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The Department of Health Care Services (DHCS) is announcing that it will begin development of a potential new “Long Term Care at Home” benefit in Medi-Cal. This new model of care is intended to help address the coronavirus pandemic, and provide eligible consumers with a coordinated and bundled set of home and community services to help vulnerable adults statewide stay healthy at home. 

The Long Term Care at Home benefit will include: 1) Individual, Person Centered Assessment; 2) Transition Services; 3) Care Management; and 4) Home and Community Based Services. This benefit will be bundled with existing Medi-Cal benefits offered through Medi-Cal managed care and fee-for-service delivery systems. 

This benefit is intended to support home care for individuals transferring from hospitals to home, from skilled nursing facilities to home or to prevent a skilled nursing facility stay. It would increase consumer and family choices in where to live and how to receive care. This benefit would also allow skilled nursing facilities and residential care facilities to decompress, so fewer people are exposed to the demonstrably-higher risks of viral infection in communal settings – critical during the coronavirus pandemic, as well as flu seasons. 

DHCS will develop this model in coordination with the Master Plan for Aging Stakeholder Advisory Committee, as well as partner departments within the Administration, including the Departments of Social Services, Aging, Public Health, Developmental Services, and Rehabilitation. DHCS will seek approval from the federal Centers for Medicare & Medicaid Services for this benefit, and is intending to implement this model by early 2021. The Long Term Care at Home benefit is intended to be cost-neutral for the state General Fund.

Additional updates will be posted to the DHCS website in the coming days.