Enhanced Care Management (ECM) and Community Supports are core components of CalAIM, a multiyear initiative led by the California Department of Health Care Services (DHCS) that take a person-centered approach to social service delivery and care management for individuals with complex health and social needs.

Recruitment and retention of the direct care workforce has been a longstanding challenge among states. Low wages are a particular barrier because direct care worker wages often compete with gig employment, where the work is less physically and emotionally taxing.

Thanks to tireless advocacy combined with impressive outcomes data, funding was allocated in the California state budget to support the continuation of the program. This is a prime example of how initial federal investments can ultimately lead to long-term sustainability of successful programs.

States are leveraging American Rescue Plan Act (ARPA) dollars to support a multi-faceted policy approach to strengthening state health care infrastructure and the health workforce.