Written by California is set to introduce ‘Transitional Rent program’ starting in January 2025, with full mandatory implementation by January 2026. This initiative, under the CalAIM framework, aims to provide up to six months of rental assistance for Medi-Cal members experiencing or at risk of homelessness. The program seeks to bridge the gap between temporary housing & permanent solutions, acknowledging that stable housing is critical for improving health outcomes. MCPs will play a central role in implementing this benefit, working closely with housing and transitional rent providers.
Eligibility: Eligibility for Transitional Rent is based on three key criteria. First, members must meet clinical risk factors, such as chronic health conditions or significant behavioral health needs. Second, members must be experiencing or at risk of homelessness, following the HUD definition with some California-specific modifications. Finally, members must be part of a specified transitioning population, including those exiting institutional care, incarceration, or the child welfare system.
Impact on Housing Community Supports Providers: This program will significantly impact Housing CS Providers, particularly those providing Housing Transition, Tenancy, Housing Deposits, and Short-Term Post-Hospitalization Housing (STPHH). Providers offering these services will need to coordinate closely with Transitional Rent providers to ensure members move seamlessly from temporary to permanent housing. Members eligible for Transitional Rent will also automatically qualify for these housing services, creating new referral pathways and increasing the demand for transition and tenancy support services.
Impact on MCPs: For MCPs, the administrative burden will increase as they take on responsibility for determining eligibility, contracting with Transitional Rent providers, and closely oversee individualized housing support plans. MCPs must also ensure that members are connected to other Medi-Cal services like Enhanced Care Management (ECM) and that data is shared across various stakeholders to facilitate whole-person care. Additionally, MCPs must track and report housing outcomes, such as whether members transition successfully to permanent housing, and oversee payments to housing providers.
Billing Guidance: Billing for Transitional Rent services will use specific HCPCS codes, including H0044 (U6) for permanent settings and H0043 (U2) for interim housing. MCPs will reimburse providers based on these codes, ensuring payment aligns with the type of housing and duration of service.
Our take: From a technology perspective, this program offers a key opportunity to streamline processes between MCPs and housing providers, which are currently manual and fragmented. Currently data sharing is inconsistent, claims and payments are delayed, and outcome tracking is lacking. Sprite is working with many providers and MCPs statewide to address these issues. Our focus is on making CalAIM more sustainable for providers and enhancing efficiency for MCPs by automating workflows, improving data integration, and enabling real-time outcome tracking.
Sprite Health offers a highly comprehensive digital platform that enables the efficient management of all ECM/CS requirements in a single place. Our solution is purposefully designed to cater to the specific needs of the CalAIM ECM/CS initiative.
Connect with us to learn how you can enhance outreach efforts, streamline care planning and coordination, and fosters a data-driven and outcome-oriented approach that advances equity, and clinical outcomes.