Strategy: Integrating ECM Revenue into Ryan White Programs — A Sustainability Playbook for FQHCs

FQHCs with Ryan White funding can layer CalAIM Enhanced Care Management (ECM) revenue on top of existing HIV/AIDS grants — but with a critical exclusion: members enrolled in the HIV/AIDS HCBS Waiver (MCWP) cannot simultaneously receive ECM. The playbook: (1) Identify Ryan White clients who are Medi-Cal eligible but NOT on the MCWP waiver — they can be referred to ECM. (2) Use ECM for HIV+ patients with complex social needs (housing instability, reentry, SUD). (3) Build CHW/care coordinator capacity funded by ECM PMPM to supplement Ryan White case management. (4) Ryan White remains payer of last resort — ECM captures Medi-Cal revenue first. Golden Valley Health Centers (Merced County) is modeling this with ECM + HIV focus.