Recuperative Care and Facilities

Here is a comprehensive breakdown of all the benefits covered under CalAIM's Recuperative Care (Medical Respite) program:

CalAIM Recuperative Care (Medical Respite) — Full Benefits Overview

What Is It?

Medical respite programs — also called recuperative care — provide temporary housing and medical care for people experiencing homelessness who have been hospitalized. These people are too sick or frail to recover on the streets or in shelters but not sick enough to remain in the hospital. Street medicine teams and clinic providers can also refer people to medical respite if they think their patient is at high risk for hospitalization. California Health Care Foundation

🏠 Core Housing & Basic Needs Benefits

At a minimum, providers must provide interim housing with a bed, meals, and ongoing monitoring of the individual's medical or behavioral health condition. Specifically this includes: Santa Clara Family Health Plan

Temporary shelter / a safe bed in a home-like residential setting

Three meals per day and nutritional support during recovery

Basic hygiene and personal care supplies

Laundry and linen services

24-hour supervision and a secure environment

🩺 Medical & Clinical Care Benefits

Members with unstable housing who no longer require hospitalization, but still need to heal from an injury or illness, receive short-term residential care that includes housing, meals, and ongoing monitoring of the member's condition. Clinical services can include: CA

Wound care and dressing changes

Medication management and administration support

Chronic disease monitoring (diabetes, hypertension, COPD, etc.)

Post-surgical recovery support

Vital sign monitoring

Nursing assessments (in clinical model programs)

Behavioral health treatment — psychiatric and substance use disorder recovery support

Referrals to specialty care and follow-up appointments

🧠 Behavioral Health Benefits

The program provides members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical, psychiatric, or substance use disorder recovery immediately after exiting an inpatient hospital, residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care facility. CalOptima

Mental health stabilization support

Substance use disorder recovery continuation

Psychiatric medication monitoring and follow-up

Referrals to behavioral health services post-discharge

📋 Care Coordination & Case Management Benefits

Integrated services connect participants to housing assistance, social services, and benefits like Supplemental Security Income (SSI). This includes: California Health Care Foundation

Discharge planning from the recuperative care facility itself

Benefits enrollment assistance (SSI/SSP, Medi-Cal, CalFresh, General Relief)

Connection to Enhanced Care Management (ECM) for ongoing complex care coordination

Coordination with the member's primary care provider and specialists

Medical records transfer and continuity of care support

Referrals to community-based organizations and social services

🏡 Housing Transition Benefits (Built In)

When members are receiving Recuperative Care or Short-Term Post-Hospitalization Housing, they should be offered Housing Transition Navigation Services (HTNS), so that the HTNS Provider can conduct a housing assessment and develop a housing support plan with the member to help identify preferences and barriers related to successful housing tenancy after transitioning from Recuperative Care. CA

Housing needs assessment conducted during the stay

Development of a personalized housing support plan

Connection to permanent housing resources and programs

Bridge to Housing Deposits to cover move-in costs

Warm handoff to Housing Tenancy and Sustaining Services (HTSS) for ongoing stability

💊 Pharmacy & Durable Medical Equipment Benefits

Medication pickup and coordination during recovery

Prescription management and refill assistance

Durable Medical Equipment (DME) coordination (walkers, wheelchairs, etc.) to the extent not covered elsewhere in Medi-Cal

Medical supply coordination for ongoing wound care or chronic conditions

📊 Program Parameters & Limits

ParameterDetailMaximum stay durationUp to 90 daysCombined capNo more than 6 months combined of Recuperative Care + Short-Term Post-Hospitalization Housing + Transitional Rent in a rolling 12-month periodWho qualifiesMedi-Cal managed care members experiencing or at risk of homelessnessEntry pointsHospital discharge, skilled nursing facility discharge, correctional facility release, SUD/mental health facility discharge, street medicine referralCost to member$0 (covered as a Community Support)Available statewideYes, through contracted Medi-Cal Managed Care Plans (MCPs)

📈 Proven Health Outcomes

Effective recuperative care reduces hospital admissions and dependence on emergency rooms. It also provides more opportunities for people experiencing homelessness to get connected with support services and transitional housing. California Health Care Foundation

Los Angeles County saw a 71% reduction in hospital readmissions and 24% reduction in emergency department visits from the use of a psychiatric recuperative care service. NASHP

Medical respite programs significantly decrease emergency room visits and prevent expensive hospital readmissions. Over 18 months, one program saved more than $17 million in medical costs for 1,200 patients. California Health Care Foundation

How the Recuperative Care Continuum Works

Hospital / SNF / Jail / SUD Facility Discharge ↓ Recuperative Care (up to 90 days) [Medical recovery + housing plan development] ↓ Housing Transition Navigation Services [Find permanent housing] ↓ Housing Deposits [Cover security deposit & move-in costs] ↓ Housing Tenancy & Sustaining Services [Stay housed long-term] ↓ Transitional Rent (up to 6 months) [Rental assistance while stabilizing]