Rochester Senior AdvisorWhat is New York's Assisted Living Program?
The Assisted Living Program (ALP), created under Social Services Law 461-l, is a Medicaid-paid package of personal care, home health aide, nursing, therapy and case management services delivered inside a licensed adult home or enriched housing program to people who are medically eligible for nursing home placement.
It exists to keep people out of nursing homes who could live safely in a less medical setting at lower public cost. The residence must hold ALP approval for a set number of beds. In the 2026 Q2 capacity report, 7 Rochester-area residences hold Assisted Living Program beds, 307 in all: Cobbs Hill Manor (93), Cirrus Manor Residential Center (57), Horizons (47), Woodcrest Commons (42), The Terrace at Newark (32), Heathwood Assisted Living at Penfield (25), Fairport Baptist Homes Adult Care Facility (11).
Who qualifies for an Assisted Living Program bed?
A person must be medically eligible for nursing home placement but not need continuous nursing care, be able to live safely in the ALP setting, and be financially eligible for Medicaid, or able to pay privately for the ALP services.
An assessment by the ALP provider and the resident's physician decides the medical side. The financial side follows the same New York Medicaid rules as other long-term care, including the 2026 income level of $1,836 a month for a single person.
How does an Assisted Living Program resident pay room and board?
Room and board is paid from the resident's own income, and residents on SSI receive New York's Congregate Care Level 3 rate, $1,688 a month in 2026 ($994 federal plus a $694 state supplement), keeping a $262 personal needs allowance while the residence receives $1,426.
That fixed rate is why ALP beds are limited and often have waiting lists: the residence accepts a set monthly amount for room and board no matter what the market rate is. Ask any ALP residence how long its list is and whether it holds beds for hospital discharges.
How is the Assisted Living Program different from private assisted living?
Private assisted living charges a market monthly rate and Medicaid pays nothing toward it, while the Assisted Living Program fixes room and board at the SSI level and has Medicaid pay for the care, in exchange for the resident meeting nursing-home medical criteria.
Several Rochester-area residences run both kinds of beds under one roof. A resident who starts as private pay and later qualifies for Medicaid may be able to move into an ALP bed in the same building, if one is open. That is worth asking about before admission.
Can someone in the Assisted Living Program also get hospice?
Yes; an ALP resident can elect Medicare hospice and stay in the residence, with the hospice team adding comfort care to the ALP services, provided the residence and hospice agree the resident's needs can be met there.
Hospices with offices in the five counties include UR Medicine Hospice and Rochester Regional Health Hospice Care; see the home care and hospice roster.
At a glance
| The Assisted Living Program is | The Assisted Living Program is not | |
|---|---|---|
| Payment | Medicaid for care, SSI-level room and board | Free room and board |
| Eligibility | Nursing-home medical eligibility | For anyone who wants assisted living |
| Where | Approved beds in adult homes and enriched housing | Available in every residence |
| Wait | Often a waiting list | Immediate in most buildings |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
