Recent Announcements


posted May 6, 2016, 9:09 PM by Dio Telmo

May, 06, 2016


Dear Licensee:


The Fresno Regional Office for Adult and Senior Care Programs will be conducting informational forums to review and discuss new laws affecting and impacting Residential Care Facilities for the Elderly.  These laws became effective beginning January 01, 2016.

     To accommodate travel for long distance facility licensees, we are scheduling three separate forums at two locations.  Each attendee only needs to attend one of the sessions.




Thursday, May 12, 2016

Malibu Room

10:00 a.m. to 12:00 noon

One Session Only



3200 N. Sillect Avenue

Bakersfield, CA 93308

(661) 327-8531




Thursday, May 26, 2016

San Joaquin Room


10:00 a.m. to 12:00 noon AND 1:30 p.m. to 3:30 p.m.



4615 N. Marty Avenue

Fresno, CA  93722

(559) 276-4300


We look forward to seeing you and your participation at one of the sessions. 


Brian Barnett

Fresno Interim Regional Manager


posted Aug 9, 2014, 10:45 PM by Dio Telmo

For all 6 beds RCFE facilities we need to VETO AB1523. Please read below.

"Thank you for your support
We are working hard to continue on this treacherous path of protecting the small 6 beds RCFEs in order to provide Safe and Affordable care for our seniors. Our rally was a success and we thank you for participating!
Action is need TODAY from all members of, their families and friends.
Attached please find a letter that needs your contact information and signature.  Please print it and mail it TODAY to the Governor’s office asking for the veto of AB1523.  Please also forward it to any supporters of our cause.  We need to flood the office of the Governor with hundreds of letters! 
United, we will prevail.
My best,
Ana Blaj
Board of directors

(copied from an E-mail)


Nursing Homes (Inappropriate use of Antipsychotic Drugs)

posted Aug 2, 2014, 6:36 AM by Dio Telmo

The electronic copy of AFL 14-18 (Centers for Medicare and Medicaid Services / California Department of Public Health Joint Letter Related to Antipsychotic Drug Use) is available for viewing/download by clicking on the following link: 

Kern County CAHF Chapter Meeting

posted Jul 14, 2014, 11:01 PM by Dio Telmo

Wednesday July 16, 2014



Glenwood Gardens

350 Calloway Dr. Bakersfield Ca 93312



"Dealing with Difficult Residents and Family Members"


"HIPAA What You Need to Know"


Cost: $10 per person

Includes 2 NHA CEUS


RSVP by Tuesday July 15, 2014 to

Cody Rasmussen


Phone: (661)854-4475

Text: (661) 319-0144



Sponsored by

Kern County CAHF



posted Jul 8, 2014, 10:19 PM by Dio Telmo

A Partnership between Hospitals and LTC Providers to Reduce our Community’s Readmission Rates 

 Thursday, July 10, 2014
 9:00 – 11:00 am 
 Bakersfield Memorial Hospital, The Learning Center Lecture Hall 

Framework for Discussion 

1. Welcome and self-introductions 
Lynne Ashbeck, Hospital Council of Northern and Central California Gina Fleming, Clinical Project Manager, Care Transitions, Health Services Advisory Group of California 

2. Meeting objectives and expectations
♦ Shared goals 
♦ Shared problem statement…what are we trying to solve? Accomplish? 

3. How did we get here? Background on the idea for this Summit (Lynne) 
♦ Larger care transitions collaborative/CCTP grant 
♦ Lessons from other communities  
♦ “Small test of change:” what can hospitals and LTC do together to ‘move the readmissions needle?’ 
♦ The hospital-LTC hand off is a key piece of the readmissions puzzle…and neither hospitals nor LTC can make significant progress on their own!! 

4. What can we learn from the data and from our experiences about the readmission process in our region? 
♦ Regional, hospital, and LTC data 

5. What are we learning from the CCTP grant experience relative to hospitals, LTC, and readmissions? 

6. What is it that we do/don’t understand about each other’s processes, expectations, capabilities that are barriers to improving our readmission rates?  

7. What is possible for us to work on together? 
♦ Can this smaller group develop a shared goal(s)? What might they be? 
♦ What metrics would we use to measure success? 
♦ Are there ‘subsets’ of the folks we both care for that we might take a closer look at in terms of their readmission practices (e.g. chronic disease, dialysis, “hospital-dependent” patients, etc.)? 

