CALA News & Views | Issue 54 | Impact

Expanding Access The Department of Health Care Services (DHCS) has discussed integrating the Assisted Living Waiver (ALW) into other waivers to allow expansion statewide on a few occasions. Renewed discussions began this year and CALA staff and CALA board member and ALW provider, Mark Cimino, CEO of CiminoCare , are part of DHCS’s Medi-Cal Home and Community Based Services Integration Planning Workgroup. The state is exploring options for integration that would shift the management of the waivers to the Medi-Cal managed care plans, with state oversight, no sooner than 2028. While the state intends for the waivers to be statewide, there will still be a limit on the number of participants and other mechanisms for ensuring cost neutrality, which is a requirement for federal waiver programs. More details will be provided in the following months when the state releases their roadmap. The CalAIM Community Supports program will continue to operate separately from the waiver program and Assisted Living Facility Transitions will remain an optional benefit that managed care plans can choose to offer. CALA will continue to focus on ensuring members are informed of upcoming changes; advocate for processes that provide a streamlined and effective contracting or licensing system; advocate for rates that provide geographic variability and account for higher levels of care; and engage with managed care plans to build relationships and learning opportunities prior to rollout of a new integrated waiver program. Once a bill becomes law, the Department tasked with implementing the law is responsible for writing regulations if additional clarity is needed. Since regulations often evolve over the years, CALA engages with the departments to ensure they continue to meet the needs of residents. Regulatory Updates

CALA created a new workgroup for members who participate in the ALW program and CalAIM or are interested in learning more – thank you to everyone who participated this year! The workgroup is a place for members to share successes with these programs and discuss challenges and pain points to help CALA understand where there are opportunities for advocacy. Workgroup members are also occasionally asked to weigh in on legislative and policy issues related to the Medi-Cal Assisted Living programs. Mark Cimino is chairing this workgroup and also facilitated discussions at both CALA conferences this year on the ALW program and CalAIM. These discussions were well attended and provided an opportunity for conference attendees to learn more about the programs and discuss their experiences.

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