California   Assisted   Living  Waiver  Program

Get the Facts

 

THE ASSISTED LIVING WAIVER PROGRAM

(ALWP)

 

  • Making affordable housing with personal and health-related services available to seniors and individuals with disabilities
  • Maximizing dignity, privacy, independence and autonomy
  • Providing an alternative to long-term care placement in a nursing home

 

The ALWP is designed to assist Medi-Cal beneficiaries to remain in their community as an alternative to care in a licensed health care facility.  The program provides specified benefits to eligible seniors and persons with disabilities. Medi-Cal reimburses for the services provided to residents enrolled in the ALWP.  However, depending on individual’s income, the resident is responsible to pay for their room and board.  For those with income of $1,122.00 room and board is $993.00 and those with income of $1,142 or greater, room and board is $1,013.00.

 

The ALWP is an alternative to long-term placement in a nursing facility and is presently available in the following counties: Sacramento, San Joaquin, Los Angeles, Fresno, San Bernardino and Riverside.  The ALW is currently enrolling beneficiaries residing in skilled nursing facilities and in the community, into licensed Residential Care Facilities for the Elderly (RCFEs) and Public Subsidized Housing (PSH).

DETERMINING MEDI-CAL ELIGIBILITY

 

Assisted Living Waiver (ALW) eligible individuals are those who are enrolled in Medi-Cal, are low income, i.e. SSI/SS, and meet the level of care provided in a nursing facility due to their medical needs.  For those who currently are not on Medi-Cal, you may apply for Medi-Cal benefits through your local county office.   Please note, the state does not determine eligibility for Medi-Cal benefits this is done at the county level. Also for those with Medi-Cal benefits that include a share of cost (SOC), you may not be enrolled in the ALWP.  Please contact your local county office to obtain information how to apply for Medi-Cal benefits.

 

 

DETERMINING SKILLED NURSING OR INTERMEDIATE LEVEL OF CARE ELIGIBILITY

 

Determination of care needs is done by registered nurses (RN) employed by a Care Coordination Agency (CCA).   A list of ALWP Care Coordination Agencies for each of the participating counties is available on our website at  http://www.dhcs.ca.gov/services/ltc/Pages/ALWPP.aspx   Click on the Care Coordination Link, and contact one of the CCAs in your county of residence to request an assessment.  A pre-screening “assessment” will be done over the phone before an appointment is set up for the actual assessment.

SOURCE: http://www.dhcs.ca.gov/SERVICES/LTC/Pages/ALWPP.aspx#project

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Residents Sell Crafts to Give Back to Community

Evelyn and Ed spend many hours a week, coloring, beading, and crafting unique works in hopes of selling these items to purchase items other residents cannot afford.  This year, the facility expanded this concept, and put a general store in the corner of a  secondary dining room, giving the Resident Store a permanent presence.  No longer was selling their wares a once monthly affair, but staff, family and residents quickly realized how handy a general store could be.

Quickly the Administrator gave the group some seed money so they could expand the shop to include food and drinks that staff and residents didn’t find on the normal meals served at the community.  All of a sudden, sinful chocolate bars, surgary colas, and deliciously red and green apples filled displays amongst the resident’s jewelry and art.  Ed said he takes great pride in the work that this group does on a daily basis, but he doesn’t do it for himself.  Ed says that the money that comes in has really benefited the community, and he has high hopes that the store will grow and continue to fundraise for events like holiday parties, birthdays, and staff appreciation.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Try A Respite Stay

Many local facilities  offer short-term respite stays. Respite care offers caregivers the opportunity to take time away from those they care for, while providing for the residents physical, mental and social needs. Many families use our facility for their annual vacation, checking their loved one –in, much like a hotel stay. These stays are often less than a week, and residents usually require basic custodial care.

RespiteStay.com is a resource that can offer more information.

ALC PationMany HMO insurance plans will cover respite stays in a nursing home if certain qualifiers are met. Call us and ask to speak to our Business Office Manager to discuss specific plans, benefits, and the cost of a Respite Stay. Often times, co-pays range from $5.00-$50.00. Families can also pay privately, which costs approximately $1,500 for the week.

