Attachment_F_–_Transformation_of_Medi-Cal_Community_Supports.pdf

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Transformation of Medi-Cal:

Community Supports

Community Supports are services provided by Medi-Cal managed care plans (MCP) to address Medi-Cal members’ health-related social needs, help them live healthier lives, and avoid higher, costlier levels of care. Members may receive a Community Supports service if they meet the eligibility criteria and if the MCP determines it is a medically appropriate and cost-effective alternative to services covered under the California Medicaid State Plan.

All MCPs are encouraged to offer as many of the following 15 Community Supports as possible.

Members, their caregivers, and providers can contact MCPs directly to learn which Community Supports are offered that members may be eligible to receive and the eligibility requirements for each service.

COMMUNITY SUPPORTS

Transitional Rent Covers up to six months of rent for members who are experiencing or at risk of homelessness and meet certain additional eligibility criteria. Transitional Rent is designed to provide a time-limited opportunity to help a member exit homelessness, or no longer be at risk of entering into homelessness, and establish a bridge to permanent housing.

Housing Transition Navigation Services Members experiencing homelessness or at risk of experiencing homelessness receive help to find, apply for, and secure housing.

Housing Deposits Members receive assistance with housing security deposits, utilities set-up fees, first and last month’s rent, and first month of utilities. Members can also receive funding for medically necessary items like air conditioners, heaters, and hospital beds to ensure their new home is safe for move-in.

Housing Tenancy and Sustaining Services Members receive support to maintain safe and stable tenancy once housing is secured, such as coordination with landlords to address issues, assistance with the annual housing recertification process, and linkage to community resources to prevent eviction.

https://www.dhcs.ca.gov/enhancedcaremanagementandinlieuofservices https://www.dhcs.ca.gov/individuals/Pages/MMCDHealthPlanDir.aspx https://www.dhcs.ca.gov/Get-Medi-Cal/Pages/default.aspx https://www.facebook.com/MediCalDHCS/ https://instagram.com/medicaldhcs https://www.youtube.com/@MediCal_DHCS https://www.tiktok.com/@medical_dhcs https://bsky.app/profile/medi-cal.bsky.social https://linktr.ee/medicaldhcs

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COMMUNITY SUPPORTS

Short-Term Post- Hospitalization Housing Members who do not have a residence, and who have high medical or mental health and substance use disorder needs, receive short-term housing for up to six months to continue their recovery. To receive this support, members must also have been discharged from an inpatient clinical setting, residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care.

Recuperative Care (Medical Respite) Members with unstable housing who no longer require hospitalization, but still need to heal from an injury or illness, receive short-term residential care. The residential care includes housing, meals, ongoing monitoring of the member’s condition, and other services like coordination of transportation to appointments.

Respite Services This provides short-term relief for member caregivers. Members may receive caregiver services in their home or in an approved facility on an hourly, daily, or nightly basis as needed.

Day Habilitation Programs Members who are experiencing homelessness, are at risk of experiencing homelessness, or formerly experienced homelessness, receive mentoring by a trained caregiver on the self-help, social, and adaptive skills needed to live successfully in the community. These skills include the use of public transportation, cooking, cleaning, managing personal finances, dealing with and responding appropriately to governmental agencies and personnel, and developing and maintaining interpersonal relationships. This support can be provided in a member’s home or in an out-of-home, non-facility setting.

Nursing Facility Transition/Diversion to Assisted Living Facilities Members living at home or in a nursing facility are transferred to an assisted living facility to live in their community and avoid institutionalization in a nursing facility, when possible. Assisted living facilities provide services to establish a community facility residence, such as support with daily living activities, medication oversight, and 24-hour onsite direct care staff.

Community Transition Services/Nursing Facility Transition to a Home Members transitioning from a nursing facility to a private residence where they will be responsible for their own expenses, receive funding for set-up services, such as security deposits, set-up fees for utilities, and health-related appliances, such as air conditioners, heaters, or hospital beds.

https://www.dhcs.ca.gov/Get-Medi-Cal/Pages/default.aspx https://www.facebook.com/MediCalDHCS/ https://instagram.com/medicaldhcs https://www.youtube.com/@MediCal_DHCS https://www.tiktok.com/@medical_dhcs

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COMMUNITY SUPPORTS

Personal Care and Homemaker Services Members who require assistance with Activities of Daily Living or Instrumental Activities of Daily Living receive in-home support, such as bathing or feeding, meal preparation, grocery shopping, and accompaniment to medical appointments.

Environmental Accessibility Adaptations (Home Modifications) Members receive physical modifications to their home to ensure their health and safety and allow them to function with greater independence. Home modifications can include ramps and grab-bars, doorway widening for members who use a wheelchair, stair lifts, or making bathrooms wheelchair accessible.

Medically-Supportive Food/Medically Tailored Meals Members receive deliveries of nutritious, prepared meals and healthy groceries to support their health needs. Members also receive vouchers for healthy food and/or nutrition education.

Sobering Centers Members who are found to be publicly intoxicated are provided with a short-term, safe, supportive environment in which to become sober. Sobering centers provide services such as medical triage, a temporary bed, meals, substance use education and counseling, and linkage to other health care services.

Asthma Remediation Members receive physical modifications to their homes to avoid acute asthma episodes caused by environmental triggers like mold. Modifications can include filtered vacuums, dehumidifiers, air filters, and ventilation improvements.

https://www.dhcs.ca.gov/Get-Medi-Cal/Pages/default.aspx https://www.facebook.com/MediCalDHCS/ https://instagram.com/medicaldhcs https://www.youtube.com/@MediCal_DHCS https://www.tiktok.com/@medical_dhcs