California has been wrestling for decades with an ever-increasing homeless population. From the Bay Area to the Los Angeles Basin, the number of unhoused persons grows exponentially each year. 

Now a fledgling program is striving to combat the crisis in an effective way by harnessing forces from Medi-Cal. It can’t arrive any sooner as the homeless epidemic has touched practically every community statewide, every news cycle, every political campaign, and every individual going about their day in the public square.

CalAIM (California Advancing and Innovating Medi-Cal) is a $6 billion initiative stretched out over the next five years to address the social forces shaping health. It’s designed to help meet the social needs of many of the state’s most vulnerable residents. Many working with the Los Angeles’s homeless population hope the new program will offer a solution to mentally ill individuals living on the streets. 

CalAIM is the culmination of years of research showing that social factors — often beyond individual control — can have a significant impact on a person’s quality of life and certainly medical care. Its large package of reforms is aimed at (1) reducing health disparities by focusing attention and resources on Medi-Cal’s high-risk, high-need populations. (2)  Restructuring behavioral health service delivery and financing. (3) Transforming and streamlining managed care and, (4) Federal funding opportunities with a focus on inpatient mental health services. 

In the latter instance, persons with an ongoing  severe mental illness — as well as those in the midst of a “severe emotional disturbance” — would be cared for during a short-term stay in a psychiatric hospital or a residential mental health facility.

“It’s about making it more integrated and seamless for [Medi-Cal] beneficiaries,” said Jacey Cooper, California state Medicaid director. “For someone who is vulnerable, it’s making sure the right services and supports are being offered to them.”

Cooper highlighted a number of specific initiatives and services of CalAIM, among them managed health care plans, or a “person-centered” strategy that includes assessments of each beneficiary’s health risks and health-related social needs. This approach, she said, centers on a focus on wellness and prevention; it provides care management/transitions across all delivery systems.

“Prior to CalAIM, there was no full continuum of care for the homeless,” Cooper explained. “There are teams on the street now to look after and better monitor behavioral health needs.” 

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