Coverage of Housing Services in Medi-Cal: Policy Recommendations for ‘In Lieu of Services’

August 11, 2020

While research has established that homelessness and housing instability are social risk factors that have a strong impact in shaping health outcomes, Medicaid has historically faced regulatory barriers to funding housing services for its low-income beneficiaries. In this policy report, Cal-IHEA Health Policy Fellow Michelle Carrera analyzes a new proposal from the CA Department of Health Care Services (DHCS) to pay for housing services in Medi-Cal ranging from medical respite to housing deposits as ‘In Lieu of Services’ - services that are medically appropriate and cost-effective substitutes to traditional medical benefits (e.g. ED/inpatient admissions). Although the proposal is currently deferred due to COVID-19, the ‘In Lieu of Services’ policy proposal has the potential to create sustained Medicaid funding for housing supports, with California being one of the first states in the country to propose this large-scale policy change to tackle housing instability. Interviews with key stakeholders informed recommendations to ensure that future implementation of ‘In Lieu of Services’ is effective and can contribute to integrating systems of medical, social and behavioral care pioneered by the Whole Person Care pilots. Read the policy report here.