For professionals
ALW referrals when a client is no longer safe at home
How community social workers and case managers refer a client to California ALW, and how to keep the client safe while no one can say when a slot comes.
Nobody can say when a community slot will come. The Assisted Living Waiver (ALW) may still be the right long-term plan when family help and In-Home Supportive Services (IHSS) are no longer enough. The state's Department of Health Care Services (DHCS) releases slots to community applicants only when capacity remains, in the order requests were received. Call to start the referral now, and keep a safety plan in place for today.
Beta takes referrals online through a secure referral portal, with a receipt and each referral's status, or by phone. How the referral portal works
Important: DHCS keeps the master waitlist and controls slot release. Beta is a Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork and care planning with the applicant. Beta cannot promise eligibility, a slot, a timeline or a facility. ALW does not pay room and board. A difficult housing situation alone is not enough; the clinical, Medi-Cal, safety and county criteria still apply.
Track 1: the ALW referral
Call Beta's ALW team, or leave your details and a coordinator calls you. A referral does not place the client on the waitlist. Once the client or their representative agrees, Beta sends the waitlist request to DHCS; state policy requires Beta to screen the request within 7 calendar days of receiving it. The date the form reaches DHCS is the client's effective date on the list.
Do not use an unknown ALW date as the safety plan. Keep the client's Medi-Cal active and their contact details current, and tell Beta about any change of setting, such as a hospital or nursing-facility admission.
Track 2: keep the client safe now
- Immediate safety and caregiver support first.
- IHSS or other in-home supports. IHSS pays for care in the person's own home. How ALW compares with IHSS.
- Community Supports from the client's Medi-Cal managed care plan, where the plan offers them.
- The Program of All-Inclusive Care for the Elderly (PACE), for people 55 or older in a PACE service area. How ALW compares with PACE.
- Housing, benefits and legal help.
- Nursing-facility planning when the client needs it.
When to refer
Refer when you see:
- rising personal-care or supervision needs;
- a caregiver who can no longer cope;
- repeated emergency or hospital use;
- a home that is unsafe even with supports;
- a likely nursing-facility placement;
- a resident of a Residential Care Facility for the Elderly (RCFE) or an Adult Residential Facility (ARF) who may fit ALW.
Adult Protective Services and the Ombudsman
Under DHCS Policy Letter 24-002, imminent need documented in an Adult Protective Services (APS) referral is a waitlist priority group. It is the only imminent-need route for a person living in the community. The Long-Term Care Ombudsman route is for nursing-facility residents under Policy Letter 26-001. An APS referral therefore carries priority. Make one for abuse, neglect or exploitation, never as a tactic, and do not shape the facts to fit a category.
What to have ready for the call
The referral form takes your own details, and a coordinator calls you. Have ready:
- your organization, role and callback number;
- the client's setting, county and Medi-Cal status, including any share of cost;
- a three-line care and safety summary, and the caregiver situation.
Keep names and clinical details out of ordinary email. If records are needed, Beta's ALW team tells you how to send them.
What to tell the client
"ALW is a state program that pays an assisted-living home for your care. It does not pay for the room or for food. The program has a waitlist. Beta can check your request and do the paperwork with you. Beta cannot say when an opening will come, and cannot promise that a home will take you."
Beta's ALW team talks with the client or their representative directly, because ALW is the client's own application. Get the client's consent before you refer and before you ask Beta for updates. If ALW may not fit, read what to do if ALW does not fit or the guide to applying from the community.
Start the referral now and keep the safety plan in place. Beta's ALW team will contact you about what comes next.
About this informationUpdated October 19, 2026. Reviewed 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.