CalAIM Santa Clara

CalAIM Santa Clara offers enhanced care management. Individuals will be assigned a lead Care Manager who will help coordinate transition out of a skilled nursing facility into a home-like environment. The Care Manager will assist with finding and applying for housing, finding doctors and scheduling appointments, understanding prescription drug medications, getting follow-up services after hospital discharge, setting up transportation, finding and applying for food, and connecting the individual to other community programs and services.

This program began as a pilot through Whole Person Care and then transitioned into CalAIM Santa Clara in 2022. Medi-Cal delivery changed to an Enhanced Care Management model with offerings for community supports in order to prioritize whole person care and healthy living.

Program Staffing

  • Care Managers
  • Occupational Therapist
  • RN
  • Program support staff
  • Supervisors and Senior Manager

Program Services

Support in

  • Finding doctors and getting appointments
  • Understanding prescriptions and medications
  • Follow-up services after you leave the hospital
  • Setting up transportation
  • Finding and applying for food and housing
  • Connecting to other community programs and services
  • Housing navigation
  • Coordinating transition out of a skilled nursing facility into a home-like environment
  • Skilled nursing admissions prevention
  • Securing meals to meet nutrition goals

Eligibility Requirements

  • Be a Santa Clara Family Health Plan (SCFHP) member
  • Have multiple chronic or mental health conditions
  • Have visited an ER or hospital multiple times in the last 6 months
  • Be willing to move to a home from a nursing facility
  • Are in need of a safe place to live

Counties Served

Santa Clara County

Related Resources

Galloping into the golden years with a friend! 🐴

Our Companioa dementia services program pairs our members with a buddy who’s always ready to ride alongside you, even if it’s not on horseback. 

Visit the link in our bio to learn more about our Companioa program and schedule a tour today!

#AgingAdventures #CompanioaCompanions #NotYourAveragePatrol
As we relish the long weekend, let’s take a moment to honor every individual's hard-earned contributions. Today, we celebrate the hard work and dedication of those caring for our elders. Your commitment embodies the true spirit of Labor Day. Wishing everyone a restful #LaborDay!

#LaborDay2024 #HonoringCaregivers #InstituteOnAging
🌷 Happy Women's Equality Day! 🌷

Today, we salute the inspiring women shaping a better future in aging and healthcare. Let's honor their achievements and continue the push for equality.

#WomensEqualityDay #Empowerment #InstituteOnAging
Join our United Health Equity in Aging Summit Watch Party! πŸ“ΊπŸŽ‰

Where: Weinberg Auditorium, 3575 Geary Blvd, San Francisco, CA
When: September 18th, 2024 | 9am-4pm - Drop in anytime!

Institute on Aging and @thescanfndtn invite you to a live viewing of the 2nd Annual United for Health Equity in Aging Summit. Come enjoy sessions focusing on:

Elevating older adults' voices πŸ—£οΈ
Innovative aging solutions ✨
Breaking down health equity barriers 🚫

Light bites and beverages provided, along with raffle and giveaway prizes! Whether you come for a bit or stay all day, we can't wait to see you!
Visit the link in our bio to RSVP today!

#HealthEquitySummit #InstituteOnAging #WatchParty #CommunityEvent