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

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: