Through CalAIM, a five-year experimental build-out of the Medicaid system, programs such as Jamboree were able to leverage federal funding to offer the kinds of nonhousing social services that experts contend are essential to keeping people permanently housed.<\/p>\n
However, these wraparound services are only one component of the CalAIM initiative, which is attempting to take Medicaid, known as Medi-Cal in California, in a more holistic direction across all areas of care. And when CalAIM launched, California officials gave the programs the Medicaid \u201cin lieu of services\u201d designation, known as ILOS, in effect putting them outside the waiver process and ensuring that even when CalAIM sunsets, money for those social initiatives will continue to flow.<\/p>\n
\u201cCalifornia has tried to future-proof many of the policy changes it has made in Medi-Cal by including them in mechanisms like ILOS that do not require federal waiver approval,\u201d said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes KFF Health News. \u201cThat allows these policy changes to continue, even with a politically hostile federal administration.\u201d<\/p>\n
The designation allows these social services to be funded through Medicaid managed-care plans under existing federal laws because they are cost-effective substitutes for a Medicaid service or reduce the likelihood of patients needing other Medicaid-covered healthcare services, said Glenn Tsang, policy advisor for homelessness and housing at the state\u2019s Department of Health Care Services. The state could not provide an estimate of the annual funding for these wraparound services because they are not distinguished from other payments made to Medicaid managed-care plans.<\/p>\n
\u201cWe are full steam ahead with these services,\u201d Tsang said, \u201cand they are authorized.\u201d<\/p>\n
Although California was the first state to incorporate the designation for such housing and other health-related social support, Tsang said, several other states \u2014 including Arizona, Arkansas, Florida, New York and North Carolina \u2014 are now using the mechanism in a similar fashion.<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2025\/12\/1767181748_628_.jpeg\")
<\/p>\n
Paul San Felipe, senior program manager for Jamboree, speaks during a meeting at Clara Vista in Stanton on Dec. 29, 2025. <\/p>\n
(Eric Thayer \/ Los Angeles Times)<\/p>\n
Early results suggest such support saves on healthcare spending. When Jamboree, MidPen Housing Corp.<\/a> in Northern California, RH Community Builders<\/a> in the Central Valley and other permanent supportive housing providers employ a holistic approach that includes social services, they reported higher rates of formerly homeless people remaining in housing, less frequent use of costly emergency health services, and more residents landing jobs that help them pay rent and stay housed.<\/p>\n At the nonprofit MidPen Housing, which serves 12 counties in and around the San Francisco Bay Area, roughly 40% of the units in the program\u2019s pipeline are earmarked for \u201cextremely low-income\u201d people, a group that includes those who are homeless, said Danielle McCluskey, senior director of resident services.<\/p>\n CalAIM reimbursements help fund the part of MidPen that focuses on supportive services across a wide range of experiences, such as chronic homelessness, mental health issues and those leaving the foster care system. McCluskey described it as one leg of a three-legged stool, the others being real estate development and property management.<\/p>\n \u201cIf any of those legs are not getting what they need, if they\u2019re not funded or not staffed or resourced, then that stool is kind of wobbly \u2014 off-kilter,\u201d the director said.<\/p>\n A recent state evaluation<\/a> found that people who used at least one of the housing support services \u2014 including navigation into new housing, healthcare assistance and a deposit to secure an apartment<\/a> \u2014 saw a 13% reduction in emergency department visits and a 24% reduction in inpatient admissions in the six months that followed.<\/p>\n Documenting those outcomes is crucial because the department needs to show federal officials that the services lessen the need for other, often costlier Medicaid-covered care \u2014 the essence of the classification.<\/p>\n Advocates for the inclusion of supportive services argue that the American system ultimately saves money on those investments. As California\u2019s homeless population has soared in recent years<\/a> to more than 187,000 on a given night \u2014 nearly a quarter of the U.S. total \u2014 Jamboree has been allocating more of its resources to permanent supportive housing.<\/p>\n Founded in 1990 in Orange County, Jamboree builds various types of affordable housing<\/a> using federal, state and private funding. Reider said about a fifth of the organization\u2019s portfolio is dedicated to permanent supportive housing.<\/p>\n \u201cThey\u2019re not going back out to the streets. They\u2019re not going to jail. They\u2019re not going to the hospitals,\u201d Reider said. \u201cKeeping people housed is the No. 1 outcome, and it is the cost-saver, right? We\u2019re using Medicaid dollars, but we\u2019re saving the system money in the long run.\u201d<\/p>\n Guevara spent years living out of her truck before a shelter worker connected her with Jamboree. Now she also has found work as a caregiver.<\/p>\n (Eric Thayer \/ Los Angeles Times)<\/p>\n Guevara, who wound up on the streets after a falling-out with family in 2015, spent years living out of her truck before a shelter worker connected her with Jamboree. There, she was paired with a specialist to help her figure out how to get and see a doctor, and to keep up with scheduling the battery of medical tests she needed after years spent living in temporary shelters.<\/p>\n \u201cI also got a job developer, who helped me get this job with the county so I can pay my rent,\u201d Guevara said of her position as a part-time in-home caregiver. \u201cNow I take care of people kind of the same way people have been taking care of me.\u201d<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF<\/a> \u2014 the independent source for health policy research, polling, and journalism.<\/p>\n","protected":false},"excerpt":{"rendered":"When Virginia Guevara moved into a studio apartment in Orange County in 2024 after nearly a decade of…\n","protected":false},"author":2,"featured_media":114892,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[7,9,8,61434,4422,1011,61431,4194,13394,611,4747,225,1291,61433,61435,61432,72],"class_list":["post-114891","post","type-post","status-publish","format-standard","has-post-thumbnail","category-california","tag-california","tag-california-headlines","tag-california-news","tag-glenn-tsang","tag-homeless-people","tag-housing","tag-jamboree-counselor","tag-job","tag-medicaid-program","tag-orange-county","tag-service","tag-state","tag-street","tag-such-social-service","tag-supportive-service-process","tag-virginia-guevara","tag-year"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/114891","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=114891"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/114891\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/114892"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=114891"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=114891"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=114891"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"a](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2025\/12\/1767181749_832_.jpeg\")
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