Bill Text: CA AB804 | 2025-2026 | Regular Session | Introduced

California Assembly Bill 804

Introduced

Bill Title: Medi-Cal: housing support services.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2025-02-19 - From printer. May be heard in committee March 21. [AB804 Detail]

Download: California-2025-AB804-Introduced.html

CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION

Assembly Bill

No. 804

Introduced by Assembly Members Wicks and Stefani

February 18, 2025

An act to repeal and add Section 14124.16 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

AB 804, as introduced, Wicks. Medi-Cal: housing support services.

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.

Existing law, subject to implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative, authorizes a Medi-Cal managed care plan to elect to cover community supports approved by the department as cost effective and medically appropriate in a comprehensive risk contract that are in lieu of applicable Medi-Cal state plan services. Under existing law, community supports that the department is authorized to approve include, among other things, housing transition navigation services, housing deposits, and housing tenancy sustaining services.

Existing law, subject to an appropriation, requires the department to complete an independent analysis to determine whether network adequacy exists to obtain federal approval for a covered Medi-Cal benefit that provides housing support services. Existing law requires that the analysis take into consideration specified information, including the number of providers in relation to each region’s or county’s number of people experiencing homelessness. Existing law requires the department to report the outcomes of the analysis to the Legislature by January 1, 2024.

This bill would delete the requirement for the department to complete that analysis, and instead would make housing support services for specified populations a covered Medi-Cal benefit when the Legislature has made an appropriation for purposes of the housing support services. The bill would require the department to seek federal approval for the housing support services benefit, as specified. Under the bill, subject to an appropriation by the Legislature, a Medi-Cal beneficiary would be eligible for those services if they either experience homelessness or are at risk of homelessness. Under the bill, the services would include housing transition navigation services, housing deposits, and housing tenancy sustaining services, as defined.

The bill would authorize the department to implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or similar instruction, and to enter into exclusive or nonexclusive contracts, or amend existing contracts for its purposes, as specified. The bill would authorize these provisions to be modified by the department to the extent necessary to meet the requirements of federal law or regulations, to obtain federal approval, or to enhance the probability that federal approval can be obtained, as specified.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

Section 14124.16 of the Welfare and Institutions Code is repealed.

14124.16.
(a)(1)Upon appropriation by the Legislature for this purpose, the department shall complete an independent analysis to determine whether network adequacy exists to obtain federal approval for a covered Medi-Cal benefit that provides housing support services. The analysis shall take into consideration all of the following in assessing capacity to provide a covered housing support services benefit:
~~(A)Providers that are not certified Medi-Cal providers, but are receiving funding from the United States Department of Housing and Urban Development to provide housing support services.~~
~~(B)The number of providers in relation to each region’s or county’s number of people experiencing homelessness.~~
(C)A comparison of provider networks in states that have implemented Medicaid benefits to fund housing support services, including any similar Medicaid benefits in California serving different populations.
(D)Specific actions the department could take to develop a network of providers meeting the criteria of this section, and an estimated timeline for developing an adequate network, should the analysis conclude that the state’s network is not yet adequate.
(2)The department shall report, in compliance with Section 9795 of the Government Code, the outcomes of the independent analysis to the Legislature by January 1, 2024, so long as an appropriation is made as described in paragraph (1).
(b)For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual, and shall be exempt from the review or approval of any division of the Department of General Services.

SEC. 2.

Section 14124.16 is added to the Welfare and Institutions Code, to read:

14124.16.

(a) For purposes of this section, the following definitions apply:

(1) “At risk of homelessness” has the same meaning as set forth in Section 91.5 of Title 24 of the Code of Federal Regulations, unless otherwise defined by the department in regulation, all-county letter, plan letter, provider bulletin, information notice, or similar instruction.

(2) “Community supports” has the same meaning as set forth in paragraph (1) of subdivision (i) of Section 14184.206.

(3) “Department” means the State Department of Health Care Services.

(4) “Homelessness” as it corresponds to the term “homeless” has the same meaning as set forth in Section 578.3 of Title 24 of the Code of Federal Regulations, as that section read on January 1, 2023, except that an individual shall continue to be considered “homeless” when living in or exiting an institutional setting, even if residing in that institutional setting for longer than 90 days, so long as they were homeless prior to residency or have nowhere to live upon exit, as well as people receiving transitional rent.

(5) “Housing transition navigation services” means evidence-based and best practices that provide outreach to, and engage with, people experiencing homelessness in order to facilitate participation in the program and assist with transitioning to housing. The term includes the following services:

(A) Assisting beneficiaries with obtaining local, state, or federal rental assistance or subsidies, and in locating permanent housing with private market landlords or property managers who are willing to accept rental assistance.

(B) Assisting beneficiaries in completing housing applications for permanent housing, including obtaining documentation needed to access permanent housing.