8. Next steps 


posted Feb 18, 2014, 4:32 PM by Dio Telmo   [ updated Feb 18, 2014, 5:44 PM ]

The ALWP was renewed for five years effective March 1, 2009 by the Centers for Medicaid & Medicare Services (CMS).  ALWP  Provider enrollment is currently open to potential providers in the following counties: Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino, Contra Costa, Alameda, San Diego and Riverside.   The ALWP is currently enrolling beneficiaries residing in skilled nursing facilities and in the community into licensed Residential Care Facilities for the Elderly (RCFEs) and Public Subsidized Housing (PSH). 

Project Description

The ALWP is designed to assist Medi-Cal beneficiaries to remain in their community as an alternative to receiving care in a licensed health care facility.  The program provides specified benefits to eligible seniors and persons with disabilities.  Eligible beneficiaries will participate in one of two care provider models: 

  1. In the first model, Assisted Living services are provided to participants who reside in Residential Care Facilities for the Elderly (RCFEs).  In this model, services are delivered by the RCFE staff.  
  2. In the second model, Assisted Living Care services are provided to participants who reside in publicly subsidized housing.  In this model, services are delivered by Home Health Agency staff.

ALWP-eligible individuals are those who are enrolled in Medi-Cal and need the level of care provided in a nursing facility due to their medical needs.  If the individual meets both the financial and health/functional requirements of the program, then she or he can choose to enroll in the ALWP.  To begin the process of enrolling in the ALWP, interested individuals should first contact a Care Coordinator Agency in one of the participating counties.  The Care Coordinator will help determine if the individual is eligible for the program.



History of the Assisted Living Waiver Program (ALWP)

The ALWP was created by legislation that directed the California Department of Health Care Services (DHCS) to develop and implement the projectto test the efficacy of assisted living as a Medi-Cal benefit.  A key goal of the program was to enable low-income, Medi-Cal eligible seniors and persons with disabilities, who would otherwise require nursing facility services, to remain in or relocate to the community. The pilot program was successful during three years in a limited trial in three counties.  In March 2009, CMS approved waiver renewal for an additional five years and expansion of the program into additional counties.  The Department of Health Care Services will continue to oversee the delivery of assisted living services and determine whether those service are being provided cost-effectively and in a manner that assures the safety and well-being of participants. 


What is Assisted Living?

The ALWP defines assisted living based on the standards set by the National Assisted Living Workgroup.   Assisted living is a state regulated and monitored residential long-term care option.  Assisted living provides or coordinates oversight and services to meet the residents’ individualized scheduled needs, based on the residents’ assessments and service plans and their unscheduled needs as they arise.  Assisted living residents have the option of a private room and the ability to prepare simple meals.



Services that are required by state statutes and regulations to be provided or coordinated must include, but are not limited to:

  • 24-hour awake staff to provide oversight and meet the scheduled and unscheduled needs of residents (24-hour awake staff is not required in RCFEs with 6 beds or less)) 
  • Provision and oversight personnel and supportive services (assistance with activities of daily living and instrumental activities of daily living)
  • Health related services including skilled nursing (e.g., medication management services, treatments, wound care, etc.)
  • Social services
  • Recreational activities
  • Meals
  • Housekeeping and laundry
  • Provide or arrange transportation


A resident has the right to make choices and receive services in a way that will promote the resident’s dignity, autonomy, independence, and quality of life. These services are disclosed and agreed to in the contract between the provider and resident.  Assisted living does not generally provide ongoing, 24-hour skilled nursing.  Assisted living units are private occupancy and shared only by the choice of residents (e.g., by spouses, partners or friends).  

Participants in the Assisted Living Waiver Program will have access to three waiver benefits:
  • Assisted Living Services - These services are called the Assisted Living Services when they’re provided in an RCFE and Assisted Care when they’re provided by a licensed Home Health Agency and delivered to residents of publicly-funded housing.
  • Care Coordination - These services include identifying, organizing, coordinating and monitoring services needed by a participant. Care Coordinators conduct assessments to assist in determining eligibility, develop Individualized Service Plans (ISPs), arrange for services, maintain contact with participants, and monitor service delivery on a monthly basis.
  • Nursing Facility Transition Care Coordination - This benefit helps to transition residents from nursing facilities to the community.


Assisted Living Services Include:

  • Assistance in developing and updating ALWP participant's Individualized Service Plans (ISP) which details in part, the frequency and timing of assistance.  Participants play active roles in the development process and must sign their ISP;
  • Providing personal care and assistance with ADLs  and IADLs sufficient to meet both the scheduled and unscheduled needs of the residents;
  • Washing, drying and folding laundry;
  • Performing all necessary housekeeping tasks;
  • Maintaining the facility;
  • Providing three meals per day plus snacks. Food must meet minimum daily nutritional requirements and meet the resident's special dietary needs as prescribed by their PCP;
  • Providing intermittent skilled nursing services as required by residents;
  • In accordance with State law, providing assistance with the self-administration of medications,  or administering medications by an RN or LVN;
  • Providing or coordinating transportation;
  • Providing daily recreational activities;
  • Providing social services;
  • Providing a response system that enables waiver beneficiaries to summon assistance from personal care providers.



