What is New York's Assisted Living Program (ALP), and how is it different from a nursing home Medicaid waiver?
Short answer: The ALP is a Medicaid State Plan service (not a 1915(c) waiver) delivered inside a licensed Adult Home or Enriched Housing Program, covering personal care, nursing, and therapies — but not room and board — for residents who need more than adult-home-level support but not full nursing home care.
A common point of confusion is treating ALP like a typical "HCBS waiver" — it technically isn't one, which matters because State Plan services and 1915(c) waivers can have different enrollment caps, appeal rights, and administrative processes. ALP is capped at roughly 4,200 slots statewide, so not every eligible person gets a slot immediately, and not every ALR-licensed community in the Buffalo metro participates in the program even if it holds an ALR license. If ALP is part of your family's plan, ask a specific community directly: do you hold ALP certification, how many current residents use it, and is there a waitlist for new ALP admissions at this location specifically.
