CalAIM Subacute Care Facility Long-Term Care Carve-In
Return to the CalAIM Homepage
Return to CalAIM Long-Term Care Carve-In Transition Homepage
Under CalAIM, subacute care services will transition statewide to Medi-Cal managed care in order to standardize adult and pediatric subacute care coverage. In addition, the Subacute Care Carve-In will advance a more consistent and integrated system of managed care and increase access to comprehensive care coordination, care management, and a broad array of services for Medi-Cal members in Subacute Care Facilities.
For more information on subacute care services, please visit the
Subacute Care webpage.
January 1, 2024 Transition
Effective January 1, 2024, all Medi-Cal managed care plans (MCPs) will become responsible for covering institutional long-term care (LTC) services in an adult and pediatric Subacute Care Facilities.
Adult subacute care services will be newly transitioning from Medi-Cal Fee-For-Service (FFS) to Medi-Cal managed care are within 31 counties:
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, El Dorado, Fresno, Glenn, Imperial, Inyo, Kern, Kings, Madera, Mariposa, Mono, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, Sierra, Stanislaus, Sutter, Tehama, Tulare, Tuolumne, and Yuba.
Pediatric subacute care services will be newly transitioning from Medi-Cal FFS to Medi-Cal managed care within 36 counties:
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, El Dorado, Fresno, Glenn, Imperial, Inyo, Kern, Kings, Los Angeles, Madera, Mariposa, Mono, Nevada, Placer, Plumas, Riverside, Sacramento, San Benito, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Sierra, Stanislaus, Sutter, Tehama, Tulare, Tuolumne, and Yuba.
Important Updates
SNF and Subacute Care Facility LTC Carve-In Resources for Managed Care Plans
The SNF and Subacute Care Facility Resources for Managed Care Plans is intended to serve as a guide for MCPs to use for the transition to managed care. The document provides information on contracting requirements, promising practices, and suggested model contract language for the SNF and Subacute Care Facility LTC Carve-In. The Resources for Managed Care Plans document can be found under Key Documents.
Frequently Asked Questions
DHCS has developed a Frequently Asked Questions document which addresses stakeholder inquiries on the Subacute Care Facility Carve-In implementation, network readiness, contracting, authorizations, facility payment, among other topics. The document was produced to help provide clarity to stakeholder questions received during the CalAIM Subacute Care Facility LTC Carve-In educational webinar series. The FAQ document can be found under Key Documents.
All Plan Letter
DHCS has released the All Plan Letter on the Subacute Care Facility Carve-In that may be found under Key Documents. The All Plan Letter 23-027, titled Subacute Care Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care, provides requirements for all Medi-Cal managed care plans for the LTC Subacute Care Facility services provisions of the CalAIM benefit standardization initiative. The APL contains requirements related to adult and pediatric Subacute Care Facilities.
Contracting with DHCS' Subacute Care Unit
MCPs must ensure that if a Medi-Cal member needs adult or pediatric subacute care services, they are placed in a health care facility that is under contract for subacute care with DHCS' Subacute Contracting Unit (SCU) or is actively in the process of applying for a contract with DHCS' SCU. A list of approved and active Subacute Care Facilities can be found on the
DHCS SCU website. More information for facilities can be found on the Medi-Cal Subacute Care Contracting: Application Information for Facilities Fact Sheet under Key Documents.
Information for Members
By January 1, 2024, Medi-Cal members in a Subacute Care Facility will transition from Medi-Cal FFS to Medi-Cal managed care. DHCS is developing member notices and other resources designed to ensure a seamless transition for members moving into managed care. Members residing in Subacute Care Facilities in the counties listed above will begin receiving member communications in the mail on the transition in November 2023 from DHCS. Copies of the Subacute Care Facility LTC Enrollment notices and other resources for members are available on the
Subacute Care Facility Carve-In Member Information webpage.
Key Documents
Informational Webinars
To support stakeholder planning and implementation, DHCS will host a series of educational webinars on the Subacute Care Facility LTC Carve-In transition. Meeting materials will be made available here following each webinar.
Past Webinars
Subacute Care Facility Carve-In Office Hours: Wednesday, February 14, 2024 at 2:30 p.m.
How Medi-Cal Managed Care Supports Subacute Care Facility and ICF/DD Home Residents: December 15, 2023 at 9:00 a.m.
Subacute Care Facilities 101 for Managed Care Plans: Wednesday, September 13, 2023 at 10:00 a.m.
Subacute Care Carve-In 101 for Subacute Care Facilities: Friday, September 15, 2023 at 9:30 a.m.
Subacute Care Facility Carve-In Billing & Payment: Wednesday, November 29, 2023 at 3:00 pm.
Additional Resources
Listed below are additional resources:
Questions and Comments
Contact DHCS with any questions or comments about the CalAIM Subacute Care Facility LTC Carve-In Transition at
LTCTransition@dhcs.ca.gov.
