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CALAIM COMMUNITY SUPPORTS BY PRESIDIUM HEALTH

 

 

 

CalAIM Community Supports: Whole-Person Support for California’s Most Vulnerable

Presidium Health delivers CalAIM Community Supports that elevate quality of life for eligible members—wherever they are in California.

What Are CalAIM Community Supports?

CalAIM Community Supports, formerly known as In Lieu of Services, are cost-effective programs offered under California Advancing and Innovating Medi-Cal (CalAIM). These support services help managed care plans (MCPs) address social needs, reduce hospitalizations, and improve outcomes for populations of focus—including those with chronic conditions, behavioral health needs, and housing insecurity.

At Presidium Health, our integrated model ensures that every Community Support is delivered in lockstep with an ECM care plan, improving outcomes for eligible members across Los Angeles County and beyond. This coordination ensures that physical, behavioral, and social needs are addressed together—resulting in measurable improvements in stability and quality of life.

What Is a Population of Focus?

Under CalAIM, populations of focus are groups of Medi-Cal members with complex needs who may benefit from Enhanced Care Management (ECM) and Community Supports. These include individuals experiencing homelessness, those with serious mental illness or substance use disorders, high utilizers of hospital services, and people transitioning from incarceration.

Presidium Health specifically serves adult members within these populations—particularly those with chronic conditions, housing instability, behavioral health needs, or recent discharges from hospitals and skilled nursing facilities. We do not currently provide services for children, postpartum individuals, or maternity care, as these fall outside our scope of expertise.

Who is Eligible?

CalAIM identifies several populations of focus as eligible for Community Supports and Enhanced Care Management. While many groups qualify, Presidium Health focuses on adult members with complex needs tied to housing, chronic illness, and high healthcare utilization. We do not currently serve pediatric or perinatal populations.

CalAIM Eligible Populations Presidium Health Serves Notes
Experiencing homelessness or at risk of homelessness ✅ Yes Core focus population
Adults with chronic physical or behavioral health conditions ✅ Yes Includes support for mental health and complex comorbidities
Recently discharged from a skilled nursing facility or hospital ✅ Yes Includes transitional and post-acute coordination
High utilizers of emergency or inpatient services ✅ Yes Supported through our wraparound, high-intensity model
Individuals transitioning from incarceration ✅ Yes Engaged through Operation Care™ field-based outreach
Youth in California Children’s Services (CCS) ❌ No Pediatric populations are outside our clinical scope
Pregnant or postpartum individuals (e.g., those accessing doula services or childbirth support) ❌ No Maternal and perinatal care not provided

Community Supports We Deliver

  • Housing Transition Navigation Services: Support with housing assessments, applications, and linkage—especially for those leaving hospitals or SNFs.
  • Housing Deposits: One-time cost assistance for security deposits, application fees, and utility setup to secure permanent housing.
  • Housing Tenancy and Sustaining Services: Ongoing tenancy support, landlord mediation, and eviction prevention—aligned with member stability goals.
  • Recuperative Care (Medical Respite): Short-term post-acute recovery for unhoused individuals with complex physical health or behavioral health services needs.
  • Short-Term Post-Hospitalization Housing: Temporary housing to support safe recovery post-discharge when no stable option exists.
  • Medically Supportive Meals: Condition-specific meal delivery coordinated with the care team to support chronic conditions and nutritional recovery.
  • Non-Medical Transportation: Transportation to essential non-medical services like housing appointments, job interviews, and referral forms processing.
  • Environmental Accessibility Adaptations: Home modifications (e.g., ramps, grab bars) to promote independence and safety, especially post-SNF or hospital discharge.

How We Deliver CalAIM Community Supports

Presidium’s delivery model ensures Community Supports are fully integrated with Enhanced Care Management and field operations—not siloed or transactional.

Unlike traditional vendors, Presidium’s CalAIM delivery model is fully embedded with Enhanced Care Management and aligns with incentive program metrics—ensuring no gaps, no silos.
Feature Presidium Health Traditional Vendors
Integrated with ECM care plan ✅ Yes ❌ No
Delivered by field-based care teams ✅ Yes ❌ No
Real-time escalation from CHWs and care managers ✅ Yes ❌ No
Seamless coordination of care across MCPs ✅ Yes ❌ No
Designed to align with the CalAIM Incentive Payment Program ✅ Yes ❌ No

Presidium also complies with return transmission file and provider return transmission file standards, ensuring seamless data exchange with MCPs for tracking, billing, and quality assurance.

Coordinated Across the Continuum

Our model addresses social determinants of health while working within a broad delivery system that includes:

Presidium integrates CalAIM services with upstream and downstream interventions—from patient search to plan-level reporting—bridging gaps that typically disrupt care.
  • Enhanced Care Management (ECM)
  • High-intensity wraparound services
  • Care manager coordination
  • Operation Care™: Our patient-finding and engagement platform
  • Behavioral health services and chronic care support
  • Member Information File and reporting requirements
  • Support for MCP-specific goals, including those from Anthem and other health plans
  • CHW and CS provider alignment
  • January and June reporting cycles for the Incentive Payment Program
  • Multilingual support and TTY access for Californians with communication needs

Why Health Plans Choose Presidium Health

Presidium’s track record includes multimillion-dollar savings, dramatic utilization drops, and measurable improvements in member stability and satisfaction.
  • Proven ability to support eligible members with complex needs
  • Embedded field teams, including community health workers (CHWs)
  • Focus on housing stability, chronic condition management, and cost reduction
  • Transparent outcomes reporting and data exchange
  • Alignment with CalAIM stakeholders and downloadable plan performance metrics
  • No duplication with services like doula, postpartum, or childbirth care, ensuring clean division of labor across providers

Contact Us

📩 Melody Shedlosky, COO
melody@presidiumhealth.com

Partner with Presidium Health to expand access to CalAIM Community Supports and deliver results where it matters most.

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