Alabama · waiver service
Alabama Community Transition (ACT) Waiver in Alabama
The ACT Waiver helps people with disabilities or long-term illnesses move out of a nursing home or other institution and back home. It pays for transition help and ongoing home care. Members can choose Personal Choices to hire their own caregiver, including a family member.
Also called: ACT Waiver · Alabama Community Transition Waiver · Gateway to Community Living
Who do you care for?
Quick facts
- Pay
- $2,320/month
- Adult children & other relatives
- Sometimes
- Spouse
- Sometimes
- Parent of a minor child
- Not right now
- Waitlist
- capped
Who qualifies for Alabama Community Transition (ACT) Waiver
- Currently living in a nursing facility or other institution and wanting to move home; Alabama rules point to people who have lived in a facility at least 90 days.
- Has a disability or long-term illness and meets nursing facility level of care.
- Income up to $2,982/month and resources up to $2,000 (2026 Alabama Medicaid handout).
- No age limit is published.
Who can be paid as the caregiver
- Adult children & other relatives Sometimes
- through Personal Choices, members can hire relatives such as adult children.
- Spouse Sometimes
- only through Personal Choices and only in some cases.
- Parent of a minor child Not right now
- no parent-of-minor payment rule is published for ACT.
- Living together
- not required.
Who employs the caregiver: Either. Agency services by default; Personal Choices lets the member be the employer with a financial management services agency.
Spouse rules differ by program — see spouse pay in Alabama.
How much Alabama Community Transition (ACT) Waiver pays
$2,320/month. No family-caregiver wage is published. Under Personal Choices the member's budget is set by the needs assessment; reported budgets reach about $2,320/month. Agency workers are paid by their agency.
Hours and budget: An ACT case manager and a Medicaid transition coordinator plan the move and the ongoing services. Services include case management, transitional assistance (such as deposits and furnishings), personal care, homemaker, adult day health, meals, respite, skilled nursing, companion, home modifications and assistive technology.
Compare with other Alabama programs on the Alabama caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
Slots are limited. The state says most transitions happen within 180 days of the application date.
How to apply for Alabama Community Transition (ACT) Waiver
- Call the Alabama Department of Senior Services at 1-877-425-2243 (the ACT contact on Alabama Medicaid's 2026 handout).
- A transition coordinator and ACT case manager review eligibility and plan the move.
- Complete the Medicaid financial and level-of-care review.
- After enrollment, ask about Personal Choices if you want a family member to be the paid caregiver.
- Alabama Department of Senior Services (ACT Waiver) · 1-877-425-2243 · official site
- Alabama Medicaid – ACT Waiver · official site
Find out in 2 minutes
Answer 5 easy questions. See your programs and pay before you share any contact info.
Alabama Community Transition (ACT) Waiver questions
Who is the ACT Waiver for?
People living in a nursing home or similar facility who want to move back to a home or community setting and who need nursing-home-level care.
Can a family member be paid under the ACT Waiver?
Yes, through Personal Choices. The member gets a budget and can hire a relative, such as an adult child, as the caregiver.
How long does the transition take?
The Alabama Department of Senior Services says most transitions happen within 180 days of the application date.
Does ACT help with moving costs?
Yes. Transitional assistance can help with costs like security deposits, utility hookups and basic household furnishings.
Is there an age limit?
No age limit is published. The main medical test is needing nursing facility level of care.
Sources: medicaid.alabama.gov · alabamaageline.gov · medicaid.alabama.gov · medicaidplanningassistance.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Alabama caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Alabama — pick yours for the local picture.
Across the line
States that border Alabama
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.