Clear Lake council approves MOU amendment allowing Adventist Health to bill CalAIM for Hope Center services

The Clear Lake City Council on May 4 unanimously approved Amendment 1 to the memorandum of understanding with Adventist Health Clear Lake that allows the health system to bill California’s CalAIM program for certain non‑medical services at the city’s Hope Center while preserving the property’s role as transitional housing.

Colleen Asawa Pisacoon, president of Adventist Health Clear Lake, told the council the organization is not seeking to convert the Hope Center into a medical clinic. “We will not be providing medical services there, but we would like to be able to bill for the things that are reimbursable through CalAIM,” she said, citing billing for recuperative care and housing navigation as examples.

Marilyn Wakefield, Adventist Health’s director of integrated care and social impact, said the CalAIM allowance lets the organization seek reimbursement for wraparound services it has been providing to people exiting the hospital, for housing‑navigation work and for housing sustainability assistance. She described those activities as services the Hope Center already offers and said CalAIM makes them billable for the first time.

City staff and Adventist representatives said the amendment is intended to ensure long‑term sustainability of Hope Center operations. Wakefield said Adventist expects the program to be “self supporting within 12 months of when we start billing.” Council materials and remarks noted the city previously invested in establishing the facility; staff reminded the council the city contributed $500,000 toward the center’s establishment in earlier agreements.

Several council members and public commenters raised questions about placement priority. Council member Overton warned that hospital discharges could become prioritized over people already on local waiting lists, saying she worried people who are homeless but not recently hospitalized could be deprioritized. A Zoom commenter representing the local continuum of care urged that Hope Center referrals continue to go through the coordinated entry system so people already on waiting lists are not displaced.

Adventist representatives said placement and prioritization would be handled through the countywide coordinated‑entry and Pathways Hub systems: Wakefield said those systems use vulnerability assessments and an algorithm that ranks candidates by need, not by referral source. Wakefield also told the council that Hope Center is under a 15‑year commitment with a funding partner to remain a transitional‑housing resource and that the house is a lower‑level, low‑barrier transitional housing option distinct from a higher‑level recuperative facility elsewhere in the county.

Council member Kramer moved to approve Amendment 1; the motion was seconded by council member Slooten and passed by unanimous vote. The amendment will allow Adventist Health Clear Lake to pursue CalAIM reimbursements for eligible non‑medical services while maintaining Hope Center’s transitional‑housing mission. Council and Adventist staff said they will monitor CalAIM funding and placement outcomes as the program begins billing.