Medi-Cal programs

 

Kaiser Permanente offers the following Medi-Cal programs:

  • Enhanced Care Management
  • Community Supports
  • Community Health Workers

These programs are for Medi-Cal members with complex health needs. They may need more care and help in the community. These services are optional. They are in addition to the Medi-Cal benefits covered for all members.

ECM gives you an extra layer of support to help coordinate your care. ECM is free for eligible Medi-Cal members who need more help with health and daily needs. If you enroll in ECM, you will have one lead care manager who works with your doctors, specialists, mental health providers, and other members of your care team. Your lead care manager makes sure everyone works together and you get the care and services you need when you need them.

These extra services are offered as part of your current Kaiser Permanente Medi-Cal plan. You will keep the Medi-Cal services you get now. You can still see your same doctors, but now you can get extra help.

Ways ECM can help you:

  • Coordinating care for your medical, dental, mental health, and social needs
  • Helping you take your medications as directed
  • Helping you make and keep medical appointments
  • Creating a care plan that fits your health goals
  • Helping you find and apply for services and programs
  • Connecting you to community resources – this can include housing, food, transportation, and other Community Supports services
  • Helping you move safely back home from a hospital or nursing facility
  • Helping you and your family stay healthy

ECM is your choice. If you qualify, you can choose to join or leave the program at any time.

If you’re already enrolled in ECM, you can ask for a new ECM provider or lead care manager. Call one of the ECM providers we work with, Monday through Friday from 8:30 a.m. to 4 p.m.

ECM is for Medi-Cal members who need extra help with their health, mental health, or daily needs. You must meet the rules for ECM services.

If you’re an adult, you may qualify if: 1

  • You and your family are homeless or do not have a stable place to live
  • You had 5 or more emergency room visits or 3 or more unplanned hospital or short-term skilled nursing facility stays in the last 6 months
  • You have a serious mental health need or problems with drugs or alcohol
  • You are getting out of jail or prison
  • You are at risk of moving into a nursing home
  • You live in a nursing home and need help moving back to the community
  • You are pregnant or had a baby in the last year and are Black, American Indian, Alaska Native, or Pacific Islander

    If you’re under age 21, you may qualify if: 1

    • You are homeless or do not have a stable place to live
    • You had 3 or more emergency visits, or 2 or more unplanned hospital or short-term skilled nursing facility stays in the last 12 months
    • You have a serious mental health need or problems with drugs or alcohol
    • You are part of California Children’s Services (CCS) or Whole Child Model (WCM) and:
      • Need extra help with things like housing, food, transportation, or behavioral health services
      • Have a mental health or substance use crisis
      • Had recent contact with police
    • You are in foster care or have a history of being in a child welfare program or foster care
    • You are getting out of a juvenile detention facility or camp
    • You are pregnant or had a baby in the last year and are Black, American Indian, Alaska Native, or Pacific Islander

    [1] Members may not be enrolled in ECM and any of the following programs at the same time: Hospice, Program for All-Inclusive Care for the Elderly (PACE), Complex Care Management (CCM), County-based Targeted Care Management (TCM), Community Health Worker (CHW), California Community Transitions (CCT), and 1915 (c) Home and Community-Based Services Waiver (HCBS) -- including Medi-Cal Waiver Program (HIV/AIDS), Home and Community-Based Alternatives (HCBA), Assisted Living Waiver (ALW), Home and Community-Based Services Waiver for the Developmentally Disabled (HCBS-DD), Multipurpose Senior Services Program (MSSP), Self-Determination Program (ICF-DD), and Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs)

    Community Supports is a California Advancing and Innovating Medi-Cal (CalAIM) program put in place by the Department of Health Care Services (DHCS). Community Supports are services provided by local organizations in your area that help with everyday needs that affect your health. These optional services are covered by Medi-Cal at no cost for members who qualify. You may be able to get Community Supports if you need them for your health. The service must also cost less than other services.