Often, families realize that a structured, social, and safe envir
onment in a nursing home may be a better long term solution. We encourage families to ‘try out’ with a respite stay, because it gives the resident and family a good sense of the facility and what it is like to live in a nursing home. Most often, respite care residents come back to a facility when their healthcare needs increase and care needs can no longer be met at home.

Respite stays can also show a family how beneficial a skilled nursing stay can be to their family member. Many residents become more social, become more compliant with medication administration and following their recommended diet. Lastly, in cases where residents need to see a physician, or require other medical services, residents feel secure knowing that medical professionals are close by.

Learn more about the benefits that a respite stay can have on your loved one, as well as the benefits this can have on the caregivers and family who take care of them.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

The Waiver Waiting Game


When California’s Medi-Cal Will Pay for a Nursing Home, Assisted Living, or Home Health Care

In California, Medi-Cal will pay nursing home costs if you require skilled nursing care and can’t afford the cost of a nursing home.

Long-term care like nursing homes, assisted living facilities, and home health care are expensive, and private health insurance policies generally do not cover those services. Medicare coverage for long-term care is very limited, and few people have purchased private long-term care insurance policies. For California residents needing long-term care services, Medi-Cal is the most common source of funding.

Medi-Cal is California’s state Medicaid program. It is funded by both federal and state funds, and it provides health insurance to about 25% of California’s population. There are many different ways to become eligible for Medi-Cal, and there are specific eligibility rules for long-term care services like nursing homes, assisted living facilities, and home health care services.

Medi-Cal for Nursing Home Residents

Nursing homes are residential facilities that offer round-the-clock skilled nursing care in addition to other supportive services. Nursing homes are expensive, averaging approximately $7,000 per month in California in 2010. Most people cannot afford to pay their own nursing home expenses. Medi-Cal pays for the nursing home expenses of approximately 65% of the residents in California nursing homes.

If you already qualify for Medi-Cal, then your Medicaid coverage includes nursing home care if you need it. Groups of people who automatically qualify for Medi-Cal include SSI recipients, participants in the CalWORKs (California’s Temporary Assistance to Needy Families) program, individuals enrolled in California’s refugee programs, and children in its foster care system.
Medi-Cal Income and Asset Limits

If you do not already qualify for Medi-Cal, you might be eligible if you have little income. Beginning in 2014, because of the Affordable Care Act (ACA), the income limit for Medi-Cal works out to 133% of the Federal Poverty Level (FPL). That is about $15,800 for an individual and $32,500 for a family of four.

While the ACA has eliminated an asset test for many Medicaid applicants, if you are elderly or disabled, you will still need to have few assets to qualify for Medi-Cal: $2,000 for an individual and $3,000 for a couple. Some assets are not counted, such as a home if your spouse is living there or if you intend to return there, one vehicle, personal belongings, and small burial or life insurance policies.

You are permitted to “spend down” your assets to qualify for Medi-Cal by paying for certain kinds of debts or expenses. If you are trying to spend down your assets, get advice from a lawyer or legal aid office first. Be very careful about transferring any of your assets. Medi-Cal will look back 60 months from the date that you apply for Medicaid-paid long-term care and examine any asset transfers to see if they were legitimate. If you give property away for less than it is worth, then Medi-Cal will impose a waiting period before you can start getting your benefits.
Share of Cost Medi-Cal

If you are “over-income” for Medi-Cal but have high health care expenses like nursing home fees, then you might qualify for a program called Share of Cost (SOC) Medi-Cal. SOC Medi-Cal allows recipients to pay a certain portion of their income every month towards their medical expenses, and Medi-Cal pays all of the expenses incurred afterwards. The portion that the Medi-Cal recipient pays is called his or her share of cost.

