CalAIM Community Supports: Promoting Independent Living Among Older Adults and People with Disabilities

ATI Advisory


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About the Series

This report is part of the series CalAIM for Seniors and People with Disabilities, which focuses on elevating experiences from California and other states to ensure CalAIM reforms impacting Medi-Cal’s seniors and people with disabilities build on past efforts to integrate and improve care.

Through CalAIM (California Advancing and Innovating Medi-Cal), a multiyear initiative to transform the Medi-Cal program, managed care plans now have the option to offer any of 14 Community Supports that provide person-centered services to address a variety of social drivers of health. Several of these Community Supports could help older adults and people with disabilities remain in their own homes, participate in their communities, and live independently in the setting of their choice.

To support understanding and increased uptake of these services over time, this report provides an overview of and evidence summary for six Community Supports most relevant to supporting independent living for older adults and people with disabilities, including:

  • Respite Services. Short-term services aimed at providing relief to caregivers of those who require occasional or temporary assistance or supervision.
  • Nursing Facility Transition / Diversion to Assisted Living Facilities. Services that help people remain in the community by facilitating transitions from a nursing facility back into a home-like, community setting or prevent nursing facility admissions for those with imminent need.
  • Community Transition Services / Nursing Facility Transition to a Home. Nonrecurring support, including setup expenses, to avoid further institutionalization and help people remain in the community as they return home from a licensed nursing facility.
  • Personal Care and Homemaker Services. Supports for people needing assistance with daily activities, such as bathing, dressing, cooking, eating, and personal hygiene.
  • Environmental Accessibility Adaptations (Home Modifications). Physical adaptations to a home when necessary to ensure health, welfare, and safety, or promote greater independence at home through improved functionality and mobility.
  • Medically Supportive Food / Meals / Medically Tailored Meals. Meal services to help people achieve their nutritional goals at critical times (such as after a hospital or nursing facility stay) to regain and maintain their health.

The accompanying compilation of published studies provides a detailed, sortable collection of literature reviewed on each Community Support described in the report, so readers can dive deeper into the evidence on specific services.

Webinar

Authors of this report and CHCF’s recently released report, CalAIM and Institutional Long-Term Care: Lessons for Medi-Cal Managed Care, jointly presented key findings about the opportunities for both Community Supports and Medi-Cal’s institutional long-term care carve-in to promote community living on a webinar on May 19, 2022. The webinar recording and slides are available here.