    Kaiser Permanente offers 15 types of Community Supports services. The services you can get depend on your county.

    Available in all counties

    Services to Address Housing Insecurity

    Housing Transition Navigation Services

    Helps you find housing if you’re homeless or at risk of being homeless.

    You may be able to get services if you:

    • Need help finding and applying for housing
    • Are homeless or may lose your housing soon
    • Have physical, mental health, or substance use needs that make it hard to find housing
    • Are eligible for Transitional Rent
    • Are getting help through a local housing program because you have high housing or health needs
    Housing Deposits

    Helps you move into a home by paying for a housing deposit and other move-in costs.

    You may be able to get services if you:

    • Need help paying a deposit or other move-in costs
    • Are homeless or may lose your housing soon
    • Have physical, mental health, or substance use needs 
    • Are eligible for Transitional Rent
    • Are getting help through a local housing program because you have high housing or health needs

    Transitional Rent

    Helps pay for rent for up to 6 months as you move from being homeless or at risk of being homeless into permanent housing. Available to members who receive mental health care. It may help to ask your county mental health provider for support with your request.

    You may be able to get services if you:

    • Are homeless or may lose your housing soon 
    • Have mental health or substance use needs
    • Are moving from a shelter, recovery program, foster care, jail, hospital, or another care setting 
    • Need short-term help paying rent while moving into permanent housing

    Housing Tenancy and Sustaining Services

    Helps you keep safe and stable housing once you have a place to live. This may include ways to avoid eviction. You can also learn about your rights and responsibilities as a tenant.

    You may be able to get services if you:

    • Are homeless or may lose your housing soon
    • Have physical, mental health, or substance use needs
    • Are eligible for Transitional Rent
    • Are getting help through a local housing program because you have high housing or health needs
    • Have recently found housing and need support to avoid losing it

    Recuperative Care (Medical Respite)

    Provides a safe place for you to recover after an injury or illness. This may include housing, meals, and rides to medical or mental health appointments.

    You may be able to get services if you:

    • Are homeless or may lose your housing soon
    • Need a safe place to heal from a serious injury or illness

    Day Habilitation

    Helps you learn skills to live in your community after being homeless or having unstable housing. You may get help with social skills, cooking, cleaning, or managing money.

    You may be able to get services if you:

    • Are homeless or may lose your housing soon
    • Moved into housing within the last 24 months after being homeless
    • Need help learning skills to live safely and independently, and keep your housing
    Short-Term Post Hospitalization Housing

    Helps you heal after a stay in a hospital or other care setting. Available through December 31, 2026.

    You may be able to get services if you:

    • Are homeless or may lose your housing soon
    • Are leaving a hospital or other care setting and need a safe place to continue your recovery
    • Have a serious physical, mental health, or substance use condition

    Please note: No new referrals will be accepted after December 1, 2026. If you need support after this program ends on December 31, 2026, you may be able to get other Medi-Cal services, including Recuperative Care, if you qualify.

    Services Provided in the Home or a Home-like Setting

    Personal Care and Homemaker Services

    Helps you with daily tasks so you can live at home. This may include bathing, dressing, and grocery shopping. It may also include meal prep or someone to go with you to medical visits.

    You may be able to get services if you:

    • Need help with daily activities and do not have enough support at home
    • Are at risk of going to the hospital or a nursing home
    • Have been approved for In-Home Supportive Services through the CA Department of Social Services

    Environmental Accessibility Services (Home Modifications)

    Helps change your home so you can live there safely on your own. This may include adding wheelchair ramps or grab bars.

    You may be able to get services if you:

    • Are at risk of moving to a nursing home
    • Need changes made to your home to stay safe and independent
    Community Transition Services/Nursing Facility Transition to a Home

    Helps pay move-in costs when you leave a nursing facility for a private home.

    You may be able to get services if you:

    • Have lived in a nursing facility or another care setting for at least 60 days and want to move back into the community
    • Can live safely in a home with the right supports

    Nursing Facility Transition/Diversion to Assisted Living Facilities

    Helps you move from your home or a nursing facility into a home like place in your community. You can get help with daily activities there.

