Home Providers & Partners CalAIM Intermediate Care Facility for the Developmentally Disabled Long-Term Care Carve-In: Member Information

CalAIM Intermediate Care Facility for the Developmentally Disabled Long-Term Care Carve-In: Member Information

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Starting on January 1, 2024, Medi-Cal members who live in Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) (collectively referred to as Homes) will be enrolled in a Medi-Cal Managed Care Plan. “Facility” and “Home” are interchangeable terms for an Intermediate Care Facility for the Developmentally Disabled (ICF/DD) Facility. Members living in the following types of Homes will get their services paid for by their Managed Care Plan:

Intermediate Care Facility for the Developmentally Disabled, (ICF/DD);
Intermediate Care Facility for the Developmentally Disabled-Habilitative (ICF/DD-H); and
Intermediate Care Facility for the Developmentally Disabled-Nursing (ICF/DD-N).

Enrollment into a managed care plan will not change a member’s relationship with their Regional Center. Regional Centers will continue to serve members in the following ways:

Intake and assessment
Eligibility determination
Case management
Individual Program Plan (IPP) development
Purchase of necessary services and supports

Below are additional resources for members and the ICF/DD Member Enrollment Notices on the upcoming transition.

ICF/DD Transition Fact Sheet (Plain Language)

This fact sheet gives members residing in an ICF/DD Home a summary of what they can expect when joining Medi-Cal Managed Care. It includes key definitions, steps members may need to take, and who to contact with questions about the transition.

ICF/DD Long-Term Care (LTC) Member Enrollment Notices

Every Medi-Cal member living in an ICF/DD Home will receive Enrollment Notices 60 days and 30 days before January 1, 2024. Member notices will also be mailed to authorized representatives documented within the Medi-Cal Eligibility Data Systems (MEDS).

These notices differ depending on the county the member lives in and whether the member is a part of Medi-Cal matching plan policy.

Members living in ICF/DD Homes in Geographic Managed Care (GMC), Two-Plan, or Regional counties that are part of the Medi-Cal matching plan policy will receive notices with the Managed Care Plan that they must join based on their Medicare Advantage plan. These members will automatically be enrolled in the Managed Care Plan that matches their Medicare Advantage plan.
- LTC ICF/DD Member Notice 60/30 Day Notices 2B (Non-COHS) (English)
- LTC ICF/DD Member Notice 60/30 Day Notices 2B (Non-COHS) (Spanish)
Members living in ICF/DD Homes in Geographic Managed Care (GMC), Two-Plan, or Regional counties, but not part of the Medi-Cal matching plan policy will receive notices that include the Medi-Cal Managed Care Plan they will be enrolled in if they do not choose one by the selection deadline. These members will also receive a separate My Medi-Cal Choice packet to choose a Medi-Cal Managed Care Plan in November.
- LTC ICF/DD Member Notice 60/30 Day Notices 2A (Non-COHS) (English)
- LTC ICF/DD Member Notice 60/30 Day Notices 2A (Non-COHS) (Spanish)

Members living in ICF/DD Homes in County Organized Health System (COHS) and Single Plan expansion counties that are part of the Medi-Cal matching plan policy will receive notices with the Managed Care Plan they will automatically be enrolled that matches their Medicare Advantage plan.
- LTC ICF/DD Member Notice 60/30 Day Notices 2B (COHS/Single) (English)
- LTC ICF/DD Member Notice 60/30 Day Notices 2B (COHS/Single) (Spanish)

Members living in ICF/DD Homes in COHS and Single Plan expansion counties, but not part of the Medi-Cal matching plan policy will receive notices with the Managed Care Plan they will automatically be enrolled in.

LTC ICF/DD Notice of Additional Information (NOAI)

The ICF/DD LTC Notice of Additional Information (NOAI) is also below. The NOAI has more information about the change to Medi-Cal Managed Care and what it means for Medi-Cal members receiving ICF/DD services.

Where Members Can Go for More Information and Help

Members can contact any of the following groups with any questions about the ICF/DD transition to managed care. All calls are free.

For Questions about Why Your Medi-Cal Services are Changing:

DHCS Ombudsman Office

Call (888) 452-8609 (TTY: California State Relay at 711) (toll free), Monday to Friday, 8 a.m. to 5 p.m. PT.
Or email them at MMCDOmbudsmanOffice@dhcs.ca.gov
The Ombudsman Office helps people with Medi-Cal use their benefits and understand their rights and responsibilities.

Medicare Medi-Cal Ombudsman Program

Call (855) 501-3077 (toll free).
The Medi-Cal Ombudsman helps people with complaints and issues for both Medicare and Medi-Cal.

Long-Term Care Ombudsman

Call (800) 231-4024. The line is available 24 hours a day, 7 days a week (toll free).
The Long-Term Care Ombudsman helps people who live in a skilled nursing home, intermediate care facility, and subacute care facility with complaints and know their rights and responsibilities.

To Learn More about Health Plan and Provider Choices:

Health Care Options

Call (800) 430-4263 (TTY: (800) 430-7077), Monday to Friday, 8 a.m. to 6 p.m.
Or go to the Health Care Options website at www.healthcareoptions.dhcs.ca.gov
Health Care Options helps people with plan choices and doctor or clinic choices.

For Questions about Medi-Cal:

DHCS Medi-Cal Helpline

Call (800) 541-5555 (toll free), Monday to Friday, 8 a.m. to 5 p.m. PT.

To Find Your Local Regional Center:

Visit the Department of Development Services website at https://www.dds.ca.gov/rc/lookup-rcs-by-county/.
Or call the Department of Developmental Services at (833) 421-0061.
The counties served by each Regional Center can be found below:

Regional Center	Counties
Alta California Regional Center	Alpine, Colusa, El Dorado, Nevada, Placer, Sacramento, Sierra, Sutter, Yuba, and Yolo
Central Valley Regional Center	Fresno, Kings, Madera, Mariposa, Merced, and Tulare
Eastern Lost Angeles Regional Center	Los Angeles (Alhambra, East Los Angeles, Northeast, Whittier)
Far Northern Regional Center	Butte, Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, Trinity
Frank D. Lanterman Regional Center	Los Angeles (Central, Glendale, Hollywood-Wilshire, Pasadena)
Golden Gate Regional Center	Marin, San Mateo, and San Francisco
Harbor Regional Center	Los Angeles (Bellflower, Harbor, Long Beach, and Torrance)
Inland Regional Center	Riverside and San Bernardino
Kern Regional Center	Inyo, Kern, and Mono
North Bay Regional Center	Napa, Solano, and Sonoma
North Los Angeles County Regional Center	Los Angeles (East Valley, San Fernando, and West Valley)
Redwood Coast Regional Center	Del Norte, Humboldt, Lake, and Mendocino
Regional Center of East Bay	Alameda and Contra Costa
Regional Center of Orange County	Orange County
San Andreas Regional Center	Monterey, San Benito, Santa Clara, and Santa Cruz
San Diego Regional Center	Imperial and San Diego
San Gabriel/Pomona Regional Center	Los Angeles (El Monte, Glendora, Monrovia, and Pomona)
South Central Los Angeles Regional Center	Los Angeles (Compton, San Antonio, South, Southeast, and Southwest)
Tri-Counties Regional Center	San Luis Obispo, Santa Barbara, and Ventura
Valley Mountain Regional Center	Amador, Calaveras, San Joaquin, Stanislaus, and Tuolumne
Westside Regional Center	Los Angeles (Inglewood and Santa Monica–West)