CurrentPHC CaliforniaPolicy CM 24.0

PHC-CA Care Management of Enrollees Receiving Transitional Rent Community Support

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Governs how PHC California identifies, refers, coordinates, monitors, and documents care management for Medi-Cal enrollees receiving Transitional Rent Community Support.

Policy Summary

PayerPHC California

PolicyPHC-CA Care Management of Enrollees Receiving Transitional Rent Community Support

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Last ReviewSep 9, 2025

Next Review DateN/A

Key ActionRefer eligible enrollees to Transitional Rent Providers within 3 to 5 business days of identification.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Up to 6 monthsMaximum Transitional Rent assistance

3–5 business daysStandard referral timeframe

1–3 business daysExpedited referral timeframe

MonthlyHousing Support Plan monitoring

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CurrentPHC CaliforniaPolicy CM 24.0

PHC-CA Care Management of Enrollees Receiving Transitional Rent Community Support

Customize your policy alerts

Sign up for phccalifornia Policy CM 24.0 alerts

Get alerted when Policy CM 24.0 changes without checking for updates manually.

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Governs how PHC California identifies, refers, coordinates, monitors, and documents care management for Medi-Cal enrollees receiving Transitional Rent Community Support.

Policy Summary

PayerPHC California

PolicyPHC-CA Care Management of Enrollees Receiving Transitional Rent Community Support

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Last ReviewSep 9, 2025

Next Review DateN/A

Key ActionRefer eligible enrollees to Transitional Rent Providers within 3 to 5 business days of identification.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Up to 6 monthsMaximum Transitional Rent assistance

3–5 business daysStandard referral timeframe

1–3 business daysExpedited referral timeframe

MonthlyHousing Support Plan monitoring

Associated Housing Trio services

AnnualPolicy review frequency

Transitional Rent Eligibility and Settings

Transitional Rent care management requirements

Transitional Rent is available when all of the following requirements are met:

ALL of the following

The enrollee is experiencing or at risk of homelessness, has applicable clinical risk factors, and has recently undergone a critical life transition—such as exiting an institutional or carceral setting or foster care—or meets other specified eligibility criteria.
The enrollee agrees to receive Transitional Rent, and the verbal agreement is obtained and documented in the electronic medical record.
Referral completed within the applicable timeframe
- The eligible enrollee is referred to a Transitional Rent Provider within 3 to 5 business days of identification.
- For an enrollee actively involved in specialty mental health or substance use disorder treatment, the referral is completed within 1 to 3 business days.
The enrollee is connected to Enhanced Care Management and the Housing Trio Community Supports as applicable; outreach is conducted when needed to engage the enrollee and coordinate Housing Transition Navigation Services, Housing Tenancy and Sustaining Services, and Housing Deposits.
A Housing Support Plan is developed in collaboration with the Housing Transition Navigation Services Provider and maintained to support transition to permanent housing before the Transitional Rent benefit ends, including how the enrollee can maintain housing and housing supports afterward.
Housing provided through Transitional Rent complies with applicable Housing and Urban Development standards or is habitable under California law, with habitability inspections conducted by the Transitional Rent Provider.
Referral and authorization dates, enrollee agreement, Housing Support Plans and updates, service utilization including the length of Transitional Rent use, and enrollee outcomes are documented and monitored.

Permitted housing settings

No specific housing setting or setting type is categorically excluded from Transitional Rent.

ALL of the following

Transitional Rent may be provided in interim or permanent housing settings; the Health Plan does not exclude coverage of any specific setting or setting type.

Service Parameters and Legal Requirements

Housing habitability legal requirementsmixed

California Civil Code §§ 1941, 1941.1, 1941.3

California habitability requirements referenced for housing provided through Transitional Rent.

Transitional Rent duration

Maximum durationUp to six months of rental assistance

Housing settingsInterim and permanent settings

Program goalConnect enrollees with permanent housing at the expiration of six months or sooner

Standard referral timeframe

Standard timeframeWithin 3 to 5 business days

Referral recipientTransitional Rent Providers

Trigger

Care Management Responsibilities

Note

Identify potentially eligible enrollees

Proactively identify enrollees who may benefit from Transitional Rent using ECM rosters, Housing Trio rosters, county and HMIS data, and utilization data, including frequent inpatient, skilled nursing, and emergency service use.

Review the Health Plan’s ECM and Housing Trio enrollee rosters.
Use data from Los Angeles County and other county agencies, including HMIS.
Review utilization data for frequent inpatient, skilled nursing, and emergency service use.

Prior Authorization

Complete standard referrals promptly

Refer eligible enrollees to Transitional Rent Providers within 3 to 5 business days of identification. Timely referral is required to connect eligible enrollees with the benefit and support transition to permanent housing.

Initiate the referral within 3 to 5 business days after identifying an eligible enrollee.

