Medi‑Cal Pilot Aims to Cut Homeless Costs

San Jose is moving health care billing into homeless shelters, betting Medi-Cal can help pay for services at three tiny home villages. (sanjosespotlight.com) The San Jose City Council voted Tuesday to accept and match a $1.3 million federal Providing Access and Transforming Health grant, or PATH, to build the billing and data systems the pilot needs. City officials said the reimbursements could save roughly $7 million to $9 million a year. (sanjosespotlight.com) The pilot will start at three city-funded tiny home sites, where providers would bill Medi-Cal for eligible services such as case management and behavioral health support under California Advancing and Innovating Medi-Cal, known as CalAIM. PATH is a five-year, $1.85 billion state initiative designed to help community groups and local agencies build the staff, billing and data capacity needed to participate in Medi-Cal. (sanjosespotlight.com) (dhcs.ca.gov) San Jose is looking for new revenue because its shelter system is getting much bigger and much more expensive. The city projected $94 million in shelter maintenance and operating costs for the coming fiscal year across 23 temporary housing sites, including 10 tiny home villages, 10 motel shelters, two safe parking sites and one safe sleeping site. (sanjosespotlight.com) Mayor Matt Mahan has also pushed to standardize shelter operations and rebid service contracts as the city tries to lower costs. San Jose estimated it could cut tiny home operating costs by about 15% by standardizing security, food and property management across multiple sites. (sanjosespotlight.com) The funding squeeze comes as San Jose says it still has far fewer beds than people living outside. The city says about 5,477 people are unsheltered, while planned new and expanded sites would bring total capacity to about 1,840 beds and spaces, leaving a gap of more than 3,000 units. (sanjoseca.gov) CalAIM is California’s effort to use Medicaid dollars more broadly for “whole person” care, including services tied to housing stability, mental health and care coordination. PATH does not directly pay shelter rent or construction costs; it funds the back-end systems and staffing that let local providers qualify for Medi-Cal reimbursement. (dhcs.ca.gov) San Jose officials told San José Spotlight the immediate goal is to preserve services and possibly expand beds without absorbing the full cost from the city budget. If the pilot works at the three villages, the city could use the same billing model at more shelters in its network. (sanjosespotlight.com) The city’s bet is simple: if some shelter services can be billed as health care, San Jose may be able to keep more beds open as its homelessness system grows. (sanjosespotlight.com)