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Strategy & Tactics

Health centers should grow ECM caseloads before the December 2026 waiver end

CaliforniaMore from California

Issue

CalAIM, Enhanced Care Management and Community SupportsDecision due

Next: · CalAIM's 1115 waiver expires; the renewal is pending and DHCS says ECM and Community Supports continue

With CalAIM's 1115 waiver expiring in December 2026, health centers should enroll more eligible patients in ECM now. Screen every Medi-Cal patient against the nine ECM populations of focus in the DHCS January 2026 policy guide, such as homelessness, frequent hospital use, serious mental illness or addiction, and justice involvement.

Corrected Sep 30, 2026: ECM has nine populations of focus under the DHCS January 2026 ECM Policy Guide. The record said eight.

Key points

  • Screen every Medi-Cal patient against the nine ECM populations of focus in the DHCS ECM Policy Guide (January 2026), including homelessness, frequent ER or hospital use, serious mental illness or addiction, and justice involvement.
  • Ryan White clients on Medi-Cal (not MCWP waiver) can be ECM-enrolled — layer revenue on grant-funded programs
  • Cross-train CHWs for both ECM care coordination and Ryan White case management
  • Build data infrastructure showing ECM outcomes (reduced ED visits, improved engagement) to justify waiver renewal
  • Join CPCA and NACHC advocacy for waiver renewal with full ECM/Community Supports authority

Sources for this story

DHCS CalAIM

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Cite this analysis

FQHC Talent. (2026, March 4). Health centers should grow ECM caseloads before the December 2026 waiver end. Source: DHCS CalAIM. Retrieved November 13, 2026, from https://www.fqhctalent.com/intel/strategy-ecm-volume-urgency