For professionals
ALW referrals from a hospital or SNF: what to send, and what ALW can't do for your discharge date.
How hospital discharge planners and SNF teams refer to California ALW: the 60-day priority, a copy-paste referral note, and the six steps after referral.
California's Assisted Living Waiver (ALW) can be a strong long-term plan for a patient who needs nursing-facility level of care but could live safely in assisted living. It is not a discharge destination: the state controls when waiver slots open, so keep your safe discharge plan running in parallel. Today, confirm the admission date, get the patient's okay, and send the secure referral.
Important: The California Department of Health Care Services (DHCS) keeps the master waitlist and decides when a slot is released; Beta is a Care Coordination Agency (CCA), the state-listed organization that does the ALW paperwork and care planning with the applicant, and cannot promise eligibility, a slot, a timeline or a bed. A facility listed as participating is not a confirmed bed. In an emergency, call 911.
Your part of the workflow
- Confirm probable fit with the quick fit check, plus the current setting and exact stay dates.
- Get permission from the patient or authorized representative for Beta to contact them.
- Send the secure referral with the copy-paste note below; records can follow securely.
- Keep the safe discharge plan running and gather records early.
Quick fit check
The nine-question quick fit check on the referral checklist decides whether a referral is worth making. For a hospital or SNF patient, add one: nobody expects ALW to meet a discharge deadline.
Copy-paste referral note
Fill in the brackets and paste into the secure referral form.
- Current setting: "Admitted to [setting] on [date]. Current discharge target is [date/unknown]."
- Baseline and present function: "Previously [baseline]. Currently requires [specific assistance] for [tasks]."
- Safety and cognition: "Cognitive status, behaviors and supervision needs: [facts]."
- Clinical and equipment: "Current treatments, equipment, transfers, wounds, oxygen and providers: [facts]."
- Why ALW may fit: "Patient prefers assisted living and may be safely supportable if a setting can provide [capabilities]."
- Current barrier: "Primary transition barriers: [Medi-Cal, slot, facility, representative, residential payment, records]."
That note, plus the patient's contact details, Medi-Cal status and your own contact, is a complete referral.
Institutional dates and the 60-day priority
Under current DHCS waitlist policy (ALW Policy Letter 24-002), first priority goes to people who have been in an institutional setting for at least 60 days when the waitlist request is submitted. Two things follow:
- Record the exact admission date, the current setting, any transitions between settings, the planned discharge date and who verified the dates. "About two months" is not a qualification statement.
- A hospital stay does not automatically count. The CCA works out how current policy applies to the actual setting and duration. Refer before discharge when long-term planning points to a fit, but don't promise assisted living at discharge.
See the Full SNF Transition Guide
What happens after you refer
Beta reviews the referral, contacts the applicant or representative, screens the waitlist request under current DHCS policy, and, once DHCS releases a slot, coordinates the assessment, care plan, facility and enrollment. Beta's ALW team will tell you which stage the referral is in when you ask, within authorization limits.
See What Happens After a Referral
Things that go wrong, and how to avoid them
| What goes wrong | Do this instead |
|---|---|
| ALW is treated as the discharge destination | Keep a documented alternative plan until enrollment is complete |
| A facility profile is read as a confirmed bed | Ask the facility directly about openings, care fit and admission |
| An Adult Protective Services or Ombudsman referral is used to move up the waitlist | Use those channels for their own purpose; they do not change waitlist position |
| Protected health information goes to ordinary email | Use the secure referral form and the secure channel Beta gives you |
Your next step
Send the referral now and keep the discharge plan moving; plan as if the slot date is unknown, because it is.
Official sourcesChecked against the official sources
Use the official sources below to confirm time-sensitive program details.
This page provides general California ALW information. It is not an eligibility decision or a promise of enrollment, and it is not a guarantee of facility placement. You may choose any Care Coordination Agency listed by DHCS and any participating facility.