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v2026.1 · Updated 2026-05-30 · License: CC BY 4.0

Open dataset · CC BY 4.0 · Quarterly refresh

California ALW waitlist and county availability, 2026.

California’s Assisted Living Waiver operates in 15 of 58 counties. As of December 2025, 14,847 people were enrolled and 18,365 were on the waitlist. The waitlist is managed statewide, so the wait is the same in every participating county. This tracker shows participating facilities and licensed capacity for each.

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Statewide headline numbers, December 2025

On the waitlist

18,365

Statewide. Slots released to Care Coordination Agencies monthly.

Currently enrolled

14,847

Participants receiving waiver-funded care in an RCFE.

Participating counties

15 of 58

1,224 participating facilities, 39,065 licensed slots.

ALW availability by county

Participating Assisted Living Waiver facilities and licensed capacity by California county, with statewide waitlist status. Accessed May 2026.
CountyParticipating facilitiesLicensed capacity
participant enrollment units		Waitlist status
Los Angeles40417,688Statewide waitlist applies
Orange2155,155Statewide waitlist applies
Riverside1323,571Statewide waitlist applies
San Diego892,624Statewide waitlist applies
San Bernardino692,359Statewide waitlist applies
Sacramento812,032Statewide waitlist applies
Fresno961,695Statewide waitlist applies
Alameda221,132Statewide waitlist applies
Kern47672Statewide waitlist applies
San Joaquin13633Statewide waitlist applies
Contra Costa35596Statewide waitlist applies
Santa Clara5270Statewide waitlist applies
San Mateo6248Statewide waitlist applies
Sonoma7210Statewide waitlist applies
San Francisco3180Statewide waitlist applies
All 15 ALW counties1,22439,06518,365 statewide

The other 43 California counties have no participating ALW facilities, so the waiver is not available there. DHCS publishes enrollment and waitlist as a single statewide figure, not by county, so the “waitlist status” column reflects the statewide list that applies to every participating county. Capacity is licensed participant-enrollment-unit capacity, not the number of open slots.

What changed recently

PACE, a common ALW alternative, paused new applications

Families weighing the ALW waitlist often look at PACE, the Program of All-Inclusive Care for the Elderly, as a parallel route. From November 20, 2025 through at least November 19, 2027, DHCS paused new PACE organization applications and service-area expansions under Policy Letter 25-002. Existing PACE programs keep enrolling, but new PACE centers will not open in that window, so in areas without an established PACE program this route is effectively closed for now. The In-Home Supportive Services, Community-Based Adult Services, and Home and Community-Based Alternatives pathways are unaffected.

Why this dataset exists

The single most common question California families ask about Medi-Cal assisted living is some version of “there is a two-year waitlist, is there anything else.” The answer depends on two separate facts that are easy to confuse: whether the Assisted Living Waiver operates in your county at all, and how long the statewide waitlist is. This tracker separates the two so families can see, county by county, where the waiver exists and how many participating facilities they can choose from, alongside the one statewide enrollment and waitlist figure that DHCS actually publishes.

Methodology

County availability and capacity. Counts of participating facilities and licensed participant-enrollment-unit (PEU) capacity are derived from the DHCS GIS dataset “ALW Assisted Living Facilities,” which lists every facility participating in the waiver with its county and licensed capacity. We accessed the dataset on 2026-05-30 and aggregated its 1,224 facility records by county. County labels were normalized so that, for example, “Los Angeles County” and “Los Angeles” are counted together.

Statewide enrollment and waitlist. The enrolled figure (14,847) and waitlist figure (18,365) are the statewide totals from the DHCS Assisted Living Waiver enrollment and waitlist dashboard, current to December 2025. DHCS updates this dashboard monthly.

What is not published. DHCS does not publish enrollment or waitlist numbers broken down by county. We therefore do not estimate or invent a per-county waitlist. Where a number is not published, this tracker says so rather than filling the gap. The “waitlist status” for every participating county is the same statewide list.

