Supported by Kaiser Permanente Community Health of Southern California, the pilot utilizes CalAIM Community Supports to increase access to recuperative care services for medically vulnerable and disabled unhoused individuals
LOS ANGELES, Calif., – Jan. 14, 2026 —The National Health Care for the Homeless Council (NHCHC), through its National Institute for Medical Respite Care (NIMRC), today announced the launch of an innovative pilot program that brings outside caregiving services into recuperative care facilities to support unhoused patients with Activities of Daily Living (ADLs). The pilot aims to expand access to recuperative care for individuals who might otherwise be denied admission due to higher care needs.
The purpose of the 12-month ADL Assistance in Recuperative Care Pilot (ADL Pilot) is to test the use of Personal Care & Homemaker Services (PCHS), which managed care plans could authorize to fund the caregiving services. PCHS is one of 14 CalAIM Community Supports from the California Department of Health Care Services’ (DHCS) Medi-Cal Transformation initiative that addresses housing-related social needs of its low-income members.
The Medi-Cal members participating in the pilot must be experiencing homelessness or be at risk of becoming homeless and be actively assigned to an L.A. County managed care plan (MCP), which will authorize a certain number of caregiving hours per month depending on the patient’s care needs identified by a hospital assessment.
Historically, Recuperative Care (also known as medical respite care) programs—short-term, post-acute residential care facilities for individuals discharged from the hospital who do not have a home in which to continue healing from illness, injury or surgery—do not offer ADL supports, as most recuperative care facilities are not licensed to provide hands-on personal care such as assistance with toileting, bathing, dressing, transferring and grooming.
“People experiencing homelessness who need support with ADLs have long been excluded from accessing recuperative care,” says Julia Dobbins, NHCHC’s Director of Medical Respite Care. “This pilot aims to fill this critical gap in care and get more vulnerable individuals off of the street and into recuperative care programs where they can be safe, get connected to services, and receive the vital medical treatment they need so badly.”
Golden State Recuperative Care, a NIMRC-certified, 27-bed recuperative care program in Los Angeles, was the first facility to accept patients with ADL support needs through the pilot and welcome the outside caregivers into their facility to care for them.
“Through this partnership, we’ve gained tools to track outcomes and better integrate ADL assessments into our care plans,” says Ruth Kelley, Golden State’s Office Manager. “Ultimately, our participation is about empowerment and ensuring that every client regains a sense of independence and hope through small, consistent steps towards self-sufficiency.”
The ADL Pilot also benefits participating hospitals who are often challenged to place unhoused patients with ADL support needs in the appropriate care setting. The pilot aims to speed up safe hospital discharges and reduce costs for the hospital system.
The success of the ADL Pilot relies on the dedicated participation of 16 organizations and health care agencies along the continuum of care in L.A. County:
The ADL Pilot workflow, which is a new referral pathway and process for all participating partners, requires a high level of collaboration between hospitals, managed care plans (MCPs), home care organizations and recuperative care providers. Partners in Care Foundation, the primary facilitator of patient referrals and care coordination, hopes to connect many unhoused members to necessary services in the Recuperative Care setting through the pilot. “We want to see a reduction in unnecessary Skilled Nursing Facility admissions, and that members are able to recover fully so they reduce their risk of hospital readmission,” says Christy Lau, Vice President of Community Integration from Partners in Care Foundation.
Once safely in a participating recuperative care facility, the patient will apply for In-Home Supportive Services (IHSS) through L.A. County’s Department of Social Services. The recuperative care provider will assist the client in finding an IHSS provider for ongoing caregiving services to promote long-term safety and stability when they move on to housing.
NHCHC is also thrilled to announce the addition of the expert UCLA-RAND evaluation team, which will analyze the health and housing outcomes of patients referred to recuperative care through the ADL Pilot. UCLA-RAND are the current evaluators of the statewide assessment of DHCS’s five-year CalAIM initiative, including its Community Supports, ECM and PATH programs.
The ADL Pilot is made possible by generous funding from Kaiser Permanente Southern California’s Community Health Program — a dedicated supporter of recuperative care services. “Kaiser Permanente understands that recuperative care is not just a service—it’s a lifesaving intervention for people experiencing homelessness. It ensures that patients leaving the hospital have a safe place to heal, recover, and regain stability,” said John Yamamoto, vice president of Community Health and Government Relations for Kaiser Permanente in Southern California. “We’re proud to support the ADL Pilot and deeply commend NHCHC for their leadership in meeting the urgent needs of our most vulnerable neighbors.”
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