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5 lessonsAbout 32 minutesNo CE or licensure credit

Is this patient an ALW candidate? A screen for discharge planners

Five short lessons for hospital and SNF discharge planners and case managers: the published Assisted Living Waiver (ALW) criteria, Medi-Cal and level of care, the waitlist and its institutional-transition priority, what a referral can and cannot promise, and who decides each question.

Begin the courseSee the sourcesPrint the job aids

Written for

  • Healthcare and referral professionals
Course version
2026.10.3
Text checked against its sources

Before you begin

What you will be able to do

  • Given a patient's chart, sort each published ALW criterion as matches, open or does not match as written, without deciding eligibility.
  • Given a Medi-Cal or level-of-care question, send it to its owner (the county, the CCA or DHCS) and record it as open until that owner answers.
  • Given an institutional stay, record the dates and proof the agency needs to screen the 60-day priority, and explain the waitlist without giving a date.
  • Given a family's or a team's expectation, correct any promise of eligibility, a slot, a placement or a price in plain words.

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In this course

  1. Screen against the five published criteriaAbout 6 minutes · Not yet
  2. Medi-Cal questions and the level-of-care decisionAbout 7 minutes · Not yet
  3. The waitlist and the institutional-transition priorityAbout 7 minutes · Not yet
  4. What a referral can and cannot promiseAbout 6 minutes · Not yet
  5. Who decides each questionAbout 6 minutes · Not yet
  6. Course check · 10 questions0 of 5 lessons done

Sources

Sources behind this course

Each lesson lists the sources it uses. Open the original for the exact rule, form or instruction that applies to your work. The source library describes each one in more detail.

California DHCS

Assisted Living Waiver program page

The ALW eligibility criteria, the fifteen counties, room and board, the current waiver and amendments, enrollment and the waitlist, and the current policy letters.

Where to look: The Eligibility, ALW Current Enrollment and Current Policy Letters and Memorandums sections.

Open the DHCS ALW page
California DHCS

The Assisted Living Waiver (ALW) Program: description and eligibility (effective January 1, 2024)

The program description, room and board, the counties, the share-of-cost rule, where Medi-Cal applications go, and how level of care is assessed.

Where to look: The Determining Medi-Cal Eligibility and Determining Level of Care Eligibility sections. Its 2024 dollar amounts are dated.

Open the DHCS ALW description and eligibility sheet (PDF)
California DHCS, approved by CMS

ALW waiver application CA.0431.R04.01, 2024 to 2029, as amended March 1, 2025

The waiver's target groups, selection of entrants, level-of-care criteria and assessment, the tiers, and freedom of choice.

Where to look: Appendix B-1 (target groups), B-2 (cost limit and safety), B-3 (selection of entrants), B-6 (level of care) and B-7 (freedom of choice).

Open the current ALW waiver (PDF)
California DHCS

Important information regarding prospective ALW enrollments (September 4, 2024)

The end of direct submission for institutional transfers: they go on the waitlist like every other request.

Where to look: The second paragraph.

Open the DHCS capacity memorandum (PDF)
California DHCS

ALW Policy Letter 24-002, Release of ALW slots and waitlist management (October 7, 2024)

The priority order for slot release, the 60-day institutional rule and its proof, screening and notice times, the 60-day application window and the no-contact rule.

Where to look: Definitions, Policy, CCA Responsibilities and footnote 1.

Open Policy Letter 24-002 (PDF)
California DHCS

ALW Policy Letter 26-001, Long-Term Care Ombudsman referrals for the ALW (June 22, 2026)

Who may receive an Ombudsman referral for ALW priority, and who may request it.

Where to look: The list of criteria and the note on who may request a referral.

Open Policy Letter 26-001 (PDF)
California CDSS (regulation text on Cornell LII)

Title 22, section 87457: Pre-admission appraisal

The RCFE interview, consent and determination of suitability before admission.

Where to look: Subdivisions (a) to (c).

Open section 87457 on Cornell LII
Call the ALW teamFit check