Low utilization, local provider concerns cloud CalAIM ECM and community supports; advocates call for higher rates and standardization

Lawmakers and stakeholders told a joint Senate Health and Public Safety hearing that CalAIM’s enhanced care management (ECM) and community supports — services designed to coordinate care and address social drivers of health — remain unevenly accessed three years after initial implementation, and they urged the state to standardize contracting, raise reimbursement and prioritize locally embedded community‑based organizations (CBOs).

The hearing framed ECM as a high‑touch care management benefit for Medi‑Cal members with complex needs and community supports as a set of optional services (14 named services in DHCS guidance) plans can offer to address housing, nutrition and other social needs. Linda Wei of the Western Center on Law & Poverty told senators that, while utilization has increased, "less than 1% of Medi‑Cal members have received ECM or community supports since implementation in 2022," and advocates report quality and access problems including long approval timelines and narrow plan eligibility policies.

Why this matters: ECM and community supports retool Medi‑Cal to fund services aimed at preventing hospitalization and institutional care by addressing housing, nutrition, transportation and other barriers. If implemented broadly and equitably, they could reduce costly acute care. Panelists, however, said administrative and rate barriers prevent community providers from scaling up.

Provider testimony emphasized local…