. Before a request can be closed for no contact, current policy requires at least three attempts: once a week over three weeks, at different times and on different days. Call back when you see a missed call.
• Keep your contact details current with your agency, keep Medi-Cal active, and keep ID, Medi-Cal and care records in one folder.

Use the waitlist readiness checklist for the full list.

What people ask

Does being in the hospital count?

The rule names a nursing facility or other institutional setting, and this page cannot say whether a particular stay meets it. Record the setting, the admission date and any moves between settings for a coordinator to review. How a nursing-home move works.

Can Adult Protective Services put me on the list?

No. The waitlist request goes through a Care Coordination Agency. An APS referral that documents urgent need places the person in the APS group once the agency has reviewed it. Call APS for real safety problems, never as a tactic.

Can a care coordination agency get me priority?

No. The agency documents what is true: the setting, the dates and any APS or Ombudsman referral. It cannot create a priority group, move anyone up the list or change the state's rules.

Before anyone moves

Keep the person safely where they are until three things are in writing: DHCS has found them eligible, your agency has the enrollment date, and the home has agreed to admit them under ALW. Priority is none of those. What happens during the application.

Not sure which group applies? Request a callback and a coordinator will say which dates and documents matter. Professionals can refer a patient or client.