CurrentmhnPolicy N/A

Short-Term Post-Hospitalization Housing (STPHH) referral

Governance and referral form requirements for arranging temporary housing for members discharged from inpatient, residential, or correctional facilities to continue recovery; affects providers submitting STPHH referrals for Community Health Plan of Imperial Valley/Medi-Cal members.

Policy Summary

Payermhn

PolicyShort-Term Post-Hospitalization Housing (STPHH) referral

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the completed STPHH referral and CHPIV Prior Authorization Request Form - Outpatient via the online portal or fax to 800-743-1655.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

1referral form described

800-743-1655fax number

provider.healthnetcalifornia.comonline portal

8/28/25document update date

Coverage Criteria

Eligibility criteria

Members are eligible for STPHH if all of the following conditions are met:

Eligibility for STPHH: Member is exiting an institution, which includes recuperative care facilities, inpatient hospitals (acute, psychiatric, or Chemical Dependency and Recovery), residential substance use disorder or mental health treatment facilities, correctional facilities, or nursing facilities.

Members are eligible for Short-Term Post-Hospitalization Housing (STPHH) when they meet all listed conditions. Eligibility requires that the member is exiting an institution such as a recuperative care facility, inpatient hospital (acute, psychiatric, or chemical dependency and recovery), residential substance use disorder or mental health treatment facility, correctional facility, or nursing facility. The program is administered for Imperial County beneficiaries by the Community Health Plan of Imperial Valley (CHPIV), which contracts with Health Net Community Solutions, Inc. to arrange services.

To request STPHH, providers must complete and submit the Short-Term Post-Hospitalization Housing referral form together with the Community Health Plan of Imperial Valley Prior Authorization Request Form – Outpatient. The preferred submission method is the online portal at provider.healthnetcalifornia.com; fax submission is available at 800-743-1655. Guidance and the authorization request form are available via the Health Net provider resources linked from the STPHH referral materials.

Policy Summary

Payermhn

PolicyShort-Term Post-Hospitalization Housing (STPHH) referral

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the completed STPHH referral and CHPIV Prior Authorization Request Form - Outpatient via the online portal or fax to 800-743-1655.

SourceLink

On This Page

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Provider Actions and Submission Requirements

Prior Authorization

Prior Authorization Required

Short-Term Post-Hospitalization Housing (STPHH) requires a completed referral and associated prior authorization request. Submit the Short-Term Post-Hospitalization Housing Referral Form together with the Community Health Plan of Imperial Valley - Prior Authorization Request Form - Outpatient. The Authorization Guide and forms are available on provider.healthnetcalifornia.com under CalAIM Resources for Providers > Forms & Tools > Authorizations.

Recommended submission: online at provider.healthnetcalifornia.com (preferred)
Fax submission: 800-743-1655
Prior authorization request form available at https://bit.ly/HN-prior-auth

Note

Provider action: confirm consent and request type

Ensure the referring provider confirms and documents member consent and whether the referring entity is the same as the community supports (CS) provider. Mark the request as Initial or Authorization Extension as applicable.

Checkbox: Initial request or Authorization extension
Checkbox: Member consented to short-term post-hospitalization housing referral
Checkbox: Indicate if referring entity is same as CS Provider

Documentation Required

Required forms and information

The referral form must include completed member, community supports provider (servicing organization), and referring entity sections. Attach the completed Community Health Plan of Imperial Valley - Prior Authorization Request Form - Outpatient and any supporting clinical documentation (discharge summary, current treatment plan, medication list, recent progress notes). Incomplete submissions may delay authorization.

Member information: name, phone, Medi-Cal ID, DOB, preferred language, home address, emergency contact (name, phone, relationship, preferred language), optional ECM Provider name/phone
Community supports provider: organization name, Tax ID, NPI, staff name/title, phone, fax, facility name and address
Referring entity: name, address, phone, email, fax
Attachments: discharge summary, current treatment plan, medication list, recent progress notes, signed member consent

Denial Risk

Consequences of incomplete submission

Failure to submit the completed STPHH referral form, the outpatient prior authorization request form, or required clinical attachments may result in processing delays or denial of the referral. Monitor for requests for additional information and submit complete documentation to avoid denials.

Incomplete or missing member identifiers (Medi-Cal ID, DOB) can delay processing
Missing signed member consent or discharge summary may result in denial or request for more information
Preferred submission method is online to expedite processing; fax is accepted but may be slower

Definitions

inv-09: Short-Term Post-Hospitalization Housing (STPHH) — definition and purpose

DefinitionTemporary housing for members discharged from inpatient or residential facilities to support continued recovery from medical, psychiatric, or substance use treatment.

PurposeProvides a stable, supportive environment to continue recovery following discharge from inpatient or residential care.

ScopeApplies to Community Health Plan of Imperial Valley (CHPIV) Medi-Cal enrollees; CHPIV contracts with Health Net Community Solutions, Inc. to arrange services.

inv-10: Eligible discharge settings — list of applicable discharge settings

Eligible discharge settings (summary)Individuals exiting an institution such as recuperative care facilities, inpatient hospitals (acute, psychiatric, or Chemical Dependency and Recovery), residential substance use disorder or mental health treatment facilities, correctional facilities, or nursing facilities.

Recuperative care facilitiesIncluded — may be facilities covered under Community Support Recuperative Care or other facilities outside of Medi‑Cal.

Inpatient hospitalsIncluded — acute, psychiatric, or Chemical Dependency and Recovery hospitals.

Residential treatment facilitiesIncluded — residential substance use disorder or mental health treatment facilities.

OpenPayer

Short-Term Post-Hospitalization Housing (STPHH) referral

Coverage Criteria

Provider Actions and Submission Requirements

Definitions

Admission Criteria

Background