Early Lessons from CalAIM Initiatives to Address Behavioral Health Needs

Historically, Medi-Cal has provided services to people with behavioral health conditions through several different, often uncoordinated systems, making whole-person care delivery challenging.

Through its CalAIM (California Advancing and Innovating Medi-Cal) program launched in early 2022, California’s Department of Health Care Services seeks to transform the Medi-Cal program by offering whole-person care and addressing fragmentation of care, including for people with behavioral health needs. Enhanced Care Management (ECM) and Community Supports, launched as part of CalAIM, hold particular promise to better support people with complex needs.

To understand lessons from the early implementation period and what refinements may improve care coordination for adult Medi-Cal members with serious behavioral health conditions, the Center for Health Care Strategies conducted interviews with stakeholders in five counties from December 2022 to March 2023. Interviewees included leaders of managed care plans, county behavioral health agencies, and community ECM and Community Supports providers. The counties selected represent a diversity of regions and managed care models.

Drawing from these interviews, this issue brief outlines considerations to improve processes for:

• Developing contracts between managed care plans, county behavioral health agencies, and community ECM providers
• Identifying eligible members for ECM
• Addressing duplication across care management programs
• Delivering ECM to eligible members
• Contracting and delivering Community Supports