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CalAIM

An RCFE (Residential Care Facility for the Elderly) can accept CalAIM residents, but with some conditions.

Key Points:

✅ 1. CalAIM Residents in RCFE:

  • CalAIM’s Community Supports and Enhanced Care Management (ECM) are aimed at providing alternatives to institutional care, including supportive housing in RCFE settings, if appropriate.

  • However, RCFE facilities are not licensed as medical facilities, so they must only serve residents whose care needs can be met legally under RCFE licensing rules (Title 22 regulations).

📄 2. Forms or Process Required:

There is no universal “CalAIM RCFE enrollment form”, but some coordination is required:

  • The managed care plan (MCP) must approve placement of the member in an RCFE under Community Supports: Housing Transition/Navigation or Housing Tenancy services.

  • The RCFE may need to sign agreements with:

    • The managed care plan

    • A Community Supports provider (e.g., for case management or tenancy support)

  • A resident assessment (LIC 602 or equivalent) must show the individual qualifies for RCFE level of care.

  • There may be additional documentation required to show that the resident does not require skilled nursing care beyond what RCFEs can legally provide.

⚠️ 3. No Special “Waiver” for RCFE Licensure:

  • RCFEs cannot waive licensing rules to accept residents who need a higher level of care (e.g., skilled nursing).

  • CalAIM does not override Title 22 regulations.

📝 What You Might Need:

Here’s a checklist if you're trying to admit a CalAIM resident to an RCFE:

Document/ProcessRequired?Notes

LIC 602/Physician's Report✅Must show RCFE-level care is appropriate

RCFE Admission Agreement✅Standard requirement

Authorization from Managed Care Plan✅If CalAIM is paying for Community Supports

Coordination with Housing Services Provider✅If part of CalAIM Community Supports

Waiver from DSS or CDSS❌Not available for RCFE license requirements

👉 What You Should Do:

  1. Contact the CalAIM resident's managed care plan to confirm if Community Supports for RCFE placement is approved.

  2. Ensure the resident’s health condition fits RCFE care limits.

  3. Coordinate with the local Community Supports provider, if applicable.

  4. Keep clear documentation of medical eligibility and funding.

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