SOC Medi-Cal is an important resource for individuals who might have higher incomes but who find that they cannot afford the cost of long-term care. However, Medi-Cal only lets long-term care residents keep a very small personal needs allowance ($35-$50/month) when they receive SOC Medi-Cal. Any non-exempt income above that personal needs allowance has to be paid to the long-term care facility before Medi-Cal will cover additional costs each month. In essence, Medi-Cal pays the difference between the monthly cost of the nursing home and the monthly income of the Medicaid recipient (minus $35.00).
When a Nursing Home Is Medically Necessary

Medi-Cal will pay for a nursing home only when it is “medically necessary.” California defines medically necessary as “when it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain.” For Medi-Cal to pay for a nursing home stay, your treating physician must prescribe a nursing home for you because you need the continual, round-the-clock availability of skilled nursing care. Skilled nursing care includes things like giving injections, feeding through a gastric tube, inserting or replacing catheters, changing wound dressings, and treating bed sores.

If you need a nurse only for one or two things a day, then Medi-Cal may find that a nursing home stay is not medically necessary, because you could get these services on an outpatient basis or by a home health provider. In essence, your doctor must find that your health is at risk if you do not have access to 24-hour skilled nursing care.
Medi-Cal for Assisted Living Facility Residents

Assisted living facilities offer a wide range of supportive services like housekeeping, medication management, meal preparation, and assistance with dressing and bathing, but they do not offer skilled nursing care. Medicaid pays for room and board only when they are offered in an institution that provides skilled care (like a nursing home), and it will not generally pay for room and board expenses in assisted living facilities.

To assist Californians with the costs of assisted living facilities, the state has created a Medi-Cal program called the Assisted Living Waiver (ALW). ALW is a Home and Community Based Services (HCBS) waiver program that offers care coordination services and can pay for expenses associated with some assisted living facilities and also with some home health services. Most recipients of ALW services still have to pay most of their income to the assisted living facility for room and board charges.

To be eligible for ALW, you must be eligible for Medi-Cal and require an institutional level of care. You meet that level of care if, without the ALW services, you would need to live in a nursing home.

Because ALW is a Medicaid waiver program, it does not need to be equally available to everyone in the state who is eligible for it. At this time, California has opted to make the services available to some seniors and people with disabilities living in Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino, Contra Costa, Alameda, San Diego and Riverside Counties.

If you qualify for ALW, you must use one of the assisted living facilities that has been approved by the state to participate in the program. The state licenses and regulates assisted living facilities that wish to receive Medi-Cal payments. Those approved facilities are called Residential Care Facilities for the Elderly (RCFE). There are three different RCFE licenses, depending on the level of care that the facility offers. In a Level 1 RCFE, residents are largely independent and receive minimal assistance with their personal care. In a Level 2 RCFE, residents receive frequent assistance with personal activities of daily living. In a Level 3 RCFE, residents receive extensive assistance with personal activities of daily living, and they may occasionally require the services of a skilled nurse or other medical professional.
Medi-Cal for Home Health Care

California covers home health services as part of its state Medicaid plan. However, Medi-Cal coverage of home health services is limited to services that are medically necessary, like skilled nursing care and medical equipment. For individuals who need ongoing, non-skilled care like assistance with bathing, cooking, and chores, California has the In-Home Supportive Services (IHSS) Program.

To be eligible for IHSS, you must be 65 or older, disabled, or blind, and you must be living in a home, not an institution. In addition, you must meet the eligibility criteria for Medi-Cal, and you must be unable to live at home safely without IHSS services.

When you apply for IHSS, your county will send a social worker to interview you about your needs and review your medical records. The county will use the results of the needs assessment to decide how many hours of in-home services it will pay for each month. In 2013, non-severely impaired applicants could receive up to 195 hours each month, and severely impaired applicants could receive up to 283 hours.

by: Elizabeth Dickey
SOURCE: NOLO Source for Law

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

صفحه اصلی‌

 

آیا شما در حال حاضر از عضوی از خانواده که توانایی رسیدگی به نیازهای خود را ندارد سرپرستی می‌کنید؟

 

