Community Supports
What are Community Supports?
Community Supports (CS), previously known as In Lieu of Services or ILOS, are community-based services that address health-related social needs. Medi-Cal managed care health plans may offer these alternative services to their members to avoid hospital care, nursing facility care, visits to the emergency department or other costly services.
Which Community Supports are offered by SFHP?
- Medical Respite (Recuperative Care)
Medical Respite is short-term residential care for individuals who no longer require hospitalization, but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment. An extended stay in a recovery care setting allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management and other supportive social services, such as transportation, food, and housing. - Sobering Center
Sobering centers are alternative destinations for individuals who are found to be publicly intoxicated (due to alcohol and/or other drugs) and would otherwise be transported to the emergency department or jail. Sobering centers provide these individuals, primarily those who are homeless or those with unstable living situations, with a safe, supportive environment to become sober. - Housing Transition Navigation Services (HTN)
Housing Transition Navigation (HTN) services assists members who are homeless or at risk of experiencing homelessness with obtaining housing. HTN provides member support to address individual barriers to successful tenancy. Services include but are not limited to a housing assessment and plan, housing search and coordination of resources, advocacy, landlord education and engagement, and assistance with move-in. Contracted Providers are listed in SFHP’s provider directory. - Medically Tailored Meals (MTM)
Medically Tailored Meals are for members with chronic conditions. MTM helps members achieve their nutrition goals at critical times and helps them regain and maintain their health. Meals are individually tailored by a Registered Dietician and can be delivered to homes or picked up at an agreed upon location. Contracted Providers are listed in SFHP’s provider directory.
Eligibility Criteria
Medical Respite:
- Individuals who are at risk of hospitalization or are post-hospitalization, and unhoused
- Individuals who live alone with no formal support; or who face housing insecurity or have housing that would jeopardize their health and safety without modification
Sobering Center:
- Individuals age 18 and older who are intoxicated but conscious, cooperative, able to walk, nonviolent, free from any medical distress (including life threatening withdrawal symptoms or apparent underlying symptoms),
- Who would otherwise be transported to the emergency department; or a jail or who presented at an emergency department and are appropriate to be diverted to a Sobering Center
Housing Transition Navigation Services:
- Prioritized for housing through the Coordinated Entry System (CES); or
- Experiencing homelessness; or
- At risk of homelessness
Medically Tailored Meals
Inpatient visit within the past 6 months AND one of the following conditions:
- Congestive Heart Failure
- Chronic Kidney Disease, stage 3 or 4
How do eligible Medi-Cal members get Community Supports services?
- Provider contacts SFHP
For information on referrals, please call the Care Management intake line at 1(415) 615-4515 or SFHP Customer Service at 1(415) 547-7800.
Providers can also submit a Community Supports Referral Form to the Care Management Intake Team. Our referral forms are below, and submission instructions are included on the forms. - A member asks to join
Members can contact SFHP Customer Service at 1(415) 547-7800 to verify eligibility and pursue applicable next steps. Enhanced Care Management members can request a referral from their care managers.
Can members receive multiple Community Supports?
Yes. Many members qualify for one or several Community Supports. Community Supports referrals are encouraged for ECM recipients as they help keep members safe, supported, and reduce inpatient stays.