Who qualifies, what your Medi-Cal plan must offer, and how to verify your eligibility — all in one place.
To receive CalAIM PCHS or Caregiver Respite, a person must meet all of the following criteria.
This is the single most important requirement. CalAIM Community Supports are only available to members enrolled in a Medi-Cal Managed Care Plan (MCP). If your Medi-Cal benefits come through fee-for-service (traditional Medi-Cal), you are not currently eligible for CalAIM Community Supports. Contact your county Medi-Cal office to ask about switching to managed care.
For PCHS, the member must have a demonstrated need for assistance with Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs) — meaning they cannot safely perform these tasks independently due to a physical, cognitive, or developmental limitation.
PCHS and Respite are provided to members living at home or in community settings. Members residing in licensed care facilities (SNFs, residential care homes, etc.) are generally not eligible for these specific Community Supports, though other CalAIM benefits may apply.
Community Supports are optional for Managed Care Plans — plans are not required to offer all 14 Community Supports. Before assuming you are eligible, confirm that your specific MCP offers PCHS and/or Respite in your county. Contact your plan's member services to verify.
Caregiver Respite is specifically for members who rely on an unpaid family member, friend, or other informal caregiver as their primary source of daily support. The plan will assess the caregiver's needs and the member's dependency on that caregiver as part of the authorization process.
Important: CalAIM Community Supports are not an entitlement — your plan has discretion in how they authorize services. However, federal and state rules require that MCPs apply eligibility criteria consistently and cannot deny services based on diagnosis alone. If you believe you were wrongly denied, you have the right to appeal.
Share of Cost (SOC): If your income is above the Medi-Cal limit, you may still qualify for full-scope Medi-Cal — and therefore CalAIM PCHS and Respite — under a monthly Share of Cost. Learn how SOC works →
PCHS is particularly valuable in these situations:
PCHS can be authorized during the IHSS application and waiting period — bridging the gap so there's no interruption in care.
If a county IHSS assessment results in fewer hours than the member needs, PCHS can supplement those hours to ensure full coverage.
PCHS is frequently authorized as part of a discharge plan to ensure a smooth, safe transition back to home.
Respite helps families sustain home-based care by giving the primary caregiver structured, authorized time away from caregiving duties.
Members who are at risk of needing nursing home or facility placement due to inadequate home support are strong candidates for PCHS authorization.
Members with Alzheimer's, dementia, Parkinson's, ALS, TBI, or physical disabilities who cannot safely be left without supervision or daily assistance.
Follow these steps to find out if you or a loved one can access PCHS or Respite right now.