Aligning Housing and Health Care to Support People Experiencing Homelessness: Opportunities in CalAIM


For people experiencing homelessness (PEH), stable housing a key social determinant of health and can help reduce unnecessary emergency room use and hospital admissions. For people with complex health needs, effective health care supports can help maintain housing.

California’s current policy and budget landscape offer an unprecedented opportunity for the homeless service and health care sectors to come together to effectively outreach PEH, provide comprehensive care and service, and ultimately reduce the number of PEH in California.

CalAIM, the state’s new plan to reform the Medi-Cal system, provides an opportunity to bring the sectors together by offering an avenue for Medi-Cal to cover nontraditional services like housing navigation, one-time housing payments, and tenancy-sustaining services, with Medi-Cal managed care plans (MCPs) taking the lead.

To successfully implement these housing supports, MCPs must engage a broad set of providers, county agencies, and community-based organizations, many of which have not had prior relationships or interactions with MCPs and have limited information technology capacity. Their ability to share and use administrative, health, and social service information is critical to implementing services under Community Supports.

Building Strong Partnerships

To take advantage of the new housing-related opportunities under CalAIM, homeless service providers and MCPs need expert guidance. The Corporation for Supportive Housing (CSH), which offers supportive housing services in over 300 cities and 48 states throughout the US, has been an active CalAIM stakeholder and has experience nationally and in California providing training for MCPs and homeless service providers.

In support of a smooth implementation to CalAIM, CHCF is partnering with CSH to provide training and ongoing technical assistance to MCPs and homeless service providers across the state. This project is designed to equip MCPs and homeless service providers with the information and confidence to form critical partnerships — to strengthen data collection and exchange and to align housing and health care resources, with the goal of scaling the health and housing supports that PEH in California need to thrive. During this two-year project, CSH will:

  • Develop and deliver trainings to help five MCPs optimize the reach and impact of CalAIM’s housing supports and the data exchange practices needed to be effective.
  • Develop and deliver a Medicaid Academy for up to 30 homeless service providers who want to contract with MCPs as providers of housing supports.
  • Conduct an MCP and homeless data sharing review in California. CSH will draw from efforts both locally and nationally to demonstrate how such efforts can support on-the-ground care coordination as well as offer population-level insights for MCPs. A report will highlight data sharing successes and challenges from at least six MCPs across a diverse range of California counties.
  • Produce a policy brief and fact sheets about the various ways housing services are provided under Medicaid and the evidence base for different approaches.

This project launches in January 2022 and will run for 18 months. The first publications are expected in spring 2022 and will be disseminated to key audiences in both the housing and health care sectors and to Sacramento policymakers through webinars, briefings, and other activities.