Community Supports (CS) Services

Molina provides eligible members with services and supports to help lead healthier lives.

What are Community Supports?

Community Supports (CS) are services or settings that may be offered in place of other covered services or settings. Community supports may be offered when they are an appropriate option that meets your needs while helping manage healthcare costs. These services have no additional costs and do not replace any current benefits or services you already receive. Members are not required to use a CS service instead of a covered service or setting.

Community Supports Offered:

DHCS offers a menu of fifteen (15) CS services to comprehensively address the needs of members, including those with the most complex challenges affecting health, such as homelessness, unstable and unsafe housing, food insecurity, and/or other social needs.

The following CS services are offered to Molina Medi-Cal members, Medicare Duals members who have both Medicare and Medi-Cal with Molina, or Medicare Duals members who are with Molina for their Medi-Cal coverage, and meet the specified criteria per the DHCS Community Supports Policy Guide.

Housing Transition Navigation Services:

This service helps people who don’t have a home, or might lose their home, find a place to live. It offers support with things like filling out housing applications, getting benefits, talking to landlords, and finding resources. If approved, a housing navigator will help you throughout the process and answer questions.

You may be eligible if you:

Are homeless or at risk of becoming homeless and have at least one of the following health challenges: need for mental health care, help with drug or alcohol problems, serious ongoing physical health issues, physical or developmental disabilities, or are pregnant (including up to one year postpartum);

OR

Have been approved for Transitional Rent.

Housing Deposits:

This service helps members who are homeless or at risk of homelessness with moving into a new home. It can help with paying for one-time costs needed to get started. Your assigned housing provider will work with you to identify the support you need for a safe move-in. They will submit the request to Molina for review and approval. These costs are not rent and may include:

• Security deposits
• Utility set-up fees, deposits, or past-due utility bills
• Help paying for the first month of utilities
• One-time services needed to make the home safe and livable, such as pest removal, basic cleaning, or small repairs that are not the landlord’s responsibility
• Application fees required to apply for housing

You may be eligible if you:

Are homeless or at risk of becoming homeless and have at least one of the following health challenges: need for mental health care, help with drug or alcohol problems, serious ongoing physical health issues, physical or developmental disabilities, or are pregnant (including up to one year postpartum);

OR

Have been approved for Transitional Rent.

Limitations: Housing Deposits cannot be used if you have already moved in and are living in the home. It is only available to help with costs for a future move in or new housing placement. This service does not cover past due or back-rent. The request must include a complete list of what is needed at the time of move-in, and will not be approved to purchase additional items after move-in has occurred.

Housing Tenancy and Sustaining Services:

This service helps members keep their housing once they have moved in. It supports members who were previously homeless by providing help and guidance to stay safe, stable, and housed in their new home.

You may be eligible if you:

Are at risk of becoming homeless and have at least one of the following health challenges: need for mental health care, help with drug or alcohol problems, serious ongoing physical health issues, physical or developmental disabilities, or be pregnant (including up to one year postpartum);

OR

Have been approved for Transitional Rent.

Short-Term Post-Hospitalization Housing:

This service helps members who do not have stable housing and need ongoing health or behavioral health support after leaving a hospital, treatment program, correctional facility, nursing facility, or recuperative care. It gives you a short-term place to stay while you continue your recovery and helps you avoid going back to a higher level of care.

You may be eligible if you:

Are leaving a place like a hospital, mental health or substance use treatment center, correctional facility, nursing facility, or recuperative care.

And

You are homeless now or could become homeless soon.

And

You also meet at least one of these:

• You are getting Enhanced Care Management (ECM).
• You have one or more serious ongoing health conditions.
• You have a serious mental health condition.
• You are at risk of needing to live in a care facility because of a substance use condition.

And

A qualified health care provider decides that you still need ongoing physical or behavioral health support and would likely need to stay in a care setting if you did not get this housing help.

Limitations: Short-Term Post-Hospitalization Housing can last up to 6 months in a 12-month period. It may be approved for less time based on your needs. This service counts toward the six (6) month total limit for Room and Board services, which includes Recuperative Care and Transitional Rent.

Recuperative Care (Medical Respite):

This service gives you a short-term place to stay while you recover from an injury, illness, or behavioral health condition if you are homeless or could become homeless.

You may be eligible if you:

You need time and support to recover from an injury, illness, or behavioral health condition.

And

You are homeless now or could become homeless soon.

Limitations: Recuperative Care can last up to six (6) months in a twelve (12) month period. It may be approved for less time based on your needs. This service counts toward the six (6) month total limit for Room and Board services, which includes Short Term Post Hospitalization and Transitional Rent.

Care Giver Respite Services:

This service gives a short break to the person who cares for you every day. It helps you stay at home when your caregiver needs time to rest or be away. This service is not medical care.

You may be eligible if you:

You live at home, need help with daily activities, and rely on a caregiver who gives most of your support.

This service may also be available for some children who used to get Respite Services through the Pediatrics Palliative Care Waiver, children in foster care, members in California Children’s Services or the Genetically Handicapped Persons Program, and members with Complex Care Needs.

Limitations: You cannot get more than 24 hours of care in one day from all services combined. Respite Services are limited to up to 336 hours each calendar year.

Day Habilitation Programs:

This service helps you build and improve daily living, social, and self-care skills so you can live more safely and successfully in your home and community.

You may be eligible if you:

You are homeless now.

OR

You were homeless and moved into housing within the last 24 months.

OR

You are at risk of losing your housing or needing to live in a care facility, and this service could help you stay safely housed.

Assisted Living Facility (ALF) Transitions:

This service helps you move from a nursing facility to an assisted living setting, or helps you stay in the community instead of moving into a nursing facility, when that is safe for you.