To be eligible to participate in the ALWP, you must be enrolled in the Medi-Cal program and be in need of the care provided by a nursing facility. If you meet these requirements, you may be eligible to choose to enroll in the ALWP and receive services as an alternative to long-term placement in a nursing facility. To determine if you are eligible to participate, contact a Care Coordinator Agency in your county.

  • Fact Sheet for New Participants (DOC)
  • Care Coordinator List
  • List of Public Subsidized Housing Facilities and Home Health Agencies.xls
  • RCFE Provider List                                                                                             




    • ALW Assessment Tool


    The ALWP is accepting applications from interested RCFE providers in all participating counites.   Please note that applications from interested RCFE providers will only be accepted by the ALWP Office for those RCFEs that have undergone a comprehensive review from Community Care Licensing (CCL) and are in substantial compliance with all licensing regulations.   

    The initial RCFE and CCA applications consist of two pages and are reviewed by ALWP staff to ensure providers meet the initial criteria for participation in the ALWP.  Once the two page application has been reviewed and approved, the RCFE or CCA applicant must then complete Medi-Cal Provider Enrollment application which consists of three documents: DHCS 6204, DHCS 6207, and DHCS 6208.  

    Before completion of the provider enrollment forms, the CCA and RCFE applicant must have a National Provider Identifier (NPI) number.

    Please Note:  As of January 1, 2013 there is an application fee of $532.00.   The fee must be submitted with your application in a cashier's check only, made payable to the State of California, Department of Health Care Services.   For more information regarding the current fee amount please visit the following website:


    The following is the link to access the ALWP Provider Agreement form.   Please fill out and send along with the initial RCFE or CCA application.

  • For RCFEs interested in providing assisted living care, please access the following link below:

  • For Home Health Agencies/CCAs  interested in providing care coordination services, please access the following link below:

  • For Medi-Cal Provider Enrollment forms, please access the following links below:


    When all documents have been completed please submit them along with a copy of the NPI application receipt showing your NPI number, and the application fee to the address below:   

    Carol Hausler, Chief
    Assisted Living Waiver Unit
    Long-Term Care Division
    Department of Health Care Services
    1501 Capitol Avenue, MS 4503
    P.O. Box 997437
    Sacramento, CA 95899-7437


    A listing of services and rates appears below.  Please note: providers can only bill for Medi-Cal services provided to enrolled clients.

    • Care Coordination:  $200/participant/month


    • Nursing Facility Transition Care Coordination:  $1,000/participant,  a one time fee only.
  • Assisted Living Services:

         Tier 1 -- $52/participant/day
         Tier 2 -- $62/participant/day
         Tier 3 -- $71/participant/day
         Tier 4 -- $82/participant/day

  • Assisted Care in Publicly Funded Housing:

    Tier 1 -- $52/participant/day
    Tier 2 -- $62/participant/day
    Tier 3 -- $71/participant/day
    Tier 4 -- $82/participant/day

  • Room and Board:  All ALWP providers receive room and board (rent) payments from ALWP participants.  The current room and board rate for RCFE assisted living is as follows:

  • $993 per month based on income of $1,122.00 from Social Security (SS) or Supplemental Security Income (SSI), less $129.00 for the personal needs allowance).
    $1,013 per month based on income of $1,142.00 or greater, less $129.00 for the personal needs allowance.       


    Back to Top


    You may reach us directly:
    Long-Term Care Division
    1501 Capitol Avenue, MS 4503
    P O Box 997437
    Sacramento, CA 95899-7437
    Phone: 916-552-9105

    For further information about this Waiver refer to the following page:  Centers for Medicare and Medicaid Services.

    Consumer Voice Releases Joint Statement on the Recent Johnson & Johnson Settlement

    posted Jan 7, 2014, 11:05 AM by Dio Telmo

    On Friday, November 8th, Consumer Voice, California Advocates for Nursing Home Reform, Center for Medicare Advocacy, Long Term Care Community Coalition and the Legal Aid Justice Center in Virginia released a joint statement on the recent Johnson & Johnson settlement, in which the company was ordered by the Department of Justice to pay $2.2 billion in civil and criminal fines for the illegal marketing of Risperdal. Risperdal, an antipsychotic medication approved for the treatment of schizophrenia, was marketed by Johnson & Johnson (J&J) for off-label use among elderly persons with dementia, despite the significant health risks that Risperdal and other antipsychotics pose to this population. The pharmaceutical company was also found responsible for paying kickbacks to physicians and pharmacies to encourage the sale of antipsychotic drugs such as Risperdal and Invega among individuals in long-term care. 

