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New York's Assisted Living Program (ALP), Explained

The Assisted Living Program (ALP) is New York's Medicaid pathway that pays for care services inside a licensed Adult Home or Enriched Housing Program.

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Short answer

New York's Assisted Living Program (ALP) is the Medicaid-funded program that pays for care services inside a licensed Adult Home or Enriched Housing Program, for residents who are medically eligible for nursing home placement but can be served in a less medically intensive, lower-cost setting.

What ALP actually covers

ALP, regulated under 18 NYCRR Part 494, covers personal care, housekeeping, supervision, home health aides, personal emergency response systems, nursing, physical/occupational/speech therapy, medical supplies and equipment, adult day health care, home health services, and RN case management -- all delivered inside the ACF.

ALP does not function as a standalone cash voucher; it operates through specific ACFs that participate in the program. Not every Adult Home or Enriched Housing Program on Long Island offers ALP beds, so ask directly whether a specific community participates and whether it currently has ALP capacity.

How to apply

Start with your county's Office for the Aging -- Nassau at 516-227-8900 or Suffolk at 631-853-8200 -- or NY Connects, which can screen for ALP eligibility alongside Managed Long Term Care and the NHTD waiver.

Source: NYSDOH Adult Care Facilities program page

Questions families ask

What is the NHTD Medicaid waiver and could it help my parent stay out of a nursing home?

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver is a federal 1915(c) Home and Community-Based Services waiver administered by NYSDOH through Regional Resource Development Centers. It helps Medicaid-eligible people age 65 and older, and younger people with physical disabilities, who have been assessed as needing nursing-home-level care receive services in the community instead, either transitioning out of a nursing facility or diverting from being admitted to one in the first place.

What is New York's Assisted Living Program (ALP) and how is it different from private-pay assisted living?

The Assisted Living Program (ALP) is New York's Medicaid-funded alternative to nursing home placement, operating inside licensed Adult Homes or Enriched Housing Programs rather than as a separate building type. It serves people who are medically eligible for nursing home care but can safely be served in a less medically intensive, lower-cost setting, covering personal care, room and board, housekeeping, home health aides, nursing, therapy, medical equipment, adult day health care, and RN case management. ALP is regulated under 18 NYCRR Part 494.

My mom is 68 with a low income - does New York's ACA Medicaid expansion cover her nursing home or home care costs?

No. New York's 2014 ACA Medicaid expansion covers a different population: adults ages 19-64 without dependent children, up to 138% of the federal poverty level, with no asset test. Long-term care Medicaid for seniors is a completely separate eligibility pathway - it is asset and resource-tested, applies to people 65 and older or those needing institutional-level care, and is what actually covers nursing home care, MLTC, the ALP, and NHTD waiver services.

How much money can my spouse keep if I go on Medicaid for nursing home care in New York in 2026?

For 2026, the community spouse may generally keep the greater of the state minimum Community Spouse Resource Allowance ($74,820) or half of the couple's countable resources, up to the federal maximum of $162,660. The community spouse is also entitled to a Minimum Monthly Maintenance Needs Allowance of $4,066.50 per month from the institutionalized spouse's income. These figures come from NYSDOH's GIS 26 MA/03 guidance, effective January 1, 2026.

How much spending money is a Medicaid nursing home resident allowed to keep each month in New York?

New York's Nursing Home Resident Personal Needs Allowance is $50 per month - the amount a Medicaid-funded nursing home resident is permitted to keep from their own income for personal expenses, with the rest going toward the cost of their care. According to the NY State Office for the Aging (NYSOFA), this figure has been unchanged since the 1980s, and NYSOFA notes that 33 other states currently pay a higher PNA, ranging from $52 to $200.

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