You may be eligible for Transition services if you:

Have lived in a nursing facility for 60 days or more.

And

Are willing to live in an assisted living setting instead of a nursing facility.

And

Are able to live safely in an assisted living facility.

You may be eligible for Diversion services if you:

Want to stay in the community.

And

Are willing and able to live safely in an assisted living facility.

And

Meet the minimum requirements for nursing facility level of care services, but choose to stay in the community and receive those needed services in an assisted living facility.

Limitations: You are responsible for your own living costs. This service does not pay for room and board. You may still get help with room and board from other sources while receiving this service.

Community or Home Transition Services:

This service helps you move from a nursing facility or recuperative care setting back into the community. It can help you get set up in a new home and avoid going back to a care facility.

You may be eligible if you:

You are getting nursing facility level of care services and want to move home instead of staying in a nursing facility or recuperative care setting.

And

Have lived 60+ days in a nursing home and/or Recuperative Care setting.

And

Are interested in moving back to the community.

And

Are able to reside safely in the community with appropriate and cost-effective supports and services.

Limitations: Services and resources cannot exceed a total lifetime maximum amount of $7,500. Services may be approved one additional time if you have to move from a Provider-operated living arrangement to a living arrangement in a private residence through circumstances beyond your control.

Personal Care and Homemaker Services:

This service helps you with daily activities at home, like bathing, dressing, and household tasks.

You may be eligible if you:

Are at risk of going to the hospital or needing to live in a nursing facility.

Or

Have trouble with daily activities and do not have enough help at home.

Or

Are approved for In-Home Supportive Services (IHSS).

Limitations: This service cannot replace In-Home Supportive Services (IHSS). If you qualify for IHSS, you must be referred to that program. If your condition changes, you may be referred to IHSS again to see if you need more support. You may continue to receive this service while waiting for your IHSS reassessment.

Environmental Accessibility Adaptations (EAA) also known as Home Modifications:

This service helps make changes to your home so it is safer and easier for you to live in. These changes can help you stay in your home and be more independent.

You may be eligible if you:

You are at risk of needing to move into a nursing facility.

Limitations: EAAs can be covered up to a lifetime maximum of $7,500. You may be able to get additional services if you move to a new home or if your health condition changes and you need more modifications to stay safe and independent at home.

Medically Tailored Meals (MTMs) / Medically Supportive Food:

This service provides healthy meals to help manage your health condition. These meals are made to meet your medical and nutrition needs. You may get this service after leaving a hospital or skilled nursing facility.

You may be eligible if you:

Have a chronic or serious health condition that is affected by the food you eat. This may include conditions like heart disease, diabetes, kidney disease, lung conditions, high blood pressure, or other ongoing physical or behavioral health conditions that are not well-managed.

OR

Have recently been discharged from the hospital.

Limitations: You may receive up to two (2) meals or meal packages each day. This service can be approved for up to 12 weeks. It may be approved again if medically necessary based on information submitted by your treating provider.

Sobering Centers:

This service gives you a safe place to stay if you are intoxicated from alcohol or drugs. It can be used instead of going to the emergency room or jail.

You may be eligible if you:

You are 18 years or older, intoxicated but awake, calm, able to walk, and not in medical danger. This service is for people who would otherwise be taken to the emergency room or jail.

Limitations: Sobering Centers are not available in San Bernardino County. You do not need approval for this service.

Asthma Remediation:

This service helps make your home safer if you have asthma. It can include finding and fixing things in your home that may trigger asthma, like dust, mold, or pests. These changes can help you breathe better and avoid trips to the hospital.

You may be eligible if you:

You are getting asthma preventive services and a home check in the past 12 months that shows changes are needed to make your home safer for your health.

Limitations: Services and items are covered up to a lifetime maximum of $7,500. You may be able to get more services one additional time if your health needs change and more home updates are needed to keep manage your asthma better.

Transitional Rent:

This service helps pay for rent for a short time if you have a mental health condition and do not have stable housing. If you qualify, it can cover up to six months of rent while you move into a safe and stable place to live.

You may be eligible if you:

You are homeless now or at risk of becoming homeless.

And

You have a serious mental health condition, such as needing specialty mental health care, or getting help with drug or alcohol use.

And

You meet at least one of the following:

• You are leaving a place like a hospital, treatment program, jail, prison, nursing facility, foster care, or other temporary housing.
• You are living somewhere not meant for housing, like a car, park, or shelter.
• You are part of a Full-Service Partnership (FSP) program.

Note: To qualify for Transitional Rent, you must have a plan for how you will pay for rent when Transitional Rent is over. This could be something like a housing subsidy, funding through the Behavioral Health Services Act, Social Security, or other guaranteed funding source. Housing Transition Navigation Services may be able to help you with this plan.

Limitations: This service can be provided once per demonstration period (through December 2029) and for no more than six months. Transitional Rent counts toward the six-month total limit for Room and Board services, including Recuperative Care and Short-Term Post-Hospitalization Housing.

How Do I Get Community Supports?

You can be referred to Community Supports by any of the following:

• ECM Provider
• Primary Care Physician/Clinic
• Specialists
• Molina Case Manager/ Transition of Care Coach
• Hospital/Skilled Nursing Facility
• Independent Medical Group (IPA) or Medical Group

Referrals for CS services can be made using the forms located on our website under Frequently Used Forms (molinahealthcare.com). Please note that all CS services require prior approval, except for Sobering Centers.

To find out if CS may be right for you, talk to your health care provider or call Member Services at 1-888-665-4621 (English) (TTY/TDD 711), Monday-Friday 7:00 A.M.- 7:00 P.M. The call is toll free.