    The joint statement on the J&J settlement, which can be read here, was prepared by Janet Wells, former Director of Public Policy at the Consumer Voice, and calls for improved national action to combat the misuse of antipsychotics like Risperdal among elderly persons with dementia. For additional information on the issue of antipsychotics being wrongly prescribed for the treatment of dementia, go to our website here.

    Cognitive Decline, a Case-Based, Systems Approach to Diagnosis and Management

    posted Mar 11, 2013, 2:15 PM by Dio Telmo   [ updated Mar 11, 2013, 2:18 PM ]


    Joshua Chodosh, MD, MSHS Associate Professor of Medicine

    UCLA / VA

    March 13, 2013 12-1PM, Room 1058 (at KMC).


    A series of lectures addressing practice gaps in clinical application of geriatric patient care.


    Clinicians (e.g. Physicians, Nurses, etc.) and all Auxiliary Personnel.



    Understand the impact of dementia recognition in the hospital setting Understand the essentials for a dementia diagnosis

    Appreciate the variety of presentations that reflect a cognitive disorder

    Distinguish dementia from a variety of presentations

    Appreciate effective dementia management from a systems perspective

    Asking questions that I hope you will want to answer

    Gerontology Film Festival

    posted Mar 7, 2013, 5:59 AM by Dio Telmo

    March 8, 2013

    9:30 am to 2:30 pm

    Location:  Regency Theaters

    East Hills Mall

    3100 Mall View Road


    Sponsored by the Archstone Foundation,

    CSUB Departments of Social Work and Nursing

    and CSUB Associated Students, Inc.


    Join us for a screening of Last Will and Embezzlement and Surfing for Life.  A dialogue after each film led by a panel of experts will explore your own perspectives and those of other participants.  Bring an open mind and your experiences!

    Last Will and Embezzlement features disturbing, first-hand accounts from real-life victims, including Hollywood icon Mickey Rooney, as well as in-depth interviews with experts who discuss such key issues as victim profiles, the perpetrators’ modus operandi, reasons for vulnerability, as well as potential solutions to this ever-increasing worldwide problem.  Written and produced by P.S.K. Glasner and D.L. Robinson. 

    SURFING FOR LIFE, a vibrant and award-winning one-hour documentary about inspiring well-spent lives, offers a totally fresh look at successful aging. Narrated by Beau Bridges, it profiles ten legendary surfers who model healthy aging by staying active and engaged into their 7th, 8th and 9th decades.





    *Please RSVP your attendance to Rose McCleary ( or 661 654 6552).  Lunch will be on your own.  The Theater concession stand will be open to buysnacks during the screenings.  


    posted Mar 7, 2013, 5:27 AM by Dio Telmo

    Effective January 1, 2013

    One Check:

    Room and Board                                 $482.00
    Care and Supervision                           $511.00
    Total to Facility:                                 $993.00
    Personal and Incidental Expense Monies 129.00
    Total Grant:                                       1122.00

    Two Checks:

    Room and Board                                 $482.00
    Care and Supervision                           $511.00
    Voluntary $20.00 Non-Exempt Income     $20.00
    Total to Facility:                                $1013.00
    Personal and Incidental Expense Monies $129.00
    Total Grant:                                      $1142.00

    Note:  Recipients who have income in addition to their SSI/SSP check (for example, a pension, Social Security retirement or disability benefits) can be charged the $993.00 amount for basic services plus an additional $20.00. Because federal rules do not count the first $20.00 of a recipient's income against his/her SSI/SSP grant, an SSI/SSP recipient with other income has an extra $20.00 that people who receive only an SSI/SSP check do not have. Neither federal nor state law restrict the recipient in how this additional $20.00 amount is spent. Thus, if the recipient agrees in the admission agreement to pay the additional $20.00 for basic services, the facility may charge the additional amount.

    Title 22, 87507(c)(4)(A) Admission Agreements, States:  "Agreements involving persons whose care is funded at government-prescribed rates may specify that operative dates of government modifications shall be considered operative dates for basic service rate modifications."  If you accept SSI/SSP residents, you do not have to give a 60-day prior notice of rate increases.

    Be Sure Your Admission Agreement Reflects These Regulations.

    Provided by:
    Community Residential Care Association of California
    PO Box 163270/1924 Alhambra Blvd.
    Sacramento, CA 95816-9270
    (916) 455-0723


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