    You may be able to get services if you:

    • Need more support than can be provided at home and want to live in an assisted living facility instead of a nursing home
    • Can live safely in an assisted living facility with support
    • Need help moving into or staying in an assisted living facility
    Caregiver Respite Services

    Provides short term relief so caregivers can take a break when needed. Offered by the hour, the day, or the night.

    You may be able to get services if you:

    • Need help with daily activities
    • Depend on a caregiver for most of your support
    • Need caregiver support to help you stay in your home

    Services for Chronic and Complex Conditions

    Medically Tailored Meals/Medically Supportive Foods

    Delivers healthy, cooked meals or groceries to your home. Meals fit your health needs, such as a special diet for diabetes.

    You may be able to get services if you:

    • Have a serious health condition that is affected by the food you eat
    • Need special meals or nutrition support
    • Have a care team that recommends this service

    Asthma Remediation

    Helps make changes to your home so you can live without acute asthma episodes. This may include items like air filters and vacuums.

    You may be able to get services if you:

    • Have poorly controlled asthma
    • Have triggers in your home that are making your asthma worse
    • Need changes or supplies to make your home safer for your asthma

     

    Available in some counties

    Sobering Centers

    Provides a safe and supportive place to help you become sober. This may include meals, a short-term place to sleep, counseling, and help finding health care services.

    You may be able to get services if you:

    • Are at least 18 years old and need a safe place to stay while recovering from alcohol or drug use
    • Do not need emergency medical care
    • Do not live in Alameda, Contra Costa, Marin, Mariposa, San Mateo, Santa Cruz, Sonoma, Sutter, or Yuba County

    Learn more about Community Supports services on the DHCS website and in the Community Supports Fact Sheet.

    To find out which supports are available in your area, call us at the phone numbers listed below.

    Eligibility for Community Supports depends on the service. Your care team can help find services that may be right for you. You can request services on your own or your provider can refer you. To learn which Community Supports services may be right for you and whether you qualify, call us at the phone numbers listed below. Many services start within 14 days after approval.

    Kaiser Permanente offers CHW services at no cost to Medi-Cal members who qualify. A CHW is a health worker who does not give medical care. This means they’re not a doctor, nurse, or social worker. You may also know them as promotores, navigators, or community health representatives. They are a trusted member of your community. They can help you use the health care system. They can also help you reach your health goals.

    CHWs can help in many ways. For example, they can:

    • Help you understand your health care choices in your language and culture 
    • Share details about your health condition
    • Help you find public programs and local help, such as food or rides 
    • Go with you to doctor’s appointments
    • Support you with issues related to domestic or community violence

    CHW services do not include:

    • Medical care or other work that needs a license 
    • Childcare
    • Chores like shopping, cooking, or driving
    • Social visits or companion services
    • Employment services
    • Bringing you medicine, medical equipment, or medical supplies

    Most Medi-Cal members may qualify for CHW services. You may qualify if you need help that is not medical care.

    You don’t qualify for CHW services if you’re enrolled in ECM.

    How can I enroll in ECM, get Community Supports, or work with a CHW?

    To learn more, call us Monday through Friday from 8:30 a.m. to 5 p.m.

    Justice Involved Liaison (JIL)

    Kaiser Permanente’s JIL supports our members as they transition from incarceration (such as jail or prison). They help these care providers work together:

    • Correctional facilities
    • Pre-release care management providers
    • ECM providers

    To contact our JIL, email Ji-Liaison@kp.org or call 626-405-5386.

    We’re here to help

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    Questions about Medi-Cal with Kaiser Permanente?

    Call the Kaiser Permanente Medicaid Assistance Center at

    1-800-557-4515 (toll free) or 711 (TTY),

    8 a.m. to 5 p.m., Monday through Friday.

    Español: 1-800-545-7263

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