CalAIM Intermediate Care Facility for Developmentally Disabled Long-Term Care Carve-In
Return to CalAIM Long-Term Care Carve-in Transition
California is transforming Medi-Cal through several initiatives to continue to drive quality of care improvements, streamline and reduce complexity, and build upon equity-focused, data-driven, and whole-person care. The Intermediate Care Facility for Developmentally Disabled (ICF/DD) Carve-In to Medi-Cal managed care standardizes ICF/DD services covered under managed care statewide in order to 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 ICF/DD Homes (including habilitative and nursing).
What the Carve-In means for Californians
On January 1, 2024, all Medi-Cal managed care plans (MCPs) became responsible for covering the following ICF/DD services:
- ICF/DD
- ICF/DD-Habilitative (ICF/DD-H)
- ICF/DD-Nursing (ICF/DD-N)
Note: ICF/DD-Continuous Nursing Care (ICF/DD-CN) Homes are not subject to the Long-Term Care (LTC) Carve-In policy.
MCPs coordinate the care members require both within their ICF/DD Homes as well as from other providers. MCPs provide members with a network of health care providers and care coordination services to help manage member care. MCPs work closely with Regional Centers to preserve the Lanterman Act protections for individuals with developmental disabilities.
More information for members can be found on the LTC Carve-In Member Information webpage.
Key Carve-In Documents
Policy Guidance
- APL 24-011 ICF/DD – LTC Benefit Standardization and Transition of Members to Managed Care (Updated September 16, 2024)
- Model Contract Language (Updated November 2023)
- ICF/DD Carve-In FAQs (Updated October 25, 2024)
- MCP Letter on Continuity of Care for Members Residing in ICD/DD Homes
Forms
Additional Carve-In Resources
- Department of Developmental Services (DDS) Authorization for Regional Centers to continue providing lag funding through December 31, 2025 (For more details, visit the DDS Regional Center Directive website)
- 2024 MCP by County and Corresponding Regional Center
- ICF/DD Billing and Invoicing Guidance
- ICF/DD Carve-In Resource Guide (Updated January 2024)
- ICF/DD Carve-In Resource Round Up (Updated January 2024)
Managed Care Resources for LTC Providers
- Medi-Cal Authorizations LTC Resource
- Medi-Cal Billing and Payment LTC Resource
- Medi-Cal Eligibility and MCP Enrollment LTC Resource
Informational Webinars
Department of Health Care Services (DHCS) hosted educational webinars to support stakeholders with the LTC Carve-In implementation. Details and materials for the webinars can be found at the following link:
ICF/DD Carve-In Workgroup Meeting Archive
DHCS and DDS convened a workgroup from March 2022 through February 2024 focused on the transition of ICF/DD services from the Medi-Cal Fee-for-Service (FFS) delivery system to the Medi-Cal managed care delivery system. The workgroup provided an opportunity for stakeholders to collaborate and provide advisory feedback on DHCS’ policy and operational efforts in carving in ICF/DD services.
Details and materials for each meeting can be found at the following link:
Additional Resources
- CalAIM Managed Long Term Services and Supports & Duals Stakeholder Integration Workgroup
- California Long-Term Services and Supports Dashboard
- Transitional Care Services for Members with Long-Term Services and Supports Needs
- Automated Eligibility Verification System (AEVS) via the DHCS Provider Portal – where providers can find MCP enrollment information for members
Questions
Contact DHCS with any questions about the ICF/DD LTC Carve-In at LTCTransition@dhcs.ca.gov.