What the dataset is and is not

This tracker tells you where the Assisted Living Waiver operates and how much licensed capacity exists in each county. It does not tell you how many slots are open today, because DHCS releases open slots to Care Coordination Agencies on a rolling monthly basis and does not publish a live open-slot count. Licensed capacity is the ceiling a facility is approved for, not a vacancy figure. A county with high capacity is not necessarily a county with a shorter wait, because the wait is statewide.

If your county does not appear in the table, the waiver is not available to you through a local facility. The other 43 California counties have no participating ALW facilities as of this edition.

How to get on the waitlist

To hold a place, contact a Care Coordination Agency in a participating county and complete the one-page Waitlist Request Form. Open waiver slots are released to those agencies monthly. While you wait, In-Home Supportive Services, Community-Based Adult Services, and the Home and Community-Based Alternatives waiver can provide care in the meantime. A benefits counselor can map which pathway fits your situation first.

License and citation

This dataset is released under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. You may freely cite, reproduce, and build on the data, with attribution.

Recommended citation:

California Care Compass. California ALW County Availability Tracker 2026. Version 2026.1, published May 2026. https://californiacarecompass.com/data/california-alw-county-tracker-2026

Refresh cadence and updates

Quarterly. The statewide enrollment and waitlist figures change monthly on the DHCS dashboard; the county facility and capacity counts shift more slowly. Version 2026.1 (May 2026) is the initial publication: 15 participating counties, 1,224 facilities, 39,065 licensed slots. The next scheduled refresh is 2026 Q3.

Common ALW waitlist questions

5 entries

Is there an Assisted Living Waiver waitlist in California?

Yes. As of December 2025, 18,365 people were on the California Assisted Living Waiver waitlist, against 14,847 enrolled. DHCS releases open waiver slots to Care Coordination Agencies monthly. The waitlist is managed statewide, so the wait is the same regardless of which of the 15 participating counties you live in.

Which California counties have the Assisted Living Waiver?

The Assisted Living Waiver operates in 15 of California's 58 counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma. Los Angeles has the most participating facilities (404); San Francisco has the fewest (3). If your county is not on this list, the waiver is not available where you live.

How long is the ALW waitlist in California?

DHCS does not publish a fixed wait time, and the wait is not broken down by county. Advocacy groups describe the current delay as significant because DHCS holds a large backlog of applications. Families commonly report waits measured in many months to a couple of years. To hold a place, contact a Care Coordination Agency in your county and complete the one-page Waitlist Request Form.

Does the Assisted Living Waiver pay for assisted living in California?

Yes. The Assisted Living Waiver is a Medi-Cal home and community-based services program that pays for care and supervision in a participating Residential Care Facility for the Elderly, so the resident pays only room and board out of pocket. It is available only in participating facilities in the 15 counties where the waiver operates, and only to people who qualify for Medi-Cal and meet a nursing-facility level of care.

If there is an ALW waitlist, what else can I do right now?

While on the waitlist, families often combine other Medi-Cal pathways: In-Home Supportive Services for hours of personal care at home, the Community-Based Adult Services day program, or the Home and Community-Based Alternatives waiver. PACE was another option, but DHCS paused new PACE provider and service-area applications from November 20, 2025 through at least November 19, 2027, so PACE availability may be limited in some areas. A benefits counselor can map which pathway fits first.

Sources

  1. 01California Department of Health Care Services · Assisted Living Waiver participating facilities (GIS dataset) · accessed 2026-05-30
  2. 02California Department of Health Care Services · Assisted Living Waiver enrollment and waitlist dashboard · accessed 2026-05-30
  3. 03California Department of Health Care Services · PACE application pause, Policy Letter 25-002 (effective 2025-11-20) · accessed 2026-05-30
  4. 04CANHR (California Advocates for Nursing Home Reform) · Assisted Living Waiver (ALW) program overview · accessed 2026-05-30
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