Does the State of California Pay For Elderly Care?

Posted on by Emily Kil

If you are an older Californian, you may wonder how you would pay for assisted living and other types of elderly care. The state of California does have programs available to assist in paying for elder care. Through this article, we review some of the programs that are available to older Californians when it comes to paying for elder care.

The four primary state programs that pay for elder care in different ways include:

  • In-home supportive services program (IHSS)
  • Assisted living waiver program (ALWP)
  • Home and community based alternatives waiver program (HCBA)
  • Multipurpose senior services program (MSSP)

In-Home Supportive Services Program (IHSS)

In-Home Supportive Services Program or IHSS is part of the California Medicaid program or Medi-Cal. IHSS provides non-medical care for individuals in their own homes. The goal of the program is to prevent or delay placement in an assisted living or nursing home setting. Services and benefits that may be available to a Californian through IHSS include:

  • Help with daily living activities
  • Housecleaning
  • Meal preparation
  • Grocery shopping
  • Other types of assistance

A person eligible to participate in this program has considerable latitude as to who will provide these services. Service providers can even include family members, including a person’s spouse. 

Assisted Living Waiver Program (ALWP)

A considerable percentage of the population of the state of California may qualify for Assisted Living Waiver Program (ALWP). The program is not available in all geographic locations in the state. ALWP is available in these California communities:

  • Alameda
  • Contra Costa
  • Fresno
  • Kern
  • Los Angeles
  • Orange
  • Riverside
  • Sacramento
  • San Bernardino
  • San Diego
  • San Francisco
  • San Joaquin
  • San Mateo
  • Santa Clara
  • Sonoma

Room and board associated with an assisted living community are not covered by this program. Having said that, this program does pay for such things as personal care assistance, medication administration, and prepared meals.

Home and Community Based Alternatives Waiver Program (HCBA)

The state of California describes Home and Community Based Alternatives Waiver Program or HCBA as:

A combination of several former waivers that helps nursing home eligible individuals receive care services, including medical care in their homes. This program also offers assistance to individuals currently residing in nursing facilities who wish to move back to their home. 

California Medicaid, or Medi-Cal, created this program (Home and Community Based Alternatives) for the target population of physically-disabled seniors who are either currently in nursing homes, intermediate care facilities, or likely to need long term nursing home care within a month. Therefore, seniors who are in skilled nursing facilities on a temporary basis for rehabilitation following a hospitalization are an important target group for this waiver.

The Home and Community Based Alternatives program allows for participant direction of personal care services. This means that program participants are able to hire the caregiver of their choosing. That includes specific relatives and friends. Generally, spouses and legal guardians are barred from receiving payment for providing care services.

Multipurpose Senior Services Program (MSSP)

The state of California defines the Multipurpose Senior Services Program or MSSP as:

The Multipurpose Senior Services Program (MSSP) Waiver helps nursing home eligible individuals who prefer to stay in their homes continue to do so. It covers care management and supportive services, such as adult day care, personal emergency response systems, and home modifications. But it doesn’t pay for medical care.

MSSP is available in California counties with the exception of these eleven:

  • Alpine
  • Colusa
  • Del Norte
  • Inyo
  • Mono
  • Nevada
  • Plumas,
  • San Benito
  • San Luis Obispo
  • Sierra
  • Sutter

Merely because you live in a county in which the program is available does not mean automatic enrollment. At the present time, the program caps the number of participants across the state of California at 11,370 participants. 

Community Based Adult Services (CBAS)

Community Based Adult Services (CBAS) itself is a fairly new program for older Californians. The program provides a menu of specific types of daytime care. These services include:

  • General daytime care
  • Meals
  • Social activities
  • Therapies of different types
  • Skilled nursing

California Local Agency on Aging Offices

In addition to the state Medicaid associated programs administered by the state of California, there are some local programs that may be helpful to a person in need of supportive assistance. A key benefit of accessing services through a local area is that you do not need to qualify for Medi-Cal to access benefits and assistance. 

Examples of services offered by local agency on aging offices include:

  • Nutrition – counseling, home delivered meals, and congregate (group) meals
  • Caregiver Support – respite care and caregiver training / education
  • Care Management – in-home care assessments and care plan development
  • Information & Referral – information about home and community based assistance programs, such as Medicaid, and referrals to administrators
  • Long Term Care Ombudsmen – information about long term care facilities and investigation of complaints
  • Insurance Counseling – assists seniors in understanding and maximizing the benefits of their insurance, especially Medicare
  • Transportation – assistance understanding and coordinating shared, non-medical transportation services