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Who can apply?
Who can apply?
Medi-Cal recipients with ZERO share of cost (ok if the application is in the process of approval)
Individuals with the ability to pay rental fees
Individuals who can either make their own decisions or have a written authorized representative to make decisions on their behalf
(DPOA, AHCD, Conservator)Individuals living in one of the following settings:
Home
RCFE/Assisted Living
Congregate Living
With a friend/family member
Homeless
Steps to Apply:
Complete the required Community Intake Packet using one of the links above.
Complete the forms and return them to our office via email or fax.
Once the intake packet is received, your name will be placed on the community waitlist.
Current wait time: 18-24 monthsWait to hear from our office that your name has come to the top of the list.
Additional Forms:
Advanced Healthcare Directive (must be witnessed by two non-family members)
LIC602 Physician’s Report (to be completed by the resident/resident's responsible person; must be signed by a physician and sent to our office)
LIC603 Facility Report (required for current Assisted Living Facility residents, This information may be obtained from the applicant, or his/her authorized representative. (Relatives, social agencies, hospital or physician may assist the applicant in completing this form.) This form is not a substitute for the Physician’s Report (LIC 602).
Have you been admitted to a skilled nursing facility or hospital? CLICK HERE to apply.
Do you have an active APS Case? CLICK HERE to apply.
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