با امکانات خانهٔ پرستاری و سالمندی تراس آسوده خاطر هستید. این تصمیم یکی‌ از بهترین تصمیم‌ها برای عزیزانتان و شما خواهد بود. خانهٔ سالمندی تراس سرپرستی حرفه‌ای برای عزیزان شما فراهم خواهد کرد. با فضای راحت مرکز سالمندی شما و عزیزانتان میتوانید از آسایش مطلوب که فراهم می‌کنیم لذت ببرید. علاوه بر فضای آسایشی، مرکز دارای جو زنده و درمانی است. ما میهمانهای خود را تشویق می‌کنیم تا با آوردن عکسهای خانواد‌گی، مبلمان کوچک و اشیای یادگاری محیط زندگی‌ خود را شخصی‌ سازی کنند. مرکز همچنین دارای محیط‌های وسیع برای گذراندن وقت با عزیزانتان و آشنایانتان است. با برنامهٔ “تشخیص نیازها میهمانان” بر آن هستیم تا با افزایش امکانات و کیفیت مرکز خود به نیازهای شما و عزیزانتان جوابگو باشیم. هر میهمان و عزیزانش از جلساتی برای تشخیص نیازها و شناسایی اهدافی برای بهبود زندگی‌ ایشان برخوردار خواهد بود. این سرویس از طرف

کیفیت پرسنل

خانهٔ سالمندی ما به عزیزان شما ارزش فراوانی‌ قائل است و آنها را مانند خانواده قبول می‌دارد. به این خاطر است که همهٔ کارکنان مرکز در کنار فراهم کردن سرویس‌ها با کیفیت بالا تلاش میکنند تا با عزیزانتان با احترام و شایسته در مقام آنها رفتار کنند. پرسنل همواره تلاش میکنند تا عزیزان شما از سلامت روحی و جسمانی برخوردار باشند. تیم مرکز روزانه در فعالیتهایی مانند حمام، لباس پوشیدن، غذا خوردن و مدیتاشین یار عزیزانتان می‌باشد. پرسنل مرکز بعد از آزمایش‌های سخت و آموزشهای ویژه انتخاب میشود، با توجه به این شما میتوانید آسوده خاطر باشید که پرسنل مرکز افراد قابل اعتماد و حرفه‌ای در زمینهٔ خود هستند. خانواده‌ها بعد از آشنایی با پرسنل مرکز مطمئن میشوند که عزیزانشان ۷/۲۴ در کنار افرادی حرفه‌ای و شایسته هستند که در نتیجه احساس آرامش میکنند

مرکز از سیدرس سینائی مدیکال سنتر 2 و مرکز درمانی الیمپیا مدیکال 3در فاصلهٔ ۵ دقیقه واقع می‌باشد. تلاشمان بر آن بود که با پزشکان و مدیریت این مرکز رابطهٔ خوبی داشته باشیم تا میهمانان در صورت لزوم از مراقبت خوبی در این سازمانها بهره‌مند شوند.
.ما در تقاطع کریسنت هایقتس 4و پیکو بلوار 5قرار داریم و نزدیک به بورلی هیلز 6و فیرفکس دیستریکت 7هستیم