(D) Assisting beneficiaries with applying for benefits to afford their housing.

(E) Ensuring that the living environment is safe and ready for move-in.

(F) Assisting and arranging for the details of the move, including identifying resources to assist with moving expenses.

(G) Developing a housing support crisis plan that includes prevention and early intervention when housing is jeopardized.

(H) Assisting the beneficiary to develop skills vital to maintaining permanent housing, including understanding and developing a budget, negotiating a lease, and building a good relationship with a prospective landlord.

(I) Working closely with enhanced care management providers, county behavioral health agencies, and long-term services and supports providers to connect participants with full-service partnership services and other supports, when participants may be eligible.

(6) “Housing deposits” means one-time expenses for move-in, such as security deposits, payment of utility arrears and startup, and necessary furniture costs.

(A) Security deposits required to obtain a lease on an apartment or home.

(B) Setup fees or deposits for utilities or service access and utility arrearages.

(D) First month’s and last month’s rent as required by landlord for occupancy.

(E) Services necessary when moving into a home for the individual’s health and safety, such as pest eradication and one-time cleaning prior to occupancy.

(F) Goods such as an air conditioner or heater, and other medically necessary adaptive aids and services, designed to preserve the persons’ health and safety in the home, such as hospital beds, Hoyer lifts, air filters, specialized cleaning or pest control supplies etc., that are necessary to ensure access and safety for the person upon move-in to the home.

(G) The administrative coordination services to administer payments for one-time expenses.

(7) “Housing tenancy sustaining services” means services that preserve and maintain a person’s housing within their community, including any of the following:

(A) Early identification and intervention of actions that may jeopardize housing security.

(B) Education and training on the rights and responsibilities of the tenant and the landlord.

(D) Assistance in resolving disputes with landlords and neighbors to reduce the risk of eviction.

(E) Advocacy and linkage with community resources to prevent eviction when housing may become jeopardized.

(F) Care coordination and advocacy with health care professionals.

(G) Assistance with a housing recertification process.

(H) Coordinating with the tenant to review and update a housing support and crisis plan.

(I) Assistance with applying for benefits to retain housing.

(J) Educating tenants about their benefits and the need for a stable source of income to maintain housing.

(K) Coordinating with, and linking individuals to, services and service providers in the community that can assist with maintaining stable housing.

(L) Providing supported employment services.

(M) Providing skills training on how to maintain a safe and healthy home environment.

(N) Working closely with enhanced care management providers, county behavioral health agencies, and long-term services and supports providers to connect participants with full-service partnership services and other supports, when participants may be eligible.

(8) “Supported employment services” means evidence-based individualized services provided to individuals with disabilities to obtain and keep competitive employment. Supported employment services include all of the following:

(A) Assistance with completing employment applications.

(B) Identifying potential workplace accommodations that may be required.

(D) Assistance with transportation needs.

(E) Coordinating vocational training.

(F) Assistance with developing skills to maintain stable employment.

(G) Care coordination and advocacy with health care professionals to support care planning and referrals to other needed services.

(b) (1) Subject to utilization controls, housing support services for the populations identified in paragraph (4) shall be a covered Medi-Cal benefit in an applicable fiscal year when the Legislature has passed an appropriation for the subject fiscal year for this express purpose.

(2) The department shall seek federal approval of a covered Medi-Cal benefit for housing support services no later than March 31, 2026.

(3) Upon implementation of a federally approved covered Medi-Cal benefit for housing support services, housing support services shall no longer be community supports that a Medi-Cal managed care plan may elect to cover.

(4) A Medi-Cal beneficiary shall be eligible for a housing support services benefit under this subdivision if they meet either of the following criteria:

(A) The beneficiary is currently experiencing homelessness.

(B) The beneficiary is at risk of homelessness.

(1) Housing transition navigation services.

(2) Housing deposits.

(3) Housing tenancy sustaining services.

(d) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, in whole or in part, by means of all-county letters, plan letters, provider bulletins, information notices, or similar instruction, without taking further regulatory action. The department shall seek stakeholder input at least two weeks before issuing guidance pursuant to this authority.

(e) This section shall be implemented only to the extent that any necessary federal approvals are obtained, and federal financial participation is available and not otherwise jeopardized.

(f) For purposes of implementing this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the State Administrative Manual, and shall be exempt from the review or approval of any division of the Department of General Services.

(g) (1) Any provision of this section may be modified by the department to the extent necessary to meet the requirements of federal law or regulations, to obtain federal approval, or to enhance the probability that federal approval can be obtained, provided the modifications do not violate the spirit and intent of the section.

(2) If the department determines that a modification is necessary pursuant to paragraph (1), the department shall consult with stakeholders and notify the Legislature of expected modifications.