Medi-Cal Assisted Living Waiver: which California communities participate (2026)

Key findings

• 11.7% of communities accept the waiver (871 of 7,458). Most California assisted living is private pay, and a family relying on Medi-Cal is choosing from a much shorter list.
• 68.4% of participating communities are small homes licensed for six residents or fewer. Large communities that take the waiver are the exception, so families expecting a big campus should plan for a board-and-care setting.
• 308 of the 502 cities we cover have no participating community at all. The waiver operates only in participating counties, and even inside them coverage is patchy city to city.

Cities with the most participating communities

Every city with a participating community

Each city links to its listings filtered to ALW communities. Confirm current enrollment and any waitlist with the community: participation changes, and a listed community may not have an open waiver slot.

What the Assisted Living Waiver is

The Assisted Living Waiver is a Medi-Cal program, run by the California Department of Health Care Services, that pays for assisted living services for eligible Medi-Cal members who would otherwise qualify for nursing-home care. The resident pays room and board from their own income; Medi-Cal pays the community for care. Only communities enrolled in the program can accept it, enrollment is capped with a waitlist, and the program operates in participating counties rather than statewide. Eligibility is handled by a care coordination agency, not by the community.

Method and limitations

• Population. The published California communities on Senior Places on September 5, 2026: the same set a visitor can browse. Communities we hold but have not published (unverified addresses, closed licenses, duplicates) are excluded.
• ALW participation means the community appears on the state’s participating-facility list, matched to our records by license number and address, or a claimed community reports accepting it on its own profile. A listed community may have no open waiver slot.
• Small homes are communities with a licensed capacity of six or fewer on the state record.
• Refresh. Figures recompute daily from the live directory; the published date is when the report first appeared. State records are re-collected on a rolling basis.

Sources

• California Department of Health Care Services, Assisted Living Waiver participating-facility list (as published for 2026), matched to our records by license number and address.
• Claimed communities that report accepting the ALW on their own Senior Places profile.
• Senior Places community records: licensed capacity and city, for published communities only.

CSV columns

city

City of the community (as licensed)

communities

Published communities in the city

alw_communities

Of those, communities on the ALW participating list or reporting that they accept it

share_alw

alw_communities divided by communities, as a percentage

alw_small_homes

ALW communities licensed for six residents or fewer

Questions about the data, or a correction? Contact us. Related: how matching works and the assisted living guide.