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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

My parent just fell and is in the hospital - what's the first call I should make?

For families in Nassau or Suffolk County, the Office for the Aging in your parent's home county is a good first call - Nassau County Office for the Aging at 516-227-8900, or Suffolk County Office for the Aging at 631-853-8200. Both function as the local NY Connects access point, a free service that helps families understand care options, eligibility, and next steps after a hospital event, without any cost or obligation.

My father was just diagnosed with dementia - what should we be planning for on Long Island?

A new dementia diagnosis typically means starting to think about progressively higher levels of support: from in-home caregiving, to a Special Needs Assisted Living Residence (SNALR)-certified memory care community, to eventually possibly a nursing home. The Nassau (516-227-8900) or Suffolk (631-853-8200) County Office for the Aging can connect families to local resources and benefits counseling as needs evolve, and it's worth confirming any Long Island community marketing memory care actually holds SNALR certification via NYS Health Profiles.

I'm exhausted from caring for my spouse or parent - what support exists for caregivers on Long Island?

Both the Nassau County Office for the Aging (516-227-8900) and Suffolk County Office for the Aging (631-853-8200) serve as local NY Connects access points and can help connect exhausted family caregivers to respite options, including adult day health care, at a New York State median of $144 per day, and in-home caregiver support, at a state median of $35 per hour, which can relieve some of the daily burden without requiring a full residential placement.

We're running out of money to pay privately for my parent's care - what are our options?

Once private funds are running low, the relevant path for most Nassau and Suffolk families is long-term-care Medicaid, a separate, asset-tested eligibility pathway from general ACA Medicaid, which can cover nursing home care, Managed Long Term Care (MLTC)-coordinated home care, the Assisted Living Program (ALP), or NHTD waiver services, depending on the level of need. The county Office for the Aging (Nassau: 516-227-8900; Suffolk: 631-853-8200) is a starting point for understanding which of these pathways may apply.

How do we know it's actually time to move my parent out of their home?

There's no single trigger, but common signals include a recent fall or hospitalization, a new or worsening dementia diagnosis, the primary family caregiver reaching burnout, or private funds running low relative to ongoing care costs, any of which typically prompts a first call to the Nassau (516-227-8900) or Suffolk (631-853-8200) County Office for the Aging to understand available options before deciding.

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