Medi-Cal: In-Lieu of Services Application + Instructions

Medi-Cal is California’s health care program that pays for a wide variety of medical services for adults and children with limited income and resources. The program is administered by the California Department of Healthcare Service (DHCS) and serves approximately 900,000 individuals in San Diego County. Beginning January 2022, DHCS will launch a new program called CalAIM: California Advancing and Innovating Medi-Cal that encompasses broad-based delivery system, program, and payment reform across the Medi-Cal program to improve the quality of life, health, and to achieve long-term cost savings for the Medi-Cal population.

One key element of CalAIM is In-Lieu of Services (ILOS) which are wrap-around services that are provided to Medi-Cal enrollees as a substitute for, or to avoid, other services such as hospitalizations or other costly services. There are 14 outlined ILOS which include:

• Housing Transition Navigation Services
• Housing Deposits
• Housing Tenancy and Sustaining Services
• Short-term Post-hospitalization Housing
• Recuperative Care (Medical Respite)
• Respite Services
• Day Habilitation Programs
• Nursing Facility Transition/Diversion
• Community Transition Services/Nursing Facility Transition to Home
• Personal Care and Homemaker Services
• Environmental Accessibility Adaptations (Home Modifications)
• Meals/Medically-tailored Meals
• Sobering Centers
• Asthma Remediation

Healthy San Diego (the convening body for San Diego’s managed care plans) recently released the application for prospective ILOS providers. If your organization is interested in becoming an ILOS provider, please complete the application and submit it to each of the managed care plans no later than 5pm, Friday, September 17, 2021. 

 

 

CalAIM ILOS Provider Certification Tool Final 8-26-21 GS

 

 

 

HSD CalAIM Contact Card 5-19-21

 

If you have any questions or concerns as you are completing the application which is linked in the above Certification Tool, please contact the respective managed care plan at their corresponding email address.