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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.

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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

¿Qué Apoyos comunitarios se ofrecen?

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Servicios de navegación de vivienda

Ayuda a los miembros a encontrar un hogar adecuado mediante una evaluación de vivienda, crear un plan de apoyo, buscar opciones y asegurar un lugar donde vivir.
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Depósitos para vivienda

Ayuda a los miembros a establecer un hogar básico con financiamiento para costos únicos, como el depósito de seguridad, tarifas/depositos de instalación de servicios públicos, limpieza única, muebles y/u otros artículos.

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Servicios de arrendamiento y mantenimiento de la vivienda

Apoyo para que los miembros conserven su hogar de manera segura y estable. Esto incluye educación sobre los derechos y responsabilidades del inquilino y el propietario, asesoría para construir y mantener una buena relación con su propietario, y apoyo continuo en actividades relacionadas con la administración del hogar.
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Atención de recuperación (relevo médico)

Cuidado residencial a corto plazo para miembros que necesitan un lugar seguro para recuperarse después de una enfermedad o lesión, sin requerir hospitalización.
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Alojamiento a corto plazo después de una hospitalización

Brinda a los miembros sin hogar y con necesidades médicas o de salud mental y del comportamiento complejas un lugar donde continuar su recuperación médica, psiquiátrica o por trastornos por consumo de sustancias tras salir de un hospital, centro de tratamiento residencial, correccional, de salud mental, de enfermería o de atención de recuperación.
Provider speaking with senior in a home

Programas de habilitación diurna

Apoyo para que los miembros desarrollen, mantengan y mejoren sus habilidades de autonomía, socialización y adaptación para vivir con éxito en su entorno habitual.
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Comidas adaptadas a necesidades médicas

Se proporcionan comidas o alimentos diseñados especialmente para cubrir las necesidades nutricionales de los miembros después de ser dados de alta de un hospital o centro de enfermería.
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Centro de desintoxicación

Ofrece una opción para los miembros que se encuentran en un estado de ebriedad o bajo los efectos de sustancias en espacios públicos. Este servicio les permite evitar tener que acudir innecesariamente a la sala de emergencias. Aquí se les ofrece un lugar seguro y vigilado mientras pasan los efectos de las sustancias.
Home help provider assisting man with shaving

Servicios de cuidado personal y tareas del hogar

Apoyo a los miembros con actividades cotidianas, como bañarse o comer, así como las actividades instrumentales de la vida diaria, como la preparación de alimentos o manejo financiero.
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Servicios de relevo

Brinda servicios y apoyo a los cuidadores de los miembros para que puedan tomar un descanso.
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Adaptaciones de accesibilidad en el hogar (modificaciones)

Realiza modificaciones físicas en el hogar que sean necesarias para garantizar la salud, el bienestar y la seguridad del miembro, o para permitirle mayor independencia y prevenir su ingreso a una institución.
Asthma inhaler

Remediaciones para el asma

Realiza modificaciones físicas en el hogar que sean necesarias para garantizar la salud, el bienestar y la seguridad del miembro, o que le ayuden a desenvolverse mejor en el hogar y disminuir episodios graves de asma que podrían requerir atención de emergencia u hospitalización.
Home help provider talking with man on sofa

Transición desde un centro de enfermería

Apoya a los miembros en su transición desde un centro de enfermería hacia un entorno comunitario similar a un hogar.
Home help provider greeting man at door

Servicios de transición a la comunidad

Brinda asistencia a los miembros para que puedan salir de un centro de enfermería y reintegrarse a un entorno comunitario similar a un hogar.

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.

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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