Assisted Living Waiver (ALW) in Santa Clara County

A directory listing, not an eligibility decision.

UniHealth can identify a possible match, but the responsible program makes the final decision.

What to know

Why it may fit: Your circumstances can be checked against the program’s published guidelines.
What to do next: The Assisted Living Waiver pays for care in an assisted living home. It is for adults 21 and older who need a nursing home's level of care. Santa Clara County takes part. You pay for room and board. The waitlist is very long.
Who runs it: DHCS / care coordination agency

What the program may consider

Age 21 or older
Full-scope Medi-Cal with zero share of cost
Nursing-facility level of care
You want to live in an assisted-living setting in Santa Clara County and can do so safely

How to get it

The Assisted Living Waiver pays for care in an assisted living home. It is for adults 21 and older who need a nursing home's level of care. Santa Clara County takes part. You pay for room and board. The waitlist is very long.

Before you start

You need this first Aged, Blind and Disabled Federal Poverty Level Medi-Cal. You need full Medi-Cal with no share of cost. A share of cost is an amount you pay each month before Medi-Cal pays. Special rules can help if you are married.

How to apply

Assisted Living Waiver waitlist request

A one-page form you fill out with a care coordination agency that serves your county.

ReferralFind a care coordination agencyChoose an agency that serves your county. Contact it to ask about applying and the waitlist.

Getting help

Someone can refer you, with your permission

A helper can contact a care coordination agency for you, with your OK. These are local groups that run this program for the state. You or your legal representative choose the assisted living home and sign its admission papers.

Only you, or someone with legal authority for you, can sign.

What happens after you apply

A care coordination agency fills out a one-page waitlist request with you. It checks the basics and confirms your place in writing.
The program or providerA helper can help with thisThe agency checks it within 7 days, and confirms in writing within 3 days after that.
Each month the state releases openings. Half go to people who have spent 60 days or more in a nursing home or other facility. The rest go to people referred by Adult Protective Services or the Long-Term Care Ombudsman. People living at home get a spot only if any are left.
The stateNo set time. At the end of 2025, more than 18,000 people were waiting.
When you get a spot, the agency calls you. It tries once a week for 3 weeks. If it cannot reach you, you lose the spot.
The program or providerA helper can help with this You must answer within about 3 weeks.
The agency assesses your needs and sends a full application to the state.
The program or providerOnly you can do thisWithin 60 days after the spot opens.
The county confirms you have full Medi-Cal with no share of cost. It may use special rules if you are married.
The countyA helper can help with this
The state approves your application.
The state
You move into a participating assisted living home, or stay in yours if it takes part. You sign its admission papers, and services start.
YouA helper can help with this

What only you can do

Take part in the agency's assessment.
Stay reachable by phone. If the agency cannot reach you in 3 weeks, you lose your spot.
Choose a participating home and sign its admission papers, or have your legal representative do it.
Pay the home for room and board yourself.
While you wait, ask your Medi-Cal health plan if it offers help moving into assisted living.

How long it takes: No set time. Most spots go to people leaving a facility or referred by protective services. For people living at home, a spot may not open.
You are enrolled when: You are enrolled when the state approves you, and you get waiver services in a participating home.
To keep it: Keep full Medi-Cal with no share of cost, and renew it each year. Keep living in a participating home and paying room and board. Stay in touch with your care coordinator.

Can’t be combined with

Multipurpose Senior Services Program (MSSP). You cannot be in the Assisted Living Waiver and MSSP at the same time.
Home and Community-Based Alternatives (HCBA) Waiver. You can be in only one Medi-Cal waiver program at a time.
Enhanced Care Management. You cannot get Enhanced Care Management (ECM) while in the Assisted Living Waiver. ECM can help while you are on the waitlist. When a spot opens, you choose one.

Coming changes

Starting July 1, 2027: Starting July 1, 2027, the Medi-Cal savings limit drops to $21,000 for one person and $31,000 for a couple. Today it is $130,000 and $195,000. Special rules may help if you are married. You need Medi-Cal to stay in the waiver.