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Supportive housing in Orange County

CalAIM Resources and Funding Opportunities

CalAIM is a transformative five-year initiative redefining Medi-Cal to enhance members’ health outcomes and quality of life. By addressing social drivers of health and delivering comprehensive whole-person care, CalAIM provides coordinated services for physical, behavioral and long-term care needs. With a focus on equity and prevention, it extends critical support into communities, better serving California’s most vulnerable populations, including those experiencing homelessness, seniors and children with complex medical needs.

Toolkits
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Visit the DHCS CalAIM page

DHCS CalAIM

CalAIM has three primary goals

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1

Identify and manage member risk and needs through whole-person care approaches and address social determinants of health

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2

Move Medi-Cal to a more consistent and seamless system by reducing complexity and increasing flexibility

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3

Improve quality outcomes, reduce health disparities and drive delivery system transformation and innovation through value-based initiatives, modernization of systems and payment reform

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KEY FEATURES

CalAIM Components

To better identify and manage the risk and needs of members who may be challenged with medical and behavioral conditions, lack of access to care or chronic illnesses and disabilities, CalAIM is a whole-system, person-centered approach that will result in a better quality of life for members, as well as long-term cost savings and avoidance. Components of this system include:

  • A statewide population health management strategy
  • A statewide Enhanced Care Management (ECM) benefit
  • Implementation of optional Community Supports
  • Implementation of incentive payments for plans and providers
  • Participation in the serious mental illness (SMI)/serious emotional disturbance (SED) demonstration
  • Required screening for and enrollment in Medi-Cal prior to release from county jail
  • A pilot with full integration of physical health, behavioral health and oral health under one contracted entity in a county
  • A long-term plan for foster care children and youth

Community Supports

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Housing Transition Navigation Services

Helps members to find housing including but not limited to conducting a housing assessment, developing a housing support plan, searching for housing and securing housing.
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Housing Deposits

Helps members establish a basic household with funding for one-time costs, like a security deposit, setup fees/deposits for utilities, one-time cleaning, furniture and/or other goods.

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Housing Tenancy and Sustaining Services

Helps members stay safe and stable in a home once they are housed. This can include education on the rights and responsibilities of the tenant and landlord, coaching on developing and maintaining a relationship with the landlord, and ongoing support with activities related to household management.
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Recuperative Care (Medical Respite)

Provides members with short-term residential care when they need a safe place to heal from an injury or illness, but no longer need to be hospitalized.
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Short-Term Post-Hospitalization Housing

Provides members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical/ psychiatric/substance use disorder recovery immediately after exiting an inpatient hospital, residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care.

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Day Habilitation Programs

Assists members in acquiring, retaining and improving self-help, socialization and adaptive skills necessary to reside successfully in the member’s natural environment.
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Medically Tailored Meals

Provides members with medically tailored meals or groceries following discharge from a hospital or nursing home to meet their unique dietary needs.
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Sobering Center

Offers an alternative for members who are found to be publicly intoxicated or otherwise under the influence of drugs, to enable them to avoid an unnecessary emergency department visit while still providing a medically safe place for them as the effects of the substance(s) wear off.
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Personal Care and Homemaker Services

Assists members with activities of daily living, such as bathing or feeding, and instrumental activities of daily living, such as meal preparation or money management.
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Respite Services

Provides services and support to caregivers of members to allow them to rest or take a break.
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Environmental Accessibility Adaptions (Home Modifications)

Makes physical adaptations to a home environment that are necessary to ensure member health, welfare and safety, or enable members to function with greater independence in the home and avoid institutionalization.
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Asthma Remediation

Makes physical modifications to a home environment that are necessary to ensure member health, welfare and safety, or enables members to function in the home and remediates acute asthma episodes that could result in the need for emergency services and hospitalization.
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Nursing Facility Transition

Helps members transition out of nursing facilities and back into a home-like, community setting.
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Community Transition Services

Allows members to live in the community and avoid further institutionalization.

Enhanced Care Management

Enhanced Care Management (ECM) is a new statewide Medi-Cal benefit available to select populations of focus that addresses the clinical and non-clinical needs of the highest-utilizing members through intensive coordination of health and health-related services. ECM meets members wherever they are — on the street, in a shelter, in their doctor’s office or at home. Members have a single lead care manager who will coordinate care and services among the physical, behavioral, dental, developmental and social services delivery systems, making it easier for them to get the right care at the right time.

Populations of focus:

  • Individuals and families experiencing homelessness
  • Adults, youth and children who are high utilizers of avoidable emergency department, hospital or short-term skilled nursing facility services
  • Adults with serious mental illness or substance use disorder
  • Children and youth with serious emotional disturbance, identified to be at clinical high risk for psychosis or experiencing the first episode of psychosis
  • Adults and youth who are incarcerated and transitioning to the community
  • Adults at risk of institutionalization and eligible for long-term care
  • Adult nursing facility residents transitioning to the community
  • Children and youth enrolled in California Children’s Services (CCS) with needs beyond CCS
  • Children and youth involved in child welfare (including those with a history of involvement in welfare and foster care up to age 26)
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Toolkits and Forms

Explore CalOptima Health’s tailored resources to support CalAIM implementation. Access shareable multilingual flyers, brochures and clinical tip sheets designed to help providers deliver whole-person care and connect members to critical services.

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Shareable CalAIM Community Supports Flyers

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Shareable CalAIM ECM Flyers

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CalAIM Provider Materials

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CalAIM ECM Referral Form

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CalAIM Community Supports Referral Form

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CalAIM Recuperative Care/Short-Term Post-Hospitalization Referral Form

Frequently Asked Questions

Open Funding Opportunities

None at this time

    Prior Funding Opportunities

    Housing and Homelessness Incentive Program (HHIP)

    To address health disparities and social determinants of health, CalOptima Health earned incentive funds from the Department of Health Care Services for making investments and progress in addressing homelessness and keeping people housed. Those funds were coupled with Board-approved dollars, and grants were awarded through a competitive application process.

    Prior Funding Opportunities

    Incentive Payment Program (IPP)

    The CalAIM Incentive Payment Program supports the implementation and expansion of Enhanced Care Management (ECM) and Community Supports by incentivizing managed care plans, including CalOptima Health, to invest in provider capacity and delivery system infrastructure, integrate physical and behavioral health, reduce health disparities and promote health equity, and achieve improvements in quality performance.

    Prior Funding Opportunities

    Homeless Clinic Access Program (HCAP)

    The Homeless Clinic Access Program provides accessible, reliable and quality medical care for members experiencing homelessness in Orange County by coordinating mobile clinics at shelter sites. The incentive dollars fund partnerships between homeless shelters and Federally Qualified Health Centers or community health centers.

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