CalAIM Community Supports: New California Medi-Cal Home Care Benefits

California Advancing and Innovating Medi-Cal (CalAIM) is one of the most ambitious Medicaid reforms in the country. Launched in 2022 and fully phased in through 2027, CalAIM expands Medi-Cal beyond traditional medical care to include a menu of Community Supports that pay for in-home services, housing assistance, medically tailored meals, and other social drivers of health. For Medi-Cal members who would otherwise need higher levels of care, these benefits can make staying at home affordable and safe.

What Is CalAIM?

CalAIM is a multi-year initiative led by the California Department of Health Care Services (DHCS) to transform Medi-Cal into a more coordinated, person-centered, and equity-focused program. Two of its centerpiece elements are Enhanced Care Management (ECM) and Community Supports, both delivered through Medi-Cal managed care plans like Anthem Blue Cross, Kaiser Permanente, Health Net, L.A. Care, and others.

The 14 Community Supports Available

Community Supports are pre-approved services that managed care plans can offer to eligible members in place of, or in addition to, more costly medical care. The 14 statewide Community Supports include:

1. Housing transition navigation services (helping members find and move into housing).
2. Housing deposits (security deposits, first month rent, utility setup).
3. Housing tenancy and sustaining services (helping members stay housed).
4. Short-term post-hospitalization housing.
5. Recuperative care (medical respite for unhoused members after hospital discharge).
6. Day habilitation programs.
7. Nursing facility transition or diversion to assisted living.
8. Community transition services (moving from a nursing home back to the community).
9. Personal care and homemaker services.
10. Environmental accessibility adaptations (home modifications such as ramps and grab bars).
11. Medically tailored meals or medically supportive food.
12. Sobering centers.
13. Asthma remediation (home environmental improvements).
14. Respite services for family caregivers.

How Community Supports Pay for Home Care

Three Community Supports directly fund in-home care:

Personal Care and Homemaker Services

For Medi-Cal members who do not qualify for IHSS but still need help with bathing, dressing, meal prep, light housekeeping, or other daily activities, this benefit pays an approved home care agency to provide the services. It is particularly useful for members who are in a higher Medi-Cal share-of-cost bracket or whose IHSS application is pending.

Respite Services

Family caregivers of Medi-Cal members can receive paid respite care so they can take a break, attend to their own health, or work without interruption. Hours and frequency vary by managed care plan.

Environmental Accessibility Adaptations

One-time payments for grab bars, wheelchair ramps, stair lifts, walk-in showers, and other home modifications that make it possible for the member to remain at home safely.

Who Is Eligible?

Community Supports are available to Medi-Cal managed care members who fall into one or more of the following Populations of Focus:

• Adults and seniors with complex physical, behavioral, or developmental needs.
• Members at risk of long-term institutional care.
• Members transitioning out of a nursing facility.
• Members experiencing homelessness or housing instability.
• Adults with serious mental illness or substance use disorders.
• Children and youth with complex needs.
• Adults released from incarceration who have a chronic condition.
• Pregnant and postpartum members at high risk.

Each managed care plan decides which of the 14 Community Supports to offer in its service area, and which Populations of Focus to prioritize. The list is expanding every year.

How to Access Community Supports

1. Confirm Medi-Cal enrollment and managed care plan membership.
2. Call your managed care plan's member services line and ask about Enhanced Care Management and Community Supports.
3. Request a referral, or work with an existing care manager to submit one.
4. The plan reviews the request and authorizes services through a contracted Community Supports provider.
5. Services begin, typically within a few weeks.

Enhanced Care Management (ECM)

ECM is a separate benefit that provides a single dedicated care manager who coordinates all of a member's medical, behavioral, social, and long-term services. ECM care managers are often the gateway to Community Supports because they identify needs and submit referrals on the member's behalf. If your loved one has multiple chronic conditions or recent hospitalizations, ask the managed care plan whether they qualify for ECM.

How CalAIM Differs from IHSS and HCBS Waivers

• IHSS pays family caregivers and is administered by counties.
• HCBS waivers have functional and waiting list requirements.
• CalAIM Community Supports are delivered by managed care plans through contracted agencies, often without long waiting periods.

Members can stack benefits. For example, IHSS may cover 120 hours of family caregiver time, while a CalAIM personal care benefit covers an additional 20 hours per week from a contracted agency, plus medically tailored meals and respite care.

Read our related guides on California IHSS and Medicaid HCBS waivers.

Estimate Your Family's Need

Before calling your managed care plan, document the help your loved one needs each day. Use our free Care Needs Assessment and Care Hours Estimator to make the conversation more productive.

Need Professional Home Care?

While CalAIM benefits are being approved, your loved one may need help right away. A licensed home care agency provides professional in-home care that can bridge the gap and continue alongside Community Supports. Visit a licensed home care agency or use our free Find Your Care Match tool for a personalized recommendation in minutes.