Are there any required documents needed to apply for the Assisted Living Waiver Program (ALWP)?

The Care Coordination Agency will ask to see the following documents, some will come from the individual and others from the skilled nursing facility and or the primary care physician.

Current Medication List

Proof of Medi-Cal (Medi-Cal Number/Card)

A physician 602 form-this is given to a primary care physician to fill out

History and Physical from the Hospital or Skilled Nursing Facility, if not in a care setting last primary physician office visit note.

Will there be any forms that the individual is required to sign?

Yes, the Care Coordination Agency (CCA) has forms that are required by DHCS.  They are as follows:

Amenity Waiver Form

Freedom of Choice Form

Last page of ISP-this is part of their assessment when conducting the review of your application

Acknowledgment of room and board fee

What if the individual is unable to sign the required forms on their own?

The state of California Department of Health Care Services only allows someone to sign on the behalf of an individual if they have the legal authority to do so.  This is done through either an Advance Health Care Directive or a Power of Attorney Document with Health Care Decision-making rights.

With Power of Attorney Documents, not all include the right to make Health Care decisions, however, allows acting on finical health care decisions such as changing an insurance policy or making payments of a premium.  If this is the case, it is best to obtain an Advance Health Care Directed to accompany the Power of Attorney document if one is not already established.

Does the individual have the right to decide what assisted living facility they move to?

Yes, the individual or their legal representative has the right to choose the facility they feel best serves the needs of the individual.  Not all assisted living facilities that are approved by the DHCS for the ALW program are the same. The Care Coordination Agency cannot tell you where you can and cannot move to.  Note, you may have a facility in mind, however it may be determined during the assessment phase that your care needs might not be met within that facility.

Each facility has its own set of care skills that they offer.  Not all facilities take more complex care needed individuals.  Some facilities might be focused on memory care, others might not offer any memory care.  This is why it is so important to know and understand what they are offering for their caregiving skills sets.

It is important that you are involved in the search for a facility that is best for the individual.  It is recommended that you tour the facility in person if possible.  If unable to tour in person prior to the move in as for a telephonic tour with a web came and a real-time walk-through, along with a virtual tour that you can review again later. 

The goal of the ALW is to:

Facilitate a safe and timely transition of Medi-Cal eligible seniors and persons with disabilities from a nursing facility to a community home-like setting in a Residential Care Facility (RCF), an Adult Residential Care Facility (ARF), or public subsidized housing, utilizing ALW services; and

Offer eligible seniors and persons with disabilities, who reside in the community, but are at risk of being institutionalized, the option of utilizing ALW services to develop a program that will safely meet his/her care needs while continuing to reside in an RCF, ARF, or public subsidized housing.