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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

提供哪些的社區支援呢？

Woman smiling at door holding a folder

過渡性住房導航服務

幫助會員尋找住房，包括但不限於進行住房評估、制定住房支持計劃、尋找住房和保障住房。
Family with keys to a home

住房押金

帮助会员建立一个基本家庭，提供一次性费用的资助，例如押金、水电设置费用/押金、一次性清洁、家具和/或其他物品。

People shaking hands

房屋租賃和維護服務

幫助會員在被安置住所後在家中保持安全和穩定。這可以包括關於租戶和房東的權利和責任的教育，關於發展和維持與房東關係的指導，以及對家庭管理相關活動的持續支持。
Man assisting senior with crutches

康復護理（醫療暫息）

當會員需要一個安全的地方從受傷或疾病中恢復過來，但不再需要住院時，為他們提供短期住宿護理。
Caregiver assisting man in wheelchair

出院後的短期住房

為沒有住所且有高度醫療或行為健康需求的會員提供在離開醫院住院、住宿式藥物濫用障礙治療或康復的設施、住宿式心理健康治療設施、懲教處、療養院或康復護理後立即可以繼續使用其醫療/精神病/藥物濫用障礙康復服務的機會。
Provider speaking with senior in a home

日間適應訓練計劃

協助會員獲得、保持和提高在會員的自然環境中成功居住所必需的自助、社交和適應技能。
People discussing diet plan

醫學定制膳食

為會員提供從醫院或療養院出院後的醫學定制膳食或雜貨，以滿足他們獨特的飲食需求。
Man with hand on back of another

戒毒戒酒中心

為被發現在公共場合醉酒或受藥物影響的成員提供替代方案，使他們能夠避免不必要的急診就診，同時在藥物作用消退時仍為他們提供醫療安全的場所.
Home help provider assisting man with shaving

個人護理和家務服務

協助會員進行日常生活活動，例如洗澡或餵食，以及日常生活中的工具性活動，例如膳食準備或資金管理。
Home health provider discussing notes with patient

暫托服務

為會員的看護者提供服務和支持，讓他們休息或休息。
Woman in wheelchair at kitchen sink

無障礙環境的適應（居家改造）

對確保成員健康、福利和安全所必需的家庭環境進行身體適應，或使成員能夠在家中以更大的獨立性運作並避免住院。
Asthma inhaler

哮喘治療

對家庭環境進行必要的物理改造以確保成員的健康、福利和安全，或使成員能夠在家中工作並糾正急性哮喘發作可能導致需要緊急服務和住院治療。
Home help provider talking with man on sofa

療養院過渡

幫助成員從療養院過渡到像家一樣的社區環境。
Home help provider greeting man at door

社區過渡服務

幫助成員從療養院過渡到像家一樣的社區環境。

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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