Health / Housing

The Promise, Pitfalls, and Potential of CalAIM

And what funders can do to ensure the success of this transformational program

In partnership with the California Community Foundation and with seed funding from Cedars-Sinai and additional support from Health Net, NFF launched a two-year initiative in 2022 to support a cohort of 11 Los Angeles-based homeless service providers in various stages of considering CalAIM. The initiative brought the cohort together for peer learning, financial management skill building, and knowledge sharing. Highlights from the report include:  

Challenges Experienced by LA Homeless Providers 

  • Complex contracting processes with managed care plans (MCPs) require community-based organizations (CBOs) to dedicate substantial unfunded time and expenses to navigate 
  • CBOs often experience a lack of funding to establish the infrastructure necessary to work with MCPs through CalAIM (e.g., software, training, hiring of new staff/contractors to perform outreach, conducting billing, and handling the additional administration under the program)   

What Funders Can Do to Ensure CalAIM’s Success 

  • Invest in CalAIM ‘start-up’ capital for grants to cover the significant up-front cost to “ready” their organizations for CalAIM and build infrastructure by adopting new IT systems, hiring new staff, acquiring healthcare billing expertise, and conducting staff training 
  • Provide working capital to help CBOs manage existing cash flow challenges and CalAIM ramp up: CalAIM has potential to eventually become a significant and consistent funding source for CBOs, but many LA homeless services agencies are grappling with the challenges of their existing funding streams 
  • Influence the CalAIM system by using our networks to connect with those in positions of power, including the state and MCPs 

Read the full report to explore how funders can help CBOs realize the full potential of CalAIM. 


This report was made possible with generous support from:

Logos for Cedars Sinai, California Community Foundation, and Health Net

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