22-451 Request Prior Authorization for Housing Deposit Support
Date: 06/02/22
Housing Deposit assistance covers some move-in costs so Medi-Cal members can afford safe, permanent housing
Medi-Cal members must be eligible to receive Housing Deposit aid. Eligibility is confirmed through the Housing Navigator who identifies the Housing Deposit needs with an individualized housing support plan.
Member eligibility starts with an assessment plan
Certain criteria are used to decide Medi-Cal member eligibility for Housing Deposit assistance. Some of the eligibility requirements are listed below1 and include members who:
- Received Housing Transition/Navigation Services in counties that offered these services.
- Are prioritized for a permanent housing unit or rental subsidy through the local homeless Coordinated Entry System (CES) and/or have one or more serious chronic conditions and/or serious mental illness and/or substance use disorder (SUD) and/or are exiting incarceration,
Or
- Meet the Housing and Urban Development (HUD) definition of homelessness, and are receiving enhanced care management, or have one or more serious chronic conditions and/or serious mental illness and/or SUD.
1 Refer to the Department of Health Care Services (DHCS) Medi-Cal In Lieu of Services (ILOS) Policy Guide for a complete list of eligibility.
Role of the Housing Navigator
Once a unit is secured, the navigator puts together projected expenses such as a security deposit, first and last month’s rent, utility deposits (i.e., electric, gas, water, and sewer), and medically necessary aids and services. The navigator attaches the supporting documentation (individualized housing support plan, lease agreement, utility statement, and housing habitability inspection) to a prior authorization request and submits it to California Health & Wellness Plan (CHWP) for approval.
Know the Housing Deposit limits
There is a lifetime maximum of one request per member. It allows up to $5,000 in approved funds. Once the funds are approved and spent, the member is no longer eligible for this service. It is recommended that providers strategize to include as many allowable expenses as possible in the request.
Note: Housing deposits can only be approved one additional time with documentation as to what conditions have changed to demonstrate why providing housing deposits would be more successful on the second attempt.
Recommended best practices
Each provider should:
- Have an internal housing deposit policy in place.
- Be able to track the funding assistance given per member.
- Produce a housing deposit check to a landlord/vendor promptly. This may include obtaining a W9 form from the vendor and then delivering the check to them once it is ready.
- Be flexible. Whenever possible pay directly to the landlord, utility company, or other vendor.
- A landlord may not want to accept third-party checks and only accept checks directly from the named leased tenant. You can make the housing deposit check in the name of the member who then pays the landlord directly.
Additional information
Providers are encouraged to access CHWP’s provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CHWP at 877-658-0305.