California to eliminate Medicaid waitlists through assisted living waiver

[MM Curator Summary]: CA is using American Rescue Plan funds to add 7,000 new “slots” for its assisted living waiver program that helps disabled members stay in their community home-like setting.


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In an effort to eliminate waiting lists, California’s Medicaid program is adding 7,000 additional slots to its assisted living waiver program through 2024. 

The federal Centers for Medicare & Medicaid Services in January approved a home- and community-based assisted living waiver amendment at the request of the California Department of Health Care Services. The approval is retroactive to July 1, 2021, and runs through Feb. 28, 2024.

The assisted living waiver offers Medi-Cal eligible beneficiaries the choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility. The goal of the waiver is to transition eligible older adults and individuals with disabilities from a nursing facility to a community home-like setting in residential care facilities, adult residential care facilities or public subsidized housing.

California Assisted Living Association President and CEO Sally Michael said that eliminating the Medicaid waitlists will enable more people to receive care in the appropriate setting. She added that CALA also supported previous efforts to increase the reimbursement rate to reflect increasing minimum wages.

As of November 2021, 5,790 individuals were enrolled in California’s assisted living waiver program, and there were 6,559 on the waitlist.

The California Department of Health Care Services intends to fund the assisted living waiver expansion through the enhanced Federal Medical Assistance Percentage available through the American Rescue Plan Act.

Congress provided states with temporary enhanced federal funds for Medicaid HCBS through the American Rescue Plan Act, passed in March 2021. ARPA included $195.3 billion for state governments to use at their discretion. The dollars have maximum flexibility, with states encouraged to direct funding for COVID-19 mitigation efforts and to support industries hardest hit by the crisis.

Some states have used ARPA funding to provide relief to the senior living sector, including Michigan, Minnesota, Montana, New Jersey and North Carolina.


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