Key Terms

Transitional Rent

BenefitA Medi-Cal benefit providing rental assistance

DurationUp to six months

Eligible enrolleesEnrollees experiencing or at risk of homelessness who have certain clinical risk factors and meet specified eligibility criteria

Specialty Mental Health Services (SMHS)

ProviderCalifornia county mental health plans rather than Medi-Cal managed care plans

Population servedMedi-Cal members with significant or complex mental health needs

Scope

Policy Summary

PayerPHC California

PolicyPHC-CA Care Management of Enrollees Receiving Transitional Rent Community Support

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2026

Last ReviewSep 9, 2025

Next Review DateN/A

Key ActionRefer eligible enrollees to Transitional Rent Providers within 3 to 5 business days of identification.

SourceLink

On This Page

Identification of an eligible enrollee

Expedited referral timeframe

Expedited timeframeWithin 1 to 3 business days

Applicable enrolleesEnrollees receiving specialty mental health or substance use disorder services

Referral recipientTransitional Rent Providers

Housing Support Plan monitoring

Monitoring frequencyAt least monthly

Monitoring focusProgress toward permanent housing

Plan requirementUpdate the Housing Support Plan in collaboration with providers

Refer the enrollee to a Transitional Rent Provider.

Prior Authorization

Expedite behavioral health referrals

For enrollees receiving specialty mental health or substance use disorder services, complete the referral within 1 to 3 business days. This applies to active involvement in specialty mental health or substance use disorder treatment, including services through LACDMH or LACDH.

Use the expedited timeframe for active specialty mental health or substance use disorder treatment.
Complete the referral within 1 to 3 business days.

Documentation Required

Document enrollee agreement

Obtain the enrollee’s verbal agreement to receive Transitional Rent and document that agreement in the electronic medical record (EMR). The enrollee must agree to the benefit before the referral is completed.

Obtain verbal agreement from the enrollee.
Record the agreement in the EMR.

Documentation Required

Obtain information-sharing permission when required

When required by federal law, obtain and document the enrollee’s permission to share health information with Transitional Rent Providers and other entities needed to coordinate care and benefits. Document verbal permission in the EMR when applicable.

Determine whether federal law requires permission to share health information.
Document the enrollee’s permission in the EMR when required.

Documentation Required

Coordinate ECM and Housing Trio services

Upon authorization for Transitional Rent, confirm that the enrollee is engaged in ECM and the Housing Trio Community Supports. Conduct outreach when needed and connect the enrollee with Housing Transition Navigation Services, Housing Tenancy and Sustaining Services, and Housing Deposits.

Conduct outreach to authorized enrollees who are not yet receiving ECM.
Contact Housing Trio providers as needed to ensure appropriate housing supports are received.
Coordinate the three Housing Trio services with the enrollee’s care.

Documentation Required

Maintain the Housing Support Plan

Develop and maintain a Housing Support Plan in collaboration with the Housing Transition Navigation Services Provider. Monitor progress toward permanent housing and update the plan at least monthly, including how the enrollee can maintain housing and housing supports after Transitional Rent ends.

Include payment sources and mechanisms or other information supporting housing maintenance after coverage ends.
Monitor progress toward permanent housing.
Update the plan at least monthly.

Documentation Required

Coordinate housing quality and services

Maintain ongoing communication among Transitional Rent Providers, Housing Trio Services Providers, and ECM staff to align services. Confirm that Transitional Rent Providers conduct habitability inspections and that housing complies with HUD standards or applicable California Civil Code requirements.

Coordinate Transitional Rent Providers, Housing Trio providers, and ECM staff.
Confirm habitability inspections are completed.
Ensure compliance with HUD or California Civil Code requirements.

Documentation Required

Track utilization and outcomes

Record referral and authorization dates, the enrollee’s agreement, Housing Support Plans and updates, service utilization including the length of Transitional Rent use, and outcomes such as permanent housing placement or transition to another housing subsidy. Use this information to evaluate the effectiveness of Transitional Rent.

Record referral and authorization dates in the EMR.
Record the enrollee’s verbal agreement and Housing Support Plan updates.
Track utilization, including the length of Transitional Rent use.
Document permanent housing placement or transition to another housing subsidy.

Needs that go beyond mild-to-moderate behavioral health services covered by health plans

Mental Health Services Act (MHSA)

AuthorityCalifornia state law passed by voters in 2004 as Proposition 63

PurposeCreates a major, ongoing source of funding for mental health services

AbbreviationMental Health Services Act (MHSA)

Behavioral Health Services Act

AuthorityCalifornia state law passed as part of Proposition 1 in March 2024

Relationship to MHSAReplaces the Mental Health Services Act (MHSA)

Expanded scopeBroadens behavioral health funding beyond mental health to explicitly include substance use disorder treatment

Enhanced Care Management (ECM)

Benefit typeA Medi-Cal benefit

ApproachWhole-person, interdisciplinary care addressing the clinical and non-clinical needs of high-need and/or high-cost enrollees

Care modelSystematic coordination of services and comprehensive care management that is community-based, high-touch, and person-centered

Housing Trio

Service typeThree interrelated Community Supports

Included serviceHousing Transition and Navigation Services

Included servicesHousing Deposits; Housing Tenancy and Sustaining Services