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Supervisors approve pilot to bill managed care for homeless outreach services
Summary
The board unanimously approved a pilot to contract with managed-care plans and bill CalAIM for outreach, case management and housing navigation already provided by the Office of Homeless Solutions, with staff estimating up to $5.6 million annually in medical revenue that could offset general-fund costs.
The San Diego County Board of Supervisors on May 19 approved a pilot to expand CalAIM billing for regional homeless outreach services delivered by the Office of Homeless Solutions (OHS). Acting Chair Montgomery Stepp and other supervisors framed the pilot as a way to align funding with the population served and to reduce reliance on general-purpose county revenue.
County presenters said an estimated 90% of OHS clients are medically eligible and that contracting with managed-care plans could offset a large share of costs. The board letter projected as much as $5.6 million a year in medical revenue, potentially covering up to 78% of regional outreach costs. Supporters and several people with lived experience urged the county to use the pilot to improve coordination, housing placements and prevention services.
Public comment was mixed: advocates and some clinicians described the value of integrated health-and-housing approaches, while skeptical callers worried about medicalizing homelessness or about managed-care administrative barriers. Board members asked staff to evaluate outcomes beyond reimbursement, including housing placements and emergency-room utilization.
The motion to proceed with the CalAIM pilot passed unanimously with all supervisors present voting yes; the county will develop contracting and data systems and report back on measurable outcomes.
