Assisted Living Waiver
Memory care with Medi-Cal in California
Medi-Cal pays for dementia care in an assisted-living home only through the Assisted Living Waiver, in a home licensed for dementia care. What you pay.
Yes, through the Assisted Living Waiver (ALW), with two conditions: the person qualifies for the waiver, and the home's state licence allows dementia care. A "memory care" community in California is an assisted-living home with that permission on its licence. ALW pays the home's care tier; the resident pays room and board. Of the 1,213 homes on the ALW list with an open licence, 559 are licensed for dementia care.
What is memory care in California, legally?
There is no separate "memory care" licence. A memory care community is a Residential Care Facility for the Elderly (RCFE) that has told Community Care Licensing it accepts or retains residents with dementia, and meets the dementia-care requirements in Title 22, section 87705: staff training, a plan of care for each resident with dementia, and, where the home uses locked or delayed-egress doors, the fire clearance and the rules for secured perimeters. A six-bed board and care home can hold the same permission as a large community. The permission shows on the home's licence record in the CDSS facility search.
Does the waiver cover memory care?
Yes, in a home that is on the ALW list and licensed for dementia care. There is no separate memory care rate: DHCS pays the home the care tier the nurse assessment supports, $95.69 to $270.80 a day in 2026, and the tier reflects how much help the person needs, day and night, including supervision and cueing for someone with dementia. The assessment is the same one every applicant has; what it covers. A person with dementia usually needs a representative to sign and to take part in the care plan.
What does the person pay?
Room and board, from income. For someone on SSI/SSP in 2026, the home may charge at most $1,444.07 a month, and the person keeps at least $182.00; the full arithmetic, including the optional $20 and the rule for other income, is on the costs page. The care is paid by Medi-Cal under the waiver and is never billed to the resident.
Which homes on the list allow dementia care?
These are the homes on the state's ALW list whose licence allows dementia care, county by county, with an open licence as of the October 17, 2026 licence file:
| County | Homes on the list | Licence allows dementia care |
|---|---|---|
| Alameda | 20 | 7 |
| Contra Costa | 32 | 8 |
| Fresno | 96 | 34 |
| Kern | 44 | 18 |
| Los Angeles | 411 | 175 |
| Orange | 213 | 116 |
| Riverside | 131 | 67 |
| Sacramento | 76 | 41 |
| San Bernardino | 66 | 31 |
| San Diego | 92 | 46 |
| San Francisco | 3 | 1 |
| San Joaquin | 13 | 6 |
| San Mateo | 5 | 3 |
| Santa Clara | 4 | 1 |
| Sonoma | 7 | 5 |
| All fifteen counties | 1213 | 559 |
Open a county to see every home with its licence facts. A listing is not an open bed, and the permission on a licence is not a promise that the home can meet a particular person's needs: ask the home what care it gives today, and ask your Care Coordination Agency to help you judge the fit. Beta never ranks homes. The homes on the state's list.
What about a nursing home, IHSS or hospice?
A person with advanced dementia who needs skilled nursing may be better served in a nursing facility, which Medi-Cal pays for in full including room and board; how the two compare. A person who can stay at home with a paid caregiver's hours may fit IHSS instead. Hospice is a separate benefit that can continue inside a licensed home; the home needs a hospice care waiver on its licence to keep a resident through the end of life, and Beta's ALW team coordinates with any hospice the person chooses.
Not sure it is time yet? Signs it may be time for assisted living, including with dementia.
What people ask
Does Medi-Cal pay for memory care at home?
Not as "memory care", but IHSS pays for hours of a caregiver's help at home for people who qualify, and a family member can be the paid caregiver. The waiver is for a licensed home.
Can someone with dementia sign the ALW forms?
A person who can no longer make decisions signs through a representative: an agent under a power of attorney for health care, a conservator, or another person recognised for that purpose. The agency tells you which document is needed.
Is there a separate waitlist for people with dementia?
No. One statewide waitlist, with priority for people leaving a nursing facility or hospital and for referrals from Adult Protective Services or the Ombudsman. A dementia diagnosis by itself does not change the order.
What if the home loses its dementia permission?
The home must tell Community Care Licensing and the residents' representatives; a resident who needs dementia care would move to a home that has the permission, with the agency's help. It is rare, and it is one reason the agency checks the licence before the move.
Does the waiver pay for a secured unit?
The waiver pays the care tier; whether the home has a secured perimeter is a licence matter, not a waiver matter. A home with the permission and a secured perimeter costs the resident the same room and board as any other.
Request a callback and Beta's ALW team will tell you whether the waiver could fit and which homes in your county hold the dementia-care permission.
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.
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.