California Advancing and Innovating Medi-Cal (CalAIM)

 

At the Alliance, we are dedicated to improving the health and quality of life for all in our community. We are working with our community partners to prepare for CalAIM in Alameda County.

CalAIM is a statewide California Department of Health Care Services (DHCS) multi-year initiative that builds upon the Whole Person Care (WPC), Health Home Program (HHP), and Coordinated Care Initiative (CCI) pilot programs, and is designed to implement a broad delivery system, program, and payment reform across the Medi-Cal program with the ultimate long-term goal of a better quality of life for all Medi-Cal members.

DHCS has indicated it will update information related to CalAIM as new or revised information is available.  Please check back periodically to insure you are viewing the latest information available from DHCS.

January 1, 2022, was the start date for CalAIM Enhanced Care Management (ECM), Community Supports (CS), and Major Organ Transplants (MOT). To learn more about the DHCS CalAIM program and to see the most recent updates, please click here.

 

Enhanced Care Management (ECM) and Community Supports (CS)

One of the first of many initiatives in this multi-year program is the implementation of the ECM benefit and the CS services. ECM will target seven specific populations of vulnerable and high-risk children and adults. CS includes fourteen (14) voluntary options, including housing-related services and flexible wraparound services so health plans may avoid costlier alternatives to hospitalization, skilled nursing facility admission and/or discharge delay. The Alliance is currently holding listening sessions with various community partners to understand their current and future capacity and capabilities to provide ECM and CS services.

Alliance members who are enrolled in the current Whole Person Care (WPC) and Health Homes Program (HHP) in December 2021 transitioned into ECM on January 1, 2022. The WPC and HHP programs were sunset on December 31, 2021.

Major Organ Transplants

As a part of the CalAIM initiative, all major organ transplants, which are currently not within the scope of many Medi-Cal Managed Care Plans (MCPs), became the responsibility for all MCPs statewide for all adult Medi-Cal members enrolled in a plan.  This change became effective January 1, 2022.

Proposed CalAIM Timelines*

*Proposed timelines will be changed if updates are made by DHCS.

Key Updates and Resources

Department of Health Care Services (DHCS) Updates & Resources

For DHCS updates and documents, please visit: https://www.dhcs.ca.gov/provgovpart/Pages/CalAIM.aspx 

CalAIM Webinar to Introduce New ECM and Community Supports Provider Resources

On January 7, 2022, from 9 am to 10 am, DHCS will host a public webinar to share a comprehensive set of resources as part of CalAIM. During the webinar, DHCS will provide an update on ECM and Community Supports implementation and walk through the following new resources, which are available on the DHCS website: ECM Provider Toolkit, Community Supports Explainer, ECM Outreach Toolkit, and ECM Member Toolkit. The webinar is intended for providers that are participating in ECM and Community Supports, providers that may be interested in participating in the future, and others engaged in the implementation of ECM and Community Supports, such as Medi-Cal managed care plans. There will be time reserved at the end of the webinar to answer participant questions. Advance registration is required.

Enhanced Care Management (ECM) Provider Toolkit

Medi-Cal Community Supports (CS) Explainer

Alliance Updates and Documents

Alliance CalAIM Entity Interest Form

To sign-up to receive additional information and updates, please complete the Alliance Entity Interest Form below.

Alliance Entity Interest Form

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