ALW starter guide for families

The Assisted Living Waiver (ALW) is a Medi-Cal program. It pays an assisted-living home for care, for adults who would otherwise need a nursing home. It does not pay for the room or for meals. Six things have to be true before anyone can enroll. Check them first, then call Beta's ALW team. This guide is general information, not a decision about anyone's eligibility.

Could ALW fit?

ALW may fit if the answer to all six questions is yes.

Is the person 21 or older?
Do they have full-scope Medi-Cal with no monthly share of cost? A share of cost is an amount some people pay before Medi-Cal pays. For ALW it must be zero.
Do they need the level of care a nursing home gives, such as daily help with bathing, dressing, medications or moving?
Could they live safely in an assisted-living home?
Will they live in one of the fifteen counties where ALW operates?
Would they rather live in an assisted-living home than a nursing home?

The state decides eligibility after a nurse assessment. A first conversation with Beta is not an official decision. Check whether ALW may fit online, or read who qualifies for ALW.

Who Beta is

To use ALW, you work with a Care Coordination Agency, the state-listed organization that does the ALW paperwork and care planning with you. We call it your agency. Beta is listed by DHCS as a participating Care Coordination Agency under the name Beta Hospice Care. Beta can be your agency in any of the fifteen ALW counties. They are Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma. You may choose any agency on the state's list.

How it works: ten steps

Some steps are yours, some are Beta's and some are the state's. Ask Beta's ALW team which step you are on.

Find out if ALW may fit. Go through the six questions above, or call us.
Choose a Care Coordination Agency. Beta can be yours.
Ask to be added to the state's waitlist. We send the request. The state keeps the list. Your place on it dates from the day the request reaches the state.
Wait, and stay ready. Keep Medi-Cal active. Keep your phone number current. Tell us about any change.
An opening is released to you. Openings go out in priority order, when the state releases capacity. The state calls an opening a waiver slot. We call you when yours is released.
The nurse assessment and your care plan. A nurse from Beta assesses the person's needs. Together we write the care plan, called the Individualized Service Plan (ISP). The state decides eligibility after the assessment.
Choose a home that takes ALW. You choose a home on the state's list that can meet the care plan and has a room. The home decides whether to admit the person.
Enrollment paperwork. We collect the forms and records and send the state a complete package.
Move-in and first month. Move-in happens after the state approves enrollment and the home confirms the room. Services in the care plan begin.
Ongoing check-ins. Your Beta care coordinator visits every month.

About the waitlist

The state, not Beta, keeps the waitlist and decides when openings are released. People who have been in a nursing home or other institutional setting for at least 60 days when the request is submitted come first. No agency can promise how long the wait will be. Keep your contact details, your representative's details and your Medi-Cal information current the whole time. Read how the waitlist works.

What it costs

ALW pays for care and for care coordination. It does not pay room and board, which means the room and meals. The person pays the home for those. If the person gets SSI/SSP, a monthly benefit for people with low income, the state sets that amount each year. If the person has other income, the amount is in the home's written agreement. Before anyone signs, get the monthly amount and any extra charges in writing. Current figures are on what ALW pays and what you pay.

Getting ready

You can do these now.

Write down the person's age, their county and where they live now, with any nursing home admission dates.
Check that Medi-Cal is active and full scope, with no share of cost.
Write down who speaks for the person, and keep any power of attorney or conservatorship papers together.
List the care needs: daytime, nighttime, mobility, memory, medications and equipment.
Decide which counties or areas would work, and note any language or accessibility needs.
Keep one folder with all of it.

Do not send a Social Security number, a Medi-Cal number or medical records by email. If Beta needs them, we tell you how to send them.

Visiting a home

Ask every home the same questions. Is the home taking ALW residents right now? Is there a room? Can the home meet this person's needs, day and night? What are the charges, in writing? Note who told you what, and when. A home on the state's list may have no room, may not admit the person or may not be able to meet their needs. Read how to choose a home and see homes on the state list.

What we can and can't do. Beta's ALW team can screen, coordinate, assess, help you find and talk with homes, and visit every month after enrollment. We can't decide eligibility, hand out an opening, or promise a waiting time, state approval, a care tier or a room. The state, the county and the homes decide those.

Contact Beta's ALW team

Call (747) 293-5777
Email alw@betahospice.com
Request a callback at alwbeta.com/callback

If someone is in danger right now, call 911.

Sources

The current version of this guide is at alwbeta.com/resources/patient-family-starter-guide. ALW terms are explained in the ALW glossary.