Understanding Transitional Rent: A New Approach to Housing as Healthcare
What is Transitional Rent?
Transitional Rent is a groundbreaking new Medi-Cal benefit apart of the CalAIM initiative that will provide up to six months of rental assistance for eligible individuals experiencing or at risk of homelessness. California is set to introduce this program starting in January 2025, with full mandatory implementation by January 2026, aiming to provide rental assistance under the CalAIM framework.¹ As California's fifteenth Community Support service, Transitional Rent represents a significant shift in how healthcare systems address the social drivers of health that profoundly impact health outcomes. This program will be optional for Medi-Cal managed care plans (MCPs) starting January 1, 2025, and will become mandatory for all MCPs by January 1, 2026.²
Who Qualifies for Transitional Rent?
To qualify for Transitional Rent, individuals must meet three key criteria:
Clinical Risk Factors: Individuals must either meet access criteria for Specialty Mental Health Services or Drug Medi-Cal services, OR have one or more serious chronic physical health conditions or physical/intellectual/developmental disabilities. Pregnant individuals and those up to 12 months postpartum automatically meet this criterion.³
Housing Status: Individuals must be experiencing homelessness or at risk of homelessness as defined by federal Housing and Urban Development (HUD) standards, with California-specific modifications that extend the timeframe for imminent housing loss from 14 to 30 days.⁴
Transitioning Population or Special Status: Individuals must either be transitioning from institutional settings (like hospitals or nursing facilities), carceral settings, interim housing, recuperative care, foster care, be experiencing unsheltered homelessness, or be eligible for Full-Service Partnership services. Additional eligible groups include those living in residential settings, the child welfare system, recuperative care facilities, short-term post-hospitalization housing, transitional housing, homeless shelters, interim housing, and Full Service Partnership participants.⁵
What Housing Settings Does Transitional Rent Cover?
Transitional Rent is remarkably flexible, covering a wide variety of housing settings including:
Apartments and single room occupancy (SRO) units
Single-family and multi-family homes
Mobile homes and accessory dwelling units
Tiny homes and shared housing arrangements
Permanent supportive housing and recovery housing
Interim settings like hotels, motels, and non-congregate shelters
Adult residential facilities and board and care homes⁶
How Does Transitional Rent Connect to Other Services?
What makes Transitional Rent truly innovative is its integration with other services. Individuals who qualify for Transitional Rent automatically qualify for:
Enhanced Care Management (ECM): Intensive care coordination services
Housing Deposits: Coverage of first/last month's rent and other move-in costs
Housing Transition Navigation Services: Help finding and securing housing
Housing Tenancy and Sustaining Services: Support maintaining stable housing⁷
The program connects recipients with services to ensure they can stay housed, such as help with traveling to medical appointments, case management services, and mental health counseling.⁸ Each member receiving Transitional Rent will have an individualized housing support plan that identifies pathways to permanent housing stability after the six-month benefit period ends.
Why Housing as Healthcare Matters
The connection between housing and health is profound. Non-elderly individuals experiencing homelessness have 3.5 times the mortality risk of those who are housed.⁹ A 40-year-old experiencing homelessness faces mortality risks similar to a housed person nearly 20 years older.¹⁰ Beyond mortality, homelessness is associated with significantly higher rates of chronic conditions, behavioral health challenges, and emergency department utilization.¹¹
Transitional Rent represents a recognition that medical care alone cannot address these disparities. By providing stable housing as part of healthcare delivery, this program aims to create the foundation upon which effective healthcare interventions can build.
Implementation Challenges and Opportunities
Successful implementation will require collaboration between healthcare systems, county behavioral health departments, housing providers, and Continuums of Care. The program follows Housing First principles, meaning eligibility isn't contingent on sobriety or service participation.¹² Additionally, mechanisms are being created to allow county behavioral health systems to directly authorize Transitional Rent for eligible individuals under their care, removing potential delays for those with significant needs.¹³
As Transitional Rent moves from concept to reality, it represents one of California's approaches to address housing as a fundamental component of healthcare—potentially transforming how we approach both homelessness and health disparities in our communities.
Footnotes
¹ Sprite Health, "Transitional Rent Program: A New Housing Support," https://spritehealth.com/2024/11/20/transitional-rent-program-a-new-housing-support/
² California Department of Health Care Services, "Transitional Rent Concept Paper," August 2024, https://www.dhcs.ca.gov/services/Documents/MCQMD/Transitional-Rent-Concept-Paper-08222024.pdf
³ California Department of Health Care Services, "CalAIM Community Supports Policy Guide," 2024, https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-Policy-Guide.pdf
⁴ Health Net, "Community Supports Resources," 2024, https://www.healthnet.com/content/healthnet/en_us/members/medi-cal/calaim-resources/community-supports.html
⁵ Justice in Aging, "Medi-Cal Policies Enhancing Housing Security Among Older Adults," December 2024, https://justiceinaging.org/medi-cal-policies-enhancing-housing-security-among-older-adults/
⁶ California Department of Health Care Services, "Community Supports - Managed Care Plan Elections," 2024, https://www.dhcs.ca.gov/Documents/MCQMD/Community-Supports-Elections-by-MCP-and-County.pdf
⁷ National Alliance to End Homelessness, "What Housing First Really Means," November 2024, https://endhomelessness.org/blog/what-housing-first-really-means/
⁸ California Health Care Foundation, "Affordable Housing Developers Use CalAIM to Help People Experiencing Homelessness," February 2025, https://www.chcf.org/blog/housing-developers-leverage-calaim-people-experiencing-homelessness/
⁹ Becker Friedman Institute, "The Mortality of the US Homeless Population," September 2024, https://bfi.uchicago.edu/insight/research-summary/the-mortality-of-the-us-homeless-population/
¹⁰ National Bureau of Economic Research, "Estimating Mortality Rates for the US Homeless Population," February 2024, https://www.nber.org/digest/202402/estimating-mortality-rates-us-homeless-population
¹¹ Los Angeles County, "New Public Health Report Shows Sharp Rise in Mortality Among People Experiencing Homelessness," May 2023, https://lacounty.gov/2023/05/12/new-public-health-report-shows-sharp-rise-in-mortality-among-people-experiencing-homelessness/
¹² National Alliance to End Homelessness, "Housing First," March 2022, https://endhomelessness.org/resource/housing-first/
¹³ Heading Home, "Housing First Model: An Evidence Based Approach to Ending Homelessness," February 2021, https://headinghomeinc.org/housing-first-model/