Thursday, November 14 | Human Services, Cause Connected

A New Hope for Homelessness in California: How CalAIM is Addressing Housing Instability

By Julie Hiett, VP and GM, Population Health

California’s homelessness crisis is among the most severe in the nation. On any given night, more than 161,000 people are experiencing homelessness, with the state accounting for more than half of the unsheltered population in the United States. These individuals not only face challenges finding stable housing but also suffer from health disparities that exacerbate their circumstances. People without stable housing face mortality rates four to ten times higher than the general population, experience more frequent and prolonged hospital stays and are three times more likely to be readmitted to hospitals. 

These statistics underline the need for comprehensive solutions that address both housing instability and health care.

In response to this complex issue, California has implemented a forward-thinking initiative: California Advancing and Innovating Medi-Cal (CalAIM). This program, spearheaded by the state’s Department of Health Care Services (DHCS), is designed to transform Medi-Cal by addressing not just medical needs but also the social determinants of health, such as housing insecurity. By focusing on the whole person, CalAIM aims to bridge the gap between healthcare and housing, offering hope to thousands of Californians experiencing or at risk of homelessness.

 

The CalAIM Approach

At the heart of CalAIM’s approach is a commitment to providing Enhanced Care Management (ECM) and Community Supports, particularly for those facing homelessness. The program’s core mission is to address the root causes of poor health, rather than just treating symptoms. By connecting people to a range of services—from healthcare to housing—CalAIM seeks to break the cycle of instability that so often traps individuals in a downward spiral. 

One of the innovative aspects of CalAIM is its collaboration with community-based organizations (CBOs). Through the Providing Access and Transforming Health (PATH) initiative, CalAIM allocates funds to help these organizations expand their capacity to provide critical services. This approach recognizes that housing is a key factor in health outcomes and that local organizations are uniquely positioned to meet the needs of individuals experiencing homelessness.

 

Housing and Healthcare: A Coordinated Solution

CalAIM’s Community Supports program is particularly vital in addressing housing instability. This program provides a range of housing-related services to Medi-Cal enrollees who are experiencing or at risk of homelessness. 

These services include:

  • Housing transition/navigation services: Helping individuals find and secure stable housing.

  • Housing deposits: Providing financial assistance for move-in costs.

  • Housing tenancy and sustaining services: Offering support to maintain housing stability.

  • Recuperative care (medical respite): A safe place for individuals to recover after a hospital stay.

  • Short-term post-hospitalization housing: Temporary housing to bridge the gap between hospital discharge and long-term housing.

  • Day habilitation: Programs designed to support individuals in developing life skills and independence.

By offering this comprehensive suite of services, CalAIM not only provides immediate relief for those in crisis but also fosters long-term stability. This focus on whole-person health is crucial for reducing the avoidable use of costly healthcare services, such as emergency department visits and extended hospital stays. Instead of waiting for individuals to reach a breaking point, CalAIM offers proactive support to keep people housed and healthy.

 

Coordinating Care Across Systems

One of the key challenges in addressing housing instability is the need for coordination across various systems—healthcare, housing, social services, and community-based organizations. CalAIM’s success hinges on its ability to bring these systems together under a unified strategy. This requires advanced technology platforms and care coordination tools that can handle the complex data-sharing needs of such a multi-faceted program.

By enabling seamless communication between county health departments, healthcare providers and community-based organizations, having the right technology in place ensures that individuals receive the care they need without falling through the cracks. This integrated approach not only improves outcomes for individuals but also reduces the strain on overburdened healthcare systems.

 

A Path Forward Powered by Technology

The challenges of housing instability in California are immense, but CalAIM offers a roadmap for tackling them head-on. By investing in community supports, enhancing care management and fostering collaboration between health and housing services, the initiative is laying the groundwork for a future where fewer Californians are left without a home or access to the care they need.

For healthcare professionals, CalAIM presents an opportunity to be part of this transformative shift. Whether through direct care, policy advocacy, or community partnerships, the healthcare sector plays a pivotal role in ensuring the success of this program. As CalAIM continues to evolve, the lessons learned in California could serve as a model for other states grappling with similar challenges, offering a beacon of hope for all those affected by housing instability across the nation.

Meet the Author

Julie Hiett Blog Photo
Julie Hiett · VP and GM, Population Health

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More