Is the state’s Assisted Living Waiver Program (ALWP) dead? Sort of. The origin of the program was a “test” to ascertain if Medi-Cal could be used as an assisted living benefit for persons eligible under the benefits from the Centers for Medicare and Medicaid Services (CMS). Every five years, CMS renews California’s program as it did in March 2024. Eligibility hinges upon being qualified for Medi-Cal benefits, receiving supplemental security income (SSI) or state supplemental program (SSP) monies and needing a level of care equal to skilled nursing but willing and able to live in an assisted living facility in selected counties. Under the ALWP facilities are provided with additional funds, above the regular SSI/SSP payments based upon each person’s need for care. The current five-year waiver-2024 to 2029—was placed on hold as the program ran short of funds after September. The current eligibility window will not open again until March 2025, according to a September 4, 2024, memorandum released by state’s health care services department. The memo stated individuals could be placed on the program’s waitlist, now totaling 4,084 persons, with 14,733 already enrolled in the program. Starting in March 2025, an additional 1800 additional spaces will open with the waitlist persons accepted first. The ALW program has been mismanaged for several years and now residents and facilities begin to pay the costs of negligence and malfeasance in the program.
Two bills, AB1993 and AB770, are in suspense, but not dead. The six-bed facility industry had pinned hopes on the expansion of six beds to up to 10 beds without additional city or county building code issues. The authors of the bills had dropped the max from 10 beds to eight, but then added that 30% of any increase in capacity over six had to be reserved for “low-income individuals or recipients of SSI/SSP benefits.” California’s master plan is to place the mentally ill, the homeless and the formerly incarcerated into residential care.
Proposition 32 comes up for vote on November 5. It is likely to pass as it will increase the state’s minimum wage to $18 per hour. If it does not pass, the minimum wage will increase to $16.50 on January 1, for most of the state. This is based upon an inflation and cost-of-living rate of 3.18% or approximately $0.5088. If Prop 32 passes, larger employers, 26 or more, will be forced to increase minimum wage to $17 per hour for the remainder of 2024, $18 per for 2025. For employers of less than 26, minimum wage would increase to $17 per hour, bypassing the $16.50 an hour, then $18 per hour in 2026. Then, for 2027, annual adjustments would be based upon cost-of-living adjustments. If Prop 32 does pass, it will affect the “exempt wage” paid to salaried employees. California labor law requires an exempt or salaried employee to make a minimum of double the state’s minimum wage. If it increases from $16.50 to $17 per hour, then the salaried minimum wage would increase to $70,720 instead of $68,640. Predictions are that Prop 32 is not likely to pass, but employers who decide not to vote thinking employees would not dare vote in a higher wage, maybe in for a higher payroll with corresponding higher payroll taxes.