Fiscal Intermediary Services

The County of Orange (County) Health Care Agency (HCA) is seeking applications from qualified organizations to act as a Fiscal Intermediary. The primary goal of this program is to coordinate with HCA to distribute timely rental subsidy and other housing intervention payments to approved providers for eligible individuals approved and referred by HCA.

Counties implementing the Behavioral Health Services Act (BHSA) housing interventions and California Advancing and Innovating Medi-Cal’s (CalAIM) Transitional Rent benefit must manage multiple complex funding sources, administrative rules, and service delivery requirements. BHSA mandates that counties dedicate thirty percent of funds to housing interventions, including supports for individuals experiencing or at risk of homelessness. At the same time, CalAIM introduces the Transitional Rent benefit, which provides up to six months of temporary rental assistance through Medi-Cal Managed Care Plans (MCPs). These programs operate under distinct funding structures, documentation requirements, and accountability expectations, yet counties must integrate them seamlessly to ensure clients experience a coordinated path from limited-term housing to long-term permanent housing stability.

HCA BHS seeks a fiscal intermediary to centrally manage rental subsidies and housing intervention payments, supporting timely coordination across providers and managed care plans as part of CalAIM Transitional Rent and BHSA Housing Interventions. Using a fiscal intermediary allows HCA to streamline financial workflows, strengthen oversight, and focus local capacity on service delivery rather than complex fund administration. This approach supports the successful implementation of both BHSA housing interventions and CalAIM’s Transitional Rent benefit by ensuring payments are timely, accurate, and aligned with California Department of Health Care Services (DHCS) guidance.

The Fiscal Intermediary shall provide rental subsidies for participants, in alignment with term limits and allowances under CalAIM Transitional Rent and BHSA Housing Interventions. Applicants shall act solely as a Third Party Administrator (TPA) to process and pay rental subsidies or other housing intervention payments to approved payees on behalf of eligible participants under HCA programs. Applicants’ authority is limited to disbursement and administrative functions described herein. Applicants are not a landlord, property manager, broker, case manager, fiduciary, or agent with decision-making authority beyond the approval matrix provided by HCA.