California, like many states, has historically provided services to people with behavioral health conditions through several different and often uncoordinated systems, making whole-person care delivery challenging. Through CalAIM, California’s Medicaid transformation initiative, the state seeks to offer more person-centered care, including for people with behavioral health needs. Enhanced Care Management (ECM) and Community Supports, launched as part of CalAIM, offer opportunities to better support people with complex physical, behavioral health, and social needs.

To understand lessons from CalAIM’s early implementation and how refinements may improve care coordination for adults with serious behavioral health conditions, the Center for Health Care Strategies, through support from the California Health Care Foundation, conducted interviews with stakeholders in five California counties. Drawing from these interviews, this brief outlines considerations to improve processes related to: (1) developing contracts between managed care plans, county behavioral health agencies, and ECM providers; (2) identifying eligible members for ECM; (3) addressing duplication across care management programs; (4) delivering ECM to eligible members; and (5) contracting and delivering Community Supports.

While geared toward the California landscape, lessons can inform stakeholders in other states seeking to provide whole-person care for people with behavioral health needs.

Download the brief at