How does Medi-Cal’s Assisted Living Waiver work, and how long is the wait?

What does the waiver pay, and what do we still pay?

The waiver pays the home for the resident’s care: help with bathing, dressing, medicines and supervision. The waiver pays for care services, not room and board.

The resident pays the home for room and board. If their only income is SSI/SSP, that is $1,444.07 a month, and they keep $182 for personal needs. With other income, the home may charge $20 more if the admission agreement says so. CDSS PIN 25-19-CCLD, note 1

Ask the Care Coordination Agency to confirm what your family member would pay each month.

Who is it for?

The waiver is for people who:

• are 21 or older;
• have full-scope Medi-Cal with no share of cost;
• need the level of care a nursing home gives, as the agency finds when it reviews their needs.

Medi-Cal alone does not make someone eligible for the waiver. DHCS reports limited enrollment slots and a waitlist.

Medi-Cal counts savings. In 2026 the limit is $130,000 for one person. W&I Code §14005.62(a)(1), to July 2027 It falls to $21,000 no sooner than July 1, 2027. W&I Code §14005.62(a)(1), from July 2027 W&I Code §14005.62(a)(2), from July 2027

How long is the wait, and who goes first?

In March 2026, 14,831 people were enrolled and 15,910 were waiting. The waitlist peaked at 20,262 in February 2026.

Waiting, March 2026

15,910DHCS waitlist table

Enrolled, March 2026

14,831DHCS waitlist table

Waiting at the peak, February 2026

20,262DHCS waitlist table

Waiting, January 2019

4,502DHCS waitlist table

DHCS releases places each month by the 10th, to four groups in this order:

1. people who have lived in a nursing home or other institution for 60 days or more (50% of the places);
2. people referred by Adult Protective Services (25%);
3. people referred by the long-term care ombudsman (25%);
4. everyone else, first come, first served, with the places left over.

The agency screens a request within 7 days and writes back within 3 days. Once a place is released, there are 60 days to finish the application.

Which counties and homes take part?

The waiver runs in 15 counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.

If a county is not in the table, the list shows no waiver homes there.

How do we apply?

You apply through a Care Coordination Agency for the county, not through a home.

1. Make sure your family member has Medi-Cal, or apply through the county first.
2. Call the Care Coordination Agency for their county. DHCS lists the agencies on its waiver page.
3. The agency reviews their care needs and writes a care plan with them.
4. When a place is released, choose a participating home and finish the application within 60 days.
5. They move in once DHCS approves the enrollment.

A place on the waiver and an opening at a home are two separate things. Ask the agency about the first, and the home about the second.

Does it pay for memory care?

Yes, in a participating home that cares for residents with dementia. Every home that cares for a resident with dementia must follow Title 22’s dementia rules. Title 22 §87705(a) Read Memory care in California.

What if the county has no waiver homes?

Ask their Medi-Cal plan about Assisted Living Facility Transitions. It may pay for care in a care home that works with the plan, and it does not pay room and board.

What if we’re turned down?

Ask the Care Coordination Agency for the decision in writing, with the reason. CANHR (California Advocates for Nursing Home Reform) explains how to challenge a waiver decision in its fact sheet, and answers families’ calls: 1-800-474-1116.