This page captures the latest news about the Enhanced Care Management (ECM) and Community Supports initiatives and the significant steps California is taking to break down the traditional walls of health care and coordinate care for high-need members.
Report Release: Enhanced Care Management and Community Supports Quarterly Implementation Report through Q2 2023
On January 29th, 2024, DHCS released its ECM and Community Supports Quarterly Implementation Report for Q2 2023. This report summarizes ECM and Community Supports implementation trends and data for the first 18 months of the programs, spanning January 2022 through June 2023. Similar to the 2022 Year One Implementation Report released last August, this report provides insight into state-, county-, and managed care plan-level data.
In the first 18 months, 140,886 Medi-Cal MCP members across the state received the ECM benefit and 75,834 members received 167,960 Community Supports services. As California continues advancing its Medi-Cal transformation, ECM and Community Supports play a critical role in supporting whole-person care for Medi-Cal members with complex medical and health-related social needs. DHCS expects to see more enrollment growth across both programs in the coming months and years, including as additional Populations of Focus become eligible for ECM and additional Community Supports services are offered in counties across the state. DHCS remains committed to supporting and sustaining this growth through program monitoring, design improvements, and standardization.
Report Link: ECM and Community Supports Quarterly Implementation Report (arcgis.com)
Updated Policy Guide Releases: ECM and Community Supports
- In July 2023, DHCS released its updated Community Supports Policy Guide. These updates reflect the policy refinements discussed at the June 9th, 2023 Summit and cover key areas including eligibility, referrals and authorizations, provider networks, payment, market awareness, and data exchange.
- In February 2024, DHCS released its updated ECM Policy Guide. Changes include an updated policy on dual enrollment in ECM and County-based Targeted Case Management (TCM), Continuity of Care policy changes for non-exclusively aligned enrollment (EAE) Dual Eligible Special Needs Plan (D-SNP) Members who were authorized to receive ECM at the end of 2023, and updated billing and coding requirements.
Now Available: ECM Spotlights
DHCS is committed to providing technical assistance and support to California's growing network of ECM Providers, and is releasing a series of ECM Spotlights to provide more detail on how Providers tailor ECM to meet the needs of different Populations of Focus (POFs).
- In November 2023, DHCS released its ECM for Children and Youth POFs Spotlight. This Spotlight is designed to help contracted and prospective ECM Providers serving children and youth develop and enhance their ECM models, and is intended to support provider organizations that are considering whether providing ECM for children and youth is right for them.
- In February 2024, DHCS released its ECM for Individuals Experiencing Homelessness POF Spotlight. This Spotlight is designed to help contracted and prospective ECM Providers serving Individuals and Families Experiencing Homelessness develop and enhance their ECM models. The Spotlight features strategies for bridging ECM with housing-related Community Supports to reduce housing insecurity of Members.
Now Available: ECM Birth Equity Population of Focus FAQs
The ECM Birth Equity POF that launched on January 1, 2024 is one component of DHCS' overall approach to improving prenatal and postpartum care and is aimed at addressing specific disparities in access to prenatal care and pregnancy-related mortality. In February 2024, DHCS released answers to frequently asked questions on Member eligibility and dual enrollment in additional Medi-Cal services for the ECM Birth Equity POF. Additional information can be found in DHCS ECM Policy Guide. DHCS welcomes additional questions via email at CalAIMECMILOS@dhcs.ca.gov.