Committee advances bill to prioritize local community‑based providers in Medi‑Cal CalAIM contracts
Summary
SB 324 would require managed care plans to prioritize local nonprofit community providers for Enhanced Care Management (ECM) and community supports where qualified local providers exist; the Assembly Health Committee passed the measure as amended to Appropriations after negotiation with hospitals and plans about exceptions and implementation.
The Assembly Health Committee voted to move SB 324, a CalAIM implementation bill, to the Assembly Appropriations Committee after supporters described the measure as an effort to ensure Medi‑Cal managed care plans contract with local community‑based organizations for Enhanced Care Management (ECM) and community supports when appropriate providers exist.
Author Senator Menjivar said CalAIM intended that ECM and community supports be provided by trusted local organizations and promotoras who know their communities; she cited data that more than half of current ECM contracts are awarded to for‑profit entities and that some contractors are out‑of‑state vendors. “We want to make sure...that the entities that are being contracted to do this work to uplift our most vulnerable are from the communities,” Menjivar said.
Witnesses from community‑based organizations described successful in‑person engagement and transitions out of institutional care. Gianna Wright of East Bay Innovations said her nonprofit helped transition 12 clients from skilled nursing facilities to independent housing in three months and emphasized that in‑person assessment and local relationships improve outcomes. Partners and advocates including the CBO Medi‑Cal Coalition, California Association of Nonprofits, Community Health Works and others testified in support.
Children’s hospitals and local health plans raised concerns. Mira Martin of the California Children’s Hospital Association said children's hospitals are not community CBOs and asked that the bill preserve their ability to provide ECM to children; Local Health Plans of California said implementation details needed further work. Committee amendments clarified exceptions so entities such as children's hospitals could continue necessary services; supporters indicated opposition would be removed once amendments were in print.
The committee recorded a roll call and referred SB 324 to Appropriations with amendments. Backers said the measure aims to standardize contracting templates, permit intermediary hub models to assist small CBOs with billing, and require state data reporting to ensure managed care plans contract appropriately with local providers.
