FREQUENTLY ASKED QUESTIONS

Learn about how to make a referral and who is eligible by visiting this page. 

CalAIM, or California Advancing and Innovating Medi-Cal, is a transformative initiative by the Department of Health Care Services (DHCS) designed to revamp the Medi-Cal program. Its primary goal is to elevate the well-being and health outcomes of Medi-Cal beneficiaries by ensuring access to comprehensive, high-quality, and integrated healthcare services.

ECM provides personalized support to Medi-Cal members facing complex health and social needs. It encompasses seven core services: comprehensive assessment, care planning, care coordination, health education/coaching, transitions of care, follow-up, and referral to community and social supports. Eligibility is determined by specific “Populations of Focus” (POFs) identified by DHCS, such as individuals experiencing homelessness, those with chronic health conditions, and children and youth with complex needs.

Community Supports are health-related services that target social determinants of health, aiming to enhance well-being and prevent negative health outcomes. These services include housing supports (e.g., housing navigation, deposits, and tenancy sustainment), medically tailored meals, environmental accessibility adaptations (home modifications), and more. Eligibility for each Community Support varies based on individual needs and program guidelines.

ECM services are provided by a network of community-based providers contracted with Medi-Cal Managed Care Plans (MCPs). These providers work closely with members, their families, and support systems to create and implement personalized care plans. Community Supports are also delivered through contracted providers, ensuring seamless coordination with ECM and other healthcare services.

The TA Marketplace is a valuable resource that offers providers, CBOs, counties, and tribal partners a range of technical assistance to implement ECM effectively. It provides access to both off-the-shelf and hands-on resources, supporting providers in areas like billing, data sharing, and program development. Providers can request access to the Marketplace and explore various TA offerings.

Capacity and Infrastructure Transition, Expansion, and Development (CITED) grants are funding opportunities provided by DHCS to bolster the capacity of ECM and Community Supports providers. These grants aim to strengthen infrastructure, enhance care management capabilities, improve billing systems, and facilitate seamless data exchange with MCPs and other providers.