Three Medi-Cal managed-care plans are ending a home-care service in January. The bigger question is whether patients will have a clear path to replacement care.
An El Segundo-based home care company is laying off 738 healthcare workers across California, with layoffs scheduled to begin Sept. 15.
But the bigger story may not be the jobs being lost. It is what happens to the Medi-Cal patients who depend on the caregivers providing their daily care.
24Hr Homecare LLC says the layoffs are the result of the unexpected end of a major third-party service arrangement and the resulting lack of work. The affected caregivers work with three managed public healthcare plans: Health Net, CalViva Health and Community Health Plan of Imperial Valley.
All three plans are also ending Personal Care and Homemaker Services as a Community Support beginning Jan. 1, 2027. The plans have instructed providers to identify affected members and coordinate transitions.
What is actually ending?
Personal Care and Homemaker Services can provide Medi-Cal members with help with everyday activities such as bathing, dressing, feeding, meal preparation, grocery shopping and other activities of daily living. California Department of Health Care Services: Personal Care and Homemaker Services
The change does not mean California is eliminating all Medi-Cal home care.
Instead, Health Net, CalViva Health and Community Health Plan of Imperial Valley are ending this particular service as a Community Supports offering for their members beginning Jan. 1.
That distinction matters because the immediate question for patients is not simply whether a benefit is ending. It is what replaces it.
How many patients are affected?
That number is not yet publicly known.
The 738 figure represents workers, not patients. One caregiver may serve multiple patients, and patients receive different amounts of care.
The health plans and 24Hr Homecare have not publicly disclosed how many Medi-Cal members currently receive these particular services through the affected arrangement.
That leaves an important gap in the public record:
How many patients will need to find another way to receive care?
The plans’ notices indicate that transition planning is required. But a transition plan on paper is not the same thing as a confirmed replacement caregiver for every patient.
The Latino impact could be significant
The three plans serve communities with large Hispanic populations.
CalViva Health reported that 71% of its members were Hispanic in its 2025 annual report. Community Health Plan of Imperial Valley has also reported a heavily Hispanic and Spanish-speaking membership, while Health Net reports that about 54% of its Medi-Cal members are Hispanic.
California’s direct-care workforce is also heavily Latino. The Public Policy Institute of California estimates that Latinos account for about 42% of the state’s direct-care workers.
That does not tell us how many of the 738 affected workers are Latino, or how many affected patients are Latino.
But it does show why the change deserves attention in communities where both the Medi-Cal population and the caregiving workforce have substantial Latino representation.
The January deadline matters
Existing authorized services are scheduled to continue through their authorized periods, but not beyond Dec. 31, 2026, according to the plans’ notices.
That gives patients, providers and health plans only a limited window to work through the transition.
California’s Department of Health Care Services has also found that Personal Care and Homemaker Services can reduce costs for some Medi-Cal populations, making the question of what replaces the service more than an administrative issue.
Parriva has scrutinize other Medi-Cal transitions where the central question for patients was what happens when their existing healthcare relationship changes. Parriva: UCLA’s Medi-Cal Contract Ended
The evidence does not establish that ending the service will cause patients to be hospitalized or placed in institutional care. But it does make the transition worth watching closely.
The unanswered question
For the 738 caregivers, the immediate issue is employment.
For patients, the question is different:
Who will provide the care?
Health plans have said transition planning will occur. What remains unclear is how many patients are affected, how many replacement providers are available, whether those providers are accepting new patients and whether patients will experience any gap in service.
Those are the questions California officials, health plans and 24Hr Homecare should be prepared to answer.
The number of workers losing their jobs is known.
The number of patients who may need a new source of care is not.
And as Jan. 1 approaches, that may be the number that matters most.