خانهٔ سالمندی & مرکز پرستاری حرفه‌ای

یکی‌ از تفاوتهای مرکز ما داشتن مرکز پرستاری حرفه‌ای تراس در کنارش می‌باشد. مرکز رهبیلیتسین و پرستاری حرفه‌ای تراس رتبه و شهرت خوبی دارد. معمولا، میهمانانی که از خانهٔ پرستاری مرخص میشوند در خانهٔ سالمندی به زندگی‌ خود ادامه میدهند. همچنین، اگر در خانهٔ سالمندی نیاز به پرستاری حرفه‌ای باشد اهمیت داشتن خانهٔ پرستاری حرفه‌ای در همان آپارتمان آشکار میشود. این خصیصه یک اوانتاژ غیر قابل انکار است، مخصوصاً اگر هزینهٔ سرپرستی دائمی مراکز مشابه را در منطقه مقایسه کنید.
برای بهبود کیفیت و جلب اعتماد شما، خانهٔ سالمندی و پرستاری تراس خدمات مرکز را متناسب با نیزها و ریشه‌های میهمان تطابق میدهیم. خانهٔ سالمندی تراس برای عزیزان شما خانه‌ای دوم است، با پرسنل دلسوز بر آنیم تا به میهمانانمان در امور روزانه یاری رسانیم و محیطی‌ صمیمانه فراهم کنیم تا احساس خانه را از دست ندهند.
انتخاب خانهٔ سالمندی تراس بهترین انتخاب برای شماست تا عزیزان شما بتوانند زندگی‌ راحت، اجتماعی و مستقل را تجربه کنند.
پرسنل ۲۴ ساعت *
کمک دارویی *
واحدهای با مبلمان و بدون مبلمان *
برنامه‌های تفریحی *
اتاق غذاخوری جادار *
نظافت روزانه *
wifi امکانات اینترنت و *
مینیبوس مرکز برای گردش و ملاقات پزشکی‌ *
سه وعدهٔ غذا *
منو‌های کوشر مانند برای میهمانان *
beauty shop *
حیاط آرامش بخش *
دسترسی به امکانات پرستاری ماهر
با مایک، مدیر مرکز آشنا شوید. به عنوان مدیر اجرایی مرکز با همکاری کارکنان عزیزم بی‌ وقفه بر آن تلاش می‌کنیم تا برای همهٔ میهمانانمان یک تجربهٔ فرهنگی‌ منحصر به فرد ارائه کنیم. بر آن متعهدم تا با تلاش فراوان خواسته‌ها و نیازهای شما عزیزان را میّسر سازم. همواره مشتاق دیدار و آشنایی با شما عزیزان هستم، در بازدید بعدی حتما سری زده و با من هم آشنا شوید

Terrace Rehab, Skilled Nursing & Assisted Living

Our address:

  • Country Villa Terrace assisted Living Center 6050 West Pico Blvd, Los Angeles, Ca90035
Contact details:

Phone number:

  • 424-222-9500

Other useful contact numbers

Referral Intake: 424-222-9950
Fax Intake Fax: (323) 596-2215

 

 

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Contact Us and We Will Guide You

Our Team of dedicated professionals across multiple companies and organizations can help guide you to resources to make your decision and application process easier.  We offer this service free.  Please contact us if you would like help navigating this sometimes lengthy process.

Learn@assistedlivingwaiver.com

(855) 851-5838

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Sign Up for the Waiver Program

Partner Care Coordination Agencies

Alternative Home Care    (800) 750-1444

 

Always Best Care (ABCM)   916.266.6444

 

Huntington Home Care          (877) 405-6990

 

Jewish Family Services           (818) 769-0560

 

Care Coordination Agency (CCA)

In addition to receiving all referrals, the Care Coordination Agency administers the screening, eligibility verification, and assessment processes. The CCA uses a standardized ALW Assessment Tool to determine applicants’ levels of care, also known as tier level assignments. The CCA develops an individualized service plan (ISP) for each waiver-eligible applicant. ISPs identify waiver-eligible applicants’ areas of difficulty and specifies interventions to mitigate problems and achieve goals as outlined by the participants and the provider. The ISP is valid for 6 months, at which time the CCA is required to conduct a reassessment. Reassessments also occur if waiver recipients experience significant changes to their functional status. Copies of the ISP are given to the HHA delivering services and family members or guardians as appropriate.

The CCA is responsible for coordinating a waiver recipient’s entire care package including consumer education, accessibility adaptations, translation services, and the community transition benefit. Contact with the CCA will be necessary during the start-up process. However, once the ALW is operational, most communication will occur between the HHA and the CCA.

LACDC ALW Guide for Housing Providers 6

All participating CCAs must meet the requirements laid out in the Provider Handbook, which is available at: www.dhcs.ca.gov/services/ltc/Pages/ALWPP.aspx under the “Care Coordinator Manual” link.

 

SOURCE: https://www.shelterpartnership.org/Common/Documents/studies/ALWPGuide.pdf

 

Dept of Healthcare Services CA Service Listing

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>